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Introduction: Sexual behaviour needs to take a central position in the heart of public health policy makers and researchers. This is important in view of its association with Sexually Transmitted Infections (STIs), including HIV. Though the prevalence of HIV/AIDS is declining in Ethiopia, the country is still one of the hardest hit in the continent of Africa. Hence, this study was aimed at identifying hot spot areas and associated factors of risky sexual behavior (RSB). This would be vital for more targeted interventions which can produce a sexually healthy community in Ethiopia. Methods: In this study, a cross-sectional survey study design was employed. A further analysis of the 2016 Ethiopia Demographic and Health Survey data was done on a total weighted sample of 10,518 women and men age 15–49 years. ArcGIS version 10.7 and Kuldorff's SaTScan version 9.6 software were used for spatial analysis. Global Moran's I statistic was employed to test the spatial autocorrelation, and Getis-Ord Gi* as well as Bernoulli-based purely spatial scan statistics were used to detect significant spatial clusters of RSB. Mixed effect multivariable logistic regression model was fitted to identify predictors and variables with a p-value ≤0.05 were considered as statistically significant. Result: The study subjects who had RSB were found to account about 10.2% (95% CI: 9.64%, 10.81%) of the population, and spatial clustering of RSB was observed (Moran's I = 0.82, p-value = 0.001). Significant hot spot areas of RSB were observed in Gambela, Addis Ababa and Dire Dawa. The primary and secondary SaTScan clusters were detected in Addis Ababa (RR = 3.26, LLR = 111.59, P<0.01), and almost the entire Gambela (RR = 2.95, LLR = 56.45, P<0.01) respectively. Age, literacy level, smoking status, ever heard of HIV/AIDS, residence and region were found to be significant predictors of RSB. Conclusion: In this study, spatial clustering of risky sexual behaviour was observed in Ethiopia, and hot spot clusters were detected in Addis Ababa, Dire Dawa and Gambela regions. Therefore, interventions which can mitigate RSB should be designed and implemented in the identified hot spot areas of Ethiopia. Interventions targeting the identified factors could be helpful in controlling the problem. [ABSTRACT FROM AUTHOR]

Currently, pesticide production and use are on the rise globally. This trend is certain to continue in the coming decades with residues posing risks to the environment and human health even at low levels. Although various aspects of pesticides and their possible implications have widely been studied, such studies have mostly been carried out in developed countries leaving the rest of the world with little scientific information. We present here the results of a study on the occurrences, concentrations, and ecological risks of 30 pesticide residues (PRs) in water and sediment samples from a tropical freshwater Lake Hawassa in the Ethiopian Rift Valley. A total of 54 composite samples of water and sediment were collected from three sampling sites on three occasions. The samples were prepared by quick, easy, cheap, effective, rugged, and safe (QuEChERS) technique, and analyzed using GC-MS at Bless Agri Food Laboratory Service located in Addis Ababa, Ethiopia. The study applied the risk quotient (RQ) method to scrutinize the risks posed to aquatic biota by the detected PRs. The results showed occurrences of 18 and 20 PRs in the water and sediment samples, respectively. The majority, 78 and 75% of the detected PRs in water and sediment samples, respectively represent the organochlorine chemical class. Concentrations of heptachlor epoxide were significantly (p ≤ 0.001) higher than those of the remaining pesticides in both matrices. Of the pesticides detected, 77% were present in water and 83% in sediment samples and pose a serious risk (RQ ≥ 1) to the Lake Hawassa biota. This calls for further research to investigate the risks to human health posed by the PRs. The findings of this study can contribute to the development of global protocols, as they support the concerns raised about the ecological and public health impacts of PRs on a global level. [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]

Optimal nutrition in early childhood increases growth and development while preventing morbidity and mortality in later life. This study focused on the quality and safety of 32 commercially produced complementary foods collected from supermarkets in Addis Ababa, Ethiopia. The proximate composition (moisture, protein, fat, crude fibre, and ash); and the mineral profile (calcium, iron, zinc, manganese, and magnesium) were determined using the AOAC method. The determination of antinutritional factors (Condensed tannin and oxalate) was done using a UV spectrophotometer. A rapid visco analyzer was used to measure the rheological property. The microbial load of commercially produced complimentary foods was identified using aerobic colony counts for mold and yeast. Labeling practice was evaluated using the WHO and Ethiopian standard tools. The results of proximate compositions were: protein (0.92–18.16 g/100g), fat (0.63–6.44 g/100g), crude fiber (1.04–13.2 g/100g), energy (410–337 kcal/100g), moisture (0.03–17 g/100g), and ash (0.60–4.67 g/100g). The protein and fat content of all the products is below international standards. Only three products met the standards for energy. Moisture and ash contents partially met the requirement, while all of the carbohydrate contents of the products fell under the specified standard. The lowest and highest mineral contents of the products were: Fe (1.38 to 15.10 mg/100g), Zn (0.64 to 6.78 mg/100g), Ca (30.55 to 364.45 mg/100g), Mg (1.2 to 34.2 mg/100g), and Mn (0.80 to 32 mg/100g). Based on these, 21.5% of the foods met the Fe standard, and 31.5% didn't meet the Zn standard. The Ca and Mg of all the products met the requirement. Except for one product, all met standards. The highest and lowest results for the tannin and oxalate content of the products were 49.20 to 90.09 mg/100g and 0.47 to 30.10 mg/100g, respectively and this shows that the products are below the permissible range for tannin and oxalate. The counts of yeast and mold were 0.00–2.95 log10 cfu/g and 0.00–2.91 log10 cfu/g, respectively. Only one product fell below the standard for yeast count, and none of the products showed a mold count that exceeded the standard. The final viscosity was 63.5–3476 RVU, and only 31.25% of the samples fell under the permissible peak viscosity range, of 83–250 RVU. Thus, regular monitoring of the raw material and processing trends and the inclusion of animal sources in the raw material are suggested for having well-enriched complementary foods. Regulatory bodies should also conduct frequent market surveillance to safeguard the health of the consumer. [ABSTRACT FROM AUTHOR]

Background: Child abuse is widespread around the world, and one continent with particularly high rates is Africa. Research in high- and middle-income countries shows the cascading effect of parental history of child abuse and neglect on adolescents' maltreatment and, in turn, on mental health problems. This cascade has been reported in young children but has rarely been studied in parent-adolescent dyads or in low-income countries (LICs). The goal of this study was to test intergenerational associations of child abuse and neglect and to examine how these experiences are in turn associated with youth anxiety and depression in an LIC. Methods: A total of 231 adolescents (age: 13–21 years) and 185 of their parents (n = 90 fathers and n = 95 mothers) were recruited from secondary schools in Addis Abeba, Ethiopia. Using a cross-sectional design, participants completed a set of questionnaires assessing child maltreatment (in adolescence and own past history in parents), parental psychological distress, youth depression and anxiety, and sociodemographic factors. Results: The frequencies of child maltreatment exposure were 68% for adolescents and 65% for their parents (when they were a child). Fifty-one percent and 42% of adolescents had borderline to clinical levels of anxiety and depression symptoms, respectively. Adolescents of parents with a history of child abuse and neglect also reported higher exposure to maltreatment themselves (p < 0.001). Current paternal, but not maternal, psychological distress mediated this intergenerational association of maltreatment experiences (95% CI [1.164, 9.467]). We further found parents' psychological distress to be a significant moderator of the indirect pathways of the intergenerational effect of child maltreatment on adolescents' anxiety and depression (95% CI [− 0.770, − 0.012]). Conclusions: We found child maltreatment to be intergenerationally associated, and this effect subsequently affected adolescents' anxiety and depression through different pathways supporting the cascading effects across generations. Intervention plans may be effective through an array of possible indirect pathways and encourage the implementation of multiple access points to facilitate change in the lives of affected youth in Africa. [ABSTRACT FROM AUTHOR]

