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Abstract Background Non-communicable diseases (NCDs) pose a significant global health challenge, constituting over 80% of mortality and morbidity. This burden is particularly pronounced in low- and middle-income countries (LMICs), including Ethiopia. Despite this, there’s limited research on this issue in Africa. This study aims to investigate the prevalence, patterns, and outcomes of NCDs in hospitalized populations across three tertiary hospitals in Ethiopia. Methods A hospital-based cohort study (August 2022 - January 2023) included patients aged 14 and older diagnosed with cardiovascular diseases (CVDs), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), asthma, or cancer at three Ethiopian hospitals. Data on demographics, socio-economic factors, clinical characteristics, and outcomes were collected through medical records and interviews. Logistic regression identified factors independently associated with in-hospital mortality, with p ≤ 0.05 considered statistically significant. Results In the study across three tertiary hospitals involving 2,237 patients, we uncovered the impact of NCDs. About 23.4% of patients struggled with NCDs, with cardiovascular diseases (53.3%), cancer (29.6%), diabetes (6.1%), and respiratory diseases (6.5%) being the most prevalent. Notably, among those affected, women comprised a slight majority (55.1%), with the average patient age being 47.2 years. Unfortunately, 15.3% of patients with NCDs faced in-hospital mortality. Our analysis revealed predictors of mortality, including cancer diagnosis (adjusted odds ratio [AOR]:1.6, 95% CI: 1.2–1.8, p = 0.01), medication adherence ( AOR: 0.36, 95% CI: 0.21–0.64, p

Abstract Background The World Health Organization has recommended a new method for HIV self-testing (HIVST) using oral fluid, intending to increase HIV testing rates, and linking individuals to medical care. Healthcare workers are chief health advocates in the community who need adequate knowledge and intention to use the newly recommended HIVST approach. However, studies on awareness and the intention to use oral fluid for HIV self-testing among Ethiopian healthcare workers are limited. Therefore, this study aimed to assess healthcare workers' knowledge of and intentions to use oral fluid for HIV self-testing in Hadiya Zone public hospitals in southern Ethiopia in 2022. Methods We conducted a facility-based cross-sectional study among a sample of 352 healthcare workers from 1 to 30 June 2022. The data were entered into Epidata version 4.2 and exported to SPSS version 23 for analysis. We used a logistic regression model with a 95% confidence interval for the interpretation of adjusted odds ratios (AORs) with P

Abstract Background Several studies were performed on transdermal (TD) insulin delivery in vitro and in vivo, and recently, the study groups included a clinical trial in humans. Therefore, this systematic review was conducted to get summary information about the effectiveness, safety, and preferability of TD insulin in comparison with subcutaneous insulin delivery. Methods We conducted a thorough search to find studies in the databases Cochrane Library, MEDLINE via PubMed, Web of Science Core Collection, EMBASE, Scopus, Hinari, Medlib, and Magiran until January 2024. We included 18 randomized clinical trials. Results Although there are various types of TD delivery methods, the TD insulin delivery methods that have undergone clinical trials are the TD patch, micro needle TD insulin delivery, and TD insulin jet injector. Eighteen studies were conducted on TD insulin delivery, which showed either superior or comparable effectiveness, safety, and preferability of TD insulin in comparison with SC insulin. About eleven out of eighteen studies (61.1%) showed more effective blood glucose control than SC delivery, and the remaining seven studies showed comparable effectiveness with SC delivery. Eleven studies (61.1%) showed equal tolerability of TD insulin versus SC insulin, and seven studies (38.9%) showed more tolerability of TD insulin over SC insulin. In most studies, eleven out of eighteen (61.1%) showed a higher preference for TD insulin delivery over traditional SC delivery; sixth out of eighteen (33.3%) showed equal preferability for TD insulin versus SC insulin; and only one study (5.6%) showed that TD insulin delivery was less preferable than SC insulin. Conclusion The review revealed that clinical trials have demonstrated the effectiveness of TD insulin delivery methods such as TD patches, MN-based insulin delivery, and insulin jet injectors compared to traditional SC routes of administration. The studies showed the superior or comparable effectiveness of TD insulin in controlling blood glucose levels. Additionally, TD insulin delivery was found to be equally or more tolerable than SC insulin delivery in all studies. Overall, the majority of studies favored TD insulin delivery over traditional SC delivery methods, highlighting its potential as a preferred option for insulin administration.

Abstract Introduction Head lice infestation remains a persistent public health concern among primary school children in resource-limited settings, affecting their well-being and academic performance. Despite previous studies, there is no consistent evidence on the prevalence and factors associated with head lice infestation. This study aimed to determine the prevalence and factors related to head lice infestation among primary school children in low and middle-income countries. Methods This review was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Relevant electronic databases, including PubMed, Cochrane Library, Web of Science, Science Direct, AJOL, and Google Scholar, were used to retrieve articles. The study included only published articles written in English languages between December 01, 2014 to January 31, 2024 for studies reporting the prevalence of head lice infestation or associated factors among primary school children in low- and middle-income countries. This review has been registered on PROSPERO with Prospero registration number CRD42024506959. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. Publication bias was evaluated using funnel plots and statistical tests, such as Egger’s and Beggs’s tests, to identify publication biases in the included studies. Meta-regression was also carried out to assess the source of publication of publication bias. Results The review included 39 studies involving 105,383 primary school children. The pooled prevalence of head lice infestation among primary school children in low- and middle-income countries was 19.96% (95% CI; 13.97, 25.95). This review also found out that being a girl was 3.71 times (AOR = 3.71; 95% CI: 1.22–11.26) more likely to have head lice infestation as compared to boys, while children with a previous history of infestation were 4.51 times (AOR = 4.51; 95% CI: 2.31–8.83) more likely to have head lice infestation as compared to their counterparts. Conclusion The overall prevalence of head lice infestation among primary school children in low- and middle-income countries was found to be high. Female gender, children who had a previous history of infestation, and family size were significant predictors of head lice infestation. As a result, policymakers and program administrators should focus on the identified determinants.

Abstract Introduction Nowadays, food safety is regarded as one of the most critical global public health issues. Edible oil, a key ingredient in food processing, is widely used and consumed in every Ethiopian household. However, its safety is often overlooked. Currently, edible oil is produced in Ethiopia from small-scale operations to large industrial levels, as well as imported from other countries. Objective This study aimed to determine the levels of heavy metals and essential minerals in edible vegetable oils produced and marketed in Gondar City, Northwest Ethiopia. Methods A laboratory-based cross-sectional study was conducted from May to July 2021 in Gondar City. Seventeen edible oil samples were collected using simple random sampling techniques. Heavy metal content was determined using an atomic absorption spectrophotometer with the standard procedures and techniques after microwave digestion. The efficiency and validity of the method used were evaluated by determining the limit of detection (LOD), the limit of quantification (LOQ), accuracy, and precision. The collected data were entered into Microsoft Excel and transported to Stata for analysis. Result A total of seventeen vegetable oil samples were analyzed. The accuracy of the method was evaluated by recovery studies, which ranged from 81 to 115%, and the relative standard deviations were found to be below 15%. The concentrations of Zn, Cu, Fe, Cd, and Pb were in the range of 0.07 to 0.8 mg/l, 0.002 to 0.06 mg/l, 0.01 to 0.8 mg/l, 0.08 to 0.18 mg/l, and 0.003 to 0.27 mg/l, respectively. In general, the lead and cadmium content was higher than other metals in some of the investigated edible vegetable oils. Most values fell within the permissible quality limits for edibility as prescribed by the World Health Organization (WHO) and the National Agency for Food and Drug Administration and Control (NAFDAC). However, the levels of Pb and Cd exceeded the reference levels in some locally produced vegetable oils. Conclusion To address the exceeded levels of heavy metals, it is imperative to implement more careful handling, processing of raw materials, and filtering practices. Producers and marketers should take the necessary precautions to prevent contamination. Strict regulatory control from responsible bodies and stakeholders is recommended to ensure the safety and metal contents of vegetable oils originating from the study area.

