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Introduction: In 2021, a staggering five million children globally succumbed to mortality before celebrating their fifth birthdays. Alarmingly, children residing in Sub-Saharan African nations faced mortality risks 15 and 19 times higher than their counterparts in Europe and Northern America, as well as the region encompassing Australia and New Zealand, respectively. Ethiopia, situated in Sub-Saharan Africa, shoulders a significant burden of under-five mortality, securing the third position in Africa and the tenth globally. The primary objective of this study was to scrutinize the trends in under-five mortality inequalities based on maternal education in Ethiopia from 2000 to 2016. Method: The analysis utilized data from repeated cross-sectional surveys, drawing upon a pooled total sample of 35,404 children aged 0–59 months. This sample was derived from the Ethiopian Demography and Health Surveys conducted in 2000, 2005, 2011, and 2016. To explore the determinants of under-five mortality among this age group, we employed multilevel binary logistic regression analysis. This approach allowed us to assess the impact of various factors at the individual, household, and community levels. Additionally, we conducted multivariate decomposition, concentration index, and decomposition rate analyses to scrutinize the evolving trends in maternal education-based disparities in under-five mortality. Result: Maternal education emerged as a significant factor influencing under-five mortality in Ethiopia. Notably, approximately one-third (31%) of the observed inequalities in under-five mortality based on maternal education could be accounted for by the effects of observed characteristics. Over the years, there has been a noteworthy reduction in absolute inequalities in under-five mortality. Specifically, a decline of 0.14 was observed between 2000 and 2005, and a more substantial decrease of 0.32 occurred in the period spanning 2000 to 2016, resulting in an overall change of 56.25%. Furthermore, this study revealed that about 43.12% of the reduction in under-five mortality could be attributed to the narrowed gap in maternal education during the survey period. Conclusion: The implications drawn from these findings underscore the importance of directing interventions aimed at reducing early mortality toward the promotion of maternal education. It is evident that addressing maternal education plays a pivotal role in mitigating inequalities in under-five mortality. Additionally, there is a pressing need to revisit and enhance existing population and health policies. Establishing stronger linkages between child survival issues and the education sector is crucial for achieving the targets outlined in the Sustainable Development Goals related to under-five mortality. By aligning policies with these insights, there is a greater likelihood of fostering sustainable improvements in child survival and advancing towards the overarching goal of reducing under-five mortality. [ABSTRACT FROM AUTHOR]

Children who do not consume enough iron have decreased growth, reduced immunity, and poor cognitive development. This study aimed to assess the pooled iron-rich food consumption, trends, and predictors among children aged 6–59 months old in Ethiopia. This study used Ethiopian demographic and health survey (EDHS-2005–2016) data with a total weighted sample size of 26,773 among children aged 6–59 months old. A multilevel mixed-effects logistic regression analysis was used to identify predictors of good iron-rich food consumption. The pooled proportion of iron-rich food consumed among children aged 6–59 months in Ethiopia was 11.77% (10.71, 12.92%). In Ethiopia, the proportion of iron-rich food intake by children aged 6–59 months was slightly increased from 9.25% (8.04, 10.62%) in EDHS 2005 to 10.86% (9.06, 12.95%) in EDHS 2011, and sharply increased to 17.49% (15.04, 20.24%) in EDHS 2016. The findings indicated that being children born to mothers aged 20 to 34 years old [AOR = 0.56, 95% CI: 0.35, 0.89], mothers aged ≥ 35 years old [AOR = 0.47, 95% CI: 0.28, 0.82], married parents [AOR = 1.68, 95% CI: 1.14, 2.48], completed primary education [AOR = 1.32, 95% CI: 1.02, 1.73], secondary education [AOR = 2.66, 95% CI: 1.53, 4.59], a higher education status of mother [AOR = 3.98, 95% CI: 1.92, 8.23], medium family [AOR = 1.39, 95% CI: 1.03, 1.89], rich family [AOR = 1.45, 95% CI: 1.09, 1.95], media exposure [AOR = 1.35, 95% CI: 1.06, 1.72], residents of the Tigray [AOR = 2.69, 95% CI: 1.51, 4.79], Oromia [AOR = 3.30, 95% CI: 1.30, 4.02], Benishangul [AOR = 2.12, 95% CI: 1.15, 3.88], Gambela [AOR = 5.85, 95% CI: 2.97, 11.50], and Dire Dawa region [AOR = 3.38, 95% CI: 1.76, 6.47], were significantly associated with good iron-rich food consumption among children aged 6–59 months old. The findings revealed that iron-rich food intake was considerably low among Ethiopian children aged 6–59 months. Increasing women's literacy and economic empowerment improves iron-rich food consumption among children aged 6–59 months old. [ABSTRACT FROM AUTHOR]

Background: Nasopharyngeal carriage of S. pneumoniae is a global health problem that has been associated with the emergence of severe disease and pathogen dissemination in the community. However, summary data on the carriage rate, antimicrobial susceptibility profile, and determinant factors is lacking. Method: Articles were extensively searched in bibliographic databases and gray literature using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported to STATA version 17 software for statistical analysis. A random-effects model was used to compute the pooled magnitude of the nasal carriage of S. pneumoniae and its multidrug resistance. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was done to assess the impact of a single study on the pooled effect size. Result: Of the 146 studies identified, 8 studies containing a total of 3223 children were selected for meta-analysis of the magnitude of the nasal carriage of S. pneumoniae and its multidrug resistance. The overall pooled prevalence of nasal carriage of S. pneumoniae and its MDR status in Ethiopian children was 32.77% (95%CI: 25.1, 40.44). and 31.22% (95%CI: 15.06, 46.84), respectively. The highest resistant pattern of S. pneumoniae was against tetracycline, which was 46.27% (95%CI: 37.75, 54.79), followed by 45.68% (95%CI: 34.43, 57.28) trimethoprim-sulfamethoxazole, while the least pooled prevalence was against chloramphenicol, which was 16.2% (95%CI: 9.44, 22.95). The pooled effect of age less than 5 years old (pooled OR = 1.97; 95% CI: 1.35, 2.88, P < 0.001), co-sleeping habit with others (pooled OR = 2.36; 95% CI: 1.77, 3.66; P < 0.001), sibling (pooled OR = 1.82; 95% CI: 1.14, 2.91, P = 0.01), history of hospitalization (pooled OR = 4.39; 95% CI: 1.86, 10.34, P = 0.001), and malnutrition (pooled OR = 2.18; 95% CI: 1.49, 3.19; P < 0.001) showed a statistical association with S. pneumoniae nasal carriage rate by using the random effect Sidik-Jonkman model. Conclusion: The magnitude of the nasopharyngeal carriage rate and multi-drug resistance status of S. pneumoniae alarms the need for immediate interventions such as strengthening antimicrobial stewardship programs, undertaking national antimicrobial surveillance, one-health initiatives, and national immunization programs. [ABSTRACT FROM AUTHOR]

This essay centers on one African woman, Ṭaytu Bǝṭul (1851–1918), and argues that her path to empowerment has a significant African and Ethiopian precedent. African scholars write about how African women have obtained authority through shifting aspects of their identities through the religious, economic and political spheres. The Ethiopian precedent is seen in the lives of historical Ethiopian women like Mǝntǝwwab, Mänän, and Wällätä Petros. Using the relevant primary and secondary sources, I continue to argue that Ṭaytu used the strategies that served these women in the past, such as the prominent position of women in African religions, imperial marriages of her relatives throughout her and her husband’s growing Empire, and her central place in her husband’s inner circle to create, maintain and expand her influence culminating in her governing the nation for years after a series of strokes incapacitated her husband Mǝnilǝk II. [ABSTRACT FROM AUTHOR]

This paper discusses cluster statehood and its implications on minority ethnic groups. Using the three statehood exercises (South-Western Ethiopian Peoples, Southern Ethiopia and Central Ethiopian regional state) as a case study, this paper highlights the main issues and challenges minority ethnic groups face in the process of statehood exercise. These include the application of the simple majority vote rule in a statehood referendum, the implication of cluster statehood on minority ethnic groups’ rights, the challenge of clustering ethnic minorities without their wishes and restructuring minorities’ ethnic administrative boundaries without a referendum. It concludes that the simple majority followed in statehood referendum makes the role of minority ethnic groups rubber-stamp rather than reflect their real interests. Creating the Central Ethiopian State without a referendum is a flagrant disregard of the constitutional procedure and hinders the full political authority of minority nnp s to decide on their affairs. [ABSTRACT FROM AUTHOR]

