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Abstract Background Describing spatio-temporal occurrence and habitat characteristics of Aedes mosquito larvae is crucial for the control of Aedes borne viral diseases. This study assessed spatio-temporal abundance and habitat characteristics of Aedes larvae in the Southern Afar Region, Ethiopia. Methods Immature mosquitoes were surveyed in Awash Sebat, Awash Arba, and Werer towns of the Southern Afar Region once per month from May 2022 to April 2023. Larvae and pupae surveys were carried out along the available water-holding containers. The collected larvae/pupae were reared to adults and identified by species/genus morphologically. The physical and chemical properties of the habitats were also characterized. Results A total of 9099 Aedes larvae/pupae were collected, of which 53.6% (4875) were from Awash Sebat, 29.5% (2687) from Awash Arba and 16.9% (1537) from Werer. Water-holding tyres harboured the highest number of Aedes larvae/pupae followed by water-storage drums. All the Aedes larvae/pupae reared to adults were morphologically identified as Aedes aegypti. The overall Container Index was 47.28%, House Index 18.19%, Breteau Index 59.94% and Pupal Index 171.94. Significant positive relations were observed in the occurrences of Ae. aegypti larvae/pupae with water-holding tyre (AOR = 15.89, CI = 3.55–71.09, p

Abstract Among the factors affecting the effectiveness of malaria control is poor knowledge of the entomologic drivers of the disease. We investigated anopheline populations as part of a baseline study to implement house screening of windows and doors as a supplementary malaria control tool towards elimination in Jabi Tehnan district, Amhara Regional State of Ethiopia. The samples were surveyed monthly using CDC light traps between June 2020 and May 2021. Mosquito trap density ( 80% of total anopheline captures and contributed ~ 42% of Plasmodium-infected mosquitoes. On the other hand, morphologically scored Anopheles funestus s.l., constituting about 6% of anopheline collections, accounted for 50% of sporozoite-infected mosquitoes. Most of the infected An. funestus s.l. specimens (86.7%) were grouped with previously unknown or undescribed Anopheles species previously implicated as a cryptic malaria vector in the western Kenyan highlands, confirming its wider geographic distribution in eastern Africa. Other species with Plasmodium infection included An. longipalpis C, An. theileri, An. demillioni, and An. nili. Cumulatively, 77.8% of the infected mosquitoes occurred outdoors. These results suggest efficient malaria parasite transmission despite the low vector densities, which has implications for effective endpoint indicators to monitor malaria control progress. Additionally, the largely outdoor infection and discovery of previously unknown and cryptic vectors suggest an increased risk of residual malaria transmission and, thus, a constraint on effective malaria prevention and control.

Abstract This study aims to examine the budget deficit–inflation relationship, considering financial sector development and broad money supply as moderating and mediating variables. For this purpose, a panel data set ranging from polled mean group, mean group, and dynamic fixed effect estimation techniques are employed. Hence, the pooled mean group estimation result reveals that the budget deficit is inflationary. In addition, GDP per capita, the effective exchange rate, financial sector development, regulatory quality, and the interaction term of the budget deficit and financial sector development are significant determinants of inflation. The study further examines the role of the broad money supply as a mediating variable in the budget deficit–inflation relationship. The structural equation model results and the mediation effect tests confirmed a partial mediation effect of the broad money supply on the budget deficit–inflation relationship. Based on the findings, it is recommended to strengthen regulatory quality, reduce broad money supply, and improve financial sector development. By doing so, we can create a more stable and efficient economy that benefits everyone in the long run.

Abyou Seyfu Ambaye,1 Fiseha Yirgu Mengiste,2 Netsanet Demise,2 Manaye Tamrie Derseh,3 Abinet Abebe,2 Ashagrachew Tewabe Yayehrad,4 Bedilu Linger Endalifer1 1Departement of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia; 2Departement of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia; 3Departement of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 4Departement of Pharmacy, College of Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Abyou Seyfu Ambaye, Tel +251910685947, Email aseyfu7@gmail.comBackground: Hypoglycemia occurs when the blood sugar levels are too low. In severe cases, hypoglycemia may give to seizures, coma, and sometimes death. The prevalence of hypoglycemia among patients with diabetes is likely underreported and undocumented.Methods: An institutional-based cross-sectional study was conducted among 336 study participants at the Tepi General Hospital in Southwest Ethiopia. A binary logistic regression model was used to determine the association between the prevalence of hypoglycemia and the factors associated with it. After a bivariate analysis, variables with a p value of < 0.25 were selected as a candidate for multivariable analysis. An odds ratio with a 95% CI was considered to indicate a significant association.Results: With 95% CI (52.48– 62.25) the prevalence of hypoglycemia was determined as 57.44%. Nearly 11% of the patients encounter severe hypoglycemia. Female patients had three times higher odds of experiencing hypoglycemia (aOR=3, 95% CI: 2.10, 6.39). Those with no formal education had 1.5 times higher odds of experiencing hypoglycemia (aOR = 1.5, 95% CI: 1.08, 5.45). Patients with type 1 diabetes were 3.4 times more likely to experience hypoglycemia (aOR = 3.4, 95% CI: 1.87, 7.50). Those who had been diagnosed before 10 years (aOR = 1.3, 95% CI: 1.02, 3.21) were more likely to have hypoglycemia. Furthermore, patients who consumed alcohol were 3.0 times more likely to have a history of hypoglycemia (aOR = 3.0, 95% CI: 2.03, 6.43).Conclusion: The magnitude of hypoglycemia among patients with diabetes is determined to be considerable with more than half of the participants encountered hypoglycemia. There is a strong relationship between the occurrence of hypoglycemia and sex, type of diabetes, time since diagnosis, alcohol status, and education status. Therefore, all concerned parties must pay close attention to lessen the prevalence of hypoglycemia and address the problems based on the primary contributing factors.Keywords: hypoglycemia, diabetes mellitus, insulin, Ethiopia

Summary: Objective: Assess dietary quality and contribution of school meals to energy and nutrient needs of school adolescents. Methods: A school-based cross-sectional study was conducted. A total of 293 adolescents were selected from 20 selected schools. A multiple-pass 24-hour recall method employed to collect dietary intake from adolescents. Then compared to the Recommended Dietary Allowance (RDA) to identify sub-optimal quality, with school meals below two-thirds of the RDA serving as an indicator. Dietary diversity was assessed with a 12-food group score using STATA software. Results: The study revealed inadequate nutrition in school meals for adolescents. While school meals provided an adequate contribution of carbohydrates (74.4% of the RDA), the contribution for other nutrients was low: energy (34.1%), protein (42.5%), calcium (9.3%), zinc (14.6%), iron (52.9%), vitamin A (14.0%), thiamine (16.7%), vitamin B12 (12.8%), and niacin (3.8%). The study also revealed a high prevalence of inadequate intakes of priority nutrients among school adolescents, including protein (57.5%), carbohydrates (25.6%), calcium (90.7%), zinc (85.4%), iron (47.1%), vitamin A RAE (86.0%), vitamin C (86.0%), thiamine (83.3%), vitamin B12 (90.2%), and niacin (96.2%). Despite high dietary diversity, key nutrient deficiencies persisted in both school meals and overall 24-hour meals. Conclusion: Nutrient deficiencies in school adolescents necessitate prioritizing menu planning with nutrient-dense foods, implementing cost-effective strategies with locally sourced options, establishing nutrition education programs, and collaborating with stakeholders on tailored initiatives like community gardens, local farmer partnerships, and subsidized/free nutritious meals to address deficiencies and promote well-being.

Abstract Breastfeeding is the cornerstone of child and maternal health. However, maternal breast problems during breastfeeding have been frequently reported as one of the reasons for early discontinuation of breastfeeding. Despite the importance of having knowledge on breast problems magnitude and its associated factors in the clinical practices and designing effective interventions, there is limited data on this topic. Therefore, this study aimed to assess the prevalence and associated factors of breast problem among postnatal lactating women in Legambo district, south wollo zone, North East Ethiopia, in 2022. A community-based cross sectional study was conducted among 610 lactating mothers in Legambo district. Multi-stage sampling was employed to select study participants. Interviewer administered, WHO B-R-E-A-S-T-Feeding, observational checklist and maternal self-reported breast problem questionnaires were used to collect the data. Epi-Data version 3.1 was used for data entry and export to SPSS version 25.0 for analysis. Descriptive statistics and bi-variable and multivariable analysis was carried out. On the multivariable logistic regression, variables with p-value

Ayanaw Dinku Abebe, Muluneh Assefa, Debaka Belete, Getachew Ferede Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Muluneh Assefa, Tel +251944900600, Email mulunehassefa2010@gmail.comBackground: Globally, viral hepatitis is a leading cause of death and is highly prevalent in Ethiopia. Military personnel are more vulnerable to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, and there are no data on such populations in the study area. Therefore, this study aimed to determine the seroprevalence of HBV and HCV infections and their associated factors among military personnel in military camps in Central Gondar, Ethiopia.Materials and Methods: This institutional-based cross-sectional study was conducted with 277 military personnel from April to August 2022 at military camps in Central Gondar, Ethiopia. A systematic random sampling technique was used to select the study participants. Sociodemographic and other relevant data were collected using a structured questionnaire. Five milliliters of venous blood were collected using a vacutainer tube and tested for hepatitis B surface antigens and anti-hepatitis C virus antibodies using an enzyme-linked immunosorbent assay. Data were analyzed using STATA version 14 software and logistic regression models were used to determine the association between HBV/HCV infection and risk factors.Results: Out of 277 participants, the overall seroprevalence of HBV and HCV infections was 19 (6.9%) and 9 (3.3%), respectively. The rate of HBV and HCV co-infection was 2 (0.7%). Having multiple sexual partners (p = 0.048), frequent alcohol use (p = 0.034), hospitalization (p = 0.014), and history of receiving injections from traditional practitioners (p = 0.040) were significant predictors of HBV infection. In contrast, a history of blood transfusion (p = 0.048) and sexually transmitted infections (p = 0.039) were significant risk factors for HCV infection.Conclusion and Recommendations: An intermediate prevalence of HBV and HCV infections was observed among the military personnel. Continuous screening, adherence to healthcare service guidelines, and strengthening of vaccination are crucial for preventing HBV and HCV infections.Keywords: hepatitis B virus, hepatitis C virus, military personnel, Ethiopia

