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There is an urgent need for interventions in addressing the rapid and disproportionate impact of antimicrobial resistance (AMR) and climate change (CC) on low- and middle-income countries. Within this context, it is important to understand indigenous knowledge in rural communities, which are highly affected. This study examined knowledge, attitude, and practices (KAP) regarding AMR and CC in the Adadle district, Somali region, Ethiopia, utilizing mixed methods, including 362 surveys and 12 focus group discussions among rural communities. Findings showed that 39% and 63% of participants were familiar with AMR and CC, respectively. Of those surveyed, 57% attributed AMR to inappropriate antimicrobial use in animals and humans, while CC was often associated with Allah/God. Multivariable analysis indicated that males exhibited superior knowledge and a positive attitude towards AMR and CC. Additionally, individuals aged 26–35 and 36–45 years showed heightened awareness of AMR and CC, respectively. Moreover, participants who were government employees, pastoralists, and business owners showed better knowledge on CC compared to family caretaker. Religious education and households with more than six members were linked to lower AMR knowledge. This study underlines a greater awareness of CC than AMR and highlights gender-based disparities, recommending integrated educational AMR programs targeting different demographics through a One Health lens, actively involving females, and incorporating local beliefs and practices. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 19 (COVID‐19) is life‐threatening infectious disease caused by SARS‐CoV‐2 virus that caused a global pandemic. SARS‐CoV‐2 has been widely transmitted throughout Ethiopia, with over 501,060 cases confirmed and 7574 deaths until November 2023. This study assessed for the first time the seroprevalence SARS‐CoV‐2 in the general population of the Somali Region during the COVID‐19 pandemic. Methods: A cross‐sectional study design was conducted from May to June 2021 in 14 districts of Somali Region. Blood samples were collected in 820 participants in addition to administering a questionnaire that included sociodemographic characteristics and history of clinical symptoms of COVID‐19. Blood samples were tested for the presence or absence of anti‐SARS‐CoV‐2 using a commercial Enzyme‐Linked Immunosorbent Assay (ELISA) kit (Euroimmun). Results: Overall, 477 (58.2%) were male and 343 (41.8%) were female. The majority of the participants (N = 581; 70.9%) were between 18 and 34 years old and not vaccinated against COVID‐19 (N = 793; 96.7%). The overall seroprevalence of SARS‐CoV‐2 antibodies was 41.7% (95% CI: 33.3%–47.6%). The highest prevalence was found in Goljano district (70%) and the lowest in Gunagado district (22.5%). Only age was found to be associated with COVID‐19 seropositivity. Conclusion: Prevalence of SARS‐CoV‐2 antibodies was the highest ever reported in Ethiopia, indicating that a large proportion of the population had been infected 14 months after the start of the outbreak in the country. Such studies are important to swiftly reassess and improve specific COVID‐19 preventive and control measures to reduce transmissions within the community in a given setting. [ABSTRACT FROM AUTHOR]

The composition and function of the intestinal microbiota are major determinants of human health and are strongly influenced by diet, antibiotic treatment, lifestyle and geography. Nevertheless, we currently have only little data on microbiomes of non-westernized communities. We assess the stool microbiota composition in 59 children aged 2–5 years from the Adadle district of Ethiopia, Somali Regional State. Here, milk and starch-rich food are predominant components of the local diet, where the inhabitants live a remote, traditional agropastoral lifestyle. Microbiota composition, function and the resistome were characterized by both 16S rRNA gene amplicon and shotgun metagenomic sequencing and compared to 1471 publicly available datasets from children living in traditional, transitional, and industrial communities with different subsistence strategies. Samples from the Adadle district are low in Bacteroidaceae, and Prevotellaceae, the main bacterial representatives in the feces of children living in industrialized and non-industrialized communities, respectively. In contrast, they had a higher relative abundance in Streptococcaceae, Bifidobacteriaceae and Erysipelatoclostridiaceae. Further, genes involved in degradation pathways of lactose, d-galactose and simple carbohydrates were enriched. Overall, our study revealed a unique composition of the fecal microbiota of these agropastoral children, highlighting the need to further characterize the fecal bacterial composition of human populations living different lifestyles. [ABSTRACT FROM AUTHOR]