Abstract Background Approximately 15% of births worldwide result in life-threatening complications during pregnancy, delivery, or postpartum. Comprehensive Emergency Management of Obstetric and Newborn Care (CEmONC) is intended as one of the measures for maternal healthcare services to reduce the high burden with regard to childbirth complications. However, its state of implementation fidelity has not been well investigated. Therefore, this study aimed to evaluate the implementation fidelity of CEmONC services at University of Gondar Comprehensive Specialized Hospital, Ethiopia. Method A case-study design with an embedded mixed method was employed. Adherence, quality of delivery, and participant responsiveness dimensions from Carroll’s conceptual framework were used in this evaluation. Four hundred four exit interviews, 423 retrospective document reviews and 10 key informants were conducted. Moreover, a binary logistic regression model was fitted. The qualitative data were transcribed, translated, coded, and analysed using a thematic analysis approach. The overall implementation fidelity of the CEmONC was judged based on the pre-seated judgmental criteria. Results Overall the implementation fidelity of the CEmONC service was 75.5%. Quality of delivery, participant responsiveness and adherence were 72.7%, 76.6% and 77.2% respectively. Signal functions like parenteral antibiotics and removal of retained products were insufficiently performed against the recommended protocols which was also evidenced by the key informant interviews. Healthcare providers’ respect for the clients was less. Age ≥ 35 years (AOR = 0.48, 95% CI: 0.24,0.98), educational status of college and above (AOR = 2.61, 95% CI: 1.46,4.66), being government employed (AOR = 1.85, 95% CI: 1.08,3.18), having ANC follow-up (AOR = 5.50, 95% CI: 1.83, 16.47) and grand multigravida (AOR = 2.17, 95% CI: 1.08, 4.38) were factors significantly associated with participant responsiveness towards the services. Conclusions The overall implementation fidelity of the CEmONC services was implemented in good fidelity. Moreover, the quality of delivery was judged as implemented in fair fidelity. Parenteral antibiotics and removal of retained products were not found to be sufficiently performed. Respect for the clients was insufficiently delivered. Therefore, it is recommended that parenteral antibiotics drugs be adequately provided and training for healthcare providers regarding compassionate and respectful care shall be facilitated. Moreover, healthcare providers are strongly recommended to adhere to the recommended guidelines.

Abstract Introduction Health policy and systems research (HPSR) is a multi-disciplinary approach of generating health system and policy-level evidence. Setting HPSR agendas is considered as an efficient strategy to map and identify policy and cost-effective research topics, but its practice in developing countries is limited. This paper aimed to conduct a collaborative health policy and system research priority-setting exercise in Ethiopia. Method The WHO’s plan, implement, publish, and evaluate (PIPE) framework and the Delphi technique were used to conduct the priority-setting exercise. The PIPE model was used to lead the priority-setting process from planning to evaluation, while the Delphi technique was used to run the rating and ranking exercise with the aim of reaching a consensus. Two rounds of expert panel workshops supplemented with an online survey were used for the HPSR agenda setting, rating and ranking purposes. Groups were formed using the WHO health system building blocks as a base framework to identify and prioritize the HPSR topics. Result Under 8 themes, 32 sub-themes and 182 HPSR topics were identified. The identified research themes include leadership management and governance, health policy, health information system, healthcare financing, human resource for health, medical products and supply, service delivery and cross-cutting issues. Conclusions Priority HPSR topics focussing on national health priority issues were identified. The identified topics were shared with policymakers and academic and research institutions. Evidence generation on the identified priority topics will guide future research endeavours and improve evidence-informed decision-making practice, health system performance and national health goals and targets.

Abstract Tick-borne encephalitis virus (TBEV) vaccine breakthrough (VBT) infections are not uncommon in endemic areas. The clinical and immunological outcomes have been poorly investigated. We assessed the magnitude and specificity of virus-specific antibody and T cell responses after TBE in previously vaccinated subjects and compared the results with those of unvaccinated TBE patients and study subjects that received vaccination without VBT infection. Symptomatic TBEV infection of unvaccinated study subjects induced virus-specific antibody responses to the E protein and non-structural protein 1 (NS1) as well as T cell responses to structural and other non-structural (NS) proteins. After VBT infections, significantly impaired NS1-specific antibody responses were observed, while the virus-specific T cell responses to the NS proteins were relatively strong. VBT infection caused predominantly moderate to severe disease during hospitalization. The level of TBEV EDIII- and NS1-specific antibodies in unvaccinated convalescent patients inversely correlated with TBE severity and neurological symptoms early after infection.

Abstract Introduction Despite COVID-19 being highly contagious and spreading to several countries, the university community has overlooked prevention measures. For more than five decades, the Health Belief Model (HBM) has been a widely used conceptual framework in health behavior. structural equation modeling(SEM) analysis is an advanced statistical method capable of rectifying failures of the basic models and showing complex relations Thus this study aimed to determine the magnitude of COVID-19 prevention behavior and identify its associated factors using HBM and SEM analysis. Method An institutional-based cross-sectional study was conducted among academic staff of the University of Gondar in Ethiopia from April 10 to May 10/2021. Daniel Soper’s sample size calculator was used to determine the sample size. Proportional allocation to each campus followed by a simple random sampling technique was employed to select study subjects. A pre-tested, structured questionnaire was used to collect the data. Structural equation modeling analysis was employed to show the relationship between health belief model constructs and their effect on preventive behavior. Result A total of 602 academic staff participated. The magnitude of good COVID-19 preventive behavior was 24.8%. The HBM explained 55% of the variance in preventive behavior. Perceived barriers (β = -0.37, p

Abstract Present study assessed the growth of two plant species and ion uptake by them grown on different proportion of industrial solid waste and garden soil. The industrial waste having high concentration of chemicals were used with garden soil at different proportion i.e. 0% (T0), 5% (T1), 10% (T2), 15% (T3) and 20% (T4). Two species namely Conocarpus erectus (alien plant) and Dodonaea viscosa (indigenous) were used as test plants in pot study. Different parameters including growth, physiology, and anatomy of plants and concentration of cations (Na+, K+, Ca2+, and Mg2+) in the plant shoot and root were measured at different time duration (initial, 1st, 2nd, 3rd and 4th month). The key objective of the study was to use these plants to establish their plantations on the barren lands where industrial solid wastes were being disposed of. C. erectus showed better growth than D. viscosa, as well as more uptake of ions. A significant increase in plant growth was observed in fourth month in T1, where plant height reached 24.5% and 46% for C. erectus and D. viscosa, respectively. At harvest, in C. erectus, no significant difference in the fresh (65–78 g) and dry weight (24–30 g) of the shoot was observed across treatments compared to the control. In D. viscosa, at the time of harvest, the fresh and dry weights of the root and shoot showed a strong, significantly decreasing pattern across T1, T2, and T3, leading to the death of the plant at T3 and T4. Further, optimum ratio of waste soil to garden soil was found as 10:90 and 20:80 to establish the plantations of D. viscosa and C. erectus, respectively in areas where such solid waste from industries are disposed. Findings can be used for the restoration of such solid waste for the sustainable management of industrial areas and their associated ecosystems.

