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Abstract The nonlinear Telegraph equation appears in a variety of engineering and science problems. This paper presents a deep learning algorithm termed physics-informed neural networks to resolve a hyperbolic nonlinear telegraph equation with Dirichlet, Neumann, and Periodic boundary conditions. To include physical information about the issue, a multi-objective loss function consisting of the residual of the governing partial differential equation and initial conditions and boundary conditions is defined. Using multiple densely connected neural networks, termed feedforward deep neural networks, the proposed scheme has been trained to minimize the total loss results from the multi-objective loss function. Three computational examples are provided to demonstrate the efficacy and applications of our suggested method. Using a Python software package, we conducted several tests for various model optimizations, activation functions, neural network architectures, and hidden layers to choose the best hyper-parameters representing the problem’s physics-informed neural network model with the optimal solution. Furthermore, using graphs and tables, the results of the suggested approach are contrasted with the analytical solution in literature based on various relative error analyses and statistical performance measure analyses. According to the results, the suggested computational method is effective in resolving difficult non-linear physical issues with various boundary conditions.

Abstract Mango anthracnose (Colletotrichum gloeosporioides), is a major postharvest disease that significantly impacts mango production and consumption globally. This study aimed to evaluate the combined effect of plant extracts and hot water treatments on the development of anthracnose and the preservation of postharvest quality in mangoes. In vitro tests using the food poisoning technique assessed the efficacy of acetone, ethyl acetate, hexane, and methanol extracts from nine different medicinal plant species against C. gloeosporioides. Among the tested extracts, Ruta chalepensis demonstrated the most pronounced effect, inhibiting mycelial growth by more than 85%. Extracts from Allium sativum also reduced mycelial growth by 80%. Furthermore, aqueous extracts from three effective plant species identified from the in vitro tests were combined with hot water treatments (HWT) to evaluate their impact on managing postharvest anthracnose. The combined treatments significantly (p

Abstract A justified cesarean delivery plays a major role in reducing maternal and neonatal death in Ethiopia. However, inequalities exist in access to cesarean delivery within the country. Therefore, this study aimed to assess the geographic variations and predictors of cesarean delivery hotspots in Ethiopia using geographically weighted regression analysis. For this study, data from the 2019 Ethiopian Mini Demographic and Health Survey were utilized. Moran’s I and Getis-OrdGi* statistics were used to assess the geographical disparities in the occurrence of cesarean deliveries. Subsequently, spatial regression was performed using ordinary least squares regression and geographically weighted regression to predict hotspot areas of cesarean delivery. The prevalence of cesarean delivery in Ethiopia was 6.07% (95% CI: 5.602, 6.538). In this study, Dire Dawa, Hareri, and the southeastern region of Somali were the hotspot areas for cesarean delivery. A higher level of education, multiple births, five or more antenatal care visits, and delivery in private health institutions were statistically significant predictors of cesarean delivery hotspots in Ethiopia. Cesarean delivery in Ethiopia is still underutilized, despite the presence of hotspot areas. Region-specific interventions are necessary, particularly in hotspot areas. Ensuring accessible and equitable cesarean delivery services is crucial, especially in cold spot areas.

Abstract Obstetric fistula is a major maternal health challenge in low-income countries like Ethiopia. Misperceptions about obstetric fistula delay seeking and accessing healthcare. Understanding community attitudes is crucial for prevention, early detection, and support for affected women. A community-based study was conducted from February 1 to April 26, 2024, among 640 women and men to assess attitudes and influencing factors. Participants were selected using a multistage sampling. Multivariable logistic regression analysis was performed, with a p-value

Abstract Despite growing utilization of family planning in Ethiopia, many pregnancies in rural areas are still unintended and unintended pregnancy remains a major global challenge in public and reproductive health, with devastating impact on women and child health, and the general public. Hence, this study was aimed to determine the prevalence and associated factors of unintended pregnancy in rural women of Ethiopia. This study used a 2016 Ethiopian Demography and Health Survey data. A total weighted samples of 974 reproductive-aged rural women were included in this analysis. Multilevel mixed logistic regression analysis was employed to consider the effect of hierarchal nature of EDHS data using Stata version 14 to determine individual and community level factors. Variables significantly associated with unintended pregnancy were declared at p-value

Abstract Recycled engine oil was produced from used engine oil (15W-40) using a combination of MEK and 1-butanol solvents with an activated carbon adsorbent through the adsorption process. The experimental design matrix was prepared using Box-Behnken design (BBD) package within RSM, and recycled engine oil is optimized by response surface methodology (RSM). By varying solvent-to-oil ratio, the temperature and contact duration optimal conditions were identified as a 5.5:1 MEK and 1-butanol solvent-to-oil ratio, 50 min of contact, 42.5 °C, and constant 1 g of activated carbon adsorbent, yielding (65.20%, 65.20%) numerically and experimentally, respectively. Process factors (solvent-to-oil ratio, the temperature, and contact duration) influencing the yield of recycled engine oil are indicated by both contour and surface plots. The characterization of recycled oil indicates that its physiochemical properties, such as density, viscosity, flash point, pour point, and total base number, met the ASTM standards. GC–MS analysis further identified the presence of natural base oil, additives (polymeric, metallic, and non-metallic), and oxidation compounds, indicating the efficacy of the recycling process in recovering valuable components from the used engine oil. Before and after adsorption, FTIR is used to analysis the effect of optimized engine oil adsorption on the activated carbon adsorbent. The recycling method that has been optimized indicates potential for sustainable resource consumption and conservation, which may help the vehicle industry practice environmental stewardship.

Abstract Introduction Echinococcus granulosus, a tapeworm, is responsible for causing hydatid disease. Hydatid cysts rarely affect the musculoskeletal system, occurring in less than 5% of cases. This case report presents the clinical presentation, diagnosis, and management of muscle echinococcosis. Case presentation A 28-year-old Black African female presented with a 4-month history of left anteromedial thigh swelling. Despite mild burning pain, she remained functional. While pyomyositis was initially considered, ultrasound and magnetic resonance imaging suggested hydatid disease. Surgical excision was performed, and histopathology confirmed the diagnosis. The patient received albendazole and praziquantel for 4 and 2 weeks, respectively, as adjunctive therapy. A year-long follow-up revealed good progress and continued health. Conclusion Primary muscle hydatid cysts should be considered in the differential diagnosis of cystic, painless, localized masses in the muscular system, especially in endemic regions. Serological tests and imaging techniques are essential for investigation. Complete surgical excision and anthelminthic therapy should be pursued when possible.

Abstract Background Measles is a very contagious illness that can be clinically diagnosed and intervened quickly. It is caused by the measles virus Morbillivirus. The disease has a case fatality rate of 5% to 10% in the sub-Saharan region. Recent information on measles forecasting is limited in this study area. Therefore, this study was aimed to assess the five-year trend and next five-year prediction of measles disease in East Gojjam zone, Amhara National Regional State (ANRS), Ethiopia, 2023. Methods A descriptive study using case based surveillance data analysis in the East Gojjam zone was conducted. Five-year data (January 1/2018-December 30/2022) was extracted from the WHO database. ARIMA (3, 1, 1) model was used for disease forecasting for the next 5 years of the zone (2023–2027). Results For the study, 1003 participants in total were enlisted. 12.3% of the subjects were IgM positive. About 59.4% and 1.2% were epidemiologically linked and died subjects, respectively. Many of the cases (54.2%) occurred in the March season and the lowest (1%) in December. For the next five years (2024–2027), it is predicted that the number of cases will rise gradually in fluctuation. Conclusion The disease had an upward trend over the five-year period, and for the next consecutive years, there will be a consistent increase in the number of cases in the zone. It is recommended that the East Gojjam Zone Health Office and different stakeholders have to monitor and evaluate the vaccination status of target children and vaccination coverage and strengthen the surveillance system in the dry-hot season, which is valuable for disease control.

