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Background: Malaria, transmitted by the bite of infective female Anopheles mosquitoes, remains a global public health problem. The presence of invasive Anopheles stephensi, capable of transmitting Plasmodium vivax and P. falciparum, was first reported in Ethiopia in 2016. The ecology of this mosquito species differs from that of An. arabiensis, the primary Ethiopian malaria vector [1]. This study aimed to evaluate the efficacy of selected insecticides, which are used in indoor residual spraying (IRS) and selected long-lasting insecticidal treated nets (LLINs) for malaria vector control, against adults An. stephensi. Methods: Anopheles stephensi were collected as larvae and pupae from Awash Subah Kilo Town and Haro Adi village, Ethiopia. Adult female An. stephensi, reared from larvae and pupae collected from the field, aged 3-5 days were exposed to impregnated papers of IRS insecticides (propoxur 0.1%, bendiocarb 0.1%, pirimiphos-methyl 0.25%), and insecticides used in LLINs (alphacyper-methrin 0.05%, deltamethrin 0.05% and permethrin 0.75%), using diagnostic doses and WHO test tubes in a bio-secure insectary at Aklilu Lemma Institute of Pathobiology, Addis Ababa University (AAU-ALIPB). For each test and control tube, batches of 25 female An. stephensi mosquitoes were used to test each insecticide used in IRS. Additionally, cone tests were conducted to expose An. stephensi to four brands of LLINs, MAGNet™ (alpha-cypermethrin), PermaNet® 2.0 (deltamethrin), DuraNet© (alpha-cypermethrin) and SafeNet® (alpha-cypermethrin). A batch of ten sugar fed female mosquitoes aged 2-5 days were exposed to samples taken from five positions/sides of a net. The data from all replicates were pooled and descriptive statistics were used to describe features of the data. Results: All An. stephensi mosquitoes collected from Awash Subah Kilo Town and Haro Adi village (around Metehara) were resistant to all tested insecticides used in both IRS and LLINs. Of the tested LLINs, only MAGNet™ (alpha-cypermethrin active ingredient) caused 100% knockdown and mortality to An. stephensi at 60 minutes and 24 hours post exposure, while all other net brands resulted below the WHO cut- off points. All these nets, except SafeNet®, were collected during LLIN distribution for community members through the National Malaria Program, in December 2020. Conclusions: Anopheles stephensi is resistant to all tested insecticides used in IRS and in the tested LLIN brands, except MAGNet, did not cause in mortality as expected. This suggests that control of this invasive vector using existing adult malaria vector control methods may not be appropriate and that alternative strategies may be necessary.

Physiochemical properties, lipid breakdown, β-carotenoids, tocopherols, and vitamins as well as amino and fatty acid profiles of Soxhlet-extracted oil from five different garden cress (Lepidium sativum L.) seed genotypes (namely: CG8, CG7, CG17, CG4, and 207910) across Ethiopia regions were investigated. Results showed that despite the seeds' proximate peak and least values, the extraction yield, viscosity, specific gravity, refractive index, lipid breakdown, and boiling point of garden cress seed oil across the genotypes noticeably varied with promising amino and fatty acid profiles. Further, the genotype CG17 obtained greater quantities of β-carotenoids, tocopherols and vitamin values compared to the other genotypes.

Background: Malaria, transmitted by the bite of infected female Anopheles mosquitoes, remains a global public health problem. The presence of an invasive Anopheles stephensi, capable of transmitting Plasmodium vivax and P. falciparum parasites was first reported in Ethiopia in 2016. The ecology of An. stephensi is different from that of An. arabiensis, the primary Ethiopian malaria vector, and this suggests that alternative control strategies may be necessary. Larviciding may be an effective alternative strategy, but there is limited information on the susceptibility of Ethiopian An. stephensi to common larvicides. This study aimed to evaluate the efficacy of temephos and Bacillus thuringiensis var. israelensis (Bti) larvicides against larvae of invasive An. stephensi. Methods: The diagnostic doses of two larvicides, temephos (0.25ml/l) and Bti (0.05mg/l) were tested in the laboratory against the immature stages (late third to early fourth stages larvae) of An. stephensi collected from the field and reared in a bio-secure insectary. Larvae were collected from two sites (Haro Adi and Awash Subuh Kilo). For each site, three hundred larvae were tested against each insecticide (as well as an untreated control), in batches of 25. The data from all replicates were pooled and descriptive statistics prepared. Results: The mortality of larvae exposed to temephos was 100% for both sites. Mortality to Bti was 99.7% at Awash and100% at Haro Adi site. Conclusions: Larvae of An. stephensiare susceptible to temephos and Btilarvicides suggesting that larviciding with these insecticides as vector control program may be effective against An. stephensi in these localities.