Abstract Introduction Ethiopia is one of those countries with higher burden of community acquired pneumonia among its people, under five children are the members of society that are highly affected by pneumonia particularly Severe Community Acquired Pneumonia. However, there are limited studies on time to recovery and its predictors in under-five children and most of them are retrospective which fails to address important variables that affect the time to recovery. Therefore, the aim of this study was to estimate the median time to recovery and its predictors among under five children admitted to South Wollo zone public hospitals, North East Ethiopia. Methods An institution-based prospective cohort study was conducted from March 10 to May 10, 2021, with 270 study subjects. A systematic random sampling technique was used. Data was collected by interview and chart review. The data were entered and analyzed using Epi Data version 3.1 and STATA version 14.0, respectively. Kaplan-Meier and Cox regression models were used to test the time and predictors of recovery from severe community-acquired pneumonia. Results The overall incidence of recovery rate (95% confidence interval) from Severe Community-Acquired Pneumonia was 20.45(17.84–23.46) per 100 person days observation with median (IQR) time to recovery of [3, 5] days. The predictors of time to recovery from Severe Community-Acquired Pneumonia were having comorbidities on admission [AHR = 0.49 (95%CI: 0.32,0.75)], reaching hospitals after 5 days of onset of symptoms [AHR = 0.35 (95%CI: 0.20,0.60)], having Middle Upper Arm Circumference

Abstract In the past two decades, significant progress has been made in the development of polygenic scores (PGSs). One specific application of PGSs is the development and potential use of pharmacogenomic- scores (PGx-scores) to identify patients who can benefit from a specific medication or are likely to experience side effects. This systematic review comprehensively evaluates published PGx-score studies in psychiatry and provides insights into their potential clinical use and avenues for future development. A systematic literature search was conducted across PubMed, EMBASE, and Web of Science databases until 22 August 2023. This review included fifty-three primary studies, of which the majority (69.8%) were conducted using samples of European ancestry. We found that over 90% of PGx-scores in psychiatry have been developed based on psychiatric and medical diagnoses or trait variants, rather than pharmacogenomic variants. Among these PGx-scores, the polygenic score for schizophrenia (PGSSCZ) has been most extensively studied in relation to its impact on treatment outcomes (32 publications). Twenty (62.5%) of these studies suggest that individuals with higher PGSSCZ have negative outcomes from psychotropic treatment — poorer treatment response, higher rates of treatment resistance, more antipsychotic-induced side effects, or more psychiatric hospitalizations, while the remaining studies did not find significant associations. Although PGx-scores alone accounted for at best 5.6% of the variance in treatment outcomes (in schizophrenia treatment resistance), together with clinical variables they explained up to 13.7% (in bipolar lithium response), suggesting that clinical translation might be achieved by including PGx-scores in multivariable models. In conclusion, our literature review found that there are still very few studies developing PGx-scores using pharmacogenomic variants. Research with larger and diverse populations is required to develop clinically relevant PGx-scores, using biology-informed and multi-phenotypic polygenic scoring approaches, as well as by integrating clinical variables with these scores to facilitate their translation to psychiatric practice.

Abstract Introduction Stroke is the leading cause of death and disability among adults and elderly individuals worldwide. Although several primary studies have been conducted to determine the prevalence of poststroke cognitive impairment among stroke survivors in sub-Saharan Africa, these studies have presented inconsistent findings. Therefore, this study aimed to determine the pooled prevalence of poststroke cognitive impairment and identify its associated factors among stroke survivors in sub-Saharan Africa. Methods The studies were retrieved from the Google Scholar, Scopus, PubMed, and Web of Science databases. A manual search of the reference lists of the included studies was performed. A random-effects DerSimonian-Laird model was used to compute the pooled prevalence of poststroke cognitive impairment among stroke survivors in sub-Saharan Africa. Results A total of 10 primary studies with a sample size of 1,709 stroke survivors were included in the final meta-analysis. The pooled prevalence of PSCI was obtained from the 9 included studies with a sample size of 1,566. In contrast, the data regarding the associated factors were obtained from all the 10 included studies with a sample size of 1,709. The pooled prevalence of poststroke cognitive impairment among stroke survivors was 59.61% (95% CI: 46.87, 72.35); I2 = 96.47%; P

Abstract Background The global over-reliance on non-renewable fossil fuels has led to the emission of greenhouse gases, creating a critical global environmental challenge. There is an urgent need for alternative solutions like biofuels. Advanced biofuel is a renewable sustainable energy generated from lignocellulosic plant materials, which can significantly contribute to mitigating CO2 emissions. Microbial Carbohydrate Active Enzymes (CAZymes) are the most crucial enzymes for the generation of sustainable biofuel energy. The present study designed shotgun metagenomics approaches to assemble, predict, and annotate, aiming to gain an insight into the taxonomic diversity, annotate CAZymes, and identify carbohydrate hydrolyzing CAZymes from microbiomes in Menagesha suba forest soil for the first time. Results The microbial diversity based on small subunit (SSU) rRNA analysis revealed the dominance of the bacterial domain representing 81.82% and 92.31% in the studied samples. Furthermore, the phylum composition result indicated the dominance of the phyla Proteobacteria (23.08%, 27.27%), Actinobacteria (11.36%, 20.51%), and Acidobacteria (10.26%, 15.91%). The study also identified unassigned bacteria which might have a unique potential for biopolymer hydrolysis. The metagenomic study revealed that 100,244 and 65,356 genes were predicted from the two distinct samples. A total number of 1806 CAZyme genes were identified, among annotated CAZymes, 758 had a known enzyme assigned to CAZymes. Glycoside hydrolases (GHs) CAZyme family contained most of the CAZyme genes with known enzymes such as β-glucosidase, endo-β-1,4-mannanase, exo-β-1,4-glucanase, α-L-arabinofuranosidase and oligoxyloglucan reducing end-specific cellobiohydrolase. On the other hand, 1048 of the identified CAZyme genes were putative CAZyme genes with unknown enzymatical activity and the majority of which belong to the GHs family. Conclusions In general, the identified putative CAZymes genes open up an opportunity for the discovery of new enzymes responsible for hydrolyzing biopolymers utilized for biofuel energy generation. This finding is used as a first-hand piece of evidence to serve as a benchmark for further and comprehensive studies to unveil novel classes of bio-economically valuable genes and their encoded products.

Fibrodysplasia ossificans progressiva (FOP) is a rare and progressively debilitating disorder affecting 1 in 2 million individuals. It is characterized by the progressive ossification of soft tissues into ectopic bone and congenital malformations of the great toes. FOP leads to significant disability and can result in death due to thoracic insufficiency syndrome. These case reports examine the presentation, diagnosis, and management of FOP, highlighting the diagnostic challenges inherent in managing such rare conditions because of their unique clinical features. They underscore the need for increased awareness among healthcare practitioners to ensure early diagnosis and the implementation of effective management strategies.

This study presents an engineering geological investigation aimed at assessing the bearing capacity of the proposed site for the Meli gold processing plant (GPP) located in the northwestern region of Tigray, Ethiopia. The geological composition of the site predominantly comprises low-grade metamorphic rocks, with intermediate metavolcanic rocks being the most prevalent. This research utilized an innovative combination of empirical methodologies, including the Hoek–Brown and Mohr–Coulomb criteria, to evaluate the strength and elasticity characteristics of the rock mass. Additionally, the rock mass foundation for the GPP was rigorously classified using renowned systems such as the rock mass rating (RMR), quality index (Q), and geological strength index (GSI). Employing five different empirical equations to estimate bearing capacity, this study significantly advances our understanding by comparing these diverse methodologies, which is a novel approach in this geological context where engineering property data are scarce or non-existent. The bearing capacities determined using the Hoek–Brown and Mohr–Coulomb criteria ranged from 11.6 to 46.2 MPa and 7.9 to 10.5 MPa, respectively. These findings not only offer valuable insights into the assessment of bearing capacity in metamorphic rock formations but also underscore the effectiveness of combining multiple empirical approaches to enhance the reliability of geological assessments. This research contributes to the advancement of construction practices and enhances project planning strategies in comparable geological environments, particularly highlighting the utility of robust empirical data in the absence of extensive drilling data. By integrating comprehensive empirical analyses, the study provides a methodological framework that significantly aids in informed decision-making for future projects located in similar geological settings.

