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Abstract Background Improving the quality of intrapartum and immediate postnatal care is critical for reducing maternal and neonatal mortality in low- and middle-income countries (LMICs). This review aimed to assess the extent of Person-Centred Maternity Care (PCMC) practices during childbirth in LMICs. Methods We retrieved studies from four databases, including PubMed/Medline, Embase, CINAHL, and Maternal and Infant Care, up to 30 May 2023 and updated 26 April 2024. Additionally, manual searching was performed to identify additional studies. Our study included studies that examined PCMC using PCMC scale. The included studies were assessed using the Joanna Briggs Institute (JBI) checklist for quality appraisal. Findings Twelve articles out of 888 were retained in the review. Among these, nine studies specifically examined various elements of PCMC, such as dignity and respect, communication and autonomy, and supportive care. The lowest and highest levels of the mean (± SD-standard deviation) PCMC were 46.5 (6.9) and 60.2 (12.3) out of 90 total scores in Ghana and urban Kenya, respectively. The lowest score was reported in the communication and autonomy subscale domain of PCMC at a mean (± SD) score of 8.3 (3.3). Women who were wealthier and educated, and those who received ANC and birthing care by the same health care providers were found to have a higher level of PCMC during childbirth. Whereas those women who did not have ANC follow-up, visited health facilities for ANC in the second or third trimester, stayed at health facilities after birth for 2–7 days, had complications, and received care from auxiliary midwives, nurses, or assisted by unskillled attendants were associated with a lower level of PCMC during childbirth. Conclusions Our findings indicated that the communication and autonomy components of PCMC are notably low, affecting the rapport between healthcare providers and women, as well as decision-making and the execution of procedures. To enhance PCMC, continuity of care through antenatal and intrapartum care provided by the same healthcare providers, along with fostering a supportive environment for both women and healthcare providers during childbirth is imperative. PROSPERO ID CRD42023426638.

Abstract Background Readiness of healthcare facilities is essential for delivering quality healthcare services. There is limited evidence on the antenatal care (ANC) readiness of healthcare facilities in Ethiopia. This study aimed to assess the readiness of ANC services and its influencing factors in Ethiopian healthcare facilities. Methods A secondary data analysis was performed using data from the Ethiopian Service Provision Assessment conducted from 11th August 2021 to 4th February 2022. A total of 905 healthcare facilities from nine regions and two city administrations in Ethiopia that provided ANC were included. Healthcare facilities’ ANC readiness was evaluated using 22 indicators across five domains: trained staff and ANC guidelines (3), basic medical equipment (4), medicines and commodities (4), infection prevention tools (6), and diagnostic tests (5). A higher score in each domain indicated greater readiness to deliver recommended ANC. A Generalized Poisson regression model identified factors influencing each domain of ANC readiness indicators. Data analysis was conducted using Stata software version 16. Results The total number of ANC readiness indicators in healthcare facilities ranged from two to seventeen. The mean score for each indicator of ANC readiness in healthcare facilities was as follows: trained staff and guidelines (1.36/3, SD = 0.96), basic medical equipment (3.20/4, SD = 0.99), medicines and commodities (1.95/4, SD = 1.36), infection prevention tools (4.33/6, SD = 1.51), and diagnostic tests (2.22/5, SD = 1.80), based on the included indicators in each domain. Regression results showed lower availability of medicines and commodities, infection prevention tools, and diagnostic tests in clinics and rural facilities. Trained staff and ANC guidelines were less available in private healthcare institutions, health posts, and clinics. Conversely, medicines and commodities were more available in healthcare facilities in the Afar, Amhara, and Somali regions. Conclusion Most healthcare facilities in Ethiopia lacked key ANC readiness indicators, which are crucial for comprehensive ANC and achieving maternal and child health Sustainable Development Goals. Strategic interventions are needed to ensure ANC readiness indicators are available in healthcare facilities and to address disparities by facility type, managing authority, location and region.

Abstract Background It is crucial to consider cultural, religious, and socio-behavioural factors that may influence the acceptability of Minimally Invasive Tissues Sampling (MITS). MITS is being used to understand the causes of child death and conducted in nine countries within Africa and South Asia with the highest child mortality. Progress has been made in the development of laboratory infrastructures and training for physicians to do MITS, but many communities are concerned about the religious acceptability of taking samples from deceased children. This paper explores the acceptability of MITS in a predominantly Muslim community. Methods A qualitative study was conducted in Kersa and Harar, in Eastern Ethiopia between April 23, 2018 and April 21, 2019 where high child mortality rates have been recorded. The study involved interviews and focus groups with 76 participants, including mothers, elders, and religious leaders. In addition, observations were conducted at burial ceremonies and in grieving families’ homes. Grounded theory framework is used in this article to understand the acceptability of postmortem MITS. Results We explore cultural, religious, and socio-behavioural barriers and facilitators that may influence the acceptability of minimally invasive tissue sampling. We identify three themes relating to the acceptability of MITS: (1) Perceptions and rituals related to child death (2), Religious acceptance of post-mortem investigation, and (3) Fears and suspicions of organ theft and body mutilation. Most participants hypothetically accepted MITS, but suggested that the procedure consider religious practices. Religious leaders and parents stated that they would accept the procedure if it would help reduce child deaths. Acceptance is inconsistent and differs across time and place. Some villages accepted the procedure swiftly, only to change their views when they became aware of suspicions from other villages about the procedure disfiguring the body. Parents of deceased children were concerned that taking samples from the children’s bodies would delay the burial. Conclusions Mortality surveillance requires a thorough understanding of the cultural, religious, and sociocultural aspects that may affect the acceptability of MITS. MITS research should be conducted close to communities, involving community members, incorporating religious perspectives, and promoting health outreach campaigns to facilitate sociocultural perceptions of the research activities.

Introduction Globally, diarrheal disease continues to be the second leading cause of death among under-five children, especially in developing countries. This study aimed to determine the prevalence of diarrhea and associated risk factors among under-five attending Robe Didea General Hospital (RDGH) in Arsi Robe Town, Oromia Regional State, Ethiopia, from October 1 to December 30 2020.Methods A hospital-based cross-sectional study was conducted among under-five children who attended the pediatrics department of RDGH. Systematic random sampling was employed to select the study subjects. An interviewer-administered structured questionnaire was used for data collection and the analysis used SPSS version 21. Bivariate and multivariable logistic regression analyses were employed to determine the association between risky factors and diarrheal prevalence, and a p value

The aim of this study was to evaluate the effect of alcohol-alkaline modified enset starch on the quality of low-fat set yogurt. This study employed factorial design with stabilizer percentage having three levels (1%, 2%, and 3%) and stabilizer type with three levels (Native Enset Starch (NES), Modified Enset Starch (MES) using alcohol-alkaline treatment, and Corn Starch (CS)). The developed yogurt was stored in refrigerator (5°C) and the physicochemical, microbial and sensory properties were evaluated on the 1st, 7th, and 14th days of storage. The low-fat set yogurt with 3% MES showed a pH, total soluble solids, and titratable acidity of 5.00, 18.00 °Brix, and 0.41% on the 1st day, 4.52; 17.93 °Brix and 0.44% on the 7th day; and 4.31, 17.05 °Brix and 0.50% on the 14th days, respectively. The low-fat yogurt with 3% MES had the lowest syneresis (6.05%), while the control yogurt had the highest syneresis (10.05%). Yogurt sample with 3% of CS had the highest L* value (89.01) while the yogurt with 3% MES had the lowest (78.85). Yogurt with 3% MES had the highest viscosity (387.9 mPa s), whereas the control had the lowest viscosity (245.6 mPa s). The highest colony forming units (5.65 × 103 CFU/mL) was detected in the yogurt sample with 2% MES, while the lowest (1.55 × 103 CFU/mL) was found in the control yogurt samples. Therefore, for the optimum physicochemical, functional, sensory and microbial properties, 3% MES is recommended as suitable stabilizer to use in the low-fat set yogurt.

Abstract Background Prescriptions come with extensive instructions on taking medicines but provide little information about the burden of unused medicines. This issue centers around the vast quantities of unused medications accumulated in households. The study aimed to assess the prevalence of unused medicines and associated factors in Gondar City. Method The study was conducted through a community-based cross-sectional survey in Gondar City from July 30 to August 30, 2023. The data was collected using the Kobo toolbox, exported into an Excel sheet, and then analyzed using SPSS version 27 software. Both multivariate and bivariate binary logistic regressions were performed in the data analysis. A p-value of 0.05 with a 95% confidence interval was used to determine statistical significance. Result The study interviewed 786 participants, with a 92.8% response rate. 55% of the 786 households surveyed kept unused medications at home, most commonly antibiotics (37%), antipyretics (17.6%), and analgesics (15%). Factors associated with having unused medicines at home included not receiving medication information (AOR = 2.327, 95% CI: 1.535, 3.527), having a chronic disease (AOR = 5.897, 95% CI: 3.667, 9.484), having health insurance coverage (AOR = 1.456, 95% CI: 1.036, 2.047), self-medicating with NSAIDs (AOR = 2.018, 95% CI: 1.396, 2.919), and poor disposal practices (AOR = 3.613, 95% CI: 2.546, 5.127). Conclusion The study found a considerable high prevalence of unused medications in Gondar City due to factors like lack of medication education, chronic conditions, insurance coverage, self-medication, and poor disposal practices. To address this, public education programs and safe disposal guidelines should be implemented to promote safer practices.

