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Rahel Mezemir,1,2 Oladapo Olayemi,3 Yadeta Dessie4 1Pan African University, Life and Earth Sciences Institute (Including Health and Agriculture), Ibadan, Nigeria; 2St. Paul’s Hospital Millennium Medical College, School of Nursing, Addis Ababa, Ethiopia; 3Department of Obstetrics and Gynecology, College of Medicine, Pan African University Life and Earth Sciences Institutes, University of Ibadan, Ibadan, Nigeria; 4College of Health and Medical Sciences Haramaya University, Harar, EthiopiaCorrespondence: Rahel Mezemir, Tel +251 911553348, Email rahelmezemir7@gmail.com; rahel.mezemir@sphmmc.edu.etBackground: Surgical site infections (SSI) after cesarean section are common in Ethiopia and result in maternal morbidity, mortality, hospitalization, and medical costs. This study aimed to determine the incidence, bacterial profile, and associated factors of surgical site infection after cesarean section (CS) in public and private referral hospitals.Methods: A prospective observational cohort study was conducted on 741 pregnant women who underwent CS from July to September 2022. Women who had CS were followed up for at least 30 days. Infected wound specimens from those who had SSIs were collected and bacteriologically analyzed. The data were analyzed with SPSS version 25. The logistic regression model assessed the relationship between the independent variable and the outcome with 95% confidence interval.Results: The incidence of post-cesarean surgical site infection was 11.6% (95% Cl: 9.4, 13.6). Staphylococcus aureus was the most common bacteria in CS wounds 10 (21.2%). Two to three antenatal care visits (ANC) (AOR: 3.11, 95% CI: 1.69, 5.75), delayed antenatal booking (AOR: 6.99, 95% CI: 2.09, 23.32), membrane rupture (AOR: 2.10, 95% CI: 1.04, 4.24), multiple vaginal examinations (AOR = 4.21, 95% CI: 1.35, 6.92) and public hospitals (AOR: 11.1, 95% CI: 1.48, 45, 14) were associated with increased risk of SSI after CS, in contrary shorter hospital stays (AOR = 0.37, 95% CI: 0.15, 0.91) and transversal incisions (AOR = 0.38, 95% CI: 0.15, 0.91) were associated with lower risk SSI after CS.Conclusion: The incidence of SSI after CS was high. Delayed antenatal booking, two to three antenatal visits, multiple vaginal exams, membrane rupture, vertical incision, longer postoperative hospital stays, and procedures in public hospitals were associated with increased risk of SSI after CS. Therefore, intervention programs should focus on post-discharge surveillance and identification of risk to reduce and prevent SSI after CS rate.Keywords: incidence, surgical site infection, cesarean section, bacterial, Addis Ababa

Samrawit Shawel,1 Behailu Hawulte Ayele,1 Yadeta Dessie,1 Abera Kenay Tura,2 Gimaye Dinsa,1,3 Abainash Tekola,1 Miheret Mandefro,1 Awoke Masrie,1 Aklilu Tamire,1 Obsan Kassa Tefasa1 1School of Public Health, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia; 3School of Population and Public Health, University of British Columbia, Vancouver, CanadaCorrespondence: Samrawit Shawel, Tel +251 913 705 953, Email samrishas@gmail.comBackground: Pregnant women face high costs for health-care services despite being advertised as free. These costs include non-medical expenses, lost productivity, difficulties caring for family members, and long-term financial impact from complications. Limited research has been done on the cost burden of maternal services and complications, despite numerous studies on maternal health service provision. This is notable considering the government’s claim of providing free maternal health-care services.Methods: A cross-sectional study was conducted in July (1– 30) 2022 among 425 randomly selected mothers in Harari and Dire Dawa City, Eastern Ethiopia. Data were collected through structured questionnaires and medical record reviews. The collected data was entered into Epi-Data version 3.02 and analyzed using STATA version 14.0 after data cleaning. Descriptive statistics and linear regression analysis were used to examine the data, ensuring assumptions of linearity, independence, homoscedasticity, and normality were met. The correlation coefficient was used to assess the strength of the association.Results: The median cost of maternal complications was around 4250 ETB (81.3 USD; IQR = 2900– 5833.3), factors that predicted cost were monthly family income of ≥ 3001 birr (β=1.13; 95% CI: 1.00, 1.26), distance from hospital (β=0.73; 95% CI = 0.64– 0.83), being admitted for less than 4 days (β=0.60; 95% CI = 0.53– 0.69), accompanied by relatives besides their husbands (β=1.93; 95% CI = 1.52– 2.46), caesarian sections delivery (β=1.17; 95% CI = 1.04– 1.31), and giving birth to a normal baby (β=0.86; 95% CI = 0.77– 0.97).Conclusion: Maternal complications incur significant costs, with factors such as family income, travel time, hospital stay, caregiver presence, mode of delivery, and neonatal outcome predicting these costs. The Ethiopian health system should address the additional expenses faced by mothers with complications and their caregivers.Keywords: direct cost, indirect cost, medical-cost, maternal complication, Eastern Ethiopia

Meseret Alemu,1 Girmay Adhena,2 Nega Assefa,3 Yadeta Dessie3 1Department of Reproductive Health, Lemmo District Health Office, Hossana, Southern Ethiopia; 2Department of Reproductive Health, International Medical Corps, Gambella, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Girmay Adhena, Email girmayrh@gmail.comBackground: Male partner involvement in reproductive health services is an important strategy to decrease maternal and child morbidity and mortality. Despite this, little attention is given to this issue around the globe, particularly in Africa, where male dominance is high. This study aimed to assess male partner involvement in institutional delivery services in Lemmo district, Southern Ethiopia.Methods: A community-based cross-sectional study was conducted among 614 male participants. A multistage sampling technique was used to select study samples. A structured, pretested, and interviewer-administered questionnaire was used to collect the data. Male involvement in institutional delivery was measured using six yes or no items. The participants were asked if they communicated with relatives and health care providers, saved money, arrange transportation, decide to give birth at an institution, and arrange blood donation. Binary and multivariable logistic regression was used to identify associated factors. An adjusted odds ratio with 95% CI was used to show the strength and direction of the association. Variables with a p-value < 0.05 were considered statistically significant.Results: A total of 251 (43.1%, 95% CI: (39.2, 46.9)) male partners were involved in the institutional delivery services of their partner. Primary educational level [AOR=2.2, 95% CI: (1.361, 3.532)], secondary and above educational level [AOR=2.4, 95% CI: (1.46, 4.01)], having good knowledge [AOR=3 (95% CI: (2, 4.49)], positive perception [AOR=3.66, 95% CI: (2.45, 5.46)], and discussing institutional delivery with their spouse [AOR=1.99, 95% CI: (1.3, 2.99)] were significantly associated factors.Conclusion: More than two out of five male partners were involved in the institutional delivery services of their partner. Attending formal education, having good knowledge, positive perception, and discussing institutional delivery with a spouse were significantly associated factors. Strengthening male partner involvement in reproductive health services and enhancing the culture of reproductive inter-spousal communication through couple counseling and peer-to-peer group sessions at a facility and community level are important measures.Keywords: male involvement, institutional delivery, Lemmo, Ethiopia

Yadeta Dessie School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Yadeta Dessie, Email yad_de2005@yahoo.comAbstract: Primiparity at an advanced age, which means having a first birth at age 35 years and beyond, is a recent emerging phenomenon in low- and middle-income countries that significantly affects maternal and child health. However, this evolving phenomenon has not been given due attention as many countries still deal with health-related issues during early-age pregnancies. This paper describes the emerging trend of primiparity during advanced age, focusing on low- and middle-income countries, elaborates on the linked adverse feto-maternal outcomes, and outlines potential interventions to bring the scenario to policymakers’ and practitioners’ attention.Keywords: primiparity, maternal, child, advanced age, birthing, SDG, complications, adverse