Soil fertility is the controlling factor of agricultural production worldwide including Waghimera zone, Ethiopia. However, it has been diminished from time to time and leads to low crop yield. Measuring of soil nutrient inflow-outflow affords necessary information about the current nutrient status of the soils, and to take appropriate nutrient management practices. The study was conducted to estimate the full soil nutrient balance of cultivated farms in the northern, of Ethiopia, in the 2020/21 main season. Inflow and Outflow of N, P, and K into, and out of farms were measured through the interview, field measurement, laboratory analysis, USLE model, and pedo-transfer functions. The full N balance of barley, tef, and wheat were -66.7, -8.9, and -47.1 kg ha-1 yr-1, respectively. P full balance was -5.4, 1.4, and -1.9 kg ha-1 yr-1 for barley, tef, and wheat farms, respectively. Whereas, K balance was also -12.4, -3.3, and -6 kg ha-1 yr-1 for barley, tef, a nd wheat, respectively. The balance quantification was done by subtracting nutrient outflows from the inflows. The results revealed that N, P, and K had negative balances except for P in tef. Grain yield and crop residue removal were the major paths of nutrient loss. To sustain, and boost agricultural production, reversing the imbalance between inflows, and outflows is critically essential for the study area. The current highly depleted nutrient should be corrected by adding sufficient organic, and inorganic nutrient sources, like in situ manuring, biochar, green manure, and remaining crop residue in the fields.

Abstract Background Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) infections are global issues that disproportionately affect developing countries. Pregnancy-related HBV and HCV infections are associated with a high risk of vertical transmission and complications for the mother as well as the newborn. Therefore, this study aims to determine the seroprevalence of hepatitis B virus and hepatitis C virus infection among pregnant women attending antenatal care at Guhala Primary Hospital, Northwestern Ethiopia. Methods A hospital-based retrospective study was conducted from July to September 2022 on HBV and HCV registered books from September 1, 2017, to August 30, 2019, for a year. The presence of HBsAg and anti-HCV in serum was detected using the One Step Cassette Style HBsAg and anti-HCV antibody test kit. Data were analyzed using SPSS version 26 software. Results In this study, a total of 2252 participants for HBsAg and 538 participants for ant-HCV rapid tests of records in the laboratory logbook were included. The mean age of the study participants was 25.6years (± 5.8SD). The overall prevalence of HBsAg and anti-HCV was 6.0% (134/2252) and 2.4% (13/538), respectively. There were 0.4% (2/538) coinfection results between HBV and HCV among pregnant women. Conclusion and recommendation In this study, intermediate seroprevalence of HBV and HCV infection was detected among pregnant women attending antenatal care. The Hepatitis B virus was predominantly higher among pregnant women aged between 25 and 34 years. To manage and stop the potential vertical transmission of these viral agents during the early stages of pregnancy, routine prenatal testing for HBV and HCV infections should be taken into consideration.

Abstract Good-quality sleep is defined by its ability to minimize disturbances, provide adequate duration, and maintain a balanced progression through sleep stages. Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness. Studies have reported sleep disturbances among HIV/AIDS patients in sub-Saharan African countries (SSA), yielding varied results at the country level. Therefore, conducting a systematic review and meta-analysis is essential. This systematic review and meta-analysis aimed to evaluate the prevalence of poor sleep quality and identify associated factors among HIV/AIDS patients in sub-Saharan African countries. We systematically searched across various databases, including PubMed, African Journals Online, Scopus, Cochrane Library, HINARI, and Science Direct. Additionally, we conducted searches using Google and Google Scholar search engines. Microsoft Excel was used for data extraction, and the data were analysed using STAT version 17.0. We assessed heterogeneity using Cochran’s Q test and I2 test and checked for small study effects using funnel plot symmetry and Egger’s test. Pooled prevalence and associated factors were estimated using a random-effects model at a 95% confidence interval (CI) and significance level of p

Abstract Background Sexually transmitted infections (STIs) are illnesses mainly spread through unprotected sexual activity. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of STI, and its associated factors among students in Ethiopia to fill the aforementioned gap. Methods We extensively searched the bibliographic databases of PubMed, Scopus, and Google Scholar to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. The PRISMA-guidline and Newcastle-Ottawa quality assessment scale were used for quality appraisal. To check heterogeneity, the Higgs I2 and Cochran’s Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger’s test and funnel plots were used. Results The pooled prevalence of STI among students in Ethiopia was 13.6% with a 95% CI (10.2, 17). Findings from sub group analysis based on student category shows that the pooled prevalence of STI were 14.5% among University students, 14.2% among college students and 10.6% among high school students. Having multiple sexual partners (AOR 3.31; 95% CI: 2.40–4.57), not using condoms during sexual intercourse (AOR 2.56; 95% CI: 1.72–3.81), and having poor knowledge about sexually transmitted infections were 3.08 times (AOR 3.08; 95% CI: 1.84–5.15) significantly associated with STI. Conclusion The pooled prevalence of STIs among students in Ethiopia was high, and factors like having multiple sexual partners, not using condoms during sexual intercourse, and having poor knowledge about sexually transmitted infections were significantly associated with STIs. Hence, reduce STIs among students, strengthening sexual and reproductive health services, raising awareness about transmission and prevention, and promoting consistent condom use through health information dissemination is crucial. Further qualitative studies are suggested to explore the barriers and facilitators of STI prevention.

Abstract Background Financial risk protection is one indicator of universal health coverage (UHC). All people should be protected from financial risks such as catastrophic health expenditures (CHE) to ensure equitable health services. Ethiopia has launched community-based health insurance (CBHI) since 2011 to protect people from financial risk. However, out-of-pocket health expenditure is a financial barriers to achieve UHC. The insured-non-insured disparity of CHE has not been well studied in Ethiopia in general and in Debre Tabor town in particular. Therefore, this study aimed to assess the disparity of CHE between insured and non-insured households and its contributing factors in Debre Tabor town. Methods This study used the primary household survey data collected from May to June 2022 in Debre Tabor town. Data were collected from 825 household heads and analyzed using STATA version 17.0 statistical software. Logit-based multivariate decomposition analysis was conducted to determine insured-non-insured disparity of CHE. Statistical significance for all analysis was declared at a p

