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IntroductionEthiopia has made notable progress in reducing maternal and perinatal mortality, yet challenges remain in meeting the 2030 Sustainable Development Goals. Persistent issues such as low service utilization, coupled with poor quality, fragmented care, and ineffective referral systems hinder progress. The "Improve Primary Health Care Service Delivery (IPHCSD)" project, implemented by JSI and Amref Health Africa since April 2022, seeks to address these gaps through a Networks of Care (NoCs) approach. This paper describes the lessons learned from implementing the NoCs approach to optimize primary health care in Ethiopia.MethodsThe project incorporates embedded implementation science, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Key implementation strategies co-designed included strengthening community engagement, establishing NoCs, and introducing quality improvement initiatives using the Model for Improvement. Routine program monitoring data, NoCs process evaluation, and facility service statistics were utilized for this study. Service statistics were analyzed using Student's t-test and interrupted time-series analysis to compare maternal and child care outcomes before and after the NoCs intervention, with counterfactual estimates generated to assess the intervention's impact. Qualitative data from key informant interviews were transcribed, coded, and analyzed to identify themes and patterns using Atlas.ti.ResultsThe NoCs approach has significantly enhanced relational linkages between primary health care facilities and health care providers, fostering stronger collaboration and communication. This has fostered trust, improved care coordination, optimized primary health care performance, and increased health service utilization within woreda health systems. The interrupted time series analysis indicated that the rate of ANC 8+ visits was 29.8% per month higher than expected without the NoCs strategy (Coef: 2.39; p-value < 0.01) and an 18.4% increase in obstetric complications managed (Coef: 1.71; p-value = 0.050), with a 43% overall increase. Perinatal mortality decreased by 34%, from 31.3 to 20.1 per 1,000 births [t-test: 2.12; p-value: 0.040)].ConclusionThe NoCs approach in Ethiopia has proven effective in enhancing the relational elements, care coordination, and quality of primary health care services, leading to better maternal and child health outcomes. The findings expand the existing body of research on NoCs implementation best practices and further confirm that it provides a scalable model for strengthening health services in low-resource settings.

BackgroundDespite a higher rate of breast cancer in sub-Saharan Africa (SSA), efforts to treat the disease through breast cancer screening are suboptimal, resulting in late diagnosis of breast cancer and poor outcomes. Several studies have been conducted in SSA countries about screening uptake, yet they addressed country or sub-country level data and did not consider both individual and beyond-individual factors related to screening. Hence, pooled prevalence as well as multilevel correlates of screening in the region is sparse, which have been addressed by this study using the most recent data among women with SSA.MethodsThis study was conducted using the Demographic Health Survey data (2013–2022) from six countries, and a total weighted sample of 95,248 women was examined. STATA version 16 was used for the data analysis. Multilevel mixed-effects logistic regression was performed and significant predictors were reported using adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).ResultsThe overall weighted prevalence of clinical breast cancer screening was 14.23% (95% CI: 13.97–14.75), with Namibia and Tanzania having the highest (24.5%) and lowest (5.19%) screening rates, respectively. Higher breast cancer screening uptake was observed among women of advanced age (35–49) [aOR = 1.78; 95% CI: 1.60, 1.98], had higher educational levels [aOR = 1.84; 95% CI: 1.66, 2.03], cohabited [aOR = 1.37; 95% CI: 1.21, 1.55], in the richest wealth quintile [aOR = 2.27; 95% CI: 1.95, 2.64], urban residents [aOR = 1.21; 95%CI: 1.10, 1.33], multiparous [aOR = 1.47; 95% CI: 1.30, 1.68], visited health facilities [aOR = 1.64; 95% CI: 1.52, 1.76], and read newspapers [aOR = 1.78; 95%CI: 1.60, 2.15].ConclusionThe prevalence of clinical breast cancer screening was low (14%). Strengthening awareness campaigns, improving healthcare infrastructure, health education, universal health coverage, and screening program access, with a focus on rural areas, women who lack formal education, and low socioeconomic status, are critical to increasing breast cancer screening rates and equity. Scale-up local and regional collaborations and the involvement of media agencies in the implementation of screening programs, advocacy, dissemination of information, and integration of screening programs with their routine care, such as perinatal care, can boost the screening. The existing health service delivery points also need to focus on integrating breast cancer screening services with routine care such as perinatal care.