Background: Internet Addiction is defined as excessive internet use or poorly controlled preoccupations, impulses, or behaviors related to computer use and internet access that cause impairment or suffering. It had devastating effect on people lives, families, productivity, academic performance and rarely engaging in criminal acts like alcohol use, drug addiction, or compulsive gambling. This study aimed to investigate the psychometric properties of the Amharic version of Internet Addiction Test-20 among Addis Ababa University, College of Health Sciences medical students, Addis Ababa, Ethiopia. Methods: A cross sectional study was carried out among 410 medical students using a convenience sampling method after stratifying them based on their year level. SPSS Version 23 was used to do Pearson's correlation coefficient to determine the convergent validity of Amharic version of IAT. We computed correlation coefficient between the aggregate scores of IAT-20 and the scores for depressive symptoms, problematic substance use, and other characteristics of participants which was assessed using Patient health questionnaire-9 (PHQ-9), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and questionnaire developed to assess demographic and internet use related characteristics, respectively. AMOS 23 software was used to conduct confirmatory factor analysis (CFA) to evaluate the construct validity of Amharic version of IAT. Test-retest reliability was also determined with 2 weeks interval (n = 51). Results: The data confirmed a two-factor structure. Normed Fit Index (NFI) = 0.89, Tucker Lewis Index (TLI) = 0.91 and Comparative Fit Index (CFI) = 0.92, Root Mean Square Error Approximation (RMSEA) = 0.07, and Standardized Root Mean Residual (SRMR) =0.05 indicated a good fit model structure. There was moderate positive correlation between the aggregate scores of IAT-20 and PHQ-9 scores (r = 0.55, p < 0.00), but weak positive correlation between IAT-20 and ASSIST scores (r = 0.14, p < 0.00). IAT-20 was also found to have good internal consistency (Cronbach's alpha = 0.89 for each factor). The test-retest reliability was also good for all items (Intra Class Correlation Coefficient (ICC) > 0.30) except item 16. Conclusion: We found that the IAT-20 is psychometrically sound and a simple screening test for Internet Addiction. However, it is important to acknowledge that further studies are necessary to replicate these findings on diverse population. [ABSTRACT FROM AUTHOR]

Background: Pericardial effusion (PE) is a rare yet an important cause of child mortality due to collection of excess fluid in pericardial space. The study aimed to describe the PE profile in the national cardiac referral hospital, Addis Ababa, Ethiopia. Methods: The study employed cross-sectional study design for a 7-year review of childhood PE in Tikur Anbessa Specialized Hospital. Descriptive and analytic statistics were applied. Results: There were 17,386 pediatric emergency/ER admissions during the study period, and PE contributed to 0.47% of ER admissions. From 71 included subjects, 59% (42) were males with mean age of 7.8 ± 3.3 years. Cough or shortness of breath,73.2% (52) and fever or fast breathing, 26.7% (19), were the common presenting symptoms. The median duration of an illness before presentation was 14days (IQR: 8–20). The etiologies for pericardial effusion were infective (culture positive–23.9%, culture negative–43.6%, tuberculous-4.2%), hypothyroidism (4.2%), inflammatory (12.7%), malignancy (7%) or secondary to chronic kidney disease (1. 4%). Staphylococcus aureus was the most common isolated bacteria on blood culture, 12.7% (9) while the rest were pseudomonas, 7% (5) and klebsiella, 4.2% (3). Mild, moderate and severe pericardial effusion was documented in 22.5% (16), 46.5% (33), and 31% (22) of study subjects, respectively. Pericardial tamponade was reported in 50.7% (36) of subjects. Pericardial drainage procedure (pericardiocentesis, window or pericardiotomy) was performed for 52.1% (37) PE cases. The case fatality of PE was 12.7% (9). Pericardial drainage procedure was inversely related to mortality, adjusted odds ratio 0.11(0.01–0.99), p 0.049). Conclusion: PE contributed to 0.47% of ER admissions. The commonest PE presentation was respiratory symptoms of around two weeks duration. Purulent pericarditis of staphylococcal etiology was the commonest cause of PE and the case fatality rate was 12.7%. Pericardial drainage procedures contributed to reduction in mortality. All PE cases should be assessed for pericardial drainage procedure to avoid mortality. [ABSTRACT FROM AUTHOR]

Background: The poor practice of tuberculosis infection control may increase the risk of transmission of tuberculosis in healthcare settings. Thus, this study aimed to determine the pooled magnitude of good tuberculosis infection control practice and associated factors among healthcare workers in Ethiopia. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was followed for this review and meta-analysis. The electronic databases (Pub Med, Cochrane Library, Google scholar and grey literatures) were searched to retrieve articles by using keywords. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used to assess the quality of studies. Heterogeneity was assessed using the I2 statistic. The meta-analysis with a 95% confidence interval using STATA 17 software was computed to present the pooled practice and odds ratio of the determinant factors. Publication bias was assessed visually by inspecting the funnel plot asymmetry and using statistical tests using the eggers and begs test. Results: Seven studies were included in this meta-analysis, with a total of 3256 health workers. The overall pooled magnitude of good tuberculosis infection control practice was 46.44% (95% CI: 34.21%, 58.67%). In subgroup analysis, the highest practice was in Addis Ababa 51.40% (95% CI: 47.40, 55.40%) and the lowest prevalence of tuberculosis infection control practice was in Amhara region 40.24% (95% CI: 15.46, 65.02%). Working in TB clinics (AOR; 7.42, 95% CI: 3.89, 14.13) and good TB related knowledge (AOR; 4.40, 95% CI: 1.76, 10.97) were the significant predictors of good TB infection control practice. Conclusions: Only less than half of the health care workers had good practice of TB infection control. Working in TB clinics and having good TB related knowledge were statistically significant predictors of TB infection control practice. Periodic shifting of health care workers to work in TB clinics and an emphasis on TB infection control related skill based training was recommended to increase the TB infection control practice. [ABSTRACT FROM AUTHOR]

Introduction: In Ethiopia, the burden of non-breastfeeding is still high despite substantial improvements in breastfeeding. However, the determinants of non-breastfeeding were poorly understood. Therefore, the aim of this study was to identify the maternal -related factors associated with non-breastfeeding. Methods: An in-depth analysis of data from the Ethiopian Demographic and Health Survey 2016 (EDHS 2016) was used. A total weighted sample of 11,007 children was included in the analysis. Multilevel logistic regression models were fitted to identify factors associated with non-breastfeeding. A p-value < of 0.05 was used to identify factors significantly associated with non-breastfeeding. Results: The prevalence of non-breastfeeding in Ethiopia was 5.28%. The odds of not breastfeeding were 1.5 times higher among women aged 35to 49 years (AOR = 1.5 CI: 1.034, 2.267) than among women aged 15to 24 years. The odds of not breastfeeding were higher among children whose mothers had BMIs of 18.5–24.9 (AOR = 1.6 CI: 1.097, 2.368) and 25–29.9 (AOR = 2.445 CI: 1.36, 4.394) than among women with BMIs of < 18.5. In addition, not breastfeeding was also significantly associated with ANC follow-up, where mothers who had 1–3 ANC follow-up had a 54% decreased odds (AOR = 0.651 CI: 0.46,0.921) compared to mothers who had no ANC follow-up. Demographically, mothers from Somalia region were five times (AOR = 5.485 CI: 1.654, 18.183) and mothers from SNNP region were almost four times (AOR = 3.997 CI: 1.352, 11.809) more likely to not breastfeed than mothers residing in Addis Ababa. Conclusions: Although breastfeeding practices are gradually improving in Ethiopia, the number of children not breastfed remains high. Individual-level characteristics (women's age, body mass index, and ANC follow-up) and community-level characteristics (geographic region) were statistically significant determinants of non-breastfeeding. Therefore, it is good for the federal minister of Health, planners, policy and decision- makers, and other concerned child health programmers to prioritize both individual and community factors. [ABSTRACT FROM AUTHOR]

Background: There is no country in the developing world where iodine deficiency is not a public health problem including Ethiopia. Therefore, this study aimed to assess inadequate utilization of iodized salt and associated factors at household level in woreda 11 Nifas Silk Sub-city, Addis Ababa, Ethiopia. Methods: A community-based cross-sectional study was conducted with multistage sampling technique on 348 household respondents. The data were collected using interviewer-administered structured questionnaires and an iodine rapid test kit. The data were edited, cleaned, and entered using Epi-data version 4.6.2 and exported to SPSS version 25 for analysis. A multivariable logistic regression model was fitted to identify associated factors for inadequate utilization of iodized salt. The statistical significance was declared at a p-value of less than 0.05 with 95% confidence interval. Results: A total of 348 household respondents were participated. The amount of iodine content in salt 0 ppm, < 15ppm and > 15ppm were 11.8%, 7.2% and 81.0% respectively. Total inadequate utilization of iodized salt was 19%. Using unpacked salt [AOR; 0.50 (95%CI: 0.27, 0.93)], using a container without a lid [AOR; 0.29 (95%CI: 013, 0.63)], and having insufficient knowledge [AOR; 2.10 (95%CI: 1.14, 3.86)] were all significantly connected with using inadequate iodized salt. Conclusions: Iodized salt utilization was inadequate. Using containers without a lid, unpacked salt, and poor knowledge were associated factors. There should be a provision of adequate knowledge about iodized salt, a proper storage and handling. [ABSTRACT FROM AUTHOR]