Introduction: Fertility refers to the biological capacity to reproduce and have children. It is a key aspect of reproductive health influenced by various factors. Therefore, this study aims to explore the determinants of fertility rates based on urban and rural settings in Ethiopia. Method: A stratified two-stage cluster sampling approach was used, employing data from the 2019 Ethiopian Mini Demographic and Health Survey (https://dhsprogram.com). The study comprised 8,885 women aged 15 to 49 years. The study employed Stata 17, and the data was described using descriptive statistics. Associations were examined using decomposition analysis and negative binomial regression. The Incidence Rate Ratio and p-value were used to determine the statistical significance of the variables examined. Results: The negative binomial regression found that factors such as maternal age (IRR, 1.08, P-value,0.00), living in rural (IRR,1.09, P-value,0.00), being Muslim (IRR,1.13, P-value,0.00), being from other religious groups (IRR,1.16, P-value,0.00), having six up to nine household members (IRR,1.24, P-value,0.00), having greater than nine household member(IRR,1.14, P-value,0.04), having one child under five year (IRR,1.35, P-value,0.00), having two children under five year (IRR,1.77, P-value,0.00), and having more than two under five years (IRR,1.99, P-value,0.00), being currently pregnant (IRR,1.08, P-value,0.00), use of contraceptive(IRR,1.13, P-value,0.00) are positively associated with bearing more children. On the other hand, completing primary education (IRR,0.84, P-value,0.00), secondary education (IRR,0.61, P-value,0.00), being from the richest household (IRR = 0.94, P-value,0.00), and being single/divorced and widowed (IRR,0.49, P-value,0.00) are negatively associated with having more children because their IRR is less than one. The decomposition analysis also demonstrated that marital status has a stronger negative correlation with fertility in rural compared to urban settings. Additionally, the number of children under five exerts a greater influence on fertility in urban areas. Conclusion: the study found significant rural-urban differences in the factors shaping fertility in Ethiopia. While demographics like maternal age, education, and wealth influenced fertility in both settings, the relationships varied in nature and magnitude. To address this, Policymakers should develop targeted fertility programs that address the unique needs and challenges faced by rural and urban populations. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Pelvic organ prolapse (POP) has a profound influence on a woman's quality of life (QoL). Assessment of QoL using patient-reported outcome (PRO) measures in pelvic organ prolapse surgery is common practice in developed countries, but despite the burden of POP in developing countries, such as Ethiopia, the use of PROs to record preoperative and postoperative QoL scores is limited. This study is aimed at assessing the QoL among Ethiopian women with POP before and after surgery using the validated Pelvic Organ Quality of Life (P-QoL) questionnaire. Additionally, we will compare postoperative QoL measurements of reconstructive procedures with those of obliterative procedures. Methods: This is a prospective observational study conducted at a single hospital in Ethiopia on women who were scheduled for surgery for symptomatic POP. Patients' QoL was assessed preoperatively using the P-QoL questionnaire and at each subsequent follow-up visit for 1 year (3, 6, 9, and 12 months). Patients undergoing an obliterative procedure were evaluated and compared with those having reconstructive procedures. Results: The mean score for general health perceptions, prolapse impact, role limitations, physical limitations, social limitations, and emotions was 0 at 12 months postoperatively. Despite significant improvements from baseline, personal relationships, sleep or energy disturbance, and symptom severity measures continued to negatively impact QoL at 12 months postoperatively. Conclusions: Quality of life among Ethiopian women with POP is poor across all domains. Native tissue repair employing either reconstructive or obliterative methods significantly improves QoL across all domains up to 12 months postoperatively. The use of validated tools to assess PROs is essential to provide evidence-based care that improves QoL in ways that are meaningful to patients. [ABSTRACT FROM AUTHOR]

Cervical cancer is the second most commonly diagnosed cancer in women in Ethiopia. However, data are limited on the prevalence of human papillomavirus (HPV) genotypes. Self-sampled vaginal lavages were obtained consecutively from 783 women attending 7 health facilities across Ethiopia. Genotype prevalence was assessed by Multiplex- Papillomavirus-Genotyping which detects and individually identifies 51 genotypes and 3 subtypes. Genotype-specific prevalence was described and associations with known risk factors were analysed. The overall HPV prevalence (age range 18-45) was 33.1% (95% confidence interval (CI) 29.8-36.4). The prevalence of HPV was different in the rural and urban population with 17.6% (95%CI 11.6-23.7) and 36.8% (95%CI 33.1-40.6) (p < 0.001 chi-square test), respectively. The most common high-risk types were HPV 16 (6.6%), followed by HPV 52 (4.3%), 51 and 39 (both 2.9%). Urban women compared to rural women had a higher risk of being HPV positive (odds ratio 2.36 (95% CI 1.47-3.79; p < 0.001). Age at sexual debut ≤15 years and polygamous husband (in urban women) also increased the risk of being HPV positive nearly two-fold. The high prevalence of hr-HPV in Ethiopian women in the reproductive age group shows the need for screening programs. The nonavalent HPV vaccine covers the most prevalent hr-HPV genotypes as found in this study and can therefore be used effectively. Since antenatal care is the bestutilised health service, implementing self-sampled vaginal lavage could be an opportunity for screening in this age group. Screening algorithms and triage still need to be defined to avoid over-treatment in these women. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionWe compared the distribution of the HLA-B27 allele among Ethiopian patients with acute anterior uveitis (AAU) and controls without that disease.The clinical features of patients were collected from their medical records. HLA-B27 genotyping was performed for 64 patients, with AAU using the real-time polymerase chain reaction (RT-PCR), and the results were compared to those from a panel of 192 healthy, unrelated volunteer control participants (refraction patients and volunteers) free of signs of anterior uveitis. Other outcomes were assessed comparing HLA-B27 positive vs. negative patients.The histocompatibility antigen HLA-B27 was identified in 6 out of 64 (9.4%) AAU patients, compared with 1.0% in controls (Odds Ratio = 9.8, 95% CI (1.93, 50.01)). Sub-group analysis of the cases revealed that patients with HLA-B27 positivity had a higher incidence of ocular hypertension (Odds Ratio = 5.93, 95% CI (1.29, 27.2)).The antigen HLA-B27 was represented ~10-fold more frequently in the patient group than in the control group. HLA-B27 allele distribution in both cases and controls is lower than in reports from Caucasian and Asian populations, but similar to South Africa. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Method Result and Discussion Conclusion Few psychosis screening instruments have been tested for use in Africa, yet appropriate tools can increase the detection of self‐reported psychotic symptoms, improve the detection of psychosis and impact its prognosis.The construct validity and factor structure of Psychosis Screening Questionnaire (PSQ) were tested with confirmatory factor analysis (CFA) and item response theory (IRT) in a sample of 1928 Ethiopian adults without any history of psychosis. We tested a unidimensional model with and without an item on mania. For IRT, unidimensional latent structure one‐parameter logistic (1PL) and two‐parameter (2PL) logistic models were tested and compared for relative fit using a likelihood‐ratio test.The prevalence of lifetime positive screens was 2.8% in an Ethiopian sample of adults from a general medical setting. A unidimensional model demonstrated good fit for the PSQ, (CFI = 0.993, TLI = 0.986 and RMSEA = 0.025). For IRT, a 2PL model was the best fitting one. IRT tests of item difficulty and discrimination parameters showed that paranoia had the highest discrimination α=4.59$$ \left(\alpha =4.59\right) $$ and lowest difficulty (β=2.53$$ \beta =2.53 $$), likely to be endorsed at low levels of psychotic features. Thought insertion had the highest item difficulty (β=2.98$$ \beta =2.98 $$). Overall, the measure captures the psychosis construct at higher levels of the latent trait and may be suited for detecting moderate to severe levels of psychosis.The PSQ is found to have good construct validity in screening for psychosis among Ethiopian adults. Future studies may focus on the diagnostic validity of the PSQ comparing it with a structured clinical interview. [ABSTRACT FROM AUTHOR]

Reggae music, a genre that was created in Jamaica in the late 1960s, has become popular across the globe for promoting positive representations of Ethiopia and Africa due to reggae's connections with the Rastafari movement. Ethiopian reggae musicians, through their interactions with Rastafari, have served as cultural ambassadors for a type of pan-Africanism that incorporates elements of Rastafari beliefs and promotes transatlantic solidarity. Some Ethiopians who emigrated have encountered Rastafari and reggae music while living outside of Ethiopia. Some Rastafari have left the Western world behind to repatriate to Ethiopia, believing it to be their homeland and Promised Land, leading to opportunities for cultural exchanges within Ethiopia. Ethiopian musicians work across cultural and linguistic barriers to engage with Rastafari and pan-Africanism through their social interactions and approaches to reggae performance conventions while navigating differences in worldviews. Based on ethnographic research with reggae musicians in Ethiopia, I argue that Ethiopian musicians use different composition and performance techniques to narrate and build on the historical connections between Ethiopia, Jamaica, and Rastafari in ways that articulate and promote a type of transatlantic solidarity informed by pan-African discourse. [ABSTRACT FROM AUTHOR]

The global centenarian population is expected to reach 4 million by 2050, yet little is known about the health status of centenarians in Sub-Saharan Africa. A case study examined the health conditions and functionality of nine Ethiopian centenarians. In-depth interviews revealed that all nine were Orthodox Christians and lived with extended family; eight were male. Aside from minor health complaints, centenarians in rural Ethiopia perceived that their sensory/cognitive functionality was normal until their late 90s. Despite a lack of medical care, the centenarians included two survivors, four delayers, and three escapers. Centenarians in rural Ethiopia were embedded in closely knit, religious, multigenerational households and communities and aspired to live resiliently. These findings call for the consideration of the unique health status of centenarians in Global South nations in their own cultural context. [ABSTRACT FROM AUTHOR]

Background: Early neonatal deaths, occurring within the first six days of life, remain a critical public health challenge. Understanding the trends and factors associated with this issue is crucial for designing effective interventions and achieving global health goals. This study aims to examine the trends in early neonatal mortality in Ethiopia and identify the key factors associated with changes in early neonatal mortality over time. Methods: This study utilized five consecutive Ethiopian Demographic and Health Survey datasets from 2000 to 2019. To investigate the trends and identify factors influencing changes in early neonatal mortality over time, conducted a trend analysis and a logit-based multivariate decomposition analysis. Data management and analyses were performed using STATA version 17/MP software. All analyses were weighted to account for sampling probabilities and non-response. Statistical significance was determined at a two-sided p-value threshold of less than 0.05. Result: The analysis included a total of 12,260 weighted women from the 2000 survey and 5,527 weighted women from the 2019 survey. Over the study period, there was an overall downward trend in early neonatal mortality, decreasing from 34 deaths per 1000 live births in 2000 to 27 deaths per 1000 live births in 2019. The annual rate of reduction was estimated to be 1.03%. Approximately 45% of the observed decline in early neonatal mortality rate can be attributed to changes in population characteristics or endowments (E) during the study period. Factors such as the mother's age, maternal education, marital status, preceding birth interval, types of pregnancy, and the sex of the child significantly contributed to the compositional change in the early neonatal mortality rate. Conclusion: Over the past two decades, Ethiopia has seen a modest decline in early neonatal mortality, but this progress falls short of the Sustainable Development Goal (SDGs) targets. To achieve the SDGs, the Ministry of Health and its partners should intensify efforts to reduce early neonatal mortality. Strategies like preventing early/late pregnancies, promoting appropriate marriage timing, and prioritizing education could help further reduce early neonatal deaths. Further research is also needed to explore the factors driving this issue. [ABSTRACT FROM AUTHOR]