Abstract Background The occurrence of potential drug‒drug interactions (pDDIs) is a serious global issue that affects all age groups, with the elderly population being the most vulnerable. This is due to their relatively high rates of comorbidity and polypharmacy, as well as physiological changes that can increase the potential for DDIs and the likelihood of adverse drug reactions. The aim of this study was to estimate the prevalence of pDDIs and associated factors among elderly patients in Ethiopia. Methods A comprehensive literature search using the preferred reporting items for systematic review and meta-analysis statement was conducted on HINARI, Science Direct, Embase, PubMed/MEDLINE, Google Scholar, and Research Gate. Data were extracted via a Microsoft Excel spreadsheet and analyzed via STATA version 11.0. Egger regression tests and funnel plot analysis were used to check publication bias, and the I2 statistic was used to evaluate statistical heterogeneity. Sensitivity and subgroup analyses were also conducted to identify potential causes of heterogeneity. Results Seven articles were analyzed, and a total of 1897 pDDIs were identified in 970 patients, resulting in an average of 1.97 DDIs per patient. The number of DDIs per patient ranged from 0.18 to 5.86. The overall prevalence of pDDIs among elderly patients was 50.69% (95% CI 18.77–82.63%). However, the prevalence of pDDIs ranged widely from 2.80 to 90.1%. When the severity of the interactions was considered, the prevalence of potential DDIs was found to be 28.74%, 70.68%, and 34.20% for major, moderate, and minor pDDIs, respectively. Polypharmacy and long hospital stays were identified as factors associated with pDDIs among elderly patients in Ethiopia. Conclusions The overall prevalence of pDDIs among elderly patients was high, with a wide range of prevalence rates. Moderate-severity interactions were the most prevalent. Polypharmacy and long hospital stays were identified as factors associated with pDDIs among elderly patients. The study suggests that DDIs identification database itself could have modified the DDIs prevalence rate. As a result, a single DDIs identification database needs to be authorized; otherwise, clinical knowledge should be taken into account when interpreting the information obtained.

Introduction: Accessory spleens are masses of splenic tissue commonly located near the splenic hilum and found in 10 %–30 % of the population. Accessory spleens can be either solitary or multiple. Due to their variable location, complications of accessory spleens can mimic other acute abdominal conditions. Case presentation: A 4-year-old girl presented with classical signs and symptoms of acute appendicitis of two days of duration. Physical examination showed an uncomfortable appearing girl with a slight tachycardia and tachypnea. She had discrete tenderness to palpation over the right iliac fossa. Complete blood count (CBC) and electrolyte levels were within normal limits. Abdominal ultrasound findings were not contributory. Because of the unavailability of other imaging studies and the persistence of her pain she was taken to the operating room with a presumed diagnosis of early acute appendicitis.The abdomen was entered through a transverse incision in the right lower quadrant. An encapsulated, rounded, 4 x 4 x 5-cm solid mass was identified on the mesenteric side of the terminal ileum. The mass had a 270-degree torsion around its pedicle. The appendix appeared normal. The pedicle of the solid mass was ligated, the mass was fully excised and was sent for a pathology analysis. The histopathological examination showed infarcted splenic tissue, consistent with torsion of an accessory spleen. The postoperative course was uneventful, and the patient was discharged home on the third postoperative day. Conclusion: Torsion of an accessory spleen should be considered in the differential diagnosis of acute abdomen in children and adolescents, particularly in those with inconclusive imaging studies.

IntroductionThe inappropriate disposal of unused medicines poses significant risks to public health and the environment. Gondar City, located in Northwest Ethiopia, is not exempt from this problem. However, little is known about the current disposal practices and the determinants influencing those practices in this specific context.ObjectivesThis study aimed to evaluate the disposal practices of unused medicines among the general public in Gondar City and to identify the factors that influence these practices.MethodsA cross-sectional study design was employed to collect data from the general public in Gondar City from July 30 to August 30, 2023. Data were collected through interviews using a structured questionnaire to gather information on disposal practices and determinants that could influence disposal practices.ResultsA total of 845 respondents were involved in this study with a response rate of 93%. 56.9% of the respondents had poor disposal practices. Lower educational status [AOR = 2.76 (CI: 1.59, 4.79)]; p

Objectives To evaluate how postmortem anthropometric malnutrition (PAM) measures align with expert panel attribution of malnutrition as a causal or significant condition in under-5 mortality (U5M).Design Cohort study using data from the Child Health and Mortality Prevention Surveillance network, incorporating clinical records, postmortem anthropometrics, minimally invasive tissue sampling, clinical abstraction and verbal autopsy to determine multiple causes of death.Setting/participants 1405 deaths of children aged 1–59 months from six African countries between 2016 and 2023.Primary and secondary outcome measures PAM was determined using z-scores from the WHO Child Growth Standards: underweight (weight-for-age

BackgroundAntenatal care (ANC) coverage in low- and middle-income countries has increased in the past few decades. However, merely increasing care coverage may not enhance maternal and newborn health unless the recommended service components are also provided. Our aim was to assess the quality of ANC and its associated factors in Ethiopia.MethodsWe used data from 2,042 pregnant women whose first ANC consultation was observed. Data were obtained from the 2021-2022 Ethiopian Service Provision Assessment survey conducted among a nationally representative sample of 1,158 healthcare facilities. Twenty-four components of ANC were assessed, and their values were summed to generate a total ANC quality score (range: 0-24). A higher score indicated a superior ANC quality. A multiple generalized Poisson regression model was fitted to identify factors influencing the quality of ANC. All statistical analyses were performed using STATA version 16.ResultsThe mean ANC quality score was 11 (standard deviation [SD]: 3.8). Blood pressure measurement was the most commonly performed ANC component, at 79.5%, and breast examination for cancer screening was the most neglected component of ANC, at 3.3%. ANC quality was higher in the Amhara region (incidence rate ratio [IRR]: 1.088; 95% confidence interval [CI]: 1.0-1.171) and Southern Nations, Nationalities, and Peoples' Region (IRR: 1.081; 95% CI: 1.002-1.166), and when the care was provided by a female healthcare worker (IRR: 1.054; 95% CI: 1.021-1.088). On the other hand, ANC quality decreased in rural healthcare facilities (IRR: 0.964; 95% CI: 0.932-0.998), clinics (IRR: 0.666; 95% CI: 0.581-0.764), and health posts (IRR: 0.817; 95% CI: 0.732-0.91). Similarly, ANC quality decreased when gestational age at the first antenatal visit increased (IRR: 0.994; 95% CI: 0.992-0.996) and when care was received from a non-nearby healthcare facility (IRR: 0.956; 95% CI: 0.923-0.990).ConclusionOverall, the quality of ANC in Ethiopia is suboptimal. Encouraging women to initiate ANC early and utilize nearby facilities, assisting providers in delivering standardized services through preservice training, supervision, and continuous education, and ensuring the availability and proper use of necessary resources at all facilities are important to improve ANC quality.

A study was carried out from November to May in the cropping season of 2016E.C to evaluate the performance of Temsa small scale irrigation scheme. Both internal and external indicators were considered for evaluation. The internal indicator efficiencies such as conveyance, application, storage, distribution uniformity, and deep percolation ratio and the external indicators such as agricultural output, water supply, water delivery capacity, physical, and economic and financial indicators were evaluated. The result reveals that, the average conveyance efficiency of the main, secondary, and tertiary canals were 79.6%, 85.6%, and 84.7%, respectively. The scheme has on average application efficiency (Ea), storage efficiency, deep percolation ratio, and distribution uniformity of 40.87%, 78.04%, 59.70%, and 93.33%, respectively. The poor Ea and low conveyance efficiency of the canal affected the overall scheme performance. The result reveals that, the overall efficiency of the scheme was 23.19%. The four basic agricultural output indicators of the scheme such as output per unit irrigated area, output per unit command area, output per unit irrigation diverted, and output per unit water consumed were 4,738.58 US$/ha, 1,176.08 US$/ha, 1.16 US$/m 3 , and 0.89 US$/m 3 , respectively. This shows that, the command area was beneficial and was giving a revenue for the farmers at the cropping season. The relative irrigation supply and the water delivery capacity of the canal were 2.37 m 3 and 83%, respectively. In the current study, the irrigation ratio and the sustainability of the irrigated area were 0.25 and 0.43, respectively. The irrigation ratio was low due to the designing problem. Availability of water throughout the year and market accessibility near the scheme were the advantage of the scheme that encourage the farmers. However, the input costs were affecting the return obtained from the product. Hence it is better to provide access to credit for the sustainable production and improve the farmers income.

