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Background Following the first report of the COVID-19 case in Ethiopia on March 13, 2020, the country promptly adopted a lockdown policy to contain the virus’s spread. Responding to the healthcare burden imposed by the COVID-19 pandemic had to be coupled with ensuring essential health care services. This study assessed the impact of COVID-19 on the trends in hospital visits and admissions at Tikur Anbessa Specialized Hospital by comparing the rate of follow-up clinic visits and admissions for the 3 months before and after the first report of the COVID-19 case. Methods A retrospective, time-series study examined the trend in follow-up visits and admissions between December 11, 2019, to June 7, 2020, with the 1st case of the COVID-19 report in Ethiopia (March 13, 2020) as a reference time. To control seasonal effects and random fluctuation, we have compared health care utilization to its equivalent period in 2018/19. A data extraction tool was used to collect secondary data from each unit’s electronic medical recordings and logbooks. Results A total of 7717 visits from eight follow-up clinics and 3310 admissions were collected 3 months before the onset of COVID-19. During the following 3 months after the onset of the pandemic, 4597 visits and 2383 admissions were collected. Overall, a 40.4% decrease in follow-up visits and a 28% decline in admissions were observed during the COVID-19 pandemic. A drop in the daily follow-up visits was observed for both genders. The number of visits in all follow-up clinics in 2019/2020 decreased compared to the same months in 2018/19 (p p = 0.04), admissions from the general pediatric and adult wards did not show a significant difference. Conclusions A decline in follow-up clinic visits and emergency admissions was observed during the first months of the COVID-19 pandemic. This will increase the possibility of avoidable morbidity and mortality due to non-COVID-19-related illnesses. Further studies are needed to explore the reasons for the decline and track the pandemic’s long-term effects among non-COVID-19 patients.

Abebe Mekonnen,1 Wallelign Alemnew,2 Zegeye Abebe,3 Getu Debalkie Demissie2 1Simada District Health Office, South Gondar, Ethiopia; 2Department of Health Education and Behavioral Health Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Wallelign Alemnew Email wallelignaleminew@gmail.comIntroduction: Even though the World Health Organization recommends daily oral iron with folic acid (IFA) supplementation as part of the antenatal care to prevent anemia, still the utilization remains low in Sub-Saharan Africa, particularly in Ethiopia. Therefore, the aim of this study was to assess the magnitude of adherence of iron with folic acid supplementation and associated factors among pregnant women who were attending antenatal care (ANC).Methods: A facility-based cross-sectional study was conducted from February 24 to March 23, 2020. Four hundred and twenty-two participants were selected using systematic random sampling technique. Data were collected using a structured questionnaire through face-to-face interview. Data were entered and analyzed using EpiData and SPSS version 20.0, respectively. Bivariate and multivariable logistic regression analyses were done to identify associated factors of adherence, and P< 0.05 was used as cutoff to determine statistical significance at multivariable logistics regressions.Results: In this study, 414 (98%) pregnant women participated. The mean age of the respondents was 28.69 ±SD 5.49 years. The magnitude of adherence of IFA supplementation among pregnant women was 67.6% (95%CI: 63.3– 72.5). Pregnant women who had a past history of preterm delivery (AOR=3.70; 95%CI: 1.46– 9.37), counseling on IFA supplementation (AOR=2.28; 95%CI: 1.15– 4.53), high perceived benefit (AOR=2.72; 95%CI: 1.25– 5.90) and high self-efficacy (AOR=2.91; 95%CI: 1.40– 6.04) were found to be significant associated factors of adherence to IFA supplementation.Conclusion: In this study, adherence to IFA supplementation among pregnant women is relatively high. Past history of preterm delivery, counseling on IFA supplementation, perceived benefit and self-efficiency had association with adherence to IFA supplementation. Proper counseling and health education should be given to pregnant women to increase their adherence.Keywords: adherence, iron with folic acid supplementation, health belief model

Shambel Araya,1,2 Moges Wordofa,1 Mintesnot Aragaw Mamo,2,3 Yakob Gebregziabher Tsegay,2– 4 Abebe Hordofa,2,5 Abebe Edao Negesso,1 Tewodros Fasil,1 Betelhem Berhanu,1 Hermela Begashaw,1 Asegdew Atlaw,2 Tirhas Niguse,1 Mahlet Cheru,1 Zemenu Tamir1 1Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Medical Laboratory, Millennium COVID-19 Treatment and Care Centre, St. Paul Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia; 4Research and Development Center, College of Health Sciences, Defense University, Addis Ababa, Ethiopia; 5Department of Medical Laboratory, Legehare General Hospital, Addis Ababa, EthiopiaCorrespondence: Moges Wordofa Email heranmakmow@gmail.comBackground: Coronavirus disease 2019 (COVID-19) is a systemic infection with cardiovascular, pulmonary, gastrointestinal, neurological, and hematological manifestations. Abnormal hematological findings are thought to have a role in early risk stratification and prognostication of COVID-19 patients. However, the data on hematological abnormalities associated with the disease among Ethiopian COVID-19 patients are limited.Objective: To determine the magnitude of hematological abnormalities among COVID-19 patients admitted at Millennium COVID-19 referral treatment center, Addis Ababa, Ethiopia.Methods: A prospective cross-sectional study was conducted among COVID-19 patients admitted to Millennium COVID-19 referral treatment center from May to July, 2020. A total of 334 COVID-19 patients were included using convenience sampling. Socio-demographic data and disease severity status of admitted patients were recorded. Three milliliters of venous blood was collected and analyzed by Beckman Coulter DXH-600 automated analyzer to determine complete blood count (CBC). The data were entered and analyzed using SPSS version 23 software. Association of age, sex, and disease severity with hematological abnormalities was analyzed using binary logistic regression. An odds ratio and 95% confidence interval were used to measure the strength of association. P-value < 0.05 was considered as statistically significant.Results: Of 334 admitted COVID-19 patients, the majority were males (62.3%) and 69.8% had moderate disease conditions. The overall magnitude of any cytopenia and pancytopenia was 41% and 1.8%, respectively. The magnitude of anemia, thrombocytopenia, and leukopenia was 24.9%, 21.6%, and 5.4%, respectively. Lymphopenia (72.2%) was the most common hematological abnormality. COVID-19 patients with severe and critical disease were more likely to develop anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia than those with moderate disease condition, with a significant association.Conclusion: Lymphopenia was the most common hematological abnormality observed among COVID-19 patients. Hematological abnormalities such as anemia, leukocytosis, neutrophilia, and combined neutrophilia-lymphopenia were significantly associated with disease severity. Monitoring and evaluation of hematological parameters could provide prognostic insight into the management and risk stratification of COVID-19 patients. However, further studies are required to fully understand the utility of hematological parameters for the prognosis of COVID-19 disease.Keywords: hematological parameters, COVID-19, disease severity

Background Human factors and ergonomics (HFE) is a scientific and practical human-centered discipline that studies and improves human performance in sociotechnical systems. HFE in pharmacy promotes the human-centered design of systems to support individuals and teams performing medication-related work. Objective To review select HFE methods well suited to address pharmacy challenges, with examples of their application in pharmacy. Methods We define the scope of HFE methods in pharmacy as applications to pharmacy settings, such as inpatient or community pharmacies, as well as medication-related phenomena such as medication safety, adherence, or deprescribing. We identify and present seven categories of HFE methods suited to widespread use for pharmacy research and clinical practice. Results Categories of HFE methods applicable to pharmacy include work system analysis; task analysis; workload assessment; medication safety and error analysis; user-centered and participatory design; usability evaluation; and physical ergonomics. HFE methods are used in three broad phases of human-centered design and evaluation: study; design; and evaluation. The most robust applications of HFE methods involve the combination of HFE methods across all three phases. Two cases illustrate such a comprehensive application of HFE: one case of medication package, label, and information design and a second case of human-centered design of a digital decision aid for medication safety. Conclusions Pharmacy, including the places where pharmacy professionals work and the multistep process of medication use across people and settings, can benefit from HFE. This is because pharmacy is a human-centered sociotechnical system with an existing tradition of studying and analyzing the present state, designing solutions to problems, and evaluating those solutions in laboratory or practice settings. We conclude by addressing common concerns about the implementation of HFE methods and urge the adoption of HFE methods in pharmacy.

Background Understanding immune mechanisms, particularly the role of innate immune markers during latent TB infection remains elusive. The main objective of this study was to evaluate mRNA gene expression patterns of toll-like receptors (TLRs) as correlates of immunity during latent TB infection and further infer their roles as potential diagnostic biomarkers. Methods Messenger RNA (mRNA) levels were analysed in a total of 64 samples collected from apparently healthy children and adolescents latently infected with tuberculosis (n = 32) or non-infected (n = 32). Relative expression in peripheral blood of selected genes encoding TLRs (TLR-1, TLR-2, TLR-4, TLR-6 and TLR-9) was determined with a quantitative real-time polymerase chain reaction (qRT-PCR) using specific primers and florescent labelled probes and a comparative threshold cycle method to define fold change. Data were analysed using Graph-Pad Prism 7.01 for Windows and a p-value less than 0.05 was considered statistically significant. Results An increased mean fold change in the relative expression of TLR-2 and TLR-6 mRNA was observed in LTBI groups relative to non-LTBI groups (p Conclusions An increased mRNA expression of TLR-2 and TLR-6 was observed in latently infected individuals relative to those non-infected, possibly indicating the roles these biomarkers play in sustenance of the steady state interaction between the dormant TB bacilli and host immunity.

Background Syzygium guineense Wall. leaf is being used as a traditional medicine against hypertension and diabetes mellitus. Unlike its efficacy, the safety profile of this plant upon long-term administration has not been investigated yet. Therefore, this study investigated the sub-chronic toxicity of S. guineense leaves in rats. Methods Wistar albino rats, 10/sex/group were randomly assigned into four groups. Group I-III respectively received 250, 500, and 1000 mg/kg of body weight of 70 % ethanol extract ofS. guineense leaves for 90 consecutive days. Group IV (control) received distilled water. Throughout the experiment, clinical observations were carried out, food intake and weight of the rats also were measured. Finally, different biochemical parameters, organ weight, and histopathology of liver and kidneys were evaluated. Results Administration of 70 % ethanol extract ofS. guineense leaves decreased food intake and body weight gain of the test animals. Rats treated with 1000 mg/kg of S. guineense extract showed significantly increased serum alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase levels. Serum urea levels also increased in female rats treated with 500 and 1000 mg/kg body weight of S. guineense. Moreover, the blood glucose level of rats treated with 1000 mg/kg body weight was significantly decreased compared to the control group. However, the histology of the liver and kidneys were not significantly altered by any of the doses administered. Conclusion Administration ofS. guineense in rats at a dose of 1000 mg/kg body weight affected the food consumption, weight gain, and serum levels of liver and kidney enzymes suggesting that S. guineense intake at high doses may be toxic. Therefore, liberal consumption of S. guineense leaves should be taken curiously and cautiously.

