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Abstract Background The Sustainable Development Goals Target 2.2 aims to eliminate all forms of malnutrition, including anemia, while the World Health Assembly targets a 50% reduction in anemia among women of childbearing age by 2025. Despite these efforts, global anemia prevalence among women has only slightly decreased from 31% to 30% between 2000 and 2019. Therefore, identifying modifiable risk factors for anemia among women of childbearing age in Africa is crucial for developing evidence-based interventions and achieving these goals. Methods We conducted an analysis of the most recent Demographic and Health Surveys datasets from 21 Sub-Saharan Africa (SSA) countries, which were carried out between 2015 and 2023. Using multilevel multinomial regression models, we calculated the Adjusted Odds Ratio (AOR) with a 95% Confidence Interval, and subsequently estimated the Population Attributable Fraction (PAF) based on these AOR values. Results The study consisted of 168,417 women of childbearing age [–] (15-49) from 21 SSA. The highest proportion of moderate to severe anemia was linked to the type of contraceptive method used (PAF = 53.11%). This was followed by the lack of health insurance coverage (PAF = 37.92%). Other significant factors included poverty (PAF = 11.50%), no formal education (PAF = 18.01%), high parity (PAF = 5.78%), and the use of unimproved drinking water sources (PAF = 3.88%). These 5 modifiable risk factors were associated with 80.60% (95%CI, 77.60-83.40%) moderate/severe anemia in SSA. Conclusion In a cross-sectional study involving 21 SSA nations, we identified 5 modifiable risk factors associated with anemia among women of childbearing age in SSA. These factors should be a priority for policymakers when planning future interventions to address anemia in SSA’s women’s health.

Abstract Background The first trimester of pregnancy is critical for fetal development, making early antenatal care visits essential for timely check-ups and managing potential complications. However, delayed antenatal care initiation remains a public health challenge in sub-Saharan Africa, including Kenya. Therefore, this study aimed to assess and provide up-to-date information on time to first antenatal care visit and its predictors among women in Kenya, using data from the most recent 2022 Kenya Demographic and Health Survey (KDHS). Methods This community-based cross-sectional study analyzed data from 19,530 birth histories in the 2022 Kenya Demographic and Health Survey (KDHS). The primary outcome was the timing of the first antenatal care (ANC) visit, classified as timely if it occurred in the first trimester. Shared frailty survival models were used to account for the hierarchical data structure and unobserved heterogeneity, with the Weibull gamma model identified as the best fit based on Information Criteria (AIC), and Bayesian Information Criteria (BIC). Variables with p

The purpose of the study was to determine how students’ acquisition of Integrated Science Process Skills (ISPS) was affected by the integration of a context-based instructional approach (CBIA) with the five stages of the learning cycle (5Es LC). Pre- and post-test assessments were administered using a quasi-experimental design to two groups of ninth-grade students: 46 students in the treatment group who were exposed to CBIA and 48 students in the comparison group who were taught using a conventional instructional strategy (CIA). The assessments focused on environmental topics, and ANCOVA, independent sample t-tests, and paired sample t-tests were used in the data analysis. The science process skill test scores of the treatment group showed a significant favourable effect of CBIA, with no discernible gender-based differences. In conclusion, the study suggested that the integration of CBIA with 5Es LC was more effective than traditional teaching methods in improving students’ ISPS proficiency.

Abstract Background Otitis media is among the leading causes of illnesses responsible for causing hearing problems and adding significant costs to the public health system. Bacteria are the most common causative agents for otitis media. Currently, there is little information on the prevalence and antimicrobial susceptibility patterns of pathogenic bacterial isolates from patients with otitis media in Ethiopia. Methodology A laboratory – based cross-sectional study was conducted from June to September 2023 among 242 patients with otitis media referred to Nekemte Public Health Research and Referral Laboratory Center. Sociodemographic and clinical data were obtained by trained nurses and/or health officers in face-to-face interviews using structured questionnaires. Middle ear discharge samples were collected by Ear, Nose and Throat (ENT) specialists (Otolaryngologist) following all aseptic techniques. Conventional culture, different biochemical tests and antimicrobial susceptibility testing were performed for all the isolated bacteria. Reference strains were used as a positive and negative controls. The data were checked for completeness and consistency, entered into EpiData version 4.6.06 and analyzed by SPSS version 25. Logistic regression analysis was performed to determine the associated factors of otitis media. Adjusted odds ratio was used to determine strength of association. Statistical significance was obtained at p-value of below 0.05. The data were interpreted using graphs, tables, and results statements. Results A total of 242 middle ear discharge samples were collected and cultured from which 212 (87.6%) were culture positive. A total of 228 pathogenic bacterial isolates were recovered. The predominant bacterial isolates were S. aureus 92 (40.4%) followed by P. aeruginosa 33 (14.5%) and E. coli 24 (10.5%). One hundred and fifty-one (66.2%) bacterial pathogens were multidrug resistant. Piperacillin-tazobactam and tobramycin were relatively common drugs to which most of the isolates were susceptible while they were most resistant to ampicillin and tetracycline. Purulent discharge (p-value = 0.001), middle ear discharge ≥ 14 days (P-value = 0.000) and a history of active/passive smoking (P-value = 0.043) were significantly associated with otitis media. Conclusion The prevalence of bacterial pathogens, most of which were multidrug-resistant, was high among patients with otitis media. A significant association was observed with purulent ear discharge, chronic otitis media, and passive or active smoking. Choosing the proper antibiotic for the treatment of bacterial infection is crucial.