BackgroundDespite the Ethiopian government included the Pneumococcal Conjugate Vaccine (PCV) in the national expanded program for immunization in 2011, only 56% of children aged 12–23 months received the full dose of PCV. Despite some studies on PCV uptake in Ethiopia, there was a dearth of information on the geographical distribution and multilevel factors of incomplete PCV uptake. Hence, this study aimed to identify the spatial variations and predictors of incomplete PCV uptake among children aged 12–35 months in Ethiopia.MethodsThe study was based on an in-depth analysis of 2016 Ethiopia Demographic Health Survey data, using a weighted sample of 3,340 women having children aged 12–35 months. Arc-GIS version 10.7 and SaTScan version 9.6 statistical software were used for the spatial analysis. To explore spatial variation and locate spatial clusters of incomplete PCV, the Global Moran's I statistic and Bernoulli-based spatial scan (SaTScan) analysis were carried out, respectively. A multilevel mixed-effect multivariable logistic regression was done by STATA version 16. Adjusted odds ratio (AOR) with its corresponding 95% CI was used as a measure of association, and variables with a p < 0.05 were deemed as significant determinants of incomplete PCV.ResultsThe overall prevalence of incomplete PCV in Ethiopia was found to be 54.0% (95% CI: 52.31, 55.69), with significant spatial variation across regions (Moran's I = 0.509, p < 0.001) and nine most likely significant SaTScan clusters. The vast majority of Somali, southeast Afar, and eastern Gambela regions were statistically significant hot spots for incomplete PCV. Lacking ANC visits (AOR = 2.76, 95% CI: 1.91, 4.00), not getting pre-birth Tetanus injections (AOR = 1.84, 95% CI: 1.29, 2.74), home birth (AOR = 1.72, 95% CI: 1.23, 2.34), not having a mobile phone (AOR = 1.64, 95% CI: 1.38, 1.93), and residing in a peripheral region (AOR = 4.63; 95% CI: 2.34, 9.15) were identified as statistically significant predictors of incomplete PCV.ConclusionThe level of incomplete PCV uptake was found to be high in Ethiopia with a significant spatial variation across regions. Hence, the federal and regional governments should collaborate with NGOs to improve vaccination coverage and design strategies to trace those children with incomplete PCV in peripheral regions. Policymakers and maternal and child health program planners should work together to boost access to maternal health services like antenatal care and skilled delivery services to increase immunization coverage.

Introduction: Globally, over 90 % of newborns’ HIV infections occur through mother-to-child transmission. However, only 50 % of pregnant women living with HIV received effective antiretroviral regimens. So, this study aimed to assess poor adherence to option B+ care and associated factors for the prevention of mother-to-child transmission among pregnant and lactating mothers attending ART clinics in Southwestern Ethiopia. Methods and materials: An institution-based cross-sectional study was conducted with a sample of 284 HIV+ pregnant and lactating mothers who were on the PMTCT follow-up in ART clinics in southwest Ethiopia. The data were entered using EPI Data Version 3.1 and exported to SPSS Version 25 for further analysis. Binary logistic regression models were employed to identify associated factors for poor adherence to option B+ care of PMTCT using AOR with the corresponding 95 % CI. Result: The level of poor adherence to option B+ care in PMTCT was 12.6 %. The study showed that disclosure status [AOR: 0.16 [95 % CI; 0.05, 0.49]], forgetfulness [AOR = 10.5; 95 % CI [3.8, 29.5]], fear of drug side effects [AOR: 3.97 [95 % CI: [1.1, 10.4]], and fear of stigma and discrimination [AOR: 6.7, 95 % CI: [2.5, 17.7]] were significantly associated with adherence to option B+ care. Conclusions: The prevalence of poor adherence to option B+ care in this study was high. Fear of drug side effects, fear of stigma and discrimination, forgetfulness, and disclosure status were factors significantly associated with adherence to option B+ care. Proper counseling and awareness creation on drug adherence were strongly recommended.