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by growth of kidney cysts and glomerular filtration rate (GFR) decline. Metformin was found to impact cystogenesis in preclinical models of polycystic disease, is generally considered safe and may be a promising candidate for clinical investigation in ADPKD. In this phase 2 two-year trial, we randomly assigned 97 patients, 18-60 years of age, with ADPKD and estimated GFR over 50 ml/min/1.73 m2, in a 1:1 ratio to receive metformin or placebo twice daily. Primary outcomes were medication safety and tolerability. Secondary outcomes included estimated GFR decline, and total kidney volume growth. Thirty-eight metformin and 39 placebo participants still received study product at 24-months. Twenty-one participants in the metformin arm reduced drug dose due to inability to tolerate, compared with 14 in the placebo arm (not significant). Proportions of participants experiencing serious adverse events was similar between the groups. The Gastrointestinal Symptoms Rating Scale score was low at baseline and did not significantly change over time. The annual change for estimated GFR was -1.71 with metformin and -3.07 ml/min/1.73m2 per year with placebo (mean difference 1.37 {-0.70, 3.44} ml/min/1.73m2), while mean annual percent change in height-adjusted total kidney volume was 3.87% in metformin and 2.16% per year in placebo, (mean difference 1.68% {-2.11, 5.62}). Thus, metformin in adults with ADPKD was found to be safe and tolerable while slightly reducing estimated GFR decline but not to a significant degree. Hence, evaluation of efficacy requires a larger trial, with sufficient power to detect differences in endpoints.

PURPOSE Constitutional mismatch repair deficiency syndrome (CMMRD) is a lethal cancer predisposition syndrome characterized by early-onset synchronous and metachronous multiorgan tumors. We designed a surveillance protocol for early tumor detection in these individuals. PATIENTS AND METHODS Data were collected from patients with confirmed CMMRD who were registered in the International Replication Repair Deficiency Consortium. Tumor spectrum, efficacy of the surveillance protocol, and malignant transformation of low-grade lesions were examined for the entire cohort. Survival outcomes were analyzed for patients followed prospectively from the time of surveillance implementation. RESULTS A total of 193 malignant tumors in 110 patients were identified. Median age of first cancer diagnosis was 9.2 years (range: 1.7-39.5 years). For patients undergoing surveillance, all GI and other solid tumors, and 75% of brain cancers were detected asymptomatically. By contrast, only 16% of hematologic malignancies were detected asymptomatically ( P < .001). Eighty-nine patients were followed prospectively and used for survival analysis. Five-year overall survival (OS) was 90% (95% CI, 78.6 to 100) and 50% (95% CI, 39.2 to 63.7) when cancer was detected asymptomatically and symptomatically, respectively ( P = .001). Patient outcome measured by adherence to the surveillance protocol revealed 4-year OS of 79% (95% CI, 54.8 to 90.9) for patients undergoing full surveillance, 55% (95% CI, 28.5 to 74.5) for partial surveillance, and 15% (95% CI, 5.2 to 28.8) for those not under surveillance ( P < .0001). Of the 64 low-grade tumors detected, the cumulative likelihood of transformation from low-to high-grade was 81% for GI cancers within 8 years and 100% for gliomas in 6 years. CONCLUSION Surveillance and early cancer detection are associated with improved OS for individuals with CMMRD.

Purpose The aim of the study was to assess the effectiveness of focused family planning counseling (FFPC) in increasing postpartum intrauterine contraceptive device (PPIUCD) uptake among mothers who gave birth in the public health facilities of the towns of Adama and Olenchiti from April 1 to May 30, 2017. Methods A quasi-experimental study design was employed, taking a sample of 726 postpartum mothers: 484 in the non-intervention group (NIG) and 242 in the intervention group (IG). Focused family planning counseling was given to the IG using a newly designed cue card adapted from World Health Organization (WHO) guidelines and developed based on the constructs of the health belief model. Counseling based on a routine counseling approach was given to the NIG. The interviewer administered a semi-structured questionnaire for data collection. Data were analyzed using SPSS software, version 20. Descriptive statistics were used to characterize the study participants. The difference in the proportion of PPIUCD uptake in the two groups was tested using an independent Z-test at an alpha level of 0.05. Binary logistics regression was used to identify factors associated with the odds of taking IUCD. The significance of association was declared for P-values less than 0.05. Results The proportion of PPIUCD uptake in the IG [12.4%; 95% CI: 8.6, 17.4] was significantly higher than in the NIG [4.8%; 95% CI: 2.9, 6.7] with a P-value = 0.000. The odds of IUCD uptake among the IG was about 6 times higher (AOR: 5.92; 95% CI: 2.79, 12.60) than in the NIG. In addition, being unmarried women (AOR: 12.96; 95% CI: 4.30, 34.56), having higher education (AOR: 3.07; 95% CI: 1.13, 8.36), grand multiparity (AOR: 3.76; 95% CI: 1.58, 8.95), making a mutual decision (AOR: 0.16, 95% CI: 0.07, 0.38) and having a better knowledge of family planning (AOR: 5.92, 95% CI: 2.79, 12.60) were factors associated with uptake. Conclusion Providing FFPC immediately increases PPIUCD uptake. The uptake was also associated with marital status, education, parity, decision and knowledge on family planning.

Background. Children are highly susceptible to Mycobacterium tuberculosis infection, and about 70% of children living in the same households with pulmonary tuberculosis-positive patients will become infected. However, pulmonary positive tuberculosis is a common phenomenon and the implementation of the recommended contact screening and initiation of isoniazid preventive therapy is very low. Therefore, this study is aimed at assessing contact screening practice and initiation of isoniazid preventive therapy of under-five children among pulmonary tuberculosis-positive patients in Bahir Dar, northwest Ethiopia. Methods. A facility-based cross-sectional study was conducted from March 1 to 30, 2016. A total of 267 pulmonary tuberculosis-positive patients were included in this study. To identify independent predictors of contact screening and isoniazid preventive therapy initiation, we performed multivariable logistic regression analyses using SPSS version 20 with CI of 95% at p value < 0.05. Results. A total of 230 (90.2%) pulmonary tuberculosis-positive patients had single contacts with their under-five children. One hundred nine (64.8%) children were screened. From those screened, 11 (7.4%) developed tuberculosis disease and started antituberculosis treatment. Forty-four (31.9%) children started isoniazid preventive therapy. Sex of the participants, place of service delivery, relationship with contacts, HIV status, and attitude of PTB+ cases were significant predictors of contact screening (p<.05). Participant’s knowledge, attitude of participants, and relationship of the child with participant were significant predictors of isoniazid preventive therapy initiation (p<0.05). Conclusion. Contact screening practice and isoniazid preventive therapy initiation of children under the age of 5 in Bahir Dar zone were very low. Intimate family contact with pulmonary tuberculosis-positive patients, place of service delivery, and attitude towards screening are the key factors of contact screening. Participant’s knowledge, attitude of participants, and relationship of the child with participant are the key factors of isoniazid preventive therapy initiation. Therefore, household contact screening and isoniazid preventive therapy initiation should be paid attention to reduce transmission.

Background Urinary tract infection (UTI) is a common cause of morbidity worldwide. Uropathogenic Escherichia coli (UPEC) bacteria are the major cause of urinary tract infections. UPEC strains derive from different phylogenetic groups and possess an arsenal of virulence factors that contribute to their ability to overcome different defense mechanisms and cause disease. The objective of this study was to identify phylogroup and virulence genes of UPEC among urinary tract infection patients. Methods A cross sectional study was conducted from January 1, 2017 to October 9, 2017. E. coli bacteria were isolated from UTI patients using culture and conventional biochemical tests. Identification of phylogroup and genes that encodes for virulence factors was done using multiplex polymerase chain reaction (PCR). Data was processed and analyzed with SPSS version16.0 and Epi-info version 3.4.1 software. Results The most common urologic clinical manifestation combinations in this study were dysuria, urine urgency and urgency incontinence. The frequent UPEC virulence gene identified was fimH 164 (82%), followed by aer 109 (54.5%), hly 103 (51.5%), pap 59 (29.5%), cnf 58 (29%), sfa 50 (25%) and afa 24 (12%).There was significant association between pap gene and urine urgency (p-0.016); sfa and dysuria and urine urgency (p-0.019 and p-0.043 respectively); hly and suprapubic pain (p-0.002); aer and suprapubic pain, flank pain and fever (p-0.017, p-0.040, p-0.029 respectively). Majority of E. coli isolates were phylogroup B2 60(30%) followed by D 55(27.5%), B1 48(24%) and A 37(18.5%). There was significant association between E. coli phylogroup B2 and three virulence genes namely afa, pap, and sfa (p-0.014, p-0.002, p-0.004 respectively). Conclusion In this study the most frequent E. coli virulence gene was fimH, followed by aer, hly, pap, cnf, sfa and afa respectively. There was significant association between E. coli virulence genes and clinical symptoms of UTI. The phylogenetic analysis indicates majority of uropathogenic E. coli isolates were phylogroup B2 followed by phylogroup D. Phylogroup B2 carries more virulence genes. Hence, targeting major UPEC phylogroup and virulence genes for potential vaccine candidates is essential for better management of UTI and further research has to be conducted in this area.

Introduction Perinatal asphyxia is a complicated newborn health problem and applies a high contribution to the increased proportion of newborn mortality. It occurs in newborns due to altered breathing or inadequate inhalation and exhalation resulting in reduced oxygen perfusion to certain body tissues and organs. Irrespective of the increased progress in health care towards newborns and implementations in reductions in under-five, infant, and neonatal mortality in the past 10 years, perinatal asphyxia remained as the most common severe newborn health challenge that causes a high number of morbidity and mortality. Methods A prospective cohort longitudinal study was implemented among 573 newborns admitted with perinatal asphyxia at public hospitals in Southern Ethiopia from 1st March 2018 to 28th February 2020. The perinatal survival time was determined using Kaplan Meier survival curve together with a log-rank test. The dependent variable was time to death and the independent variables were classified as socio-demographic factors, obstetrics related factors, newborn related factors and maternal medical related factors. The study subjects were entered in to the cohort during admission with perinatal asphyxia in the hospital and followed until 7 days of life. Results The cumulative proportion of survival among the newborns admitted with perinatal asphyxia was 95.21% (95%CI:91.00,97.48), 92.82% (95%CI:87.95,95.77), 92.02%(95%CI:86.84,95.22) and 90.78%(95%CI:84.82,94.48) at the end of first, second, third and fourth follow-up days respectively. The mean survival date was 6.55(95%CI: 6.33, 6.77) and cord prolapse (AHR:6.5;95%CI:1.18,36.01), pregnancy induced hypertension (AHR:25.4;95%CI:3.68,175.0), maternal iron deficiency anemia (AHR:5.9;95%CI:1.19,29.5) and having convulsion of the newborn (AHR:10.23;95%CI:2.24,46.54) were statistically significant in multivariable cox proportional hazard model. Conclusion The survival status among newborns with perinatal asphyxia was low during the early follow-up periods after admission to the hospital and the survival status increased after fourth follow up days. In addition, cord prolapse, history of PIH, maternal iron deficiency anemia and newborns history of convulsion were the independent predictors of mortality.