An experiment was conducted on maize at Omo Nada district on a split-plot design with the objective of determining the optimum combination of furrow length and inflow rate under smallholder farmers’ conditions. The treatments include furrow lengths (10 m, 30 m, and 50 m) in the main plot and three inflow rates based on the maximum non-erosive inflow rates in the sub-plot. The data reveals that the plant height was affected ( p .05). The maximum and minimum plant heights of 224 and 209 cm were recorded at 30 and 50 m furrow length, respectively. Furrow length has an effect on the dry biomass of maize ( p

Abstract Background The urease-producing Helicobacter pylori increase the likelihood that pathogenic intestinal protozoa will use the stomach’s increased hydrogen potential to propagate the disease. Coinfections exacerbate the onset and severity of gastrointestinal symptoms. This study aimed to assess the prevalence of intestinal parasites/Helicobacter pylori coinfection and contributing factors in patients with gastrointestinal symptoms at Addis Zemen Primary Hospital, Northwest Ethiopia. Methods From April to July 2023, patients with gastrointestinal problems participated in a cross-sectional study carried out in a hospital. To collect the clinical and sociodemographic data, a questionnaire was employed. Intestinal parasites and Helicobacter pylori were detected using the saline stool wet mount and Helicobacter pylori stool antigen tests, respectively. SPSS version 20 was used to analyze the data and variables with p-values

BackgroundPharmaceuticals are expected to improve human and animal health, but improper management and regulation have led to adverse effects such as reproductive disorders, antibiotic resistance, and biodiversity loss in ecosystems. Their presence in the environment poses significant risks, including a reduction in biodiversity, reproductive issues, and the development of antimicrobial resistance. This review aims to examine the occurrence and sources of pharmaceuticals in the environment and their ecotoxicological and regulatory aspects, with a focus on Ethiopia.MethodsA narrative review of relevant studies conducted in Ethiopia was undertaken. The review included findings on the occurrence, sources, contributing factors, ecotoxicological impacts, and regulatory concerns related to pharmaceutical residues in the environment. Literature was sourced from Google Scholar, Scopus, PubMed, and institutional repositories.ResultThe findings revealed the detection of pharmaceutical residues in wastewater treatment facilities, aquatic environments (e.g., lakes and rivers), and commercially available animal products. Aquatic samples also showed significant concentrations, with sulfamethoxazole and fluconazole detected at 0.15 μg/L and 0.012 μg/L, respectively. Antimicrobial resistance genes were identified in wastewater and treatment plant samples, which correlate with the presence of pharmaceutical residues. An ecological risk assessment based on the risk quotient (RQ) revealed ciprofloxacin as a major concern, with an RQ of 8.58, indicating high ecological risk. Sulfonamides exhibited moderate risk, with RQ values ranging from 0.1 to 1.ConclusionThe study highlights the significant presence of pharmaceutical residues in the environment and underscores the inadequacy of regulatory enforcement in addressing this public health issue. Urgent measures are required to prevent environmental contamination and mitigate public health risks, including antimicrobial resistance. Strengthened regulatory measures and proactive interventions by relevant organizations are essential to control and prevent pharmaceutical residues in the environment, offering a critical solution for the country.

Introduction Malnutrition contributes to 45% of all childhood deaths globally, but these modelled estimates lack direct measurements in countries with high malnutrition and under-5 mortality rates. We investigated malnutrition’s role in infant and child deaths in the Child Health and Mortality Prevention Surveillance (CHAMPS) network.Methods We analysed CHAMPS data from seven sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone and South Africa) collected between 2016 and 2023. An expert panel assessed each death to determine whether malnutrition was an underlying, antecedent or immediate cause or other significant condition. Malnutrition was further classified based on postmortem anthropometry using WHO growth standards for underweight (z-scores for weight-for-age

Pharmaceutical care in the majority of developing countries is hindered by a lack of techniques, limitations in mobility, and a shortage of staff to provide patient care. However, there is no evidence that professionals intend to use telepharmacy in patient care. To fill this gap, this study was designed to examine whether pharmacists, physicians, and nursing professionals intend to use telepharamcy in their care practice.A cross-sectional investigation was carried out from November 29 to December 30, 2023. A study was conducted at all Hawassa public hospitals. A total of 592 Pharmacists, Physicians, and nurses participated. Simple random sampling and proportional allocation were utilized. A structured self-administered questionnaire was used, and a 5% pretest was administered. The data were entered into Epi Data 4.6 and exported to SPSS 26. The AMOS 23 SEM was also used to describe and assess the degree and significance of the relationships between variables.51.4% (304/592) (95% CI, 47.2-55.4) of the participants intended to use telepharmacy. Performance expectancy (β = 0.23, p-value

IntroductionMaternal mortality is a global issue, with developing countries accounting for over 99% of maternal deaths, with 30% of Ethiopian mothers dying from pregnancy-related causes. This study aimed to assess the magnitude, associated factors, and reasons for home delivery among women who gave birth after antenatal care follow-up in the last 6 months in Jabitehnan District, Northwest Ethiopia.MethodsA mixed community-based study was conducted on women who gave birth after antenatal care follow-up in the last 6 months. Data was collected through face-to-face interviews and structured questionnaires. Bivariate and multivariable logistic regressions were performed to identify factors associated with home delivery. Qualitative data were collected through focus group discussions and in-depth interviews and analyzed using a thematic content analysis method.ResultIn this study, the magnitude of home delivery after ANC follow-up among mothers who gave birth in the last 6 months was 37%, with a 95% CI of 32.5 and 41.5. Pregnancy plan [AOR: 4.56 (2.65, 7.86)], experience of abortion AOR: 3.01 [1.631, (5.55)], ANC follow-up at public hospitals [AOR: 1.89 (1.119, 3.18)], and pregnant mothers visited at home by healthcare providers during their ANC follow-up absent [AOR: 1.61 (1.02, 2.53)] were predictors of home delivery. Poor counseling during ANC, and lack of pregnancy plans, traditions, and beliefs were reasons for home delivery.ConclusionThe study reveals a high magnitude of home delivery as compared to a study done in Bahir Dar (21.2%). Factors include pregnancy plans, health institution type, abortion experience, and absence from antenatal care. Poor counseling during ANC, and lack of pregnancy plans, traditions, and beliefs were reasons for home delivery. Health professionals should receive training in communication and counseling techniques, and they should encourage mothers to plan their pregnancies and visit facility delivery services during ANC follow-up.

Soybean is a vital oil crop in Ethiopia to attract foreign income. In southwest Ethiopia's irrigated conditions, phosphorus fertilization and water stress limits soybean yield. A three-year field experiment (2018/19–2020/21) assessed the impact of deficit irrigation (DI) and phosphorus rate (P rate) on crop water productivity (WPc), agronomic efficiency of phosphorus (AEP) and soybean yields. It included two DI levels and one control treatment (I50 = 50 % ETc, I75 = 75 % ETc, and I100 = 100 % ETc) in the main plot and five P rates (P0 = 0, P10 = 10, P20 = 20, P30 = 30, and P40 = 40 kg ha−1 P) in the subplot, arranged in a randomized split plot design with three replicates. P rates were optimized for each DI level using a quadratic polynomial regression model, predicting maximum agronomic yield and economically optimal P rate based on yield and cultivation cost. The study's results demonstrated a highly significant difference in soybean yield, WPc, and AEP among various P treatments. Furthermore, the highest WPc (0.63 kg m−3) and AEP (31.67 kg kg−1) were achieved with treatments with 30 kg ha−1 P and 10 kg ha−1 P. Among DI treatments, 75 % ETc reduced water usage by 25 % and increased WPc by 13.3 %. The application of 30 kg ha−1 P improved WPc and increased yield by 91 % and 90 %, respectively. The combined effect of I100×P30 significantly increased plant height (68.23 cm), dry matter (4.4 t ha−1), and yield (2965.49 kg ha−1) by 40.3 %, 104.3 %, and 215.2 %, respectively. The maximum WPc (0.83 kg m−3) and the lowest (0.30 kg m−3) were achieved at I50×P30 and I100×P0, respectively. The lowest AEP (9.36 kg ha−1) was obtained at I50×P40, while AEP (64.49 kg kg−1) significantly improved by 85 % at I100×P10. The maximum agronomic yields ranged from 1842.5 to 2895 kg ha⁻¹, with the corresponding combined treatments of I50×P26 to I100×P32. Economically optimal P rates ranged from 26 kg ha−1 (I50) to 31 kg ha−1 P (I100), giving net returns of $1666.1 to $3028.4 ha−1. Efficient management of DI and P can optimize irrigation, reduce P losses, and mitigate economic and environmental risks. Based on the result of this finding, applying 31 kg ha−1 of P under 100 % ETc and 28 kg ha−1 of P under 75 % ETc is recommended as the optimal P application strategy to achieve higher yield, WPc, AEP, and maximize economic returns in southwest Ethiopia. In addition, the breeder needs to develop soybean varieties that are more resistant to water stress and efficient in P uptake.