Shiferaw Letta,1 Fekadu Aga,2 Tesfaye Assebe Yadeta,1 Biftu Geda,3 Yadeta Dessie4 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Nursing, College of Health Sciences, Madda Walabu University, Shashamene Campus, Shashamene, Ethiopia; 4School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Shiferaw Letta, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia, Tel +251911771934, Email shife1973@gmail.comBackground: Diabetes, together with its complications, has a considerable negative influence on people’s quality of life and healthcare delivery and raises diabetic mortality. However, there is limited information about the diabetes-associated chronic complications in the study setting. Therefore, this study aimed to determine the burden and factors related to the chronic complications among patients with type 2 diabetes (T2D) in Eastern Ethiopia.Methods: A hospital-based cross-sectional study was conducted among 879 patients with T2D at two public hospitals in Harar. The data were collected through interviews using a structured questionnaire. Data related to the diagnosis of chronic complications and biochemical tests were extracted from medical records. The outcome variable was the number of chronic complications that happened to the patients. A generalized Poisson regression model with robust variance estimation was used to investigate the association of independent variables with chronic complications. An adjusted prevalence ratio with a 95% CI was reported to show an association using a p-value ≤ 0.05.Results: One or more chronic complications were presented in 43% of T2D (95% CI: 39.65, 46.19). Macrovascular and microvascular complications were found in 27.6% and 23.5% of patients, respectively. Urban residence (APR = 2.64; 95% CI: 1.54, 4.54), low wealth status (APR = 1.80; 95% CI: 1.17, 2.76), diabetes duration ≥ 5 years (APR = 1.46; 95% CI: 1.05, 2.01), hypertriglyceridemia (APR = 1.48; 95% CI: 1.07, 2.09) and poor self-care practices (APR = 1.62; 95% CI: 1.18, 2.23) were factors significantly associated with the chronic complications.Conclusion: The burden of chronic complications was high, with nearly half of T2D patients experiencing one or more chronic complications. Almost one in ten patients suffered from multiple chronic complications. The complications were mainly influenced by being urban resident, low wealth status, and poor self-care practices. Therefore, health care providers need to educate patients and promote self-care practices and healthy lifestyles to achieve treatment goals and lower the risk of chronic complications.Keywords: chronic complications, type 2 diabetes, Harar, Eastern Ethiopia

Bedasa Taye Merga,1 Galana Mamo Ayana,1 Temam Beshir Raru,1 Addisu Alemu,1 Belay Negash,1 Miressa Bekana,2 Abdi Birhanu,2 Yadeta Dessie1 1School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Bedasa Taye Merga; Galana Mamo Ayana, School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O.Box.: 235, Harar, Oromia, Ethiopia, Email tbadhaasaa@gmail.com; gelomamo724@gmail.comBackground: Comorbidities and advanced age increase the risk of severe outcomes of COVID-19. In order to shift the possible unfavorable treatment outcome in patients with chronic illnesses, information related to the prevalence of chronic illness and its effect on severity of COVID-19 infection has paramount importance.Objective: This study was aimed at assessing the prevalence of comorbidities and associated severity among COVID-19 patients admitted to COVID-19 treatment center, eastern Ethiopia.Methods: An institution-based cross-sectional study design was employed among 422 COVID-19 patients admitted to COVID-19 treatment center, eastern Ethiopia from April 10, 2020, to August 10, 2021. Binary logistic regression was fitted to identify comorbidities and other factors associated with severe clinical outcome, associations were presented with adjusted odds ratios (AORs) and 95% confidence intervals (CIs). In all analyses statistical significance were declared at p-value < 0.05.Results: More than half (52.4%) of the COVID-19 patients were presented with comorbid conditions. One third (34.6%) of the admitted COVID-19 patients were in severe clinical stages. Marital status (AOR=4.56; 95% CI: 1.40, 14.76), hypertension (AOR=2.08; 95% CI: 1.09, 3.97), diabetes mellitus (AOR=3.31; 95%:1.84, 5.98), and cardiovascular diseases (AOR=4.22; 95% CI: 2.18, 8.15) were identified as factors associated with severe clinical stages.Conclusion: The comorbid conditions such as diabetes, hypertension, and cardiovascular diseases, and marital status were identified as significant predictors of severe outcomes of COVID-19. Therefore, identifying the people with chronic comorbidities as a risk group would help to anticipate and prevent the serious outcomes of COVID-19 infection.Keywords: COVID-19, coronavirus, comorbidities, severe clinical stages, Ethiopia

Gari Hunduma,1 Negussie Deyessa,2 Yadeta Dessie,3 Biftu Geda,4 Tesfaye Assebe Yadeta1 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Nursing and Midwifery, College of Health and Medical Sciences, Meda Welabu University, Shashamene, EthiopiaCorrespondence: Gari Hunduma, Tel +251911347558, Email garihunduma@gmail.comPurpose: The importance of social capital for adolescent mental health has not been explored in low resource settings like Ethiopia. In this study, we examined the association between social capital and mental health problems among in-school adolescents in Harari Regional State, eastern Ethiopia.Methods: A cross-sectional study was conducted among 3227 in-school adolescents of 13– 19 years. A multistage sampling was used to select participants. Guided self-administered questionnaire was used to collect data. Mental health problem was measured using a self-administered version of the strength and difficulty questionnaire (SDQ), while social capital questionnaire for adolescent students (SCQ-AS) was used to collect data about the condition of social capital. The data were double entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA 14.1. The association between the outcome variable and predictors was analyzed using an ordinal logistic regression model. The result was reported using an odds ratio along with 95% confidence interval (CI) and a p-value < 0.05 was considered statistically significant association.Results: A total of 740 (22.93%) students had mental health problem, of which 9.7% (95% CI, 8.7– 10.8) and 13.20% (95% CI, 12– 14) were classified as “abnormal” and “borderline”, respectively. Factors associated with decreased mental health problem were increased network of friends at school (AOR = 0.75, 95% CI: 0.58– 0.99), increased trust in school or neighborhood (AOR = 0.52, 95% CI: 0.44– 0.63), and high social cohesion in the community (AOR = 0.75, 95% CI: 0.62– 0.89).Conclusion: Higher social capital is associated with a decreased mental health problem among in-school adolescents. Prevention and treatment of mental health problems require strengthening social capital at school, household, and in the neighborhood.Keywords: adolescents, social capital, mental health problems, eastern Ethiopia, in-school

Tamirat Tesfaye Dasa,1,2 Michael A Okunlola,3 Yadeta Dessie4 1Department of Reproductive Health Sciences, Life and Earth Sciences Institute (Including Agriculture and Health), Pan African University, Ibadan, Nigeria; 2Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 3Department of Obstetrics and Gynaecology, College of Medicine, University College Hospital, University of Ibadan, Ibadan, Nigeria; 4School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Tamirat Tesfaye Dasa, Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, P.O. Box 235, Hawassa, Ethiopia, Tel +251 938611577, Email tamirathenna@gmail.comBackground: Adverse birth outcome is associated with grand multiparity and is still a major public health problem in developing countries. There is limited information that investigates the effect of grand multiparity on perinatal outcomes in a prospective follow-up design in Ethiopia. Therefore, this study was aimed to investigate the effect of grand multiparity on the occurrence of adverse perinatal outcomes in the Sidama Region of Ethiopia.Methods: We conducted a prospective follow-up study among 837 women who gave birth in selected public hospitals of the Sidama Region from January 1 to August 31, 2021. Data were collected using a structured questionnaire and medical record review. A modified Poisson regression model with robust standard errors was applied to estimate the adjusted risk ratio and its 95% CI of the risk factors for adverse perinatal outcomes to examine the association of the multi-parities with the adverse birth outcome. STATA Version 14 was used for analysis.Results: The overall cumulative incidence of adverse perinatal outcomes was 33% (95% CI: 29.9%, 36.4%). After adjusted for confounders, women with grand multiparity gave birth to babies with a higher risk of stillbirth (ARR = 1.6; 95% CI: 1.01– 2.51), macrosomia (ARR = 1.6; 95% CI: 1.23– 2.07), and preterm birth (ARR = 1.3; 95% CI: 1.1– 1.66) compared to their counterparts.Conclusion: High incidences of adverse perinatal outcomes occurred among women with grand multiparity. We recommend that the region and districts health bureau should give close monitoring for pregnant women with high parity throughout their prenatal, intrapartum, and postpartum periods.Keywords: birth complication, parity, fetal abnormality, cohort, Sidama, Ethiopia