Abebe Dires,1 Sisay Gedamu,1 Yemiamrew Getachew2 1Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Community and Mental Health, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Abebe Dires Tel +251 921559907Email abede9907@gmail.comBackground: In Ethiopia, people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been increasing dramatically. COVID-19 precaution measures are essential for highly susceptible groups. However, it was not known previously to what extent chronic disease patients were perceived to know about the efficacy of prevention measures. Hence, the aim of this study was to assess perception of patients with chronic disease toward the efficacy of COVID-19 preventive measures and their intention to carry out those measures.Methods: A multicentered institutional-based cross-sectional study was conducted among 413 patients attended in selected hospitals of Dessie town from July 21 to August 5, 2020. Hospitals were selected using the lottery method and systematic random sampling was utilized to select study participants. An interviewer-administered structured questionnaire was used to collect the data and the tool had four dimensions which include sociodemographic, clinical profile and risk assessment, perceived efficacy of prevention measures, and patient’s intention to carry out measures. In multivariable analysis, variables were declared statistically significant at a p-value of < 0.05.Results: In this study, the mean age of participants was 48.2 years (SD ± 15.8 years) and 52.1% were females. In overall, 42.1% of participants had low perception on the efficacy of prevention measures and 28.3% had low intention to carry out measures. In this study, young adults (AOR=2.48; 95%CI: 1.42– 4.31), male gender (AOR=2.75; 95%CI: 1.73– 4.37), low literacy (AOR=3.42; 95%CI: 1.47– 7.94) and face mask nonusers (AOR=1.64; 95%CI: 1.03– 2.61) were significantly associated with low perceived efficacy of COVID-19 prevention methods.Conclusion: In this study, a significant proportion of patients had low perception about the efficacy of COVID-19 prevention measures and nearly one-third of them had low intention to carry out prevention measures. Therefore, health education programs about efficacy of preventive measures should be provided by health professionals targeting high risk groups.Keywords: perception, COVID-19, prevention methods, efficacy, intention, patients with chronic disease

Background Quality of essential newborn care is defined as the extent of health care services to improve the health of newborns. However, studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia. Methods A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities from November 2018 to March 2019. Essential newborn care implementation perceived quality was assessed in two domains (delivery and process) from clients’ perspectives. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. The research data were collected by trained midwives and nurses. A binary logistic regression model was used to identify associated factors with newborn care implementation perceived quality. Odds ratio with 95% CI was computed to assess the strength and significant level of the association at p-value, Plain language summary Essential newborn care is a set of practices provided by healthcare workers and mothers to every newborn during delivery. Studies are scarce regarding the quality of newborn care implementation. Therefore, this study aimed to measure the magnitude and factors associated with essential newborn care implementation perceived quality among health facility deliveries in Northwest Ethiopia. A facility-based cross-sectional study design was employed to collect data from 370 randomly selected deliveries in 11 health facilities. A pre-tested interviewer-administered structured questionnaire was adopted from different kinds of literature and guidelines. A binary logistic regression model was fitted to assess the strength and significant level of the association at p-value

Sabit Zenu,1 Endegena Abebe,2 Yohannes Dessie,3 Rukiya Debalke,1 Tsegaye Berkessa,1 Mohammed Reshad1 1Department of Public Health, Mettu University, Mettu, Ethiopia; 2Department of Biomedical Science, Mettu University, Mettu, Ethiopia; 3Department of Nursing, Mettu University, Mettu, EthiopiaCorrespondence: Sabit ZenuDepartment of Public Health, Mettu University, Mettu, EthiopiaEmail sabitzeinu91@gmail.comBackground: Non-communicable diseases are priority global health problems. Smoking, harmful alcohol consumption, physical inactivity, and an unhealthy diet are four behavioral risk factors of these diseases. Studies in Ethiopia have focused on establishing associations between these factors and incommunicable diseases.Objective: To assess the prevalence, co-occurrence, and social determinants of behavioral risk factors of non-communicable diseases among adults in urban centers of southwestern Ethiopia.Methods: This study employed a cross-sectional design. Multistage sampling and the Kish method were used. The WHO’s STEPS instrument was used for data collection. Proportions and other descriptive measures are used to describe the data. Bivariate and multivariate logistic regression was run to assess associations. Associations between dependent and independent variables were determined using AORs, 95% CIs, and significance level of P=0.05.Results: A total of 1,191 adults participated in the study for a 93.3% response rate. In sum, 4.8% of participants were smokers and 15.6% indulge in harmful drinking. Prevalence of physical inactivity was 60.45%, and 94.8% consumed insufficient fruit and vegetables. Regarding co-occurrence of these factors, 65.5% of participants had two or more behavioral risk factors. Female sex (AOR 3.1, 95% CI 1.8– 5.5), no formal employment (AOR 1.9, 95% CI 1.02– 3.7), greater wealth (AOR 2.44, 95% CI 1.1– 5.1), not having a friend who does physical exercise (AOR 2.7, 95% CI 1.5– 4.7), having friends who do not drink (AOR 0.20, 95% CI 0.09– 0.44), and participating in community activities (AOR 2.95, 95% CI 1.4– 6.0) were associated with co-occurrence of behavioral risk factors of non-communicable diseases.Conclusion: The prevalence and co-occurrence of behavioral risk factors of non-communicable diseases in the study area are alarming. Several factors were associated with co-occurrence of these factors. Community-based interventions have to be implemented considering family settings. Special focus has to be given to physical inactivity and fruit and vegetable consumption.Keywords: behavioral risk factors, non-communicable diseases, southwestern Ethiopia

The COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It is one of the RNA coronaviruses which share the highest mutation rates of RNA viruses when compared with that of their hosts. The collective mutation rate of RNA viruses is up to a million times higher than their hosts and is correlated with enhanced virulence of viruses. The RNA, genomic material of SARS-CoV-2, has the capacity of showing amplified fast changes as the infection spreads. These changes were frequently observed in genes for spike glycoprotein, nucleocapsid, ORF1ab, and ORF8, together with RNA dependent RNA polymerase. In contrast, genes for envelope, membrane, ORF6, ORF7a and ORF7b showed no observable changes in terms of amino acid substitutions. Mutated SARS COV-2 at these particular sites has been associated with viral infectivity, false laboratory results and viral genome mutation and interferes with therapeutic targets. Interferences with therapeutic targets is frequently observed in genes for RdRp. Additionally, mutated viral genes for RdRp render slow fidelity of RdRp protein, resulting in a high mutation rate. Such a high mutation rate might allow new virulent forms of the virus to emerge and influence the disease profile. This review aimed to elaborate on the effect of genomic and amino acid sequence mutations on the virulence and therapeutic targets of SARS COV-2. To achieve this objective, multiple literatures have been reviewed.

Ayenew Mose,1 Daniel Adane,1 Haimanot Abebe2 1Department of Midwifery, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia; 2Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, EthiopiaCorrespondence: Ayenew Mose Tel +251913634706Email ayenew8484@gmail.comBackground: Skin-to-skin care is placing an unclothed or diaper-only newborn baby on the mother’s bare chest, covered with a warm blanket. The World Health Organization recommends immediate, uninterrupted, and continuous mother–newborn skin-to-skin care practice almost immediately after birth. Despite this recommendation, separation of the newborn from the mother is common in many public health institutions. There was a limited study that examined the prevalence of skin-to-skin care practice and associated factors in Ethiopia. Therefore, the main aim of this study was to assess the prevalence of skin-to-skin care practice and its associated factors among postpartum mothers in Gurage Zone public health centers, Southern Ethiopia, 2020.Methods: An institution-based cross-sectional study was conducted in twenty-two public health centers of Gurage Zone from January 1st up to 30th, 2020. A total of 382 postpartum mothers were selected using a systematic sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires. Data were entered into EpiData version 3.1.0 and exported to SPSS version 23 for analysis. Both bivariable and multivariable logistic regression analyses were used to identify significant factors associated with skin-to-skin care practice. Statistical significance was declared at a P-value of < 0.05 with a 95% confidence level.Results: About 35.3% (95% CI; 31.3%– 40.4%) of new-borns were received skin-to-skin care practice. Being urban residence [AOR=2.23, (95% CI; 1.17– 4.23)], normal newborn birth weight (≥ 2500gm) [AOR=3.1, (95% CI; 2.15– 3.89)], early initiation of breastfeeding [AOR=2.93, (95% CI; 1.29– 6.64)], colostrum feeding [AOR=4.19, (95% CI; 2.01– 8.73)], and having mothers good knowledge on skin-to-skin care practice [AOR=8.51, (95% CI; 4.32– 16.75)] were some of factors associated with mother to newborn skin-to-skin care practice.Conclusion: The proportion of mother newborn skin-to-skin care practice was low in the study area. Mothers resided in the urban areas, normal newborn birth weight, early initiation of breastfeeding, colostrum feeding, and having good knowledge of the mothers about skin-to-skin care were factors associated with skin-to-skin care practice. Therefore, health care workers should counsel mothers on optimal breastfeeding practice and enhance maternal awareness regarding the merits of skin-to-skin care practice before discharge from the health facilities are recommended.Keywords: skin-to-skin care, colostrum, breastfeeding, mother, newborn

Aim This study aimed to assess the impact of the Supporting Wellness at Pantries (SWAP) system on client food selections at a food pantry. Subject and methods In a pre–post comparison study design, a client-choice food pantry implemented SWAP by reorganizing its inventory to promote healthy options. Each product was ranked as “choose often” (green), “sometimes” (yellow), or “rarely” (red) based on saturated fat, sodium, and sugar. Signage was added to indicate each item’s SWAP rank and healthier foods were placed at eye level. Client food baskets were assessed at time 1 (n = 121) and time 2 (n = 101). The proportions of green and red foods selected were compared using regression analyses. Results The regression analyses showed that the proportion of green foods selected by clients increased by 11% (p < 0.001) and the proportion of red foods selected decreased by 7% (p n = 222). Conclusions SWAP has the potential to positively shift client choices among the items available in a food pantry setting. SWAP is one component of a suite of changes to the charitable food system that have the potential to alleviate food insecurity, improve diet quality, and assist clients in managing diet-related diseases.

BACKGROUND: The Novel Coronavirus Disease 2019 (COVID-19) has proved to be one of the most burdensome respiratory disease outbreaks ever. Moreover, the public health emergency of the COVID-19 outbreak has been seen by the World Health Organization (WHO) as global health concern since March 2020 and there has been a significantly increased morbidity and mortality in the community worldwide. The objective of this review is to describe and review the global public health significances and community and healthcare perception of features, treatments, prevention and control methods to slow the transmission of the outbreak. METHODS: For this review, the literature has been searched by following online databases, including medRxiv, pubmed, medline and Google scholar databases. The key search terms ‘COVID-19’, ‘2019 novel coronavirus’, ‘2019-nCoV’, ‘novel coronavirus’ and ‘Pneumonia’ were used to search the literature. Scientific papers published online by the Center for Disease Control (CDC) and the WHO from 01 January to 06 May 2020 in the English language were included for analysis. RESULTS: The results of this review indicated that COVID-19 is a serious global public health problem. It affects immune compromised individuals living with chronic diseases, the elderly and pregnant women more severely. The disease spread rapidly from one country to countries worldwide. In all, 212 countries highlighted the weakened state of essential public health and emergency services. The researchers addressed the lack of perception in communities, including health professionals, with regard to COVID-19. Healthcare settings were analyzed in terms of the pandemic nature of the virus, onset and the overall characteristics of disease outbreak. Microbiogists were also used to assess the daily cumulative index of COVID-19. With regard to treatment, chloroquine phosphate and herbal medicines were shown to be promising as supportive treatments to slow COVID-19 transmission, coupled with isolation and quarantine techniques. CONCLUSION: The review indicates that COVID-19 has a high global public health significance due to its high morbidity and mortality rates. Still, there was no specific or effective vaccine or treatment, moreover, the community, including health professionals, have a low perception as regards COVID-19, even though different prevention and control methods have been conducted. Thus, there is a need for awareness creation, alongside further research applied to finding effective vaccine and treatments.