BackgroundThe provision of medicines with confirmed quality and efficacy is critical for maintaining the public health and building confidence in the healthcare systems. However, the presence of poor-quality medicines still presents a significant challenge in the pharmaceutical landscape across the African regions. This is further exacerbated by the lack of consistency or discrepancy in the current regulatory framework. As a consequence, given the current constraints, a robust regulatory structure that can guarantee the supply chains attainment of the intended medicinal product requirements are required.ObjectiveThe review aimed to provide a detailed analysis of the quality issues in the pharmaceutical supply in Africa, highlighting the challenges and proposing potential solutions for its mitigation.MethodsThe review was conducted from May 2023 to April 2024. This narrative review examined poor-quality medicines, regulatory challenges, and mitigation strategies in the African pharmaceutical industry. The review utilized databases such as Google Scholar, PubMed, and Web of Science. The search strategy was customized to include open-access articles published in peer-reviewed scientific journals in English and focused exclusively on studies conducted in African countries.ResultsThe review portrays the prevalence of poor-quality medicinal products in various regions of Africa. Among various categories of findings, 42% of the reports on poor-quality medicinal products come from the African region, as per the WHO report. Furthermore, separate findings on substandard medicinal products from many African countries were encountered. The presence of problems in the regulatory system, such as the absence of any pharmacopeia belonging to any African country and variation/inconsistency in each country’s regulatory set-up, was indicated. Other factors for the inability to enforce regulatory law, such as insufficient skilled and committed human resources, the presence of corruption, as well as financial resource scarcity, were revealed in the review. From the situational analysis, the possibility of building a robust quality assurance system in the near future through a quality by design approach under existing resource limitations was discussed.ConclusionThe pharmaceutical sector in Africa faces significant challenges, including the prevalence of poor-quality medicines and weak regulatory enforcement. Tackling these challenges are vital for enhancing health outcomes throughout the continent through the provision of high-quality medicines. Trending toward quality by design in the quality assurance system under prevailing financial scarcity can be very beneficial.

Abstract Background The Ethiopian Ministry of Health (EMOH) has recently introduced a Continuous Professional Development (CPD) program for healthcare workers to ensure they maintain the necessary competencies to meet the community’s health needs. However, there is limited information on healthcare workers’ knowledge and perceived need for CPD. This study aims to assess healthcare workers’ CPD knowledge, perceived needs, and factors associated with these in eastern Ethiopia. Methods A health facility-based cross-sectional quantitative study was conducted from September 1, 2022, to October 30, 2022. Health facilities and study participants were selected using a simple random sampling technique. A total of 731 healthcare professionals were randomly selected. Data was collected using a self-administered questionnaire developed from national CPD guidelines. Data analysis was performed using the STATA statistical package version 14. A logistic regression model was used to assess the association between predictors and the outcome variable. Adjusted odds ratios with 95% confidence intervals were calculated to determine the strength of the association. A p-value

Abstract Background Depression during pregnancy is a significant health concern that can lead to a variety of short and long-term complications for mothers. Unfortunately, there is a lack of information available on the prevalence and predictors of prenatal depression in rural eastern Ethiopia. This study assessed prenatal depression and associated factors among pregnant women attending public health facilities in the Babile district, Eastern Ethiopia. Method An institution-based cross-sectional study was conducted among 329 pregnant women attending Babile District Public Health Facilities from November 1 to December 30, 2021. Bivariable and multivariable logistic regression were used to identify factors associated with prenatal depression. The adjusted odds ratio (AOR) with a 95% confidence interval was used to report the association, and the significance was declared at a p-value

Abstract Background Diagnostic autopsy is the most reliable approach to definitively ascertain the cause of death and evaluate the accuracy of antemortem clinical diagnoses. Identifying diagnostic discrepancies is vital to understanding common gaps in antemortem clinical diagnoses and modifying antemortem diagnostic approaches to increase the accuracy of clinical diagnosis. The objective of this study was to determine the frequency of diagnostic discrepancies between antemortem clinical diagnoses and postmortem autopsies on lung pathologies and to understand the reasons for diagnostic discrepancies among cases included in Child Health and Mortality Prevention Surveillance (CHAMPS) in Ethiopia. Methods A clinical case series study of deaths among children under-five in the CHAMPS study at three sites in Ethiopia between October 2019 and April 2022 was conducted. The antemortem clinical diagnoses and postmortem pathological diagnoses of the lung were compared for each case. Two senior physicians assessed the findings for both agreement and disagreement. McNemar’s test was used to assess for statistically significant differences between antemortem and postmortem diagnoses. Results Seventy-five cases were included (73.3% male). Over half (54.7%) died between the 1st and 7th day of life. Sepsis (66.7%), pneumonia (6.7%), and meconium aspiration syndrome (5.0%) were the most common immediate causes of death. Half (52%) of cases were correctly diagnosed antemortem. The magnitude of diagnostic discrepancy was 35% (95% CI: 20-47%). The most common contributing factors to diagnostic discrepancy were gaps in knowledge (22/75, 35.5%) and problems in consultation and teamwork (22/75, 35.5%). Conclusions Misdiagnoses were common among young children who died with positive lung pathology findings. In-service education initiatives and multidisciplinary collaboration are needed to mitigate high rates of diagnostic discrepancies among young children to potentially prevent future deaths.

Key Clinical Message Diagnosis of Erdheim–Chester disease (ECD) requires the clinician to be familiar with its various manifestations, classic radiologic and histologic features. This case highlights the significance of considering ECD in any patient presenting with bone pain and symmetric osteosclerosis of long bones of extremities to allow for early diagnosis and treatment. Abstract Erdheim–Chester disease (ECD) is a rare non‐Langerhans histiocytic disorder with diverse clinical manifestations, ranging from indolent, localized presentation to life‐threatening, multi‐systemic disease. Delayed or erroneous diagnosis is common. The presence of classic radiographic finding along with foamy histiocytes that is positive for CD68 but negative for CD1a on histologic examination establishes the diagnosis. We report a second case of ECD from Ethiopia. A 50‐year‐old Ethiopian man presented with a 13‐year history of bilateral lower leg bone pain, cold intolerance, somnolence, constipation, impotence, decreased libido, and secondary infertility. The diagnosis was suspected when skeletal X‐ray revealed bilateral symmetric sclerosis of metadiaphysis of femur, tibia, and humerus. The demonstration of foamy histiocytes that were positive for CD68 but negative for CD1a on histologic examination with immunohistochemical staining confirmed the diagnosis. Evaluation for the extent of the disease revealed coated aorta sign, hairy kidney sign, and cystic lesion with ground glass opacity of lung, primary hypothyroidism, and hypergonadotropic hypogonadism. ECD is rare histiocytic neoplasm with wide range of clinical features which often delay the diagnosis. Clinician should be mindful of the various presentations and the classic radiographic and histologic features of ECD. This case highlights the significance of entertaining ECD in any patient presenting with lower leg bone pain and symmetric osteosclerosis of long bones of lower extremities to allow for early diagnosis and treatment.

Stroh formalism provides an elegant method of solution for two-dimensional anisotropic elasticity problems through the generalized eigen relation associated with the dual coordinate system that gives the material eigen values and eigen vectors, and also the fundamental elasticity matrix and its associated Barnett-Lothe tensors. The extended Stroh-like formalism of Hwu and Hsieh has expanded the scope of basic Stroh formalism by addressing the electro-mechanical coupling effects in electro elastic plates. This paper presents an inclusive solution that addresses the two-dimensional problems in infinite electro-elastic, anisotropic, and isotropic plates with an arbitrary hole under remote arbitrary coupled electro-mechanical loading. This is achieved by adopting the Stroh formalism and its subsequent versions to consider the anisotropic and electro-elastic plates, and further, by incorporating the arbitrary biaxial loading condition into the boundary conditions, and the generalized mapping function into the basic formulation to accommodate all types of in plane loading and a variety of hole shapes respectively. Various equations of the solution are derived explicitly for easy understanding and computer implementation. The stress function is derived explicitly to satisfy the condition of traction free hole with remote electro-mechanical loading under generalized plane stress-open circuit condition. The stresses and electric displacements around the hole boundary are obtained by taking the derivative of the stress function with respect to unit normal along the hole boundary. The solution presented can be degenerated to the anisotropic or isotropic case by choosing the corresponding material properties, or appropriate values of complex parameters respectively. This general solution has exactly reproduced the results of other solutions in the literature for piezoelectric plates given by different methods. New results of stresses and electric displacements are obtained for various arbitrary holes in [PZT5H/45/-45/PZT5H]s graphite/epoxy plate and PZT 4 plates. Results for holes in piezoelectric laminates and PZT 4 piezo layer are also presented by FEM.