BackgroundActive trachoma is a highly contagious ongoing stage of trachoma that predominantly occurs during childhood in an endemic area. This study assessed the prevalence and factors associated with active trachoma among school-aged children.Methodology/principal findingsA community-based analytical cross-sectional study was done from March 1st to June 30th, 2021, in Southwest Ethiopia's people's regional state. A total of 1292 school-aged children were surveyed. The quantitative data were collected using a pre-tested, structured interview-based questionnaire and observation check list. The World health organization (WHO) simplified trachoma grading system was used to assess stages of trachoma. In this study, the prevalence of active trachoma was 570(44.1%), 95% CI (41.4, 46.9). Also, age group 6-10; being female; flies at household (HH), flies on child's face, improved water source, improved sanitation, presence of ocular discharge, presence of nasal discharge, and unclean faces of the child were significantly associated with active trachoma.Conclusions/significanceThe very high prevalence of active trachoma in the study area is significantly associated with; age group 6-10, female gender, presence of flies in household and on child's face, presence of ocular and nasal discharge, unclean faces, improved water source, improved sanitation in the household. Thus, environmental sanitation and facial cleans trachoma elimination strategy should be intensified in the study area.

Abstract Background High prevalence of Human Immune virus/Acquired immunodeficiency syndrome (HIV/AIDS) in Female Sex Workers (FSWs) is identified as a bottleneck in fighting against HIV/AIDS. To this end, the international community planned a strategy of 'Ending inequality' and 'Ending the AIDS epidemic' by 2030. This could not be achieved without due attention to FSWs. Thus, this study attempted to assess HIV prevention behavior and associated factors among FSWs in Dima district of Gambella region, Ethiopia by using the Health Belief Model. Methods A community-based cross-sectional study was conducted from March to May 2019 among 449 FSWs selected using the snowball sampling technique. Socio-demographic features, knowledge about HIV, attitude toward HIV prevention methods, and Health Belief Model (HBM) constructs (perceived susceptibility to and severity of HIV, perceived barriers, and benefits of performing the recommended HIV prevention methods, self-efficacy, and cues to practice HIV prevention methods) were collected using face to face interview. Data were entered into Epi-data 3.1 and analyzed using SPSS version 23. Bivariable and multivariable binary logistic regression analysis was done to identify the association between dependent and independent variables. P-value

Abstract Background Although studies on the uptake of Adolescent sexual and reproductive health (ASRH) services in Ethiopia have been conducted they have failed to show the disparity in service uptake among rural and urban settings. Once the extent and determinants of ASRH service uptake in urban and rural contexts are known, it will be crucial to provide evidence-based information and recommendations for potential interventions to reduce the burden of disease and disability among adolescents. This study aimed at determining the level of SRH service utilization among urban and rural adolescents in the Guraghe zone, Southern Ethiopia. Methods A community-based comparative cross-sectional study was undertaken from November 1 –30, 2020. A multi-stage sampling technique was employed and a total of 1083 adolescents (361 from the urban and 722 from the rural areas) were selected randomly to take part in the study. Pre-tested, interviewer-administered, structured questionnaires were used to collect the data. The data were encoded and entered into Epi-Data version 3.1 and then exported to SPSS version 23 for analysis. χ2 test was computed to see a significant difference in SRH service utilization among urban and rural adolescents. In a bivariable logistic regression analysis, a variable with a p-value less than 0.25 has been selected for a multivariable logistic regression model. Variables with p-values less than 0.05 were declared statistically significant in multivariate logistic regression. Results A total of 1,075 adolescents (358 from urban and 717 from rural) took part in the study, yielding a response rate of 99.3%. The overall SRH service utilization among the whole adolescents was 39.5% (95%CI: 36.5, 42.4). There was a significant difference in SRH service utilization between urban 56.9% (95%CI: 51.8, 62.1) and rural 30.8% (95%CI: 27.4, 34.2) adolescents (χ2 = 68.3, p