BACKGROUND: The novel Coronavirus Disease 2019 is the major public health burden in the world. The disease and death of the global community from corona virus disaes 19 rapidly increasing from time to time worldwide. However, there was a lack of well-organized information about the level of risk, effects, prevention and control methods of the disease. Therefore the aim of this study was to identify and review a published level of risk, effects response to potential health emergencies, prevention, and control methods of Coronavirus Disease 2019 at the global level. METHODS: A systematic review was performed after literatures were identified by searching the following online databases: medRxiv, Google scholar, PubMed, MEDLINE, EMBASE, and the Cochrane Library with supplementary hand searching of conferences. The online databases contain archives of most English biomedical journals. Scientific papers published online by the Center for Disease Control and the World Health Organization were also included for this analysis. The scientific publications from 1 December, 2019 to 13 April 2020. were included. The 'COVID-19', '2019 novel coronavirus', '2019-nCoV', 'novel coronavirus', and 'Pneumonia' key search terms were used in this review. RESULTS: Twenty published articles with reputable journals met the inclusion criteria, representing 20 articles analyses. From these, 11 (55%) in China and 3 (15%) in United State of America. All the 20 were statistical analyses of individual patient data, while 33 used decision-analytic modeling. The overall structures were most commonly described as being Markov (n= 27) but, the methods were heterogeneous. The World Health Organization was reported that most frequently world communities including health care providers were 'alive' or 'dead', with COVID-19 related outcomes such as hospitalization and other enclosed.

The novel coronavirus disease 2019 (COVID-19) pandemic is severely challenging the healthcare systems and economies of the world, which urgently demand vaccine and therapy development to combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, advancing our understanding of the comprehensive entry mechanisms of SARS-CoV-2, especially the host factors that facilitate viral infection, is crucial for the discovery of effective vaccines and antiviral drugs. SARS-CoV-2 has previously been documented to reach cells by binding with ACE2 and CD147 receptors in host cells that interact with the spike (S) protein of SARS-CoV-2. A novel entry factor, called neuropilin 1(NRP1), has recently been discovered as a co-receptor facilitating the entry of SARS-CoV-2. NRP1 is a single-pass transmembrane glycoprotein widely distributed throughout the tissues of the body and acts as a multifunctional co-receptor to bind with different ligand proteins and play diverse physiological roles as well as pathological and therapeutic roles in different clinical conditions/diseases, including COVID-19. The current review, therefore, briefly provides the overview of SARS-CoV-2 entry mechanisms, the structure of NRP1, and their roles in health and various diseases, as well as extensively discusses the current understanding of the potential implication of NRP1 in SARS-CoV-2 entry and COVID-19 treatment.

BACKGROUND: Recent work suggests that dysregulated cellular metabolism may play a key role in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD). The TAME-PKD clinical trial is testing the safety, tolerability, and efficacy of metformin, a regulator of cell metabolism, in patients with ADPKD. This study investigates the cross-sectional association of urinary metabolic biomarkers with ADPKD severity among TAME-PKD trial participants at baseline. METHODS: Concentrations of total protein, targeted metabolites (lactate, pyruvate, succinate, and cAMP), and key glycolytic enzymes (pyruvate kinase M2 [PKM2], lactate dehydrogenase A [LDHA], and pyruvate dehydrogenase kinase 1 [PDK1]) were measured by ELISA, enzymatic assays, and immunoblotting in baseline urine specimens of 95 TAME-PKD participants. These analytes, normalized by urinary creatinine or osmolality to estimate excretion, were correlated with patients’ baseline height-adjusted total kidney volumes (htTKVs) by MRI and eGFR. Additional analyses were performed, adjusting for participants’ age and sex, using multivariable linear regression. RESULTS: Greater htTKV correlated with lower eGFR (r=−0.39; P=0.0001). Urinary protein excretion modestly correlated with eGFR (negatively) and htTKV (positively). Urinary cAMP normalized to creatinine positively correlated with eGFR. Among glycolytic enzymes, PKM2 and LDHA excretion positively correlated with htTKV, whereas PKM2 excretion negatively correlated with eGFR. These associations remained significant after adjustments for age and sex. Moreover, in adjusted models, succinate excretion was positively associated with eGFR, and protein excretion was more strongly associated with both eGFR and htTKV in patients

Introduction A growing body of scientific evidence points to the potentially harmful cognitive effects of anticholinergic medications among older adults. Most interventions designed to promote deprescribing of anticholinergics have directly targeted healthcare professionals and have had mixed results. Consumer-facing technologies may provide a unique benefit by empowering patients and can complement existing healthcare professional-centric efforts. Methods We initiated a randomized clinical trial to evaluate the effectiveness of a patient-facing mobile application (Brain Safe app) compared to an attention control medication list app in reducing anticholinergic exposure among community-dwelling older adults. Study participants are adults aged 60 years and above, currently using at least one prescribed strong anticholinergic, and receiving primary care. The trial plans to enroll a total of 700 participants, randomly allocated in 1:1 proportion to the two study arms. Participants will have the Brain Safe app (intervention arm) or attention control medication list app (control arm) loaded onto a smartphone (study provided or personal device). All participants will be followed for 12 months and will have data collected at baseline, at 6 months, and 12 months by blinded outcome assessors. The primary outcome of the study is anticholinergic exposure measured as total standard daily dose (TSDD) computed from medication prescription electronic records. Secondary outcomes of the study are cognitive function and health-related quality of life. Discussion A consumer-facing intervention to promote deprescribing of potentially high-risk medications can be part of a multi-pronged approach to reduce inappropriate medication use among older adult patients. Delivering a deprescribing intervention via a mobile app is a novel approach and may hold great promise to accelerate deployment of medication safety initiatives across diverse patient populations. Clinical trial registration Registered at ClinicalTrials.gov on October 10, 2019. Identifier number: NCT04121858.

Assalif Beyene Haile,1 Mesfin Beyene Haile,2 Abebe Mihretie Dagnaw,1 Eyosiyas Yeshialem Asefa,1 Michael Amera Tizazu1 1Midwifery Department, Health Science College, University of Debre Berhan, Debre Berhan, Ethiopia; 2Addis Ababa Health Bureau, Addis Ababa, EthiopiaCorrespondence: Assalif Beyene HaileUniversity of Debre Berhan, P. O. Box: 445, Debre Berhan, EthiopiaTel +251 911712023/+251946690434Email assalif2522@gmail.comBackground: A board member was an important bridge to accelerate a day-to-day health care quality in a routine clinical activity at health institutions. They are significant in planning and examine integrated governance systems that encourage quality of care and accountability. So, the current research was planned to identify the level of engagement of the board members in health care quality and factors associated.Methods: A facility-based cross-sectional study was implemented among 250 board members and data were collected by self-administered questionnaire at selected governing health centers in Addis Ababa, Ethiopia from May 1 to 30, 2018. A simple random sampling technique was used to reach the study participants. Data were entered using EpiData 3.1 software and analysis was done using SPSS 23. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 was used to declare statistical significance. The level of board members’ engagement was found to be low which implies that the board members do not give appropriate attention to the quality of care.Results: Good level of engagement of board members was (50.9%) [AOR=7.11, 95% CI (3.07– 16.47)]. Most of the governing board members did not engage in the quality of health care activities. Uses quality data as a basis for recognition [AOR=7.11, 95% CI (3.07– 16.47)], review a quality scorecard or dashboard [AOR=10.83, 95% CI (3.75– 31.29)], establishing goals relating to staff satisfaction [AOR=15.42, 95% CI (6.14– 38.75)] and receiving formal training [AOR=3.42, 95% CI (1.35 − 8.62)], having a strategy relating to communication with clients [AOR= 4.95, 95% CI (2.02– 12.15)] and spending more than 20% [AOR=11.96, 95% CI (3.27– 43.83)], received training on healthcare disparities [AOR=3.81, 95% CI (1.40– 10.36)], and having a plan on quality [AOR=16.38 95% CI (5.39– 49.72)] were found to be significant predictors of level of board member engagement.Conclusion: Collectively, most of the governing board members did not engage in the quality of health care activities. Stakeholders should work on capacity building for board members using training and further follow-up. Encouraging them to put quality health services at the forefront of their agenda during their involvement at their respective facilities.Keywords: clinical governance, health center, health care quality, Ethiopia

Objective This paper aimed to derive analytical solutions for the shrinkage stress and cuspal deflection in model Class-II mesial-occlusal-distal (MOD) resin-composite restorations to better understand their dependence on geometrical and material parameters. Based on the stress solutions, it was shown how design curves could be obtained to guide the selection of dimensions and materials for the preparation and restoration of this class of cavities. Methods The cavity wall was considered as a cantilevered beam while the resin composite was modeled as Winkler’s elastic foundation with closely-spaced linear springs. Further, a mathematical model that took into account the combined effect of material properties, sample geometry and compliance of the surrounding constraint was employed to relate the shrinkage stress at the “tooth-composite” interface to the local compliance of the cavity wall. Exact analytical solutions were obtained for cuspal deflection and shrinkage stress along the cavity wall by solving the resulting differential equation, which had the same form as that for a beam on elastic foundation with a distributed load. To quantify the shrinkage stress at the cavity floor, the resin composite was assumed to be a beam, fixed at both ends and loaded with a uniformly distributed load that approximated the shrinkage stress. The analytical solutions thus obtained were compared with results from finite element analysis (FEA). Results The analytical solution for cuspal deflection contains a dimensionless parameter, γ, which represents the stiffness of the cavity wall relative to that of the cured resin composite. For the same shrinkage strain, cuspal deflection increases with reducing γ, i.e. reducing stiffness of the cavity wall or increasing stiffness of the composite. For the same γ, cuspal deflection increases proportionally with shrinkage strain. Shrinkage stress along the cavity wall is maximum at the cavity corner and reduces towards the occlusal surface; the maximum value depends only on Young’s modulus and the shrinkage strain of the resin composite. For low values of γ, the interfacial stress at the occlusal surface can become compressive. The interfacial stress at the cavity floor can be much higher than that along the cavity wall, increasing exponentially with the resin composite’s thickness. The analytical solutions agree well with FEA predictions. Significance When validated, the analytical solutions and design curves presented in this study can provide useful guidelines for choosing appropriate dimensions of cavity preparations and resin composite materials with suitable mechanical properties for Class-II MOD restorations to help avoid tooth fracture and interfacial debonding caused by polymerization shrinkage.