Introduction Determining aetiology of severe illness can be difficult, especially in settings with limited diagnostic resources, yet critical for providing life-saving care. Our objective was to describe the accuracy of antemortem clinical diagnoses in young children in high-mortality settings, compared with results of specific postmortem diagnoses obtained from Child Health and Mortality Prevention Surveillance (CHAMPS).Methods We analysed data collected during 2016–2022 from seven sites in Africa and South Asia. We compared antemortem clinical diagnoses from clinical records to a reference standard of postmortem diagnoses determined by expert panels at each site who reviewed the results of histopathological and microbiological testing of tissue, blood, and cerebrospinal fluid. We calculated test characteristics and 95% CIs of antemortem clinical diagnostic accuracy for the 10 most common causes of death. We classified diagnostic discrepancies as major and minor, per Goldman criteria later modified by Battle.Results CHAMPS enrolled 1454 deceased young children aged 1–59 months during the study period; 881 had available clinical records and were analysed. The median age at death was 11 months (IQR 4–21 months) and 47.3% (n=417) were female. We identified a clinicopathological discrepancy in 39.5% (n=348) of deaths; 82.3% of diagnostic errors were major. The sensitivity of clinician antemortem diagnosis ranged from 26% (95% CI 14.6% to 40.3%) for non-infectious respiratory diseases (eg, aspiration pneumonia, interstitial lung disease, etc) to 82.2% (95% CI 72.7% to 89.5%) for diarrhoeal diseases. Antemortem clinical diagnostic specificity ranged from 75.2% (95% CI 72.1% to 78.2%) for diarrhoeal diseases to 99.0% (95% CI 98.1% to 99.6%) for HIV.Conclusions Antemortem clinical diagnostic errors were common for young children who died in areas with high childhood mortality rates. To further reduce childhood mortality in resource-limited settings, there is an urgent need to improve antemortem diagnostic capability through advances in the availability of diagnostic testing and clinical skills.

Abstract Background HIV/AIDS is one of the top global public health threats that causes significant cases, deaths, and socioeconomic impact. Even though both HIV testing and counseling are identified as essential HIV interventions during pregnancy, large population-representative data shows that service coverage and determinants are limited. Therefore, this study aimed to assess the coverage and determinants of HIV testing and counseling services among pregnant mothers attending antenatal care services in sub-Saharan African countries using different nationwide data. Methods This study was conducted on large national-representative data from the Demographic Health Survey (DHS) using multilevel analysis. Data extraction, cleaning, coding, and statistical analysis were performed using STATA version 17. Weighting was used to ensure the representativeness of the sample and to obtain reliable estimates and standard errors. The multivariable multilevel logistic regression model was used to identify the determinants of HIV testing and counseling during the antenatal care visit. Adjusted odds ratios with 95% confidence intervals were used to measure statistical significance. Results A total of 83,584 women attending antenatal care were included in this study. HIV testing and counseling coverage in sub-Saharan Africa was found to be 62.87% with a 95% CI of 62.54–63.19%. The HIV testing and counseling determinants included being in the age group of 35–49 (AOR = 1.64; 95% CI: 1.46–1.83), secondary and above education levels (AOR = 1.50; 95% CI: 1.39–1.60), having at least four ANC visits (AOR = 1.85; 95% CI: 1.68–2.02), living in an urban area (AOR = 1.40; 95% CI: 1.30–1.52), and living in countries such as Rwanda (AOR = 6.19; 95% CI: 5.19–7.38) and Mauritania (AOR = 0.02; 95% CI: 0.01–0.03). Conclusion This study revealed that HIV testing and counseling coverage was 62.87% in sub-Saharan Africa. Factors affecting the HIV testing and counseling coverage were age, education, frequency of antenatal care visits, residence area, and living in Rwanda and Mauritania. Therefore, to increase HIV testing and counseling coverage in sub-Saharan Africa, policymakers on maternal health and other stakeholders should work with an integrated approach with other sectors and give prior attention to modifiable factors such as promoting women’s education and the comprehensiveness of antenatal care follow-up services during the follow-up.

Abstract Background Poor adherence to long-term medication increases the risk of morbidity and mortality and decreases the quality of life of patients with hypertension. One strategy to improve treatment adherence is to use a short text message reminder. Although evidence indicates that such programs increase medication adherence, the extent of their effectiveness and translation into clinical practice needs to be better documented. Our systematic review will collect and analyze the available evidence for clinical practice implementation. This systematic review aimed to evaluate the effectiveness of short mobile phone text message reminders versus usual/standard care for medication adherence in patients with hypertension. Methods This review will include and summarize evidence from randomized controlled trials. Adults (age > 18 years) with hypertension. The comparator group received either the usual care or standard care. It encompasses standard medical care for patients not participating in a structured and supervised intervention program such as a telemedicine program. We will include studies that assess the effectiveness of short mobile phone text message reminders in improving medication adherence in patients with hypertension compared to usual care. We will search the following databases: PubMed, EMBASE, CINAHL, SCOPUS, Web of Science, Cochrane Library Central Register of Controlled Trials, and Cochrane Library. We will include studies published in English. Furthermore, we will consider studies published from the inception of the database until April 20, 2024. At least two reviewers will independently conduct study selection, data extraction, and quality assessment. A third reviewer will determine and resolve discrepancies. We will conduct a quality assessment using the ROBIS 2 critical appraisal checklist. At least two independent reviewers will crosscheck the data synthesis. Discussion We expect this review to provide current evidence for future studies and clinical practice concerning the impact of mobile phone text message reminders on medication adherence issues. We will publish our results in a peer-reviewed journal for publication. Systematic review registration PROSPERO CRD42023391236.

Abstract Introduction Multiple pregnancies are much more common today than they were in the past. Twin pregnancies occur in about 4% of pregnancies in Africa. Adverse pregnancy outcome was more common in twin pregnancy than in singleton pregnancy. There is no pooled evidence on the burden and adverse pregnancy outcome of twin pregnancy in eastern Africa. Thus, this systematic review and meta-analysis were conducted to assess the prevalence and adverse pregnancy outcomes of twin pregnancies. Methods This systematic review and meta-analysis covers published and unpublished studies searched from different databases (PubMed, CINAHL (EBSCO), EMBASE, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, Google Scholar, and Google search). Finally, 34 studies were included in this systematic review and meta-analysis. JBI checklist was used to assess the quality of included papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Data synthesis and statistical analysis were conducted using STATA Version 14 software. Heterogeneity and publication bias were assessed. A forest plot was used to present the pooled prevalence using the random effect model. Results The prevalence of twin pregnancy in eastern Africa was 3% [95% CI: 2, 3]. The adverse pregnancy outcomes like neonatal intensive care unit admission (78%), low birth weight (44%), low APGAR score (33%), prematurity (32%), stillbirth (30%), neonatal mortality (12%) and maternal complications like hypertensive disorder of pregnancy (25%), postpartum hemorrhage (7%), Cesarean section (37%), premature rupture of membrane (12%) and maternal mortality are more common among twin pregnancy than singleton pregnancy. Conclusion One in every 33 children born a twin in east Africa; admission to neonatal intensive care unit, low birth weight, low APGAR score, prematurity, stillbirth, neonatal mortality and maternal complications are its associated adverse birth outcomes. Since twin pregnancy is a high-risk pregnancy, special care is needed during pregnancy, labor and delivery to reduce adverse pregnancy outcomes.

