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Background End-Stage Kidney Disease, the most severe form of chronic kidney disease, is fatal if not treated by renal replacement therapy. Thus, patients with End-Stage Kidney Disease depend on hemodialysis as a lifesaving treatment for the remainder of their lives. However, the health-related quality of life (HRQOL) of patients on hemodialysis is much more underappreciated in resource limited countries. Methods A hospital based cross-sectional study was conducted in Addis Ababa, Ethiopia, from August 01 to October 31, 2019. All patients who were on hemodialysis in five randomly selected public and private hospitals (n = 125) were included in the study. Data were administered by trained nurses by using a standardized Kidney Disease Quality of Life questionnaire. Clinical data were extracted from the patients’ medical charts. HRQOL was categorized as low, if the overall mean score was ≤ 50, or as high, if the overall mean score was > 50. Factors associated with lower HRQOL were identified by multi-variable binary logistic regression analysis and expressed by adjusted odds ratio (aOR) and its respective 95 % confidence interval. Results The mean age of the study participants (n = 125) was 50.33 years (± 15.07) and more than two-thirds (68.8 %) of the participants were males. The mean score of HRQOL was 49.08 ± 11.09, with 48.0 % (95 % CI: 42.2 − 54.5 %) of them had lower HRQOL. Unemployed patients (aOR = 2.40, 95 % CI: 1.10–5.90) and patients who had hemodialysis 2 times per week (aOR = 1.71, 95 % CI: 1.07–3.83) had lower HRQOL. Elderly patients had higher odds of having lower mean score on the burden of kidney disease (aOR = 2.07; 95 % CI 1.18–4.13) as compared to the younger patients. Conclusions Nearly half of the patients with ESKD on hemodialysis had lower overall HRQOL which is associated with their unemployment status and frequency of hemodialysis per week. Elderly patients had lower mean score of burden of kidney disease. Therefore, quality of life of patients with chronic dialysis should be given special attention during the patients’ care. Measures should be taken by the government to ensure accessibility and affordability of the hemodialysis services in the country.

Background; Malaria is caused by one or more of the five species of plasmodium species that can infect by the bite of female Anopheles. In Ethiopia, about 68% of the total population resides in areas with high malaria risk and 2,174,707 cases and 662 deaths due to malaria were reported in 2014–2015 with case fatality rate of 0.03%. The outbreak was reported on April 22/2019 (WHO week 17) then we investigate the outbreak to describe the magnitude of morbidity and mortality due to malaria outbreak, identify the etiologic agent and investigate factors associated with an occurrence of malaria outbreak.Methods; we conducted case control study in Bolosso Sore woreda. We used outbreak investigation questionnaire to asses’ risk factor for both cases and controls of patients. We collected 75 cases and 150 controls by face to face interview by administered questionnaire. We analysed the data with Epi Info.Version7.2.0.1 and SPSS.V 23 and the statistical we used 95% CI. Result; the overall attack rate of the woreda was 36.4 per 1000. From the cases Males are slightly more affected than females (38: 37) .The most affected age group is >15 years, 54 (72%) followed by 5-14, 17(22.7%). Plasmodium falcifarem is the highest proportion of malaria in the wereda. Having impregnated treated net have no problem but impregnated treated net who have used sometimes (AOR 10.214; 95% CI) was identified as a risk factor for malaria or more likely affected by malaria ten times each respectively than those impregnated treated net used always. Conclusion; Presence of intermittent rivers nearest to the community, open deep well near to their home and usage of impregnated treated net (those impregnated treated net use sometimes and never use impregnated treated net) were risk factors for onset/occurrence of the outbreak of malaria. We recommend all malarias area insecticide treated bed net should be distributed for all households according to their family member. Beside this, utilization of bed net should be monitored and optimized.

Background In 2010–2017, meningococcal serogroup A conjugate vaccine (MACV) was introduced in 21 African meningitis belt countries. Neisseria meningitidis A epidemics have been eliminated here; however, non-A serogroup epidemics continue. Methods We reviewed epidemiological and laboratory World Health Organization data after MACV introduction in 20 countries. Information from the International Coordinating Group documented reactive vaccination. Results In 2011–2017, 17 outbreaks were reported (31 786 suspected cases from 8 countries, 1–6 outbreaks/year). Outbreaks were of 18–14 542 cases in 113 districts (median 3 districts/outbreak). The most affected countries were Nigeria (17 375 cases) and Niger (9343 cases). Cumulative average attack rates per outbreak were 37–203 cases/100 000 population (median 112). Serogroup C accounted for 11 outbreaks and W for 6. The median proportion of laboratory confirmed cases was 20%. Reactive vaccination was conducted during 14 outbreaks (5.7 million people vaccinated, median response time 36 days). Conclusion Outbreaks due to non-A serogroup meningococci continue to be a significant burden in this region. Until an affordable multivalent conjugate vaccine becomes available, the need for timely reactive vaccination and an emergency vaccine stockpile remains high. Countries must continue to strengthen detection, confirmation, and timeliness of outbreak control measures.