Clustered Regularly Interspaced Short Palindromic Repeats and CRISPR-associated proteins are referred to as CRISPR-Cas9. Bacteria and archaea have an adaptive (acquired) immune system. As a result, developing the best single regulated RNA and Cas9 endonuclease proteins and implementing the method in clinical practice would aid in the treatment of diseases of various origins, including lung cancers. This seminar aims to provide an overview of CRISPR-Cas9 technology, as well as current and potential applications and perspectives for the method, as well as its mechanism of action in lung cancer therapy. This technology can be used to treat lung cancer in two different ways. The first approach involves creating single directed RNA and Cas9 proteins and then distributing them to cancer cells using suitable methods. Single directed RNA looks directly at the lung’s mutated epidermal growth factor receptor and makes a complementary match, which is then cleaved with Cas9 protein, slowing cancer progression. The second method is to manipulate the expression of ligand-receptors on immune lymphocytic cells. For example, if the CRISPR-Cas9 system disables the expression of cancer receptors on lymphocytes, it decreases the contact between the tumor cell and its ligand-receptor, thus slowing cancer progression.

Trachoma control in the Amhara region of Ethiopia, where all districts were once endemic, began in 2001 and attained full scale-up of the Surgery, Antibiotics, Facial cleanliness, and Environmental improvement (SAFE) strategy by 2010. Since scaling up, the program has distributed approximately 14 million doses of antibiotic per year, implemented village- and school-based health education, and promoted latrine construction. This report aims to provide an update on the prevalence of trachoma among children aged 1–9 years as of the most recent impact or surveillance survey in all 160 districts of Amhara. As of 2019, 45 (28%) districts had a trachomatous inflammation-follicular (TF) prevalence below the 5% elimination threshold. There was a statistically significant relationship between TF prevalence observed at the first impact survey (2010–2015) and eventual achievement of TF < 5% (2015–2019). Of the 26 districts with a first impact survey < 10% TF, 20 (76.9%) had < 5% TF at the most recent survey. Of the 75 districts with a first survey between 10% and 29.9% TF, 21 (28.0%) had < 5% TF at the most recent survey. Finally, among 59 districts ≥ 30% TF at the first survey, four (6.8%) had < 5% TF by 2019. As of 2019, 30 (18.8%) districts remained with TF ≥ 30%. Amhara has seen considerable reductions of trachoma since the start of the program. A strong commitment to the SAFE strategy coupled with data-driven enhancements to that strategy is necessary to facilitate timely elimination of trachoma as a public health problem regionally in Amhara and nationwide in Ethiopia.

Endrias Zewdu Gebremedhin,1 Gadisa Hirpa,2 Bizunesh Mideksa Borana,1 Edilu Jorga Sarba,1 Lencho Megersa Marami,3 Kebede Abdisa Kelbesa,1 Nega Desalegn Tadese,3 Hirut Abebe Ambecha3 1Department of Veterinary Sciences, College of Agriculture and Veterinary Science, Ambo University, Ambo, Ethiopia; 2Department of Biology, Ambo Preparatory School, Ambo, Ethiopia; 3Department of Veterinary Laboratory Technology, College of Agriculture and Veterinary Science, Ambo University, Ambo, EthiopiaCorrespondence: Endrias Zewdu GebremedhinAmbo University, P.O. Box 19, Ambo, EthiopiaTel +251 911894802Fax +251 112609503Email endrias.zewdu@gmail.comPurpose: Listeriosis is one of the globally distributed foodborne diseases with the highest fatality rate. The objectives of this study were to isolate and identify Listeria species, assess factors for contamination of beef, and antibiogram of Listeria monocytogenes in Ambo and Holeta towns, Central Ethiopia.Materials and Methods: A total of 450 meat samples were collected from abattoirs (n=150), butchers (n=150), and restaurants (n=150) for isolation and identification of Listeria species. Logistic regression analysis was used to assess the association between the occurrence of Listeria species in meat and potential risk factors. The antimicrobial susceptibility test was done using the Kirby Bauer test.Results: The overall occurrence of Listeria species in Ambo and Holeta towns was 28.4% (128/450; 95% confidence interval [CI]: 24.3– 32.9%). The isolation rate of Listeria monocytogenes was 4.4%, Listeria ivanovii 2.2%, Listeria seeligeri 1.8%, Listeria welshimeri 3.8%, Listeria innocua 6.2%, and Listeria grayi 10.2%. The probability of contamination of meat in butchers and restaurants was higher in Holeta than Ambo [OR=3.4; 95%; p=0.001], in dry than wet season [OR=5.2; p=0.009], and where the hygiene of cutting boards was poor (OR=7.7; p=0.008). Of the 20 Listeria monocytogenes isolates, 80%, 70%, 60%, and 55% were resistant to oxacillin, amikacin, and nalidixic acid, chloramphenicol, and tetracycline, respectively. The Listeria monocytogenes isolates were 95%, 90%, and 85% susceptible to amoxicillin, vancomycin, and clindamycin, respectively. About 95% of Listeria monocytogenes isolates were multidrug-resistant. One isolate (5%) had developed resistance to 10 classes of antimicrobial drugs.Conclusion: Listeria species are widespread and study towns, season, and hygiene of cutting boards are independent predictors of isolation of Listeria species. Multidrug resistance among Listeria monocytogenes was very high. Therefore, adequate cooking of meat, regular training of beef handlers, prudent use of drugs, and further molecular studies on Listeria species are important.Keywords: antimicrobial susceptibility, beef, Listeria species, Listeria monocytogenes, multidrug resistance, risk factors, Ethiopia

Meseret Derbew Molla,1 Abebe Bekele,2 Daniel Seifu Melka,3,4 Maria Degef Teklemariam,3 Feyissa Challa,2 Birhanu Ayelign,5 Tewodros Shibabaw,1 Yonas Akalu,6 Zeleke Geto7 1Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 3Department of Medical Biochemistry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Biochemistry, Division of Biomedical Sciences, University of Global Health Equity, Kigali, Rwanda; 5Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 6Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 7Department of Biomedical Science, School of Medicine, College of Medicine and Health Science, Wollo University, Desse, EthiopiaCorrespondence: Meseret Derbew Molla; Zeleke Geto Tel +251 918331617; Tel +251 912785918Email messidrm19@gmail.com; zegetdm@gmail.comBackground: Hyperuricemia is related not only to an increased risk of gouty arthritis but also to an increased risk of cardiovascular diseases, resistant hypertension, insulin resistance and progression of type 2 diabetes mellitus. However, to the best of our knowledge, the prevalence of hyperuricemia and its associated factors have rarely been assessed in Ethiopian populations. Therefore, this study aimed to determine the prevalence of hyperuricemia and its associated factors among adult staff members of the Ethiopian Public Health Institute.Methods: An institution-based cross-sectional study was conducted from July 1 to October 28, 2018. A total of 402 study participants were selected using a simple random sampling technique. An interviewer-administered questionnaire was used to collect the data. A blood sample of approximately 5 mL was collected from each study participant after overnight fasting through standardized methods for biochemical tests, and analyses were carried out with an automated COBAS 6000 analyzer. Data analysis was performed by SPSS version 20 software. The factors associated with the outcome variable were identified by bivariable and multivariable logistic regression analyses, and a p value < 0.05 was used to declare statistical significance.Results: The mean age of the study participants was 37.13± 10.5 (mean ± SD), and 51.5% of the participants were male. The overall prevalence of hyperuricemia (> 5.7 mg/dL for females and > 7 mg/dL for males) was found to be 31.0%. The multivariable logistic analysis revealed that age (AOR=1.59, 95% CI 1.01– 2.78), sex (AOR=1.66, 95% CI 1.02– 2.70), cigarette smoking (AOR=2.05, 95% CI 1.01– 4.19) and serum low-density lipoprotein (LDL) (AOR=1.70, 95% CI 1.01– 2.87) were significantly associated with hyperuricemia.Conclusion: The prevalence of hyperuricemia was relatively high compared to similar studies. Early screening for hyperuricemia in the general population, especially in those who are smokers, of older age and with high serum LDL levels, is vital to control its adverse effects at an early stage.Keywords: adults, associated factors, uric acid, hyperuricemia

Background Appendiceal agenesis is a rare intraoperative diagnosis which occurs in 0.001% of laparotomies done for presumed acute appendicitis. To our knowledge, this is the first report of appendiceal agenesis in our country and the second in Africa. Case Presentation A 19 year old Ethiopian female student came with clinical and imaging findings of acute appendicitis. No history of previous abdominal surgery and similar illness. The vermiform appendix could not be identified following laparotomy performed for the assumption of acute appendicitis. The surgical exploration also revealed no cause for the abdominal pain. Then appendiceal agenesis was declared with an additional diagnosis of nonspecific abdominal pain (NSAD). The postoperative follow-up was uneventful. Conclusion Appendiceal agenesis is a rare malformation which demands a careful examination and meticulous laparotomic/laparoscopic exploration for diagnosis.

This study was conducted with the objective to investigate the diversity of wild and cultivated yams based on morphological characters and to assess its correspondence with folk taxonomy. The local...

Background Multidrug resistance (MDR), extended-spectrum beta-lactamase (ESBL) and carbapenemase-producing Gram-negative bacteria (GNB) has become a public health threat worldwide. This threat is worse in developing countries where there is high infectious disease burden and spread of antimicrobial resistance co-exist. The aim of the present study was, therefore, to assess MDR, ESBL and carbapenemase producing GNB from patients attending three selected referral hospitals in Amhara region. Methods A cross-sectional study was conducted from December 2017- April 2018 at the University of Gondar Comprehensive Specialized Hospital, Dessie Referral Hospital and Debre Markos Referral Hospital of Amhara national regional state. A total of 833 study subjects were recruited using a convenient sampling technique. Clinical samples such as blood, urine, stool, wound, abscess, ear discharge, nasal discharge, cervical discharge and body fluid specimens were aseptically collected. Culturing for identification of bacteria and determination of drug susceptibility testing were done following standard microbiological techniques. Selected MDR isolates were phenotypically assessed for ESBL and carbapenemase production. Results Of the 833 clinical samples cultured for bacterial growth, 141 (16.9%) were positive for GNB. The most common GNB identified were E. coli 46 (32.6%), Klebsiella spp. 38 (26.5%) and Proteus spp. 13 (9.2%). The overall MDR prevalence was 121 (85.8%). Among the total isolates, 137 (97.2%) were resistant to ampicillin followed by cotrimoxazole 115 (81.6%), amoxicillin-clavulanic acid 109 (77.3%), cefixime 99 (70.2%), cefepime 93 (66.0%) and tetracycline 91 (64.5%). The extended-spectrum beta-lactamase producing GNB were 69/124 (55.6%). Of which Klebsiella spp. 19 (15.3%) and E. coli 17 (13.7%) were common ESBL producers. Carbapenemase-producing isolates were 8/51(15.7%). Of which Enterobacter, Klebsiella and E. coli were common carbapenemase producers. Conclusion and recommendation Multi-drug resistance and ESBL producing isolates in the present study were high. E. coli and Klebsiella spp. were the most common ESBL producing GNB. Klebsiella spp., Enterobacter spp., E. coli and Citrobacter spp. were typical carbapenemase-producing isolates. Continuous monitoring, antibiotic stewardship and molecular detection of the gene responsible for drug resistance are important means to reduce the spread of drug-resistant pathogens.