Background: Breast milk is the first, highly valuable, and solely natural food recommended for infants in their first six months of life, which is critical for children's overall growth and development. Evidence suggests that exclusive breastfeeding differs by geographic area in Ethiopia. However, little is known regarding the geographic distribution of exclusive breastfeeding practice. Hence, this study aimed to assess exclusive breastfeeding practice, its geographic variation and associated factors among Ethiopian mothers. Method: The study used the 2019 Ethiopian mini demographic and health survey data. All living children born 0–23 months before the survey were included. Global Moran's I statistics on Arc-GIS and Getis Ord Gi* statistics was used to visualize the spatial pattern and hotspot and cold spot areas, respectively. Kulldorff SaTScan was used to show purely significant spatial clusters. The associated factors were identified using a multilevel mixed-effects logistic regression model. Statistically significant factors were reported using the AOR with a 95% CI and a p-value of < 5%. Result: The coverage of exclusive breastfeeding practice in Ethiopia was 56.05% (95% CI: 53.95%, 58.10%). The spatial pattern was non-random across the country's regions. Somalia, Gambela, Benshangul Gumuz, Dire Dawa, and Harari regions had low clustering of exclusive breastfeeding practices, whereas Amhara, Eastern SNNPR, and Central and Northern Oromia regions had high clustering. Children born through caesarean delivery [AOR = 0.36; 95% CI: 0.21, 0.63], initiated breastfeeding within the first 1 h [AOR = 0.55; 95% CI: 0.34, 0.90], after 1–24 h of delivery [AOR = 0.36; 95% CI: 0.24, 0.54], after a day [AOR = 0.04; 95% CI: 0.02, 0.08], and women residing in the pastoralist region [AOR = 0.22; 95% CI: 0.12, 0.39] or city administrations [AOR = 0.49; 95% CI: 0.27, 0.89] had lower odds of exclusive breastfeeding practice. Conclusion: Exclusive breastfeeding practice in Ethiopia remained low. The practice had a spatial variation across the country. Caesarean section delivery, late breastfeeding initiation, and region were statistically significant variables. Therefore, promoting timely initiation of breastfeeding and improving the utilization of maternal health services and designing special intervention strategy for women residing in city administrations and pastoralist regions of the country may increase the coverage of exclusive breastfeeding practice. [ABSTRACT FROM AUTHOR]

Background: Contraceptive usage in Ethiopia is significantly influenced by the decision-maker at the household level. Joint decision-making involving both women and their husbands/partners is considered ideal for improving contraceptive uptake among women and for managing health outcomes related to contraceptive side effects. However, there is a lack of substantial evidence regarding the prevalence and impact of joint decision-making on contraceptive use in Ethiopia. Therefore, the current study aimed to assess the magnitude of joint decision-making on contraceptive use and its determinant factors among married, contraceptive-using, reproductive-age women in Ethiopia. Methods: This study was conducted based on the Ethiopian Demographic and Health Survey (EDHS) 2016 data. A total weighted sample of 3,669 married, contraceptive-using, reproductive-age women were included in the study. Multilevel logistic regression was employed due to the hierarchical nature of the data. Variables with a p-value of ≤ 0.2 in the bivariate multilevel analysis were included in the multivariable multilevel analysis. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to determine the direction and strength of associations. Variables with a p-value of < 0.05 in the multivariable multilevel analysis were considered statistically significant for joint decision-making on contraceptive use. Results: The prevalence of joint decision-making on contraceptive use in Ethiopia was 78.81% [95% CI: 71.35-74.23%]. Several factors were found to be statistically significant in relation to joint decision-making on contraceptive use: Women educational level primary, secondary, and higher (Adjusted odds' ratio (AOR = 1.5; CI 1.2–1.9), (AOR = 1.9; CI 1.3–2.9), and (AOR = 2.1; CI 1.2–3.5) respectively, protestant in religion (AOR = 1.7; CI 1.7–2.5), wealth status rich (AOR = 1.4; CI 1.1–1.9), media exposure (AOR = 1.4; CI 1.1–1.9), and community poverty high (AOR = 0.6; CI 0.6–0.9). Conclusions: In Ethiopia, the majority of contraceptive users are married, reproductive-age women, and their decision to use contraceptives is typically made jointly with their husbands or partners. Factors positively associated with joint decision-making on contraceptive use include women's educational level (primary, secondary, and higher), being Protestant, having a higher wealth status, and media exposure. Conversely, women living in communities with high poverty levels are less likely to make joint decisions about contraceptive use. Health care providers, health care programmers and policy makers should be focused on these determinant factors to enhance joint decision-making in women's contraceptive use in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: While evidence-based practice has demonstrated its capacity to enhance healthcare quality and bolster clinical outcomes, the translation of research into clinical practice encounters persistent challenges. In Ethiopia, there remains a dearth of comprehensive and nationally representative data concerning the extent of Evidence-based practice adoption among nurses. Thus, this systematic review and meta-analysis endeavors to assess the overall prevalence of Evidence-based practice implementation and delve into its determinants among Ethiopian nurses. Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines. In order to identify pertinent studies, a search was conducted across PubMed, Scopus, Google Scholar, and EMBASE databases. A weighted inverse variance random-effects model was employed to estimate the pooled prevalence. Cochrane's Q-test and I2 statistics were calculated to assess heterogeneity among studies. Funnel plots and Egger's test were utilized to evaluate publication bias. Pooled implementation rates and meta-regression analysis were carried out using STATA 17. Results: Of the total 1,590 retrieved articles, twelve studies including 4,933 nurses were included in the final analysis. The pooled prevalence of Evidence-based practice uptake among nurses in Ethiopia is 53% (95% CI: 46%-60%). Having knowledge about Evidence-based practice (AOR = 2.29; 95% CI: 1.90, 2.69; I2 = 70.95%), holding a favorable attitude towards Evidence-based practice (AOR = 2.56; 95% CI: 1.63, 3.49; I2 = 88.39%), occupying a head nurse position (AOR = 3.15; 95% CI: 1.85, 4.46; I2 = 87.42%), possessing effective communication skills (AOR = 4.99; 95% CI: 1.47, 8.51; I2 = 99.86%), and having access to Evidencebased practice guidelines (AOR = 1.90; 95% CI: 1.55, 2.24; I2 = 57.24%) were identified as predictors of the uptake of Evidence-based practice. Conclusion: Only half of Ethiopia's nurses exhibit a strong embrace of Evidence-Based Practice within clinical settings, underscoring the urgent necessity for coordinated endeavors to cultivate this essential practice. Possessing knowledge, effective communication skills, access to updated guidelines, maintaining a positive attitude towards Evidence-Based Practice, and holding a position as head nurse emerged as predictors of successful implementation of Evidence-Based Practice. Hence, policymakers must prioritize capacity-building initiatives, disseminate the latest EBP guidelines widely, and strengthen mentorship roles for head nurses. [ABSTRACT FROM AUTHOR]

Background: Undiagnosed diabetes mellitus poses a significant global public health concern, exerting a substantial impact on the well-being of individuals, their families, and societies at large. Those individuals with undiagnosed diabetes miss opportunities to maintain quality of life and prevent diabetes-related complications. Even if there are ample primary studies on undiagnosed diabetes in Ethiopia, the results reveal conflicting results. Therefore, a comprehensive national picture of undiagnosed diabetes is essential for designing effective strategies at the national level. Methods: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for prevalence studies (PROSPERO ID: CRD42021266676). PubMed, Web of Science and the World Health Organization's Hinari portal were searched using a strategy developed in collaboration with Liberians. The inclusion criteria comprised studies reporting undiagnosed diabetes in Ethiopia. Two independent reviewers conducted a quality assessment using a 10-item appraisal tool. Meta-analysis and metaregression were performed using a random-effects model. Result: Twenty-five studies with 22,193 participants met the inclusion criteria. The pooled prevalence of undiagnosed diabetes among the Ethiopian adult population was 5.68% (95% CI: 4.53 - 6.83, I² = 75.4). Factors significantly associated with undiagnosed diabetes include age, waist circumference, overweight, family history of diabetes, and a history of hypertension. Conclusion: Our systematic review found a noteworthy prevalence of undiagnosed diabetes in Ethiopia. The majority of factors linked with undiagnosed diabetes in this review were modifiable. This underscores the importance of targeted factors and public health interventions to improve early detection and reduce the burden of undiagnosed diabetes and its complications in Ethiopia. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasound imaging is an important aspect of antenatal care, though access to antenatal ultrasound imaging is limited in many developing countries. The objective of this study was to evaluate a pilot programme which aimed to improve access to antenatal ultrasound for rural Ethiopians through enhanced training of healthcare providers (including midwives, nurses and clinical officers) with support remotely provided by obstetricians using a tele-ultrasound platform. Methods: Thirteen healthcare providers in the North Shoa Zone in Ethiopia completed training to enable them to perform antenatal ultrasound with the remote supervision of an obstetrician via a tele-ultrasound platform. Pregnant women attending an antenatal appointment at two facilities were offered an antenatal ultrasound exam performed by one of the healthcare providers. Image interpretations between obstetricians and healthcare providers were compared. Participants and healthcare providers were invited to complete a questionnaire regarding their experience with tele-ultrasound, and participants, healthcare providers and obstetricians were interviewed regarding their experience with the tele-ultrasound pilot programme. Results: 2795 pregnant women had an antenatal ultrasound exam. Of 100 exams randomly selected to assess concordance between healthcare providers' and obstetricians' image interpretations, concordance ranged from 79% to 100% for each parameter assessed. 99.4% of participants surveyed indicated that they would recommend antenatal ultrasound using tele-ultrasound to friends and family. Themes relating to participants' experiences of having a tele-ultrasound exam were reduced travel and cost, equivalence in quality of virtual care to in-person care and empowerment through diagnostic information. Conclusion: Healthcare provider–performed antenatal ultrasound – supported by obstetricians via tele-ultrasound – showed high levels of concordance, was well-received by participants and provided rural Ethiopian women with enhanced access to antenatal imaging. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections (STI) are public health problems in Ethiopia. Women have a higher chance of acquiring STI. STI complications are more severe in women compared to men. Despite that, treatment seeking for STI among women is poor. Woman empowerment and gender related factors may be playing a role for treatment seeking practice for STI. However, there are no studies that assess the association between these factors and treatment seeking practice for STI among married reproductive age women in Ethiopia. Therefore, this analysis was designed to explore this association in Ethiopia. Methods: This analysis used the 2016 Ethiopian demographic and health survey (EDHS) data. The 2016 EDHS collected data about STI treatment seeking practice for STI among other variables. Data was analyzed using STATA 17.0. Sampling weights were applied to improve the representativeness of the samples. Descriptive statistics were computed to describe the characteristics of the women. Binary and multivariable logistic regression models were fitted to identify the association between treatment seeking practice for STI and predictor variables. Multicollinearity was checked using variance inflation factors before running the multivariable logistic regression. Results: In this study, about 28% (95%CI: 20.87, 36.77) married reproductive age women with STI or STI symptoms sought treatment from the formal sector. Women whose husband attended secondary and higher education (AOR, 8.52; 95%CI 1.42, 51.21), and women with higher women empowerment scores (AOR 1.38, 95%CI 1.06, 1.81) had higher odds of treatment seeking for STI or STI symptoms. On the other hand, women who believe wife beating is justified had lower odds (AOR 0.32; 95%CI 0.15, 0.68) of treatment seeking for STI or STI symptoms. Conclusions: Treatment seeking practice for STI among married reproductive age women in Ethiopia is low. The Ministry of Health and development partners shall conduct further research to identify barriers for treatment seeking practice. Gender variables (women empowerment and belief that wife beating is justified) were significantly associated with STI treatment seeking practice among married reproductive age women. STI prevention and control strategies shall include women empowerment and gender issues as essential component in STI prevention, treatment, and control activities. [ABSTRACT FROM AUTHOR]