In Ethiopia, malaria incidence has significantly reduced in the past decade through the combined use of conventional vector control approaches and treatment using antimalarial drugs. However, the sustainability of this achievement is threatened by the shift in biting and resting behaviors and emergence of insecticide resistance by the primary malaria vector. Therefore, continuous monitoring of the behaviour of malaria mosquitoes in different sentinel sites is crucial to design effective prevention and control methods in the local context. Entomological investigations were conducted in three sentinel sites for five consecutive months during the major malaria transmission season. The species composition, population dynamics, biting and resting behaviours of malaria vectors were determined using center for disease control and prevention (CDC) light trap, human landing catch (HLC), pyrethrum spray catch (PSC) and Pitfall shelter collection (PFS). Accordingly, 10 households for CDC, 10 households for PSC, 10 households for PFS and 5 households for HLC from each site were randomly enrolled for mosquito collection. A total of 8,297 anopheline mosquitoes were collected from the three sites, out of which 4,525 (54.5 %) were

In Ethiopia, malaria incidence has significantly reduced in the past decade through the combined use of conventional vector control approaches and antimalarial drugs. However, the sustainability of this achievement is threatened by the shift in biting and resting behaviors and emergence of insecticide resistance by the primary malaria vector. Therefore, continuous monitoring of the behaviour of malaria mosquitoes in different sentinel sites is crucial to design effective prevention and control methods in the local context. Entomological investigations were conducted in three sentinel sites for five consecutive months during the major malaria transmission season. The species composition, population dynamics, biting and resting behaviours of malaria vectors were determined using center for disease control and prevention (CDC) light trap, human landing catch (HLC), pyrethrum spray catch (PSC) and Pit shelter collection (PFS). Accordingly, 10 households for CDC, 10 households for PSC, 10 households for PFS and 5 households for HLC from each site were randomly enrolled for mosquito collection. A total of 8,297 anopheline mosquitoes were collected from the three sites, out of which 4,525 (54.5%) were An. gambiae, s.l. 2,028 (24.4%) were An. pharoensis, 160 (1.9%) were An. funestus and the rest 1,584 (19%) were other Anophelines (An. coustani, An. cinerus and An. tenebrosus). No significant variation (P = 0.476) was observed between indoor (25.2/trap-night and outdoor collections (20.1/trap-night). Six hundred seventy six (43.3%) of An. gamiabiae s.l. (primary vector) were collected between 18:00 and 22:00 hours. Biting activity declined between 00:00 and 02:00 hours. The national malaria control program should pay close attention to the shifting behavior of vector mosquitoes as the observed outdoor feeding tendency of the vector population could pose challenges to the indoor intervention tools IRS and LLINs. Funding Information: This work was supported by the Ministry of health (Global fund). Declaration of Interests: The authors declare that they have no conflicts of interest. Ethics Approval Statement: This study was issued ethical clearance by the Scientific and Ethical Review Committee (SERC) in Ethiopia Public Health Institute with reference number EPHI 6.13/976. Verbal consent was obtained from the heads of households before commencing mosquito collection in houses. The heads of households surveyed were informed that participation in the study was absolutely voluntary and that even after consenting they would be free to withdraw from the study at any time.