Abstract Birth asphyxia is a well-known cause of neonatal mortality, and the survivors suffer from long-lasting sequels such as seizures, intellectual disabilities, and motor disorders that are great challenges for newborns. Elucidating the determinants of birth asphyxia helps implement evidence-based practice in the local context. Thus, this study aimed at elucidating the determinants of birth asphyxia in urban south Ethiopia. A community-based unmatched nested case-control study was conducted on a cohort of 2548 pregnant women who were followed up until delivery in urban areas of Hadiya Zone, south Ethiopia. All newborns who experienced birth asphyxia (n = 118) were taken as cases. Newborns who were randomly selected from the risk-set (n = 472) were taken as controls (those without birth asphyxia). A binary logistic regression was done using R software. Induction of labor [AOR = 2.98, 95% CI: 1.20, 7.42], prolonged labor [AOR = 2.12, 95% CI: 1.02, 4.37], delivery through cesarean section [AOR = 3.81, 95% CI: 1.67, 8.72], instrumental delivery [AOR = 3.91, 95% CI: 1.72, 8.89], and low birth weight [AOR = 6.52, 95% CI: 3.40, 12.51] were determinants of birth asphyxia. Asphyxia during birth was mainly related to obstetric care and maternal nutrition, highlighting the need to pay attention during the course of labor and maternal nutrition during pregnancy. This study might have selection bias and loss of power so careful interpretation of the results is needed.

Abstract Neonatal hypothermia is a significant global problem of neonates with huge contribution of neonatal morbidity and mortality. Recognizing major contributors of neonatal hypothermia is very important in designing preventing methods which was the objective of our study. This was an institution-based cross-sectional study conducted on 339 neonates admitted to Neonatal Intensive Care Unit of University of Gondar Comprehensive Specialized Hospital over 6months. Study participants were selected using systematic random sampling techniques and both bivariate and multivariate logistic regression analyses were used to identify contributors and p-value of

Abstract Burnout is a global concern because of its potential to affect the health of nurses and the quality of service provided. However, less consideration has been given to research in the study setting. Therefore, the study aimed to assess the prevalence of burnout and associated factors among nurses working in public hospitals of Wolaita zone, Southern Ethiopia. Institution based embedded mixed method was employed on 374 nurses working in public hospitals of Wolaita zone from July to August, 2022. A systematic and criterion purposive sampling was employed. Burnout was assessed by the Maslach Burnout Inventory- Human Services Survey (MBI-HSS). Quantitative data were entered into Epi data version 4.6.2 and then exported to SPSS version 25 for analysis. Qualitative data was analyzed by open code version 4.3. Binary logistic regression followed by multivariable logistic regression was used and P-value of

Abstract Visceral leishmaniasis (VL) is a neglected tropical disease that mostly affects the working-class and impoverished segments of society, having a significant negative effect on the economic development of the affected nation. While anti-leishmanial medications lower mortality among VL patients, patients may still die or require more time to recover (TTR) while receiving treatment. In this regard, there are limited studies in Ethiopia. This study aims to determine the time to recovery and its associated predictors among adult VL patients at Metema Hospital. A hospital-based cross-sectional study design was employed, and the data were collected in patient’s charts from September 2017 to September 2021. Data were entered and analyzed using Epi-data, STATA version 14.2, and R 3.4.0 statistical software. The Kaplan–Meier survival curve and log-rank tests were used to compare the survival time. The Cox proportional hazard model assumption and model fitness were checked and used to identify statistical association predictors in VL patients. The Cox proportional hazard (Cox-PH) model was fitted. The overall medium recovery time was 7 days (minimum 4, maximum 14 days). The variables nasal bleeding (adjusted hazard ratio/AHR: 0.44; 95% CI: 0.19–0.89), no comorbidity (AHR: 2.29; 95% CI: 1.27–4.11), relapse VL (AHR: 0.33; 95% CI: 0.15–0.75),low parasite load (AHR: 2.58; 95% CI: 1.48–4.51), and ambulatory (AHR: 3.26; 95% CI: 2.45–6.53) were significantly associated with TTR in VL patients. Patients with comorbidities, nasal bleeding, relapse VL, bedridden, and high parasite load should be treated and monitored carefully to recover quickly from their illness.

Abstract Despite extensive efforts, malnutrition persists as a critical public health concern, particularly in developing nations like Ethiopia. Concurrent occurrence of wasting and stunting poses severe consequences. Analyzing trends and factors contributing to this double burden is vital for evaluating and enhancing existing nutritional programs. Additionally, understanding the spatial distribution of malnutrition is crucial for targeted resource allocation, expediting progress towards optimal child growth. A 20-year trend and spatial analysis was conducted among 27,138 weighted samples of under-five children using EDHS (2000–2019). The data extraction was conducted between October 1 and November 1, 2023. STATA 18, ArcGIS Pro, and Sat Scan 9.6 were used for analysis. A logit-based multivariate decomposition analysis was used to identify contributing factors for the change in the double burden of wasting and stunting in the past 20 years. The statistical significance was declared at a P-value

Abstract Background Despite primary care being largely free at the point of delivery, many Canadians experience challenges in accessing the services they need. A systematic review was conducted to summarize the evidence on the level of unmet need for primary care in Canada and its social determinants. Methods MEDLINE, Embase, Cochrane, and Web of Science databases were screened from inception to December 2023 using relevant search terms for primary care and unmet healthcare needs. Quantitative observational studies in the English language that included Canadian adults aged 18 years and older and focused on unmet needs for primary care were included. The risk of bias in the studies was assessed using either the Joanna Briggs Institute (JBI) critical appraisal checklist or the Newcastle–Ottawa Scale. The included studies were synthesized narratively. Results Forty-six studies met the inclusion criteria for this review. Of the included studies, 96% were cross-sectional in design and 91% had low risk of bias. The prevalence of unmet need, mostly self-reported, varied between 6.6% and 25.2% in national studies. Social determinants of unmet needs were heterogeneous across studies. Findings suggest that unmet need for primary care is related to having low income, mental health diagnoses, and chronic conditions, and negatively associated with older age, having better-perceived health, and having a family physician. Conclusions Universal access to primary care is the founding principle of the Canadian healthcare system. However, we found evidence suggesting that the extent to which primary care needs are met is influenced by social determinants of health. Further research is needed to improve our understanding of the mechanisms of unmet primary care needs in Canada. Systematic review registration PROSPERO CRD42021285074.

Abstract The world’s energy consumption is being replaced by renewable energies in large part because of the depletion of fossil fuels and the acceleration of environmental change. This study reports the amount of inward solar radiation in the date range from January 2018 to December 2022 in the Gregorian Calendar for certain areas in Bahir Dar, Ethiopia: 37°E and 11.6°N. On the horizontal surface of the case area, the month with the highest global radiation (monthly average daily) is March, at approximately 42.56 MJ/m2. day; June has the lowest diffuse radiation, at 16.2 MJ/m2.day. Furthermore, April had the most global radiation (monthly average hourly) on the horizontal surface, measuring 9.09 MJ/m2.hour, while June had the lowest diffuse radiation, measuring 2.3 MJ/m2.hour. In addition, this study predicts the beam, diffuse, and total radiation on the tilted collector using the total available horizontal radiation on a monthly and hourly basis. According to the research, the output of the radiation on the tilted surface towards the equator in the northern hemisphere, azimuth angle, γ = 0°, shows that the highest possible total radiation (monthly average daily) is 48.3 MJ/m2. day (January) and the highest possible total radiation (monthly average hourly) in February, 9.14 MJ/m2.hour at 1:00 p.m.

