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Tekalign Tadesse,1,* Haile Alemayehu,2 Girmay Medhin,2 Aberaw Akalu,3 Tadesse Eguale2,4,* 1Department of Veterinary Science, Mattu University, Mattu, Ethiopia; 2Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia; 3Food, Medicine and Healthcare Administration and Control, Addis Ababa, Ethiopia; 4The Ohio State University, Global One Health LLC, Addis Ababa, Ethiopia*These authors contributed equally to this workCorrespondence: Tekalign Tadesse, Department of Veterinary Science, Mattu University, P.O Box 318, Mattu, Ethiopia, Email tsquaregr@gmail.comBackground: Antimicrobial resistance (AMR) is a global threat to public and animal health. Escherichia coli is considered an indicator organism for monitoring AMR among gram-negative Enterobacteriaceae in humans and animals. The current study aims to assess the antibiogram profile of E. coli isolated from dairy cattle and in-contact humans in central Ethiopia and to identify risk factors associated with multidrug resistance (MDR).Methods: A cross-sectional study was conducted in which 58 farms were recruited from selected districts of central Ethiopia. E. coli was isolated using standard bacteriological techniques. A total of 200 representative isolates (140 from cattle and 60 from humans in contact) were randomly selected and tested for susceptibility to a panel of 13 antimicrobials using the Kirby-Bauer disc diffusion assay.Results: The highest rate of resistance was observed for sulfamethoxazole+trimethoprim (58.6%, 82/140) and amoxicillin+clavulanic acid (70.0%, 42/60) among E. coli isolates from cattle and hmans, respectively. In contrast, resistance rates in isolates from in contact humans with the cattle were 30%, 33.3%, and 66.7%, respectively. Resistance to tetracycline (p=0.02), streptomycin (p=0.03), and sulfamethoxazole+trimethoprim (p=0.007) was significantly high in E. coli isolated from cattle on commercial dairy farms than in those isolated from cattle on smallholder farms. There was no significant difference (p> 0.05) in the rate of resistance between E. coli isolated from in contact humans with smallholder and commercial dairy farms. Antimicrobial use for treatment purpose (p=0.04) and non-compliance with the drug withdrawal period (p=0.03) were significantly associated with the farm-level occurrence of MDR.Conclusion: A high rate of resistance was detected in E. coli isolated from the feces of dairy cattle and in-contact humans. This necessitates an effective intervention through a one-health approach and further molecular studies are required to establish source attribution.Keywords: antimicrobial resistance, dairy cattle, E. coli, humans

Temesgen Mulugeta,1 Henock Alemayehu,1 Urge Gerema2 1Jimma University, Institute of Health, School of Pharmacy, Department of Clinical Pharmacy, Jimma, Oromia, Ethiopia; 2Jimma University, Institute of Health, School of Biomedical Sciences, Anatomy Course Unit, Jimma, Oromia, EthiopiaCorrespondence: Temesgen MulugetaJimma University, Institute of Health, School of Pharmacy, Department of Clinical Pharmacy, Jimma, Oromia, EthiopiaEmail temesgenmulugetaf@gmail.comBackground: Burn is a serious public health problem and a leading cause of disability and disfigurement. However, there was no published study from our Hospital Burn Unit that assessed the clinical profiles and the outcomes of burn patients.Objective: This study was aimed to assess the clinical profiles and the outcomes of patients admitted with burn injuries.Methods: Hospital-based retrospective cross-sectional study was conducted at the Burn Unit of JMC. Systematic random sampling was used to include the burn patients. Data were analyzed using SPSS version 25. Descriptive statistics, chi-square (χ2), and student-t-test were performed to describe and assess the relationships between the variables. Multivariate logistic regression was performed to determine the factors affecting the length of hospital stays.Results: One hundred twenty-four burn patients (51.6% female) were included. The majority (79.84%) of the patients were in the age category of less than 29 years. Scalds (47.6%) were the most common cause of burns with three times in females. The extremities (93.5%) were the most frequently affected areas. Patients with second-degree superficial burns accounted for 61.3% of all patients. In 95.88% of the patients, the total body surface area burn (TBSA) was below 20%. Lactated ringers (69.4%) and tramadol (71.0%) were the most frequently used IV fluid for resuscitation and analgesic agent for pain, respectively. Patients who undergo any of the surgical procedures stayed in the hospital for greater than 30 days more than 4 times likely (OR = 4.8, 95% CI 2.08– 11.2, P < 0.001).Conclusion: Scalds are the most common cause of burn injury, particularly in patients aged less than 14 years. Educating the community about the risk groups, household safety precautions, and early seeking medical care may reduce the incidence and morbidity of burn injuries.Keywords: burn, clinical profiles, outcomes, Jimma Medical Center