BackgroundLow women empowerment, is a known contributing factor to unmet needs for contraception by limiting access to health services through negative cultural beliefs and practices. However, little is known about the association between unmet needs and domains of women empowerment in Sub-Saharan African (SSA) countries. Hence, this study aimed at assessing the influence of women empowerment domains on the unmet need for contraception in the region using the most recent Demographic and Health Survey (DHS) data (2016-2021).MethodsThe data for the study was derived from the appended women's (IR) file of eighteen SSA countries. A weighted sample of 128,939 married women was analyzed by STATA version 16. The Harvard Institute's Gender Roles Framework, which comprised of influencer, resource, and decision-making domains was employed to identify and categorize the covariates across three levels. The effects of each predictor on the unmet need for spacing and limiting were examined using a multivariable multilevel mixed-effect multinomial logistic regression analysis. Adjusted relative risk ratio (aRRR) with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables.ResultsThe pooled prevalence of unmet needs for contraception was 26.36% (95% CI: 24.83-30.40) in the region, with unmet needs for spacing and limiting being 16.74% (95% CI: 16.55, 17.02) and 9.62% (95% CI: 9.45, 12.78), respectively. Among variables in the influencer domain, educational level, family size of more than five, parity, number of children, attitude towards wife beating, and media exposure were substantially linked with an unmet need for spacing and limiting. Being in the poorest wealth quintile and enrollment in health insurance schemes, on the other hand, were the two variables in the resource domain that had a significant influence on unmet needs. The overall decision-making capacity of women was found to be the sole significant predictor of unmet needs among the covariates in the decision-making domain.ConclusionUnmet needs for contraception in SSA countries were found to be high. Reproductive health program planners and contraceptive service providers should place due emphasis on women who lack formal education, are from low-income families, and have large family sizes. Governments should collaborate with insurance providers to increase health insurance coverage alongside incorporating family planning within the service package to minimize out-of-pocket costs. NGOs, government bodies, and program planners should collaborate across sectors to pool resources, advocate for policies, share best practices, and coordinate initiatives to maximize the capacity of women's decision-making autonomy.

BackgroundIn many low- and middle-income countries (LMIC), men are the key decision-makers and chief providers, often determining women's access to economic resources and maternal health services. Despite the important role of men in maternal healthcare, the involvement of male partners in maternal and child health in LMIC, including Ethiopia, is low.ObjectivesThis study aims to assess the extent of male involvement and associated factors in antenatal care (ANC) service utilization in the Bench Sheko zone, Southwest, Ethiopia.MethodsA community-based, cross-sectional study was conducted in the Bench Sheko zone from February to May 2021. A multistage sampling technique was employed to select study participants. Variables with p-values

BackgroundVirological failure remains a public health concern among patients with human immunodeficiency virus (HIV) after treatment initiation. Ethiopia is one of the countries that aims to achieve the global target of 90-90-90 that aims to achieve 90% virological suppression, but there is a paucity of evidence on the determinants of virological failure. Therefore, the study is intended to assess determinants of virological treatment failure among patients on first-line highly active antiretroviral therapy (HAART) at Mizan Tepi University Teaching Hospital (MTUTH), Southwest Ethiopia.MethodA hospital-based unmatched case-control study was conducted from 11 November to 23 December 2020, among 146 cases and 146 controls. All cases and controls were selected randomly using computer-generated random numbers based on their medical record numbers. During the document review, data were collected using checklists, entered into Epi-data version 4.0.2, and analyzed by SPSS version 25. A multivariable logistic regression analysis was done to identify the independent determinants of virological treatment failure.ResultsIn this study, being male (adjusted odds ratio (AOR) = 1.89, 95% CI: 1.04, 3.47), substance use (AOR = 2.67, 95% CI: 1.40, 4.95), baseline hemoglobin (Hgb) < 12 mg/dl (AOR = 3.22, 95% CI: 1.82, 5.99), poor drug adherence (AOR = 3.84, 95% CI: 1.77, 5.95), restart ART medication (AOR = 2.45, 95% CI: 1.69, 7.35), and opportunistic infection (OI) while on HAART (AOR = 4.73, 95% CI: 1.76, 12.11) were determinants of virological treatment failure.ConclusionThe study revealed that the sex of the patient, history of substance use, baseline Hgb < 12 mg/dl, poor drug adherence, restart after an interruption, and having OI through the follow-up period were determinants of virological failure. Therefore, program implementation should consider gender disparity while men are more prone to virological failure. It is also imperative to implement targeted interventions to improve drug adherence and interruption problems in follow-up care. Moreover, patients with opportunistic infections and restart HAART need special care and attention.