Galana Mamo Ayana,1 Bedasa Taye Merga,1 Abdi Birhanu,2 Addisu Alemu,1 Belay Negash,1 Yadeta Dessie1 1School of Public Health, College of Health and Medical Science, Haramaya University, Harar, Ethiopia; 2School of Medicine, College of Health and Medical Science, Haramaya University, Harar, EthiopiaCorrespondence: Abdi Birhanu Tel +251 917094058Email abdiibiree@gmail.comBackground: The very unprecedented virus causing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continued causing catastrophes in economy and loss of human lives. Despite countries’ urgent and resilient public health actions against the COVID-19 pandemic, the disease is causing a large number of deaths. However, predictors of mortality among hospitalized COVID-19 patients have not been well investigated in Ethiopia. Therefore, this study aimed to identify the predictors of mortality among hospitalized COVID-19 patients at a tertiary care hospital in Ethiopia.Methods: A hospital-based retrospective cohort design study was implemented among hospitalized COVID-19 patients at a tertiary care hospital in Harar, Ethiopia from March 20 to August 20, 2021. Data of 531 admitted patients were entered using Epi-data 3.1 and exported to STATA 14.2 for analysis. Binary logistic regression was used to identify significant predictors of outcome variables with an adjusted odds ratio (AOR) with a 95% confidence interval.Results: Of the total 531 study participants, 101 deaths occurred. The mortality rate was 16.2 per 1000 person-days of observation with median survival time of 44 days with IQR [28, 74]. Smoking history [AOR=2.55, 95% CI (1.15, 5.65)], alcohol history [AOR=2.3, 95% CI (1.06, 4.97)], comorbidities [AOR=2.95, 95% CI (1.26, 6.91)], and increasing oxygen saturation [AOR=0.92, 95% CI (0.89, 0.95)], and lymphocyte count [AOR=0.90, 95% CI (0.88, 0.97)] were independent significant predictors of death from Covid-19.Conclusion: The incidence of mortality among hospitalized COVID-19 patients was found to be high. Devising individual, tailored management for patients with “risk” behaviors, comorbid conditions, and poor prognostic markers such as lymphopenia and low oxygen saturation, may reduce the incidence of death among hospitalized COVID-19 patients.Keywords: mortality rate, predictors, COVID-19, SARS-COV-2

Shiferaw Letta,1 Fekadu Aga,2 Tesfaye Assebe Yadeta,1 Biftu Geda,3 Yadeta Dessie4 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Nursing, College of Health Sciences, Madda Walabu University, Shashamene Campus, Shashamene, Ethiopia; 4School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Shiferaw LettaSchool of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, EthiopiaTel +251911771934Email shife1973@gmail.comBackground: All types of diabetes can damage the heart, blood vessels, eyes, kidneys, nerves and increase the overall risk of disability and premature death. Diabetes mellitus requires a range of self-care practices, scientifically recommended to control the glycemic level and maintain the patient’s health. However, perceived barriers that hinder patients from fully implementing these diabetes self-care practices and obstacles have not been thoroughly explored. Therefore, this study aimed to explore the barriers to diabetes patients’ self-care practices from the perspective of health care providers in two public hospitals in Harar City, Eastern Ethiopia.Methods: Researchers conducted an exploratory qualitative study among 26 health care providers working in two public hospitals from March to June 2021. The study participants were recruited from different disciplines working on diabetes care. Interviews were conducted in the Amharic language until the saturation point was reached. The interviews were tape-recorded, transcribed, and translated to English. Each transcript was read, re-read, and then exported to ATLAS.ti 7 software for coding. Field notes were used to supplement verbatim transcriptions. Initial codes were generated. The consistency between the two coders and their alignment with research questions were checked and applied to all subsequent transcripts after reached on consensus. The thematic analysis was employed in line with the primary set research question.Results: Researchers identified barriers to diabetes patients’ self-care practices such as system, health care providers, and patient-level. These barriers were categorized under three main themes: lack of organized diabetes care services, limited collaborative care practices, and perceived lack of knowledge on self-care practices. In addition, the lack of multidisciplinary team care, lack of training for health care providers on diabetes self-care practices, and availability of laboratory tests and diabetes medication were prominent barriers.Conclusion: Multi-level barriers to diabetes patients’ self-care practices such as system, health care providers, and patients were identified. Therefore, interventions targeting proper service integration, building providers’ and patients’ capacity on diabetes self-care practices, and ensuring the sustainability of laboratory tests and medication supplies are essential. These interventions need to be accomplished through multi-level stakeholders’ engagement and one-to-one or group interventions covering the multi-level challenges.Keywords: diabetes, self-care, barriers, health care providers, holistic care, Eastern Ethiopia

Merga Dheresa,1 Yadeta Dessie,2 Belay Negash,2 Bikila Balis,1 Tamirat Getachew,1 Galana Mamo Ayana,2 Bedasa Taye Merga,2 Lemma Demissie Regassa2 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Bedasa Taye MergaSchool of Public Health, College of Health and Medical Sciences, Haramaya University, P.O.Box: 235, Harar, EthiopiaTel +251917723961Email tbadhaasaa@gmail.comBackground: Every year, immunization prevents about 4– 5 million child fatalities from vaccine preventable morbidities. Conversely, in Ethiopia, achieving full coverage of vaccination has continued to be challenging. Socio-demographic, caregivers and child related factors determine vaccination coverage. Therefore, this study aimed to find out recent coverage, trends in coverage, and its predictors in eastern Ethiopia.Methods: A population-based longitudinal study design was conducted among 14,246 children aged 12– 24 months from 2017 to 2021 in Kersa Health and Demographic Surveillance System site (KHDSS). The data were collected from caregivers of the child by face to face interview. Multinomial logistic regressions were used to identify predictors of vaccination. The association between vaccination coverage and its predictors was presented by adjusted odds ratio with 95% confidence interval. A p-value of < 0.05 was used to establish statistical significance.Results: From the 14,198 included children, only 39% of children were fully vaccinated, with highest proportion in 2020 (45%) and lowest proportion in 2019 (32%). In comparison to fully vaccinated, being partially vaccinated was positively associated with older maternal age, rural residence, unemployment, rich wealth index, no antenatal care, facility delivery, and birth order whereas negatively associated with semi-urban residence. In compared to fully vaccinated, being not vaccinated was positively associated with older maternal age, rural residence, maternal education, unemployment, and no antenatal care whereas negatively associated with semi-urban residence, poor wealth index, multipara, grand multipara, and facility delivery.Conclusion: Less than two-fifths of children aged 12 to 24 months were fully vaccinated. Socio-demographic factors and maternity care utilization were found to be predictors of vaccination coverage. Therefore, strategies that emphasize women’s empowerment in terms of education, economy, and employment status, and enhancing maternal healthcare utilization may improve vaccination coverage.Keywords: immunization, vaccination, coverage, trends, Kersa HDSS, Ethiopia