Small communities in remote areas of the United States often lack adequate water treatment services. Adsorption by granular activated carbon (GAC) is a vital drinking-water purification approach in small water treatment plants and point-of-entry and point-of-use systems. This study shows that rural communities can utilize a simple approach, thermal air oxidation (TAO), to produce their own GAC from locally available biomass materials. Unlike commercial GAC production processes that require high temperatures and activating gasses, activation of charcoals (biochars) by TAO can be achieved at moderate temperatures of 400‒500 °C without a regulated supply of activating gasses. After a brief TAO for 30‒40 min, charcoals/biochars showed significant increases in the surface area by up to 80-fold, oxygen-containing functional groups, porosity, and adsorption of test organic contaminants, including one anionic herbicide, two neutral triazine herbicides, and one natural estrogen. The GAC produced by the TAO process had a N2 B.E.T. surface area of up to approximately 850 m2/g, which is comparable to that of commercial GAC. The pore size distribution (PSD) of TAO-generated GAC was narrow and peaked at an approximate pore width of 0.8‒0.9 nm. Both the surface area and PSD were significantly affected by the conditions of TAO. GAC made from walnut/almond charcoals exhibited the highest adsorptivity, despite a relatively low surface area. This simple, innovative GAC production approach is suitable for use in small community- and household-scale applications, and therefore may benefit rural communities, water treatment professionals, farmers, and the GAC industry as a whole.

White birch was stored in the form of bundles, wood chips, and loose slash for a period of one year to examine the changes in biomass fuel properties. The samples were collected at regular quarterly intervals to measure moisture content, CNS content, ash content, and calorific value. Data loggers were also placed into the stored woody biomass to measure the temperature change inside the piles. After the first quarter of the storage period and continuing into the next three months of storage, the moisture content showed the most significant change. The moisture content of the biomass bundles increased from 29 % to above 80 % (db). The moisture content of the pile of wood chips covered with a tarp decreased from 51% to 26% and showed a continuous decline in moisture content to the end of storage period to an average range of 16.5% (db). However, the moisture content of uncovered wood chip pile was observed to continuously increase throughout the storage period, resulting in more than double in magnitude from 59% to 160% (db). The dry matter loss was higher in wood chip piles (8~27%) than in bundles (~3%). Among the other properties, there was slightly higher loss of calorific value in wood chips (~1.6%) as compared to bundles (~0.7%) at the end of one year.

We tested whether the brain and kidney respond differently to cardiopulmonary bypass (CPB) and to changes in perfusion conditions during CPB. Therefore, in ovine CPB, we assessed regional cerebral oxygen saturation (rSO2) by near‐infrared spectroscopy and renal cortical and medullary tissue oxygen tension (PO2), and, in some protocols, brain tissue PO2, by phosphorescence lifetime oximetry. During CPB, rSO2 correlated with mixed venous SO2 (r = 0.78) and brain tissue PO2 (r = 0.49) when arterial PO2 was varied. During the first 30 min of CPB, brain tissue PO2, rSO2 and renal cortical tissue PO2 did not fall, but renal medullary tissue PO2 did. Nevertheless, compared with stable anaesthesia, during stable CPB, rSO2 (66.8 decreasing to 61.3%) and both renal cortical (90.8 decreasing to 43.5 mm Hg) and medullary (44.3 decreasing to 19.2 mm Hg) tissue PO2 were lower. Both rSO2 and renal PO2 increased when pump flow was increased from 60 to 100 mL kg−1 min−1 at a target arterial pressure of 70 mm Hg. They also both increased when pump flow and arterial pressure were increased simultaneously. Neither was significantly altered by partially pulsatile flow. The vasopressor, metaraminol, dose‐dependently decreased rSO2, but increased renal cortical and medullary PO2. Increasing blood haemoglobin concentration increased rSO2, but not renal PO2. We conclude that both the brain and kidney are susceptible to hypoxia during CPB, which can be alleviated by increasing pump flow, even without increasing arterial pressure. However, increasing blood haemoglobin concentration increases brain, but not kidney oxygenation, whereas vasopressor support with metaraminol increases kidney, but not brain oxygenation. [ABSTRACT FROM AUTHOR]