Abstract Background Enhancing cultural competence stands as a cornerstone in the realm of clinical nursing. Consequently, nurses engaging with culturally diverse communities encounter significant challenges. In Ethiopia, nurses providing care often prioritize physical well-being, the therapeutic journey, and medical interventions, while overlooking the critical cultural dimensions of patient care. Therefore, this study aims to assess the level of cultural competence and its determining factors among nurses employed in public hospitals located in the South Wollo Zone of northeastern Ethiopia. Methods A multicenter, institution-based cross-sectional study was conducted, involving 629 nurses employed in public hospitals across northeastern Ethiopia. Participants were selected using a simple random sampling method. Data were gathered using a structured, self-administered English version of the Nurse Cultural Competence Scale Questionnaire (NCCSQ), and subsequently entered into Epi-data 4.6 for analysis. Statistical analysis was performed using SPSS version 26, employing multiple linear regression analysis to identify determining factors. Result The participants’ overall mean score for cultural competence was 3.198 [95% CI: 3.161, 3.234]. Specifically, factors such as being a female nurse (β = 0.089, CI: 0.019–0.159), having a diploma level of education (β = -0.084, CI: -0.101 to -0.007), having 11–20 years of work experience (β = 0.412, CI: 0.090–0.815), a 1:15 nurse-to-patient ratio (β = 0.081, CI: 0.010–0.162), experience with caring for culturally and ethnically diverse patients (β = 0.362, CI: 0.248–0.476), comprehensive hospital level (β = 0.699, CI: 0.496–0.903), and attending cultural training (β = 0.002, CI: 0.234–0.931) were predictors of the mean score for cultural competence. Conclusion In this study, the level of cultural competence was found to be at a moderate level and need more effort. Factors such as gender, years of work experience, nurse-to-patient ratio, experience in caring for culturally and ethnically diverse patients, hospital level, educational attainment, attendance of cultural training, and the presence of a feedback system for cultural competence were identified as predictors of cultural competence level. Sharing experiences from higher-level hospitals to lower-level ones and strengthening cultural competence training sessions for nurses can significantly enhance cultural competence within clinical settings.

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

Abstract Introduction Scabies is a widespread issue in prisons due to overcrowded living conditions and limited healthcare resources. A recent study published in the Journal of Infection and Public Health discovered that the prevalence of scabies varies greatly among prisoners in different regions and facilities. This review aimed to determine the global prevalence and predictors of scabies among prisoners by conducting a systematic review and meta-analysis. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist to report the findings of our systematic review and meta-analysis. Relevant databases including PubMed, Cochrane Library, ScienceDirect, and other grey literature databases were used to search and retrieve articles. The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis. Results The review included 7 studies involving 1, 309,323 prisoners. All included studies involved cross-sectional study design. The prevalence of scabies among prisoners ranges from 0.72% in Italy to 41.01% in Cameroon. The global pooled prevalence of human scabies among prisoners was found to be 6.57% (95% CI; 2.16–19.94). According to subgroup analysis, the overall prevalence of scabies among African prisoners was 19.55% (95% CI; 9.44–40.45), while the prevalence among prisoners outside of Africa was 1.57% (95% CI; 0.77–3.19). The length of time spent in prison, sharing of clothing or beds, and hygiene practices were found to be factors that were significantly associated with the likelihood of prisoners developing human scabies. Conclusion The overall prevalence of human scabies is high among prisoners worldwide. Prisoners who spent more time in prison shared clothing or beds, and had poor hygiene practices were more likely to develop human scabies. Thus, efforts should be made by policymakers and program administrators to decrease the prevalence of scabies in prisons. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024516064.

Abstract A low level of work autonomy is the bottleneck for the health service delivery and the quality of the service. Although work autonomy is the pillar of organizational commitment and a means of employee retention mechanism, information about the magnitude of work autonomy among health professionals is limited in Ethiopia. Therefore, this study aimed to assess work autonomy and its predictors among health professionals working in public hospitals of Northeast Ethiopia. Institution-based cross-sectional study was conducted from March 24 to April 24, 2021, among health professionals using a stratified sampling technique. Variables with a p-value of

Abstract Antibiotic resistance is a worldwide problem that imposes a devastating effect on developing countries and requires immediate interventions. Initially, most of the antibiotic drugs were identified by culturing soil microbes. However, this method is prone to discovering the same antibiotics repeatedly. The present study employed a shotgun metagenomics approach to investigate the taxonomic diversity, functional potential, and biosynthetic capacity of microbiomes from two natural agricultural farmlands located in Bekeka and Welmera Choke Kebelle in Ethiopia for the first time. Analysis of the small subunit rRNA revealed bacterial domain accounting for 83.33% and 87.24% in the two selected natural farmlands. Additionally, the analysis showed the dominance of Proteobacteria representing 27.27% and 28.79% followed by Actinobacteria making up 12.73% and 13.64% of the phyla composition. Furthermore, the analysis revealed the presence of unassigned bacteria in the studied samples. The metagenome functional analysis showed 176,961 and 104, 636 number of protein-coding sequences (pCDS) from the two samples found a match with 172,655 and 102, 275 numbers of InterPro entries, respectively. The Genome ontology annotation suggests the presence of 5517 and 3293 pCDS assigned to the “biosynthesis process”. Numerous Kyoto Encyclopedia of Genes and Genomes modules (KEGG modules) involved in the biosynthesis of terpenoids and polyketides were identified. Furthermore, both known and novel Biosynthetic gene clusters, responsible for the production of secondary metabolites, such as polyketide synthases, non-ribosomal peptide synthetase, ribosomally synthesized and post-translationally modified peptides (Ripp), and Terpene, were discovered. Generally, from the results it can be concluded that the microbiomes in the selected sampling sites have a hidden functional potential for the biosynthesis of secondary metabolites. Overall, this study can serve as a strong preliminary step in the long journey of bringing new antibiotics to the market.

Faidherbia albida can enhance the bio-physicochemical fertility of inherently infertile Arenosols. Changes in the soil ammonium (NH4+)-to-nitrate (NO3−) ratio have agricultural, environmental, and ecological implications. Thus, the present study mainly examined the changes in Arenosol NH4+/NO3− ratios, as influenced by varying Faidherbia albida tree age classes. We collected 40 composite soil samples (4 tree age classes×2 soil depths×5 replications) from 0 to 15 and 15 to 30 cm soil depths following core and auger sampling techniques. Analyses of variance have shown that the highest NH4+/NO3− ratios for soil under the old tree canopies are followed by the medium age. In contrast, the significantly lowest NH4+/NO3− ratios were recorded for soil out-of-canopy. Pearson correlation analysis revealed that the NH4+/NO3− ratio was strongly and positively correlated with clay content, total nematode abundance, the fungi/bacterial biomass ratio, cation exchange capacity, microbial biomass carbon, total nitrogen, and soil organic carbon but negative for sand content, bulk density, and pH. The increment in the plant-available forms of nitrogen might be attributed to the accumulation of biologically fixed nitrogen by the Faidherbia albida tree–Rhizobium bacteria symbiosis. The NH4+/NO3− ratio approached one in soil under the old Faidherbia albida trees. The findings suggest that (1) the ability of soil to retain NH4+ increased and (2) the rate of nitrification might be decreased due to inhibition of nitrification by direct and indirect effects of the tree on the nitrifying group of bacteria. The increment in the NH4+/NO3− ratio could also be due to the lowering of the soil’s pH in the older Faidherbia albida trees because lower pH is known to inhibit the activities of nitrifying bacteria. Moreover, maintaining older Faidherbia albida trees in farmlands could contribute to retaining nitrogen and trigger below- and above-ground communities’ successions and ultimately surpass the productivity of arid and semi-arid Arenosols.