Taye Mekonnen, 1 Yadeta Dessie, 2 Biftu Geda, 3 Zelalem Bekele, 3 Genanaw Atnafe, 3 Lemma Getacher 4 1Department of Public Health Emergency, Harari Regional Health Bureau, Harar, Ethiopia; 2School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Public Health, College of Health Sciences, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, EthiopiaCorrespondence: Lemma Getacher Email lemmagetacher@gmail.comBackground: The issue of service satisfaction with antiretroviral therapy services needs more attention as it indicates the outcome of quality health services. Although different studies have been conducted on client satisfaction in different countries, there is limited evidence on the major predictors of client satisfaction with ART services in Ethiopia.Objective: To assess the predictors of service satisfaction among clients receiving antiretroviral therapy services at a public hospital in Harar Town, Eastern Ethiopia.Methods: A hospital-based cross-sectional study design was employed among 413 antiretroviral therapy clients from February to March 2018. The data were cleaned and entered into EpiData version 3.1 and exported to SPSS version 21 for analysis. A five-point Likert scale was used to assess client satisfaction with the ART services. Clients who scored ≥ 75% of the items were categorized as “satisfied” and those who scored < 75% of the items were categorized as “dissatisfied”. Independent variables with a p-value of ≤ 0.25 in the binary regression analysis were included in the multivariate logistic regression analysis to control confounding factors. Statistical significance was set at a p-value less than 0.05.Results: The overall client satisfaction with ART services was 76.9% (95% CI: 72.6, 80.6). Regarding the predictors, clients who were not attending formal education [(AOR=3.7, 95% CI: 1.75,8.12)] and primary education [(AOR=3.9, 95% CI: 1.66,9.32)], low wealth index [(AOR=2.8, 95% CI: 1.27, 6.28)], longer duration of treatment [(AOR=2.7, 95% CI: 1.46, 5.5.20)], shorter waiting time [(AOR=5.4, 95% CI: 2.52, 11.57)], disclosure of serostatus of HIV [(AOR=3.7, 95% CI: 1.59, 8.49)], seen by the same health care providers repeatedly [(AOR=2.0, 95% CI: 1.06, 3.82)], loss of medical records [(AOR=0.26, 95% CI: 0.13,0.50)] and social supports [(AOR=2.3, 95% CI: 1.12,4.63)] were significantly associated with service satisfaction on antiretroviral therapy services.Conclusion: Overall client satisfaction with ART services was relatively low in the study area. However, not attending formal and primary education, low wealth index, longer duration of treatment, shorter waiting time, disclosure of serostatus, seen by the same health care providers, loss of medical records, and social support were independent predictors of client satisfaction.Keywords: antiretroviral therapy, client satisfaction, Ethiopia, Harar, public hospitals, predictors

Mekonnen Sisay,1 Tigist Gashaw,1 Natanim Degefu,2 Bisrat Hagos,3 Addisu Alemu,4 Zenebu Teshome,5 Mekonnen Admas,6 Haregeweyn Kibret,7 Yadeta Dessie4 1Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Pharmaceutics, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Social Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Public Health and Health Policy, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5East Harerge Zone Administration Office, Harar, Ethiopia; 6HIV/AIDS Unit, Gender, HIV/AIDS and Special Need Affair Directorate, Haramaya University, Harar, Ethiopia; 7Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Mekonnen SisayDepartment of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box, 235, Harar, EthiopiaEmail mekonnensisay27@yahoo.comBackground: The COVID-19 crisis has already resulted in an economic and labor market shock and a rise of informal work sectors. Being an informal job, traditional coffee vending can predispose women to a myriad of mental disorders. Therefore, this study was aimed to assess depressive symptoms during the COVID-19 pandemic and associated factors among street traditional coffee vendors in Harar town, Eastern Ethiopia.Methods: A cross-sectional study was employed on 180 women engaged in street traditional coffee vending business in Harar town. Data were collected through a face-to-face interview using a Public Health Questionnaire and analyzed using SPSS version 20. Binary logistic regression was executed to identify factors associated with depression at a cut-off point of P < 0.05.Results: The mean age of the study participants was 31.83 (± 10) years. The majority of the participants were currently married (n = 77, 42.8%), attended primary education (n = 68, 37.8%), had a family member of four or more (n = 60, 33.3%), and had two years or less work experience (n = 123, 68.3%). Most of the study participants obtained COVID-19-related information from television (n = 125, 69.4%). The prevalence of depression was found to be 18.9%. Attending primary education (AOR: 0.34; 95% CI: 0.12, 0.98), attending secondary education or higher (AOR: 0.23; 95% CI: 0.07, 0.69), and having four or more family members (AOR: 2.81; 95% CI: 1.14, 6.92) were significantly associated with depression.Conclusion: One in five street traditional coffee vendors suffered from depression during the COVID-19 pandemic. Lower odds of being depressed were observed in those who attended a minimum of primary education. On the contrary, having a greater family size was associated with higher odds of being depressed. This finding will direct the government and other concerned bodies to be involved in the provision of psychological and material support for such informal workers during COVID-19.Keywords: coronavirus, depression, street, traditional coffee vending

Hilawi Kifle,1 Bedasa Taye Merga,2 Yadeta Dessie,2 Melake Demena,2 Gelana Fekadu,3 Belay Negash2 1Haramaya University Higher Health Center, Haramaya University, Haramaya, Ethiopia; 2School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Bedasa Taye MergaSchool of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, EthiopiaTel +251917723961Email tbadhaasaa@gmail.comBackground: Inequity in healthcare use is avoidable inequality, and it exists when there are differences in the use of healthcare after standardization of different needs among the population. In Ethiopia, wide variation and lower achievement exists in outpatient visit per person per year against the target to reach by 2020. Therefore, this study is aimed at measuring inequalities and inequities in outpatient care utilization in Ethiopia.Methods: The study utilized data from 2015/16 Ethiopian National Health Account survey. The analysis included a weighted sample of 42,460 individuals. Concentration curve and indices were used to measure inequality in outpatient care utilization. Deviations in the degree to which outpatient care was distributed according to need were measured by the horizontal inequity index. All statistical analyses were done using STATA version 14. In all analyses statistical significance was declared at a p-value < 0.05 and a 95% confidence interval.Results: The outpatient care utilizations were found to be concentrated among the rich. The actual (C = 0.0335, 95% CI: 0.0298, 0.0431) and need predicted (C = 0.0157, 95% CI: 0.0117, 0.0413) utilizations were concentrated among the rich. The distributions of outpatient care in Ethiopians were pro-rich (rich-favoring). The decomposition analysis revealed that need factors were the main positive contributors to the inequality (23.6%) and non-need factors were among the negative contributors to the inequality (− 48.4%).Conclusion: This study evidenced the presence of rich-favoring inequality and inequity in outpatient care utilization in Ethiopia. Therefore, there is a need to consider implementation strategies that focus on fairness in healthcare utilization.Keywords: national health accounts, outpatient care utilization, inequality, inequity, decomposition analysis, Ethiopia