Background: Drug resistance in tuberculosis poses challenges to both the control and prevention of the disease. The extent of resistance is not well known in developing countries, including Ethiopia. This study was conducted to determine the drug resistance patterns and mutation characteristics of Mycobacterium tuberculosis among extra pulmonary tuberculosis patients in selected health facilities in Addis Ababa.Material and Methods: A cross-sectional study was conducted from February 2022 to August 2022 in selected hospitals in Addis Ababa. Socio-demographic and clinical data were collected using structured questionnaire. Mycobacterium tuberculosis complex (MTBC) isolates were tested for phenotypic drug susceptibility patterns using the Mycobacterium growth indicator tube (MGIT) method for first-line drugs and mutation characteristics using the Line Probe Assay (LPA) method. The data were analyzed using: SPSS version 23, and a P-value ≤ 0.05 was considered statistically significant.Results: From a total of 308 patient samples from presumptive extra pulmonary patients, 44 (14.3%) were positive for MTBC. Any drug resistance was discovered in 25% of 44 MTBC isolates evaluated for five first-line drugs phenotypically, with isoniazid (INH) and pyrazinamide (PZA) resistance accounting for a greater proportion with 13.6% and 11.4% of the isolates, respectively. Two (4.5%) of the isolates were MDR-TB. Out of 44 isolates tested using the Geno Type MTBDRplus assay, 5 (11.4%) showed mutations at katG and 2 (4.5%) showed mutations in the rpoB genes.Conclusion: Both the phenotypic and genotypic drug susceptibility test results showed a high proportion of INH resistance. All INH resistance-conferring mutations were identified from katG gene. The overall prevalence of MDR-TB was also high. For early case detection and treatment, expanding diagnostic capacity for first-line DST is a vital step to limit further spread of drug resistant TB strains in the study area. [ABSTRACT FROM AUTHOR]

BACKGROUND: In developing countries, the diagnosis of congenital heart diseases (CHD) is growing as the availability of echocardiography is increasing with most diagnoses made after birth. However, the access to pediatric surgery is still low and is mainly done by global surgical campaigns rather than local surgeons. Ethiopia has trained its local surgeons, and this is expected to improve the care of children with CHD. We aimed to evaluate the experience of local pediatric CHD surgery and its outcome in a single-center in Ethiopia. METHODS: A hospital-based retrospective cohort study was done by including all patients with CHD and acquired heart disease in patients under the age of 18 operated at children's cardiac center in Addis Ababa Ethiopia. We set in-hospital mortality, 30-day mortality, and the prevalence of complications including major complications after cardiac surgery as the primary outcomes. RESULTS: A total of 76 children were operated. The mean age at the time of diagnosis and surgery was 4 (±5) and 7 (±5) years, respectively. Forty-one (54%) were female. Ninety five percent of the 76 operated children were with the diagnoses of congenital heart diseases while the rest (5%) with acquired heart disease. Of those with congenital heart disease, Patent ductus arteriosus (PDA) accounted for (33.3%), Ventricular septal defect (VSD) for 29.5% and Atrial Septal Defect (ASD) for 10% and Tetralogy of Fallot (TOF) for 5%. According to the RACS-1 category, 26 (35.1%) were in category 1, 33 (44.6%) were in category 2, 15 (20.3%) were in category 3 and none of the children were in category 4 and 5. In-hospital mortality was 2.6% whereas there was no patient who died within 30 days after discharge. Operative mortality was 2.6%. CONCLUSION: Various types of lesions were treated in the hands of the local teams with VSD and PDA ligations as the commonest of all. The 30day mortality was within acceptable range and this outcome shows congenital and acquired heart diseases can be operated on in developing countries with good outcome despite the limited resources. [ABSTRACT FROM AUTHOR]

Background: Adolescent population Global Diet Quality Score (GDQS) is uncommon in low-income settings. Though Global Diet Quality Score is a good measure of dietary diversity, it has not been used in assessing nutritional outcomes among adolescents. Therefore, the aim of this study is to assess school-attending adolescents stunting and thinness status and associations with global diet quality scores in Addis Ababa. Methods: A school-based cross-sectional study was conducted among school-attending adolescents in the age group of 10–14 years in urban settings in Ethiopia. A multi-stage stratified random sampling procedure was used to select schools and students. A total of 1200 adolescents were included in the study. Binary and Multinomial logistic regression analyses were used to determine the predictors of stunting and thinness respectively. Results: The proportion of school-attending adolescents stunting was 8.17% (95% CI: 6.74%,9.85%) and their thinness status 12.66% (95% CI: 10.89%, 14.67%). The overall mean GDQS food groups for Seven days period consumed were 19.99 + 2.81 SD. Male adolescents were 1.95 times more likely to be stunted compared to female adolescents (1.95; 95%CI: 1.11,3.39). Frequent consumption of low-fat dairy increased the risk of thinness, while frequent consumption of citrus fruits and white root tubers decreased the risk of school-attending adolescents' thinness. Conclusion: The proportion of thin or stunted adolescents attending school was high still, about 1 in 10. Stunting and thinness have no association with the overall GDQS. Nutritional interventions need to consider frequent consumption of citrus fruits, low-fat dairy, and white roots and tubers in school adolescents' nutritional programs. Further studies should validate the GDQS for stunting and thinness of school adolescents. [ABSTRACT FROM AUTHOR]

Background: The Xpert MTB/RIF Ultra (Xpert-Ultra) assay provides timely results with good sensitivity and acceptable specificity with stool specimens in children for bacteriological confirmation of tuberculosis (TB). This study aims to optimize the Simple One-Step (SOS) stool processing method for testing stool specimens using the Xpert-Ultra in children and adults in selected health facilities in Addis Ababa, Ethiopia. The study is designed to assess the robustness of the SOS stool method, to help fine-tune the practical aspects of performing the test and to provide insights in stool storage conditions and sampling strategies before the method can be implemented and scaled in routine settings in Ethiopia as well as globally. Methods and design: The project "painless optimized diagnosis of TB in Ethiopian children" (PODTEC) will be a cross sectional study where three key experiments will be carried out focusing on 1) sampling strategy to investigate if the Xpert-Ultra M. tuberculosis (MTB) -positivity rate depends on stool consistency, and if sensitivity can be increased by taking more than one stool specimen from the same participant, or doing multiple tests from the same stool specimen, 2) storage conditions to determine how long and at what temperature stool can be stored without losing sensitivity, and 3) optimization of sensitivity and robustness of the SOS stool processing method by varying stool processing steps, stool volume, and storage time and conditions of the stool-sample reagent mixture. Stool specimens will be collected from participants (children and adults) who are either sputum or naso-gastric aspiration (NGA) and/or stool Xpert-Ultra MTB positive depending on the experiment. Stool specimens from these participants, recruited from 22 sites for an ongoing related study, will be utilized for the PODTEC experiments. The sample size is estimated to be 50 participants. We will use EpiData for data entry and Stata for data analysis purposes. The main analyses will include computing the loss or gain in the Xpert-Ultra MTB positivity rate and rates of non-determinate Xpert-Ultra test results per experiment compared to the Xpert-Ultra MTB result of stool processed according to the published standard operating procedures for SOS stool processing. The differences in the MTB positivity rate by regarding testing more than one sample per child, and using different storage, and processing conditions, will be also compared to the baseline (on-site) Xpert-Ultra result. [ABSTRACT FROM AUTHOR]