Abstract Micronutrient deficiencies, known as “hidden hunger” or “hidden malnutrition,” pose a significant health risk to pregnant women, particularly in low-income countries like the East Africa region. This study employed eight advanced machine learning algorithms to predict the status of micronutrient supplementation among pregnant women in 12 East African countries, using recent demographic health survey (DHS) data. The analysis involved 138,426 study samples, and algorithm performance was evaluated using accuracy, area under the ROC curve (AUC), specificity, precision, recall, and F1-score. Among the algorithms tested, the random forest classifier emerged as the top performer in predicting micronutrient supplementation status, exhibiting excellent evaluation scores (AUC = 0.892 and accuracy = 94.0%). By analyzing mean SHAP values and performing association rule mining, we gained valuable insights into the importance of different variables and their combined impact, revealing hidden patterns within the data. Key predictors of micronutrient supplementation were the mother’s education level, employment status, number of antenatal care (ANC) visits, access to media, number of children, and religion. By harnessing the power of machine learning algorithms, policymakers and healthcare providers can develop targeted strategies to improve the uptake of micronutrient supplementation. Key intervention components involve enhancing education, strengthening ANC services, and implementing comprehensive media campaigns that emphasize the importance of micronutrient supplementation. It is also crucial to consider cultural and religious sensitivities when designing interventions to ensure their effectiveness and acceptance within the specific population. Furthermore, researchers are encouraged to explore and experiment with various techniques to optimize algorithm performance, leading to the identification of the most effective predictors and enhanced accuracy in predicting micronutrient supplementation status.

Abstract Braille, the most popular tactile-based writing system, uses patterns of raised dots arranged in cells to inscribe characters for visually impaired persons. Amharic is Ethiopia’s official working language, spoken by more than 100 million people. To bridge the written communication gap between persons with and without eyesight, multiple Optical braille recognition systems for various language scripts have been developed utilizing both statistical and deep learning approaches. However, the need for half-character identification and character segmentation has complicated these systems, particularly in the Amharic script, where each character is represented by two braille cells. To address these challenges, this study proposed deep learning model that combines a CNN and a BiLSTM network with CTC. The model was trained with 1,800 line images with 32 × 256 and 48 × 256 dimensions, and validated with 200 line images and evaluated using Character Error Rate. The best-trained model had a CER of 7.81% on test data with a 48 × 256 image dimension. These findings demonstrate that the proposed sequence-to-sequence learning method is a viable Optical Braille Recognition (OBR) solution that does not necessitate extensive image pre and post processing. Inaddition, we have made the first Amharic braille line-image data set available for free to researchers via the link: https://github.com/Ne-UoG-git/Am-Br-line-image.github.io .

ABSTRACT Background and Aims Schistosoma mansoni and malaria share a similar epidemiological distribution or co‐endemicity. Co‐infection are a global public health burden where epidemiological evidence is crucial to taking evidence‐based intervention. Thus, the aim of this study was to assess the prevalence and associated factors of Schistosoma mansoni and other intestinal Helminthes co‐infection among malaria positive patients in malaria endemic areas of Northeast Ethiopia. Methods A cross‐sectional study was conducted from September 2018 to June 2019 among randomly recruited 145 microscopically confirmed malaria patients in Kemisse and Chefa Robit, Northeast Ethiopia. A pre‐tested semi‐structured questionnaire was used for sociodemographic and other risk factor data; blood samples for malaria microscopy and stool samples for S. mansoni and other intestinal Helminthes examinations were collected from each participant. STATA 17 was used for analysis. Chi‐square and Fishers' exact test were used as required. The internal consistency and model good ness of fitness test were checked using Cronbach's alpha and Hosmer‐Lemshow test, respectively. Bivariable and multivariable logistic regression model was used for analysis. Finally, variables with p

Objectives The study aimed to assess the prevalence of reproductive health problems among youths and the utilisation of services and associated factors in urban Ethiopia.Design This paper presents findings related to sexual and reproductive health (SRH) based on a formative assessment of the Integrated Youth Activity which is conducted by cross-sectional study.Setting Youths from community and higher education institutions were included from 13 major urban towns of Ethiopia in the study.Participants A total of 1954 youths from community settings were included from randomly selected eligible households and 1261 students were included from higher education institutions.Primary outcomes The youths’ experience of unwanted pregnancy; exposure to high-risk sexual behaviour (HRSB); SRH service utilisation; and current use of family planning (FP) services.Results Among youths, 35% have engaged in HRSB, more than 14% have experienced at least one unwanted pregnancy and 26.7% have used SRH services. Additionally, only 26.4% of female youths use FP. The uptake of SRH services is lower among unmarried youths, those aged 18–19, individuals with no access to mass media and those who do not encounter SRH messages. Unintended pregnancy among women is common among those in higher education, lacking comprehensive HIV knowledge and engaging in HRSB. HRSB is prevalent among youths with no education, aged 18–19, who have not used SRH or FP services, and those with multiple social media accounts.Conclusion A relatively high proportion of youths exhibit low uptake of SRH and FP services, with a higher proportion exposed to HRSB and unintended pregnancy. Barriers to the utilisation of SRH services as well as increased risk of HRSB, including unwanted pregnancies, are often linked to poor access to accurate and relevant SRH information. To address this gap, delivering targeted SRH-related messages through social media and mass media broadcasts can play a transformative role. This approach not only broadens youth access to reliable SRH information but also enhances their health literacy by increasing the credibility and relevance of the information provided.

Objectives To evaluate how postmortem anthropometric malnutrition (PAM) measures align with expert panel attribution of malnutrition as a causal or significant condition in under-5 mortality (U5M).Design Cohort study using data from the Child Health and Mortality Prevention Surveillance network, incorporating clinical records, postmortem anthropometrics, minimally invasive tissue sampling, clinical abstraction and verbal autopsy to determine multiple causes of death.Setting/participants 1405 deaths of children aged 1–59 months from six African countries between 2016 and 2023.Primary and secondary outcome measures PAM was determined using z-scores from the WHO Child Growth Standards: underweight (weight-for-age

BackgroundAntimicrobial resistance (AMR) poses a severe global health threat, driven by the overuse and misuse of antimicrobials across the human, agricultural, and veterinary sectors. To combat this, global and national AMR prevention and containment strategies have been implemented, necessitating continuous monitoring of antimicrobial consumption (AMC) as an integral part of antimicrobial stewardship interventions.ObjectiveThis study aims to assess and analyze trends in AMC in Ethiopia from 2020 to 2022, with the goal of informing national and sub-national strategies to combat AMR.MethodsA three-year AMC surveillance was conducted from 2020 to 2022. Data on locally manufactured and imported antimicrobials were collected from local manufacturers and Ethiopian Food and Drug Authority (EFDA)-regulated ports of entry. AMC was analyzed using the WHO GLASS AMC tool, with antimicrobials categorized using the WHO Anatomical Therapeutic Chemical (ATC) classification system. Consumption was measured in Defined Daily Doses (DDDs) and DDD per 1,000 inhabitants per day (DID), normalized using population estimates from the World Population Prospects for Ethiopia.ResultsThe total AMC in Ethiopia increased from 432 million DDDs in 2020 to 485 million DDDs in 2022. The DID rose from 10.63 in 2020 to 11.34 in 2022. Antibacterials dominated consumption, comprising 98.87% in 2020, 95.96% in 2021, and 99.79% in 2022. Penicillins (J01C) and quinolones (J01M) were the most consumed antimicrobials. As per the Ethiopian AWaRe classification, the majority of antibacterial agents consumed were in the Access group, accounting for 71.14% in 2020, 70.65% in 2021, and 74.2% in 2022. Oral formulations consistently made up over 87% of the total consumption each year. Reliance on imported antimicrobials remained high, with imports comprising 64.76% in 2020 and 74.47% in 2022.ConclusionThe increasing trend in AMC in Ethiopia from 2020 to 2022 underscores the urgent need to establish and strengthen national, sub-national, and facility-level surveillance and reporting systems to better monitor and ensure rational antimicrobial use.