Abstract The World Health Organization [WHO] recommends a genotype-specific human papillomavirus [HPV] vaccination as a primary prevention strategy to control the burden of cervical cancer globally. In Ethiopia, where the non-vaccine-targeted HPV genotypes have not been adequately studied, a vaccination initiative was launched in 2018 targeting HPV-6,-11, -16, and -18 for girls aged 14–18 years. The co-existence of both vaccine-targeted and non-targeted genotypes is a serious concern, as it can accelerate cancer progression. Therefore, this study was conducted to determine the prevalence of non-vaccine-targeted HPV genotypes and assess the level of multiple infections with other genotypes in eastern Ethiopia. A health facility-based cross-sectional study including 110 women with positive HPV DNA results was conducted from April to August 2021. A structured questionnaire to collect demographic and clinical data was used. Cervical swabs were collected using L-shaped FLOQSwabs. Women's cytological profile was determined based on Pap smear test results. An automated nucleic acid extraction system using STARMag 96 ProPrep Universal Extraction Kit was utilized following the manufacturer's protocol. An amplification assay in real-time was employed to amplify and identify the HPV Late 1 [L1] gene, which is utilized for genotyping purposes. Following this, the collected data was entered into Epi data version 3.1 software, and the analysis was performed using STATA version 14. A total of 110 women [age range 30–60 years, mean age = 36.5 years and SD ± 6.9] had positive HPV DNA results and were included in the study. Among these, 108 women had valid co-testing [Pap test and HPV DNA test] results for further analysis, and the results of the remaining 2 women were rejected. Overall, the prevalence of non-vaccine-targeted HPV was 56 (51.8%, 95%CI [0.42, 0.61]), of which 28 women (25.4%, 95%CI [0.18, 0.34]) had a single non-vaccine HPV genotype infection. The remaining 29 women (26.4%, 95% CI: 0.190–0.355) experienced multiple infections. The non-vaccine-targeted genotypes of HPV-35 accounted for 11 cases (10%, 95%CI [0.06, 0.17]), HPV-68 was detected in 9 women (8.2%, 95%CI [0.04, 0.15]), HPV-56 and HPV-66 were both found in 8 cases each (7.3%, 95%CI [0.04, 0.14]) of the total. In addition, out of these 108 women, 93 (86.1%, 95%CI [0.78, 0.91]) had low-grade squamous intraepithelial lesions, 13 (12%, 95%CI [0.07, 0.20]) no intraepithelial lesion or malignancy, and two (1.9%, 95%CI [0.01, 0.07]) high-grade squamous intraepithelial lesions. Furthermore, there was no statistical difference [p = 0.755] between vaccine-targeted and non-vaccine-targeted genotypes as the primary cause of cervical lesions. In conclusion, the findings of the present study highlight the existence of a notable prevalence of multiple infections caused by non-vaccine-targeted HPV genotypes. Therefore, it is recommended that both the Federal and regional health bureaus to evaluate the range of hr HPV genotypes protected by the current HPV vaccine and explore the option of transitioning from the quadrivalent HPV vaccine to a novavalent vaccine that includes seven high-risk HPV genotypes.

ABSTRACTIntroduction Tuberculosis remains a major global health problem and ranks alongside the human immunodeficiency virus (HIV) as a leading cause of mortality worldwide. This study investigated the treatment outcome of tuberculosis and predictors of unsuccessful treatment outcome of tuberculosis (TB) patients enrolled in Arsi-Robe Hospital, central Ethiopia between January 2013 and December 2017.Methods An institution-based retrospective study was conducted on patients who had all forms of TB such as smear positive tuberculosis (PTB+), smear negative tuberculosis (PTB-), and extrapulmonary tuberculosis (EPTB) in the DOTS clinic. A multivariable logistic regression model was employed to identify predictors of unsuccessful treatment outcome and a P

Abstract Background Preterm birth is a significant contributor to newborns morbidity and mortality. Despite the availability of highly effective and powerful interventions, the burden of preterm birth has not decreased. Given the relevance of the topic to clinical decision-making, strong conclusive and supporting evidence emanating from the umbrella review is required. To this end, this umbrella review study sought to determine the association between intimate partner violence and obstetrics characteristics of women with preterm birth in Ethiopia. Methods Six systematic review and meta-analysis studies searched across multiple databases were included in this umbrella review. The quality of the included systematic review and meta-analysis studies was evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR-2) checklist. STATA version 18 was used for the statistical analysis. A random-effects model was used to calculate the overall effect measurement. Results A total of 114 observational studies in the six systematic review and meta-analysis studies involving 75,624 pregnant women were included in this comprehensive analysis. The preterm birth rate among mothers in Ethiopia was 11% (95% CI 10–13%; I2 = 98.08). Preterm birth was significantly associated with intimate partner violence (POR: 2.32; 95% CI 1.74–2.90), multiple pregnancies (POR: 3.36; 95% CI 2.41–4.32), pregnancy-induced hypertension (POR: 4.13; 95% CI 3.17–5.10), anemia (POR: 2.76; 95% CI 1.97–3.56), and premature rupture of pregnancy (POR: 5.1; 95% CI 3.45–6.75). Conclusions More than one out of ten pregnant women experienced preterm birth in Ethiopia. Intimate partner violence is significantly associated with preterm birth. Furthermore, multiple pregnancies, pregnancy-induced hypertension, anemia, and premature rupture of the membrane were significant predictors of preterm birth. Therefore, policymakers should consider further instigations and implementations of policies and strategies closely related to reductions of intimate partner violence. It is also crucial to the early identification and treatment of high-risk pregnancies.

Abstract Background Alcohol consumption during the pregnancy period is high despite the well-established evidence of its harmful effects on pregnancy and infant development. Early identification and behavioral modification are of great significance. This study aimed to assess the prevalence and associated factors of alcohol consumption among pregnant women attending antenatal care at governmental hospitals in the Harari regional state, Eastern Ethiopia. Method From April 1/2022-May 1/2022, an institutional-based cross-sectional survey was conducted among 589 pregnant women attending antenatal care governmental hospitals in Harari regional state. A systematic random sampling technique was used to select study participants during the study period. Data were collected through face-to-face interview methods using AUDIT-C. The collected data were coded, entered into Epi-data data version 3.1, and analyzed by SPSS Version 26. Binary logistic regression was carried out to identify independent predictors of alcohol consumption at a 95% confidence level. Results From a total of 617 eligible participants, 589 participated in the study with a response rate of 95.46%. The overall prevalence of alcohol consumption among pregnant women in Harari regional state governmental hospitals was 21.2% (95% CI:17.8, 24.4). In multivariate analysis, single marital status (AOR = 5.18;95% CI (2.66,10.11), previous history of abortion(AOR = 4.07;95% CI(2.06,8.04), family history of mental illness (AOR = 4.79;95% CI (1.94,11.83), depression (AOR 2.79; 95%CI(1.35,5.76), and anxiety(AOR = 2.51; 95% CI (1.23, 5.12) were variables found to have a statistically significant association with alcohol consumption during pregnancy in Harari regional state governmental hospitals. Conclusion In comparison to the majority of other research, the prevalence of alcohol usage during pregnancy was high in this study. This study observed that single marital status, previous history of abortion, family history of mental illness, depression, and anxiety were highly associated with alcohol consumption during pregnancy. Hence, responsible bodies working on mother and child health should try to mitigate or remove the above-mentioned risks when developing interventions.

Background: Picture archiving and communication system is an innovation system in the health information that reduces costs, facilitates access to medical image, and improves workflow in radiology department. However, studies indicated that intention and usage of picture archiving and communication system is limited in middle-income and developing countries. Objective: This study aimed to assess the intention to use picture archiving and communication system and its predictors among physicians and nurses at specialized teaching hospitals in Amhara region, Northwest Ethiopia. Method: Institution-based cross-sectional study design was conducted from October 11 to November 12, 2023. Proportional allocation and a simple random sampling were used to select participants of the study. A self-administered structured English questionnaire was used, and a 5% pretest was performed. Data were entered into Epi data 4.6 and exported to SPSS 26 and AMOS 23. Descriptive and structural equation modeling analysis was performed. The hypothesis was tested using a path coefficient and a p -value

BackgroundProper disposal of unwanted medicines, in addition to reducing wastage, has a positive impact on the environment and public health. Improper disposal of medications increases the risk of accidental poisonings, particularly among children. This study aimed to assess the level of knowledge, attitudes, and awareness regarding the proper disposal of unused medicines in Gondar city, northwest Ethiopia.MethodFrom 30 July to 30 August 2023, a community-based cross-sectional study was conducted among the public in Gondar city. The data were gathered using the Kobo toolbox, exported into an Excel sheet, and then analyzed using SPSS version 27. Multivariate and bivariate binary logistic regressions were performed. A p-value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance.ResultFrom 786 study participants, the overall knowledge and attitude of the community toward the proper disposal of unused medicines were 42.6 and 42.9%, respectively. Factors identified in this study included ages between 19 and 25 [AOR = 6.91, 95% CI: (3.45, 13.84); education level: secondary [AOR = 11.82, 95% CI: (1.01, 3.29)] and college and above [AOR = 5.68, 95% CI: (2.25, 14.30)]; prior information [AOR = 6.41; 95% CI: (4.02, 10.22)]; and good attitudes [AOR = 2.11; 95% CI: (1.47, 3.02)]] as factors associated with good knowledge toward proper disposal of unused medicines. In addition, receiving information [AOR = 1.86 95% CI: (1.22, 2.86)], taking medication in the past 6 months [AOR = 1.61, 95% CI: (1.09, 2.38)], and being knowledgeable [AOR = 2.07 95% CI: (1.46, 2.94)] were factors contributing to positive attitudes toward the disposal of unused medicines among the general public. Furthermore, approximately 369 participants (46.9%) in our study lacked awareness about the harmful effects of disposing of unused medicine in regular waste.ConclusionA relatively low level of knowledge and attitudes about the proper disposal of unused medications is present in the community. In this regard, a well-coordinated and methodical public awareness campaign is recommended to disseminate information and promote the appropriate disposal of unused medications.