Background: Diabetes is a major health concern globally and in Ethiopia. Ensuring optimal diabetes management through minimizing drug therapy problems is important for improving patient outcomes. However, data on the prevalence and factors associated with unmet drug-related needs in patients with diabetes in Ethiopia is limited. This systematic review and meta-analysis aims to provide a comprehensive analysis of the prevalence of unmet drug-related needs among patients with diabetes mellitus in Ethiopia. Methods: A thorough exploration of databases, including PubMed, Scopus, Hinari, and Embase and Google Scholar, was conducted to identify pertinent studies. Inclusion criteria involved observational studies that reported the prevalence of unmet drug-related needs in Ethiopian patients with diabetes. The quality of the studies was assessed using Joanna Briggs Institute (JBI) checklists. A random-effects meta-analysis was employed to amalgamate data on study characteristics and prevalence estimates, followed by subsequent subgroup and sensitivity analyses. Graphical and statistical assessments were employed to evaluate publication bias. Results: Analysis of twelve studies involving 4,017 patients revealed a pooled prevalence of unmet drug-related needs at 74% (95% CI 63-83%). On average, each patient had 1.45 unmet drug-related needs. The most prevalent type of unmet need was ineffective drug therapy, 35% (95% CI 20-50). Type 2 diabetes, retrospective study designs, and studies from the Harari Region were associated with a higher prevalence. Frequently reported factors associated with the unmet drug-related needs includesmultiple comorbidities, older age, and polypharmacy. Notably, the results indicated significant heterogeneity (I² = 99.0%; p value < 0.001), and Egger's regression test revealed publication bias with p<0.001. Conclusion: The prevalence of unmet drug-related needs among diabetes patients with diabetes in Ethiopia is high with the most prevalent issue being ineffective drug therapy. Targeted interventions are needed; especially patients on multiple medications, advanced age, with comorbidities, and prolonged illness duration to improve diabetes management and outcomes. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42024501096. [ABSTRACT FROM AUTHOR]

Background: Identification of neonatal danger signs and immediate access to health care are two global efforts aimed at enhancing newborn and child survival by preventing 75% of neonatal deaths. Despite various small-scale studies on women's awareness of neonatal danger signs in Ethiopia, little is known about the level of receiving health information on those danger signs during the immediate postpartum period at the national level. Hence, this study aimed at assessing the level, and its determinants of the service uptake in Ethiopia. Methods: The data for this study was taken from the Ethiopian Demographic and Health Survey (EDHS), which took place from January to June 2016 and covered all administrative regions of Ethiopia. A weighted sample of 7,589.8 women was analyzed using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was employed to determine the effects of each predictor on the outcome variable. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the explanatory variables. Results: The receipt of health information on neonatal danger signs during the immediate postpartum period was 10.70% [95% CI:10.01, 11.40]. Variables namely living in Metropolitans [AOR = 2.06; 95%CI: 1.48, 2.88] and Large central [AOR = 1.83; 95%CI: 1.38, 2.42] regions, being in the highest wealth quintile [AOR = 1.87; 95% CI: 1.23, 2.84], being nulliparous [AOR = 0.27; 95% CI: 0.08, 0.87] and primiparous[AOR = 0.61;95% CI: 0.46, 0.79], getting adequate antenatal visits [AOR = 2.42; 95% CI: 1.75, 3.33], institutional delivery [AOR = 5.91; 95% CI: 4.66, 7.53], and receipt of postnatal visits [AOR = 3.52; 95% CI: 2.84, 4.38] were identified as significant determinants of receiving health information on newborn danger signs. Conclusion: The findings revealed that unacceptably low uptake of health information on newborn danger signs during the immediate postpartum period in Ethiopia. A concerted effort is needed from all stakeholders in the health sector to enhance the uptake of maternal health services (antenatal care, skilled delivery service, and postnatal care). Healthcare providers should pay special attention to nulliparous and primiparous women during and after delivery, and the government should also focus on women of peripheral regions, who make up a large portion of the low coverage. [ABSTRACT FROM AUTHOR]

This paper theorizes the gendered consequences of refugee dispossession for social reproduction, focusing on Ethiopian refugees in Nairobi, Kenya. We analyze the Kenyan refugee regime as structured by colonial legacies of racialization and by neo-colonial global political economy strategies of managing 'surplus' populations. We demonstrate that refugees' ongoing experiences of interpersonal and structural violence constitutes an attack on their capacity for social reproduction and argue the 'feminization of refugee survival' is an important gendered consequence. We identify two transnational displacements that produce a new form of racialized enclosure and the alienation of refugees from the means of social reproduction. The first transnational displacement occurs due to their dispossession from support infrastructure for social reproduction in their origin country, and in the host country. A second, invisible but racialized transnational displacement is the refusal of global North countries to take on the anticipated welfare costs of refugee social reproduction. Transformative and re-generative approaches to refugee social reproduction would need to address both forms of displacement. The paper thus urges IPE scholarship to recognize that the crisis of refugee social reproduction is not only produced by global capitalist regimes, but also deeply structured by gendered, racialized, and colonial hierarchies of inequality. [ABSTRACT FROM AUTHOR]

Introduction: Collaboration is gaining prominence in the priority setting of Health Policy And System Research (HPSR). However, its practice and challenges are not well explored in Ethiopia. Understanding the practice and barriers of collaborative Health Policy and System Research will help design approaches and platforms for setting inclusive and participatory policy and system-level health research topics. This paper explores the practice and barriers of collaborative HPSR-priority setting exercise in Ethiopia. Methods: This study investigates the practice and barriers of collaborative health policy and system research priority-setting exercises in Ethiopia. Utilizing a mixed-methods approach, we conducted Key Informant Interviews (KIIs) and an online self-administered survey with open-ended questionnaires to capture diverse perspectives from stakeholders involved in the research priority-setting process. Through conventional content analysis, we identified key contents related to current practices, challenges, and opportunities for enhancing collaboration in health policy and system research prioritization. Results: Our findings reveal a complex landscape characterized by varying levels of stakeholder engagement, institutional capacity constraints, and competing priorities within the health research ecosystem. Despite notable efforts to foster collaboration, stakeholders identified persistent challenges such as limited resources, institutional fragmentation, and inadequate coordination mechanisms as barriers to effective priority-setting processes. The implications of our research extend beyond academic discourse, with direct relevance to health policy and system research practice in Ethiopia. By shedding light on the dynamics of collaborative priority-setting exercises, our findings offer valuable insights for policymakers, researchers, and practitioners seeking to enhance the effectiveness and inclusivity of health research prioritization processes. Addressing the identified barriers and leveraging existing strengths in the research ecosystem can contribute to more evidence-informed health policies and programs, ultimately improving health outcomes for Ethiopian populations. Conclusions: Most institutions do not apply health policy and system research-priority setting to conduct informed decision-making. The barriers explored were weak integration, lack of knowledge, system, and platforms for the priority setting of Health Policy and System Resreach. So, it is recommended to build skills of different actors in the Health Policy and System Research-priority setting exercise and design a system and platform to integrate different stakeholders for collaborative research topics priority setting. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia. Methods: A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15–49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test. Result: The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20–24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25–29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30–34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35–39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40–44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45–49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42–3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV. Conclusion and recommendation: This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences. [ABSTRACT FROM AUTHOR]