Abstract Background Genomic surveillance is crucial for monitoring malaria transmission and understanding parasite adaptation to interventions. Zambia lacks prior nationwide efforts in malaria genomic surveillance among African countries. Methods We conducted genomic surveillance of Plasmodium falciparum parasites from the 2018 Malaria Indicator Survey in Zambia, a nationally representative household survey of children under five years of age. We whole-genome sequenced and analyzed 241 P. falciparum genomes from regions with varying levels of malaria transmission across Zambia and estimated genetic metrics that are informative about transmission intensity, genetic relatedness between parasites, and selection. Results We provide genomic evidence of widespread within-host polygenomic infections, regardless of epidemiological characteristics, underscoring the extensive and ongoing endemic malaria transmission in Zambia. Our analysis reveals country-level clustering of parasites from Zambia and neighboring regions, with distinct separation in West Africa. Within Zambia, identity by descent (IBD) relatedness analysis uncovers local spatial clustering and rare cases of long-distance sharing of closely related parasite pairs. Genomic regions with large shared IBD segments and strong positive selection signatures implicate genes involved in sulfadoxine-pyrimethamine and artemisinin combination therapies drug resistance, but no signature related to chloroquine resistance. Furthermore, differences in selection signatures, including drug resistance loci, are observed between eastern and western Zambian parasite populations, suggesting variable transmission intensity and ongoing drug pressure. Conclusions Our findings enhance our understanding of nationwide P. falciparum transmission in Zambia, establishing a baseline for analyzing parasite genetic metrics as they vary over time and space. These insights highlight the urgency of strengthening malaria control programs and surveillance of antimalarial drug resistance.

IntroductionOne feasible way to prepare for the adverse effects of climate change in rainfed-dependent livelihood zones is through irrigation. This study examines small-scale irrigation practices and their determinants.MethodsUsing structured survey questionnaires, interviews, and field observations, we used a cross-sectional survey design to collect data from 380 randomly selected households. The data analysis involved percentages, problem confrontation index, Chi-square test, independent samples t-test, and binary logistic regression model.ResultsThe findings revealed that river/stream diversion (40%), using nearby springs (19%), and hand-dug walls (18%) were the predominant types of irrigation. At the same time, water scarcity (PCI = 743), land shortage (PCI = 345), and labor (PCI = 212) were the main impediments to irrigation practices. The binary logistic regression model revealed educational status (OR = 1.239, p

BackgroundThis study compared the clinical sensitivity and the time-to-result of an individual testing (IT) and a cascaded pooled testing approach (CPT; a positive test result in a pooled sample triggers examination of smaller-sized pools or individual samples) for assessing the prevalence and the intensity of Schistosoma haematobium infection. We also compared the sensitivity of the CPT in detecting S. haematobium infection when deploying urine filtration microscopy (UFM) vs. urine reagent strips (URS), and testing 10 mL vs. 15 mL of urine.Methodology/principal findingsBetween October 2021 and April 2022, S. haematobium eggs were counted in urine samples collected from school-aged children living in the Afar and Gambella Regional States of Ethiopia. Urine samples were collected at baseline (n = 1,288), and one month after administration of praziquantel (n = 118). All urine samples were processed through both an IT and a CPT approach (pools of 5, 10, 20, and 40 individual samples), deploying UFM (10 mL) and URS (10 mL). In addition, 15 mL urine was processed through the CPT deploying UFM. At baseline, the prevalence of S. haematobium infection estimated when using UFM and deploying a CPT approach was significantly lower (17.3%) compared to an IT approach (31.5%). The clinical sensitivity of the CPT in detecting S. haematobium eggs was 51.7%. The sensitivity increased significantly as a function of increasing log transformed urine egg counts (UECs) of the individual samples (OR 2.71, 95%CI 1.63 - 4.52). The sensitivity was comparable when the amount of urine examined was 10 mL (51.7%) vs. 15 ml (50.8%), and when UFM was used for testing vs. URS (51.5%). The mean log UECs estimated following the CPT approach was lower compared to the estimate by the IT (p Conclusions/significanceCPT based on UFM and URS techniques may help to rapidly identify areas with higher prevalence of S. haematobium infection (hotspots) in a population. However, the performance of this approach in estimating the prevalence of infection may be compromised, particularly in endemic areas with low intensity infection.

Ethiopia is currently facing a major environmental problem caused by soil erosion. In order to tackle this problem, it is essential to implement a comprehensive watershed management approach and give priority to conservation efforts depending on the level of severity. Therefore, the objective of this research is to evaluate the mean annual soil erosion and rank the sub-watersheds for conservations in the Ayu watershed, utilizing the Revised Universal Soil Loss Equation (RUSLE) model and the Sub-Watershed Prioritization Tool (SWPT). RUSLE was utilized to predict the annual average soil erosion rate, while SWPT was applied to conduct Weighted Sum Analysis (WSA) for ranking sub-watersheds. Support Vector Machine (SVM) was employed for classifying land use and land cover. The Relative importance of morphometric and topo-hydrologic features in the SWPT was analyzed using a Random Forest model. The Bland-Altman plot and Wilcoxon Signed Rank Test were employed to assess the agreement in prioritizing watersheds between RUSLE results and the SWPT. Furthermore, field observations were conducted to validate the land use classification by collecting ground data. In addition, the study was enhanced with local viewpoints by conducting focus group discussions with agricultural experts and farmers to obtain qualitative insights and validation of resuts. The findings showed that soil loss varied from 0 to 110 t/ha/yr, with an average of 8.95 t/ha/yr, resulting in a total loss of 384365.3 tons annually. The comparison of RUSLE and SWPT showed a moderate positive relationship (r = 0.59). The results of the Bland-Altman plot indicate a consistent agreement between the two methods. However, there is inconsistency among the five sub watersheds. This study enhances the knowledge of soil erosion patterns and offers useful guidance for watershed conservation techniques. It can be also used as a beneficial framework for managing watersheds, with possible uses outside of the Ayu watershed.

The productivity and sustainability of agricultural systems are heavily influenced by soil fertility and physicochemical properties. This study investigated the effects of climate-smart soil and water conservation (SWC) practices and slope gradient on selected soil physicochemical properties and soil organic carbon stock (SOCS) in the Kulkullessa Sub-Watershed of Goro Gutu District, Eastern Ethiopia. The research focused on farmland conserved by stone bunds (SB), bench terraces (BT), and grass strips (GS) five years post-implementation, across two slope gradients (15-20% and 21-30%). Twenty-four composite soil samples were collected from a depth of 0-20 cm and analyzed at the Haramaya University soil laboratory. Results demonstrated that climate-smart SWC practices significantly improved soil physicochemical properties and SOCS in the study area. Slope gradients also induced considerable variations in these parameters. Conserved farmland and areas with lower slope gradients exhibited higher clay content and lower sand fractions. Bench terraces were associated with lower bulk density (BD) and significantly higher total porosity (p ≤ 0.05). Conserved farmlands showed higher electrical conductivity (EC) and lower pH values, both statistically significant (p ≤ 0.05). Stone bunds were most effective in increasing soil organic matter (SOM) content and total nitrogen (TN). Climate-smart SWC practices also enhanced exchangeable bases in the farmlands. Cation exchange capacity (CEC) was significantly improved (p ≤ 0.05) on farmland conserved by SB and BT. In conclusion, climate-smart SWC practices demonstrated substantial potential for improving agriculturally and environmentally relevant soil physicochemical properties and organic carbon stocks. These findings underscore the importance of such conservation measures in enhancing soil quality and promoting sustainable agriculture in the region.

Abstract Background Tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide, particularly in countries with limited resources. The emergence of drug resistance in mycobacterium tuberculosis (MTB), particularly rifampicin (RIF) resistance, hindered TB control efforts. Continuous surveillance and regular monitoring of drug-resistant TB, including rifampicin resistance (RR), are required for effective TB intervention strategies and prevention and control measures. Objective Determine the trend of TB and RR-TB among presumptive TB patients in Northwest Ethiopia. Method A retrospective study was conducted at the University of Gondar Comprehensive Specialized Hospital (UoG-CSH). The study included TB registration logbook data from all patients who visited the hospital and were tested for MTB using the Xpert® MTB/RIF assay between 2015 and 2021. The SPSS version 26 software was used to enter, clean, and analyze the laboratory-based data. Results A total of 18,787 patient results were included, with 93.8% (17,615/18787) of them being successful, meaning they were not invalid, error, or aborted. About 10.5% (1846/17615) of the 17,615 results were MTB-positive, with 7.42% (137/1846) RIF resistant. Age, anti-TB treatment history, and diagnosis year were associated with the presence of MTB and RR-MTB. Tuberculosis (TB) prevalence was higher in productive age groups, whereas RR-TB prevalence was higher in the elderly. Regarding diagnosis year, the prevalence of TB and RR-TB showed a declining trend as the year progressed. While MTB was detected in 12.8% (471/3669) of new and 22.2% (151/679) of re-treatment presumptive TB patients, RR-MTB was detected in 8.5% (40/471) of new and 18.5% (28/151) of re-treatment TB cases. Conclusion The prevalence of TB and RR-TB in the study area showed a declining trend over the years. While TB was more prevalent in productive age groups (15 to 45 years), RR-TB was more prevalent in older populations (over 45 years), than others. Moreover, patients with a history of anti-TB drug exposure were more likely to be positive for DR-TB, highlighting the need to strengthen DOT programs for proper management of TB treatment.