BackgroundMaternal health service uptake remains an important predictor of maternal outcomes including maternal mortality. This systematic review and meta-analysis aimed to summarize the available evidence on the uptake of maternal health care services in developing countries and to assess the impact of place of residence, education status, and wealth index on the uptake of these services.MethodsWe examined the databases MEDLINE, Web of Science, Global Index Medicus, and Scopus until June 14, 2022. Cross-sectional studies done between 2015 and 2022 were considered. Mothers of reproductive age and all states of health were included in the study. Independently, two authors determined the eligibility of studies, extracted data, evaluated the risk of bias, and ranked the evidence’s degree of certainty. To combine the data, we performed a random-effects meta-analysis. The PROSPERO registration ID is CRD42022304094.ResultsWe included 51 studies. Mothers living in urban areas were three times more likely to receive antenatal care (OR 2.95; 95% CI 2.23 to 3.89; 15 studies; 340,390 participants) than rural mothers. Compared with no education, those with primary education were twice as likely to utilize antenatal care (OR 2.36; 95% CI 1.80 to 3.09; 9 studies; 154,398 participants) and those with secondary and higher education were six and fourteen times more likely to utilize antenatal care, respectively. Mothers in the second wealth index were twice as likely as mothers in the lowest wealth index to utilize antenatal care (OR 1.62; 95% CI 1.36 to 1.91; 10 studies; 224,530 participants) and antenatal care utilization increased further among mothers in the higher wealth index. We observed similar relative inequalities in skilled delivery care and postnatal care utilization based on the pace of residence, education, and wealth index.ConclusionIn developing countries, the problem of inequity in utilizing maternal health care services persists and needs considerable attention.

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers’ attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals’ attitudes regarding safe abortion services. Study heterogeneity was assessed by using I 2 and P -values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers’ attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women’s access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers’ attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services.

Abstract While the importance of knowledge about contraceptives in improving their utilization and thereby reducing the risk of unintended pregnancies is well documented, there are limited studies documented about the Lactational Amenorrhea Method (LAM). Thus, understanding the knowledge of postpartum mothers about LAM is essential for designing tailored interventions. This study assessed the level of knowledge about LAM and its associated factors among postpartum mothers in Ethiopia. A facility-based cross-sectional study was conducted among 3148 randomly selected postpartum participants. The study utilized multistage sampling approach in hospitals located across five regions and one city administration in Ethiopia. Data were collected using face-to-face interviews at discharge. A participant was categorized as having knowledge of LAM if she correctly answered the three LAM criteria: amenorrhea, the first 6 months, and exclusive breast feeding. A binary logistic regression model was used to identify factors associated with knowledge of LAM. Variables with p

Abstract Introduction Child marriage is a union before the age of 18 and a violation of human right. Around 21% of young women in the world married before reaching the age of 18. Every year, 10 million girls under the age of 18 are married. Child marriage causes lifetime suffering, and its abolition was one component of the Sustainable Development Goal to achieve gender equality and empower women and girls. However; abolition of child marriage by 2030 will not happen because its prevalence in the community has remained stable. Objective To assess the prevalence of child marriage and its associated factors among reproductive-age women from March 7 to April 5, 2022 in Harari Regional State, eastern Ethiopia. Methods Community-based cross-sectional study was conducted from March 7 to April 5, 2022 among the reproductive age group in the Harari Region state, Eastern Ethiopia. A systematic random sampling technique was used to find study participants. Data were obtained by face-to-face interview using a pre-tested structured questionnaire, input into EpiData version 3.1 and analyzed using Stata version 16. The proportion with 95% confidence interval (CI) and the summery measure were used to report the prevalence. A multivariable logistic regression analysis model was used to examine associated factors, and the results were provided as an adjusted odds ratio (AOR) with a 95% confidence interval. Result In this study 986 were responded to the interview, making response rate of 99.6%. The median age of study participants was 22 years. The prevalence of child marriage was 33.7% [95% CI: 30.8–36.7] in this study. Being a Muslim (AOR = 2.30, 95% CI = 1.26, 4.19), diploma or higher level of education (AOR = 0.26, 95%CI = .10, 0.70), rural residence (AOR = 5.39, 95% CI = 3.71, 7.82), a marriage arranged by others (AOR = 2.68, 95% CI = 1.49, 4.82) and not knowing legal age of marriage (AOR = 4.49, 95% CI = 2.57, 7.85) were significantly associated with child marriage. Conclusion According to this report, nearly one out of every three women engages in child marriage. The practice was more common among those with lower educational attainment, those who lived in rural areas, people who were unaware of the legal age of marriage, and those whose engagement was decided by others. Focusing on strategies that allow for intervention in these factors is beneficial in ending child marriage, which has a direct and indirect impact on women's health and educational achievement.

Summary: Background: Identifying the critical modifiable risk factors for acute respiratory tract infections (ARIs) and diarrhoea is crucial to reduce the burden of disease and mortality among children under 5 years of age in sub-Saharan Africa (SSA) and ultimately achieving the Sustainable Development Goals (SDGs). We investigated the modifiable risk factors of ARI and diarrhoea among children under five using nationally representative surveys. Methods: We used the most recent demographic and health survey (DHS) data (2014–2021) from 25 SSA countries, encompassing a total of 253,167 children. Countries were selected based on the availability of recent datasets (e.g., DHS-VII or DHS-VIII) that represent the current socioeconomic situations. Generalised linear latent mixed models were used to compute odds ratios (ORs). Population attributable fractions (PAFs) were calculated using adjusted ORs and prevalence estimates for key modifiable risk factors among ARI and diarrhoeal cases. Findings: This study involved 253,167 children, with a mean age of 28.7 (±17.3) months, and 50.5% were male. The highest PAFs for ARI were attributed to unclean cooking fuel (PAF = 15.7%; 95% CI: 8.1, 23.1), poor maternal education (PAF = 13.4%; 95% CI: 8.7, 18.5), delayed initiation of breastfeeding (PAF = 12.4%; 95% CI: 9.0, 15.3), and poor toilets (PAF = 8.5%; 95% CI: 4.7, 11.9). These four modifiable risk factors contributed to 41.5% (95% CI: 27.2, 52.9) of ARI cases in SSA. The largest PAFs of diarrhoea were observed for unclean cooking fuel (PAF = 17.3%; 95% CI: 13.5, 22.3), delayed initiation of breastfeeding (PAF = 9.2%; 95% CI: 7.5, 10.5), household poverty (PAF = 7.0%; 95% CI: 5.0, 9.1) and poor maternal education (PAF = 5.6%; 95% CI: 2.9, 8.8). These four modifiable risk factors contributed to 34.0% (95% CI: 26.2, 42.3) of cases of diarrhoea in SSA. Interpretation: This cross-sectional study identified four modifiable risk factors for ARI and diarrhoea that should be a priority for policymakers in SSA. Enhancing home-based care and leveraging female community health workers is crucial for accelerating the reduction in under-5 mortality linked to ARI and diarrhoea in SSA. Funding: None.

BackgroundThe short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia.MethodsA community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value

Background: Person-centered maternity care is a crucial scheme for a positive childbirth experience. It enhances facility-based delivery, improves patient–provider communication, and increases women’s satisfaction. However, there is limited evidence on the magnitude of person-centered care and certain variables were missed in Ethiopia. Therefore, this study assessed the magnitude of person-centered maternity care during childbirth and associated factors at health institutions of Debre Markos town, Ethiopia. Methods: Institution-based cross-sectional study was conducted at public health institutions of Debre Markos town. Participants were enrolled using systematic random sampling technique. Data were collected through face-to-face exit interviews, cleaned, coded, and entered into Epi-Data version 3.1 then exported to SPSS version 25 for analysis. After generating simple linear regression analysis, variables with p -value ⩽ 0.25 were fitted into multivariable linear regression model and p -value

Introduction. Neonatal sepsis is the primary cause of increased newborn morbidity and mortality worldwide, particularly in developing countries. In Ethiopia, the factors of neonatal sepsis are not well understood. Therefore, the purpose of this study was to determine the factors associated with neonatal sepsis in the study area. Methods. A case-control study design was conducted among 60 cases and 120 controls. Variables with P ≤ .25 in the bivariate analysis were entered into multivariable logistic regression, and statistical significance was declared at P