Background Essential newborn care is a wide-ranging strategy intended to improve the health of newborns by implementing appropriate interventions. Approximately in 2018, an estimated 2.5 million children died in their first month of life, which is approximately 7000, newborns every day, with about a third of all neonatal deaths occurring within the first day after birth. Even though the most cause of death is preventable the burden of neonatal death is a still high in developing countries including Ethiopia. Therefore this study is aimed to assess the level of essential newborn care practice among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. Methods A community-based cross-sectional study was conducted among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. For the quantitative part, 624 study participants were involved by using a multi-stage sampling method. A systematic random sampling technique was to reach the study subjects. Data entry was carried out by Epi data version 4.0.0 and analysis was done by SPSS window version 24. Binary and multivariate logistic regressions were used to identify associated factors. For the qualitative part, three focus group discussions (FGD) with purposively selected 30 mothers were involved. The data were analyzed deductively by using the thematic framework analysis approach by using Open code version 4.02. Result Overall good essential newborn care practice was found to be 41.0% [95%CI, 36.6–44.7]. Being urban residence [AOR 1.70, 95%CI: 1.03–2.79], attending antenatal care visit [AOR = 3.53, 95%CI: 2.14–5.83], attending pregnant mothers meeting [AOR = 1.86, 95%CI: 1.21–2.86], had immediate postnatal care [AOR = 3.92, 95% CI: 2.65–5.78], and having good knowledge about ENC [AOR = 2.13, 95% CI: 1.47–3.10] were significantly associated with good essential newborn care practice. Conclusion This study indicated that the magnitude of essential newborn care practice was low. Thus, a primary health care provider should regularly provide ENC for newborns and take opportunities to counsel the mothers about ENC during pregnant mothers meeting and MCH services sessions.

Bekele Sharew,1,2 Feleke Moges,1 Gizachew Yismaw,1 Adane Mihret,3 Wondiwossen Abebe,1 Surafal Fentaw,4 Belay Tessema1 1Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 3Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 4Ethiopian Public Health Institute, Addis Ababa, EthiopiaCorrespondence: Bekele SharewDepartment of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 45, Gondar, EthiopiaTel +251 911 165431Email bsharew@gmail.comBackground: In Ethiopia, pneumococcal conjugate vaccine 10 (PCV10) was introduced in 2011 in the national vaccination program. This study was aimed to assess serotype distribution of invasive and non-invasive Streptococcus pneumoniae isolates using whole-genome sequencing.Methods: A hospital-based prospective study was conducted from 2018 to 2019 at Addis Ababa and Amhara region referral hospitals, from all patients. Clinical Samples were collected and initially cultured onto 5% sheep blood agar at 37°C in a 5% CO2 atmosphere. Sequencing was done using the Illumina NextSeq 500 and SeroBA was used to predict serotypes from whole-genome sequencing raw data.Results: Of the 57 S. pneumoniae isolates, there were 32 circulating serotypes. The most common serotypes were 15A/B/C (n=5, 8.8%), 6A (n=4, 7.0%), 10A/F (n=4, 7.0%), 23A (n=4, 7.0%) and 7C (n=3, 5.3%). The serotype coverage of PCV10 and PCV13 were 12.3% and 26.3% respectively. The most common invasive serotypes were 15A/B/C (n=5, 8.8%) and 6A (n=4, 7.0%), and non-invasive serotypes were 23A (n=4, 7.0%) and 10A/F (n=3, 5.3%). The most prevalent serotype obtained from PCV10 eligible children was 3 (n=2, 3.5%). The prevalent serotype obtained from PCV10 non-eligible patients were type 23A (n=4, 7%) and type 6A (n=3, 5.2%). The most common serotypes among children ≤ 18 years old were 10A/F, 7C, 35A/B, 16F, 19A, 3 and 38. However, the proportions of some non-vaccine serotypes (11A/B and 15A/B/C) were higher in adult patients.Conclusion: In this study a shift in the distribution of non-vaccinated S. pneumoniae serotypes increases in the population, and PCV10 serotype coverage was reduced as compared to PCV13. Therefore, it is important to continue monitoring serotype changes among all patients in addition to assessing the impact and effectiveness brought by vaccines and provides a foundation for prevention strategies and vaccine policies.Keywords: Streptococcus pneumoniae, serotypes, whole-genome sequencing

Background Liver cancer is the sixth most common cancer worldwide. It is mostly diagnosed with a computed tomography scan. Nowadays deep learning methods have been used for the segmentation of the liver and its tumor from the computed tomography (CT) scan images. This research mainly focused on segmenting liver and tumor from the abdominal CT scan images using a deep learning method and minimizing the effort and time used for a liver cancer diagnosis. The algorithm is based on the original UNet architecture. But, here in this paper, the numbers of filters on each convolutional block were reduced and new batch normalization and a dropout layer were added after each convolutional block of the contracting path. Results Using this algorithm a dice score of 0.96, 0.74, and 0.63 were obtained for liver segmentation, segmentation of tumors from the liver, and the segmentation of tumor from abdominal CT scan images respectively. The segmentation results of liver and tumor from the liver showed an improvement of 0.01 and 0.11 respectively from other works. Conclusion This work proposed a liver and a tumor segmentation method using a UNet architecture as a baseline. Modification regarding the number of filters and network layers were done on the original UNet model to reduce the network complexity and improve segmentation performance. A new class balancing method is also introduced to minimize the class imbalance problem. Through these, the algorithm attained better segmentation results and showed good improvement. However, it faced difficulty in segmenting small and irregular tumors.

Background Authentication of food and agricultural products is important to trace out the right product and ensure the customer’s preference and their health. Sesame (Sesamum indicum L.) is one of the most important crops used for food and medicine in Ethiopia and different varieties and cultivars are produced in different regions of the country. This study was undertaken to determine the total flavonoid content, total phenolic content, antioxidant activity, and fatty acids profile of black and white sesame seed varieties. Samples were obtained from three major sesame seed-producing districts of Ethiopia. Results The total phenolic content (TPC), total flavonoid content (TFC), and the half-maximal inhibitory concentration (IC50) were ranged from 2.95 to 6.95 mgGAE/g, 2.13–4.99 mgCE/g and 8.3–16.8 AAE/g of the sample, respectively. In general, white sesame seed samples showed the highest TPC, TFC, and antioxidant activity than the black variety. Location wise, samples collected from the Metema district were found to contain a relatively higher concentration of the phytochemicals. The white seed variety was characterized by significantly higher content of oil (53.2–58.2% by mass of the sample) than the back variety (47.6–51.4%).The oil content of the seeds was found to contain nine identifiable fatty acids (FAs). The total unsaturated fatty acids constituted more than 82% of the total FAs, while the saturated FAs were lower than 18% of the total FAs. Among the unsaturated FAs, linoleic acid (C18:2, omega-6 FAs) was the dominant FA (42.5–44.3%) followed by oleic acids (37.2–38.9%). On the other hand, palmitic acids (9.35–11.2%) and stearic acid (5.78–6.52%) were the dominant FAs among the saturated FAs. Conclusions The studied samples had higher concentration of linoleic acid (omega-6 FA) than oleic acid, as opposed to other reported accessions of sesame seeds. Furthermore, white sesame seeds were richer in oil content than the black variety. The high concentration of unsaturated FAs, omega-6 FA, and phenolic compounds make sesame seeds nutritionally and medicinally important for the human diet. Unlike the fatty acids profiles, the level of phenolic compounds in sesame seeds was highly dependent on the geographical region and varietal type of the seeds.

Background Globally, 4 million infants die in their first 4weeks of life every year; above 8 million infants died before their first year of birthday, and nearly 10 million children died before their 5th birthday. Majority of the deaths were occurred at home because of not receiving health care. In Ethiopia, 120,000 infants died during their first 4 weeks of life. The aim of this study was to assess maternal knowledge about neonatal danger signs and its associations after they had been thought by health professionals in Ethiopia. Methods This study used the 2016 Ethiopian Demographic and Health Survey data (EDHS) as a data source. The 2016 EDHS data were collected using a two stage sampling method. All the regions were stratified into urban and rural areas. The study sample taken from the 2016 EDHS data and used in this further analysis was 325. A logistic regression model was used to assess the associations with post health education maternal knowledge on neonatal danger signs. Results In this study, mothers who had poor knowledge about neonatal danger signs (NDS) were 69.8 % (227) (95 %CI (64.8, 74.8 %). In the final logistic model, wanted no more child ((AOR = 4.15), (95 %CI = 1.12, 15.41)), female child ((AOR = 0.58), (95 %CI = 0.34, 0.98)), primary level maternal education ((AOR = 0.42), (95 %CI = 0.19, 0.92)), secondary level maternal education ((AOR = 0.37), (95 %CI = 0.16, 0.91)), and average size of child ((AOR = 2.64), (95 %CI = 1.26, 5.53)), and small size child ((AOR = 4.53), (95 %CI = 1.52, 13.51)) associated with post health education maternal knowledge about NDS. Conclusion The mothers’ knowledge about NDS is poor even they were gave a birth in health facilities. Wanting of additional child, child sex, maternal education and size of child were associated with NDS knowledge. This indicates that the mode of health education provided for mother might not be appropriate and needs protocol changes.

Objective. The study objective was to estimate the burden of human rabies in Ethiopia from 2015–2019. Study Design. A descriptive study design was applied to measure the size of the problem. Method. Retrospective data were used from the Ethiopian Public Health Institute rabies case record book that was registered between 2015 to 2019. Result. Eighty-seven (87) cases of human rabies were diagnosed clinically in the Ethiopian Public Health Institute over the period of five years (2015–2019) with 100% case fatality. Of these, 83 (95.4%) cases were attributed to dog bites, whereas 1 (1.1%) to a cat and 3 (3.4%) to wild animals. The fatalities were from Oromia (n = 51 (58.6%), 13 (14.9%) were from Amhara, 15 (17.2%) were from Addis Ababa, and 8 (9.2%) from the Southern region. All referred cases had no record of immunization against rabies except eight. Ineffective postexposure treatment was the reason for 5 (5.7%) deaths. Out of 1,652 brain samples of different animals, mainly dogs, submitted for examination, 1,122 (68%) were found to be positive for rabies by the FAT. Dog bites were more common among males than females. The number of dog bite victims who had visited the EPHI counseling office and recommended to take postexposure prophylaxis against rabies both from Addis Ababa and the surrounding areas were 9,592 and 4,192, respectively. Out of these, 5,708 were males and 3,884 females for the capital Addis Ababa. Similarly, 2,439 males and 1,753 females account for areas surrounding Addis Ababa. Among those exposed from Addis Ababa, 1,079 (11.2%) were in the age group less than five, 1696 (17.7%) were in the age group 6–13, and 6,817 (71.1%) in the age group 14 and greater. Victims from outside of the capital Addis Ababa account for 644 (15.4%) for the age group less than 5 years, 964 (23%) for the age group 6–13 and, 2,584 (61.6%) for the age group 14 and greater. Conclusion. Mechanisms must be sought to reduce the cost of PEP and means of obtaining funds so as to initiate timely treatment for rabies exposed individuals of low socioeconomic status. Besides prevention, strategies should focus on public education and strict dog population control.