Abstract Background Tanzania is currently implementing therapeutic efficacy studies (TES) in areas of varying malaria transmission intensities as per the World Health Organization (WHO) recommendations. In TES, distinguishing reinfection from recrudescence is critical for the determination of anti-malarial efficacy. Recently, the WHO recommended genotyping polymorphic coding genes, merozoite surface proteins 1 and 2 (msp1 and msp2), and replacing the glutamate-rich protein (glurp) gene with one of the highly polymorphic microsatellites in Plasmodium falciparum to adjust the efficacy of antimalarials in TES. This study assessed the polymorphisms of six neutral microsatellite markers and their potential use in TES, which is routinely performed in Tanzania. Methods Plasmodium falciparum samples were obtained from four TES sentinel sites, Kibaha (Pwani), Mkuzi (Tanga), Mlimba (Morogoro) and Ujiji (Kigoma), between April and September 2016. Parasite genomic DNA was extracted from dried blood spots on filter papers using commercial kits. Genotyping was done using six microsatellites (Poly-α, PfPK2, TA1, C3M69, C2M34 and M2490) by capillary method, and the data were analysed to determine the extent of their polymorphisms and genetic diversity at the four sites. Results Overall, 83 (88.3%) of the 94 samples were successfully genotyped (with positive results for ≥ 50.0% of the markers), and > 50.0% of the samples (range = 47.6–59.1%) were polyclonal, with a mean multiplicity of infection (MOI) ranging from 1.68 to 1.88 among the four sites. There was high genetic diversity but limited variability among the four sites based on mean allelic richness (RS = 7.48, range = 7.27–8.03, for an adjusted minimum sample size of 18 per site) and mean expected heterozygosity (H e = 0.83, range = 0.80–0.85). Cluster analysis of haplotypes using STRUCTURE, principal component analysis, and pairwise genetic differentiation (F ST ) did not reveal population structure or clustering of parasites according to geographic origin. Of the six markers, Poly-α was the most polymorphic, followed by C2M34, TA1 and C3M69, while M2490 was the least polymorphic. Conclusion Microsatellite genotyping revealed high polyclonality and genetic diversity but no significant population structure. Poly-α, C2M34, TA1 and C3M69 were the most polymorphic markers, and Poly-α alone or with any of the other three markers could be adopted for use in TES in Tanzania.

This study presents the development and examination of a streamlined $H_{\infty }$ loop-shaping continuous-time controller tailored for nonlinear Hard Disk Drive (HDD) systems. Using the Hankel-norm approximation technique, the complexity of the controller is systematically reduced, emphasizing preserving the system’s efficacy while enhancing computational efficiency. The dynamics of the HDD system and the performance of the proposed controller are investigated through MATLAB simulations. The effectiveness of the controller is quantitatively measured by employing the ITAE (Integral of Time multiplied by Absolute Error) criterion. The results indicate that a controller of the 10th-order provides a desirable compromise between maintaining robust control and minimizing disturbances and noise without significant loss in performance. This method illustrates the capacity for implementing more straightforward controllers in complex HDD systems, paving the way for their application in precision-critical industrial settings.

Aynias Seid,1,2 Yilak Girma,3 Eseye Dereb,3 Meseret Kassa,3 Semira Nureddin,4 Ayenesh Abebe,3 Nega Berhane2 1Department of Biology, College of Natural and Computational Science, Debre-Tabor University, Debre-Tabor, Ethiopia; 2Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia; 3TB Culture Laboratory, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia; 4Department of Biology, College of Natural and Computational Science, Woldia University, Woldia, EthiopiaCorrespondence: Aynias Seid, Email ayniasseid2@gmail.comBackground: In Ethiopia, tuberculosis (TB) is a major public health problem. The aim of the study was to determine the in vitro susceptibility level of drugs and drug interaction profiles against drug-resistant and susceptible M. tuberculosis clinical isolates. A laboratory-based cross-sectional study was conducted between January 2023 and August 2023. GenoType MTBDRplus v.2.0 was facilitated in genetic mutation detection. Minimum inhibitory concentration (MIC) was determined using resazurin microtitre assay (REMA), while fractional inhibitory concentration index (FICI) using resazurin drug combination microtitre assay (REDCA) for in vitro quantitative susceptibility and drug interaction prediction.Results: Among 32 clinical isolates, a total of 14 (43.8%) RIF, 20 (62.5%) INH, 2 (6.3%) EMB-related resistant and 14 (43.8%) MDR isolates were identified. Five of RIF-resistant isolates (55.6%) carrying rpoB common mutations at codon S450L were associated with high levels of RIF-resistance with MICs of ≥ 2μg/mL, whereas 100% of isolates harboring rpoB substitutions at codons D435V and H445Y were linked with moderate or low-level RIF-resistance in the MIC ranges from 0.5 to 1μg/mL. A proportion of 81.8% of isolates harboring katG S315T mutations were associated with high-level INH resistance (MIC ≥ 1μg/mL), while the 18.2% of isolates with S315T katG mutations and 100% of isolates with inhA C-15T mutations were linked to the low-level of INH resistance with MIC variability from 0.25 to 0.5μg/mL. Our results indicated that most FICIs of the dual drugs INH+RIF and INH+LEV combination for 9 (28.1%) and 4 (12.5%) INH-resistant isolates, respectively, were ≤ 0.5, whereas triple drugs INH+RIF+EMB, INH+RIF+LEV and INH+EMB+LEV combination for 6 (18.8%), 11 (34.4%) and 8 (25%) INH-resistant isolates were from 0.62 to 0.75, all showed synergistic effect.Conclusion: The study highlights that isolates with rpoB S450L and katG S315T substitutions were associated with high level of RIF and INH resistance. It is concluded that REDCA can quantitatively determine anti-mycobacterial synergy and that LEV being of potential use against INH-resistant isolates including MDR-TB when combined with RIF+INH and INH+EMB.Keywords: drug combination, drug interaction, MIC, mutations, synergism

Abstract Background In low-income countries, women with disabilities have limited access to essential sexual and reproductive health services and are disadvantaged socioeconomically. Even though some studies have been conducted previously, there are scanty findings on contraceptive use and associated factors among women with disabilities. Thus, this systematic review aimed to assess contraceptive use and associated factors among women with disabilities of reproductive age in Ethiopia. Methods The Preferred Reporting Item for Systematic Review and Meta-Analyses [PRISMA] guidance is used to conduct this systematic review. Data were searched from electronic databases: PubMed/Medline, Scopus, Google Scholar, and other relevant sources. Studies screening was done using Rayyan software. The findings were narratively synthesized using a socio-ecological framework for health promotion. Result Ten cross-sectional studies and 4436 women with disabilities of reproductive age were included in this review. According to this review, women with disabilities are less likely to use contraceptives, with a prevalence of 21.7% in Gondor City and 44.4% in Addis Ababa. The associated factors were identified and themed at individual, interpersonal, community, and institutional levels. Conclusion Overall, the review findings revealed that women with disabilities continue to encounter challenges ranging from individual level to disability-unfriendly health facility infrastructure or institutional level. Therefore, health professionals and other relevant stakeholders should draw attention to creating awareness towards contraceptive use at individual and interpersonal levels, ensuring accessible contraceptive services and disability-friendly health facilities.

Abstract The emergence and spread of artemisinin partial resistance in East and Horn of Africa is alarming. However, artemisinin-based combination therapy (ACT) generally remains efficacious for the treatment of falciparum malaria. The emergence of partial artemisinin resistance does not currently meet the criteria to initiate change on treatment guidelines nor affect ACT routine procurement and distribution. It is high time for scientists and transitional researchers to be more critical and vigilant on further changes so that national programmes will be able to make informed decisions as well as remain alert and prepared for any change that may be required in the future.

Abstract In this study, we have formulated and analyzed the Tinea capitis infection Caputo fractional order model by implementing three time-dependent control measures. In the qualitative analysis part, we investigated the following: by using the well-known Picard–Lindelöf criteria we have proved the model solutions' existence and uniqueness, using the next generation matrix approach we calculated the model basic reproduction number, we computed the model equilibrium points and investigated their stabilities, using the three time-dependent control variables (prevention measure, non-inflammatory infection treatment measure, and inflammatory infection treatment measure) and from the formulated fractional order model we re-formulated the fractional order optimal control problem. The necessary optimality conditions for the Tinea capitis fractional order optimal control problem and the existence of optimal control strategies are derived and presented by using Pontryagin’s Maximum Principle. Also, the study carried out the sensitivity and numerical analysis to investigate the most sensitive parameters and to verify the qualitative analysis results. Finally, we performed the cost-effective analysis to investigate the most cost-effective measures from the possible proposed control measures, and from the findings we can suggest that implementing prevention measures only is the most cost-effective control measure that stakeholders should consider.

Endayen Deginet, Abeba Mengesha Abebe, Meskerem Abatkun Department of Pediatrics and Child Health, School of Medicine, College of Health and Medical Sciences, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaCorrespondence: Endayen Deginet, Email endayend@gmail.comBackground: Dystonia, one of the most common movement disorders, It was mostly a result of pathology in basal ganglia; there have been increasing numbers of dystonia cases reported in patients with spinal cord pathology.Case Presentation: Here we report, a 14 year old female adolescent from Addis Ababa Ethiopia presented with dystonia of extremities within one month after she was diagnosed with transverse myelitis.Conclusion: Although any spinal cord pathology can result in spinal dystonia, demyelinating diseases are among the leading causes. There are few case reports on dystonic spasm caused by acute transverse myelitis. This case report describes an instance of spinal dystonia associated with transverse myelitis in an adolescent female.Keywords: spinal dystonia, transverse myelitis, adolescent

AbstractOne of the earliest forms of cultural and economic support for people worldwide, especially in Ethiopia, is indigenous knowledge-based handcrafting. This study uses exploratory, descriptive research design to understand the indigenous knowledge-based tub and griddle pan handcrafting industry in Dessie, Ethiopia. The required data was gathered through in-depth questionnaires and interviews with 97 business owners and employees, supplemented by first-hand field observation and secondary data from offices. Data from different sources was analyzed using descriptive statistical factors such as percentages and frequencies. Content analysis was also used to examine non-numeric qualitative information. The study revealed that artisans produced various goods for indoor and outdoor functions, mainly unique artisan products such as the tub and griddle pan. Artisans can support themselves using manual tools, equipment, and long-established traditional knowledge and skills. Most artisans had learned their skills through apprenticeships or hands-on training. The manufacturing compound was covered in discarded garbage and scrap. Artisans were at risk of injury because they worked without the proper safety gear. Other production barriers included a lack of appropriate production utilities and facilities, including credit, raw materials, markets, and information for product distribution. Therefore, it is vital to find ways to support the Tub and Griddle Pan handcrafting business, by figuring out how to get better production tools and equipment, access to credit, raw materials, market outlets, and training and skill development through the practical application of the policies and strategies set forth by the government.