Background: Worldwide, come out and dissemination of extended-spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae has been warning the efficacy of antibiotics to treat an infection. Hospital wastewaters were a reservoir of such kind of resistant bacteria. Currently, the predominant antibiotics used for the treatment of hospitalized patients infected by Gram-negative bacteria are the β-lactam antibiotics. Therefore, it is an important source to investigate the magnitude of ESBLs producing bacteria and their antimicrobial susceptibility pattern. This study aimed to determine the occurrence of ESBLs producing Enterobacteriaceae (ESBLs-pE) and their antibiotic susceptibility pattern in wastewater released from five governmental hospitals in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from April 1 to May 31, 2020. A total of 100 wastewaters were collected from five governmental hospitals in Addis Ababa using a grap-sampling technique. All Enterobacteriaceae were screened for ESBLs production using cefotaxime and ceftazidime as per 29th CLSI guideline. Each screen positive for ESBLs production was confirmed by the combination disk method (CDT) and their antibiotic susceptibility pattern was done using the Kirby–Bauer disk diffusion method on Muller Hinton agar (MHA). Data were entered and summarized using SPSS version 20 software. Results: Of all Enterobacteriaceae, 48.3% were confirmed ESBLs-pE. The highest ratio of ESBLs-PE was observed in the adult ward (66.7%) and laundry unit effluent (58.8%). The highest ESBL producers were E. coli (21.8%) and K. pneumoniae (4.8%). The most elevated resistance level of ESBL producers were observed to cefotaxime (95.8%) and amoxicillin/clavunalate (93%). 64% of tested Enterobacteriaceae isolates were multi drug resistant (MDR). Conclusions: Higher magnitude of MDR and ESBLs-pE were present in the hospital wastewater. The majority of them were in the adult ward and laundry unit effluents. The most frequent ESBLs-pE was among E.coli and K. pneumoniae. Hence, Consistent infection prevention and control procedures should be in practice at each ward/unit. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) is the leading killer of people living with HIV (PLHIV) and almost one-third of deaths in the world are attributed to it and many of these deaths occur in developing countries. Despite these evidences, after the implementation of universal test and treat (UTT) strategy, information regarding the incidence and predictors of tuberculosis among PLHIV is limited in Ethiopia. Therefore, this study aimed to assess the incidence and predictors of tuberculosis among patients enrolled in Anti-Retroviral Therapy (ART) after universal test and treat program at St. Peter hospital and Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Methods: Institutional-based retrospective cohort study was conducted from November 1 to 30, 2020. Simple random sampling was used to select a total of 539 adults records which was enrolled on ART. Data was collected and entered into EPI DATA 3.1 and analyzed using STATA version 14.1. Time-to-event distributions were estimated using Kaplan–Meier estimates. Hazards across different categories were compared using log-rank tests. Predictors were identified using the Cox proportional hazards model. The hazard ratio (HR) and 95% confidence interval (CI) were computed. Variables having P-value < 0.05 from the multivariable analysis were considered as a statistically significant. Result: Among 539 records reviewed, 529 (98%) were included in the final analysis. The total follow-up period was 1529 Person-Year (PY). The incidence rate in this cohort was found to be 4.84 per 100-person year (95%CI,3.83–6.11). CD4 count<200 (AHR: 3.14,95% CI:1.64–7.10), poor adherence (AHR:2.16, 95% CI:1.21–3.85), underweight (AHR:2.42, 95% CI: 1.30–4.51), not taking isoniazid prophylaxis therapy (AHR: 2.78,95% CI: 1.06–7.30), being bedridden 3.06; (AHR: 3.06, 95% CI: 1.50–6.24), and baseline WHO stage three or four (AHR:2.33, 95% CI:1.08–5.02) were independent predictors for the incidence of TB among HIV positive patients. Conclusion: In this study, the incidence of tuberculosis is relatively low as compared to studies done before the initiation of test and treat program in Ethiopia. low CD4count, poor level of adherence, low BMI, not taking IPT prophylaxis, bedridden functional status, and being on baseline WHO stage III or IV were found to increase the hazard of tuberculosis. Hence, close follow up, reminders, surveillance, and tracing mechanisms targeting this higher risk group would decrease Tuberculosis among PLHIV. [ABSTRACT FROM AUTHOR]

Background: Mycobacterium tuberculosis (M. tuberculosis) remains one of the most significant causes of death and a major public health problem in the community. As a result, the aim of this study was to determine magnitude of Mycobacterium tuberculosis, its drug resistance, and associated factors among presumptive tuberculosis (TB) patients at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: Cross-sectional study was conducted at St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia from January to July 2019. Demographic and clinical data were collected by structured questionnaire through face to face interview. Using microscopic examination and GeneXpert MTB/RIF assay and culturing in the Lowenstein-Jensen (LJ) culture media, we collected and analyzed both pulmonary and extra-pulmonary clinical samples. Data were analyzed by SPSS version 23. Binary logistic regression was done to identify the associated risk factors and p-value less than 0.05 was taken as significant association. Results: Of the total 436 respondents, 223(51%) were male. The mean ±SD age of the participants was 38±17years. Overall, 27/436(6.2%) of the participants had confirmed Mycobacterium tuberculosis using the GeneXpert MTB/RIF assay and LJ culture media, and two isolates were resistant to RIF and one to INH medication, with two (0.5%) being MDR-TB. MTB infection was associated with previous TB contact history, patient weight loss, and CD4+ T-cell counts of 200-350/mm3 of blood. Conclusion: The magnitude of M. tuberculosis and MDR-TB in this study underscores the need for improved early case detection and management of MDR-TB in order to reduce transmission and patient suffering. [ABSTRACT FROM AUTHOR]

Background: Even though adherence to dietary counselling for patients with diabetes is essential for improving health and preventing complications, access to an adequate and quality diet is challenging for patients living in a food-insecure household. The availability of data in this regard is limited in Ethiopia. Thus, this study assessed the food security status of patients with type 2 diabetes, their adherence to dietary counselling, and contributing factors at public hospitals in Addis Ababa, Ethiopia. Methods: This was a facility-based cross-sectional study among 602 patients with Type 2 diabetes in Addis Ababa, Ethiopia, from July to August 2019. Patients were selected randomly after the total number of samples was proportionally allocated to four public hospitals. Relevant information was collected by trained data collectors using a pre-tested questionnaire. Data were entered into Epi-info version 7 and exported to SPSS version 24 for data analysis. Logistic regression analysis was employed to identify factors associated with adherence to dietary counselling. Result: The proportion of nonadherence to dietary counselling among patients with type 2 diabetes was 67.3% (95%CI: 63.5%-71.1%). Nearly half (50.7%) of the respondents were food insecure. Of these, mildly food insecure, moderately food insecure, and severely food insecure were 8.5%, 29.2%, and 13%, respectively. Physical activity (AOR = 1.7; 95%CI: 1.1–2.9); diabetes knowledge (AOR = 1.8; 95%CI: 1.2–2.6); lack of access to information (AOR = 1.6; 95%CI: 1.1–2.6); moderately food insecure (AOR = 2.2; 95%CI: 1.3–3.7); and severely food insecure (AOR = 5.6; 95%CI: 2.1–15.0) were the major significant factors associated with nonadherence to dietary counselling. Conclusion: Over two-thirds of patients with diabetes did not adhere to dietary counselling, which appears high. As a result, improving diabetes education, information access, and food security status should be considered to ensure dietary counselling adherence among type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Background: As the use of antiretroviral therapy (ART) increases, the issue of treatment failure is still a global challenge, particularly in a resource limited settings including Ethiopia. The results of former studies in Ethiopia were highly variable and inconsistent across studies. Thus, this systematic review and meta-analysis intended to provide the pooled estimation of treatment failure and associated factors among children on antiretroviral therapy. Methods: We searched international databases (i.e., PubMed, Google Scholar, Web of Science, Ethiopian Universities' online repository library, Scopus, and the Cochrane Library) during the period of February 30 to April 7, 2021. All identified observational studies reporting the proportion of treatment failure among HIV positive children in Ethiopia were included. Heterogeneity of the studies was checked using I2 test and Cochrane Q test statistics. We run Begg's regression test to assess publication bias. A random-effects meta-analysis model was performed to estimate the pooled prevalence of treatment failure. Results: The estimated pooled prevalence of treatment failure among children in Ethiopia was 12.34 (95%CI: 8.59, 16.10). Subgroup analysis of this review showed that the highest prevalence was observed in Addis Ababa (15.92%), followed by Oromia region (14.47%). Poor ART adherence (AOR = 2.53, CI: 2.03, 4.97), advanced WHO clinical staging (AOR = 1.66, CI: 1.24, 3.21), and opportunistic infections (AOR = 2.64 CI: 2.19, 4.31 were found to be significantly associated factors with childhood treatment failure. Conclusions: This study revealed that treatment failure among children on ART was high in Ethiopia. Poor ART adherence, advanced WHO clinical staging, opportunistic infections, and low level of CD4 cell counts increased the risk of treatment failure. [ABSTRACT FROM AUTHOR]

Background: Bottle feeding is associated with diarrheal disease morbidity and mortality and risk of pyloric stenosis, especially in developing countries. Even though, World Health Organization (WHO) recommended avoiding bottle feeding among children, still higher magnitude was reported in developing countries. This study aimed to assess the spatial distribution and determinants of bottle feeding among children 0-23 months in Ethiopia.Methods: This study was conducted based on Ethiopian Demographic and Health Surveys data (EDHS). The data were weighted using sampling weight for probability sampling and non-response to restore the representativeness of the data and get valid statistical estimates. Then a total of 4,275 weighted samples of under two years children were used to investigate the study. The data were cleaned using MS excel and extracted and analyzed using STATA V.16 software. A multilevel binary logistic regression model was fitted. P-value < 0.05 was taken to declare statistical significance. A spatial analysis was done using ArcGIS and SaTScan software.Results: The prevalence of bottle feeding practice among under two years children in Ethiopia were 13.5% (95%CI: 11.16, 15.29) and ranges from the lowest 5.16% (95% CI: 3.28, 78.73) Amhara region to the highest 55.98% (95% CI: 47.98, 61.46) Addis Ababa region. Women with secondary and above education status [AOR=2.49; 95%CI; 1.66, 3.74], women from richest household [AOR=1.33; 95%CI; 1.01, 1.78], child 12-23 months age [AOR= 1.59; 95%CI; 1.23, 2.05], multiple birth [AOR=4.30; 95%CI; 1.88, 9.84], rural residence [AOR=0.49; 95%CI; 0.16, 0.82] and large central region [AOR= 0.15; 95%CI; 0.08, 0.27] have significantly associated with bottle feeding. Addis Ababa, Central Oromia, Dire Dewa, Somali and Harari regions were the hot spot areas for bottle feeding practice among under two years children.Conclusion and Recommendations: The prevalence of bottle feeding practices in Ethiopia is relatively moderate. Maternal education, wealth index, child age, multiple births, residence and region were significant predictors of bottle feeding. These findings highlight that, the Ministry of Health Ethiopia (MOH), policymakers, and other stakeholders had better give prior attention to preventable factors such as empowering women, enhancing household wealth status to decreasing bottle feeding practice in Ethiopia. [ABSTRACT FROM AUTHOR]