Background: Infertility remains a serious health concern for Ethiopian women. Most of its treatment approaches entail controlled ovarian stimulation, the responses of which vary. However, there are no data on ovarian response to stimulation or its predictors in our situation. Thus, the current study aimed to assess the ovarian response to controlled stimulation and identify predictors. Methods: A retrospective follow-up study was undertaken from April 1, 2021, to March 31, 2022, among patients who had first-cycle controlled ovarian stimulation at St.Paul's Hospital Fertility Center in Addis Ababa, Ethiopia. Clinical data were extracted using a checklist. SPSS-26 for data analysis and Epidata-4.2 for data entry were employed. The binary logistic regression model was fitted. A p-value < 0.05 indicated a significant association. The ROC curve was used to determine cutoff values and identify accurate predictors. Results: A total of 412 study participants were included in the final analysis. The patients had a mean age of 32.3 ± 5.1 years (range: 20 − 4). The good ovarian response rate was 67% (95% CI: 62.2–71.5). An anti-Mullerian hormone (AMH) concentration < 1.2ng/ml (AOR = 0.19, 95% CI (0.06–0.57)), an antral follicle count (AFC) < 5 (AOR = 0.16, 95% CI (0.05–0.56)), and an induction length < 10 days (AOR = 0.23, 95% CI (0.06–0.93)) were significantly associated with ovarian response. The prediction accuracies for the AFC and AMH concentrations were 0.844 and 0.719, respectively. The optimal cutoff point for prediction was 5.5 AFC, which had a sensitivity of 77.2% and a specificity of 72.8%. However, its positive and negative predictive values were 85.2% and 61.1%, respectively. For AMH, the optimal cutoff value was 0.71ng/mL, with a corresponding sensitivity and specificity of 65.2% and 66%. At this value, the positive and negative predictive values were 63.8% and 67.3%, respectively. Conclusion: Only two-thirds of our patients achieved a good ovarian response. Induction duration, AMH concentration, and AFC were found to be predictors, with the AFC being the strongest predictor. Therefore, the AFC should be performed on all of our patients, and the AMH is selectively employed. Future research must verify the best cutoff points and investigate additional factors affecting ovarian response. [ABSTRACT FROM AUTHOR]

Background: Composite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess undernutrition status of children. There is no study on CIAF to identify the real and severe form of under nutrition among Ethiopian children that addressed community level factors. So, this study determined CIAF and identified important factors which helps to design appropriate intervention strategies by using multi-level advanced statistical model. Methods: The study included 5,530 under five children and utilized a secondary data (EMDHS 2019) which was collected through community-based and cross-sectionally from March 21 to June 28, 2019. Composite index of anthropometric failure among under five children was assessed and a two-stage sampling technique was used to select the study participants. Descriptive summary statistics was computed. A multi-level binary logistic regression model was employed to identify important predictors of CIAF in under five children. Adjusted odds ratio with its 95% CI was estimated and level of significance 0.05 was used to determine significant predictors of CIAF. Results: The prevalence of composite index of anthropometric failure (CIAF) was 40.69% (95% CI: 39.41, 42.00) in Ethiopia. Both individual and community level predictors were identified for CIAF in under five children. Among individual level predictors being male sex, older age, short birth interval, from mothers who have not formal education, and from poor household wealth quintile were associated with higher odds of CIAF among under five children. Low community women literacy and being from agriculturally based regions were the community level predictors that were associated with higher odds of CIAF in under five children in Ethiopia. Conclusions: The burden of composite index of anthropometric failure in under five children was high in Ethiopia. Age of child, sex of child, preceding birth interval, mother's education, household wealth index, community women literacy and administrative regions of Ethiopia were identified as significant predictors of CIAF. Therefore, emphasis should be given for those factors to decrease the prevalence of CIAF in under five children in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Approximately 80% of the Ethiopian population predominantly depends on herbal medicines (HMs) for their primary healthcare needs. Nevertheless, worries regarding the safety, efficacy, and standard of herbalbased treatments have been escalating due to the lack of strong regulatory frameworks. Therefore, the study aimed to assess the presence of regulatory frameworks for traditional herbal medicines and their enforcement in Ethiopia. Methods: The qualitative-phenomenological study design was conducted from November 2021 to March 2022 G.C. The study included 25 regulatory official key informants (KIs) who work for national and regional medicine regulatory agencies, and 15 traditional herbal medicine (THM) practitioners who work at the regional level were purposefully selected for an in-depth interview (IDI). An indepth interview guide was developed through the purposive sampling technique. The collected data were analyzed using thematic content analysis techniques. Results: The study found that the current national medicine proclamation is deemed inadequate in the regulation of THM. Both conventional and traditional herbal medicines are regulated by a single agency. Weak legal enforcement, a lack of government commitment and support, resource constraints, and inadequate regulatory tools are the main challenges faced in THM regulation. Conclusion: Overall, the study found inadequate legal frameworks and weak THM regulatory implementations in Ethiopia. Consequently, it is critical for all regulatory authorities in Ethiopia to exert their utmost efforts to effectively regulate THM. [ABSTRACT FROM AUTHOR]

Background: A child's transition to complementary food (CF) feeding is important, and it should be ensured that CF is prepared, stored, and fed in a hygienic manner using clean hands, dishes, and utensils to prevent infections. However, there are no comprehensive review statistics available at the national level. Hence, the aim of this study is to determine the hygienic practices of complementary food preparation and its factors among Ethiopian women with children between the ages of 6 and 24 months. Methods: On the nationwide prevalence of hygienic practices during the preparation of complementary foods and their determinants among mothers of children aged 6-24 months in Ethiopia, a systematic review and meta-analysis were performed. We searched in PubMed, ScienceDirect, Scopus, African Journal Online (AJOL), Google Scholar, and the websites to identify studies that were published until March 2023. We performed this review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A random-effects meta-analysis was done using StatsDirect statistical software and Open Meta Analyst to estimate the prevalence of hygienic practices, and the results were reported in a forest plot. Simple charts and tables were used to summarize the evidence on complementary food preparation and determinates. Results: Nine studies involving 4,403 mothers were included in this Ethiopian study. The overall prevalence of good hygienic practices during complementary food preparation among mothers who have children aged 6-24 months was 46.53% (95% CI: 28.13-64.94) (p < 0.0001). Having a separate kitchen (AOR = 6.78; 95% CI: 1.04-44.20), having a three-bowl washing facility in their houses (AOR = 10.61; 95% CI: 7.31-15.41), mothers' access to media (AOR = 4.81; 95% CI: 1.23-18.82), and urban residence (AOR = 4.78; 95% CI: 2.73-8.38) were the predictors of good hygienic practice during complementary food preparation. Conclusion: Regarding the prevalence of hygienic procedures among the mothers of children aged 6-24 months nationwide when preparing complementary foods, there is a significant lack of hygienic behavior among Ethiopian mothers. Hence, the Ethiopian ministries of health focus on designing complementary food guidelines for the prenatal healthcare system. Furthermore, health extension workers are also better advised to maintain food hygiene during prenatal care visits, which is recommended to improve good hygienic practices during complementary food preparation in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: The Family Guidance Association of Ethiopia (FGAE) operates as a non-governmental organization dedicated to offering family planning and reproductive health services to the Ethiopian population. The gap in the study regarding client satisfaction and contributing factors towards sexual and reproductive health services for youth at FGAE clinics highlights the need for a comprehensive investigation to fill this void. By conducting a mixed-method study, this research aims to provide a holistic understanding of the factors influencing client satisfaction in the delivery of sexual and reproductive health services to youth at FGAE clinics. The added value of this study lies in its potential to offer valuable insights and recommendations for improving service delivery systems and enhancing client satisfaction levels, ultimately contributing to the overall well-being and health outcomes of youth in North Ethiopia. Therefore study aimed to asses Client Satisfaction and Contributing Factors towards in sexual and reproductive health services delivery system among youth at Family Guidance Association of North Ethiopia (FGAE) Clinics, 2023. Method: The study was conducted within the clinics of the Family Guidance Association of Ethiopia (FGAE), spanning Dessie, Kombolcha, and Woldia city administrations, involving a participant cohort of 416 clients. Facility-based concurrent type mixed method study design both quantitative and qualitative techniques were applied. Quantitative research employed a simple random sampling technique and conversely, the qualitative study utilized a heterogeneous type of purposive sampling strategy to recruit participants The collected data underwent a rigorous process of entry, cleaning, and coding using Epi-Data 4.6 software, followed by analysis in STATA V17. Descriptive statistics and binary logistic regression were employed to highlight the impact of independent variables on the dependent variable. A more comprehensive examination was provided through multivariable logistic regression. Crude and adjusted odds ratios, along with a 95% confidence interval, were computed, with significance set at a p-value ≤ 0.05. Result: Nearly more than half of the clients 194 (47.8%) came to receive family planning services followed by maternal and child health 107 (26.4%). Sixty patients (14.8%) didn't receive all the services they wanted or came for. Half of the participants 30 (50%) raised the unavailability of the service as a reason for not taking the service followed by not having enough time in the clinic 12 (20%). About 65.52% (60.74-70.00%) of the participants were satisfied with the Sexual and Reproductive Health services provided by the clinics of FGAE in northeast Ethiopia. Clients in the age group of 25–34 (AOR = 2.04; 95%CI: 1.11–3.72). Clients who had primary and secondary education (AOR = 2.49; 95%CI: 1.03–6.02) and (AOR = 3.05; 95%CI: 1.25–7.49) respectively. Clients who responded that physicians show respect (AOR = 5.59; 95%CI: 1.89–16.49). clients who received an explanation about the side effects of the utilized methods and follow-up dates (AOR = 4.59;95%CI:1.68–12.53) and (AOR = 2.89;95%CI:1.53–5.49) respectively. Conclusion: The proportion of client satisfaction with Client Satisfaction in the Services delivery system at Family Guidance Association of Ethiopia (FGAE) Clinics was low as compared to the previous study. Age group 25–34 years, primary and secondary education, showing respect, explaining side-effects and follow-up visits were significant associated factors of client service satisfaction. Enhancing service delivery at Family Guidance Association of Ethiopia (FGAE) Clinics by targeting specific areas identified in the study. Strategies should focus on improving communication regarding side effects, ensuring respectful interactions, and prioritizing follow-up visits, particularly for clients aged 25–34 with primary and secondary education backgrounds. [ABSTRACT FROM AUTHOR]