Ethiopia's diverse ecology faces challenges from significant deforestation. Church forests are relatively protected although under pressure from agricultural expansion, grave house construction and climate related factors. The present study was aimed to assess the woody species composition, structure and regeneration status of church forests in the West Gojjam Zone. Twenty-six church forests were selected using stratified random sampling based on agroecology, elevation, forest size, and distance from population centers. A total of 175 main plots of 20 m × 20 m (400 m2) for trees, 875 subplots of 5 m × 25 m (25 m2) for saplings, and 875 subplots of 1 m × 21 m (1 m2) for seedlings were laid down. Diameter at breast height (DBH) was measured for woody plants with a DBH ≥2.5 cm and also height ≥ 2.5 m. Diversity and structural analysis of the woody species were carried out using appropriate tools. The regeneration status of the study forests was evaluated based on the number of seedlings, sapling and matured plants. A total of 111 woody species that belong to 95 genera and 51 families with 72 (64.86 %) trees, 23 (20.72 %) shrubs, 8 (7.2 %) shrubs/trees and 8 (7.2) lianas were identified. In the study sites, the woody plant species consist of 82.88 % indigenous, 15.32 % exotic, and 1.8 % endemic species. Fabaceae was the dominant family in West Gojjam zone church forests. The Shannon diversity ranged from 0.99 to 3.47, with an average of 2.55, and evenness varied from 0.5 to 0.96 (average 0.82). Species richness ranged from 7 to 45 with the average value of 23.81, and a total stem density of 5880 individuals per hectare. Additionally, 5923 saplings and 6136 seedlings per hectare were recorded. The most abundant species include Eucalyptus camaldulensis, Calpurnia aurea, and Juniperus procera. The average basal area was 29.268 m²/ha for the studied church forests, with Ficus vasta having the highest basal area. Juniperus procera and Rhus vulgaris exhibited the highest Importance Value index (IVI), while Premna schimperi, and Myrtus communis had the lowest IVI. The overall regeneration status of west Gojjam church forests was found to be good. Significant differences in woody species composition and diversity were observed between church forests. The study revealed the importance of church forests in the West Gojjam Zone for plant diversity conservation, revealing their resilience and potential for sustainable protection of forests despite the challenges like deforestation and climate change, and their potential for sustainable maintenance. As we have already seen, some of the church's forests were converted to agriculture as a source of income for the church. This practice is dangerous for the survival of the endemic plants in the church forests and leads to deforestation. Therefore, it is recommended to form an alternative source of income for the church.

Assessing soil organic carbon (SOC) is vital for water retention, soil health, nutrient cycling, greenhouse gas emissions, and pollutant reduction and thereby contributes to sustainable agricultural production and food security. Thus, using long-term climate, soil, and land management inputs, the Rothamsted Carbon (RothC) model was applied to assess the current and future SOC stocks in the Anjeni watershed using long term climate, soil and land management data. RothC was calibrated with long-term SOC, land management, and climatic data from the Anjeni watershed in north-west Ethiopia. The correlation coefficient between simulated and observed SOC in 1997 and 2021 were 0.77 and 0.86, respectively, suggesting that the model could characterize the SOC of the Anjeni watershed. Then, the RothC was used to estimate SOC in the watershed for 30 years, from 2022 to 2052, under three slope gradients and four land use type and carbon storage scenarios (business as usual (BAU), low, medium and high carbon inputs). The result indicated that in the lower slope gradient, the current SOC simulation is less than all future scenarios considered under all land use types. Grass/fallow land showed higher current and projected SOC than cultivated land and plantation forest. Moreover, grass/fallow land with a gentle slope gradient had higher SOC than the watershed's middle and high-elevation parts. Overall, the model projected an increase of SOC under different future scenarios that could be due to climate and land use cover changes, the long-term soil-water conservation camping works and better soil and land managements in the watershed. This future assists for water retention, soil health, nutrient cycling, soil aeration, and greenhouse gas emission reduction, which in turn could enhance agricultural productivity, food security, and sustainable development.

Abstract Background Pregnant women have an increased risk of Plasmodium infections and disease. Malaria in pregnancy is a major public health problem in endemic areas. Assessment of the burden and risk factors of malaria in pregnancy across different malaria transmission settings is required to guide control strategies and for malaria elimination. Thus, the current study is generating such evidence from parturient women in northwest Ethiopia. Methods A cross-sectional study was conducted among 526 pregnant women admitted to the delivery rooms of selected health facilities in Jawi district, northwest Ethiopia, between November 2021 and July 2022. Data on the socio-demographic, clinical, obstetric, and malaria prevention practices of pregnant women were collected using interviewer-administered questionnaires and from women’s treatment cards. Malaria was diagnosed by light microscopy, rapid diagnostic test, and multiplex real-time polymerase chain reaction. Risk factors for malaria were evaluated using bivariable and multivariable logistic regression models. A P-value of

Assefa Asnakew Abebe,1,2 Alemayehu Godana Birhanu1 1Department of Molecular Biology, Institute of Biotechnology, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Medical laboratory Sciences, Institute of Health, Bule Hora University, Bule Hora, EthiopiaCorrespondence: Assefa Asnakew Abebe, Po Box 1176, Tel +251911629276, Email assefa1775@gmail.comAbstract: Antimicrobial resistance (AMR) represents a major threat to global health. Infection caused by Methicillin-resistant Staphylococcus aureus (MRSA) is one of the well-recognized global public health problem globally. In some regions, as many as 90% of S. aureus infections are reported to be MRSA, which cannot be treated with standard antibiotics. WHO reports indicated that MRSA is circulating in every province worldwide, significantly increasing the risk of death by 64% compared to drug-sensitive forms of the infection which is attributed to its antibiotic resistance. The emergence and spread of antibiotic-resistant MRSA strains have contributed to its increased prevalence in both healthcare and community settings. The resistance of S. aureus to methicillin is due to expression of penicillin-binding protein 2a (PBP2a), which renders it impervious to the action of β-lactam antibiotics including methicillin. The other is through the production of beta-lactamases. Although the treatment options for MRSA are limited, there are promising alternatives to antibiotics to combat the infections. Innovative therapeutic strategies with wide range of activity and modes of action are yet to be explored. The review highlights the global challenges posed by MRSA, elucidates the mechanisms underlying its resistance development, and explores mitigation strategies. Furthermore, it focuses on alternative therapies such as bacteriophages, immunotherapy, nanobiotics, and antimicrobial peptides, emphasizing their synergistic effects and efficacy against MRSA. By examining these alternative approaches, this review provides insights into the potential strategies for tackling MRSA infections and combatting the escalating threat of AMR. Ultimately, a multifaceted approach encompassing both conventional and novel interventions is imperative to mitigate the impact of MRSA and ensure a sustainable future for global healthcare.Keywords: MRSA, AMR, resistome, phage therapy, nanoparticles, antimicrobial peptides, lytic

Lidet Terefe,1 Aschalew Nardos,1 Asfaw Debella,2 Beyene Dereje,3 Melese Arega,4 Abiy Gelagle Abebe,2 Worku Gemechu,2 Samuel Woldekidan2 1Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2Department of Traditional and Modern Medicine Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 3Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia; 4Department of Pharmacy, Pawi Health Sciences College, Pawi, EthiopiaCorrespondence: Lidet Terefe, Email lidetterefe05@gmail.comBackground: Olinia rochetiana has been used traditionally to cure diarrheal disease. Therefore, this study aimed to investigate the acute toxicity and antidiarrheal effect of O. rochetiana leaf extracts.Methods: Cold maceration was used to extract plant leaf powder with 80% methanol. The extract’s antidiarrheal action was tested against a castor oil-induced diarrheal model, a charcoal meal test, and enteropooling tests at doses of 100, 200, and 400 mg/kg. Negative controls received the vehicle at 10 mL/kg, while positive controls received loperamide at 3 mg/kg.Results: From the study, no apparent toxicity was observed when a single dose of 2000 mg/kg was administered. In the castor oil-induced model, the extract delayed the onset of diarrhea, reduced stool frequency, and decreased wet feces weight and number in a dose-dependent manner at 200 mg/kg (p < 0.05) and 400 mg/kg (p < 0.01). The percent reduction in moist feces at 100, 200, and 400 mg/kg was 54.2, 23.97, and 18.26%, respectively, indicating a significant dose-dependent decrease. In a charcoal meal test, the extracts at 200 and 400 mg/kg revealed a peristaltic index of 65 and 46%, respectively, with considerable inhibition of charcoal transport at 23 and 39%. The weight and volume of intestinal contents dropped significantly at a dose of 400 mg/kg (p < 0.01), which is 0.43 mg/kg, in the enteropooling test when compared with the tested dose. The computed in vivo antidiarrheal index revealed diarrheal inhibition values of 46.06 and 71.06% at 200 and 400 mg/kg, respectively.Conclusion: In the current investigation, O. rochetiana showed significant antidiarrheal activity with no symptoms of toxicity in mice.Keywords: antidiarrheal activity, castor oil-induced diarrhea, gastrointestinal transit time, enteropooling, Olinia rochetiana