Abstract Background Women of reproductive age (WRA) in developing countries are often at risk of micronutrient deficiencies due to inadequate intakes and excessive losses. Objective The purpose of this trial is to assess the effectiveness of United Nations International Multiple Micronutrient Antenatal Preparation-Multiple Micronutrient Supplements (UNIMMAP-MMS) versus iron-folic acid (IFA) among WRA in reducing anemia. Methods Three parallel groups of WRA will participate in a community-based, individually randomized, double-blinded, placebo-controlled superiority trial. After consent, the sample of 375 mildly or moderately anemic women based on hemoglobin by Hemocue will be randomly assigned across two interventions and one control arm. Trial participants in intervention arms will receive UNIMMAP-MMS or IFA while those in the control arm will receive placebos twice a week for 17 weeks. The primary outcome will be a change in mean hemoglobin (Hb) concentrations. Outcome assessors and study participants will be blinded to the type of supplements and study arm. Discussion The World Health Organization (WHO) added UNIMMAP-MMS to its essential medicine lists in 2021 but recommended rigorous study. Several factors in addition to inadequate intakes of iron and folic acid contribute to the high prevalence of anemia among WRA in the Somali region. The findings of this study will provide evidence on the effect of UNIMMAP-MMS and IFA on Hb concentrations and anemia prevalence among anemic WRA. Trial registration ClinicalTrials.gov NCT05682261. Registered on January 12, 2023.

Abstract The objective of our study was to reanalyse the Ethiopia STEPwise approach to Surveillance Noncommunicable Disease Risk Factors survey (NCD STEPS), using causal path diagrams constructed using expert subject matter knowledge in conjunction with graphical model theory to map the underlying causal network of modifiable factors associated with prediabetes/diabetes and hypertension. We used data from the 2015 Ethiopia NCD STEPS representative cross‐sectional survey (males; n = 3977 and females; n = 5823 aged 15–69 years) and performed directed acyclic graph‐informed logistic regression analyses. In both sexes, a 1‐unit higher in body mass index (BMI) and waist circumference (WC) were positively associated with prediabetes/diabetes (BMI: males: adjusted odds ratio [aOR]: 1.07 [95% confidence interval: 1.0, 1.1], females aOR: 1.03 [1.0, 1.1]; WC: males: aOR: 1.1 [0.9, 1.2], females: aOR: 1.2 [1.1, 1.3]) and hypertension (BMI: males: aOR: 1.2 [1.1, 1.2], females aOR: 1.1 [1.0, 1.1]; WC: males: aOR: 1.6 [1.4, 1.8], females: aOR: 1.3 [1.2, 1.5]). Although residing in urban settings was associated with higher odds of hypertension in both males (aOR: 1.79 [1.49, 2.16]) and females (aOR: 1.70 [1.49, 1.95]), it was only associated with prediabetes/diabetes in males (aOR: 1.56 [1.25, 1.96]). Males and females in pastoralist areas had lower odds of prediabetes/diabetes compared with their agrarian counterparts (males: aOR: 0.27 [0.14, 0.52], females: aOR: 0.31 [0.16, 0.58]). Physical activity was associated with lower odds of prediabetes/diabetes among females (aOR: 0.75 [0.58, 0.97]). Other diet‐related modifiable factors such as consumption of fruit and vegetable, alcohol or salt were not associated with either prediabetes/diabetes or hypertension. Our findings highlight the need to implement interventions that prevent overweight/obesity and nutrition‐related NCDs, particularly in urban areas.

Abstract The prevention of wasting should be a public health priority as the global burden of acute malnutrition is still high. Gaps still exist in our understanding of context‐specific risk factors and interventions that can be implemented to prevent acute malnutrition. We used data from the four rounds of the Ethiopia Demographic and Health Survey (2000–2016) to identify risk factors that have contributed to the change in weight‐for‐height z‐score (WHZ) among children under 5 years of age. We performed a pooled linear regression analysis followed by a decomposition analysis to identify relevant risk factors and their relative contribution to the change in WHZ. Modest improvements in WHZ were seen between 2000 and 2016. The sharpest decrease in mean WHZ occurred from birth to 6 months of age. Perceived low weight at birth and recent diarrhoea predicted a decline in WHZ among children aged 0–5, 6–23 and 23–59 months. Less than 50% of the change in WHZ was accounted for by the change in risk factors included in our regression decomposition analysis. This finding highlights data gaps to identify context‐specific wasting risk factors. The decline in the prevalence of recent diarrhoea (15% of the improvement), decline in low birth size (7%–9%), and an increase in wealth (15%–30%) were the main risk factors that accounted for the explained change in WHZ. Our findings emphasize the importance of interventions to reduce low birthweight, diarrhoea and interventions that address income inequities to prevent acute malnutrition.