Rifampicin, a key drug against tuberculosis (TB), displays wide between-patient pharmacokinetics variability and concentration-dependent antimicrobial effect. We investigated variability in plasma rifampicin concentrations and the role of SLCO1B1, ABCB1, arylacetamide deacetylase (AADAC) and carboxylesterase 2 (CES-2) genotypes in Ethiopian patients with TB. We enrolled adult patients with newly diagnosed TB (n = 119) who had received 2 weeks of rifampicin-based anti-TB therapy. Venous blood samples were obtained at three time points post-dose. Genotypes for SLCO1B1 (c.388A > G, c.521T > C), ABCB1 (c.3435C > T, c.4036A > G), AADACc.841G > A and CES-2 (c.269-965A > G) were determined. Rifampicin plasma concentration was quantified using LC-MS/MS. Predictors of rifampicin Cmax and AUC0–7 h were analysed. The median rifampicin Cmax and AUC0–7 were 6.76 µg/mL (IQR 5.37–8.48) and 17.05 µg·h/mL (IQR 13.87–22.26), respectively. Only 30.3% of patients achieved the therapeutic efficacy threshold (Cmax>8 µg/mL). The allele frequency for SLCO1B1*1B (c.388A > G), SLCO1B1*5 (c.521T > C), ABCB1 c.3435C > T, ABCB1c.4036A > G, AADAC c.841G > A and CES-2 c.269-965A > G were 2.2%, 20.2%, 24.4%, 14.6%, 86.1% and 30.6%, respectively. Sex, rifampicin dose and ABCB1c.4036A > G, genotypes were significant predictors of rifampicin Cmax and AUC0–7. AADACc.841G > A genotypes were significant predictors of rifampicin Cmax. There was no significant influence of SLCO1B1 (c.388A > G, c.521T > C), ABCB1c.3435C > T and CES-2 c.269-965A > G on rifampicin plasma exposure variability. Subtherapeutic rifampicin plasma concentrations occurred in two-thirds of Ethiopian TB patients. Rifampicin exposure varied with sex, dose and genotypes. AADACc.841G/G and ABCB1c.4036A/A genotypes and male patients are at higher risk of lower rifampicin plasma exposure. The impact on TB treatment outcomes and whether high-dose rifampicin is required to improve therapeutic efficacy requires further investigation. [ABSTRACT FROM AUTHOR]

Political parties and their internal working policy and pattern of interactions have a profound impact on the operation of federations and the character of intergovernmental relations (IGR). By using the Ethiopian party system as a case study, this article aims to explore the impacts of party ideology, structure and style of functioning on the overall operation of a federation and the (de)institutionalisation of intergovernmental relations. It shows that the party structure, internal practices and ideological conviction of two parties—the Ethiopian People's Revolutionary Democratic Front (EPRDF) and the Prosperity Party (PP)—have shaped and reshaped the functioning of the Ethiopian federation and the dynamics of vertical and horizontal relations. At the same time, constitutional and IGR principles have been sidelined. There is a need to entrench stable and formal IGR frameworks for negotiation, the exchange of information and co-operation between federal and sub-state institutions. Reducing excessive reliance on the party line is essential to optimise the regularity, continuity and effectiveness of the interactions. [ABSTRACT FROM AUTHOR]

Spurred by international commitments to address age- and gender-based violence, this article uses a capabilities framework to address an important data gap on violence against adolescents in Ethiopia. It draws on mixed-methods data collected in 2019/2020 in three diverse rural regions. This includes surveys completed by 5539 girls and boys as well as 819 qualitative interviews with adolescents, caregivers, community members, and service providers. We find that threats to adolescents' bodily integrity are shaped by a complex interplay of age, gender, and socio-cultural environment. Girls are less able than boys to enjoy freedom of movement and control over their bodies, and age-related violence is often deeply gendered in ways that are context specific. Differences in service provisioning augment already large gaps between adolescents in different regions. To tackle threats to adolescents' bodily integrity, awareness-raising efforts need to be twinned with improved access to education, health, social protection, and justice services. [ABSTRACT FROM AUTHOR]

Recent research suggests a significant rise in both international and intra-African migrations, with South Africa emerging as the primary destination for irregular migrants in the region. However, the phenomenon of irregular migration to South Africa has received limited attention despite the growing number of migrants hosted by the country. To address this gap, this study adopts a concurrent cross-sectional mixed-methods approach to explore the patterns of inter-state irregular migration in Africa, specifically focusing on Ethiopian migrants to the Republic of South Africa (RSA). The investigation draws on quantitative data collected from 316 migrant returnees, as well as qualitative in-depth interviews and focus-group discussions. The findings of this study reveal that there is a decline in the patterns of Ethiopian irregular migration to the RSA within the past decade due to tight legal restrictions. The COVID-19 pandemic has had a significant impact on the pattern of irregular migration, leading to a decline in the number of migrants from mid-2018 to 2020 due to stringent border closures. Irregular migration to the RSA tends to be temporary, with an increasing migrants returning to their home country once they have achieved economic success or as they encountered precarious conditions at the destination. Addressing the root causes that drive migration, improving border control mechanisms, and implementing inclusive integration strategies are key steps toward minimizing the risks and maximizing the benefits associated with this migration phenomenon. [ABSTRACT FROM AUTHOR]

Introduction: Indigenous education has recently gained prominence in international debates for its role in addressing the social, economic, and political issues faced by African states. Ethiopia, like other African countries, had its education system based primarily on the transmission of socio-professional aptitudes, religious values, skills, and intergenerational knowledge as a way to preserve the social, cultural, and religious values of the Ethiopian community. In the early 20th century, Ethiopia wholeheartedly adopted a Western higher education system in a tabula rasa approach that sought to obliterate deeply rooted cultural norms and rapidly transition the country's traditional religious system to a secular one. Methods: This qualitative study used semi-structured interviews to explore the perspectives of Ethiopian university teachers about the benefits and limitations of traditional education and the potential to integrate traditional and modern education in Ethiopian universities. Results: Study findings show that, despite agreement that "traditional" education is distinct from other educational systems, there are varying notions of what constitutes "indigenous" education. Participants also suggested that the dominant rationale for the tabula rasa approach in Ethiopian modern education was to modernise the country and embrace a global perspective on education that incorporates ideas and advances from other cultures while still being firmly entrenched in local values and educational systems. Discussion: Insights have implications for education systems in African and other low- and middle-income countries (LMICs) in terms of developing strategies for the pluralistic approach to knowledge systems. [ABSTRACT FROM AUTHOR]

The Ethiopian empire retained its political independence through the European Scramble for Africa. The imperial elites oversaw the transformation of the empire into a territorially-bounded state, part of an international system of states regulated by international law and by international institutions such as the League of Nations, and later the UN. Ethiopian intellectuals were keenly aware that Ethiopia had joined this international system from a subordinated position and that its sovereignty remained at risk. The struggle for sovereignty was fought not only at a diplomatic level, but also at a narrative level. Afäwärḳ Gäbrä-Iyyäsus's 1908 Traveller's Guide to Abyssinia and Käbbädä Mikael's 1949 Ethiopia and Western Civilisation pushed back against the European depiction of Ethiopia as intrinsically inferior and intrinsically unable to develop. Both Afäwärḳ and Käbbädä rejected the rigid determinism of stagist models of development, and argued that Ethiopia and Europe were natural allies by virtue of their shared Christian heritage. Global power hierarchies rigidified Ethiopia's domestic power hierarchies. The article shows how the way in which Afäwärḳ and Käbbädä defended Ethiopia's place in an unequal world had important consequences on their vision of domestic nation building, resulting in hierarchical assimilationist policies that marginalised Ethiopia's non-Christian citizens. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between spousal discordance or concordance khat use and women's experience of emotional abuse, physical, and sexual violence. A cross-sectional data from Ethiopia's Demographic and Health Survey (EDHS-2016 that included couple's data (n=2734) was used. Overall, 21.2%, 95% CI (18.3, 24.4) were discordant khat users (either couple use) and 11.8%, 95% CI (8.9, 15.5) were concordant khat users (both). Among married/partnered women, 22.5%, 95% CI (19.8, 25.3), 22.3%, 95% CI (19.8, 24.9) and 9.6%, 95% CI (7.9, 11.7) reported to have ever experienced emotional abuse, physical abuse, or sexual abuse, respectively. Concordant couple's khat use was significantly (OR=2.67, 95% CI (1.55, 4.61) associated with self-reported experience of physical violence by women. In the context of widespread use of khat in Ethiopia, couples' khat use may have a potential to be a risk factor for intimate partner violence. Efforts to reduce intimate partner violence in Ethiopia may benefit from incorporating strategies for reducing khat use and addiction. [ABSTRACT FROM AUTHOR]