Abstract Background Antimicrobial resistance is one of the common global public health problems. The emergence of antimicrobial resistance is multifactorial, and tackling its development is challenging. Consequently, infections caused by resistant bacteria are unresponsive to conventional drugs, resulting in prolonged and severe illnesses, higher mortality rates, and considerable healthcare costs. Therefore, understanding the antimicrobial resistance profiles of bacterial pathogens is essential to optimize treatments and reduce the risks associated with infections. This study aimed to determine the antimicrobial resistance patterns of bacterial isolates from different clinical specimens at the Ethiopian Public Health Institute (EPHI). Materials and methods The retrospective cross-sectional study was conducted on the bacterial culture and antibiotic susceptibility reports of different clinical specimens referred to the Bacteriology Laboratory of EPHI from September 2015 to August 2019. Standard bacteriological techniques were used for the isolation and identification of the bacteria. Data were extracted from 840 patients’ records, which included the type of clinical sample cultured, the name of the bacteria, the representations of the antibiotics used for susceptibility testing, and the susceptibility results. Descriptive statistics were used to describe the bacterial isolates and the antimicrobial resistance profiles. Results Eight types of clinical specimens were analyzed for bacterial isolates and urine specimens were the most analyzed. Ten different genera of bacteria were identified by culture. Almost all the isolates were gram-negative bacteria, while only one species of gram-positive (Staphylococcus aureus) was reported. Antibiotic sensitivity patterns were tested on 840 culture isolates. Escherichia coli strains revealed more than 57% resistance to seventeen antibiotics. Klebsiella pneumoniae showed nearly 70% or greater resistance rates for 17 of the antibiotics used. The overall detected multidrug resistance (MDR) was 64.29%. The highest MDR was reported in Acinetobacter strains (84%) followed by K. pneumoniae (80%). Conclusions The multidrug resistance rates found in this study were alarming. Strengthening antimicrobial resistance surveillance at the national level is mandatory, and antimicrobial sensitivity testing should be accessible at local diagnostic centers.

Melese Arega,1 Aschalew Nardos,2 Asfaw Debella,3 Beyene Dereje,4 Lidet Terefe,2 Abiy Abebe3 1Department of Pharmacy, Pawi Health Sciences College, Pawi, Ethiopia; 2Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 3Department of Traditional and Modern Medicine Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 4Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Melese Arega, Email m88arega@gmail.comBackground: Even though it is a protective reaction, inflammation continues to be one of the most challenging medical disorders. The current conventional anti-inflammatory drugs have many undesirable health effects and are in need of newer drugs. The purpose of this study was to evaluate the anti-inflammatory effects of an aqueous methanol crude extract of Premna schimperi leaves.Methods: Premna schimperi leaf was extracted with 80% methanol and concentrated; the concentrated extract was used to evaluate the acute toxicity and anti-inflammatory effects. For the acute toxicity study, a single dose of Premna schimperi extract at a dose of 2000 mg/kg was administered and observed for 14 days. Acute, sub-acute, and chronic anti-inflammatory models were employed to evaluate the anti-inflammatory effect of the extract compared to the standard drug. Data were analyzed with SPSS V. 27, and the significance was established with a one-way ANOVA followed by a post hoc Tukey’s test.Results: Acute oral toxicity testing at a dose of 2000 mg/kg did not show any sign of toxicity. According to the phytochemical study, the plants contained flavonoids, terpenoids, tannins, cardiac glycosides, steroids, phenolics, and anthraquinones. The extract doses of 200 mg/kg, 400 mg/kg, and 800 mg/kg of extracts effectively (p< 0.001) reduced paw edema in the acute and sub-acute models of inflammation. When compared to the negative control group, all tested doses in the chronic model significantly (p< 0.05) decreased the production of exudates and the amount of granuloma tissue.Conclusion: Premna schimperi displayed significant anti-inflammatory activity. The tested doses inhibit the formation of edema, granulomas, and exudates.Keywords: anti-inflammation, carrageenan, indomethacin, paw edema, Premna schimperi

Abstract Background Therapeutic communication can assist nurses in achieving their goals. Effective nurse-patient communication can improve clinical outcomes and boosts patient satisfaction. But, there is an arming gap in therapeutic communication between nurses and patients in Ethiopia, which hinders the quality of nursing care. Some studies have been done on therapeutic and its barriers. Nevertheless, those studies did not fully address factors from different perspectives and were supported by nursing theories or models. Therefore, this study aimed to fill these gaps in the study setting. Methods Institution-based cross-sectional study was conducted among 408 nurses working in public hospitals of Gamo zone from December 1, 2021, to January 30, 2022. Out of the six hospitals in the Gamo zone, three were selected by simple random sampling method. The data were collected by an interview-administered Open Data Kit survey tool and analyzed by SAS version 9.4. Descriptive statistics were computed and a generalized linear model was used to identify associated factors. Results In this study, a standardized percentage of the maximum scale of therapeutic communication was 52.32%. Of the participants, 40.4% had high, 25.0% moderate, and 34.6% had low levels of therapeutic communication. Age, marital status, and qualification showed significant and positive relationships with the overall therapeutic communication. However, sex, working unit, nurse burnout, lack of empathy from nurses, challenging nursing tasks, lack of privacy, use of technical terms by nurses, lack of confidence in nurses, stress, unfamiliarity with the nursing job description, shortage of nurses, insufficient knowledge, lack of participation in decision making, and having contagious disease showed a significant and negative relationship with overall therapeutic communication. Conclusions This finding indicates a gap in therapeutic communication between nurses and patients, and modifiable factors are identified. Therefore, giving opportunities for nurses to improve their qualifications, a special attention to nurses working in stressful areas, sharing the burden of nurses, involving nurses and patients in decision-making, and motivating and creating a positive working environment is vital to improving therapeutic communication.

Ayanaw Dinku Abebe, Muluneh Assefa, Debaka Belete, Getachew Ferede Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Muluneh Assefa, Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, Ethiopia, Tel +251-944-90-06-00, Email mulunehassefa2010@gmail.com; muluneh.assefa@uog.edu.et

Background: Clinicians rely on local antimicrobial resistance pattern data to guide empiric treatment for seriously ill patients when culture and antimicrobial susceptibility testing results are not immediately available. Objective: This study aimed to analyse 5-year trends in antimicrobial resistance profiles of Escherichia coli and Klebsiella pneumoniae isolates. Methods: Bacteriology reports from 2017 to 2021 at the Ethiopian Public Health Institute were analysed retrospectively. Isolates were identified using either the VITEK 2 Compact system, the BD Phoenix M50 instrument, or conventional biochemical tests. Antimicrobial susceptibility testing was conducted using either the Kirby-Bauer disk diffusion method or the VITEK 2 Compact system and BD Phoenix M50 systems available at the time of testing. The Cochran Armitage trend test was employed to test the significance of antimicrobial resistance trends over time. P-values less than 0.05 were considered statistically significant. Results: Of the 5382 bacteriology reports examined, 458 (9%) were on E. coli and 266 (5%) were on K. pneumoniae. Both K. pneumoniae (88%) and E. coli (65%) demonstrated high resistance to extended-spectrum cephalosporins. However, both K. pneumoniae (14%) and E. coli (5%) showed lower rates of resistance to carbapenems compared to other antimicrobials. In K. pneumoniae, resistance to carbapenems (from 0% to 38%; p 0.001) and ciprofloxacin (from 41% to 90%; p 0.001) increased significantly between 2017 and 2021. Conclusion: Both organisms showed very high resistance to broad-spectrum antibiotics. Additionally, K. pneumoniae demonstrated a statistically significant rise in ciprofloxacin and carbapenem resistance. What this study adds: This study emphasises the significance of regular reporting of local antimicrobial resistance patterns as this information can guide appropriate empiric therapy and efforts to address antimicrobial resistance issues.

Soil degradation in sub-Saharan Africa is a serious problem that causes declines in agricultural productivity linked to hunger and poverty. The study was conducted in the Kulkullessa sub-watershed of Goro Gutu District in Eastern Ethiopia to assess the effects of climate-smart soil and water conservation (SWC) practices and slope gradient on selected physicochemical properties of the soil and the soil’s organic carbon stocks. The farmland conserved by stone bund (SB), bench terrace (BT), and gras strip (GS) five years after construction with two slope gradients (15-20%) and (21-30%) was selected. Twenty-four composite soil samples were collected from a depth of 20 cm and tested in the Haramaya University soil laboratory. The study found that climate-smart SWC practices were very effective on the soil physicochemical properties and soil organic carbon stock (SOCS) of the study area. Similarly, the slope gradient brought considerable variation in soil physicochemical properties and soil organic carbon stock. On farmland that a bench terrace had preserved, the bulk density (BD) value was lower. The recorded value for total porosity on the farmland conserved by BT was also positively higher and significant (p ≤ 0.05). Likewise, the higher mean values for micronutrients and SOCS were recorded on farmlands conserved by SB, BT, and GS in contrast to the values recorded on non-conserved farmland (NCF) in the study area. Based on the study findings, climate-smart soil water and conservation practices have outstanding potential for improving soil physicochemical properties essential for agricultural crop production, climate change adaptation, and strengthening smallholder farmers’ resilience.

BackgroundEffective breastfeeding techniques, which include proper attachment, positioning, and suckling, offer a range of benefits for both the mother and the infant. These techniques ensure efficient milk transfer, reduce the risk of infections, support optimal infant weight gain, enhance maternal comfort, and foster a strong emotional bond. This study aimed to identify the magnitude and factors associated with effective breastfeeding techniques among lactating women in the Legambo district of South Wollo, Ethiopia, in 2022.MethodsA community-based cross-sectional study was conducted from September to November 2022. Samples were selected using a multi-stage sampling method from 18 wards (kebele). Data were collected using an interviewer-administered structured questionnaire and an observational checklist. The collected data were entered into Epi-Data and then exported to SPSS version 25.0 for analysis. Descriptive statistics and bivariate and multivariable logistic regression analyses were performed to identify the magnitude and associated factors. Variables with a p-value less than 0.05 on multivariable analysis were considered independent factors associated with the outcome variable.ResultsSix hundred and ten lactating women were included for observation and interviewed, resulting in a 96.2% response rate. The magnitude of effective breastfeeding technique practice was found to be 25.9% (95% CI: 22.47–29.57%). Factors associated with effective breastfeeding technique practice included being a working woman (AOR = 1.70; 95%CI: 1.07–2.72), age between 26 and 30 years (AOR = 0.37; 95%CI: 0.16–0.84), urban residence (AOR = 1.59; 95%CI: 1.06–2.39), initiating breastfeeding 1 to 2 h after birth (AOR = 0.27; 95%CI: 0.16–0.43), and initiating breastfeeding after 2 h of birth (AOR = 0.34; 95%CI: 0.17–0.67). Additionally, not receiving breastfeeding education (AOR = 0.46; 95%CI: 0.30–0.72) and experiencing current breast problems (AOR = 0.28; 95%CI: 0.28–0.75) were also found to have a significant association with effective breastfeeding technique practice.ConclusionOnly one in four women demonstrated effective breastfeeding techniques, indicating that their practice was below the WHO’s recommendations. Therefore, it is crucial to consider the identified variables to improve the practice of effective breastfeeding techniques.