Abstract Inadequate safe water supply and poor sanitation and hygiene continue to be important risk factors for diarrhoea and stunting globally. We used data from the four rounds of the Ethiopian Demographic and Health Survey and applied the new World Health Organization (WHO)/UNICEF Joint Monitoring Program (JMP) service standards to assess progress in water, sanitation and hygiene (WASH) coverage between 2000 and 2016. We also performed an age‐disaggregated pooled linear probability regression analysis followed by a decomposition analysis to determine whether changes in WASH practices have contributed to the changing prevalence of diarrhoea and stunting in children under 5 years of age. We observed a significant increase in the coverage of safe drinking water and adequate sanitation facilities over the period. At the national level, the use of a basic water source increased from 18% in 2000 to 50% in 2016. Open defecation declined from 82% to 32% over the same period. However, in 2016, only 6% of households had access to a basic sanitation facility, and 40% of households had no handwashing facilities. The reduction in surface water use between 2000 and 2016 explained 6% of the decline in diarrhoea observed among children aged 0–5 months. In children aged 6–59 months, between 7% and 9% of the reduction in stunting were attributable to the reduction in open defecation over this period. Despite progress, improvements are still needed to increase basic WASH coverage in Ethiopia. Our findings showed that improvements in water and sanitation only modestly explained reductions in diarrhoea and stunting.

In Ethiopia, Social Health Insurance (SHI) implementation was delayed repeatedly due to employees’ unwillingness to pay 3% of their monthly salary and fear related to the scheme’s healthcare coverage. However, provisions of comprehensive training for health workers on health insurance and inclusion of healthcare financing methods in health practitioner education curriculum make their level of willingness to pay for SHI schemes uncertain. Thus, this study aimed to assess willingness to pay for the SHI scheme and its determinant factors among Healthcare providers in the Gedeo zone. From July 1 to 15, 2022, we carried out an institution-based cross-sectional study among 430 healthcare providers recruited using a multistage sampling technique. A multivariable logistic regression model was used to determine the factors associated with willingness to pay for Social Health insurance. Adjusted odds ratio (AOR) and P values of 10, 000 Birr monthly salary (AOR = 2.45, 95% CI: 1.14, 5.26), difficulty in paying for healthcare (AOR = 3.55, 95% CI: 1.22, 10.29), history of chronic conditions (AOR = 4.61, 95% CI: 2.41, 8.82), positive attitude (AOR = 3.16, 95% CI: 1.62, 6.18), and good knowledge of the social health insurance scheme (AOR = 2.35, 95% CI: 1.17, 4.72) were more likely to pay for the social health insurance. More than half of the healthcare providers expressed a lack of willingness to pay for the social health insurance scheme. So, the government should provide an awareness creation program on the concepts and principles of the SHI scheme to improve the willingness to pay for the scheme.

Root-knot nematodes (Meloidogyne spp., RKN) are among the most destructive endoparasitic nematodes worldwide, often leading to a reduction of crop growth and yield. Insights into the dynamics of host-RKN interactions, especially in varied biotic and abiotic environments, could be pivotal in devising novel RKN mitigation measures. Plant growth-promoting bacteria (PGPB) involves different plant growth-enhancing activities such as biofertilization, pathogen suppression, and induction of systemic resistance. We summarized the up-to-date knowledge on the role of PGPB and abiotic factors such as soil pH, texture, structure, moisture, etc. in modulating RKN-host interactions. RKN are directly or indirectly affected by different PGPB, abiotic factors interplay in the interactions, and host responses to RKN infection. We highlighted the tripartite (host-RKN-PGPB) phenomenon with respect to (i) PGPB direct and indirect effect on RKN-host interactions; (ii) host influence in the selection and enrichment of PGPB in the rhizosphere; (iii) how soil microbes enhance RKN parasitism; (iv) influence of host in RKN-PGPB interactions, and (v) the role of abiotic factors in modulating the tripartite interactions. Furthermore, we discussed how different agricultural practices alter the interactions. Finally, we emphasized the importance of incorporating the knowledge of tripartite interactions in the integrated RKN management strategies.