Introduction: Loss of follow-up (LTFU) from ART regular follow-up is one of the key acknowledged causes for the development of ART-resistant virus strains currently. It becomes a major weakness for the successful implementation of HIV care and treatment programs mainly in Sub-Saharan Africa but also globally. About 20—40% of children on ART loss their regular ART follow-up annually. Because of the inconsistency of the prior publications' findings, policymakers, programmers, and healthcare providers find it difficult to intervene. Hence, this study was conducted to provide a pooled incidence and identify the predictors of LTFU among children on ART in Ethiopia. Methods: Articles were searched from PubMed/ MEDLINE, CINAHL, EMBASE, Google Scholar, and Science Direct, as well as organizational records and websites. This review included both retrospective and prospective follow-up studies published in English. The data were extracted using Microsoft Excel and exported into Stata™ Version 17.0 for further processing and analysis. The presence of heterogeneity was assessed using forest plots with the I2 test. To identify the source of heterogeneity subgroup analysis, meta-regression, publication bias, and sensitivity analysis were computed. The pooled incidence of LTFU was estimated using a random effects meta-analysis model with the DerSimonian-laired method. To identify the predictors, a 95% confidence interval with relative risk was used to declare the presence or absence of an association. Results: In this systematic review and Meta-analysis, nine studies with a total of 3336 children were included. The pooled incidence of LTFU from ART was 5.83 (95% CI: 3.94, 7.72) per 100 children-years of observation with I2: 83% & p-value < 0.001. Those children who were from rural were had a 1.65 (95% CI: 1.06, 2.52) times higher chance of getting LTFU when compared with their counterparts. Children who had poor ART adherence had a 2.03 (95% CI: 1.23, 3.34) times higher chance of experiencing LTFU of ART than children having good ART adherence. Conclusions: Among Ethiopian children on ART, one out of 167 had the risk of experiencing LTFU. Being rural dwellers and having poor ART adherence were the identified predictors of LTFU. Close follow-up and phone message text should be used to have good ART adherence among rural dwellers to meet the predetermined goal of ART. [ABSTRACT FROM AUTHOR]

Background: An unintended pregnancy is a pregnancy that is either unwanted or mistimed, such as when it occurs earlier than desired. It is one of the most important issues the public health system is currently facing, and it comes at a significant cost to society both economically and socially. The burden of an undesired pregnancy still weighs heavily on Ethiopia. The purpose of this study was to assess the effectiveness of machine learning algorithms in predicting unintended pregnancy in Ethiopia and to identify the key predictors. Method: Machine learning techniques were used in the study to analyze secondary data from the 2016 Ethiopian Demographic and Health Survey. To predict and identify significant determinants of unintended pregnancy using Python software, six machine-learning algorithms were applied to a total sample of 7193 women. The top unplanned pregnancy predictors were chosen using the feature importance technique. The effectiveness of such models was evaluated using sensitivity, specificity, accuracy, and area under the curve. Result: The ExtraTrees classifier was chosen as the top machine learning model after various performance evaluations. The region, the ideal number of children, religion, wealth index, age at first sex, husband education, refusal sex, total births, age at first birth, and mother's educational status are identified as contributing factors in that predict unintended pregnancy. Conclusion: The ExtraTrees machine learning model has a better predictive performance for identifying predictors of unintended pregnancies among the chosen algorithms and could improve with better policy decision-making in this area. Using these important features to help direct appropriate policy can significantly increase the chances of mother survival. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis B affects close to 300 million people globally with 1.5 million new infections per year. It causes the highest numbers of cirrhosis and liver cancer diagnoses each year. In children, perinatal transmission and contact with infected blood or body fluids remain the main methods of transmission. There are increasing reports of breakthrough hepatitis B infections in fully vaccinated children born to hepatitis B-negative mothers, especially in low- and middle-income countries. Our study aimed to measure the adequacy of hepatitis B surface antibody levels among children and adolescents who received three rounds of hepatitis B vaccination during infancy and delivered to hepatitis B-negative mothers in Addis Ababa, Ethiopia. Method: This was a retrospective cohort study analyzing results of paired serology tests for hepatitis B surface antibody and antigen tests performed for children aged 1–18 years from July 2022 to June 2023. All recorded data were transferred to SPSS version 29.0. The prevalence of adequate hepatitis B surface antibody levels was determined and sub-group analysis conducted using descriptive statistics, frequencies and tables. The magnitude of association between different variables and vaccine-induced hepatitis B immunity was assessed using logistic regression. Statistically significant differences were taken at p < 0.05. Results: A total of 256 children were included in the study (mean age: 7.53 years). Six children (2.3%) had breakthrough hepatitis B infections. Overall, 37 children (14.4%) were categorized as having optimal hepatitis B surface antibody levels (vaccine-induced antibody titers of >10 IU/mL), while 219 (85.6%) had low titers of <10 IU/mL. Nearly all (97.4%) of the sub-group aged 10 years and above had below-par antibody levels, with adolescents (11–18 years) being ten times more likely to have low seroprotection than those aged less than 5 years. Conclusions: Our study showed markedly low vaccine-induced hepatitis B surface antibody levels among the study population, especially adolescents. The presence of breakthrough infections may suggest a genuine lack of response and not just a mere drop in antibody titers and thus could highlight a significant public health problem in Ethiopia. Further immunologic studies and a thorough analysis of vaccine storage and administration should be conducted to inform prevention programs. [ABSTRACT FROM AUTHOR]

Introduction: Female genital amputation is a harmful traditional practice that has adverse risks on health outcomes. Consequently, it affects girls and women's physical, psychological, and mental health conditions. However, evidence on female genital amputation factors among adolescent girls and young women in Ethiopia was limited. Method: Secondary data analysis was conducted from the 2016 Ethiopian Demographic and Health Survey. A weighted sample size included in this study was 2961 adolescent girls and young women. Data management and further analysis were performed using Stata 14 software. An adjusted odds ratio with a 95% confidence interval was used for measuring a significant relationship between factors with the outcome variable. Result: This study found that the prevalence of female genital amputation among adolescent girls and young women in Ethiopia was 53.4%. Among individual- and community-level variables included in the multivariable multilevel analysis: maternal age, religious status, marital status, maternal educational level, occupational status, residence areas, community uneducated level, and community mass media were significant factors for female genital amputation. Conclusion: The prevalence of female genital amputation among adolescent girls and young women in Ethiopia remains high. Those individual- and community-level factors influence female genital amputation among adolescent girls and young women in Ethiopia. It requires health interventions on female genital amputation to improve behavioral changes and create awareness about harmful practices. [ABSTRACT FROM AUTHOR]

Introduction: Early initiation of antenatal care visits is an essential component of services to improve maternal health. Conducting a detailed study about the mean difference in timing at first antenatal checks across regions and factors associated with timing at first antenatal checks among women attending antenatal in Ethiopia is essential to ensure maternal and newborn health. Therefore, this study aimed to describe the mean difference in timing at first antenatal visits and associated factors among pregnant women attending different health facilities across regions in Ethiopia. Method: The Ethiopian Demographic and Health Survey (EDHS) conducted a community-based cross-sectional study in 2019. In this study, data about the timing of the first antenatal check-ups were requested from the Demographic Health Survey in February 2023, and the required variables were downloaded in SAS and SPSS formats from the data set. A total of 2935 women from nine regional states and two city administrations with an age range of 15 to 49 years were included in the study. The mean difference in timing at first antenatal check-ups, its correlation and various factors were estimated using multiple linear regressions to identify factors. Result: The majority of the 2034 (69.3%) of pregnant women who participated in the study were rural residents. The mean (± SD) age of the pregnant women was 29 (± 6.5) years. Approximately 32.5% of pregnant women visited their first antenatal check after 4 months of pregnancy. The results showed that counselling by health workers during a previous pregnancy (p < 0.01) significantly predicts timing at first antenatal checks in months holding previous delivery, previous antenatal care at both government and private facilities, ever attended school, and highest educational level. Timing at the first antenatal check-in months is expected to decrease by 0.99 months for every counselling session at each pregnancy. The results of the analysis suggested that the regression model significantly predicted timing at the first antenatal check (p = 0.001). Conclusion: The mean difference in timing at the first antenatal check in months among Ethiopian pregnant women relatively significantly varies in two regions. Previous pregnancy counselling by health workers positively influences the timing of first antenatal check-ups for subsequent antenatal check follow-ups in Ethiopia. [ABSTRACT FROM AUTHOR]

Background: Emergency contraceptives (EC) are used to avoid unintended pregnancy, hence avoiding its incidence and its effects. In Ethiopia, emergency contraception is commonly accessible, especially in the big cities. However, there is virtually little understanding of or awareness of EC and Ethiopia has a high abortion rate. Therefore this study was aimed to assess the magnitude and associated factors for emergency contraceptive knowledge in Ethiopia. Methods: The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1236 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of emergency contraceptive knowledge. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval. Results: Overall magnitude of emergency contraceptive knowledge was observed to be 17.19% (95% CI: 15.18, 19.40) with intra-class correlation (ICC) 57% and median odds ratio (MOR) 6.4 in the null model. Women's age 25–34 (AOR = 2.6; 95% CI: 1.2, 5.5), and 35–49 (AOR = 1.5; 95% CI: 1.06, 3.3), secondary and above educational level (AOR = 3.41; 95% CI: 2.19, 4.88), media exposure (AOR = 2.97; 95% CI: 1.56, 5.64), Being in metropolitan region (AOR = 2.68; 95% CI: 1.46, 4.74), and women being in urban area (AOR = 3.19; 95% CI: 1.20, 5.23) were associated with emergency contraceptive knowledge. Conclusion: Emergency contraceptive knowledge in this study was low. Women age, educational level, media exposure, residency, and region were significantly associated with emergency contraceptive knowledge. Therefore, to enhance understanding and use of ECs in the current Ethiopian setting, it is imperative to ensure exposure to EC information, particularly in rural regions. [ABSTRACT FROM AUTHOR]