Primary central nervous system lymphoma is a rare form of central nervous system malignancy. It predominantly affects immunocompromised individuals and the elderly population. Diffuse large B-cell lymphoma is the most common type. This case report presents a 35-year-old female patient presented with progressive difficulty maintaining balance, headaches, seizures, and blurry vision for 2 months. Physical examination was unremarkable except for sluggish bilateral pupillary reaction and lower extremity weakness. MRI revealed multiple bilateral intraaxial masses. Biopsy and immunohistochemistry confirmed diffuse large B-cell lymphoma, nongerminal center B-cell type. However, the diagnosis was delayed for 4 months. The delay in the diagnosis was caused by its atypical presentation, a surgical site infection, and limited resources, which led the patient to disregard the recommended treatment and leave the hospital against medical advice. Even in the absence of risk factors of primary central nervous system lymphoma, it should be considered as a differential in a young patient with neurologic symptoms and intraaxial mass. Minimally invasive biopsy techniques and readily available immunohistochemistry are essential for prompt diagnosis and guiding treatment.

This study examines challenges faced by middle-level social studies teachers in West Gojjam, Ethiopia, while implementing the Constructivist Teaching and Learning Approach (CTLAT). 178 social studies teachers were randomly selected and eight were chosen using maximum variation sampling based on characteristics such as teaching experience, female representation, school location, and willingness to observe the classroom. Findings indicate a lack of commitment, resource scarcity, teacher and student pedagogical preferences, and inadequate training. Additional obstacles, including teachers' deficiencies in constructivist skills, student preference for note-taking, and a lack of accountability, affected the practice of CTLA. The study emphasizes that institutional, teacher, student, parent, and curriculum-related challenges significantly affect the implementation of CTLA in social studies classrooms. To overcome these challenges, teachers are encouraged to adopt constructivist techniques and stay informed through reading, professional development, and sharing experiences. The study concludes with a request for educational institutions and stakeholders to prioritize and emphasize CTLA adoption.

Study region: Surface water supply source of Addis Ababa, the capital city of Ethiopia, relies primarily on the small reservoirs in Gefersa and Legedadi water supply systems located upstream of Little and Big Akaki rivers. Thus, Gefersa and Legedadi are the study watersheds of this research. Study focus: This study evaluates the impacts of land use and climate changes on surface water availability and the benefits of nature-based solutions (NbS) to enhance the water supply and the life of the dams in the Gefersa and Legedadi small watersheds that supply water to Addis Ababa city, Ethiopia. Several land use and climate change scenarios have been developed and integrated into baseline hydrological model to assess their impact on water balance components and sediment yield. Extreme climate change scenarios were developed using the combination of the 5th, 50th and 95th percentiles of future precipitation and temperature changes. New hydrological insights for the region: The results of the land use change analysis revealed a shift between 2012, 2022 and 2042, with a significant expansion of urban settlements and a decline in forestland and vegetation cover. Under climate change scenario, the simulations project that drier seasons become drier and wet seasons become wetter. Overall, this study highlights the potential benefits of NbS in enhancing water availability, particularly during the dry season, promoting dry season farming and increasing the water supply to meet the water demand. The approach followed in this study can be adapted to other watersheds with access to more recent and good quality datasets for future research.