Background: Knowledge about community awareness and practices related to a disease, among other things, helps to plan relevant control strategies. This study assessed the knowledge, attitude, and practices (KAPs) of the community in Abobo district of Gambella Regional State in Southwestern Ethiopia about urogenital schistosomiasis (UGS), which is endemic to the region. Methods: A community-based cross-sectional study was conducted in 2022. A pretested structured questionnaire was administered. Multivariable logistic regression was used to examine factors associated with KAPs variables. Results: Most study participants (90.6%) responded they have previously heard of UGS. Over 95% of the participants knew at least 1 symptom of UGS and 30% knew the transmission cycle. About 15.9% and 26.8% knew keeping environmental hygiene and refraining from using cercariae infested water, as preventive methods, respectively. Over half of the participants (50.1%) disagreed or did not know that urinating close to the river/dam water contributes to transmission, and almost all participants had contact with the dam/river water in one way or another. Education status and history of having the infection were the key significant correlates of most KAPs variables. Conclusion: Most of the community members had poor knowledge and attitudes about the mode of transmission and preventive measures of UGS. Thus, besides school-based mass drug administration (MDA), UGS control efforts in the region should incorporate health education in conjunction with safe water supplies, and provision of sanitary facilities to effectively reduce the transmission of the disease.

Mosquito-borne viral diseases such as dengue fever, chikungunya, and yellow fever have been documented in Ethiopia since the 1960s. However, the efficacy of public health insecticides against Aedes aegypti that transmits these viruses remains poorly understood in the country, particularly in the Afar Region. Thus, the aim of the study was to assess the susceptibility status of Ae. aegypti to deltamethrin, permethrin, alpha-cypermethrin, pirimiphos-methyl, bendiocarb, and propoxur insecticides. Larvae and pupae of Aedes species were collected from Awash Arba, Awash Sebat, and Werer towns of the Afar Region of Ethiopia during July-October 2022, brought to the Aklilu Lemma Institute of Pathobiology, insectary and reared to adults. Non-blood-fed, 3-5 days-old females Ae. aegypti were exposed to pyrethroid, carbamate, and organophosphate insecticide impregnated papers in tube test following the standard guidelines. Knockdown rates were noted at 10 minutes interval until one hour. The mortality in mosquitoes was recorded 24 hours after 60 minutes of exposure. The mortality rates of Ae. aegypti exposed to propoxur were 87% in all the study towns. Similarly, 88% mortality in Ae. aegypti was recorded when tested with bendiocarb in Awash Sebat and Awash Arba towns. Suspected resistance of Ae. aegypti (95% mortality) to alpha-cypermethrin was observed in Awash Arba town. However, Ae. aegypti collected from all the three sites was observed to be susceptible to deltamethrin, permethrin, and pirimiphos-methyl. Ae. aegypti was resistant to 0.1% bendiocarb and 0.1% propoxur and possibly resistant to 0.05% alpha-cypermethrin. On the other hand, it was susceptible to 0.05% deltamethrin, 0.75% permethrin, and 0.25% pirimiphos-methyl. Thus, vector control products with deltamethrin, permethrin, and pirimiphos-methyl can be used in the control of adult Ae. aegypti in the Afar Region of Ethiopia. However, further studies should be carried out to evaluate the susceptibility status of Ae. aegypti to alpha-cypermethrin in the Awash Arba area.

IntroductionBronchial asthma is a major public health issue that affects patients, families, and communities worldwide. Despite the growing importance of self-management and its clear link to better health outcomes, the uptake and use of self-management among asthmatic patients is not well understood. Thus, the study aimed to determine the level of self-management practice and associated factors among asthmatic patients on follow-up care at public tertiary hospitals found in south-west Ethiopia.MethodAn institutional-based cross-sectional study design was employed from August 1 to September 30, 2022. The study included all asthmatic patients on follow-up care at public tertiary hospitals found in south west Ethiopia, among whom 274 were interviewed. All asthmatic patients who were registered at the chronic follow-up unit of each hospital and fulfilled inclusion criteria were included and interviewed consecutively. The data were collected using a structured interviewer-administered questionnaire adapted from previous studies, entered into EpiData version 4.6, and exported to SPSS version 25 for analysis. Descriptive statistics were used to summarize the participant's characteristics. Linear regression was used to identify variables associated with asthma self-management practice, and variables with a p-value of 0.05 were considered statistically significant. Finally, tables, graphs, and text were used to present the data.ResultOut of 274 interviewed asthmatic patients, 45.26% 95% CI (39, 51) had good asthma self-management practices. Advancing in age (ß = -0.009, P = 0.043), being a smoker (ß = -0.346, 95%, P = 0.03, being alcohol drinker (ß = -0.217, P = 0.001), having depression (ß = -0.038, P = 0.005), having anxiety (ß = -0.029, P = 0.02) and having social support (ß = 0.022, PConclusionThe finding revealed that four of every nine asthmatic patients had good asthma self-management practices. Age, alcohol consumption, smoking, anxiety, depression, and social support were significantly associated with asthma self-management practice. Ongoing self-management support and collaborative target interventions aimed at improving asthma self-management practices and identified factors are very crucial.

IntroductionAfrica exhibits a considerably high prevalence of the hepatitis B virus among pregnant women. Furthermore, there is a discernible lack of a well-established surveillance system to adequately monitor and comprehend the epidemiology of the hepatitis B virus, particularly among pregnant women. The eradication efforts of the virus in Africa have been impeded by the significant disease burden in the region, and there is a lack of evidence regarding the pooled prevalence of the hepatitis B virus in Africa. Consequently, this systematic review and meta-analysis aims to determine the prevalence of hepatitis B virus infection among pregnant women in Africa.MethodsWe conducted a systematic literature search using reputable databases such as PubMed, Advanced Google Scholar, Scopus, and the Cochrane Library. The search spanned from July 2013 to July 2023 and included all relevant articles published within this period. To identify potentially eligible articles, we conducted a comprehensive manual review of the reference lists of the identified studies. Our review encompassed articles from the African Journal Online. The analysis focused on observational studies published in peer-reviewed journals that reported the prevalence of hepatitis B surface antigen-positive testing among pregnant women. We utilized the Newcastle-Ottawa critical appraisal checklist to assess the methodological quality of each paper. Finally, a meta-analysis was conducted using a random-effects model.ResultsOut of the 774 studies identified, 31 studies involving 33,967 pregnant women were selected for the meta-analysis. According to the random-effects model, the combined prevalence of hepatitis B virus among pregnant women was 6.77% [95% CI: 5.72, 7.83]. The I2 statistic was calculated to be 95.57% (p = 0.00), indicating significant heterogeneity among the studies. The high I2 value of 95.57% suggests a substantial degree of heterogeneity. A subgroup meta-analysis revealed that factors such as time-dependent bias, sample size dependence, or individual variation among study participants contributed to this heterogeneity (p-difference < 0.05).ConclusionAccording to the findings of this study, the pooled prevalence of hepatitis B infection among pregnant women in Africa was found to be intermediate-high. It is recommended that policymakers implement hepatitis B virus immunization programs targeting pregnant women and their new-born babies at higher risk of exposure.

Azanaw Abebe, Zegeye Kebede, Dereje Bayissa Demissie Schools of Nursing, St. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaCorrespondence: Dereje Bayissa Demissie, School of Nursing, St. Paul’s Hospital Millennium, Addis Ababa, Ethiopia, Email derebayu@gmail.comBackground: Medical emergencies require quick field interventions and stabilization before transport, while rapid transportation to definitive healthcare with fewer field interventions improves trauma outcomes. Poor prehospital healthcare practices negatively impact patients’ health, and limited studies exist on providers’ practices in resource-limited areas like Ethiopia. This study aimed to assess the practice of pre-hospital emergency care and associated factors at pre-hospital health facilities in Addis Ababa, Ethiopia.Methods: A facility-based cross-sectional study was conducted 191 pre-hospital healthcare providers, of which 20 randomly selected participants were participated in the observational study from October 2021 to February 2022 in Addis Ababa Ethiopia. Data was collected using a checklist and self-administered questionnaire. Data was cleaned, entered into Epi data version 4.4, and exported to SPSS software for analysis. Binary and multivariable logistic regression analyses were performed, with a P-value of 0.05 considered statistically significant.Results: The study found that 43% (82) of pre-hospital healthcare providers in Addis Ababa, Ethiopia, had good practice in pre-hospital emergency care. The identified factors that increased the odds of good practice in pre-hospital emergency care were: being able to provide advanced life support (AOR = 88.99; 95% CI: 27.143– 291.603); adequate monitoring and defibrillators (AOR = 5.829; 95% CI: 1.430– 23.765); having work experience of 4– 5 years (AOR = 5.86; 95% CI: 1.424– 24.109); and having the opportunity to continue education (AOR = 31.953; 95% 6.479– 157.591).Conclusions and Recommendations: The study found high levels of poor practice among pre-hospital healthcare providers in Addis Ababa, Ethiopia. Factors contributing to good practice include being trained in advanced Life Support, adequate monitoring, defibrillators, work experience, and having the opportunity to continue education. Therefore, policymakers and health planners should establish teaching and training centres based on Ministry of Health and Education guidelines.Plain Language Summary: Medical emergencies, such as cardiac arrests, benefit more from quick field interventions and stabilization before transport, while rapid transportation to definitive healthcare with fewer field interventions by trained paramedic professionals improves trauma outcomes. A facility-based cross-sectional study was conducted from October 2021 to February 2022, with 191 prehospital healthcare providers working in prehospital healthcare facilities in Addis Ababa. Participant observational study data were collected using a checklist, followed by a self-administered questionnaire administered by trained data collectors at each prehospital health facility. The identified factors increased the odds of good practice of pre-hospital emergency care, including advanced life support, adequate monitoring and defibrillator, and 4– 5 years of work experience and opportunities to continue education.More than half of the prehospital healthcare providers had poor prehospital care practices. Factors that increase the likelihood of good practice include competently performing ALS, adequate monitoring and defibrillation, work experience, and opportunities for continuing education. Policymakers and health planners should establish prehospital healthcare teaching and training centers based on prehospital healthcare guidelines.Keywords: pre-hospital healthcare providers practice