Solid wastes are substances thrown away by the institutions of individual households in the urban community. The solid waste management practice in Asella town was inappropriate caused environmental pollution and exposed different urban health difficulties. The main objective was to determine the environmental and health impacts of solid waste management problems and associated factors in Asella town. Data collection was carried out through a house-to-house community survey process with a method of cross-sectional study design. A total sample size of 418 households was selected and implemented a simple random and systematic probability sampling technique. The statistical analysis of the binary logistic regression model was used to perform the correlational test about health issues in Asella town.The environmental impact assessment indicators were 13.4% soil pollution, 31.6% air pollution, 20.8% environmental deterioration, and 34.2% water pollution. The health impact indicators were 49.5% respiratory diseases, 18.2% asthmatic (bronchitis) cases, 15.8% diarrheal diseases, 14.8% protozoan illnesses, and 1.7% cancer cases.The odds ratio of females AOR = 1.18; 95%, CI:0.48–2.89, educational districts of can't read and write AOR = 2.31: 95% CI = 0.48–11.1, primary cycle AOR = 2.32, 95% CI:0.58–9.21, Secondary cycle AOR = 2.19, 95% CI = 0.60–7.98, and tertiary cycle AOR = 4.98, 95% C1.06–23.46. the odds ratio of house ownership of government AOR = 2.95, 95% CI:0.54–16.14, private households AOR = 4.18, 95% CI:0.79–22.16 and rented house property AOR = 1.71, 95% CI:0.32–9.18. The odds ratio of income group of lower status AOR = 2.0, 95% CI:0.91–4.98, middle income AOR = 5.7, 95% CI: 0.73–44.53 and higher income AOR = 2.8, 95% CI:0.35–23.14. The odds ratio for sorting of solid waste AOR = 1.38, 95% CI:0.56–3.40, and reusing of solid waste AOR = 7.90, 95% CI:2.12–29.42. Thus, the odds ratio of reusing solid waste was statistically significant correlated factors that limit health issues in Asella town.Therefore, the inadequate solid waste management practice was a query for environmental and health impacts in Asella town. The principles of reusing, reducing, and recovering solid waste management practice must be supported by professional interventions and government policy.

Abstract Background The coronavirus disease 2019 (Covid-19) pandemic is a global public health problem. The Covid-19 pandemic has had a substantial impact on the economy of developing countries, including Ethiopia.This study aimed to determine the hospitalisation costs of Covid-19 and the factors associated with the high cost of hospitalisation in South Central Ethiopia. Methods A retrospective cost analysis of Covid-19 patients hospitalised between July 2020 and July 2021 at Bokoji Hospital Covid-19 Treatment Centre was conducted using both the micro-costing and top-down approaches from the health system perspective. This analysis used cost data obtained from administrative reports, the financial reports of the treatment centre, procurement invoices and the Covid-19 standard treatment guidelines. The Student’s t-test, Mann-Whitney U test or Kruskal-Wallis test was employed to test the difference between sociodemographic and clinical factors when appropriate.To identify the determinants of cost drivers in the study population, a generalised linear model with gamma distribution and log link with a stepwise algorithm were used. Results A total of 692 Covid-19 patients were included in the costing analysis. In this study, the mean cost of Covid-19–infected patients with no symptoms was US$1,073.86, with mild symptoms US$1,100.74, with moderate symptoms US$1,394.74 and in severe–critically ill condition US$1,708.05.The overall mean cost was US$1,382.50(95% CI: 1,360.60–1,404.40) per treated episode.The highest mean cost was observed for personnel, accounting for 64.0% of the overall cost. Older age, pre-existing diseases, advanced disease severity at admission, admission to the intensive care unit, prolonged stay on treatment and intranasal oxygen support were strongly associated with higher costs. Conclusions This study found that the clinical management of Covid-19 patients incurred significant expenses to the health system. Factors such as older age, disease severity, presence of comorbidities, use of inhalation oxygen therapy and prolonged hospital stay were associated with higher hospitalisation costs.Therefore, the government should give priority to the elderly and those with comorbidities in the provision of vaccination to reduce the financial burden on health facilities and health systems in terms of resource utilisation.

Abstract Background The Coronavirus Disease (COVID-19) caused by SARS-CoV-2 infections remains a significant health challenge worldwide. There is paucity of evidence on the influence of the universal health coverage (UHC) and global health security (GHS) nexus on SARS-CoV-2 infection risk and outcomes. This study aimed to investigate the effects of UHC and GHS nexus and interplay on SARS-CoV-2 infection rate and case-fatality rates (CFR) in Africa. Methods The study employed descriptive methods to analyze the data drawn from multiple sources as well used structural equation modeling (SEM) with maximum likelihood estimation to model and assess the relationships between independent and dependent variables by performing path analysis. Results In Africa, 100% and 18% of the effects of GHS on SARS-CoV-2 infection and RT-PCR CFR, respectively were direct. Increased SARS-CoV-2 CFR was associated with median age of the national population (β = -0.1244, [95% CI: -0.24, -0.01], P = 0.031 ); COVID-19 infection rate (β = -0.370, [95% CI: -0.66, -0.08], P = 0.012 ); and prevalence of obesity among adults aged 18 + years (β = 0.128, [95% CI: 0.06,0.20], P = 0.0001) were statistically significant. SARS-CoV-2 infection rates were strongly linked to median age of the national population (β = 0.118, [95% CI: 0.02,0.22 ], P = 0.024); population density per square kilometer, (β = -0.003, [95% CI: -0.0058, -0.00059], P = 0.016 ) and UHC for service coverage index (β = 0.089, [95% CI: 0.04,0.14, P = 0.001 ) in which their relationship was statistically significant. Conclusions The study shade a light that UHC for service coverage, and median age of the national population, population density have significant effect on COVID-19 infection rate while COVID-19 infection rate, median age of the national population and prevalence of obesity among adults aged 18 + years were associated with COVID-19 case-fatality rate. Both, UHC and GHS do not emerge to protect against COVID-19-related case fatality rate.