IntroductionAlthough late initiation of antenatal care has been linked with adverse pregnancy outcomes, a significant number of pregnant women in resource-limited regions are seeking this care late. There has been a lack of information on the extent and factors influencing late initiation of antenatal care in the African context following the implementation of the new antenatal care model in 2016. Thus, we aimed to determine the pooled prevalence of late antenatal care visit and its determinants among women in Sub-Saharan Africa (SSA) using national surveys conducted after the implementation of new guidelines.MethodsWe analyzed data from the recent demographic and health survey (DHS) conducted in 16 SSA between 2018 and 2022 using a weighted sample of 101,983 women who had antenatal care follow-up during their index pregnancy. A multilevel logistic regression models were fitted and likelihood and deviance values were used for model selection. In the regression model, we used adjusted odds ratios along with their corresponding 95% confidence intervals to determine the factors associated with late antenatal care visit.ResultsThe pooled prevalence of late antenatal care visit among pregnant women in SSA was 53.8% [95% CI: 46.2% - 61.3%], ranging from 27.8% in Liberia to 75.8% in Nigeria. Women's age and education, working status, partner's education, health insurance coverage, birth order, household wealth, age at marriage, decision on health care, residence, and community-level women's illiteracy were the factors associated with late antenatal care visit.ConclusionMore than half of pregnant women in SSA initiated attending antenatal care during late pregnancy, with significant differences seen among countries. These results underscore the necessity for focused interventions to tackle these issues and enhance prompt access to antenatal services for better maternal and child health outcomes in the area. Moreover, creating tailored interventions for younger women, those with multiple previous births, employed women, and those who experienced early marriage to address their specific challenges and obstacles in seeking care is crucial.

ABSTRACT Background Thromboembolic events are a common cause of morbidity and mortality in patients with cancer. While direct‐acting oral anticoagulants (DOACs) have been established as the preferred agents of anticoagulation in most patients with cancer, data in resource‐limited settings is limited. Aims The study aims to assess the comparative efficacy and safety of warfarin and rivaroxaban for cancer‐associated thrombosis (CAT) in a resource‐limited setting. Methods and results A single‐center retrospective cohort study was conducted on 201 patients who were on follow‐up from September 2021 to August 2023. The patients were categorized into two groups (1) warfarin and (2) rivaroxaban. They were then retrospectively followed for 12 months. The primary endpoint was a composite of recurrence of venous thromboembolism (VTE), major bleeding event, or all‐cause mortality. The Cox regression model was used to compare the outcome of the two groups. The baseline mean (standard deviation) age of the patients was 48.4 (15.0) and 140 (69.7%) of them were female. 41.3% of the participants had one or more comorbidities, and the most common types of cancer were gynecologic (28.9%), hematologic (21.4%), and intra‐abdominal (16.9%). The most common type of thrombosis was deep vein thrombosis (DVT) (77.1%). The primary composite outcome of VTE recurrence, major bleeding event, and all‐cause mortality occurred in 25 (24.3%) patients in the warfarin group and 11 (11.2%) in the rivaroxaban group (hazard ratio (HR), 0.48; 95% confidence interval (CI), 0.24–0.97; p = 0.041). Conclusion Rivaroxaban was found to be more efficacious and safer than warfarin for patients with CAT in a resource‐limited setting. This finding is congruent with reports from resource‐abundant countries and recommendations from major international societies.

Background Sexually transmitted infections (STIs) are a significant global health challenge, demanding attention and intervention. Despite many STIs being manageable, their asymptomatic nature poses a formidable threat to both mental and physical well-being. This silent impact can lead to substantial morbidity and mortality, which is particularly pronounced in East Africa.Objective To investigate the prevalence and factors associated with self-reported STIs among sexually active men in East Africa.Design Cross-sectional study design.Setting 10 East African countries.Participants 66 833 sexually active men.Primary outcome measure Self-reported STI in the 12 months preceding the survey. A multilevel mixed-effects logistic regression model was fitted to identify factors associated with self-reported STIs. An adjusted OR with the corresponding 95% CI was used to estimate the strength of the association, and statistical significance was set at a p value

BackgroundHarmful substance-related infections that cause neonatal deaths on the umbilical stump continue to be a major cause of worry, accounting for a large portion of the yearly mortality toll in developing nations such as Ethiopia. In our study region, there is, however, little data regarding these issues. In Chencha town, Southern Ethiopia, mothers who gave birth in the last six months were the subjects of this study.MethodsA community-based cross-sectional mixed study design was conducted among mothers who gave birth within the past six months, from April to May 2023. Quantitative data was collected through structured interview questionnaires from 312 randomly selected mothers. The collected data was coded, cleaned, and entered into Epi-info version 7.2.5.0, and analyzed using SPSS version 26. Binary logistic regression analysis was used to identify associated factors, and the strength of association was measured by odds ratios with a 95% confidence interval at a p-value of