Desalew Zelalem,1 Alemayehu Worku,2 Tadese Alemayehu,1 Yadeta Dessie1 1School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Desalew ZelalemSchool of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box, 235, Harar, EthiopiaEmail desalewzelalemayele@yahoo.comBackground: Spousal family planning communication plays an important role in making better reproductive health decisions and in increasing the use of modern contraceptive methods. The objective of the current study is to examine the association of spousal family planning communication in its broader context with current modern contraceptive use among couples.Methods: A community based cross-sectional survey was conducted in twelve kebeles of Harar Urban Health and Demographic Surveillance System. A total of 2700 currently married couples of whose wives were in the reproductive age participated in the study. The selection of the study participants was made using simple random sampling and data were collected using an interviewer administered structured questionnaire and analyzed using Stata version 12.Results: The level of current modern contraceptive use was 57.1% (95% CI: 0.53, 3.39). Effective spousal family planning communication was significantly associated with current modern contraceptive use even after controlling for socio-economic and demographic variables. Socio-economic and demographic variables such as religion of couples, number of couples’ living children, household monthly income, couples’ family planning approval and women’s counseling about family planning by health workers were significantly associated with current modern contraceptive use.Conclusion: Policies and programs aimed at increasing contraceptive prevalence should properly address the importance of spousal communication about family planning and integrate men into family planning programs to facilitate and enhance couples communication skills.Keywords: effective communication, Poisson regression, Harar Urban HDSS, current contraceptive use

Abera Abose,1 Girmay Adhena,2 Yadeta Dessie3 1Department of Reproductive Health, West Badewacho, Ethiopia; 2Department of Reproductive Health, Tigray Regional Health Bureau, Tigray, Ethiopia; 3School of Public Health, College of Health and Medical Science, Haramaya University, Harar, EthiopiaCorrespondence: Girmay Adhena Email girmayrh@gmail.comBackground: Male involvement in family planning use particularly in long-acting and permanent contraceptive methods (LAPCM) is a key strategy to reduce fertility, and promote maternal and child health. Despite this, little is known about male involvement in LAPCM use of their partners in Africa, particularly in Ethiopia. This study aimed to assess male involvement in long-acting and permanent contraceptive method use in west Badewacho district, Southern Ethiopia.Methods: A community-based cross-sectional study was conducted among 564 participants from April 1 to 30/2019. A multi-stage sampling technique was used to select eligible participants. A pre-tested, structured, and interviewer-administered questionnaire was used. Binary and multivariable logistic regression analysis was done to identify associated factors. The adjusted odds ratio with 95% CI was estimated to show the direction and strength of the association. Variables with p< 0.05 were considered statistically significant.Results: About 108 (19.9%, 95% CI: (16.8, 23.2)) participants were involved in LAPCM use. Being urban dweller [AOR=3.13; 95% CI: (1.58, 6.19)], discussion with wives about LAPCM [AOR=2.81; 95% CI: (1.64, 4.8)], having good knowledge about LAPCM [AOR=2.55; 95% CI: (1.42, 4.57)], and positive attitude towards LAPCM [AOR=2.16; 95% CI: (1.16, 4.02)] were significantly associated factors.Conclusion: Overall, the male involvement in LAPCM use was low. Enhancing male involvement in family planning use through creating community awareness, encouraging inter-spousal communication to enhance decision making, and increasing positive attitude towards LAPCM in the community is crucial to decrease the problem.Keywords: male involvement, long-acting contraceptive, permanent contraceptive, Ethiopia

Abishu Kado,1 Bedasa Taye Merga,2 Hassen Abdi Adem,2 Yadeta Dessie,2 Biftu Geda3 1West Hararghe Zonal Health Department, Chiro, Ethiopia; 2School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Colleges of Health and Medical Sciences, Arsi University, Asella, EthiopiaCorrespondence: Bedasa Taye MergaSchool of Public Health, College of Health and Medical Sciences, Haramaya University, P.O.Box. 235, Harar, EthiopiaTel +251917723961Email tbadhaasaa@gmail.comBackground: In sub-Saharan Africa, out-of-pocket expenditures constitute approximately 40% of total healthcare expenditures, imposing huge financial burdens on the poor. To tackle the effects of out-of-pocket payment for healthcare services, Ethiopia has been focusing on implementation and expansion of a community-based health insurance (CBHI) program since 2011. This study assessed willingness to pay for CBHI scheme and associated factors among rural communities in Gemmachis district, eastern Ethiopia.Methods: Community-based cross-sectional study was conducted among 446 randomly selected participants in Gemmachis district from April 1 to April 30, 2019. Data were collected from participants using pretested structured questionnaires through face-to-face interview. Data were entered into EpiData version 3.1 and analyzed using SPSS version 24. Bivariable and multivariable logistic regression analyses were conducted to identify factors associated with willingness to pay for CBHI.Results: A total of 440 (98.7%) participants were involved in the study. Three in every four (74.8%) participants were willing to pay for CBHI (95% CI: 70.7%, 78.9%). Primary education (AOR=5.1, 95% CI: 2.4, 11.1), being merchant (AOR=0.23, 95% CI: 0.10, 0.51), housewife (AOR=3.8, 95% CI: 1.3, 11.0), poor (AOR=2.5, 95% CI: 1.3, 4.7), illness in the last one year (AOR=3.1, 95% CI, 1.9, 5.2), good knowledge about CBHI (AOR=2.3, 95% CI: 1.5, 3.6) and access to public health facility (AOR=2.0,95% CI: 1.1, 3.7) were all significantly associated with willingness to pay for CBHI.Conclusion: A significant proportion of participants were willing to pay for CBHI scheme. Education, occupation, wealth status, illness in the last one year, knowledge about CBHI and access to healthcare facility were factors significantly associated with willingness to pay for CBHI. If the scheme is to serve as a means to provide access to health service, the premium for membership should be tailored and customized by individual socioeconomic factors.Keywords: willingness to pay, community-based health insurance, associated factors, Ethiopia

Gebiso Roba Debele,1 Eyasu Shifera,1 Yohannes Lulu Dessie,2 Debela Dereje Jaleta,2 Megersso Urgessa Borena,3 Shuma Gosha Kanfe,4 Kabtamu Nigussie,5 Galana Mamo Ayana,5 Temam Beshir Raru5 1Department of Public Health, College of Health Sciences, Mattu University, Mattu, Ethiopia; 2Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia; 3Department of Public Health, School of Health Sciences, Shashemene Campus, Madda University, Shashemene, Ethiopia; 4Department of Health Informatics, College of Health Sciences, Mattu University, Mattu, Ethiopia; 5College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Gebiso Roba Debele, Email gebisa.roba123@gmail.comBackground: Even though podoconiosis can cause physical, financial, and social impairments, it is commonly overlooked by organizations, and one-fourth of the predicted worldwide burden will fall on Ethiopia. In spite of this, there are only a few attempts for prevention and control in certain areas in Ethiopia. Updated statistics on prevalence and contributing factors could make local efforts at prevention, control, and rehabilitation more effective. Thus, this study was aimed to assess the prevalence of podoconiosis and its associated factors among Ilu Aba Bor zone residents, South West Ethiopia.Methods: A community-based cross-sectional study was conducted on 491 participants from March 25 to April 25, 2022. Data were entered into Epi-Data version 4.6.0, then exported to SPSS version 25 for final analysis. In the bi-variable regression, variables with P-values less than 0.25 were included in the multivariable model. Finally, multivariable logistic regression was performed to identify factors associated with podoconiosis at a 5% level of significance.Results: In this study area, podoconiosis prevalence was found to be 5.7% [3.6– 7.2]. In multivariable regression model, lower tertile wealth status [AOR=2.09; (95% CI (1.384, 5.343)], no formal education [AOR=2.23; (95% CI; 1.179– 3.820)] and average distance to reach water source to home [AOR=2.061; (95% CI: 1.78– 7.35)] were significantly associated podoconiosis.Conclusion and Recommendation: According to this study, one in every seventeen individuals had podoconiosis, which is a significant prevalence when compared to earlier studies. Podoconiosis was observed to be associated with factors like wealth status, educational attainment, and distance from water source. To address this public health issue, strong preventive and therapeutic treatments should be used.Keywords: prevalence, factors, podoconiosis, Ilu Aba Bor zone

Abstract Background Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa. Methods A cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses. Results Six hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9%) had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63); lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23); lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76); and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57). Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80), or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39) were associated with less risky practice. Conclusions A considerable proportion (36.9%) of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to be provided. The health education and counseling can be provided to these people at ART appointments on follow- up care. It can be provided in a one-on-one basis or through patient group educational discussions at the clinics.