BackgroundChildhood overweight and obesity are emerging public health challenges of the twety-first century. There was a 24% increase in the number of overweight children under the age of 5 years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children.MethodsThis study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019 and June 28, 2019. Both descriptive and analytic findings were produced. The overweight/obesity was measured by the weight-for-height (WFH) index, more than two standard deviations (+2 SD) above the median of the reference population based on the BMI Z-score. To identify significantly assoResultsA total of 5,164 under-five children were included in this study cited factors of overweight/obesity, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI) was reported to show the strength of association and statistical significance. The overall prevalence of overweight/obesity was 2.14% (95% CI: 1.74–2.53). The odds of overweight/obesity was higher among children aged

Background: Delayed tuberculosis (TB) diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control. Objective: The main objective of this study was to assess the magnitude and factors associated with health system delay among tuberculosis patients in Gamo Zone, Southern Ethiopia. Methods: A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities in the study area were selected randomly and 255 TB patients who were ≥ 18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Health system delay was analyzed using the median as a cut-off. Logistic regression analysis was performed to investigate factors of delays. A p-value of ≤ 0.05 at multivariable analysis was considered statistically significant. Results: The median (inter-quartile range) of health system delays was 14(6–30) days. About 54.5% of patients had prolonged health system delays. Patients who had multiple healthcare contacts (AOR: 5.74; 95% CI: 2.47, 13.34) and aged between 25 and 44 years old (AOR: 1.98; 95% CI: 1.02, 3.86) and aged ≥ 45 years (AOR: 3.54; 95% CI: 2.17, 14.27) were significantly associated with longer health system’s delay. However, female gender (AOR: 0.46; 95% CI: 0.25, 0.87) and patients presenting symptoms [Hemoptysis (AOR: 0.27; 95%CI: 0.11, 0.65) and Chest pain (AOR: 0.28; 95%CI; 0.14, 0.56)] were significantly associated with reduced health system’s delay. Conclusion: In this study, it was observed that a significant proportion of patients experienced more than the acceptable level for health system delay. The number of health care contact, presenting symptoms, age and sex were factors associated with health system delay. Hence, increasing clinician awareness of TB clinical presentation, implementing systems enabling early case detection, and ensuring rapid diagnosis of TB are required to achieve further TB control. Finally, maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long health system delays in the management of TB.

BackgroundAdequate sleep is vital for physical and mental wellbeing. Sleep-related problems including poor quality of sleep have been increasing throughout the world among reproductive-aged women. Poor sleep quality has been related with number of diseases and health problems However, evidences are scarce regarding poor sleep quality and its associated factors among women of the reproductive age group in Ethiopia.ObjectiveTo assess sleep quality and associated factors among women of reproductive age group in Mizan Aman town, Southwest Ethiopia.MethodCommunity-based cross-sectional study was conducted among 606 reproductive-aged women from 06 November to 20 December 2020, in Mizan Aman town. Data were collected using structured interview administered questionnaires. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Multivariable logistic regression was applied using an adjusted odds ratio with a corresponding 95% confidence interval to evaluate the statistical significance of associated factors.ResultThe overall prevalence of poor sleep quality was 71.3%. The late age group of 42–49 (AOR, 95% CI; 1.21 (1.08–5.76), palpable/visible thyroid gland (AOR, 95% CI; 2. 12 (1.08–3.82), current substance use (AOR, 95% CI; 1.76 (1.11–6.10) and having premenstrual syndrome (AOR, 95% CI; 1.86 (1.38–3.12) were significantly associated with poor sleep quality among reproductive age group women.ConclusionSignificant majority of reproductive age group women faced poor sleep quality. Therefore, screening of sleep patterns among this particular age group is warranted. Moreover, education about sleep hygiene needs to be given considering the identified factors to improve sleep quality.

Background: Implanon discontinuation before the recommended time is problematic, as it puts women at risk of unwanted pregnancies and unsafe abortions, along with negative maternal health outcomes. Although the magnitude and determinants of Implanon discontinuation have been studied in Ethiopia, the results were inconsistent, with significant variability. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of Implanon discontinuation and its determinants in Ethiopia. Methods: A comprehensive search of studies published before 18 February 2022 was done using electronic databases such as PubMed, Embase, Google Scholar, Scopus, Web of Science, Science Direct, and Cochrane Library. The relevant data were extracted using a Microsoft Excel 2013 and analyzed using STATA Version 16. A random-effect meta-analysis model was used to compute pooled prevalence and odds ratio. The Cochrane Q test statistics and I 2 tests were used to assess the heterogeneity of the included studies. A funnel plot, Begg’s, and Egger’s tests were used to check for the presence of publication bias. Results: A total of 11 studies with 4320 study participants were included in this meta-analysis. The overall pooled prevalence of Implanon discontinuation in Ethiopia was found to be 32.62% (95% confidence interval = 24.10, 41.13). There was significant heterogeneity among the included studies ( I 2 = 97.4%, p