Aquatic macrophytes absorb a number of pollutants from where they are growing and thus, they can be used as a tool for the removal of pollutants from the aquatic ecosystem. Therefore, the aim of this study was to evaluate heavy metals (Hg, Cr, Zn, Cd, and Pb) removal efficiency of Typha latifolia L. from the offshore of Hawassa Lake, Ethiopia. Based on the potential exposure of the lake to different sources of pollutants, six sampling sites were selected, and then T. latifolia and composite plant samples were collected from each sampling site and transported to Addis Ababa Environmental Protection Agency (EPA) laboratory for analysis. The results showed that significantly (P <.05) higher heavy metal concentration was recorded in T. latifolia than in composite plant samples, particularly samples collected from S2, S4, and S5. Moreover, significantly (P <.05) higher heavy metal concentration was found in the root parts of the T, latifolia than its shoot. The concentration of heavy metals recorded in this study has slightly exceeded the level set by the WHO guideline. In addition, medium to very high correlations were recorded for some heavy metal pairs as well as with some physicochemical parameters (e.g. pairs of Zn/Pb, Cd/Pb, EC, and pH with most heavy metals).In conclusion, T. latifolia have shown promising potential for the removal of Zn, Pb and Cd, while composite macrophytes samples for Hg and Cr. The shoot part of T. latifolia has a relatively better capacity to remove Cr, while the root is for Hg, Zn, Cd and Pb. These results indicated the suitability of the plant for phytoremediation, and the usefulness of the technique as an option for improving the water quality of the lake by removing those heavy metals from the lake offshore. [ABSTRACT FROM AUTHOR]

Objective: School absenteeism and grade retention are associated with various life-course problems. In this study, we examined school absenteeism and grade retention in Ethiopian adolescents, as well as factors associated with them. Methods: We analyzed data from 1200 adolescents (aged 10-14 years) from 20 public primary schools in Addis Ababa, Ethiopia. We carried out multivariate logistic regression analyses, adjusting for school-level clustering, to determine the factors associated with school absenteeism and grade retention. Results: Grade retention, father's lower education, parental occupation other than a government job, household food insecurity, being in large schools, and not having toilets in the school were associated with higher absenteeism rates, while involvement in paid work was associated with lower absenteeism rates. Having educational resources at home was associated with lower odds of retaining a grade but having mental health problems and a father's occupation other than a government job were associated with higher odds of grade retention. Conclusions: Interventions aiming to increase school presence and performance among urban Ethiopian adolescents may require a multi-level approach addressing food insecurity, psychosocial problems, and provision of sanitation facilities at schools. [ABSTRACT FROM AUTHOR]

Background: Asthma is a common airways disease with significant morbidity and mortality in all ages. Studies of pediatric asthma control and its determinants yielded variable results across settings. However, there is paucity of data on asthma control and its factors in Ethiopian children. We aimed to assess the level of asthma control and the related factors in children attending pediatric respiratory clinics at three tertiary hospitals in Addis Ababa.Methods: We conducted a cross-sectional study from March 1 to August 30, 2020 using standardized questionnaires and review of patient's charts. Data was analyzed using SPSS software for window version 26.Results: A total of 105 children (56.2% male) were included in the study. The mean age (± SD) and age at Asthma diagnosis (± SD) were 6 (± 3.3) and 4 (± 2.8) respectively. Uncontrolled asthma was present in 33 (31%) of children. Comorbidities (Atopic dermatitis and allergic Rhinitis (AOR = 4.56; 95% CI 1.1-18.70; P = 0.035), poor adherence to controller medications (AOR = 3.23; 95% CI 1.20-10.20; P = 0.045), inappropriate inhaler technique (AOR = 3.48; 95% CI 1.18-10.3; P = 0.024), and lack of specialized care (AOR = 4.72; 95% CI 1.13-19.80; P = 0.034) were significantly associated with suboptimal asthma control.Conclusion: One-third of children attending pediatric respiratory clinics in Addis Ababa had uncontrolled Asthma. Treatment of comorbidities, training of appropriate inhaler techniques, optimal adherence to controllers, and proper organization of clinics should be emphasized to improve asthma control among children. [ABSTRACT FROM AUTHOR]

Nowadays, video streaming has become one of the most dominant services due to increasing interest in watching online television programs and video-on-demand activities. Providing this service requires high quality, high speed and high-capacity network infrastructures. In this work, we propose a data-drivenbased fuzzy logic inference algorithm for quality of experience (QoE) modeling of video streaming services in Addis Ababa City LTE network. The proposed fuzzy logic inference system model is used to measure the user perception from the key quality of indicator (KQI) parameters. The model is essential to replace conventional subjective measurement techniques that are costly and inefficient. In addition, the proposed fuzzy logic inference system model is helpful for business decision making, network planning and optimization activities. To analyze the performance of the proposed model, we consider main KQI parameters such as video streaming start success rate, video streaming start delay, video streaming play disconnection rate, video streaming stall frequency and video streaming stalled time rate. We perform numerical simulation to analyze the proposed model and to validate the impacts of main KQI parameters on the quality of experience in LTE video streaming services. The simulation results show that video streaming stall frequency and video streaming start delay rate play a major impact on user perception by 33% and 25%, respectively. Besides, validation of the results shows that the proposed fuzzy logic inference system model is accurate, consistent and linear compared to currently existing models. [ABSTRACT FROM AUTHOR]

Background: There is limited information on the performance of the Xpert® MTB/RIF test for diagnosis of smear-negative pulmonary tuberculosis (SNPT) and rifampicin resistance (RR) in the same-day diagnosis approach. The effects of sputum quality and other factors affecting the Xpert performance are also under-investigated. Objective: This study aimed to determine the performance of the Xpert® MTB/RIF test for detection of SNPT and RR in the same-day diagnosis strategy and the effect of sputum quality and other factors on its performance. Methods: A cross-sectional study was conducted from August 2017 to January 2018 across 16 health facilities in Addis Ababa, Ethiopia. Two spot sputum samples were collected from 418 presumptive SNPT patients, tested with Xpert® MTB/RIF, then compared to tuberculosis culture. Additionally, culture isolates were tested for RR by BACTEC MGIT™ 960 drug susceptibility testing (DST) and MTBDRplus version 2. Results: The Xpert® MTB/RIF test detected 24 (5.7%) SNPT cases, with a sensitivity of 92.3% (75.9% – 97.9%) and specificity of 99.2% (97.8% – 99.7%) compared with tuberculosis culture. Xpert® MTB/RIF also detected three (11.58%) RR strains with 100.0% concordance with BACTEC MGIT™ 960 DST and MTBDRplus results. Three blood-stained SNPT samples were positive by Xpert (30.0%), which was 6.9 times higher compared to salivary sputum (odds ratio: 6.9, 95% confidence interval: 1.36–34.96, p = 0.020). Conclusion: The performance of the Xpert® MTB/RIF to detect SNPT and RR in same-day diagnosis is high. However, SNPT positivity varies among sputum qualities, and good sample collection is necessary for better test performance. [ABSTRACT FROM AUTHOR]