Summary Background Gestational diabetes mellitus (GDM), body mass index (BMI) and gestational weight gain (GWG) are salient predictors of pregnancy-outcomes. However, findings on the association between GDM, BMI, and GWG with fetal growth measures are limited. Objective The aim of this study was to investigate the effect of GDM on fetal growth measures and birth outcomes. Methods All participants came from Tongji Maternal and Child health cohort, in which pregnant women were enrolled before 16 weeks of gestation and had their weights measured regularly during antenatal visits. GDM was diagnosed by oral glucose tolerance test (OGTT) during 24–28 weeks of gestation. Ultrasound measurements of fetal bi-parietal diameters (BPD), head circumferences (HC), abdominal circumferences (AC) and femur length (FL) before birth were collected and neonate outcomes were obtained from the hospital records. Odds ratios were calculated using logistic regression to assess the association of GDM, pre-pregnancy BMI, and GWG with fetal growth measures of ultrasound and birth outcomes, while controlling confounding. Results Of 3253 singleton pregnant women, 293 (9.0%) were diagnosed with GDM, 357 (11.0%) were overweight before pregnancy, and 1995 (61.3%) had excessive GWG. GDM was associated with decreased intrauterine fetal growth measurements including BPD and AC. Maternal pre-pregnancy overweight was associated with increased fetal HC and neonatal birth weight and length, women gained excessive GWG had increased fetal growth measurements of BPD, HC, AC, FL, neonatal birth weight and length. Offspring of GDM women had increased odds of cesarean section 1.31 (1.03, 1.66) and preterm birth 2.02 (1.05, 3.91) in unadjusted models, but these associations disappeared after adjustment. Compared with neonate born to mothers with normal pre-pregnancy weight, those born to underweight mother had higher risk of SGA, and lower risk of cesarean section, LGA and macrosamia, whereas those born to overweight mother had increased risk of cesarean section, LGA and macrosamia. Compared with neonate born to mothers of adequate GWG, neonate of women with excessive GWG had elevated risk of cesarean section, LGA and macrosamia, but lower risk of preterm birth and SGA. Conclusion Pre-pregnancy BMI, GWG and GDM all associated with fetal growth and birth outcomes. The effect of GDM decreased after adjusting pre-pregnancy BMI and GWG. Early screening and management of GDM, preventing excessive GWG could help protect fetuses of GDM mothers from adverse birth outcomes.

Background Integrated Community Case Management (iCCM) is a strategy for promoting access of under-served populations to lifesaving treatments through extending case management of common childhood illnesses to trained frontline health workers. In Ethiopia iCCM is provided by health extension workers (HEWs) deployed at health posts. We evaluated the association between the implementation of iCCM program in Assosa Zuria zone, Benishangul Gumuz region and changes in care-seeking for common childhood illnesses. Methods We conducted a pre-post study without control arm to evaluate the association of interest. The iCCM program that incorporated training, mentoring and supportive supervision of HEWs with community-based demand creation activities was implemented for two years (2017–18). Baseline, midline and endline surveys were completed approximately one year apart. Across the surveys, children aged 2–59 months (n = 1,848) who recently had cough, fever or diarrhea were included. Data were analysed using mixed-effects logistic regression model. Results Over the two-year period, care-seeking from any health facility and from health posts significantly increased by 10.7 and 17.4 percentage points (PP) from baseline levels of 64.5 and 34.1%, respectively (pp = 0.420) and public hospitals (p = 0.129) did not meaningfully change while proportion of caregivers who approached private (p = 0.003) and informal providers (ppppp = 0.038) significantly increased. After accounting for extraneous variables, we observed that care-seeking from iCCM providers was almost doubled (adjusted odds ratio = 2.32: 95% confidence interval; 1.88–2.86) over the period. Conclusion iCCM implementation was associated with a meaningful shift in care-seeking to health posts.

Childhood malnutrition is well estimated as the major underlying risk factor for morbidity and mortality in children under 5 years. Feeding practices greatly influence the dietary condition of children aged 6–23 months in developing countries. Therefore, this study was performed to determine the association between infant young children feeding (IYCF) practices and the dietary conditions of children aged 6–23 months in Ethiopia. A cross-sectional study was conducted based on data on 5638 children aged 6–23 months from three Ethiopia Demographic and Health Surveys (EDHS) (2005, 2011, 2016). Multivariable logistic regression was performed to estimate the odd ratios (ORs) and 95% confidence intervals (CIs) of stunting and anaemia with IYCF practices. The prevalence of stunting among children aged 6–23 months in Ethiopia decreased greatly from 49% in 2005 to 32% in 2016. Among the IYCF practices, consumption of iron-rich foods, minimum dietary diversity (MDD), and minimum acceptable diet (MAD) were significant predictors of stunting. In addition, the prevalence of anaemia declined significantly from 26% in 2005 to 16% in 2011, but increased to 29% in 2016. Among the IYCF practices, breastfeeding and minimum meal frequency (MMF) had lower odds of childhood anaemia. The present study showed that anaemia and stunting among children aged 6–23 months in Ethiopia is critical public health problems that need urgent attention.