Tef is the most important and well adapted cereal crop in Ethiopia and grows better than other cereals both in biotic and abiotic stress conditions. In this study 93 tef accessions representative of various agro-ecologies of Ethiopia along with four improved varieties, one local check and six wild relatives were studied. The materials were genotyped with 12 simple sequence repeat markers (SSRs) to investigate the extent and structure of the genetic diversity of tef. A total of 152 alleles were detected indicating high polymorphism in the studied accessions. The number of alleles per polymorphic loci ranged from seven for CNLT 538 to 29 for CNLT150 with an average of 12.67. High average polymorphic information content (0.82) and average expected heterozygosity (0.86) also signifies the suitability and efficiency of SSR markers to discriminate among tef genotypes. Cluster, principal coordinate and structure analyses grouped the 98 tef genotypes and six wild relatives into four distinct classes. The groupings showed no special pattern despite the different regions of origins for the accessions; however, the five wild relatives were grouped together. The analysis of molecular variance and fixation index showed low genetic differentiation and high gene flow between regions revealing that much of the variability was attributed to within populations variation. Generally, the present study showed that there is high genetic variability with unstructured genetic pattern among the studied tef genotypes which implies the vitality of conserved tef germplasms at Ethiopian Biodiversity Institute and the impact of the seed exchange system on tef breeding activities in Ethiopia.

Background The respiratory syncytial virus (RSV) has been established as a leading cause of acute lower respiratory illness (ALRI) in infants and children. In 2015, the global disease burden (GBD) study estimated that the overall RSV-ALRI mortality could be as high as 118,200, with most death occurring in low- and middle-incomes countries (LMIC). This study aimed to assess the burden of RSV infection among children less than 2 years with acute respiratory infections (ARI) in the Littoral region of Cameroon. Methods We carried out a cross-sectional study in seven health centres in the Littoral region of Cameroon. Venous blood was collected using serum separation tubes from eligible children who visited these health centres with acute respiratory infections. ELISA (Enzyme-linked immunosorbent assay) testing was used to assess the seroprevalence of anti-IgM RSV for the total population and by selected demographic and health parameters and potential risk factors. Results The overall RSV-associated ARI seroprevalence was 33% (95%CI:23.6–42.3; 33/100 children). The only demographic factor significantly associated with RSV acquisition was age of 6 months and below (odds ratio: 7.54 (2.62, 23.36); p = 0.000). Children who were clinically diagnosed to be concomitantly infected with malaria had a lower risk of RSV infection (odds ratio: 0.38 (0.14, 0.95; P = 0.03). Conclusions The RSV burden is high among children less than 2 years with ARI in the Littoral region of Cameroon. There is a need for an effective public health RSV surveillance system with standard laboratory techniques and equipment to better understand the RSV disease age-specific incidence, seasonality, risk factors and RSV burden among patients in communities in Cameroon.

Kassahun Haile,1 Abebe Timerga2 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia; 2Department of Biomedical Science, Wolkite University, Wolkite, EthiopiaCorrespondence: Kassahun HaileDepartment of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, P.O. Box: 07, Wolkite, EthiopiaTel +25-926-07-43-74Fax +251 11 322 0041Email kassahaile07@gmail.comBackground: Helicobacter pylori (H. pylori) infection is a global public health problem, a higher burden of the infection was reported in developing countries including Ethiopia. It has been associated with several gastrointestinal diseases, and recently implicated in some hematological abnormalities. Despite the high prevalence of H. pylori infection in Ethiopia, there was limited data regarding the relationship between hematological parameters with H. pylori infection. Therefore, this study aimed to evaluate selected hematological parameters of H. pylori-infected patients attending Wachemo University Nigist Eleni Mohammed Memorial Referral Hospital (WUNEMMRH), Hosanna, Southern, Ethiopia.Methods and Materials: A comparative cross-sectional study was conducted from January to May 2019 among 374 (187 H. pylori-infected patients and 187controls) study participants. Data on socio-demographic characteristics were collected using a structured questionnaire. A five-milliliter venous blood sample was collected for hematological parameter analysis. Approximately two gram of stool specimen was collected to assess the presence of H. pylori antigen. Data were entered and analyzed by using SPSS version 21. Pearson correlation analysis and independent sample T-test was performed, and P-value < 0.05 was considered statistically significant.Results: Mean value of Hgb (p< 0.001), RBC count (p< 0.001), HCT (p< 0.001), MCV (p=0.003), MCH (p=0.008), and MCHC (p=0.006) of H. pylori-infected patients were significantly lower than control group. However, the mean value of RDW (p=0.003) in H. pylori-infected patients was significantly higher than in the control group. About 13.3%, 7%, 6.4%, and 18.2% of H. pylori-infected patients showed reduced Hgb concentration, RBC count, HCT, and MCV values, respectively.Conclusion: The study showed a statistically significant difference in the mean value of Hgb, RBC count, HCT, MCV, MCH, MCHC, and RDW of H. pylori-infected patients and controls. Thus, hematological parameters should be considered for proper diagnosis and management of H. pylori-infected patients and eradication of this microorganism from infected patients, determination of hematological parameters for H. pylori-infected patients were recommended.Keywords: hematological parameters, H. pylori infection, southern, Ethiopia

Abebe Muche Belete,1 Daniel Seifu,2 Menakath Menon,3 Wondwossen Amogne,4 Aster Shewa,5 Alemu Adela Tefera1 1Department of Biochemistry, Medical Faculty, Debre Berhan University, Debre Berhan, Ethiopia; 2Department of Biochemistry, Division of Biomedical Sciences, University of Global Health Equity, Kigali, Rwanda; 3Department of Biochemistry, Medical Faculty, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Internal Medicine, Medical Faculty, Addis Ababa University, Addis Ababa, Ethiopia; 5Department of Internal Medicine, Zewditu Memorial Hospital, Addis Ababa, EthiopiaCorrespondence: Abebe Muche BeleteDepartment of Biochemistry, Medical Faculty, Debre Berhan University, P.O. Box 445, Debre Berhan, EthiopiaEmail abebemuche3@gmail.comBackground: Dyslipidemia represents significant health care concerns in patients taking antiretroviral therapy due to their association with cardiovascular disease risk. There is limited data regarding the effects of boosted atazanavir (ATV/r) treatment in the lipid profiles of Ethiopian HIV patients. Thus, this study compares the mean values of lipid profile differences of HIV patients on ATV/r-based regimen compared to efavirenz (EFV)-based regimen, while the background is Tenofovir Disoproxil Fumarate/lamivudine.Materials and Methods: A comparative hospital-based cross-sectional study was conducted among adult HIV-infected patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia, from July–September 2017. An equal number of EFV and ATV/r-treated patients (n=90 each) receiving for 1-year and over were included in the study. Serum total cholesterol (TC), triglyceride (TG), gigh-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) were measured. Data comparison used chi-square test, Student’s t-test and Mann–Whitney U-test. Multivariate logistic regression analysis and p-value< 0.05 were used to identify associated factors of serum lipid profiles.Results: In the present study, the ATV/r-treated group results were significantly higher in the median values of TG [207 (56– 1094) vs 145 (42– 768) mg/dL; p=0.001] and the mean value of TG/HDL-c (6.6 vs 4.4; p=0.001) as compared to the EFV-treated group. The EFV-treated group showed significantly higher in the mean value of HDL-c (44.7 vs 38.7 mg/dL; p=0.001) as compared to the ATV/r-treated group. Body mass index was associate with LDL and HDL. CD4 was associated with TC. Current antiretroviral therapy was associated with TG. Duration of HIV since first diagnosis and duration of ART were associated with HDL.Conclusion: ATV/r is associated with elevated in TG and TG/HDL-C, but low HDL as compared to EFV. Differences in LDL or HDL that were found were of unclear clinical significance. The long-term significance is unknown.Keywords: dyslipidemia, antiretroviral therapy, efavirenz, ritonavir-boosted atazanavir

Background In Ethiopia, malaria cases are declining as a result of proven interventions, and in 2017 the country launched a malaria elimination strategy in targeted settings. Accurate malaria diagnosis and prompt treatment are the key components of the strategy to prevent morbidity and stop the continuation of transmission. However, the quality of microscopic diagnosis in general is deteriorating as malaria burden declines. This study was carried out to evaluate the competency of microscopists and the performance of health facilities on malaria microscopic diagnosis. Methods A cross-sectional study was conducted from 1 August to 30 September, 2019 in 9 regional states and one city administration. A standard checklist was used for on-site evaluation, archived patient slides were re-checked and proficiency of microscopists was tested using a WHO-certified set of slides from the national slide bank at the Ethiopian Public Health Institute (EPHI). The strength of agreement, sensitivity, specificity, and positive and negative predictive values were calculated. Results In this study, 102 health facilities (84 health centres and 18 hospitals) were included, from which 202 laboratory professionals participated. In slide re-checking, moderate agreement (agreement (A): 76.0%; Kappa (K): 0.41) was observed between experts and microscopists on malaria detection in all health facilities. The sensitivity and specificity of routine slide reading and the re-checking results were 78.1 and 80.7%, respectively. Likewise, positive predictive value of 65.1% and negative predictive value of 88.8% were scored in the routine diagnosis. By panel testing, a substantial overall agreement (A: 91.8%; K: 0.79) was observed between microscopists and experts in detecting malaria parasites. The sensitivity and specificity in the detection of malaria parasites was 92.7 and 89.1%, respectively. In identifying species, a slight agreement (A: 57%; K: 0.18) was observed between microscopists and experts. Conclusion The study found significant false positive and false negative results in routine microscopy on slide re-checking of Plasmodium parasites. Moreover, reduced grade in parasite species identification was reported on the panel tests. Implementing comprehensive malaria microscopy mentorship, in-service training and supportive supervision are key strategies to improve the overall performance of health facilities in malaria microscopy.