Crops respond differently to soil nutrients because of climate, soil, and management. This study aimed to determine the most important nutrients for tef production. The experiment was conducted over two production seasons. All (NPKSZnB), All-B, All-Zn, All-S, All-K, All-P, All-N, RNP, RNP+Sx1, and no fertilizer treatments were applied. The pre-planning soil status of the study sites, available P concentrations during the rainy season are between 5.1 and 8.9 mg kg-1, however, 21.4 mg kg-1 of available P is observed during irrigation. In rain-fed production systems, the mean soil N concentrations are 0.12% in nitisols and 0.15% in vertosols, whereas in irrigation production systems, it is 0.14% in nitiosols. The grain yield significantly (p ≤ 0.01) varied with the omission of nutrients during the production season. However, there was no significant (p

IntroductionDiabetes mellitus (DM) is one of the most significant public health problems. Globally, one in ten adults has diabetes, and it results in macro- or microvascular complications, such as diabetic retinopathy (DR). It is one of the most prevalent eye complications associated with DM, and it is the main cause of vision loss. Even though East African countries face a growing burden of diabetes and DR, no study depicts the regional prevalence and its associated factors. Therefore, this study aimed to estimate the pooled prevalence of DR and its associated factors among adults in East African countries.MethodsWe extensively searched PubMed, Embase, Scopus, Google Scholar, and Google for relevant studies. A forest plot was used to estimate the pooled prevalence of diabetic retinopathy using DerSimonian and Laird's random-effects model. We checked publication bias using funnel plots and Egger's regression test. Potential heterogeneity was tested using the I-squared statistic. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also performed. Furthermore, the pooled odds ratios for the associated factors were estimated. The research protocol was registered in PROSPER.ResultsAmong the 29 included studies, the estimated pooled prevalence of DR in East African countries was 28% (95% CI 23.0, 33.0). Besides, age ≥60 (OR = 2.88, 95% CI: 1.55, 5.32), body mass index ≥ 25 (AOR = 2.85; 95% CI: 1.69, 4.81; I2 = 85.4%, p < 0.001), and hemoglobin A1c levels ≥7 (OR = 2.48, 95% CI: 1.46, 4.23) were significantly associated with the prevalence of DR.ConclusionsThe prevalence of DR in East Africa was high, with more than one in four individuals with diabetes developing DR. Besides, advanced age, higher body mass index, and elevated hemoglobin A1c levels were significant factors associated with increased DR prevalence. Therefore, comprehensive diabetes management focusing on optimal glycemic control and healthy weight maintenance is essential to mitigate the problems. Also, the Ministries of Health and policymakers should prioritize and implement targeted strategies to address the identified modifiable risk factors, aiming to reduce the prevalence of DR in the region.Trial registrationSystematic review registration: PROSPERO (2024: ID = CRD42024511437). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511437.

[This corrects the article DOI: 10.1371/journal.pone.0291996.].

BackgroundStunting is a vital indicator of chronic undernutrition that reveals a failure to reach linear growth. Investigating growth and nutrition status during adolescence, in addition to infancy and childhood is very crucial. However, the available studies in Ethiopia have been usually focused in early childhood and they used the traditional stastical methods. Therefore, this study aimed to employ multiple machine learning algorithms to identify the most effective model for the prediction of stunting among adolescent girls in Ethiopia.MethodsA total of 3156 weighted samples of adolescent girls aged 15-19 years were used from the 2016 Ethiopian Demographic and Health Survey dataset. The data was pre-processed, and 80% and 20% of the observations were used for training, and testing the model, respectively. Eight machine learning algorithms were included for consideration of model building and comparison. The performance of the predictive model was evaluated using evaluation metrics value through Python software. The synthetic minority oversampling technique was used for data balancing and Boruta algorithm was used to identify best features. Association rule mining using an Apriori algorithm was employed to generate the best rule for the association between the independent feature and the targeted feature using R software.ResultsThe random forest classifier (sensitivity = 81%, accuracy = 77%, precision = 75%, f1-score = 78%, AUC = 85%) outperformed in predicting stunting compared to other ML algorithms considered in this study. Region, poor wealth index, no formal education, unimproved toilet facility, rural residence, not used contraceptive method, religion, age, no media exposure, occupation, and having one or more children were the top attributes to predict stunting. Association rule mining was identified the top seven best rules that most frequently associated with stunting among adolescent girls in Ethiopia.ConclusionThe random forest classifier outperformed in predicting and identifying the relevant predictors of stunting. Results have shown that machine learning algorithms can accurately predict stunting, making them potentially valuable as decision-support tools for the relevant stakeholders and giving emphasis for the identified predictors could be an important intervention to halt stunting among adolescent girls.

BackgroundAntenatal care (ANC) coverage in low- and middle-income countries has increased in the past few decades. However, merely increasing care coverage may not enhance maternal and newborn health unless the recommended service components are also provided. Our aim was to assess the quality of ANC and its associated factors in Ethiopia.MethodsWe used data from 2,042 pregnant women whose first ANC consultation was observed. Data were obtained from the 2021-2022 Ethiopian Service Provision Assessment survey conducted among a nationally representative sample of 1,158 healthcare facilities. Twenty-four components of ANC were assessed, and their values were summed to generate a total ANC quality score (range: 0-24). A higher score indicated a superior ANC quality. A multiple generalized Poisson regression model was fitted to identify factors influencing the quality of ANC. All statistical analyses were performed using STATA version 16.ResultsThe mean ANC quality score was 11 (standard deviation [SD]: 3.8). Blood pressure measurement was the most commonly performed ANC component, at 79.5%, and breast examination for cancer screening was the most neglected component of ANC, at 3.3%. ANC quality was higher in the Amhara region (incidence rate ratio [IRR]: 1.088; 95% confidence interval [CI]: 1.0-1.171) and Southern Nations, Nationalities, and Peoples' Region (IRR: 1.081; 95% CI: 1.002-1.166), and when the care was provided by a female healthcare worker (IRR: 1.054; 95% CI: 1.021-1.088). On the other hand, ANC quality decreased in rural healthcare facilities (IRR: 0.964; 95% CI: 0.932-0.998), clinics (IRR: 0.666; 95% CI: 0.581-0.764), and health posts (IRR: 0.817; 95% CI: 0.732-0.91). Similarly, ANC quality decreased when gestational age at the first antenatal visit increased (IRR: 0.994; 95% CI: 0.992-0.996) and when care was received from a non-nearby healthcare facility (IRR: 0.956; 95% CI: 0.923-0.990).ConclusionOverall, the quality of ANC in Ethiopia is suboptimal. Encouraging women to initiate ANC early and utilize nearby facilities, assisting providers in delivering standardized services through preservice training, supervision, and continuous education, and ensuring the availability and proper use of necessary resources at all facilities are important to improve ANC quality.