Background: Depression is a significant public health concern in both developed and developing countries. The burden of depression is particularly high among patients with chronic illnesses in developing countries, creating a dual challenge for both patients and the community. However, depression goes undiagnosed in 50%-75% of patients with chronic conditions such as diabetes mellitus. Additionally, there is limited information about the prevalence of depression among diabetic patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among type 2 diabetic patients in Ethiopia., Method: An institution-based cross-sectional study was conducted on 376 randomly selected type 2 diabetic patients. Data were collected through face-to-face interviews and from patients' follow-up records. The data were entered into EpiData version 4.6 and analyzed using STATA 14. Bivariable and multivariate logistic regression analyses were employed to identify associated factors. Variables with a p-value of less than 0.25 in the bivariable analysis were selected for multivariate logistic regression. Model fitness was assessed using Hosmer-Lemeshow's test, and associations were reported using adjusted odds ratios with 95% confidence intervals., Results: In this study, the prevalence of depression among type 2 diabetic patients was found to be 69.72% (95% CI: 64.75, 74.27). Three factors were significantly associated with depression in these patients: the duration of diabetes mellitus since diagnosis [AOR: 1.17; 95% CI (1.02, 1.34)], glycaemic control [AOR: 1.8; 95% CI (1.09, 3.01)] and cigarette smoking [AOR: 2.18; 95% CI (1.07, 4.46)]., Conclusion: The prevalence of depression among type 2 diabetic patients was high. The Federal Ministry of Health, stakeholders, and the Ethiopian Diabetes Association should collaborate to reduce this burden. Mental health assessment and treatment should be integrated into chronic care follow-up services. Additionally, healthcare providers should closely monitor and counsel patients who smoke and those with poor glycemic control., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Dukato, Beyamo, Habte Hailegebireal, Teklehaimanot, Ayfokru, Alemnew, Birhanu Abate, Abemie, Mengistu, Ayehu Dessie, Mengstie and Girma.)

Objectives: This review aimed to report the estimated pooled level of prevalence, risk factors, and birth outcome of hypertensive disorder of pregnancy in Ethiopia, in 2024., Design: A systematic review and meta-analysis approach was utilized., Data Sources and Methods: PubMed/MEDLINE, Google Scholar, African Index Medicus, Web of Science, and CINHAL (EBSCO) search was carried out. The result was written according to the PRISMA-updated guidelines. To estimate the pooled prevalence and effect sizes, a random-effect model was used. Heterogeneity was assessed and investigated using I 2 test statistics and meta-regression, respectively. Publication bias was assessed using funnel plot and Egger's test statistics. Statistical tests result at p -value < 0.05 were declared as having significance., Result: From a total of 52 primary studies with a total sample size of 269, 158 were included in this systematic review and meta-analysis. The pooled prevalence of hypertensive disorder in pregnancy was 8%. Egger's test statistics ( p  = 0.8013) showed there is no publication bias. Having a history of kidney disease (AOR: 3.47), being rural resident (AOR: 2.5), having fruit intake during pregnancy (AOR: 0.39), being overweight (AOR: 2.24), and having multiple pregnancy (AOR: 2.1) were found to have a significant association with hypertensive disorder of pregnancy., Conclusion: Overall, the level of prevalence of hypertensive disorders of pregnancy in Ethiopia was significantly increasing. Having a history of kidney disease was found to have a strong association with hypertensive disorders of pregnancy among factors. The most common or dominant adverse maternal and childbirth outcomes were low birth weight, preterm birth, fifth minute low APGAR score; and eclampsia, hemolysis, elevated liver enzymes, and low platelets syndrome, and acute kidney injury. The governments and other stakeholders should work to broaden and strengthen the existing maternal and child health (MCH) practice by incorporating all possible risk factors of hypertensive disorders of pregnancy in MCH guidelines. In addition, a large-scale study is required that considers those important missed variables, especially, in the eastern part of Ethiopia., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Energy crises, along with environmental tampering, are currently a big topic on the global scene. The most promising strategy in the current research trend is the creation of ecologically pleasant renewable green alternative energy sources. Since adequate access to green, ecologically acceptable energy sources promotes industrialization and the well-being of human society. Hence, in this review, the most recent carbon electrocatalysts electrode materials prepared from porous activated carbon (PAC) in electrochemical energy conversion and storage systems due to its long life cycle, porosity and high surface area nature as well as low-cost nature have been clearly discussed. This review aims to demonstrate that the increasing interest in the synthesis of PAC is accompanied by extensive research into their application in supercapacitors, where they continue to be the preferred electrode material. Their challenges and current progress of PAC electrodes are also discussed. The systematic methods of modifying PAC from biomass as well as some commercially available carbon materials have been thoroughly summarized in this review as an alternate high-surface area electrode for the effective generation of energy in many energy conversion and storage devices. The critical assessment is also extends to evaluate its recent advancements, trends in research progress, and future prospects., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

In the current world, storing and converting energy without affecting the natural ecosystem are considered a sustainable and efficient green energy source production technology. Especially, using low-cost, environmentally friendly, and high-cycle stability activated carbon (AC) from the water hyacinth ( Eichhornia crassipes ) waste material for charge storage application is the current attractive strategy for renewable energy generation. In this study, preparation of AC from water hyacinth using a mixed chemical activation agent followed by activation time was optimized by the I-optimal coordinate exchange design model based on a 3-factor/3-level strategy under nine experimental runs. The optimum conditions to prepare AC were found to be potassium hydroxide (≈17 g) and potassium carbonate (≈11 g), and the carbonization time was approximately 1 h. Under these augmented conditions, the maximum specific capacitance suggested by the designed model was found to be ≈75.2 F/g. The regression coefficient ( R 2 = 0.9979), adjusted ( R 2 = 0.9917), predicted ( R 2 = 0.8706), adequate precision (39.2795), and p -values (0.0062) proved the good correlation between actual and predicted values. The physicochemical and electrochemical properties of the final optimized AC were characterized by thermogravimetric/differential thermal analysis (TGA/DTA), X-ray diffractometry (XRD), Fourier transform infrared (FTIR), Brunauer-Emmett-Teller (BET), scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS), transmission electron microscopy (TEM), high-resolution TEM (HRTEM), selected area electron diffraction (SAED), and potentiostat (CV and EIS) instruments. Finally, the optimized AC electrode after 100 cycles at a current density of 2 A g -1 retains an efficiency of 71.57%, indicating the good stability and sustainability of this material., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Background: Addressing attitudes is central to achieving sexual and reproductive health and rights (SRHR) and Agenda 2030. We aimed to develop a comprehensive index to measure attitudinal support for SRHR, expanding opportunities for global trend analyses and tailored interventions., Methods: We designed a new module capturing attitudes towards different dimensions of SRHR, collected via the nationally representative World Values Survey in Ethiopia, Kenya, and Zimbabwe during 2020-2021 (n = 3,711). We used exploratory factor analysis of 58 items to identify sub-scales and an overall index. Adjusted regression models were used to evaluate the index according to sociodemographic characteristics, stratified by country and sex., Results: A 23-item, five-factor solution was identified and used to construct sub-indices reflecting support for: (1) sexual and reproductive rights, (2) neighborhood sexual safety, (3) gender-equitable relationships, (4) equitable masculinity norms, and (5) SRHR interventions. These five sub-indices performed well across countries and socioeconomic subgroups and were combined into a comprehensive "SRHR Support Index", standardized on a 1-100 scale (mean = 39.19, SD = 15.27, Cronbach's alpha = 0.80) with higher values indicating more support for SRHR. Mean values were highest in Kenya (45.48, SD = 16.78) followed by Ethiopia (40.2, SD = 13.63), and lowest in Zimbabwe (32.65, SD = 13.77), with no differences by sex. Higher education and being single were associated with more support, except in Ethiopia. Younger age and urban residence correlated with more support among males only., Conclusion: The SRHR Support Index has the potential to broaden SRHR attitude research from a comprehensive perspective - addressing the need for a common measure to track progress over time., (© 2024. The Author(s).)