Background: Rapid and sensitive Tuberculosis (TB) diagnosis closer to patients is a key global TB control priority. Truenat assays (MTB, MTB Plus, and MTB-RIF Dx) are new TB molecular diagnostic tools for the detection of TB and Rifampicin (RIF)-resistance from sputum samples. The diagnostic accuracy of the assays is needed prior to implementation in clinical use in Ethiopia. This study aimed to determine the sensitivity and specificity of Truenat assays; and aimed to compare the assays to the Xpert MTB/RIF assay. Methods: A prospective evaluation study was conducted among 200 presumptive TB patients in microscopy centers in Addis Ababa, Ethiopia from May 2019 to December 2020. Culture (Solid and Liquid methods) and phenotypic (liquid method) drug susceptibility testing (DST) were used as a reference standard. Results: Of 200 adult participants, culture confirmed TB cases were 25 (12.5%), and only one isolate was resistant to RIF by phenotypic DST. The sensitivity of Truenat MTB was 88.0% [95% CI 70.1, 95.8], while 91.7 [95% CI 74.2, 97.7] for Truenat MTB Plus at the microscopy centers. The specificity of Truenat MTB was 97.2% [95% CI 93.1, 98.9], while for Truenat MTB Plus was 97.2% [95% CI 93.0, 99.0]. The sensitivity of Truenat MTB was 90.5% while for MTB Plus, 100% compared to the Xpert MTB/RIF assay. Conclusion: Truenat assays were found to have high diagnostic accuracy. The assays have the potential to be used as a point of care (POC) TB diagnostic tests. [ABSTRACT FROM AUTHOR]

Objective: To examine the prevalence of and factors associated with different forms of household-level double burden of malnutrition (DBM) in Ethiopia. Design: We defined DBM using anthropometric measures for adult overweight (BMI ≥ 25 kg/m2), child stunting (height-for-age Z-score <-2 sd) and overweight (weight-for-height Z-score ≥2 sd). We considered sixteen biological, environmental, behavioural and socio-demographic factors. Their association with DBM forms was assessed using generalised linear models. Setting: We used data from two cross-sectional studies in an urban (Addis Ababa, January–February 2018), and rural setting (Kersa District, June–September 2019). Participants: Five hundred ninety-two urban and 862 rural households with an adult man, adult woman and child <5 years. Results: In Addis Ababa, overweight adult and stunted child was the most prevalent DBM form (9 % (95 % CI 7, 12)). Duration of residence in Addis Ababa (adjusted OR (aOR) 1·03 (95 % CI 1·00, 1·06)), Orthodox Christianity (aOR 1·97 (95 % CI 1·01, 3·85)) and household size (aOR 1·24 (95 % CI 1·01, 1·54)) were associated factors. In Kersa, concurrent child overweight and stunting was the most prevalent DBM form (11 % (95 % CI 9, 14)). Housing quality (aOR 0·33 (95 % CI 0·20, 0·53)), household wealth (aOR 1·92 (95 % CI 1·18, 3·11) and sanitation (aOR 2·08 (95 % CI 1·07, 4·04)) were associated factors. After adjusting for multiple comparisons, only housing quality remained a significant factor. Conclusions: DBM prevalence was low among urban and rural Ethiopian households. Environmental, socio-economic and demographic factors emerged as potential associated factors. However, we observed no common associated factors among urban and rural households. [ABSTRACT FROM AUTHOR]

Cities in developing countries are experiencing rapid transformation, one of which is caused by top-down inner city slum renewal. Usually the process happens without real participation of residents and focuses only on physical aspects resulting in a range of sustainability challenges. This study aimed at understanding citizens' concerns and identifying assessment indicators for sustainable urban renewal in Addis Ababa, Ethiopia. Two purposively selected inner city slum neighborhoods before (Golla Sefer) and after renewal (relocated households due to Lideta Condominium) were examined from bottom-up side. Using multidisciplinary experts and literature review, twenty-six urban sustainability indicators were identified. The indicators were later used to assess the renewal in Lideta Condominium using Likert-Scale. Results showed that households' concerns focused on livelihood, affordability, social network, security and proximity issues as these factors directly affect their daily lives. Expert's assessment revealed that the renewal has brought improvement in land value while important economic indicators like affordability, job creation showed poor performance of varying percentage. Social indicators such as social network and safety showed poor assessment result while access to transport showed improvement. Some environmental indicators such as open space quantity, road and walkway and mixity showed improvements while governance has poor assessment result. Therefore, future renewal should improve public participation, revise the focus on home ownership, minimize relocation and enhance urban design. The study underlines important indicators from households' perspective and other relevant indicators, which are important to sustainably guide future renewal in Ethiopia and other Sub-Saharan African cities with similar context. [ABSTRACT FROM AUTHOR]

Background: Job loss in patient with chronic illness like schizophrenia is the most serious public concern in the clinical and socio-economic terms worldwide. Patients with schizophrenia usually have unsatisfactory job termination like quitting or getting fired which results well-established negative outcomes. The complex interplay between one another has made job and mental illness the focus areas. In the developing nations, there is limited study on these areas in spite of higher rates of job loss. Objectives: This study aimed to assess the prevalence and correlates of job loss among schizophrenia outpatient units in Addis Ababa, Ethiopia. Methods: Institutional based cross-sectional study was conducted at Saint Amanuel Mental Specialized Hospital among schizophrenia outpatient units in Addis Ababa from May to June 2018. A total of 421 study subjects were interviewed using Positive and Negative Syndrome Scale and Perceived devaluation and discrimination scale. Out of the total study participants, female populations were slightly higher (50.4%) and the majorities (38.6%) were orthodox religion followers. Study characteristics was summarized using descriptive statistics and bi-variable and multivariable analysis was performed using Statistical Package for Social Science version 24. Furthermore, those factors at p value ≤ 0.05 were considered as statistically significant. Results: The prevalence of job loss among patients with schizophrenia was 37.3%. Factors including unmarried [AOR = 2.42:95% CI (1.28, 4.54)], divorced [AOR = 2.34: 95% CI (1.16, 4.71)], severe positive symptoms [AOR = 2.03: 95% CI (1.15, 3.60)], severe general psychopathology [AOR = 1.76: 95% CI (1.01, 3.08)], and poor level of social and occupational functioning [AOR = 5.05: 95% CI (2.81, 9.09)] were significantly associated with job loss among schizophrenia people. Conclusion: This study suggested that job loss among schizophrenia outpatients was high. There was significant association among people with unmarried, divorced, severe positive symptoms, poor functionality and higher general psychopathology. Therefore, clinical and psychosocial factors were responsible for job loss which warrant further attention and investigation. [ABSTRACT FROM AUTHOR]

Background: Molecular characterization of Mycobacterium tuberculosis (MTB) is important to understand the pathogenesis, diagnosis, treatment, and prevention of tuberculosis (TB). However, there is limited information on molecular characteristics and drug-resistant patterns of MTB in patients with extra-pulmonary tuberculosis (EPTB) in Ethiopia. Thus, this study aimed to determine the molecular characteristics and drug resistance patterns of MTB in patients with EPTB in Addis Ababa, Ethiopia. Methods: This study was conducted on frozen stored isolates of EPTB survey conducted in Addis Ababa, Ethiopia. A drug susceptibility test was performed using BACTEC-MGIT 960. Species and strain identification were performed using the Geno-Type MTBC and spoligotyping technique, respectively. Data were entered into the MIRU-VNTRplus database to assess the spoligotype patterns of MTB. Analysis was performed using SPSS version 23, and participants' characteristics were presented by numbers and proportions. Results: Of 151 MTB isolates, 29 (19.2%) were resistant to at least one drug. The highest proportion of isolates was resistant to Isoniazid (14.6%) and Pyrazinamide (14.6%). Nine percent of isolates had multidrug-resistant TB (MDR-TB), and 21.4% of them had pre-extensively drug-resistant TB (pre-XDR-TB). Among the 151 MTB isolates characterized by spoligotyping, 142 (94.6%) had known patterns, while 9 (6.0%) isolates were not matched with the MIRU-VNTRplus spoligotype database. Of the isolates which had known patterns, 2% was M.bovis while 98% M. tuberculosis. Forty-one different spoligotype patterns were identified. The most frequently identified SpolDB4 (SIT) wereSIT149 (21.2%), SIT53 (14.6%) and SIT26 (9.6%). The predominant genotypes identified were T (53.6%), Central Asia Strain (19.2%) and Haarlem (9.9%). Conclusion: The present study showed a high proportion of MDR-TB and pre-XDR-TB among EPTB patients. The strains were mostly grouped into SIT149, SIT53, and SIT26. The T family lineage was the most prevalent genotype. MDR-TB and pre-XDR-TB prevention is required to combat these strains in EPTB. A large scale study is required to describe the molecular characteristics and drug resistance patterns of MTB isolates in EPTB patients. [ABSTRACT FROM AUTHOR]