Background Respectful maternity care is the provision of woman-centered health care during childbirth that is friendly, abuse-free, timely, and discrimination-free. Although several epidemiological studies on the magnitude and determinants of Respectful maternity care in Ethiopia have been conducted, the results have been inconsistent and varied. This makes drawing equivocal conclusions and evidence at the national level harder. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of respectful maternity care and its determinants in Ethiopia. Methods Studies conducted from 2013 to June 30, 2022, were searched by using PubMed, Google Scholar, Science Direct, Scopus, ProQuest, Web of Science, Cochrane Library, and Direct of Open Access Journals. Searching was carried out from May 15- June 30, 2022. In total, sixteen studies were considered in the final analysis. The data were extracted using Microsoft Excel and analyzed using STATA 16 software. The methodological quality of included studies was assessed by using Joanna Briggs Institute’s critical appraisal checklist for prevalence studies. To estimate the pooled national prevalence of respectful maternity care, a random effect model with a DerSimonian Laird method was used. To assess the heterogeneity of the included studies, the Cochrane Q test statistics and I2 tests were used. To detect the presence of publication bias, a funnel plot and Begg’s and Egger’s tests were used. Results Sixteen studies were eligible for this systematic review and meta-analysis with a total of 6354 study participants. The overall pooled prevalence of respectful maternity care in Ethiopia was 48.44% (95% CI: 39.02–57.87). Receiving service by CRC-trained health care providers [AOR: 4.09, 95% CI: 1.73, 6.44], having ANC visits [AOR: 2.34, 95% CI: 1.62, 3.06], planning status of the pregnancy [AOR = 4.43, 95% CI: 2.74, 6.12], giving birth during the daytime [AOR: 2.61, 95% CI: 1.92, 3.31], and experiencing an obstetric complication[AOR: 0.46, 95% CI: 0.30, 0.61] were identified as determinants of RMC. Conclusion As per this meta-analysis, the prevalence of respectful maternity care in Ethiopia was low. Managers in the health sector should give due emphasis to the provision of Compassionate, Respectful, and Care(CRC) training for healthcare providers, who work at maternity service delivery points. Stakeholders need to work to increase the uptake of prenatal care to improve client-provider relationships across a continuum of care. Human resource managers should assign an adequate number of health care providers to the night-shift duties to reduce the workload on obstetric providers.

Background: In Ethiopia, the human papillomavirus vaccine has been introduced since 2018. Since the vaccination program targets girls age 9–13, the success of vaccination depends on the parental decision and their willingness to vaccinate their daughters. Therefore, a study on parental willingness to vaccinate their daughter and factors associated is needed. Objective: To assess parent's willingness to vaccinate their daughter against the human papillomavirus and its associated factors in Bench-Sheko Zone, southwest Ethiopia. Methods: A community-based cross-sectional study was conducted among 502 participants in Bench-Sheko Zone, southwest Ethiopia. The participants were selected using a systematic random sampling method. Frequency tables, mean and standard deviation were used to summarize the data. A binary logistic regression using bivariate and multivariable logistic regression analysis was used to identify factors associated with parental willingness to vaccinate their daughter. The level of significance was declared at P-value < 0.05. Results: Of the 502 participants interviewed, 399 (79.5%), 95% CI (76%, 83%) of parents were willing to vaccinate their daughter. The study found that primary education and above (AOR = 2.9, 95% CI [1.79, 4.95]), having good knowledge (AOR = 2.1, 95% CI [1.15, 4.10]) and positive attitude (AOR = 2, 95% CI [1.30, 3.41]) were significantly associated with parental willingness to vaccinate their daughter. Conclusion: This study found that there was a high parental willingness to vaccinate their daughter against the human papillomavirus in the study area. Primary education and above, having good knowledge and positive attitude were factors associated with parental willingness to vaccinate their daughter. Therefore, providing health information's regarding human papillomavirus vaccination with emphasis to raise community awareness should be designed especially less educated parents need to be targeted.