Background: Overweight and obesity continue to escalate, despite the regulations and interventions that have been put in place. To support further policy directions, it is necessary to have pooled data that illustrate the burden of overweight and obesity among adolescents nowadays. Thus, this systematic review and meta-analysis aimed to determine the burden of overweight and obesity among Ethiopian adolescents., Methods: Embase, Science Direct, Medline, PubMed, Google Scholar and Web of Science were the databases used in the search for publications that ran from inception until 25 October 2023. STATA version 18 was used to analyze data on overweight and obesity in adolescents. Using the random effect model, the pooled estimates with 95% CIs were calculated. Using the Galbraith plot, I2 statistics and Cochrane Q statistics, heterogeneity was investigated., Results: In total, 20145 adolescents aged 10-19 years were included in this meta-analysis study. The pooled prevalence of overweight and obesity among adolescents in Ethiopia was 10% (95% CI 9 to 12%; I2=94.03%). There was a substantial correlation between being female (OR=1.81, 95% CI 1.47 to 2.15), attending private schools (OR=1.78, 95% CI 1.31 to 2.26), having a family size of ≥4 (OR=1.86, 95% CI 1.14 to 2.58) and being of middle economic status (OR=1.62, 95% CI 1.14 to 2.10)., Conclusions: In Ethiopia, one in 10 adolescents is overweight/obese. The study's findings clearly show that a large number of adolescents are dealing with this emerging public health issue. Moreover, characteristics related to physical activity, nutrition and sociodemographics were discovered to be associated with overweight and obesity. To lessen the burden of overweight and obesity, the government and other parties should work together to support gender-specific nutritional interventions, encourage healthy lifestyle choices among teenagers and facilitate these efforts., (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: Feeding the world's future population while still facing a variety of socioeconomic and climate change scenarios with uncertain outcomes is a key global societal concern that should be addressed in a science-based manner. Ethiopia boasts a great diversity of wild edible plant species (WEPS), but millions of its citizens still suffer from chronic hunger every year. In this context, we here document the use and conservation of WEPS in the Awi Agäw community, Northwestern Ethiopia., Methods: We performed a cross-sectional study from October 2021 to June 2022. Ethnobotanical and conservation status data were collected via semi-structured interviews, focus group discussions, field walks and market surveys. A total of 374 respondents from three districts (Guangua, Jawi and Ankasha) were purposely selected for the study. Descriptive statistics, including preference rankings, frequencies and direct matrix rankings, were employed for the data analysis., Results: We identified a total of 39 WEPS plant taxa distributed among 26 families and 32 genera. The Moraceae and Rosaceae had the greatest numbers of plants, with five and three species, respectively. The WEPS are regularly consumed in the study area to alleviate hunger. However, threats such as habitat loss, agricultural expansion, deforestation for firewood and other reasons, and pesticide use threaten WEPS availability., Conclusion: Therefore, community-based conservation interventions need to be encouraged to safeguard WEPS and associated traditional knowledge. Furthermore, nutritional quality analysis is recommended for the selection of promising WEPS candidates., (© 2024. The Author(s).)

Background: Intimate partner violence (IPV) is recognized as a main public health challenge, with serious consequences for women's physical, mental, sexual, and reproductive health. Despite its public health importance, most studies of IPV in Ethiopia mainly focused on individual characteristics and didn't identify how factors operating at different levels affect IPV. Thus, there is limited evidence regarding the hierarchical-level factors of IPV and the effect of individual and community-level determinants of IPV. The aim of this study is to assess the individual and community-level factors associated with violence against women among ever-married reproductive-age women in Ethiopia., Methods: A retrospective analysis of secondary data retrieved from the Ethiopia Demographic and Health Survey was conducted among reproductive age group women (15-49 years of age) who reported ever being married within the available data set for the domestic violence module. STATA 14 was used to conduct the analysis. A two-level mixed-effects logistic regression analysis was used to determine associations between IPV and individual- and community-level factors. IPV variability across the community was assessed using ICC and PCV. The model's fitness was assessed using the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the likelihood ratio test., Result: The life time prevalence of IPV in this study was 33% [95% CI: 30.74, 34.25]. Women's age 20-24 (AOR = 5.85, 95% CI: 201 3.10, 11.04), 25-29 age group (AOR = 6.41, 95% CI; 3.34, 12.32), 30-34 age group (AOR = 9.48, 95% CI: 4.71, 19.06), 35-39 age group (AOR = 9.88, 95% CI: 4.79, 20.39), 40-44 age group (AOR = 11.10, 95% CI: 5.16, 23.89), and 45-49, (AOR = 14.15, 95% CI: 6.01, 32.80), early marriage (AOR = 1.21, 95% CI: 1.08, 1.47), witnessing inter-parental violence during childhood (AOR = 2.80, 95% CI: 2.16, 3.96), having a lot of living children (AOR = 0.45, 95% CI: 0.26, 0.74), having a partner who drank alcohol (AOR = 3.00, 95% CI: 2.42-3.67), decision-making autonomy of the women (AOR = 0.77, 95% CI: 0.62, 0.97), Poor wealth index (AOR = 1.64, 95% CI: 1.23, 2.18), middle wealth index (AOR = 1.86, 95% CI: 1.36, 2.54) and exposure to media (AOR = 1.47, 95% CI: 1.06, 2.00) were all significantly associated with IPV., Conclusion and Recommendation: This study showed that one-third of the women experienced IPV in their lifetime. The finding suggested that community based interventions and multi-sectorial collaborations are needed to reduce the IPV and its adverse consequences., (© 2024. The Author(s).)