Background: Flour mill workers are at high risk of developing respiratory symptoms due to exposure to flour dust in their working environment. Exposure to flour dust linked with the development of chronic respiratory disorders. However, very little evidence has been available on the respiratory symptoms of exposed workers in large-scale flour mill factories. Therefore, the aim of this study was to assess chronic respiratory health symptoms and associated factors among flour mill workers in Addis Ababa, Ethiopia. Methods: Cross-sectional study was conducted among a sample of 424 randomly selected workers from Addis Ababa flour mill factories. Respiratory health symptoms were assessed using an American Thoracic Society standard questionnaire customized with local context. Data were checked for completeness and Epi-Info V. 7.2 and SPSS V.21 statistical software were used for data entry and analysis, respectively. Multivariable logistic regression model was used to identify variables associated with chronic respiratory health symptoms. Variables that had significant association were identified based on adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05. Data were presented using tables, texts and figures. Results: The prevalence of chronic respiratory health symptoms among flour mill factory workers was 58.3% (95% CI: 53.7– 63.4). Chronic respiratory health symptoms were significantly associated with age group (AOR=1.95, 95% CI; 1.17– 2.79 and AOR=12.3, 95% CI; 4.39– 34.6), monthly income (AOR=1.68, 95% CI; 1– 2.79), work experience (AOR=2.58, 95% CI; 1– 6.62), past dust exposure (AOR=1.86, 95% CI; 1.08– 3.2) and utilization of respiratory protective equipment (AOR=2.29, 95% CI; 1.27– 4.13). Conclusion and Recommendation: Chronic respiratory health symptoms were highly prevalent among flour mill factory workers. Supportive supervision and cooperation between Ministry of Labour and Social Affairs, flour mill managers and workers are needed to reduce exposure and improve working environment. [ABSTRACT FROM AUTHOR]

Background: Xpert® MTB/RIF assay is currently used in Ethiopia for the rapid diagnosis of Mycobacterium tuberculosis (MTB) and mutations that confer Rifampicin resistance. Rifampicin resistance is determined based on any mutation in the 81 bp of rpoB gene using five overlapping probes represented as Probe A (codons 507-511), Probe B (codons 512-518), Probe C (codons 518-523), Probe D (codons 523-529) and Probe E (codons 529-533). In this review, we assessed the frequency of missed probe types for Rifampicin Resistance results.Methods: Data were reviewed from specimens received and tested using Xpert® MTB/RIF assay at Ethiopian National Tuberculosis Reference Laboratory, in Addis Ababa from 15 July 2016 to 31 December 2018 retrospectively. All archived data were reviewed carefully to describe missed probe types and the quantity of DNA in the sample.Results: A total of 100 specimens were reported as MTB Detected Rifampicin Resistance Detected by Xpert® MTB/RIF assay. More than half (55%) of these results were reported from male patients. The median age was 28.0 years (5 months to 88 years). Majorities (62%) of the cases were detected from sputum. Among the total of 38 extrapulmonary samples, lymph node aspirates were accounted for 50% (19/38). The most common mutations (81.0%) were found in the Probe E region followed by Probe D (10.0%), and Probe B (3.0%). Mutations in Probe A and Probe C regions were not observed. However, six (6.0%) Rifampicin resistance cases were found without any missed probe type. The delta Ct max is ≥4.3. No specimen yielded Rifampicin resistance associated with more than one probe failure or mutation combinations.Conclusion: Mutations associated with Probe E (codons 529-533) region were identified as the commonest rpoB gene mutations. The Rifampicin resistance results found without any identified missing probe needs further study. The lower DNA amount was observed in extrapulmonary specimens compared with sputum. [ABSTRACT FROM AUTHOR]

The incorrect author name is: Abdallah Noor The correct author name is: Ramadhani Abdallah Noor Further to this, affiliation 3 has been corrected to United Nations Children's Fund, Addis Ababa, Ethiopia. B Correction: BMC Nutr 8, 159 (2022) b B https://doi.org/10.1186/s40795-022-00653-1 b Following publication of the original article [[1]], the authors identified an error in the author name Ramadhani Abdallah Noor. [Extracted from the article]

Background: Little is known about the prevalence of tuberculosis (TB) and HIV among TB suspects in primary health care units in Ethiopia. Methods: In the period of February to March, 2009, a cross sectional survey was done in 27 health centers of Addis Ababa to assess the prevalence of TB and HIV among TB suspects who have .= 2 weeks symptoms of TB such as cough, fever and weight loss. Diagnosis of TB and HIV was based on the national guidelines. Information concerning socio-demographic variables and knowledge of the respondents about TB was collected using pretested questionnaire. Results: Of the 545 TB suspects, 506 (92.7%) of them participated in the study. The prevalence of both pulmonary and extra pulmonary TB was 46.0% (233/506). The smear positivity rate among pulmonary TB suspect was 21.3%. Of the TB suspects, 298 (58.9%) of them were tested for HIV and 27.2% (81/298) were HIV seropositive. Fifty percent of the HIV positive TB suspects had TB. TB suspects who had a contact history with a TB patient in the family were 9 times more likely to have TB than those who did not have a contact history, [OR = 9.1, (95%CI:4.0, 20.5)]. Individuals who had poor [OR = 5.2, (95%CI: 2.3, 11.2)] and fair knowledge [OR = 3.7, (95%CI: 1.3, 10.4)] about TB were more likely to have TB than individuals who had good knowledge. Conclusion: In conclusion, the prevalence of TB among TB suspects with duration of 2 or more weeks is high. Fifty percent of the HIV positive TB suspects had TB. Case finding among TB suspects with duration of 2 or more weeks should be intensified particularly among those who have a contact history with a TB patient. [ABSTRACT FROM AUTHOR]

Background: Nutritionally inadequate diets in Ethiopia contribute to a persisting national burden of adult undernutrition, while the prevalence of noncommunicable diseases (NCDs) is rising.Objectives: To evaluate performance of a novel Global Diet Quality Score (GDQS) in capturing diet quality outcomes among Ethiopian adults.Methods: We scored the GDQS and a suite of comparison metrics in secondary analyses of FFQ and 24-hour recall (24HR) data from a population-based cross-sectional survey of nonpregnant, nonlactating women of reproductive age and men (15-49 years) in Addis Ababa and 5 predominately rural regions. We evaluated Spearman correlations between metrics and energy-adjusted nutrient adequacy, and associations between metrics and anthropometric/biomarker outcomes in covariate-adjusted regression models.Results: In the FFQ analysis, correlations between the GDQS and an energy-adjusted aggregate measure of dietary protein, fiber, calcium, iron, zinc, vitamin A, folate, and vitamin B12 adequacy were 0.32 in men and 0.26 in women. GDQS scores were inversely associated with folate deficiency in men and women (GDQS Quintile 5 compared with Quintile 1 OR in women, 0.50; 95% CI: 0.31-0.79); inversely associated with underweight (OR, 0.63; 95% CI: 0.44-0.90), low midupper arm circumference (OR, 0.61; 95% CI: 0.45-0.84), and anemia (OR, 0.59; 95% CI: 0.38-0.91) in women; and positively associated with hypertension in men (OR: 1.77, 95% CI: 1.12-2.80). For comparison, the Minimum Dietary Diversity-Women (MDD-W) was associated more positively (P < 0.05) with overall nutrient adequacy in men and women, but also associated with low ferritin in men, overweight/obesity in women, and hypertension in men and women. In the 24HR analysis (restricted to women), the MDD-W was associated more positively (P < 0.05) with nutrient adequacy than the GDQS, but also associated with low ferritin, while the GDQS was associated inversely with anemia.Conclusions: The GDQS performed capably in capturing nutrient adequacy-related outcomes in Ethiopian adults. Prospective studies are warranted to assess the GDQS' performance in capturing NCD outcomes in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: The diagnoses of active smear negative PTB, remains difficult. As a result, treatment is often carried out empirically relaying on clinical criteria. The distribution and magnitude of smear negative PTB, smear negative MDR-TB and associated factors in the same day diagnosis strategy are not clearly known in the study area. Therefore, this study aimed to determine the prevalence of TB, MDR-TB and associated risk factors among presumptive smear negative pulmonary tuberculosis patients in Addis Ababa, Ethiopia.Methods: Analytic cross sectional study design was used. A total of 418 smear negative presumptive pulmonary TB patients were enrolled from selected health facilities since August 01, 2017 to January 5, 2018. Sputum samples were examined by Ziehl Neelsen microscopy, Xpert MTB/RIF assay and Culture. Drug susceptibility testing was performed by line probe assay and BACTEC MGIT 960 system. These laboratory tests were performed in Ethiopian Public Health Institute, National TB Reference Laboratory. Data was analyzed by SPSS Ver.20.Results: From the total of 418 enrolled patients, 27 (6.5%) were Xpert MTB/ RIF and 26 (6.4%) were culture confirmed smear negative PTB patients. The positivity rate among male and female was 10.2 and 3.5% (p = 0.005) respectively. From 26 culture positive isolates 3 (11.54%) were MDR TB; from MDR-TB confirmed isolates 2/23 (8.7%) were among new and 1/3 (33.3%) was among retreatment smear negative presumptive pulmonary TB patients. All Rifampicin resistant smear negative pulmonary TB isolates by Xpert MTB/ RIF assay were found to be MDR TB and 7/26 (26.9%) isolates were INH mono resistant. History of migration found to be a potential factor for developing smear negative pulmonary TB.Conclusion: In this study a significant proportion of smear negative pulmonary TB was diagnosed. Furthermore, a high smear negative multi drug resistant (MDR) TB and other mono drug resistant TB prevalence was confirmed. Due to the limitations of smear microscopy which is used as a primary diagnostic tool, these TB strains are missed to be diagnosed and transmission continues in the community. [ABSTRACT FROM AUTHOR]