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

Increased groundwater extraction for irrigation is leading to the intrusion of saline seawater into many wells in some communities in Anloga District, Volta Region, Ghana, with resultant adverse effects on crop productivity. This study investigated the water quality of selected wells in four communities of the district for their suitability for irrigation. Water samples were collected from 10 representative wells, purposively selected out of 60, to determine the pH, electrical conductivity, total dissolved salt by means of a pH/EC/TDS/Temperature portable meter, and the concentrations of sodium, potassium, calcium, magnesium, sulphates, chlorides, bicarbonate and nitrate, using standard chemical laboratory procedures. The geochemical characterization of the sampled water sources was carried out using the Piper trilinear diagram, and revealed the dominance of Na-Cl facies of the groundwater in Tegbi, Whuti and Anyanui, suggesting seawater encroachment connected with groundwater abstraction. The water samples from wells in Woe indicated the Ca-Mg-Cl-SO4 mixed type and are considered suitable for irrigation. About 50% of the sampled wells could be classified under the high salinity-low sodium hazard (C3-S1), 20% are under very high salinity-medium sodium hazard (C4-S2), another 20% under very high salinity-high sodium hazard (C4-S3) and 10% under medium salinity-low sodium (C2-S1) classes. These wells are prone to salinity, and farmers’ discretion is recommended through the adoption of conditional use of the irrigation water such as growing of salt-tolerant crops.

High-altitude adaptation is a remarkable example of natural selection, yet the genomic and physiological adaptation mechanisms of Ethiopian highlanders remain poorly understood compared to their Andean and Tibetan counterparts. Ethiopian populations, such as the Amhara and Oromo, exhibit unique adaptive strategies characterized by moderate hemoglobin levels and enhanced arterial oxygen saturation, indicating distinct mechanisms of coping with chronic hypoxia. This review synthesizes current genomic insights into Ethiopian high-altitude adaptation, identifying key candidate genes involved in hypoxia tolerance and examining the influence of genetic diversity and historical admixture on adaptive responses. Furthermore, the review highlights significant research gaps, particularly the underrepresentation of Ethiopian populations in global genomic studies, the lack of comprehensive genotype-phenotype analyses, and inconsistencies in research methodologies. Addressing these gaps is crucial for advancing our understanding of the genetic basis of human adaptation to extreme environments and for developing a more complete picture of human physiological resilience. This review offers a comparative perspective with Tibetan and Andean highlanders, emphasizing the need for expanding genomic representation and refining methodologies to uncover the genetic mechanisms underlying high-altitude adaptation in Ethiopian populations.

Introduction: Postpartum depression is a non-psychotic depressive illness that affects women who have recently given birth. Symptoms of the illness include thoughts of suicide, low self-worth, guilt about not being able to care for their newborn, blaming themselves thoughts, and nervousness. Despite there being many studies conducted at the hospital level there are limited studies conducted at the national level to determine the individual and community level factors. Depression during childbirth can have several detrimental effects, including increased risk of complication and decreased satisfaction with birth, decreased trust in medical facilities, and decreased women's participation in maternity and newborn healthcare units.Therefore, this study amid to reveal the prevalence of postpartum depression and associated factors at individual and community levels among women who give birth in Mozambique's recent data Demographic and Health Survey (DHS). Method: Multilevel logistic regression analysis was carried out from the recent Demographic and Health Survey data. A total of 5,468 sample sizes of Mozambique DHS data were used for this secondary data analysis. At individual and community level factors were assessed to determine the burden of postpartum depression at a p-value of 0.05 with a 95 % CI with AOR. Results: The prevalence of postpartum depression among women who give birth from the recent Mozambique DHS data was 24.60 % with a CI of 23.47 %–25.75 %. No education [AOD = 1.37: 95 % CI; (1.26, 1.68)] at individual level and [AOR = 3.14:95 % CI; (2.39, 5.18)] at the community level, widowed/divorced [AOR = 1.73: 95%CI; (1.14, 3.61)], and No occupation [AOR = 1.35:95 % CI; (1.19, 1.64)] were the associated variables with postpartum depression. Conclusion: Nearly three women out of ten women who give birth develop postpartum depression. Low education status, widowed/divorced, and no occupation were the associated factors with postpartum depression. Therefore, enhancing education, creating job opportunities, and keeping married will reduce the burden of postpartum depression. This study indicates maternal depression post-delivery should be given attention by the National Health Office and other police makers. Educational level should be improved to have a continuous and sharp change in maternal depression after delivery.