BackgroundEquids play a crucial role in the Ethiopian economy, transporting agricultural inputs and outputs in the dominant subsistence agricultural systems and the critical link for value chains throughout the country. However, these species are often neglected in policies and interventions, which reflects the data and information gaps, particularly the contribution of working equids to Ethiopia.ObjectiveTo assess population dynamics, distribution, biomass, and economic value of equids in Ethiopia.Materials and methodsEquine population data were obtained from the Ethiopian Central Statistics Agency (CSA) annual national agriculture surveys published yearbooks from 2004 to 2020. Parameters such as the number of effective service days and daily rental value were obtained from interviews and literature to estimate the stock monetary and service value of equids. Descriptive statistics were used to assess population dynamics and the geographical distribution was mapped.ResultsThe estimated total Ethiopian equid population increased by more than doubled (by 131%) between 2004 and 2020 from 5.7 (4.9-6.6) million to 13.3 (11.6-15) million with 2.1 million horses, 10.7 million donkeys, and 380 thousand mules. Similarly, the number of households owning a working equid has increased. Equine populations are unevenly distributed across Ethiopia, although data were lacking in some districts of the country. The per human-capita equine population ranged from 0-0.52, 0-0.13, and 0-0.02 for donkeys, horses, and mules, respectively. The equid biomass was 7.4 (6.3-8.4) million Tropical livestock unit (TLU) (250 kg liveweight), 10% of total livestock biomass of the country. The stock monetary value of equids was USD 1,229 (651-1,908) million, accounting for 3.1% of total livestock monetary value and the services value of equids was USD 1,198 (825-1,516) million, which is 1.2% of Ethiopian 2021 expected GDP.ConclusionThe Ethiopian equine population has grown steadily over the last two decades. Equids play a central role in transportation and subsistence agriculture in Ethiopia and contribute significantly to the national economy. This pivotal role is insufficiently recognized in national livestock investments.

BackgroundThe provision of equitable and accessible healthcare is one of the goals of universal health coverage. However, due to high out-of-pocket payments, people in the world lack sufficient health services, especially in developing countries. Thus, many low and middle-income countries introduced different prepayment mechanisms to reduce large out-of-pocket payments and overcome financial barriers to accessing health care. Though many studies were conducted on willingness to pay for social health insurance in Ethiopia, there is no aggregated data at the national level. Therefore, this systematic review and meta-analysis aimed to estimate the pooled magnitude of willingness to pay for social health insurance and its associated factors among public servants in Ethiopia.MethodStudies conducted before June 1, 2022, were retrieved from electronic databases (PubMed/Medline, Science Direct, African Journals Online, Google Scholar, and Web of Science) as well as from Universities' digital repositories. Data were extracted using a data extraction format prepared in Microsoft Excel and the analysis was performed using STATA 16 statistical software. The quality of the included studies was assessed using the Newcastle-Ottawa Scale for cross-sectional studies. To evaluate publication bias, a funnel plot, and Egger's regression test were utilized. The study's heterogeneity was determined using Cochrane Q test statistics and the I2 test. To determine the pooled effect size, odds ratio, and 95% confidence intervals across studies, the DerSimonian and Laird random-effects model was used. Subgroup analysis was conducted by region, sample size, and publication year. The influence of a single study on the whole estimate was determined via sensitivity analysis.ResultTo estimate the pooled magnitude of willingness to pay for the Social Health insurance scheme in Ethiopia, twenty articles with a total of 8744 participants were included in the review. The pooled magnitude of willingness to pay for Social Health Insurance in Ethiopia was 49.62% (95% CI: 36.41-62.82). Monthly salary (OR = 6.52; 95% CI:3.67,11.58), having the degree and above educational status (OR = 5.52; 95%CI:4.42,7.17), large family size(OR = 3.69; 95% CI:1.10,12.36), having the difficulty of paying the bill(OR = 3.24; 95%CI: 1.51, 6.96), good quality of services(OR = 4.20; 95%CI:1.97, 8.95), having favourable attitude (OR = 5.28; 95%CI:1.45, 19.18) and awareness of social health insurance scheme (OR = 3.09;95% CI:2.12,4.48) were statistically associated with willingness to pay for Social health insurance scheme.ConclusionsIn this review, the magnitude of willingness to pay for Social Health insurance was low among public Civil servants in Ethiopia. Willingness to pay for Social Health Insurance was significantly associated with monthly salary, educational status, family size, the difficulty of paying medical bills, quality of healthcare services, awareness, and attitude towards the Social Health Insurance program. Hence, it's recommended to conduct awareness creation through on-the-job training about Social Health Insurance benefit packages and principles to improve the willingness to pay among public servants.