ABSTRACT Background Globally, infectious diseases such as pneumonia, diarrhea, and malaria are the leading causes of death for children under 5. Diarrheal disease is a significant public health concern and causes the death of approximately 525,000 children under the age of 5 every year. In Ethiopia, studies revealed that the prevalence of diarrhea among children under 5 years is alarming. However, there has been a shortage of studies regarding the predictors of diarrheal disease in Geshiyaro project implementation sites in Ethiopia. Therefore, this study aimed to fill this gap. Methods A community‐based cross‐sectional study was conducted from June to July 2023. A total of 2937 participants were enrolled in this investigation. Descriptive and multivariate logistic regression analysis was performed using STATA version 16. Results The 2‐week prevalence of diarrhea among children under 5 years was 11.8%. The following factors were significantly associated (p

BackgroundUnder-five mortality continues to be a serious public health concern in low-and middle-income countries, particularly in Africa. This study investigates the probability of under-five survival and its predictors of mortality in the African continent using a recent demographic health survey from 2014-2022.MethodsThis study utilized recent Demographic and Health Survey data from 30 African countries, encompassing 226,862 live births. This study employed a multivariable lognormal accelerated failure time gamma shared frailty parametric survival regression analysis to identify the predictors of time-to-death among under-five children in these African nations.ResultThe overall under-five child mortality rate in Africa was 37.55 per 1,000 live births (95% CI: 37.35, 37.74. In this study, children born in Western Africa; children born in Eastern Africa; children born to mothers aged 15-19 years; maternal educational status; maternal decision autonomy; being female; place of delivery; number of ANC visits; children born among mothers who delivered by Cesarean section; mothers who have multiple birth outcome; children who were second birth order; and third birth order and third birth order; children who were small in size at birth; children who were born from a community with a low women education; having poor wealth index; respondents working; mothers delivered at the age between 20-35 were significant predictors of survival time to event of under-five children in Africa.ConclusionThis study found that the overall under-five mortality rates remain high across Africa. In this study country region, maternal age, maternal education status, maternal age at first birth, respondent's employment status, birth outcome, wealth index, birth order, place of delivery, mode of delivery, women's autonomy in healthcare decision-making, number of antenatal care visits, child's size at birth, sex of the neonate, and community-level women's education were found to be significant predictors of survival time to death of under-five children. Addressing these multilevel factors is crucial for developing targeted interventions to reduce under-five mortality further and improve child survival in African countries.

ABSTRACT Severe hypokalemia can primarily present as a weakness of the limbs, without any other clinical manifestation. A life‐threatening level of decreased serum potassium level can be unusually present with isolated weakness of the limbs and might be misdiagnosed, or the diagnosis may be delayed.

BackgroundThe full pentavalent (DPT-HepB-Hib) vaccination is the main strategy to prevent five communicable diseases in early childhood, especially in countries with huge communicable disease burdens like Ethiopia. Exploring spatial distributions and determinants of full pentavalent vaccination status in minor ecological areas in Ethiopia is crucial for creating targeted immunization campaigns and monitoring the advancement of accomplishing sustainable development goals. This study aimed to investigate the spatial disparities and determinants of full pentavalent vaccination among 12-23-month-old children in Ethiopia.MethodThe data on pentavalent vaccine uptake was found in the Ethiopian Health and Demographic Survey (EDHS, 2019). A two-stage cluster sampling method was applied to collect the EDHS data. The enumeration area was the primary sample unit while the household served as the secondary sampling unit. The geographical variations of full pentavalent vaccine uptake were explored using Quantum Geographic Information System (QGIS) software. The significant predictors of full pentavalent vaccination were identified using a simple logistic regression model through R version 4.1 software.ResultThe national full pentavalent vaccine uptake was 59.2%. The spatial distribution of full pentavalent vaccine uptake was not uniform in Ethiopia. Spatial cluster analysis revealed that most of low coverage regions for full pentavalent vaccine uptake were Afar, Somali, and Harari. The regions with the highest and lowest rates of vaccine uptake were Tigray and Harari region, respectively. Maternal age of 35-49 years (AOR = 3.42; 95% CI: 1.99, 5.87), and 25-34 years (AOR = 1.55; 95% CI: 1.17, 2.19), primary education attended (AOR = 1.51; 95%CI: 1.07, 2.11), richness wealth index (AOR = 1.96; 95% CI: 1.40, 2.75), birth order of 1-3 (AOR = 1.88; 95% CI: 1.19, 2.96), and delivery in the health facility (AOR = 3.41: 95% CI: 2.52, 4.61) were the determinants of full pentavalent vaccine uptake in Ethiopia.ConclusionEthiopia's full pentavalent vaccine uptake was far lower than the global target. Older maternal age, maternal education, wealth index, birth order, and giving birth in a health facility were the determinants of full pentavalent vaccine uptake. Special attention should be given to Afar, Somali, and Harari regions, to strengthen the vaccine uptake. Moreover, improved socioeconomic status and getting maternal health services during delivery are necessary to enhance vaccine uptake.

Introduction Although evidence exists on the impact of microbiota on pregnancy outcomes in many high-resource settings, there is a lack of research in many low-resource settings like Ethiopia. This study aims to fill this gap by studying the gut and vaginal microbiota changes throughout pregnancy and assess how these changes relate to pregnancy outcomes among a cohort of pregnant women in eastern Ethiopia.Methods and analysis Vaginal and stool samples will be collected using DNA/RNA Shield Collection kits three times starting at 12–22 weeks, 28–36 weeks and at birth (within 7 days). Postnatally, newborns’ skin swabs (at birth) and rectal swabs will be obtained until 2 years of age. Moreover, breast milk samples at birth and 6 months and environmental samples (water, indoor air and soil) will be collected at enrolment, birth, 6, 12 and 24 months post partum. DNA will be extracted using Roche kits. Metagenomic sequencing will be performed to identify metataxonomic profiling and assess variations in microbial profiles, and α and β diversity of the microbiota. Information on socioeconomic, behavioural, household and biological factors will be collected at enrolment. The collected data will be coded, entered into EpiData 3.1 and analysed using Stata 17.Ethics and dissemination The Institutional Health Research Ethics Review Committee (Ref No. IHRERC/033/2022) of Haramaya University, Ethiopia has approved this study ethically. Written informed consent regarding the study and sample storage for biobanking will be obtained from all participants. Results will be published in international peer-reviewed journals, and summaries will be provided to the study funders. Clinical study data will be submitted to Data Compass (https://datacompass.lshtm.ac.uk/), and molecular profiles of the microbiome and whole-genome sequences will be submitted to the European Nucleotide Archive (https://www. ebi.ac.uk/ena). Requests for data should be directed to daberaf@gmail.com. The decision to share data will be made by the study steering committee under the College of Health and Medical Sciences, Haramaya University, Ethiopia.