Rabies infection is almost always a 100% lethal viral disease in all mammals, including humans. Although rabies is vaccine preventable disease, more than 60,000 people worldwide, and 2,700 people in Ethiopia die of fatal human rabies annually. The aim of this study was to generate strategic information on the extent of the burden of rabies and the existing major response strategies, in order to overcome and bring attention to the management of rabies outbreaks. Cross - sectional study design was used to assess the current situation of rabies burden in the Southern Nations, Nationalities, and Peoples' Regional States of Ethiopia. Data analysis revealed a total of 16 fatal human rabies and 287 suspected rabies exposures. The highest attack rate of 116.3 cases per 100,000 human subjects was reported in Tembaro woreda. As a result, 48 animal deaths of rabies have been reported, while cattle (28) have been more affected than other animal species. The lack of dog immunization, lack of community awareness of dog management, and inaccessibility and inefficiency of anti - rabies vaccines were major risk factors associated with the spread of rabies exposure between humans and animals. In conclusion, this study has clearly shown that both the existence and the high magnitude of fatal human and animal rabies are significant in the area. Multidisciplinary approach interventions to increase community awareness of dog vaccination, effective and immediate treatment of exposed individuals is recommended as a method of disease control and prevention.

Background The influenza virus spreads rapidly around the world in seasonal epidemics, resulting in significant morbidity and mortality. Influenza-related incidence data are limited in many countries in Africa despite established sentinel surveillance. This study aimed to address the information gap by estimating the burden and seasonality of medically attended influenza like illness in Ethiopia. Method Influenza sentinel surveillance data collected from 3 influenza like illness (ILI) and 5 Severe Acute Respiratory Illness (SARI) sites from 2012 to 2017 was used for analysis. Descriptive statistics were applied for simple analysis. The proportion of medically attended influenza positive cases and incidence rate of ILI was determined using total admitted patients and catchment area population. Seasonality was estimated based on weekly trend of ILI and predicted threshold was done by applying the “Moving Epidemic Method (MEM)”. Result A total of 5715 medically attended influenza suspected patients who fulfills ILI and SARI case definition (77% ILI and 23% SARI) was enrolled. Laboratory confirmed influenza virus (influenza positive case) among ILI and SARI suspected case was 25% (1130/4426) and 3% (36/1289). Of which, 65% were influenza type A. The predominantly circulating influenza subtype were seasonal influenza A(H3N2) (n = 455, 60%) and Influenza A(H1N1)pdm09 (n = 293, 38.81%). The estimated mean annual influenza positive case proportion and ILI incidence rate was 160.04 and 52.48 per 100,000 population. The Incidence rate of ILI was higher in the age group of 15–44 years of age [‘Incidence rate (R) = 254.6 per 100,000 population’, 95% CI; 173.65, 335.55] and 5–14 years of age [R = 49.5, CI 95%; 31.47, 130.43]. The seasonality of influenza has two peak seasons; in a period from October–December and from April–June. Conclusion Significant morbidity of influenza like illness was observed with two peak seasons of the year and seasonal influenza A (H3N2) remains the predominantly circulating influenza subtype. Further study need to be considered to identify potential risks and improving the surveillance system to continue early detection and monitoring of circulating influenza virus in the country has paramount importance.