The purpose of this paper is to reveal the effects of porous structure and surface acid-base sites on CO2 adsorption for those nitrogen-doped activated carbons, which were prepared in a tube furnace with anaerobic conditions (TF) and muffle furnace with oxygen-poor conditions (MF), respectively. Subsequently, the porous structure and surface group distribution of the prepared activated carbons TF and MF were characterized in detail through those methods such as scanning electron microscope (SEM), Brunauer-Emmett-Teller (BET), Barret-Joyner-Halenda method (BJH), Horvath-Kawazoe method (HK), Dubinin-Radushkevich method (DR), mercury intrusion porosimetry (MIP), non-local density functional theory method (NLDFT), (in-situ) Fourier transform infrared spectroscopy (FTIR), Raman spectra (RS), X-ray photoelectron spectroscopy (XPS), and temperature programmed desorption (TPD). Then the thermodynamic and kinetic characteristics of CO2 adsorption such as adsorption capacity, selectivity, and activation energy were systematically investigated based on the static volumetric method and dynamic adsorption method. The results showed that the anaerobic or oxygen-poor preparation atmosphere affected the micropore volume and surface functional group distribution of activated carbons. Thus the activated carbon TF exhibited a higher adsorption capacity of CO2 (7.9 mmol g−1, 100 kPa and 273 K) and longer dynamic breakthrough time due to the higher microporosity (Vmic/Vt = 90 %), while the activated carbon MF exhibited the higher selectivity (14.7, CO2/N2 molar ratio of 1:1) and adsorption rate due to the higher nitrogen and oxygen contents (11.23 %, 13.53 %) in the main forms such as pyrrole nitrogen (N-5), carbony, and carboxyl. Overall, CO2 adsorption on the activated carbons was verified to be a dominant physical adsorption and exothermic process, which was suitable to be described by a quasi-first-order dynamic model. Meanwhile, compared with TF, the activated carbon MF exhibited the higher activation energy of CO2 adsorption (12.98 kJ mol−1 for TF and 17.23 kJ mol−1 for MF), accompanied by the larger rate constants (k1) and diffusion coefficients (D). The higher activation energy for MF meant that the adsorption temperature had a stronger effect on the rate constant during CO2 adsorption.

Birhanu Belete Aragaw,1 Haile Woretaw Alemu,2 Aragaw Kegne Assaye,2 Yared Ayelign Belete,1 Henok Biruk Alemayehu1 1Department of Ophthalmology and Optometry, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2Department of Optometry, School of Medicine, College of Medicine and Health Sciences University of Gondar, Gondar, EthiopiaCorrespondence: Birhanu Belete Aragaw, Tel +251923701934, Email birhanubelete2009@hu.edu.etIntroduction: Acquired immune deficiency syndrome is a disease with common clinical ocular manifestations. Ocular manifestations lead to blindness, which has a common social and economic impact.Purpose: This study aimed to assess the prevalence and associated factors of ocular manifestations of acquired immune deficiency syndrome among adults at the University of Gondar Hospital, North West Ethiopia, 2021.Patients and Methods: A cross-sectional study was conducted on 401 patients from June to August 2021. Samples were selected based on a systematic random sampling technique. Data collection was done using structured questionnaires. Data extraction format was used to collect the clinical characteristics of patients including ocular manifestations. Data entry was done by EpiData version 4.6.0.6 and exported to the Statistical Package for the Social Sciences version 26 for data analysis. Associated factors were analyzed by binary logistic regression. P-value < 0.05 with a 95% confidence level was used to declare a significant association.Results: A total of 401 patients were involved with a response rate of 91.5%. The overall prevalence of ocular manifestations of acquired immune deficiency syndrome was 28.9%. The common ocular manifestations were seborrheic blepharitis at 16.4% and squamoid conjunctival growth at 4.5%. Age > 35 years (AOR=2.52, 95% CI: 1.19, 5.35), Clusters of differentiation 4 count < 200 cells/μL (AOR=4.76, 95% CI:2.50, 9.09), World Health Organization stage II (AOR=2.60, 95% CI: 1.23, 5.50), history of eye disease (AOR=3.05, 95% CI: 1.38, 6.72), and duration of Human Immunodeficiency Virus > 5 years (AOR=2.79, 95% CI: 1.29, 6.05) were statistically associated with the ocular manifestation of acquired immune deficiency syndrome.Conclusion and recommendations: In this study, the prevalence of ocular manifestation of acquired immune deficiency syndrome was high. Age, CD4 count, duration of HIV, eye disease history, and WHO clinical staging were the significant factors. Early eye checkups and regular ocular examinations of HIV patients would be helpful.Keywords: ocular manifestation, HIV/AIDS, Gondar, Ethiopia