Objectives To assess the geographical equity in Ethiopian infants’ exclusive breastfeeding at 5 months and dietary diversity at 12 months and whether social factors explained the spatial inequities.Design Secondary analysis of a birth cohort study.Setting Analysis of data from the Ethiopian Performance Monitoring for Action panel study conducted from July 2020 to August 2021 in five regions (ie, Oromia, Amhara, Afar and Southern Nations, Nationalities and Peoples regions and the Addis Ababa City administration). We analysed geographical autocorrelation to assess geographical variations in exclusive breastfeeding and dietary diversity. Areas with higher and lower coverage of appropriate infant feeding outcomes were analysed using hotspot analyses. We performed geographically weighted regression to investigate whether sociodemographic factors explained the geographical feeding differences.Participants 1850 infants were prospectively followed from birth to 12 months.Outcome measures Exclusive breastfeeding at 5 months and minimum-level dietary diversity at 12 months.Results Sixty-nine percent (95% CI 67 to 71) of infants were exclusively breastfed at 5 months, while at 12 months, only 16% (95% CI 13 to 19) had complementary feeding from five or more food groups. There were geographical variations in the coverage of exclusive breastfeeding and minimum dietary diversity. Higher proportions of infants were exclusively breastfed at 5 months in northern areas, and more 12-month-old infants in central parts of the country had complementary feeding from at least five food groups. Sociodemographic factors explained a quarter of the geographical variation in dietary diversity.Conclusion Most Ethiopian infants were exclusively breastfed, which was in line with global recommendations but with some geographical differences. There was prominent geographical variation in dietary diversity, partly explained by social factors, but overall, very few 12-month-old infants were fed from at least five food groups. This low dietary quality could impair Ethiopian children’s physical growth, development and health.

Objective This study aimed to assess the determinants of underweight among returnees lactating mothers in governmental health facilities of Gedeo zone, Southern Ethiopia.Design Case–control study.Setting Gedeb District governmental health facilities.Participants A total of 264 returnees lactating mothers (88 cases and 176 controls) were randomly selected from four health institutions of Gedeb District.Outcome measures Underweight was measured by anthropometric measurement weight/height2. An institutional-based unmatched case–control study was conducted from 11 July 2022 to 20 September 2022. The study involved 264 returnee lactating mothers, with 88 classified as cases (body mass index, BMI

Abstract Background Although vaginal stenosis following pelvic or vaginal radiotherapy for cancer treatment is a common complication, postpartum vaginal stenosis is a very rare obstetric complication. We report two cases of postpartum vaginal stenosis. Case presentation The first was case was a 30-year-old para-I Ethiopian woman who presented with a history of foul-smelling vaginal discharge on her 11th postpartum day. Pelvic magnetic resonance imaging (MRI) demonstrated a 1.4 cm distal vaginal stenosis. The second case was a 39-years-old para-II Ethiopian woman who presented with history of amenorrhea and dysparunia of 20 months duration. Abdominopelvic ultrasound examination revealed hematometrocolpos secondary to postinflammatory vaginal stenosis, and 3300 ml of hematocolpometra was drained. In both cases, adhesion excision with successful vaginal reconstruction was performed. Conclusion Postpartum vaginal stenosis is a rare obstetric complication and vaginal adhesions excision with regular vaginal dilation is the recommended management for it.

Abstract Introduction Non-pancreatic pseudocysts are rare lesions that typically form from the omentum and mesentery. These cysts have a thick fibrotic wall made up of fibrous tissue and may show signs of calcifications and inflammatory changes. The fluid inside them can vary, ranging from hemorrhage and pus to serous or sometimes chylous content. In most cases, these cysts appear as a result of trauma, surgery, or infection. Case presentation A 35-year-old male patient from Ethiopia presented with swelling in his lower abdomen that had been present for 2 years. Initially, the swelling was small but gradually increased in size. The patient experienced frequent urination but no pain or difficulty during urination, urgency, intermittent urination, or blood in the urine. The swelling was initially painless but became painful 2 months prior to his presentation. Abdominal computed tomography scans revealed a well-defined, lobulated peritoneal lesion measuring 16 × 12 × 10 cm, consisting primarily of fluid-filled cysts with a thick, enhancing wall and septa. Additionally, there was a large, heterogeneous enhancing soft tissue component measuring 8 × 6 cm. As a result, the cystic mass was surgically removed in its entirety with partial removal of the bladder wall, and the patient was discharged in an improved condition. Conclusion Primary non-pancreatic pseudocysts are extremely rare lesions that must be differentiated from other possible causes of cystic lesions within the peritoneal or retroperitoneal regions. Surgeons should be aware of the potential occurrence of these lesions, which may have an unknown origin.

Abstract Background and purpose A stroke or a cerebrovascular accident is a common cause of death and a leading cause of long-term, severe disability in both developed and developing countries. The most recent global burden of disease report states that there were 11.9 million new cases of stroke worldwide; stroke accounts for nearly 1 in 8 deaths globally (12%, 6.5 million deaths) and claims a life every 5 s, making it the second most common cause of death worldwide. The goal of the study was to identify the most important factors influencing stroke patients' time to death at Gambella General Hospital. Methods Data was gathered from patient files in a hospital using a retrospective study methodology, spanning the period from September 2018 to September 2020. R 3.4.0 statistical software and STATA version 14.2 were used for data entry and analysis. The survival time was compared using the log-rank tests and the Kaplan–Meier survival curve. The fitness of the Cox proportional hazard model was examined. Results The final model that was fitted was the log-logistic AFT model. A statistically significant correlation was defined as having a p value of less than 0.05 and the accelerated factor (γ) with its 95% confidence interval was employed. Eight days was the total median death time (95% CI 6–10). Significant predictors for shortened mortality time were age (γ = 0.94; 95% CI (0.0.920–0.980), hypertension (γ = 0.63; 95% CI (0.605–0.660), and baseline complications (γ = 0.24; 95% CI (0.223–0.256). Conclusions The shortened timing of death was significantly predicted by age, hypertension, and baseline complications. In light of the study's findings, health administrators and caregivers should work to improve society's overall health.

Abstract Background Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) proteins are expressed on the surface of infected erythrocytes, mediating parasite sequestration in the vasculature. PfEMP1 is a major target of protective antibodies, but the features of the antibody response are poorly defined. Methods In Malawian children with cerebral or uncomplicated malaria, we characterized the antibody response to 39 recombinant PfEMP1 Duffy binding like (DBL) domains or cysteine-rich interdomain regions (CIDRs) in detail, including measures of antibody classes, subclasses, and engagement with Fcγ receptors and complement. Using elastic net regularized logistic regression, we identified a combination of seven antibody targets and Fc features that best distinguished between children with cerebral and uncomplicated malaria. To confirm the role of the selected targets and Fc features, we measured antibody-dependent neutrophil and THP-1 cell phagocytosis of intercellular adhesion molecule-1 (ICAM-1) and endothelial protein C (EPCR) co-binding infected erythrocytes. Results The selected features distinguished between children with cerebral and uncomplicated malaria with 87% accuracy (median, 80–96% interquartile range) and included antibody to well-characterized DBLβ3 domains and a less well-characterized CIDRγ12 domain. The abilities of antibodies to engage C1q and FcγRIIIb, rather than levels of IgG, correlated with protection. In line with a role of FcγRIIIb binding antibodies to DBLβ3 domains, antibody-dependent neutrophil phagocytosis of ICAM-1 and EPCR co-binding IE was higher in uncomplicated malaria (15% median, 8–38% interquartile range) compared to cerebral malaria (7%, 30–15%, p