Abstract Background In the Somali region of Ethiopia, visceral leishmaniasis (VL) is a public health concern. However, VL epidemiology and sand fly vectors have not been well studied in various areas of the regional state, including Denan district. Therefore, this study was conducted to determine the sero-prevalence, associated factors, and distribution of sand fly vectors of VL in Denan district, south-eastern Ethiopia. Methods A facility-based cross-sectional study was conducted from April to September 2021 among VL patients with classic signs and symptoms visiting Denan Health Center in south-eastern Ethiopia. Using a convenience sampling method, 187 blood samples were collected from individuals who visited Denan Health Center during the study period. Blood samples were subjected to Direct Agglutination Test for the detection of antibodies to VL. A pre-tested structured questionnaire was also used to gather information on risk factors and other characteristics of knowledge and attitude assessment. Sand flies were also collected from indoor, peri-domestic, mixed forest, and termite mounds using light and sticky traps to determine the fauna and abundance. Results The overall sero-prevalence rate was 9.63% (18/187). The sero-prevalence was significantly associated with outdoor sleeping (OR = 2.82), the presence of damp floors (OR = 7.76), and sleeping outdoor near animals (OR = 3.22). Around 53.48% of the study participants had previously heard about VL. Study participants practiced different VL control methods, including bed nets (42%), insecticide spraying (32%), smoking plant parts (14%), and environmental cleaning (8%). In total, 823 sand fly specimens, comprising 12 species in two genera (Phlebotomus and Sergentomyia), were trapped and identified. The most abundant species was Sergentomyia clydei (50.18%), followed by Phlebotomus orientalis (11.42%). Also, a higher proportion of P. orientalis was found in termite mounds (65.43%), followed by mixed forest (37.8%) and peri-domestic (20.83%) habitats. Conclusion The study demonstrated a 9.63% sero-positivity of VL and a remarkable gap in knowledge, attitude, and practices towards VL. P. orientalis was also detected, which could be a probable vector in this area. Thus, public education should be prioritized to improve the community’s awareness of VL and its public health impact. In addition, detailed epidemiological and entomological studies are recommended.

Abstract Background Understanding temporal and spatial dynamics of malaria transmission will help to inform effective interventions and strategies in regions approaching elimination. Parasite genomics are increasingly used to monitor epidemiologic trends, including assessing residual transmission across seasons and importation of malaria into these regions. Methods In a low and seasonal transmission setting of southern Zambia, a total of 441 Plasmodium falciparum samples collected from 8 neighbouring health centres between 2012 and 2018 were genotyped using molecular inversion probes (MIPs n = 1793) targeting a total of 1832 neutral and geographically informative SNPs distributed across the parasite genome. After filtering for quality and missingness, 302 samples and 1410 SNPs were retained and used for downstream population genomic analyses. Results The analyses revealed most (67%, n = 202) infections harboured one clone (monogenomic) with some variation at local level suggesting low, but heterogenous malaria transmission. Relatedness identity-by-descent (IBD) analysis revealed variable distribution of IBD segments across the genome and 6% of pairs were highly-related (IBD ≥ 0.25). Some of the highly-related parasite populations persisted across multiple seasons, suggesting that persistence of malaria in this low-transmission region is fueled by parasites “seeding” across the dry season. For recent years, clusters of clonal parasites were identified that were dissimilar to the general parasite population, suggesting parasite populations were increasingly fragmented at small spatial scales due to intensified control efforts. Clustering analysis using PCA and t-SNE showed a lack of substantial parasite population structure. Conclusion Leveraging both genomic and epidemiological data provided comprehensive picture of fluctuations in parasite populations in this pre-elimination setting of southern Zambia over 7 years.

BackgroundProphylactic antibiotics reduce surgery-associated infections and healthcare costs. While quantitative methods have been widely used to evaluate antibiotic use practices in surgical wards, they fall short of fully capturing the intricacies of antibiotic decision-making in these settings. Qualitative methods can bridge this gap by delving into the often-overlooked healthcare customs that shape antibiotic prescribing practices.AimThis study aimed to explore the etiquette of the antibiotic decision-making process of surgical prophylaxis antibiotic use at Tikur Anbessa Specialized Hospital (TASH).MethodsThe observational study was carried out at TASH, a teaching and referral hospital in Addis Ababa, Ethiopia, from 26 August 2021 to 1 January 2022. Overall, 21 business ward rounds, 30 medical record reviews, and 11 face-to-face interviews were performed sequentially to triangulate and cross-validate the qualitative observation. The data were collected until saturation. The data were cleaned, coded, summarized, and analyzed using the thematic analysis approach.ResultSurgical antibiotic prophylaxis (SAP) discussions were infrequent during surgical ward rounds in TASH, leading to practices that deviated from established recommendations. Clear documentation differentiating SAP from other antibiotic uses was also lacking, which contributed to unjustified extended SAP use in the postoperative period. Missed SAP documentation was common for emergency surgeries, as well as initial dose timing and pre-operative metronidazole administration. Importantly, there was no standardized facility guideline or clinical protocol for SAP use. Furthermore, SAP prescriptions were often signed by junior residents and medical interns, and administration was typically handled by anesthesiologists/anesthetists at the operating theater and by nurses in the wards. This suggests a delegation of SAP decision-making from surgeons to senior residents, then to junior residents, and finally to medical interns. Moreover, there was no adequate representation from pharmacy, nursing, and other staff during ward rounds.ConclusionDeeply ingrained customs hinder evidence-based SAP decisions, leading to suboptimal practices and increased surgical site infection risks. Engaging SAP care services and implementing antimicrobial stewardship practices could optimize SAP usage and mitigate SSI risks.

IntroductionDietary pattern analysis allows us to characterize the dietary intakes of individuals rather than nutrient intake data and strongly predicts disease risks. The relationship between food intake and adolescents’ nutritional health is not well understood yet. Therefore, this study aimed to generate evidence for context-specific dietary intervention for adolescents.ObjectiveThis study aimed to determine dietary patterns and their relationship with nutritional outcomes and identify the contributing factors among adolescents in the Agrarian Community of Northwest Ethiopia.MethodsA cross-sectional survey was conducted among 622 randomly selected adolescents. Dietary data were collected over a 1-week recall period using the Food Frequency Questionnaire (FFQ). After testing the basic assumptions, an exploratory factor analysis was conducted to determine the dietary patterns. Anthropometric data on weight and height were collected to determine the nutritional status using WHO Anthroplus 2010 software. A chi-square test was conducted to evaluate the effect of different dietary patterns on nutritional outcomes. A multivariable binary logistic regression model was used to identify factors affecting the dietary patterns of adolescents.ResultThree types of dietary patterns, namely, traditional, mixed, and animal-source foods with traditional alcoholic beverage consumption were identified. These dietary patterns explain 58.64% of the variance in adolescent diet in the study setting. The burden of stunting was 15.12% vs. 11.21, 19.40% vs. 6.94, and 8.36% vs.17.97% among adolescents with lower traditional, mixed, and higher animal sources with alcoholic dietary pattern consumption habits, respectively (value of p

Urine filtration microscopy (UFM) lacks sensitivity in detecting low-intensity Schistosoma haematobium infections. In pursuit of a superior alternative, this study evaluated the performance of FlukeCatcher microscopy (FCM) at detecting S. haematobium eggs in human urine samples. Urine samples were collected from 572 school-age children in Afar, Ethiopia in July 2023 and examined using UFM and FCM approaches. Using the combined UFM and FCM results as a reference, the sensitivity, negative predictive value, and agreement levels for the two testing methods in detecting S. haematobium eggs in urine samples were calculated. The sensitivity and negative predictive value of detecting S. haematobium eggs in urine samples for FCM was 84% and 97%, respectively, compared to 65% and 93% for UFM. The FCM test results had an agreement of 61% with the UFM results, compared to 90% with the combined results of FCM and UFM. However, the average egg count estimates were lower when using FCM (6.6 eggs per 10 mL) compared to UFM (14.7 eggs per 10 mL) (p < 0.0001). Incorporating FCM into specimen processing could improve the diagnosis of S. haematobium infection but may underperform in characterizing the intensity of infection.