Abstract Background Cervical cancer is a major public health problem affecting women worldwide. It is the second cause of mortality among women in Ethiopia. Early Cervical cancer screening has a tremendous impact on reducing morbidity and mortality related to cervical cancer infection. Therefore, this study aimed to assess cervical cancer screening utilization and associated factors among women attending Antenatal Care at Asella referral and teaching hospital, Arsi Zone, south-central Ethiopia. Method This study employed a facility-based cross-sectional study among 457 Antenatal Care mothers from December 2020 to February 2021. Data collection was performed using interviewer-administered structured questionnaires. Data were entered into EpiInfo Version 7 and transferred to SPSS V.21 for analysis. A logistic regression model was used to determine the factors associated with cervical cancer screening utilization and an adjusted odds ratio with a 95% confidence interval at p-value

Oldeania alpina (highland) and Oxytenanthera abyssinica (lowland) bamboo are two indigenous bamboo species and are vigorous in highland and lowland agro-ecologies, respectively. They have enormous socioeconomic, ecological, and traditional roles in the community. We address bamboo plantations and their distribution, identify factors influencing bamboo planting and marketing, and assess the role of bamboo for smallholder farmers and customers in Ethiopia. We also examine planting and management practices, governance, and challenges and opportunities for bamboo production and marketing. The decisions to plant bamboo are influenced by many demographic and socioeconomic factors, such as age, educational status, family size, income, farm size, land scarcity, bamboo culm price, and market information. They are also influenced by institutional factors, including market distance, marketing linkages, access to markets, tenure security, and psychological factors such as the perception of risk and attitude towards bamboo production. Bamboo plays a variety of socio-economic, ecological, and traditional roles in the community. It is one of the essential components of agricultural tasks and practices for most households and provides considerable cash income. For instance, it provides material for house and fence construction, furniture, wood fuel, and musical instruments. It is used as a source of food, medicine, and fodder and also for soil and water conservation, biodiversity functioning, and mitigating global climate change, as well as an alternative source of timber and non-timber products for rural and urban people, forest industries, construction, and energy sectors. Despite this, its significance has been affected by deforestation and degradation, overexploitation, increased agricultural investment, and social issues. Although there is a positive policy environment, there is still a lack of coordination, overlap of roles and responsibilities, and limited dedicated manpower and resources in the bamboo sector, as well as limited government support for the value chain development of the sector. Creating an enabling market environment and constructing a value chain are critical for the development of the sector. Furthermore, the selection of higher-quality bamboo landraces, extension support, and the local application of the established regulations are all critical.

Abstract Poor diet quality related to inadequate complementary feeding is a major public health problem in low and middle‐income countries including Ethiopia. Low dietary diversity has been linked to negative health outcomes in children. To provide a package of interventions to close nutritional gaps through agriculture, the Sustainable Undernutrition Reduction in Ethiopia (SURE) programme was set up as a multi‐sectoral initiative and the results of combined effects of community‐based and enhanced nutrition services, compared to community‐based alone, on diet diversity and diet quality of complementary feeding of young children are presented. The study used pre‐ and post‐intervention design. Baseline (n = 4980) data were collected from May to July 2016, and follow‐up (n = 2419) data from December 2020 to January 2021. From 51 intervention districts having the SURE programme, 36 intervention districts were randomly selected for baseline and 31 for the follow‐up survey. The primary outcome was diet quality: minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). Comparing endline to baseline over the 4.5‐year intervention, the use of standard community‐based nutrition services of growth monitoring and promotion increased (16%–46%), as did enhanced nutrition services of infant and young child feeding counselling, and agricultural advising (62%–77%). Women involved in home gardening significantly increased (73%–93%); however, household production of food decreased yet consumption of most own‐grown foods increased. Importantly, MAD and MDD increased four‐fold. The SURE intervention programme was associated with improvements in complementary feeding and diet quality through enhanced nutrition services. This suggests programmes targeted at nutrition‐sensitive practices can improve child feeding in young children.

Objective This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019.Design This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI).Study setting The study includes nine region states and two chartered cities of Ethiopia.Outcome measures We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates.Results In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6–8918), 59.4 (95% UI 49.8–71.4) and 2404.5 (95% UI 2059.4–2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions—Benishangul-Gumuz 101.8 (95% UI 84.0–121.7) and Afar 103.7 (95% UI 86.6–122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country.Conclusion In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.