Abstract Background Fetal calf serum (FCS), an existing cell culture supplement, is effective but has several drawbacks, including being expensive, requiring a lengthy process of production, and requiring a hard currency. With this in mind, we planned to evaluate chick embryo extract and egg yolk extracts in cell culture as alternatives to fetal calf serum (FCS). Methods Specific pathogen-free eggs were purchased from the National Veterinary Institute, Bishoftu, Ethiopia, and incubated in a humidified incubator at 37 °C for 11 days. Egg yolk extract (EYE) and chick embryo extract (CEE) were collected after the egg was opened with caution not to destroy the yolk sack or the chick embryo itself. Chick fibroblasts and Vero cells were cultured in minimum essential medium (MEM) supplemented with egg yolk extract or chick embryo extract at ratios of 0:10, 1:9, 2.5:7.5, and 5:5% fetal calf serum. Results Fibroblast cell attachment was better in media supplemented with 5% CEE and 5% FCS. The confluency was also greater than 50% at this concentration. Vero cells cultured with 5% CEE and 5% FCS also exhibited very good cell attachment and a confluency of up to 70%. Viability and confluency were also observed at 5%:5% ratios of 50 and 70%, respectively. Conclusion This investigation evaluated these two extracts as cell culture supplements and revealed promising results as alternatives to fetal calf serum. The limitation of this study is that it only used two cell types and additional cell lines, and different ratios should be tested. With the above findings, further research using different cell lines, ratios and conditions is warranted.

Abstract Background Simulation is a method of learning in which the learner experiences a simulated situation instead of being physically present in the clinical area. Exposing students to simulation-based education improves learners’ clinical competence and ability to make decisions, which are crucial for today’s health workforce. When given the proper circumstances, such as receiving feedback on their performance, having the chance for repeated practice, and having simulation as a core component of the curriculum, simulated instruction greatly aids in learning. Although previous studies have been conducted in this area, there are gaps in determining the factors related to their learning environment and design characteristics. Method An institution-based cross-sectional study was conducted on 413 midwifery students in Amhara region universities from August 1–30, 2022. Study participants were selected via a simple random sampling technique. Data were collected from third and fourth-year undergraduate midwifery students through a self-administered questionnaire. Epi Data version 4.6 and Statistical Package for Social Sciences version 26 were used for data entry and analysis, respectively. Bivariable and multivariable logistic regression analyses were employed; a P-value of less than 0.05 was considered statistically significant in the study. Result This study revealed that 84.7% (95% CI: 81.1–88.3) of midwifery students in Amhara region universities were satisfied with simulation-based education. Year of study [AOR: 2.936; 95% CI (1.531–5.631)], adequate support [AOR: 2.903; 95% CI (1.217–6.922)], availability of instructors [AOR = 2.861, 95% CI (1.078–7.591)], and provision of checklists [AOR: 2.326; 95% CI (1.143–4.734)] were found to be statistically significant variables. Conclusion This study revealed undergraduate midwifery students were more satisfied with simulation-based education compared with previous studies conducted in Ethiopia. Predictor variables such as year of study, support, instructor availability, and provision of checklists were significantly associated with student satisfaction. Hence, midwifery departments should strengthen the support given by staff, encourage their instructors to be available during simulations, improve the utilization and provision of checklists to students as much as possible.

Abstract Nonlinear time-fractional partial differential equations (NTFPDEs) play a great role in the mathematical modeling of real-world phenomena like traffic models, the design of earthquakes, fractional stochastic systems, diffusion processes, and control processing. Solving such problems is reasonably challenging, and the nonlinear part and fractional operator make them more problematic. Thus, developing suitable numerical methods is an active area of research. In this paper, we develop a new numerical method called Yang transform Adomian decomposition method (YTADM) by mixing the Yang transform and the Adomian decomposition method for solving NTFPDEs. The derivative of the problem is considered in sense of Caputo fractional order. The stability and convergence of the developed method are discussed in the Banach space sense. The effectiveness, validity, and practicability of the method are demonstrated by solving four examples of NTFPEs. The findings suggest that the proposed method gives a better solution than other compared numerical methods. Additionally, the proposed scheme achieves an accurate solution with a few numbers of iteration, and thus the method is suitable for handling a wide class of NTFPDEs arising in the application of nonlinear phenomena.

Abstract Background When a pregnant mother finds out she has a fetus with a congenital defect, the parents feel profound worry, anxiety, and melancholy. Anomalies can happen in singleton or twin pregnancies, though they are more common in twin pregnancies. In twins, several congenital defects are typically discordant. Case summary We present a rare case of concordant fatal anomaly in twin pregnancy in a 22-year-old African patient primigravida mother from Western Ethiopia who presented for routine antenatal care. An obstetric ultrasound scan showed anencephaly, meningomyelocele, and severe ventriculomegaly. After receiving the counseling, the patient was admitted to the ward, and the pregnancy was terminated with the medical option. Following a successful in-patient stay, she was given folic acid supplements and instructed to get preconception counseling before getting pregnant again. Conclusion The case demonstrates the importance of early obstetric ultrasound examination and detailed anatomic scanning, in twin pregnancies in particular. This case also calls for routine preconceptional care.

Abstract A growing body of evidence indicates the emergence of overweight/obesity in developing countries before the battle against undernutrition has been won. We conducted this study to quantify the reduction of underweight and the emergence of overweight among Ethiopian women from 2000 to 2016 and evaluate factors explaining the progress. We used the four Ethiopian Demographic and Health Surveys (2000–2016) to analyze body mass index (BMI) trends among women. Data from 43,815 non-pregnant, non-puerperal reproductive-age women was used to evaluate the linear change in BMI and changes in the percentage of overweight and underweight over time. Using multivariate decomposition analysis of change in underweight and overweight percentages, we identified sources of change in BMI in the past 16 years of the survey periods. The BMI of Ethiopian reproductive-age women increased by 0.88 kg/m2 from 2000 to 2016. The increment was pronounced in urban areas with 1.46 kg/m2. There has been a significant reduction in underweight women since 2000 (p-value

Abstract Background Endometriosis is one of the most common gynaecological diseases, yet it lacks efficient biomarkers for early detection and unravels disease mechanisms. Proteomic profiling has revealed diverse patterns of protein changes in various clinical samples. Integrating and systematically analysing proteomics data can facilitate the development of biomarkers, expediting diagnosis and providing insights for potential clinical and therapeutic applications. Hence, this systematic review and meta-analysis aimed to explore potential non-invasive diagnostic biomarkers in various biological samples and therapeutic targets for endometriosis. Methods Online databases, including Scopus, PubMed, Web of Science, MEDLINE, Embase via Ovid, and Google Scholar, were searched using MeSH terms. Two independent authors screened the articles, extracted the data, and assessed the methodological quality of the included studies. GO and KEGG analyses were performed to identify the pathways that were significantly enriched. Protein‑protein interaction and hub gene selection analyses were also conducted to identify biomarker networks for endometriosis. Results Twenty-six observational studies with a total of 2,486 participants were included. A total of 644 differentially expressed proteins (180 upregulated and 464 downregulated) were identified from 9 studies. Proteins in peripheral blood exhibited a sensitivity and specificity of 38-100% and 59-99%, respectively, for detecting endometriosis, while proteins in urine had a sensitivity of 58-91% and specificity of 76-93%. Alpha-1-antitrypsin, albumin, and vitamin D binding proteins were significantly DEPs in both serum and urine. Complement C3 is commonly expressed in serum, menstrual blood, and cervical mucus. Additionally, S100-A8 is commonly expressed in both menstrual blood and cervical mucus. Haptoglobin is commonly detected in both serum and plasma, whereas cathepsin G is found in urine, serum, and plasma. GO and KEGG enrichment analyses revealed that proteoglycans in cancer pathways, which regulate cell-to-cell interactions, modulate the extracellular matrix, and promote the proliferation and invasion of endometrial cells, are commonly enriched in serum and urine. Conclusion This comprehensive study revealed potential proteomes that were significantly differentially expressed in women with endometriosis utilizing various non-invasive clinical samples. Exploring common differentially expressed proteins in various biological samples provides insights into the diagnosis and pathophysiology of endometriosis, as well as potential clinical and therapeutic applications. Graphical abstract