Tadesse Asmamaw Dejenie,1 Worku Mamo Degu,2 Setognal Birara Aychiluhm,3 Endeshaw Chekol Abebe,4 Markeshaw Tiruneh G/Medhin1 1Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia; 3Carter Center, Atlanta, Ethiopia; 4Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Tadesse Asmamaw Dejenie Tel +251 909045760Email as24tadesse@gmail.comBackground: TB-HIV co-infection is the most common problem of African countries, especially, Sub-Saharan countries including Ethiopia. So this study aimed to assess TB-HIV co-infection with its associated factors in patients with Tuberculosis in Northwest Ethiopia. Although the prevalence of TB-HIV was low, the need for strengthening the health extension program especially in urban dwellers also needed to include TB-HIV testing.Objective: This study aimed to assess TB-HIV co-infection with its associated factors in patients with Tuberculosis in Northwest Ethiopia.Methodology: Institutional based cross-sectional study has been done and a total of 638 subjects participated in the study. The data of the study subjects were collected from the tuberculosis logbook using two trained data collectors who were work in the TB DOTS program and by using a well-prepared checklist and SPSS was used for analyzing data.Results: 9.7% (62/638) of TB patients were found to be co-infected with HIV. Among these 32 (11.4%) were females and 30 (8.4%) were males. More infected individuals were found in urban residents 44 (20%) than rural residents and age groups 30– 40 years 31 (22.5%) are more infected than the other age group. TBforms, age, and residence were associated with HIV/TB co-infection significantly.Conclusions and Recommendations: Although the prevalence of TB-HIV was low, the need for strengthening the health extension program especially in urban dwellers is needed to include TB-HIV testing. Further surveys involving HIV infected TB patients to strengthen and scale-up for TB and HIV is needed.Keywords: TB-HIV co-infection, Kolla Diba, Northwest Ethiopia

Background Globally, visual impairment affects about 285 million (4.25%) people, of those, 266.4 million were adults aged 18 years and above. Ethiopia is one of developing countries estimated to have high prevalence of visual impairment which have an enormous socio-economic impact. Also there is limited available information regarding with the magnitude of visual impairment among adults in our country at large and east Gojjam zone in specific. Therefore the aim of this study was to assess the magnitude of visual impairment and its associated factors among patients attending Debre Markos Referral Hospital ophthalmic clinics in east Gojjam zone, North West Ethiopia. Methods An institutional-based cross-sectional study was conducted at Debre Markos Referral Hospital which is the only hospital in east gojjam zone with ophthalmic care service from March 1 to 30, 2020 by using systematic random sampling technique to select study participants after informed consent was obtained. Data were collected by interview with 5% pretested, structured questionnaire and ocular examinations. Data were cleaned, coded and entered to Epi-data version-3.1, and analyzed using Statistical Package for Social Science software version 26. The descriptive statistics was presented in tables, text and graphs. Bivariable and multivariable logistic regression analysis to identify factors associated with visual impairment was conducted. Covariates with P-value Results A study was conducted among 312 study participants with 96% response rate. The magnitude of visual impairment was 114 (36.5%) [95% CI, (33.8, 39.2%)]. Age > 50 years [AOR = 3.82; 95% CI (1.56, 9.35)], rural residency [AOR = 4.33 95% CI (1.30, 14.44)], inability to read and write [AOR = 3.21; 95% CI (1.18, 8.73)] and Cataract [AOR = 4.48; 95% CI (1.91, 10.52)] were factors significantly associated with visual impairment. Conclusions The overall magnitude of visual impairment was found to be high. Older age, rural residency, inability to read and write and cataract were associated with visual impairment. Increasing literacy, expanded cataract surgery, as well as community based visual acuity screening especially for elders and rural residents is crucial. Zonal police makers should give emphasis on prevention of visual impairment to decrease economic, social and political burden of visual disability.

Sexual violence (SV) is pervasive and economically burdensome in the USA. According to the CDC, SV prevention could avert $122,461 in costs per victim of rape, totaling an estimated $3.1 trillion. Coaching Boys into Men (CBIM) is an evidence-based dating abuse and SV prevention program found to reduce dating abuse and SV perpetration among male high school athletes and dating abuse among middle school athletes. This secondary data analysis of CBIM’s high school (N = 1520) and middle school (N = 973) RCTs estimated the incidence of dating abuse, sexual harassment, and sexual assault that CBIM could prevent as well as the potential cost savings. Ten items measured dating abuse, with a subset measuring sexual assault and sexual harassment, among participants who had ever dated a female. Perpetration measures were dichotomized as present or absent. Maximum likelihood estimates of Poisson-distributed event rates allowed for possible multiple incidents of perpetration per athlete. Among high school athletes, CBIM was associated with a relative reduction of 85 incidents of dating abuse (95%CI 24, 146), 48 incidents of sexual harassment (95%CI 3.8, 92), and 20 incidents of sexual assault (95%CI 1.7, 38) per 1,000 athletes. Results among middle school athletes demonstrated similar, albeit non-significant, trends. Based on the reduction of sexual assaults among high school athletes alone, CBIM may have resulted in $2.4 million reduction in costs per 1000 athletes exposed. CBIM may be associated with significant sexual assault-related cost reductions. Given the low costs and time needed to implement the program, sexual and dating violence prevention programs like CBIM may result in substantial economic benefits.

Plasmodium falciparum sporozoite (PfSPZ) Vaccine (radiation-attenuated, aseptic, purified, cryopreserved PfSPZ) and PfSPZ-CVac (infectious, aseptic, purified, cryopreserved PfSPZ administered to subjects taking weekly chloroquine chemoprophylaxis) have shown vaccine efficacies (VEs) of 100% against homologous controlled human malaria infection (CHMI) in nonimmune adults. Plasmodium falciparum sporozoite-CVac has never been assessed against CHMI in African vaccinees. We assessed the safety, immunogenicity, and VE against homologous CHMI of three doses of 2.7 × 106 PfSPZ of PfSPZ Vaccine at 8-week intervals and three doses of 1.0 × 105 PfSPZ of PfSPZ-CVac at 4-week intervals with each arm randomized, double-blind, placebo-controlled, and conducted in parallel. There were no differences in solicited adverse events between vaccinees and normal saline controls, or between PfSPZ Vaccine and PfSPZ-CVac recipients during the 6 days after administration of investigational product. However, from days 7–13, PfSPZ-CVac recipients had significantly more AEs, probably because of Pf parasitemia. Antibody responses were 2.9 times higher in PfSPZ Vaccine recipients than PfSPZ-CVac recipients at time of CHMI. Vaccine efficacy at a median of 14 weeks after last PfSPZ-CVac dose was 55% (8 of 13, P = 0.051) and at a median of 15 weeks after last PfSPZ Vaccine dose was 27% (5 of 15, P = 0.32). The higher VE in PfSPZ-CVac recipients of 55% with a 27-fold lower dose was likely a result of later stage parasite maturation in the liver, leading to induction of cellular immunity against a greater quantity and broader array of antigens.

Samuel Woldekidan,1 Abay Mulu,2 Wondwossen Ergetie,3 Frehiwot Teka,1 Asfaw Meressa,1 Ashenif Tadele,1 Abiy Abebe,1 Worku Gemechu,1 Negero Gemeda,1 Rekik Ashebir,1 Meron Sileshi,4 Yoseph Tolcha4 1Directorate of Traditional and Modern Medicine Research, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 2Department of Anatomy, School of Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Pathology, School of Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia; 4National Clinical Chemistry Reference Laboratory, Addis Ababa, EthiopiaCorrespondence: Samuel WoldekidanDirectorate of Traditional and Modern Medicine Research, Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, EthiopiaEmail woldekidans6@gmail.comBackground: Diabetes is a serious metabolic disorder with complications that result in significant morbidity and mortality. Current drugs used for diabetes therapy are not free from side effects and do not restore normal glucose homeostasis. Therefore, the purpose of this study is to evaluate the antidiabetic effect of Moringa stenopetala (Baker f.) aqueous leaves extract.Methods: Thirty rats of weight 90– 150 gram were distributed to five groups (n= 6). Then labelled as diabetic control (DC), normal control (NC), extract treated (MS 250 and 500mg/kg), and glibenclamide treated (GL 5mg/kg). The experimental rats were induced by intra-peritoneal injection of Alloxan monohydrate at a dose of 180 mg/kg after dissolving in normal saline. Clinical biochemistry such as AST, ALT, ALP, urea, creatinine, and cholesterol, blood glucose level, histopathological and preliminary phytochemical screening were evaluated.Results: Phytochemical tests revealed the presence of different secondary metabolites. Alkaloid, flavonoid, tannin, saponin, phytosteroids, phenols and terpenoids. Moringa stenopetala (Baker f.) leaves aqueous extract (250 and 500mg/kg) improved the body weight of rats, showed remarkable reduction in blood glucose concentration (P< 0.05), and significantly decreased serum urea, creatinine, ALT, AST and ALP (P < 0.05). Levels of serum cholesterol remained unaltered in the experimental groups when compared with diabetic control. Histopathology of non-treated rats showed deterioration of insulin producing pancreas cells; nevertheless, β-cells restoration was observed due to administration of Moringa stenopetala (Baker f.) aqueous leaves extract.Conclusion: It is possible to conclude that oral administration of Moringa stenopetala (Baker f.) aqueous leaf extracts (250mg/kg and 500mg/kg) for 28 days showed beneficial effects on antihyperglycemia, improved body weight and Alloxan damaged pancreatic β-cells, and restored biochemical changes.Keywords: diabetes, Moringa stenopetala, pancreatic β-cells, alloxan monohydrate

Equivalent to regulatory T cells, a novel B cell populace, called regulatory B cells (Bregs), has been found to exert a negative immune regulatory role. These subsets of cells account for 0.5% of human B cells from the periphery that expand after activation upon certain stimuli depending on the nature of the microenvironment and provide a variety of Breg cell phenotypes. The increasing number of suppressive mechanisms attributed to Bregs suggests that these immune cells play many roles in immune regulation. Bregs have been confirmed to play a role in host defense mechanisms of healthy individuals as well as they play pathologic and protective roles in diseases or other conditions. Accumulating evidence reported that Bregs have a role in autoimmune and infectious diseases to lower inflammation, and in cancer to attenuate antitumor immune responses, thereby to promote cancer growth and metastasis. More recently, Bregs are also found to be involved in conditions like transplantation for transplant tolerance, during pregnancy to create an immune-privileged uterine environment and during early neonate life. Herein, the review summarizes recent findings aimed to provide understanding on the Breg cells, in the hope to gain insight on the general overview, development, mechanism of activation, and action of Bregs as well as their potential roles in health and diseases.

Mekedes Dejene,1 Azeb Tefera,1 Abebe Dires,2 Sisay Gedamu,2 Yemiamrew Getachew,3 Sewunet Ademe2 1Emergency Department, Dessie Referral Hospital, Dessie, Ethiopia; 2Department of Nursing, School of Nursing and Midwifery, College of Medicine & Health Sciences, Wollo University, Dessie, Ethiopia; 3Department of Community and Mental Health, School of Nursing and Midwifery, College of Medicine & Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Abebe Dires Email abede9907@gmail.comIntroduction: Blood transfusion is a basic and an emergency intervention in health care facilities which has a great role in reducing significant morbidity and mortality. However, there is a major shortage of blood and blood products in developing countries including Ethiopia. This study aimed to assess practice of blood donation and associated factors among health science college students in Dessie town, northeast Ethiopia.Methods: An institution-based cross-sectional study was conducted among health science college students from May to June 2019. A pre-tested and self-administered structured questionnaire was used for data collection. Multivariable logistic regression analysis model was applied to identify independent predictors of blood donation practice at the level of significance below 0.05.Results: Overall, 12.4% (95% CI: 9.5– 15.5) of participants had been donated blood at least once in their lifetime. However, 59.2% of participants have willingness to donate blood in the future. In this study, older age (≥ 25years) (AOR=2.30, 95% CI: 1.18– 4.46), had family history of blood transfusion (AOR=3.55, 95% CI: 1.71– 7.36), had knowledge (AOR=2.09, 95% CI: 1.04– 4.17) and favorable attitude (AOR=2.41, 95% CI: 1.01– 5.75) about blood donation were significantly associated with practice of donating blood.Conclusion: In this study, blood donation practice of health sciences college students was found to be low. Age, family history of blood transfusion, knowledge and attitude towards blood donation were independent predictors of blood donation practice. Therefore, Red Cross societies, Dessie town health office, health science colleges and other stakeholders should enhance the awareness of college students regarding the importance of donating blood.Keywords: blood donation, college students, northeast Ethiopia