Background: Intestinal parasitic infections (IPIs) can cause illness, morbidity, and occasional mortality in children. Agro-pastoralist and pastoralist children in the Somali Regional State of Ethiopia (ESRS) are especially at risk for IPIs, as access to safe water, sanitation, and health services is lacking. Minimal data on the prevalence of IPIs and associated risk factors exists in this region. Methodology: We assessed the prevalence of IPIs and associated risk factors during the wet season from May-June 2021 in 366 children aged 2 to 5 years in four agro-pastoralist and four pastoralist kebeles (wards) in Adadle woreda (district) of the Shebelle zone, ESRS. Household information, anthropometric measurements, and stool samples were obtained from included children. Parasites were identified microscopically using Kato-Katz and direct smear methods. Risk factors were assessed using general estimating equation models accounting for clustering. Principal findings: Overall prevalence of IPIs was 35%: 30.6% for single infections and 4.4% for poly-parasitic infections. Intestinal protozoan prevalence was 24.9%: 21.9% Giardia intestinalis, and 3.0% Entamoeba spp.. Intestinal helminth prevalence was 14.5%: 12.8% Ascaris lumbricoides, 1.4% hookworm (Ancylostoma duodenale /Necator americanus.), and 0.3% Hymenolepis nana. G. intestinalis infection was associated with drinking water sourced from the river (aOR 15.6, 95%CI 6.84, 35.4) and from collected rainwater (aOR 9.48, 95%CI 3.39, 26.5), with toilet sharing (aOR 2.93, 95%CI 1.36, 6.31) and with household ownership of cattle (1–5 cattle: aOR 1.65, 95%CI 1.13, 2.41; 6+ cattle: aOR 2.07, 95%CI 1.33, 3.21) and chickens (aOR 3.80, 95%CI 1.77, 8.17). A. lumbricoides infection was associated with children 36 to 47 months old (aOR 1.92, 95%CI 1.03, 3.58). Conclusions/Significance: Improving access to safe water, sanitation, and hygiene services in Adadle and employing a One Health approach would likely improve the health of children living in (agro-) pastoralist communities in Adadle and the ESRS; however, further studies are required. Author summary: Intestinal parasitic infections remain a silent threat to the health and life-trajectories of children living in areas with inadequate access to clean water, proper sanitation, and hygiene facilities, including the Somali region of Ethiopia. A large majority in this region live as pastoralists (semi-mobile animal herders), in close contact with their animals and nature, at risk for climate-related threats like drought and flooding, and at risk for infectious agents like intestinal parasites. We assessed the prevalence of intestinal parasitic infections in pastoralist children in the Adadle district of the Somali region of Ethiopia (ESRS), and the individual and household-level factors associated with these infections. We found that locally collected water, shared toilets, along with ownership of cows and chickens increased the risk for having an intestinal parasitic infection with Giardia intestinalis, which can cause diarrhea and is transmitted through water, food, and soil that have been contaminated by the feces of infected humans and animals. If access to clean water, sanitation, and hygiene infrastructure is not improved, these infections remain recurrent in these communities and their animals, continually affecting the health of children. This study is one of few involving pastoralists in this region, hopefully lending guidance to regional public health policies. [ABSTRACT FROM AUTHOR]

Pastoralists and wildlife co‐exist in the Somali Regional State competing for habitat, food and water resources. A questionnaire survey conducted among 198 pastoralists, captured information on their perception of wildlife against the backdrop of wildlife population decrease, illegal wildlife trade and lack of quantitative and qualitative data in the area. The top perceived threats to livestock were drought (46%), wildlife attacks (33.8%) and diseases (20.2%). Daily encounters between wildlife and livestock were reported by 61.1% of respondents. Herbivores, including warthogs, accounted for the majority of these encounters (88.4%), whereas carnivores were rarely observed with livestock, except for jackals. The majority (92.9%) of the respondents did not think that wildlife could transmit diseases to livestock. Jackals were reported by 7.1% to transmit rabies. A strong dislike for wildlife was recorded in 99% of all respondents. All stated that wildlife should not be protected. Half of the respondents did not see any benefits in wildlife. Wildlife populations have decreased over the last 10 years, particularly lions and cheetahs. Pastoralist's attitudes and perceptions towards wildlife in the study area were negative, potentially affecting conservation efforts. There is an urgent need to improve awareness of the benefits of wildlife and to include wildlife in integrated human‐livestock‐environment surveillance systems. [ABSTRACT FROM AUTHOR]