Background Cutaneous leishmaniasis (CL) is a skin neglected tropical disease, with an estimated 40,000 new cases each year in Ethiopia. CL causes ulcers, nodules, and plaques on the skin, and in some instances the destruction of the nasopharyngeal mucosa and cartilage. Some CL lesions may heal spontaneously, whilst other lesions may require therapies which are associated with discomfort, adverse effects, prolonged treatment, and a frequent lack of a complete response. Scarring, a sequela of CL, causes permanent disfigurement and is associated with stigma linked with a reduction in health-related quality of life. The choice of treatment for CL is based upon factors including the causative species; the number, extent, size, and location of lesions; and the availability of treatments. The development of robust evidence for CL treatment is hindered by a lack of validated and appropriate outcome measures and few data to support hypothesis-generation and trial design. There is a paucity of prospective data with well-defined treatment outcomes for CL caused by L. aethiopica. Aim The overall aim of this study is to improve the understanding of the health and economic burden of CL. Methods We have designed an observational, multi-centre cohort study to examine treatment outcomes for CL in Ethiopia which includes clinical outcomes, laboratory outcomes, patient reported outcome measures, scar assessments and cost effectiveness. We aim to recruit up to 750 participants across two hospital sites. We present here the protocol for this cohort study with a 12-month follow up period for each participant. Conclusions These data will inform the design of randomized controlled trials to evaluate new treatment strategies, with appropriate economic evaluations. This will help improve evidence-based guidelines and support evidence-led policy decisions, not only in Ethiopia but also globally.

ABSTRACT Arteriovenous fistula is an abnormal connection between arteries and veins occurring usually following surgery, trauma, catheterization, or local procedures. Spontaneous arteriovenous fistulas are a rare clinical entity with very few cases reported in the literature with unclear mechanisms. We present a case report of a 54‐year‐old Ethiopian female with known chronic kidney disease on hemodialysis for 2 years thrice a week who presented with progressive pulsatile right thigh mass of 7 months duration in the absence of trauma, catheter insertion previously, or surgery. The arteriovenous fistula was confirmed by computed tomography angiography and it was intervened with open surgery with no complication.

ABSTRACT Background and Aims Access to eye health care, which has a substantial influence on quality of life, is crucial for preventing and treating vision impairments. The determinants of access to eye health care in Ethiopia, especially in the Gamo and Gofa Zones in southern Ethiopia, are not well known. Therefore, this study aimed to identify barriers to accessing eye health services at the community level. Methods A community‐based, exploratory descriptive qualitative study was conducted among adult women and men residing in two zones from June 2 to July 10, 2023. A purposive sampling technique was utilized to collect qualitative data. In‐depth interviews and FGDs were included among the purposefully selected study participants. During the interviews and discussions, digital audio recording was carried out. The data were analysed via the inductive thematic analysis technique and direct quotations from participants' opinions. The respective themes and subthemes provided a detailed overview of the findings, and the Atlas software was used to support the analysis. Findings Nine FGDs were conducted among 90 participants. Moreover, a total of 26 in‐depth interview participants were included. The mean (±SD) age of the participants in the in‐depth interviews was 32.96 ± 4.8 years. The most commonly cited barriers (1) poor awareness and misperception, financial constraints and community‐based health insurance implementation gaps; (2) lack of social support; (3) lack of healthcare accessibility, shortage of basic medical equipment; (4) cultural eye care practices and (5) poor road access, rough topography, and difficulty reaching areas, which are identified as obstacles for accessing eye health services. Conclusion This study identified pertinent barriers that hinder access to eye health care in the study area. Therefore, tailored strategies are needed to tackle the challenges. This approach is helpful for the local context and offers actionable insights for health policymakers and program designers.

Objectives To identify the determinants of traditional birth attendants’ utilisation among reproductive-age women in Ethiopia.Design Cross-sectional study design.Setting Ethiopia.Participants A total of 3979 weighted samples of reproductive-age women were included.Outcome measure Traditional birth attendant utilisation.Results This study found a high prevalence (29.76%) of Ethiopian mothers using traditional birth attendants for delivery, based on data from the 2019 Ethiopian Demographic and Health Survey. Mothers with higher education (adjusted OR (AOR)=0.11, 95% CI: 0.01 to 0.62), who had four or more antenatal care visits (AOR=0.34, 95% CI: 0.21 to 0.54), communities with lower levels of education (AOR=2.21, 95% CI: 1.30 to 3.73), communities with higher poverty levels (AOR=1.71, 95% CI: 1.99 to 2.96) and those from peripheral regions (AOR=3.41, 95% CI: 1.77 to 6.56) were found to be predictors of traditional birth attendants.Conclusion This study indicates a high prevalence (29.76%) of Ethiopian mothers using traditional birth attendants, highlighting the need for targeted interventions to promote skilled birth attendance. Policymakers should focus on implementing educational programmes targeting reproductive-age women and improving access to quality antenatal care. Specific initiatives could include community-based educational workshops and subsidies for transportation to healthcare facilities. Furthermore, mothers in remote and border districts should receive specialised attention in terms of resource allocation, including skilled personnel and enhanced healthcare access.

Background: The World Health Organization recommends that all postpartum women be examined for resumed sexual activity. Despite this, postpartum sexual health education and health promotion are not adequately incorporated into current maternal healthcare systems in low- and middle-income nations. There were variations in the prevalence and variables associated with early postpartum sexual intercourse across several studies. Objectives: The purpose of this systematic review and meta-analysis was to evaluate the pooled prevalence and associated factors for early postpartum sexual intercourse in sub-Saharan African countries. Data Sources and Methods: Primary studies were identified using international databases such as Scopus, PubMed, Google Scholar, Embase, and CINAHL. The Newcastle‒Ottawa Scale quality assessment tool was used to evaluate the quality and strength of the included studies. STATA version 17 was used for the meta-analysis. The heterogeneity of the studies and publication bias was examined using I 2 statistics and Egger’s regression test. Subgroup analysis decreased the underlying heterogeneity based on the study years and sample sizes. Results: Seventeen primary articles were included in the meta-analysis with 8507 study participants. The pooled prevalence of early postpartum sexual resumption in sub-Saharan Africa was 39.41% (95% CI: 31.55%–47.27%). Primiparous (OR = 3.32; 95% CI: 2.26–5.90), spontaneous vaginal delivery (OR = 5.98; 95% CI: 1.74–20.51), formula feeding (OR = 2.24; 95% CI: 1.46–3.44), family planning (OR = 2.91; 95% CI: 1.89–4.49), husband pressure (OR = 4.99; 95% CI: 1.38–18.05), have no formal education (OR = 2.36; 95% CI: 1.49–3.76), and monogamy (OR = 4.18; 95% CI: 2.27–7.69) were significantly associated with early postpartum sexual resumption. Conclusion: Four out of 10 women had returned to sexual activity within 6 weeks of giving birth. This suggests that a large proportion of women are more vulnerable to unwanted pregnancies and sexual health problems. Sexual health education and counseling should be incorporated into standard postpartum care to increase contraceptive use and delay unplanned pregnancies.