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

Introduction: Breast cancer is presently the most commonly diagnosed cancer in women, and it stands as the leading cause of cancer-related deaths worldwide. Notably, breast cancer rates have seen a significant increase in sub-Saharan African countries, including Ethiopia. Several risk factors contribute to breast cancer, some of which can be modified, while others are inherent. Promoting a healthier diet is strongly encouraged as a preventive measure against breast cancer. However, it's noteworthy that no previous research has investigated the connection between dietary patterns and the risk of breast cancer among Ethiopian women. Therefore, the primary objective of the current study is to examine the relationship between dietary patterns, socioeconomic and behavior factors associated with breast cancer in Ethiopian women. Methods: A case-control study was conducted at an institution in Bahir Dar, Northwest Ethiopia, involving 260 women, comprising 86 cases and 174 controls. We administered a standardized and validated questionnaire to assess a range of sociodemographic, reproductive, clinical, lifestyle, and dietary characteristics through face-to-face interviews. To analyze the differences between the cases and controls, we employed the Chi-square test. Furthermore, we assessed the relationships between these variables using binary multivariate logistic regression. To measure the association between variables, we utilized odds ratios with 95% confidence intervals. Results: The results of the multivariate analysis indicated that participants in the younger age group had significantly lower odds of developing breast cancer (AOR = 0.05; 95% CI: 0.00-0.91) compared to those in the older age group. Additionally, women who breastfed their children for shorter durations were 3.66 times more likely to develop breast cancer (AOR = 3.66; 95% CI: 2.78–6.89) than those who breastfed for longer periods. Furthermore, women with sedentary lifestyles faced a significantly higher risk of breast cancer, with odds 10.53 times greater (AOR = 10.53; 95% CI: 5.21–21.36) than their counterparts who engaged in moderate or highly active lifestyles. Lastly, participants who had previously undergone chest therapy were 6.43 times more likely to develop breast cancer (AOR = 6.43; 95% CI: 3.20–13.90) compared to those who had not. Conclusions: Breast cancer prevention interventions, including breastfeeding counseling and increased physical activity should be recognized as a central strategy for lowering breast cancer risk. Furthermore, healthcare providers should aim to minimize exposure to chest radiation therapy. [ABSTRACT FROM AUTHOR]

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that results in progressive weakness of skeletal muscles including respiratory muscles. Epidemiological and clinical aspects of ALS are derived from a few world regions with very little representation of low- and middle-income countries. We therefore set out to determine the epidemiological and clinical phenotype of individuals with ALS in Ethiopia. Multicenter retrospective analysis was conducted using clinical records from ALS patients seen in Ethiopia at Tikur Anbessa Specialized Hospital and Yehuleshet specialty clinic between January 2016 and August 2021. The data collected included clinical characteristics, disease-related symptoms, a revised ALS functional rating scale, and medications. Patients in Ethiopia had a younger age of onset with a mean age of disease onset of 51.9 years. 2.9% of patients had juvenile ALS, and the male-to-female ratio was almost 2:1. 4.9% had a positive family history of the disease. 68% of patients had spinal region involvement at onset, while 32% had bulbar region involvement at onset. Riluzole was used by 31% of ALS patients. 20.6% of patients had some respiratory symptoms, but none received a standard respiratory function assessment. 33.3% of patients were wheelchair-bound. In this retrospective study spanning 5 years, we examined the clinical phenotype of ALS in Ethiopian patients. Our findings suggest that most patients had clinically definite ALS with spinal region involvement. Further research, including genetic and epigenetic information, is necessary to understand the early onset of the disease in Ethiopia. [ABSTRACT FROM AUTHOR]

The multifaceted notion of 'returning home,' and not least the dualities between expectation, anticipation and the realities facing migrants upon their return, is a key component in understanding East African migration dynamics and implications. This article constitutes an exploratory attempt to understand the nexus between return migration journeys, reintegration, psychosocial well-being, and masculinity for the hundreds of thousands of Ethiopian men that migrate every year. Through our empirical findings, we emphasize how fluidity of migration demands a nonlinear interpretation of migratory lives and argue for return migration to be seen not as an outcome or an ending but an unfolding state of being. The traumatic events of irregular Ethiopian migration suggest it becomes an existential journey as much as a physical one. Returning thus should not be seen as a temporary process or journey, but rather an enduring process of personal, mental, and existential change. We ground our argument on analysis of findings of a qualitative study conducted in two sites in Ethiopia, in Arsi zone of Oromia regional state and Addis Ababa, the federal capital. [ABSTRACT FROM AUTHOR]

Human lice, Pediculus humanus, can transmit various pathogens, including Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii. Xenosurveillance is an epidemiological approach to assessing human infection risks performed by screening vectors of infectious disease agents. In the proof-of-principle study reported herein, the DNA of 23 human lice was collected from the clothes of 30 homeless Ethiopian individuals. These samples were assessed using 16S rRNA gene-specific pan-eubacterial PCR for screening, followed by Bartonella genus 16S-23S internal transcribed spacer (ITS) sequence-specific PCR, Bartonella genus gltA gene-specific PCR, and 16S rRNA gene PCR with specificity for relapsing-fever-associated Borrelia spp. with subsequent sequencing of the amplicons. In one sample, the pan-eubacterial 16S rRNA gene-specific screening PCR, the Bartonella genus 16S-23S ITS sequence-specific PCR, and the Bartonella genus gltA gene-specific PCR allowed for the sequencing of B. quintana-specific amplicons. In two additional samples, Bartonella genus gltA gene-specific PCR also provided sequences showing 100% sequence identity with B. quintana. In total, 3/23 (13.0%) of the assessed lice were found to be positive for B. quintana. Correlating clinical data were not available; however, the assessment confirmed the presence of B. quintana in the local louse population and thus an associated infection pressure. Larger-sized cross-sectional studies seem advisable to more reliably quantify the infection risk of lice-infested local individuals. The need for prevention by providing opportunities to maintain standard hygiene for Ethiopian homeless individuals is stressed by the reported findings, especially in light of the ongoing migration of refugees. [ABSTRACT FROM AUTHOR]

Background: Ethiopia is among the highly HIV-affected countries, with reported 12,000 and 12,000 AIDS-related deaths and incidents as per reports from 2021. Although the country has made a promising progress in antiretroviral therapy, recent studies have indicated that pretreatment drug resistance (PDR) is alarmingly increasing, which has become a challenge for the effectiveness of HIV treatment. Epidemiologic data on PDR is necessary to help establish ART regimens with good efficacy. Thus, this systematic review aimed to determine the trend analysis of PDR among ART-naïve individuals along with HIV variant dynamics in Ethiopia. Method: HIV-1 pol sequences from studies conducted between 2003 and 2018 among ART-naïve Ethiopian individuals were retrieved from GenBank and analyzed for the presence of PDR mutations (PDRM) along with the analysis of HIV-1 variant dynamics. The Calibrated Population Resistance (CPR) tool Version 8.1 and the REGA HIV-1 Subtyping Tool Version 3 were used to determine the PDRM and HIV-1 genetic diversity, respectively. Result: We identified nine studies and analyzed 1070 retrieved HIV-1 pol sequences in this systematic review. The pooled prevalence of PDR was 4.8% (51/1070), including 1.4% (15/1070), 2.8% (30/1070), and 0.8% (9/1070) for nucleoside reverse transcriptase inhibitor (NRTI), non-NRTI (NNRTI), and protease inhibitor (PI) resistance, respectively. NRTI and NNRTI concurrent PDRM were observed among 0.2% (2/799) of the analyzed sequences. The overall PDR prevalence has been increasing over the years. Though the prevalence of the NNRTI, NRTI, and PI PDR also increased over the years, the NNRTI increment was more pronounced than the others, reaching 7.84% in 2018 from 2.19% in 2003. The majority (97%; 1038/1070) of the genetic diversity was HIV-1 subtype C virus, followed by subtype C' (2%; 20/1038) and other subtypes (1%; 10/1038). Conclusions: According to this systematic review, the overall pooled prevalence of PDR is low. Despite the low prevalence, there has been an increasing trend of PDR over the years, which implies the need for routine surveillance of PDRMs along with preventive measures. Hence, this supports the recently endorsed transition of ART regimens from NNRTI to integrase strand transfer inhibitor-based regimens recommended by the WHO. In addition, this finding underscores the need for routine baseline genotypic drug resistance testing for all newly diagnosed HIV-infected patients before initiating treatment to halt the upward trend of PDR. [ABSTRACT FROM AUTHOR]

Introduction: Tetanus is a major public health problem caused by clostridium tetani. Although it is vaccine-preventable, the case fatality rate among neonates in areas with poor immunization coverage and limited access to clean deliveries reaches 80-100%. Vaccination of pregnant mothers with the tetanus toxoid (TT) vaccine is the most effective way to protect against neonatal tetanus. This study aimed to examine the spatial distribution and determinants of tetanus toxoid immunization among pregnant mothers using the 2016 EDHS data. Method: Secondary analysis of the Ethiopia Demographic and Health Survey 2016 was done to assess the spatial distribution and determinants of tetanus toxoid vaccine among pregnant women in Ethiopia. Spatial autocorrelation analysis and hot spot analysis were used to detect spatial dependency and spatial clustering of the tetanus toxoid vaccine in Ethiopia. Spatial interpolation was used to predict the tetanus toxoid vaccine coverage in unsampled areas. The multilevel binary logistic regression model was fitted to identify factors associated with tetanus toxoid vaccination. An adjusted odds ratio with 95% CI was calculated and used as the measure of association and a p-value less than 0.05 were considered statistically significant. Result: From the total of 7043 pregnant women, 42.4% of them have taken at least two doses of tetanus toxoid immunization. Spatial clustering of TT immunization was observed in the Northern, Southwestern and Southwestern parts of Ethiopia. Whereas, low TT coverage was observed in the Eastern and Western parts of the country. Increased ANC visits and the richest economic status favored TT immunization, whereas living in Addis Ababa and Dire Dewa cities decreased the TT immunization coverage. Conclusion: The finding of this study reveals that TT immunization had spatial dependency, with the highest immunization coverage observed in the Northern, Southwestern and Southeastern parts of the Country. Thus, geographically targeted interventions should be implemented particularly in the eastern and western parts of the country. [ABSTRACT FROM AUTHOR]

Background: Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients. Methods: A systematic review was conducted using the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle–Ottawa Scale. Results: In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL. Conclusions: The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL. [ABSTRACT FROM AUTHOR]