Abstract Introduction Respiratory syncytial virus (RSV) and influenza pose major disease burdens in older adults due to an aging immune system and comorbidities; seasonal overlap exists between these infections. In 2023, the RSV prefusion protein F3 older adult (RSVPreF3 OA) vaccine was first approved in the USA as a single dose for prevention of lower respiratory tract disease due to RSV in adults aged ≥ 60 years. The vaccine has since been approved in the European Union and elsewhere. RSVPreF3 OA and FLU-QIV-HD could be coadministered if immunogenicity, safety, and reactogenicity are not affected. Methods This open-label, randomized (1:1), controlled, phase 3 study in 1029 adults aged ≥ 65 years in the USA evaluated the immunogenicity (up to 1 month after last vaccine dose) and safety (up to 6 months after last vaccine dose) of RSVPreF3 OA coadministered with FLU-QIV-HD (co-ad group) versus FLU-QIV-HD alone followed by RSVPreF3 OA at a separate visit 1 month later (control group). Non-inferiority criterion was defined as an upper limit of the two-sided 95% confidence interval of the geometric mean titer (GMT) group ratio (control/co-ad) ≤ 1.5. Secondary endpoints included safety and reactogenicity. Results Proportions of participants across age categories between groups and proportions of male (50.4%) and female (49.6%) participants were well balanced; most participants were white (68.7%). Group GMT ratios for RSV-A neutralizing titers, hemagglutination inhibition titers for four influenza vaccine strains, and RSV-B neutralizing titers were non-inferior in the co-ad group versus the control group. No clinically meaningful differences in local or systemic solicited and unsolicited adverse events (AEs), serious AEs, and potential immune-mediated diseases were identified. The most common solicited AEs in both groups were injection-site pain and myalgia. Conclusion In adults aged ≥ 65 years, coadministration of RSVPreF3 OA and FLU-QIV-HD was immunogenically non-inferior to the sequential administration of both vaccines 1 month apart, and had clinically acceptable safety and reactogenicity profile. Trial Registration ClinicalTrials.gov identifier, NCT05559476. Graphical Abstract

Abstract Introduction There has been extensive research conducted on open defecation in Ethiopia, but a notable gap persists in comprehensively understanding the spatial variation and predictors at the household level. This study utilizes data from the 2021 Performance Monitoring for Action Ethiopia (PMA-ET) to address this gap by identifying hotspots and predictors of open defecation. Employing geographically weighted regression analysis, it goes beyond traditional models to account for spatial heterogeneity, offering a nuanced understanding of geographical variations in open defecation prevalence and its determinants. This research pinpoints hotspot areas and significant predictors, aiding policymakers and practitioners in tailoring interventions effectively. It not only fills the knowledge gap in Ethiopia but also informs global sanitation initiatives. Methods The study comprised a total weighted sample of 24,747 household participants. ArcGIS version 10.7 and SaT Scan version 9.6 were used to handle mapping, hotspots, ordinary least squares, Bernoulli model analysis, and Spatial regression. Bernoulli-based model was used to analyze the purely spatial cluster detection of open defecation at the household level in Ethiopia. Ordinary Least Square (OLS) analysis and geographically weighted regression analysis were employed to assess the association between an open defecation and explanatory variables. Results The spatial distribution of open defecation at the household level exhibited clustering (global Moran’s I index value of 4.540385, coupled with a p-value of less than 0.001), with significant hotspots identified in Amhara, Afar, Harari, and parts of Dire Dawa. Spatial analysis using Kuldorff’s Scan identified six clusters, with four showing statistical significance (P-value

Abstract Background Civilian war and internal conflicts increase the incidences of mental health conditions among war survivors. It is crucial to assess war-related psychological consequences in war-affected areas in Ethiopia to intervene in the future. Thus, this study aimed to determine the magnitude of psychological distress and associated factors of psychological distress among war survivor women in Northern, Ethiopia. Methods A community-based cross-sectional survey was conducted, and 1596 war survivor women were recruited to participate using a face-to-face interviews with a census sampling technique from May 1–30, 2022. The psychological distress was assessed using a Kessler psychological distress scale (K10). Bi-variable and multi-variable logistic regression analyses were used, and variables with a p-value less than 0.05 in the multivariable analyses were considered statistically significant. Result In this study, the response rate was 100% and the prevalence of psychological distress was 44.90% at a 95% CI: (42.40, 47.40). Psychological distress was significantly associated with the education of ability to read and write (AOR = 2.92; 95% CI: 2.12, 4.01), primary education and above (AOR = 3.08; 95% CI: 2.09, 4.54), housewife (AOR = 5.07; 95%CI: 2.64, 9.74), farmer (AOR = 8.92; 95%CI: 4.03, 19.70), emotional violence (AOR = 1.52; 95%CI: 1.05, 2.18), physical violence (AOR = 3.85; 95%CI: 2.37, 6.26) and sexual violence (AOR = 3.25; 95%CI: 1.98, 5.33) whereas being separate was protective for psychological distress (AOR = 0.38; 95%CI: 0.16, 0.92). Conclusion The prevalence of psychological distress was found to be high. Therefore, women who are housewives, married, farmers, educated, and who have experienced violence must be the focus of governmental and private collaborative interventions to prevent war-related psychological morbidity and mortality.

Abstract Background Lithium (Li) remains the treatment of choice for bipolar disorders (BP). Its mood-stabilizing effects help reduce the long-term burden of mania, depression and suicide risk in patients with BP. It also has been shown to have beneficial effects on disease-associated conditions, including sleep and cardiovascular disorders. However, the individual responses to Li treatment vary within and between diagnostic subtypes of BP (e.g. BP-I and BP-II) according to the clinical presentation. Moreover, long-term Li treatment has been linked to adverse side-effects that are a cause of concern and non-adherence, including the risk of developing chronic medical conditions such as thyroid and renal disease. In recent years, studies by the Consortium on Lithium Genetics (ConLiGen) have uncovered a number of genetic factors that contribute to the variability in Li treatment response in patients with BP. Here, we leveraged the ConLiGen cohort (N = 2064) to investigate the genetic basis of Li effects in BP. For this, we studied how Li response and linked genes associate with the psychiatric symptoms and polygenic load for medical comorbidities, placing particular emphasis on identifying differences between BP-I and BP-II. Results We found that clinical response to Li treatment, measured with the Alda scale, was associated with a diminished burden of mania, depression, substance and alcohol abuse, psychosis and suicidal ideation in patients with BP-I and, in patients with BP-II, of depression only. Our genetic analyses showed that a stronger clinical response to Li was modestly related to lower polygenic load for diabetes and hypertension in BP-I but not BP-II. Moreover, our results suggested that a number of genes that have been previously linked to Li response variability in BP differentially relate to the psychiatric symptomatology, particularly to the numbers of manic and depressive episodes, and to the polygenic load for comorbid conditions, including diabetes, hypertension and hypothyroidism. Conclusions Taken together, our findings suggest that the effects of Li on symptomatology and comorbidity in BP are partially modulated by common genetic factors, with differential effects between BP-I and BP-II.

Abstract Background Sexually transmitted infections continue to be a significant public health issue on a global scale. Due to their effects on reproductive and child health as well as their role in facilitating the spread of HIV infection, sexually transmitted infections impose a heavy burden of morbidity and mortality in many developing countries. In addition, stigma, infertility, cancer, and an increased risk of HIV are the primary impacts of STIs on sexual and reproductive health. While numerous studies have been conducted in Tanzania to address this specific topic in various settings, the majority of them weren’t representative. Therefore, the main objective of this study was to use data from the most recent Tanzania Demographic and Health Survey in order to evaluate the individual and community-level factors associated with sexually transmitted infections among Tanzanian men at the national level. Methods The most recent datasets from the Tanzania demographic and health survey were used for secondary data analysis. A total of 5763 men participated in this study. The recent Tanzania demographic and health survey provides data for multilevel mixed effect analysis on the variables that contribute to sexually transmitted infections among men in Tanzania. Finally, the percentage and odd ratio were provided, together with their 95% confidence intervals. Result This study includes a total weighted sample of 5763 men from the Tanzania demographic and health survey. Of the total study participants, 7.5% of men had sexually transmitted infections in the last twelve months. Being married [AOR: 0.531, 95% CI (0.9014, 3.429)] was a factor that reduced the risk of sexually transmitted infections among men. On the other hand, being between the age range of 20 and 24 years [AOR: 6.310, 95% CI (3.514, 11.329)] and having more than one union [AOR: 1.861, 95% CI (1.406, 2.463)] were the factors that increased the risk of sexually transmitted infections among men. Conclusions Men’s sexually transmitted infections have been associated with individual-level factors. So, the Tanzanian governments and the concerned stakeholders should provide special attention for men whose age range is 20–24 years old. Promoting marriages and limiting the number of sexual partners should be the main strategies to lower the risk of sexually transmitted infections among men in Tanzania.