Introduction Suspected cholera cases were reported to the city administration health bureau in Addis-Ababa, Ethiopia on June 5, 2016 and it was laboratory confirmed by culture on 7 June 2016. The outbreak was declared by the government on June 8, 2016. The aim of this study was to rapidly investigate the outbreak epidemiologically and guide response activities in the affected Sub cities of Addis Ababa city administration. Methods An unmatched 1:2 case-control study was conducted in six selected sub-cities of the city administration. Different laboratory tests were also done from suspected possible risk factors identified to support the epidemiological findings. A case was a patient greater than 5 years old, who developed acute watery diarrhea with or without Vomiting. Control was an individual greater than 5 years' old who stayed in the same township and did not suffer from cholera. A structured questionnaire was used to select cases and controls. Epi InfoTM statistical software was used to analyze the data. Results were presented in narratives, figures and tables. Results The present study found that, the study participants who used street-vended water (Odds Ratio (OR)=10.4; 95% CI: 1.20-90.9), those who reported holy water sources use (OR=2.7, 95% CI: 1.45-5.04), eating raw meat (OR=7.75; 95% CI: 3.86-15.54) or roasted meat (OR=2.16; 95% CI: 1.19-3.93) and vegetable salad (OR=2.07; 95% CI: 1.14-3.76) were associated with contracting cholera infection. The likelihood of contracting cholera was significantly higher among those who ate food from street vendor sources (OR=5.32; 95% CI: 1.82-15.56) and those who practiced open defecation (OR=8.12; 95% CI (2.20-29.81). Having a latrine (OR=0.29; 95% CI: 0.12-0.69) and proper hand hygiene practice (OR=0.22; 95% CI: 0.14-0.38) were found to be protective against cholera infection. Conclusion Improving awareness of the community by intensifying social mobilization activities through community participation in proper hygienic practice, proper waste disposal and latrine facility construction and utilization. Provision of safe water for the community by strictly conducting end-point assessment of water points and conducting a KAP assessment among food handlers to explore their knowledge and practices regarding safe food/drink handling and water treatment as well as initiate appropriate PH actions based on the findings which will be necessary for prevention of similar cholera outbreaks in the future.

Background: Dengue fever is a rapidly emerging vector born infectious disease caused by Dengue virus and it is now one of WHO reportable diseases. About 50 -200 million cases, 20,000 deaths occur annually. In Ethiopia the first outbreak of Dengue fever appeared in Dire Dawa city in 2013, where 9441 cases were recorded. The second Dengue fever outbreak occurred in Afar Region. Third and fourth was in Somali Region in Godey town, 2014 and 2015. In Godey town acute febrile illness cases of unknown cause become increased started from May 27, 2015. We investigated to identify risk factors of Dengue fever outbreak and commence control measures. Methods: A case-control study was conducted in Godey town, Ethiopia from 8-22 July 2015. Cases were defined according to the WHO guideline and controls were individuals with no sign and symptoms living in the same town with cases. We recruited 50 cases and 100 controls in the study. Medical records and line lists were reviewed. Data were collected at household level using structured questionnaires. Twenty-four serum samples collected from cases. Data was analyzed using SPSS 20 software. Result: We identified 223 cases with 0 death, 116 (52%) were male. The mean age of cases was 25.8 years. Ten cases were positive for Dengue fever by PCR at national laboratory. Lack of formal education (AOR=3.1; 95%CI: 1.30-7.49), living with ill person (AOR=2.8; 95%CI: 1.22-6.52), open containers in household (AOR=3.6; 95%CI: 1.34-9.38) and presence of larvae in the water containers (AOR=5.4; 95%CI: 2.33-12.44) were risk factors for the outbreak. Conclusion: Poor household water handling, living with ill person and lack of formal education contributes for occurrence of Dengue fever outbreak in Godey town. Health education and all other interventions associated with use of water and sanitation needs to be part of long-term control of Dengue.

Routine Malaria surveillance data is useful for assessing incidence and trends over time and in stratification for targeting of malaria. The reporting completeness and potential bias of such data needs assessment. Approximately 52 million people (68%) live in malaria risk areas in Ethiopia, primarily at altitudes below 2,000 meters. Objective: The general objective of this analysis was to assess the trend and magnitude of Malaria surveillance data by time, place and laboratory result for the last five years in Benishangul Gumuz Region. Descriptive cross-sectional study was used to analyze Malaria surveillance data in terms of time, place and laboratory result. Data cleaning and analysis was made by using excel 2013 software. A total of 96757 expected health facilities were in the region from 2013-2017. A total of 86266 health facilities were reported in the last five years with an average completeness of 89.2%. In the last five years (2013-2017) total of 1186514 clinically and confirmed malaria cases were reported regionally with 2290606 total malaria suspected fever examined with ninety inpatient deaths. Among the total clinically and confirmed cases, 1172244 (98.8%) were outpatients, 14248 (1.2%) were inpatients and 1013046 (85.0%) cases were confirmed by laboratory. Out of the total confirmed malaria cases 811984 (80.2%) cases were due to P.falciparum malaria and 201030 (19.8%) cases were due to P.vivax malaria. There were no other species of malaria reported other than these two species. From the total expected health facilities; a total of 86266 health facilities were reported in the last five years with an average completeness of 89.2% which is above the WHO minimum requirement (80.0%). The malaria reports shows that significant improvement in cases of data quality and management from year to year and currently all zones, Woredas and health facilities including private and NGO facilities are included and reported weekly the malaria surveillance from the data report identified in this study. The average five year regional incidence of confirmed malaria (P. Falciparum and P. Vivax) was less than half the incidence of the clinical and confirmed malaria cases.