Background: In co-endemic areas, rate of intestinal parasites and tuberculosis (TB) co-infection thought to be high. However, there are limited studies on the epidemiology of this co-infection in Ethiopia. Therefore, the present study aimed to generate evidence on intestinal parasites co-infection rate and associated factors among pulmonary tuberculosis patients (PTB) and their household contacts in Addis Ababa, Ethiopia.Methods: Unmatched case-control study was conducted. Data were collected from 91 PTB patients (cases) and 89 household contacts (controls). Socio-demographic characteristics and associated factors were collected using structured questionnaire. Sputum, stool and blood specimens were collected, processed and examined for PTB, intestinal parasites and Human Immunodeficiency virus anti-body test, respectively. Data were entered and analyzed by Statistical Packages for Social Sciences (SPSS) Version 20. Descriptive statistics, Fisher's exact test, binary logistic regression, and odds ratio were used. P-value of < 0.05 was considered as statistically significant.Results: The infection rate of intestinal parasites based on one stool samples in PTB patients and controls was 22 and 9%, respectively. The difference was statistically significant (COR = 2.85;95% CI = 1.18-6.87). The most prevalent intestinal parasite in PTB patients was Gardia lamblia (8.8%, 8), followed equally by Ascaris lumbricoides, Haymenolopsis nana and Entamoeba histolytica/dispar (4.4%, 4). Co-infection in PTB patients was associated with body mass index (BMI) < 18.5 (AOR = 6.71;95% CI = 1.65-27.25) and dirty material in finger nails (AOR = 8.99;95% CI = 2.46-32.78). There was no variable associated with parasitic infections in controls in our analysis, which might be due to the low prevalence of intestinal parasites'.Conclusions: There was a statistical significant difference in the infection rate of intestinal parasites in PTB patients compared to healthy household contacts. The consequence of co-infection on developing an active disease, disease severity and treatment efficacy needs to be investigated in future. [ABSTRACT FROM AUTHOR]

Background: The exact cause of brain tumours is still unknown, but disruptions of redox balance are thought to play a significant role in all stages of brain tumour development. However, the roles of free radical imbalance at different grades of brain tumour and degree of oxidative stress before and after surgery have not been addressed in prior studies. Aim: A comparative cross-sectional study was conducted to assess the redox imbalance among confirmed brain tumour patients. Methods and results: An institution-based comparative cross-sectional study was conducted on a total of 100 participants (50 brain tumour patients and 50 controls) at referral hospitals in Addis Ababa, Ethiopia. Descriptive statistics, t-test and analysis of variance (ANOVA) (post-hoc) analysis were used and statistical significance was declared at p ≤ 0.05. The serum oxidised glutathione and total oxidative stress were significantly higher in the serum of brain tumour patients (0.72 ± 0.03 μM/μg and 9.66 ± 1.76 μmol H2O2 Eq/L, respectively) compared to the control group (0.21 ± 0.07 μM/μg and 6.59 ± 0.81 μmol H2O2 Eq/L, respectively) (p ≤ 0.05). The serum total oxidant status gradually increased as the tumour grade increased, being higher in grade four (11.96 ± 0.72) and lower in grade one (8.43 ± 1.56), and the mean differences were statistically significant (p ≤ 0 05). A statistically significantly higher total antioxidant capacity (116.78 ± 5.03 Trolox Eq/L) was obtained in the post-surgery than pre-surgery level (79.65 ± 17.914 Trolox Eq/L) (p ≤ 0 05). Conclusion: Higher oxidant and lower antioxidant levels were found in the serum of brain tumour patients than in the control group. The post-surgery oxidant level was lower than the pre-surgery state. The findings of this study could suggest that redox imbalance may have a role in the pathophysiology of brain tumours, but further experimental studies are needed. [ABSTRACT FROM AUTHOR]

Background. In Ethiopia, tuberculosis (TB) is one of the most common causes of illness and death. However, there is limited information available on lineages associated with drug resistance among extrapulmonary tuberculosis patients in Ethiopia. In this study, researchers looked into Mycobacterium tuberculosis lineages linked to drug resistance in patients with extrapulmonary tuberculosis in Addis Ababa, Ethiopia. Methods. On 151 Mycobacterium tuberculosis isolates, a cross-sectional analysis was performed. Spoligotyping was used to characterize mycobacterial lineages, while a phenotypic drug susceptibility test was performed to determine the drug resistance pattern. Data were analyzed using SPSS version 23. Results. Among 151 Mycobacterium tuberculosis complex (MTBC) genotyped isolates, four lineages (L1–L4), and Mycobacterium bovis were identified. The predominantly identified lineage was Euro-American (73.5%) followed by East-African-Indian (19.2%). Any drug resistance (RR) and multidrug-resistant (MDR) tuberculosis was identified among 16.2% and 7.2% of the Euro-American lineage, respectively, while it was 30.8% and 15.4% among the East-African-Indian lineages. Among all three preextensively drug-resistance (pre-XDR) cases identified, two isolates belong to T3-ETH, and the other one strain was not defined by the database. There was no statistically significant association between any type of drug resistance and either lineage or sublineages of Mycobacterium tuberculosis. Conclusion. A higher proportion of any type of drug resistance and MDR was detected among the East-African-Indian lineage compared to others. However, there was no statistically significant association between any type of drug resistance and either lineages or sublineages. Thus, the authors recommend a large-scale study. [ABSTRACT FROM AUTHOR]

Objective: To determine the knowledge and attitude of caregivers of HIV-infected children taking antiretroviral therapy (ART) in Ethiopia. Methods: A total of 390 caregivers of HIV infected children were surveyed in selected ART units in Addis Ababa. Data was collected using a pretested and structured questionnaire. Results: Seventy two (18.5%) of the caregivers believed that HIV can be cured by taking antiretroviral (ARV) medications. Three hundred and nineteen (81.8%) participants reported that taking ARVs incorrectly would bring about resistance to the drug. Three hundred and eighty (97.4%) caregivers had favorable attitude toward administration of ARV medication to children. Almost all of the caregivers (379, 97.2%) reported to have had enough privacy in their consultation with the doctor or nurse. Having enough privacy during consultation (OR 7.18; 95% CI 1.24–41.6) and knowledge that HIV cannot be cured by ART (OR 3.89; 95% CI 1.05–14.4) were associated with favorable attitude toward ART administration. Conclusion: The majority of the caregivers had good knowledge and favorable attitude toward administration of ARV medication to children. However some misconceptions such as beliefs that ART cures HIV/AIDS exist. Practical implications: Health education efforts should continue focusing on the objective of ART treatment and toward dispelling the prevailing misconceptions. [Copyright &y& Elsevier]

Objective A substantial number of infants in Ethiopia suffer from hydrocephalus. Neurosurgical expertise has until recently been virtually nonexistent in the country; however, since 2006, a neurosurgery training program has been established in Addis Ababa, where hydrocephalus surgery now is performed in 3 hospitals. Our experience is that hydrocephalus is diagnosed and treatment is too late to avoid severe brain damage. Introducing routine head circumference (HC) measurements can ease the detection of hydrocephalus and thus lead to earlier diagnosis, thereby reducing the brain damage caused by the condition. The present pilot project had two major aims: to get the process of implementation started and to gain experience with how this implementation best can be achieved. Methods We educated and encouraged the nurse staff members of 12 randomly selected health (mother and child) clinics in Addis Ababa in performing HC measurements, using a recently developed Ethiopian HC chart. Much of the work was related to follow-up. A local Ethiopian healthcare worker was employed to lead the follow-up and to continue the implementation in the remaining 14 clinics. Results During our attempted implementation of routine HC measuring, we encountered a line of administrational, cultural, infrastructural, and didactic problems and challenges, which are discussed. Conclusions The experience we have gained during this pilot project will be used in further development and implementation of routine HC measuring throughout Ethiopia. These experiences may be of interest and use to others wanting to introduce similar routines in low-income countries. [ABSTRACT FROM AUTHOR]