Abstract Despite their large numbers, the vertical growth of micro, small, and medium enterprises (MSMEs) is not readily apparent, even though they have a substantial impact on Ethiopia’s economy. Earlier studies have underscored enterprise-related factors as hindrances to the expansion of MSMEs. However, entrepreneurs are blamed for their limited practice of innovative marketing that the researchers wanted to verify whether marketing innovation can positively influence the growth of MSMEs in Ethiopia. Therefore, the major objective of the study was to examine the effect of competency and marketing innovation on the growth of MSMEs in the Ethiopian business environment taking marketing innovation as a mediating variable. To collect data, researchers used a stratified random sampling technique and obtained data from 288 owner–managers of micro, small, and medium enterprises. The results of the study revealed that competency has a significant direct effect on enterprise growth. However, the study also found that the effect of competency on innovation and the effect of innovation on enterprise growth were not statistically significant. These findings suggest that competency directly influences the growth of enterprises, while the impact of innovation on growth is not evident in the context of Ethiopian enterprises. The negligible impact of competency on marketing innovation, coupled with the minimal effect of marketing innovation itself, suggests that entrepreneurs may not be prioritizing the adoption of innovative marketing strategies, assuming they can sell their existing products. However, such an approach is typically short-sighted and could leave the business exposed to future vulnerabilities. This study adds to the body of knowledge by indicating that marketing innovation does not mediate between competency and the growth of MSMEs. Instead, it is the competency of entrepreneurs that has a direct and exclusive impact on growth.

At a rhetorical level, the SDGs provide a unified global agenda, and their targets and indicators are believed to drive action for social and environmental transformation. However, what if the SDGs (and their specific goals and indicators) are more of a problem than a solution? What if they create the illusion of action through a depoliticised and technical approach that fails to address fundamental dilemmas of politics and power? What if this illusion continues to reproduce poverty, inequality, and environmental degradation? This paper addresses these questions through a focus on SDG 6.5.1 – the implementation of integrated water resources management (IWRM), measured on a 0-100 scale through a composite indicator. The paper presents an empirical analysis of SDG 6.5.1 reporting in Colombia, Ethiopia, India, Malaysia, and the UK, drawing on research from the Water Security and Sustainable Development Hub.1 An evidence review and series of expert interviews are used to interrogate the local politics of IWRM measurement, specifically three dilemmas of global composite indicator construction: (1) reductive quantification of normative and contested processes; (2) weak analysis of actually existing institutional capability, politics, and power; and (3) distracting performativity dynamics in reporting. The paper concludes that SDG 6.5.1 is an example of a 'fantasy artefact', and that in all countries in this study, IWRM institutions are failing to address fundamental and 'wicked' problems in water resources management. We find little evidence that these numbers, or the survey that gives rise to them, drive meaningful reflection on the aims or outcomes of IWRM. Instead, they tend to hide the actually-existing political and institutional dynamics that sit behind the complexity of the global water crisis.

Abstract Neuroendocrine neoplasms (NENs) are highly heterogeneous and potentially malignant tumors arising from secretory cells of the neuroendocrine system. Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are the most common subtype of NENs. Historically, GEP-NENs have been regarded as infrequent and slow-growing malignancies; however, recent data have demonstrated that the worldwide prevalence and incidence of GEP-NENs have increased exponentially over the last three decades. In addition, an increasing number of studies have proven that GEP-NENs result in a limited life expectancy. These findings suggested that the natural biology of GEP-NENs is more aggressive than commonly assumed. Therefore, there is an urgent need for advanced researches focusing on the diagnosis and management of patients with GEP-NENs. In this review, we have summarized the limitations and recent advancements in our comprehension of the epidemiology, clinical presentations, pathology, molecular biology, diagnosis, and treatment of GEP-NETs to identify factors contributing to delays in diagnosis and timely treatment of these patients.

Abstract The aim of the experiment was to evaluate the potential of promising summer maize genotypes and optimal stage of harvesting these genotypes for ensiling in terms of dry matter (DM), starch, and crude protein (CP) yields, silage fermentation quality, nutrients profile, total digestible nutrients, metabolizable energy (ME) content, Cornell Net Carbohydrate and Protein System (CNCPS) carbohydrate (CHO) subfractions composition, in vitro DM digestibility (DMD) and in situ starch degradation characteristics. Six maize genotypes were chosen for the study: DK9108 from Monsanto, P30Y87, P3939 from Pioneer, QPM-300 (quality protein maize) and W94 from the International Maize and Wheat Improvement Center (CIMMYT), and a local cultivar, Afgoii, from the Cereal Research Institute (Persabaq, KP). A total of 72 plots (8 m × 10 m) were blocked in three replicate fields, and within each field, each genotype was sown in four replicate plots according to a randomized complete block design. For the data analysis, the Proc-Mixed procedure of Statistical Analysis System with repeated measure analysis of variance was used. The DM yield was strongly influenced (P

In most developing countries, including Ethiopia, the excessive use of toxic and persistent pesticides for agricultural and malaria control purposes poses a significant challenge. This study focuses on evaluating the concentration and ecological risks associated with organochlorine pesticides (OCPs) in the sediments of Lake Tana and Hayqe. Employing a laboratory-based cross-sectional approach, the residues of OCPs in sediment samples were extracted using the Quick, Easy, Cheap, Effective, Rugged, and Safe (QuEChERS) method, followed by dispersive solid phase extraction cleanup (d-SPE) techniques and analyzed for 18 OCPs by gas chromatography coupled to tandem mass spectrometry (GC-MS). The risk Quotient (RQ) method was adopted for ecological risk assessments by using fish, daphnia, and algae as indicators. The concentration of OCPs ranged from 10.11 to 125.65 μg/kg and 10.96–45.17 μg/kg in Lake Tana and Hayqe, respectively. There was a statistically significant difference in the mean concentration of OCPs across the sampling sites in Lake Tana. Deltamethrin and lindane exhibit comparatively lower concentrations among the OCPs, whereas endrin, DDT, and their metabolites were the predominant pesticides in the study area, exceeding WHO and USEPA residue limits, except for endosulfan. Risk Quotient values ranged from 0.006 to 865.4 in Lake Tana and 0.005 to 729.9 in Lake Hayqe, indicating potential low to high ecological risks for aquatic organisms. High ecological risks are particularly evident in fish, daphnia, and algae species exposed to α and β-Endosulfan, DDT, and their metabolites, while specifically in daphnia, endrin poses high ecological risks. The ANOVA test revealed there were statistically significant differences (p-value

This paper is aimed at exploring the contributing factors for the integration of Information and Communication Technology (ICT) into higher education teaching-learning practices. For the study, a qualitative case study was used and the stakeholders from higher learning institutions were selected via purposive sampling. The data collected through interview and focus group discussions were analyzed using the QDA Miner Lite software. Information system theories such as the Technology Acceptance Model (TAM) and Technology, Organisation, and Environment (TOE) framework guided the discussion of the results. The findings showed that there are limited ICT resources for education in Ethiopian higher learning institutions and the limited resources are not used effectively. The challenges like insufficient ICT infrastructure, lack of skill, resistance to change, wrongly perceiving ICT as an additional burden, lack of cooperative work, and lack of policy for ICT integration into teaching-learning practices are identified as the contributing factors. Based on the discussion using TAM and the TOE framework, the researchers developed a conceptual framework guiding the integration of ICT into the higher education system of Ethiopia. The research suggested that the stakeholders involved in the education sector specifically, higher learning institutions, should follow the framework developed for ICT integration into their education system.