Cereal crops play an important role in ensuring food security in Africa and providing cash income for most households in the rural areas. In the last two decades, African region has been experiencing a significant decline in per capita food production in which the cereals explaining most of the observed variance in total food production. The decline in cereal production causes food self insufficiency and exposes the smallholder farmers and rural communities as whole to food shortage and famines. Striga weed and stem borers were among the major pests that contribute to the significant decline in cereals production in Ethiopia. In response to these challenges the Agricultural research Institutes both at national and international level has come up with various control strategies. Among these, Push-Pull technology was one of the strategies to cope the significant decline in cereals production. The Technology has been one of the most successful methods and with an advantage of controlling both the stem borers and striga weed simultaneously, while improving soil fertility status. The technology provides an integrated soil and pest management that makes an efficient use of natural resource to increase farm productivity. Even though the result from on farm research experiments and pre-extension demonstration revealed the positive effect of the push pull technology in improving production and productivity of cereal crops in different parts of Ethiopia (Boset, Mieso, Habro and Daro Labu), perception and acceptance of the wider smallholder farmers for the technology was not evaluated. Hence, this study was intended to analyze perception and acceptance of the smallholder farmers for the push pull technology in Habro and Daro Labu districts of western hararghe zone of Oromia regional state, Ethiopia. Ten kebeles and 81 farmers implementing the push-pull technology were purposively selected and interviewed using structured questionnaire. Both primary and secondary data used to attain the research objectives. The structured questionnaire was a primary data collection tool. Collected primary data analyzed using the Statistical Package of Social Science software (SPSS). From the total sample farm households, about 77.8% of them were fully agree and 9% of them were agree with the idea that push-pull technology is efficient in controlling stem borer and improve the production and productivity of the cereals (maize and sorghum) in the study area. Smallholder farmers perceive benefits of the push pull technology through its role in improving the cereal yield by improving soil fertility, maintaining soil moisture, reducing soil erosion and the negative effect of striga.

INTRODUCTION: The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) adapted a collaborative improvement strategy to develop woreda (district) leadership capacity to support and facilitate continuous improvement of community maternal and neonatal health (CMNH) and to provide a model for other woredas dubbed "lead" woredas. Community-level quality improvement (QI) teams tested solutions to improve CMNH care supported by monthly coaching and regular meetings to share experiences. This study examines the extent of the capacity built to support continuous improvement in CMNH care. METHODS: Surveys and in-depth interviews assessed the extent to which MaNHEP developed improvement capacity. A survey questionnaire evaluated woreda culture leadership support motivation and capacity for improvement activities. Interviews focused on respondents understanding and perceived value of the MaNHEP improvement approach. Bivariate analyses and multivariate linear regression models were used to analyze the survey data. Interview transcripts were organized by region cadre and key themes. RESULTS: Respondents reported significant positive changes in many areas of woreda culture and leadership including involving a cross-section of community stakeholders (increased from 3.0 to 4.6 on 5-point Likert scale) using improvement data for decision making (2.8-4.4) using locally developed and tested solutions to improve CMNH care (2.5-4.3) demonstrating a commitment to improve the health of women and newborns (2.6-4.2) and creating a supportive environment for coaches and QI teams to improve CMNH (2.6-4.0). The mean scores for capacity were 3.7 and higher reflecting respondents agreement that they had gained capacity in improvement skills. Interview respondents universally recognized the capacity built in the woredas. The themes of community empowerment and focused improvement emerged strongly from the interviews. DISCUSSION: MaNHEP was able to build capacity for continuous improvement and develop lead woredas. The multifaceted approach to building capacity was critical for the success in creating lead woredas able to serve as models for other districts. (c) 2014 by the American College of Nurse-Midwives.