BackgroundDelayed tuberculosis diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control. Therefore, the main objective of this study was to assess the magnitude and factors associated with patient delay among tuberculosis patients in Gamo Zone, Southern Ethiopia.MethodsA cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities of the study area were selected randomly and 255 TB patients who were ≥18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Patient delay was analyzed using the median as the cut-off value. Multivariable logistic regression analysis was fitted to identify factors associated with patient delay. A p-value of ≤ 0.05 with 95% CI was considered to declare a statistically significant association.ResultsThe median (inter-quartile range) of the patient delay was 30 (15-60) days. About 56.9% of patients had prolonged patients' delay. Patient whose first contact were informal provider (adjusted odds ratio [AOR]: 2.24; 95% confidence interval [CI] 1.29, 3.86), presenting with weight loss (AOR: 2.53; 95%CI: 1.35, 4.74) and fatigue (AOR: 2.38; 95%CI: 1.36, 4.17) and body mass index (BMI) categories of underweight (AOR: 1.74; 95%CI: 1.01, 3.00) were independently associated with increased odds of patient delay. However, having good knowledge about TB (AOR: 0.44; 95% CI: 0.26, 0.76) significantly reduce patients' delay.ConclusionIn this study, a significant proportion of patients experienced more than the acceptable level for the patient delay. Knowledge about TB, the first action to illness, presenting symptoms, and BMI status were identified factors associated with patient delay. Hence, raising public awareness, regular training, and re-training of private and public healthcare providers, involving informal providers, and maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long delays in the management of TB.

Background. Abnormal body mass index (BMI ≥ 25 kg/m2) has become a major global public health problem which is rising at a faster rate in urban areas of low- and middle-income countries. In Ethiopia, the prevalence gradually increases. Long-distance truckers are at a high risk of developing overweight or obesity due to the sedentary nature of their job. Despite these populations at a high risk of developing overweight/obesity such as drivers elsewhere, pieces of data that showed the prevalence and contributing factors of overweight and obesity among long-distance truckers in Ethiopia are not yet available. Objective. To assess the prevalence and contributing factors of overweight and obesity among long-distance truckers in Ethiopia. Methods. A cross-sectional study was conducted among 400 systematically selected truckers at Modjo dry port in Ethiopia from February to March, 2018. Data were collected through face-to-face interviews using a structured questionnaire. The final results were presented in tables and numerical summary measures such as mean and standard deviation (SD). Results. Of the 400 truckers interviewed, the prevalence of overweight and obesity was 56.5%, 95% CI (51.6%–61.4%). The study also found that a monthly income ≥220 USD (AOR = 1.83, 95% CI (1.05–3.18)), having 3 or more family sizes (AOR = 2.24, 95% CI (1.15–4.36)), less than 6 hours of sleep at night (AOR = 3.34, 95% CI (1.99–5.78)), driving for 9 or more hours daily (AOR = 2.29, 95% CI (1.09–4.81)), and a truck driving experience of 10 or more years (AOR = 2.13, 95% CI (1.29–4.18)) were significantly associated with overweight and obesity. Conclusion. The prevalence of overweight and obesity was substantially high. The study also found that sociodemographic and occupational factors are mainly associated with overweight and obesity. Therefore, a health education program should be designed for awareness creation on the importance of reducing a sedentary lifestyle, consuming healthy foods or drinks, and having regular physical exercise to mitigate the problem.

Trypanosomosis is one of the most economically challenging diseases affecting mammals, and it is a serious haemoprotozoan disease caused by different species of unicellular eukaryotic parasite of the genus trypanosome. The study was conducted to access the prevalence of bovine trypanosomosis, its associated risk factors, and vector density on cattle reared in three selected districts, namely, Chewaka, Dabo Hana, and Meko districts. Blood was collected from a total of 1046 cattle of age groups extending from 1 to 6 years. The buffy coat technique was used to check the presence of parasites from sampled blood, and the trypanosome species were identified using Giemsa-stained thin blood films. The packed cell volume of sampled blood was determined using the haematocrit. A total of 160 traps were deployed to study the entomological survey. Generally, 3.44% of the studied animal was infected with trypanosomosis, and T. vivax was the dominant species of trypanosomosis in the study areas. Significant differences (P