Ethiopia's dominant maize production relies on rain, but growing water scarcity challenges dry season irrigation efforts. This necessitates smarter irrigation techniques to maximize water use efficiency. This study optimizes water use efficiency in maize production through deficit irrigation in Gazhen-Fuafuat kebele, Fogera woreda, Ethiopia. A field experiment was conducted during the 2019/20 dry season, comparing four irrigation levels: 55%, 70%, 85%, and 100% of crop water requirements (ETc). Findings revealed that while higher irrigation levels generally enhanced plant growth and grain yield, irrigation water use efficiency was optimized at 70% ETc. Deficit irrigation at 55% ETc proved to be suboptimal, leading to significant reductions in crop growth and grain production. Conversely, applying 70% ETc resulted in a 30% reduction in irrigation water use without compromising yield. Compared to full irrigation, deficit irrigation at 85% ETc, 70% ETc, and 55% ETc resulted in yield reductions of 8%, 13.5%, and 33.1%, respectively. However, these reductions were accompanied by water savings of 15%, 30%, and 45%, respectively, leading to corresponding increases in water use efficiency of 8%, 23.4%, and 21.9%. These results suggest that deficit irrigation practices can be effectively employed to improve water use efficiency in maize production, especially in the study area facing water scarcity. This study provides valuable insights into the potential of deficit irrigation to improve maize production in Ethiopia while conserving water resources. Therefore, by implementing deficit irrigation strategies and supporting farmers with appropriate training and resources, Ethiopia can enhance its agricultural productivity and ensure food security in the face of increasing water scarcity.

Knowledge-based evidence about potential and existing rainfed cropping is crucial for decision-making for sustainable land use and food security. Using multi-criteria spatial analysis techniques, this study assessed the current status of cropland availability and projected impacts on future crop production in Ethiopia. The study primarily defined the extent of the Rainfed Cropping Area (RCA) and assessed the performances of different cropping practices. After precisely mapping cultivated area, cropping intensification potentials were estimated. Subsequently, disregarding the existing cultivated area, completely unsuitable areas, and protected and intact forest areas, the potentially available arable land using suitability analysis techniques was determined. In addition, the performance of existing crop production systems was evaluated against the natural potential. The findings reveal that RCA covers ~60% of the country’s landmass, of which cropping is practiced in only 33%. The coverage of Potentially Available Cropland (yet uncultivated) accounts for 16% of the country’s RCA. This is dominantly located in sparsely populated western and southwestern parts of the country. This study confirms that Horizontal Cropping Intensification (HCI) in the RCA of Ethiopia reaches only 33%. On the other hand, Vertical Cropping Intensification (VCI) practices cover only 10%, while about 1/3 of the RCA is suitable for VCI strategies at various levels of suitability. The performance of existing VCI-oriented cropping (which covers only 10% of the RCA) is very poor. Challenges to the use of the available cropland and ways of addressing land shortage for needy farmers are highlighted to inform efforts to readdress landlessness and food insecurity in Ethiopia.

Non-typhoidal Salmonella (NTS) is a zoonotic pathogen that exerts huge public health and economic impacts in the world. The severity of illness is mainly related to the serovars involved, the presence of virulence genes, and antimicrobial resistance (AMR) patterns. However, data are scarce on serovars, virulence genes, and AMR among NTS identified from the human-dairy interface in Northwest Ethiopia. Thus, this study investigated the serovars, common virulence genes, and AMR patterns of NTS isolates in the area. The study was conducted from June 2022 to August 2023 among randomly selected 58 dairy farms. A total of 362 samples were processed to detect NTS using standard bacteriological methods. The presumptive positive colonies were confirmed by Matrix-Assisted Laser Desorption Ionization-Time-of-Flight (MALDi-ToF). Polymerase chain reaction (PCR) was used to detect virulence genes, including invA and spvC. A slide agglutination test according to the White-Kauffmann-Le Minor scheme was employed to identify the serovars of the NTS isolates. The Kirby-Bauer disk diffusion method was used to assess the antimicrobial susceptibility patterns. Of the processed samples (362), 28 (7.7%) NTS isolates were detected. When distributed among samples, the proportions were 11.9%, 10.5%, 10.3%, 5.2%, 4.3%, and 1.7% among cows' feces, dairy farm sewage, pooled raw milk, milk container swabs, milkers' stool, and milkers' hand swab samples, respectively. Six serovars were detected with the dominancy of S. Uganda (39.3%), followed by S. enterica subsp. diarizonae (25.0%) and S. Typhimurium (21.4%). Among the 28 NTS isolates, 100% and 21.4% had the virulence genes invA and spvC, respectively. The susceptibility profile showed that 89.3% of the NTS isolates were resistant to at least one antimicrobial agent and 46.4% were resistant to three or more classes of antimicrobials (multidrug-resistant). Among antimicrobials, isolates were highly resistant to ampicillin (57.1%), followed by tetracycline (42.9%) and chloramphenicol (35.7%). On the other hand, the NTS isolates were 100%, 96.4%, and 96.4% susceptible to ceftriaxone, azithromycin, and norfloxacin, respectively. In conclusion, we detected NTS from humans, dairy cows, raw milk, dairy utensils, and the environment (sewage), showing the potential of the human-dairy farm-environment nexus in the NTS circulation. These further highlight that the interface is a good point of intervention in the control and prevention of NTS infection. The susceptibility profiles of the isolate necessitate interventions including the prudent use of the antimicrobials.

The role of digital adherence technologies (DATs) in improving tuberculosis (TB) treatment adherence is an emerging area of policy discussion. Given that the directly observed therapy (DOT) has several shortcomings, alternative approaches such as DATs are vital to enhancing current practices by rendering person-centered models to support the completion of TB treatments. However, there is a lack of evidence that informs policy and program on facilitators and barriers to the uptake of DATs in the context of country-specific real-world situations. The purpose of this study was to explore the facilitators and barriers to the uptake of DATs by drawing from the accounts of people with TB (PWTB), healthcare workers (HCWs) and other key policy stakeholders in Ethiopia. A qualitative study was conducted to capture the perspectives of participants to help understand the contextual factors that are important in the uptake of DATs. The overall response from participants highlighted that uptake of DATs was high despite some critical implementation barriers. DATs were useful in reducing the burden of treatment management on both PWTB and HCWs, improving adherence and flexibility, and enhancing the patient-provider relationship. The relative simplicity of using DATs, positive feedback from important others, and current policy opportunities were seen as additional facilitators for the uptake of DATs in the Ethiopian context. Key barriers including network issues (mobile phone signals), lack of inclusivity and fear of stigma (as perceived by HCWs) were identified as key barriers that could limit the implementation of DATs. The findings of this qualitative study have provided a rich set of perspectives relevant to policymakers, providers and implementers in identifying the facilitators and barriers to the uptake of DATs in Ethiopia. The overall finding suggests that DATs are highly acceptable among the diverse categories of participants in the presence of critical barriers that limit uptake of DATs including poor infrastructure. However, key policy stakeholders believe that there are several opportunities and initiatives for feasible implementation, adaptation and scale-up of DATs in the current Ethiopian context.