BackgroundAntenatal care (ANC) is essential health care and medical support provided to pregnant women, with the aim of promoting optimal health for both the mother and the developing baby. Pregnant women should initiate ANC within the first trimester of pregnancy to access a wide range of crucial services. Early initiation of ANC significantly reduces adverse pregnancy outcomes, yet many women in Sub-Saharan Africa delay its initiation. The aim of this study was to assess prevalence and determinants of delayed ANC initiation in Ethiopia.MethodsWe conducted a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). The study involved women of reproductive age who had given birth within the five years prior to the survey and had attended ANC for their most recent child. A total weighted sample of 2,895 pregnant women were included in the analysis. Due to the hierarchical nature of the data, we employed a multi-level logistic regression model to examine both individual and community level factors associated with delayed ANC initiation. The findings of the regressions were presented with odds ratios (OR), 95% confidence intervals (CI), and p-values. All the statistical analysis were performed using STATA-14 software.ResultsThis study showed that 62.3% (95% CI: 60.5, 64.1) of pregnant women in Ethiopia delayed ANC initiation. Participants, on average, began their ANC at 4 months gestational age. Women with no education (AOR = 2.1; 95% CI: 1.4, 3.0), poorest wealth status (AOR = 1.9; 95% CI: 1.3, 2.8), from the Southern Nations, Nationalities, and Peoples (SNNP) region (AOR = 2.1; 95% CI: 1.3, 3.3), and those who gave birth at home (AOR = 1.4; 95% CI: 1.1, 1.7) were more likely to delay ANC initiation.ConclusionsThe prevalence of delayed ANC initiation in Ethiopia was high. Enhancing mothers' education, empowering them through economic initiatives, improving their health-seeking behavior towards facility delivery, and universally reinforcing standardized ANC, along with collaborating with the existing local community structure to disseminate health information, are recommended measures to reduce delayed ANC initiation.

Background: Rhesus isoimmunization is preventable by giving anti-rhesus D immune globulin during and after each pregnancy. There is limited evidence on the awareness of reproductive age group women about rhesus isoimmunization in the country Ethiopia. Objectives: This study is aimed at assessing awareness and associated factors towards Rhesus isoimmunization among reproductive age women in Debre Markos Town. Methods: A community-based cross-sectional study design was conducted at Debre Markos Town from December 1–30, 2022. Six hundred and five study subjects were selected using the multistage sampling technique. Data were collected by using an interviewer-administered, pretested, structured questionnaire. Data were entered into Epi-data version 4.2 and then exported to SPSS version 25 for further analysis. A binary logistic regression model was used. Variables with a p value of ≤ 0.05 in the multivariable logistic regression with a 95 % CI were declared statistically significant. The adjusted odds ratio was used to show the strength of the association between the dependent and independent variables. Results: Among the 605 respondents, 367 (60.7 %, 95 % CI; 56.9 %, 64.7 %) had poor awareness about rhesus isoimmunization. Women who can only read and write (AOR = 0.38, 95 % CI: 0.23, 0.65), completed primary school (AOR = 0.40, 95 % CI: 0.24, 0.68), secondary school (AOR = 0.40, 95 % CI; 0.24, 0.67), women who did not get health information (AOR = 0.50, 95 % CI; (0.33, 0.75), and average monthly income

BackgroundAlthough Ethiopia has substantial improvements in various health indicators such as maternal and child mortality, the burden of neonatal mortality remains high. Between 2016 and 2019, neonatal mortality increased from 29 deaths per 1,000 live births to 33 deaths per 1,000 live births. This study aimed to explore the spatial patterns and factors contributing to neonatal mortality in Ethiopia.MethodsData from the Ethiopian Demographic and Health Surveys (EDHS) for the years 2000, 2005, 2011, 2016, and 2019 were analyzed. The EDHS sampling design uses a two-stage cluster sampling technique, considering census enumeration areas as primary sampling units and households as secondary sampling units. We used the Spatial Scan analysis in SaTScan and Getis-Ord Gi* statistic in Geographic Information System (GIS), to analyse the spatiotemporal patterns of neonatal mortality. Maternal, newborn and health service-related factors contributing to neonatal mortality were also analyzed using a multilevel logistic regression model. Adjusted Odds Rios (AOR) with corresponding 95% CI were presented as a measure of association and a P-value of 0.05 was used to declare statistical significance.ResultsDuring the initial three consecutive surveys, there was a consistent pattern of hot spot clusters in the Amhara and Benshangul Gumuz regions, along with certain parts of the Oromia region. However, in later surveys, these clusters shifted to the eastern parts of the country, notably including the Somali region. Early initiation of breast feeding was associated with reduced chances of neonatal death (Adjusted Odds Ratio [AOR]) = 0.27; 95% Confidence Interval [CI]: 0.23, 0.32). Neonates born at home (AOR = 1.46; 95% CI: 1.16, 1.82) and male babies had a higher likelihood of mortality during the neonatal period compared to their counterparts (AOR = 1.36; 95% CI: 1.24, 1.51). The odds of neonatal mortality increased with the number of children a mother had ever given birth to (AOR = 1.36; 95% CI: 1.24, 1.51). In contrast, longer birth intervals were associated with a reduced risk of neonatal mortality (AOR = 0.76; 95% CI: 0.68, 0.83).ConclusionThe central southern, central-western, north-western, and northern parts of Ethiopia had most of the neonatal death clusters in the first three rounds of DHS while eastern Ethiopia had the highest neonatal mortality clusters in the latest two surveys. Our results underscore the importance for policymakers and health administrators to reassess intervention approaches and reallocate resources to regions identified as hot spots for neonatal mortality. Enhancing the initiation of breastfeeding within the first hour of birth would improve newborn survival rates. Special attention and care need to be given to babies born of smaller sizes.

Abstract Introduction Reproductive health encompasses all conditions relating to the reproductive system and goes beyond simply being free from disease or infirmity. Several socioeconomic and socio-cultural factors affect reproductive health service utilization. Objectives To assess reproductive health service utilization and its associated factors among government secondary school students in Harari regional state, Eastern Ethiopia 2022. Methods A school-based cross-sectional study design was conducted among 1275 secondary school students in six randomly selected secondary schools in Harari Regional state, in eastern Ethiopia. The study participants were chosen using a simple random sampling method. Data was gathered using self-administered questionnaires, entered into Epi Data version 3.1, and exported to SPSS version 25 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were carried out to compute the frequency of each independent variable and the magnitude of the outcome variables, then to identify factors associated with the outcome variable, respectively. To declare a significant association, an adjusted odd ratio (AOR) with a 95% confidence interval and a p-value of 0.05 were used. Results Our finding indicated that 25.3% (95% CI:22.9, 27.7) of the secondary school students utilized reproductive health services. Being in grade 11–12 (AOR = 1.67, 95% CI: 1.18, 2.38), having a history of sexually transmitted infection (AOR = 6.11, 95% CI: 2.20, 16.99), presence of a health facility nearby (AOR = 1.49, 95% CI: 1.12, 1.99), discuss voluntary counseling and testing with family (AOR = 2.73, 95% CI: 1.90, 3.94), and discussing about contraceptive with friends (AOR = 1.22, 95% CI: 0.91, 1.65) were the elements that had a strong correlation with reproductive health service utilization. Conclusion In this study, only one-fourth of secondary school students utilized RH service during the past year. The student's educational level, having a history of STI, the presence of a health facility nearby, and discussing RH service with family/friends were the factors significantly associated with reproductive service utilization among secondary school students.

Abstract Nowadays, addressing the drawbacks of liquid electrolyte-based batteries is a hot and challenging issue, which is supposed to be fulfilled through solid electrolyte systems such as polymer electrolytes. Polymer blend electrolytes (PBEs) are widely investigated as viable options to solve the undesired characteristics of their liquid counterparts and also the poor ionic conductivity of homopolymer-based electrolytes. Even though PBEs outperform homopolymer-based electrolytes in terms of performance, the conductivity of pristine PBEs is quite low for practical applications (i.e. below 10–3 S/cm at room temperature). A very promising approach to solve this limitation is to incorporate additives into the electrolyte systems, to select suitable polymeric materials and to employ the desired synthesizing techniques as the performance of PBEs is strongly dependent on the selection of polymeric materials (i.e. on the inherent properties of polymers), the nature and amount of salts and other additives, and also the techniques employed to synthesize the polymer blend hosts and/or polymer blend electrolytes, determining the functionality, amorphousness, dielectric constant, dimensional stability, and, ultimately, the electrochemical performances of the system. This paper reviews the different factors affecting the miscibility of polymer blends, PBEs synthesizing techniques, the thermal, chemical, mechanical and electrochemical characteristics of PBEs, and also the challenges and opportunities of PBEs. Moreover, the paper presents the current progress of polymer blend electrolytes as well as future prospects for advancing polymer blend electrolytes in the energy storage sectors.