Aynias Seid,1,2 Yilak Girma,3 Ayenesh Abebe,3 Eseye Dereb,3 Meseret Kassa,3 Nega Berhane2 1Department of Biology, College of Natural and Computational Science, Debre-Tabor University, Debre-Tabor, Ethiopia; 2Department of Medical Biotechnology, Institute of Biotechnology, University of Gondar, Gondar, Ethiopia; 3TB Culture Laboratory, University of Gondar Comprehensive Specialized Hospital, Gondar, EthiopiaCorrespondence: Aynias Seid, Email ayniasseid2@gmail.comBackground: Multidrug-resistant tuberculosis (MDR-TB) has continued to be a serious public health threat and significantly challenges global TB control and prevention efforts, where the TB/HIV co-infection epidemic makes the situation much worse. The aim of the study was to determine the determinant factors associated with patterns of MDR-TB among pulmonary TB patients in the Northwest Amhara, Ethiopia.Methods: A hospital-based cross-sectional study was conducted from May 2022 to February 2023 in the Northwest Amhara, Ethiopia. Data on the participants’ socio-demographics and clinical characteristics were obtained using a pre-tested checklist. Phenotypic susceptibility testing to first-line anti-TB drugs was performed on 180 isolates by automated BD BACTEC MGIT 960 system. Logistic regression analysis was performed to determine the association of risk factors with patterns of MDR-TB. A p-value ≤ 0.05 was considered statistically significant.Results: The overall proportion of TB with HIV co-infected cases was 19.8% (50/252). Culture positivity was confirmed in 203/252 (80.6%) of sputum samples. Among 168 isolates, the DST showed that 119 (70.8%) isolates were pan-susceptible to all first-line drugs and prevalence of any resistance to first-line drugs was 49,168 (29.2%). Among the resistant isolates, 28 (16.7%) were any mono-resistance and 12 (7.1%) were determined to be resistant to MDR-TB. TB with a previous TB treatment (aOR = 6.73, 95% CI: 1.78– 25.47, p = 0.005) and HIV co-infected (aOR = 0.252, 95% CI: 0.73– 0.875, p = 0.03) were significantly associated with MDR-TB.Conclusion: Higher prevalence of TB and MDR-TB was examined among TB patients in the study area. In the study, history of previous TB treatment was the strongest risk factor MDR-TB infection followed by TB with HIV co-infected cases. Therefore, there is a need of strengthening TB control and prevention programs to reduce the increase of TB incidence, further emergence and transmission of a public health threat of MDR-TB cases.Keywords: drug resistance, MDR-TB, prevalence, risk factors, TB/HIV co-infection

Shimalis Tadasa,1 Bereket Dencha,2 Messay Gebrekidan,3 Selamawit Bedasso,4 Abel Tsehay Abebe5 1Department of Radiology, College of Health Science, Mizan Tepi University, Mizan, Ethiopia; 2Department of Pathology, College of Health Science and Medicine, Bahirdar University, Bahirdar, Ethiopia; 3Department of Radiology, Menelik II Comprehensive Specialized Hospital, Addis Ababa, Ethiopia; 4ALERT Hospital/Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 5Detroit Medical Center/Wayne State University, Sinai Grace Hospital, Detroit, MI, USACorrespondence: Shimalis Tadasa, Department of Radiology, College of Health Science, Mizan Tepi University, P.O. Box: 260, Mizan, Ethiopia, Tel +251911994319, Email shimalis.tadesse379@gmail.comAbstract: Hydatid cyst, which is caused by Echinococcus larvae, is a worldwide zoonotic disease which can affect virtually any organ in the body. Although the liver and lungs are the most commonly affected, it can occur in other parts of the body. Mediastinal hydatid cysts are incredibly rare, but imaging is crucial to diagnose and determine the extent of involvement and complications. In this article, we present a case of posterior Mediastinal hydatid cyst with adjacent chest wall and spinal involvement, diagnosed through chest CT and histopathology.Keywords: hydatid cyst, mediastinum, spine, lytic bone lesion

Abstract CTX-Ms are encoded by bla CTX-M genes and are widely distributed extended-spectrum β-lactamases (ESBLs). They are the most important antimicrobial resistance (AMR) mechanism to β-lactam antibiotics in the Enterobacteriaceae. However, the role of transmissible AMR plasmids in the dissemination of bla CTX-M genes has scarcely been studied in Africa where the burden of AMR is high and rapidly spreading. In this study, AMR plasmid transmissibility, replicon types and addiction systems were analysed in CTX-M-producing Escherichia coli clinical isolates in Ethiopia with a goal to provide molecular insight into mechanisms underlying such high prevalence and rapid dissemination. Of 100 CTX-Ms-producing isolates obtained from urine (84), pus (10) and blood (6) from four geographically distinct healthcare settings, 75% carried transmissible plasmids encoding for CTX-Ms, with CTX-M-15 being predominant (n = 51). Single IncF plasmids with the combination of F-FIA-FIB (n = 17) carried the bulk of bla CTX-M-15 genes. In addition, IncF plasmids were associated with multiple addiction systems, ISEcp1 and various resistance phenotypes for non-cephalosporin antibiotics. Moreover, IncF plasmid carriage is associated with the international pandemic E. coli ST131 lineage. Furthermore, several CTX-M encoding plasmids were associated with serum survival of the strains, but less so with biofilm formation. Hence, both horizontal gene transfer and clonal expansion may contribute to the rapid and widespread distribution of bla CTX-M genes among E. coli populations in Ethiopian clinical settings. This information is relevant for local epidemiology and surveillance, but also for global understanding of the successful dissemination of AMR gene carrying plasmids.

IntroductionThe Government of Ethiopia (GoE) has made significant progress in expanding access to primary health care (PHC) over the past 15 years. However, achieving national PHC targets for universal health coverage will require a significant increase in PHC financing. The purpose of this study was to generate cost evidence and provide recommendations to improve PHC efficiency.MethodsWe used the open access Primary Health Care Costing, Analysis, and Planning (PHC-CAP) Tool to estimate actual and normative recurrent PHC costs in nine Ethiopian regions. The findings on actual costs were based on primary data collected in 2018/19 from a sample of 20 health posts, 25 health centers, and eight primary hospitals. Three different extrapolation methods were used to estimate actual costs in the nine sampled regions. Normative costs were calculated based on standard treatment protocols (STPs), the population in need of the PHC services included in the Essential Health Services Package (EHSP) as per the targets outlined in the Health Sector Transformation Plan II (HSTP II), and the associated costs. PHC resource gaps were estimated by comparing actual cost estimates to normative costs.ResultsOn average, the total cost of PHC in the sampled facilities was US$ 11,532 (range: US$ 934–40,746) in health posts, US$ 254,340 (range: US$ 68,860–832,647) in health centers, and US$ 634,354 (range: US$ 505,208–970,720) in primary hospitals. The average actual PHC cost per capita in the nine sampled regions was US$ 4.7, US$ 15.0, or US$ 20.2 depending on the estimation method used. When compared to the normative cost of US$ 38.5 per capita, all these estimates of actual PHC expenditures were significantly lower, indicating a shortfall in the funding required to deliver an expanded package of high-quality services to a larger population in line with GoE targets.DiscussionThe study findings underscore the need for increased mobilization of PHC resources and identify opportunities to improve the efficiency of PHC services to meet the GoE’s PHC targets. The data from this study can be a critical input for ongoing PHC financing reforms undertaken by the GoE including transitioning woreda-level planning from input-based to program-based budgeting, revising community-based health insurance (CBHI) packages, reviewing exempted services, and implementing strategic purchasing approaches such as capitation and performance-based financing.

Objectives: Currently, evidence synthesis targeting asymptomatic malaria infections in Ethiopia are scarce. This review intended to collect and organize information on asymptomatic malaria. Methods: A Joanna Briggs Institute, scoping review protocol was used. Searches for peer-reviewed articles published between 01 January 2010 and 10 August 2022, were done through a variety of databases, and gray literatures. Results: 17 articles were included out of 7672 articles identified. There was no any longitudinal study to trace forward these asymptomatic malaria cases. The reviewed studies did not address how asymptomatic malaria could be treated. Moreover, living in index houses, their neighbours and family sizes were the main predictors and more associated with onward transmission of malaria. Asymptomatic malaria (ASM) infection might persist in all seasons except June–August, for which data is lacking. Conclusions: Therefore, as implication of research and policy, it would be necessary to focus on index families and their neighbours in prevention of ASM, conducting longitudinal studies to ascertain when and how many asymptomatic malaria cases without fever during diagnosis would develop clinical malaria. As well, establishing a more sensitive diagnostic technique of malaria surveillance. It is also necessary to provide information regarding the feasibility of treating asymptomatic malaria cases in Ethiopia.

Getachew Ashagrie,1 Abiy Abebe,2 Shemsu Umer3 1Department of Pharmacy, College of Health Sciences, Woldia University, Woldia, Ethiopia; 2Biomedical Research Team, Traditional and Modern Medicine Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 3Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Getachew Ashagrie, Tel +251927368467, Email Getachewashagrie16@gmail.comBackground: Ethnobotanical studies in various districts of Ethiopia reported that Ehretia cymosa (E. cymosa) is used for the management of headache, abdominal pain, arthritis and rheumatism. However, there is no scientific investigation done so far to confirm these traditional claims. Thus, the aim of this study was to assess the analgesic and anti-inflammatory effects of the 80% methanol extract and fractions of E. cymosa leaves.Methods: The dried and pulverized leaves of E. cymosa were soaked with 80% methanol to obtain a crude extract. Fractionation was done using chloroform, ethyl acetate and water by a soxhlet apparatus. The analgesic effects of the crude extract and solvent fractions were assessed using acetic acid-induced writhing and hot plate tests whereas anti-inflammatory activities were investigated using carrageenan-induced paw edema and cotton-pellet-induced granuloma models.Results: In all the tested doses, the 80% methanol extract and solvent fractions revealed substantial (p < 0.001) analgesic activities in acetic acid induced writhing test. In the hot plate method, all the tested doses of E. cymosa crude extract and the solvent fractions produced significant analgesic activities (p < 0.05). In the carrageenan-induced acute inflammation model, all tested doses of the crude extract and solvent fractions resulted in a significant decline in paw edema. The 80% methanol extract and solvent fractions of E. cymosa at all the tested doses significantly reduced inflammatory exudates and granuloma mass formations (p < 0.001).Conclusion: From the results of this investigation, it can be stated that 80% methanol extract, aqueous, ethyl acetate and chloroform fractions of E. cymosa exhibited considerable analgesic and anti-inflammatory activities, supporting the plant’s traditional use as a remedy for a variety of painful and inflammatory conditions.Keywords: analgesic, hot plate, anti-inflammatory, Ehretia cymosa, carrageenan-induced paw edema, cotton pellet granuloma