Tuberculosis (TB) and human immunodeficiency virus (HIV) coinfection pose significant challenges to global health, particularly in achieving the target of ending TB. However, the impact of HIV status on TB treatment outcomes remains unclear, especially in eastern Ethiopia. This study aimed to assess the treatment outcomes of TB cases by HIV status and associated factors in Haramaya General Hospital from November 15 to December 30, 2022. A retrospective cross-sectional study was conducted, reviewing the TB registry and treatment cards of patients who received anti-TB treatment between September 2017 and August 2022. Of the 420 samples addressed, 91.0% (95% CI: 88.3%-96.7%) of all TB patients had successful treatment outcomes. The treatment success rates of HIV-positive and HIV-negative TB patients were 80.0% and 91.9%, respectively. Being HIV-negative (AOR: 2.561, 95% CI: 1.002-6.542), being in the age group of 20 to 35 years (AOR: 2.950, 95% CI: 1.171-7.431), and urban residence (AOR: 2.961, 95% CI: 1.466-5.981) were associated with the TB treatment success rate. There was a high treatment success rate among all patients with TB. HIV status was associated with TB treatment outcomes. Strengthening TB-HIV collaborative activities, providing patient-centered care and support, and frequent monitoring and evaluation are recommended to improve the TB success rate., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Hyperglycemia in pregnancy (HIP) is a significant medical complication affecting pregnant women globally and is considered a public health burden due to the negative outcomes it can cause for both mother and infant. The aim of this systematic review and meta-analysis was to examine the prevalence, risk factors, and feto-maternal outcomes of HIP in Ethiopia., Methods: To gather relevant information for this study, both published and unpublished studies were searched for in several major databases, including PubMed, Embase, HINARI, Web of Science direct, and Google Scholar, as well as other sources. The Joanna Briggs Institute (JBI) tool was used to evaluate the methodological quality of the findings from these studies. Data was then extracted and summarized using a template in Microsoft Excel software, and the extracted data was analyzed using Stata software version 16.0. If significant heterogeneity was found between studies, subgroup analyses were conducted to further examine the data., Result: Eighteen studies were included in this systematic review and meta-analysis, involving a total sample size of 50,816 pregnant women in Ethiopia. The prevalence of HIP among pregnant women varied considerably across the primary studies, ranging from 0.4 to 26.2%. The pooled prevalence of HIP among pregnant women in Ethiopia was found to be 6.9% (95% C 2.2-11.6). Pregnant women with a family history of diabetes had 2.5 times higher odds of developing HIP compared to those without a family history of diabetes (OR = 2.49; 95% CI = 2.02, 2.96). However, there was no significant association found between HIP and maternal obesity (OR 2.31, 95% CI = 0.85, 3.78) or previous history of abortion (OR 3.89; 95% CI 0.85, 6.94). The common fetal outcomes associated with HIP were admission to the intensive care unit (46.2; 95% CI 27.4, 65.1), macrosomia (27.3%; 95% CI 9.4%, 45.1%), and preterm birth (16.9; 95% CI 12.5, 21.3). Additionally, hypertensive disorders of pregnancy (28.0%; 95% CI 15.2, 40.8) and operative delivery (51.4%; 95% CI 35.9, 66.8) were more common among women with HIP in Ethiopia., Conclusion: Although there was some variation between studies, the meta-analysis revealed that approximately seven out of 100 pregnant women in Ethiopia had HIP. A family history of diabetes was found to be a significant predictor of HIP in Ethiopia. Additionally, HIP was associated with various serious adverse outcomes for both mothers and infants in Ethiopia. These findings highlight the need for national guidelines to ensure that pregnant women are uniformly screened for HIP., (© 2024. The Author(s).)

Aims: This study aims to assess the dynamics of in-school adolescents' mental health problems in Harari regional state, eastern Ethiopia for a year., Materials and Methods: Using multistage sampling technique, we conducted a year-long longitudinal study at three public high schools between March 2020 and 2021. Three hundred fifty-eight in-school adolescents were chosen by systematic random sampling for the baseline assessment, and 328 completed the follow-up assessment. We used self-administered, adolescent version of SDQ-25 Questionnaire to collect the data. Wilcoxon matched-pairs signed-rank test and McNemara's Chi-squared tests were used to examine the median difference and distribution of mental health problems between times one and two. Random-effects logistic regressions on panel data was used to identify factors associated with mental health problems. A p-value < 0.05 was considered as statistically significant., Results: The magnitude of overall mental health problems at baseline assessment was 20.11% (95% CI: 16-25), with internalizing problems accounting for 27.14% (95% CI: 23-32) and externalizing problems accounting for 7.01% (95% CI: 4.6-10.3). At the follow-up assessment, these proportions rose to 22.56% (95% CI, 18-27) for overall problems and 10.3% (95% CI, 7.7-14.45) for externalizing problems. On other hand, internalizing problems decreased unexpectedly to 22.86% (95% CI, 18.6-27.7) at follow-up assessment. Internalizing problem scores at time two were significantly lower than baseline among older adolescents, girls and those with average wealth index in our study cohort., Conclusions: The prevalence of mental health problems were high among the study cohort. The proportion of overall problems and externalizing problems has increased over time, indicating a deterioration in the mental health of the study cohort. However, the decrease in internalizing problems among older adolescents, girls, and those with an average wealth index is a positive sign. The findings highlight that tailored interventions are required to reduce externalizing problems and maintain the decrease in internalizing problems. These interventions should target middle-aged and male adolescents from low-income families., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hunduma et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Despite lifelong and detrimental effects, the co-occurrence of health risk behaviors (HRBs) during adolescence remains understudied in low- and middle-income countries. This study examines the co-occurrence of HRBs and its correlates among adolescents in sub-Saharan Africa, China, and India., Methods: A multi-country cross-sectional study was conducted in 2021-2022, involving 9697 adolescents (aged 10-19 years) from eight countries, namely Burkina Faso, China, Ethiopia, India, Ghana, Nigeria, Tanzania, and Uganda. A standardized questionnaire was administered to examine five types of HRBs - physical inactivity, poor dietary habits, smoking, alcohol consumption, and risky sexual behavior. Latent class analysis was employed to identify clustering patterns among the behaviors, and logistic regression was used to identify the correlates of these patterns., Findings: Three clusters of HRBs were identified, with Cluster 1 (27.73%) characterized by the absence of any specific risky behavior, Cluster 2 (68.16%) characterized by co-occurrence of physical inactivity and poor dietary habits, and Cluster 3 (4.11%) characterized by engagement in smoking, alcohol consumption, and risky sexual behavior. Relative to Cluster 1, being in Cluster 2 was associated with being female (aOR 1.20, 95% CI 1.09-1.32), not enrolled in education (aOR 0.84, 95% CI 0.71-0.99), and not engaged in paid work (aOR 1.23, 95% CI 1.08-1.41). Compared with those Cluster 1, adolescents in Cluster 3 were less likely to be female (aOR 0.41, 95% CI 0.32-0.54), be engaged in paid work (aOR 0.54, 95% CI 0.41-0.71), more likely to be older (aOR 7.56, 95% CI 5.18-11.03), not be enrolled in educational institution (aOR 1.74, 95% CI 1.27-2.38), and more likely to live with guardians other than parents (aOR 1.56, 95% CI 1.19-2.05)., Interpretation: The significant clustering patterns of HRBs among adolescents in sub-Saharan Africa, China, and India highlights the urgent need for convergent approaches to improve adolescent health behaviors. Early life and school-based programs aimed at promoting healthy behaviors and preventing risky and unhealthy behaviors should be prioritized to equip adolescents with the tools and skills for lifelong well-being., Funding: Fondation Botnar (Grant #INV-037672) and Harvard T.H. Chan School of Public Health, partially funded this study., Competing Interests: We declare no conflicts of interest., (© 2024 The Author(s).)

Adolescent's mental health issues are a major social burden and a significant public health issue, but they have not received enough attention in Ethiopia. Therefore, this study aimed to determine the prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in the Harari region, eastern Ethiopia. A cross-sectional study was conducted among 3227 in-school adolescents. Multistage sampling was used to select schools and eligible students to participate in the study. A guided, self-administered strength and difficulty questionnaire measured mental health problems. Data were double-entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA version 17. Ordinal logistic regression analysis was performed to estimate the adjusted odds ratio between mental health problems and their correlates. Statistical significance was set at p-value < 0.05. The magnitudes of mental health problems among in-school adolescents by subscale was 24.17% (95% CI 22.72; 25.67) for internalizing and 11.93% (95% CI 10.85; 13.09) for externalizing problems. A high internalizing problem score was associated with females, rural residents, alcohol users, attending public schools, those bullied at school, and those in the lowest wealth index. Likewise, the likelihood of a high externalizing problem score was high among alcohol users, adolescents whose fathers are uneducated, rural, and bullied at school. The study suggests that mental health problems are prevalent among in-school adolescents in Ethiopia, especially internalizing problems. The study also identifies several risk factors associated with internalizing and externalizing problems, such as wealth index, school types, alcohol use, bullying, and rural residence. These factors may indicate the need for more mental health awareness and support programs for adolescents in Ethiopia. This highlights that schools and communities should prioritize mental health awareness and support programs for adolescents. These programs should be tailored to address the specific needs of the population, such as rural residents, those in the lowest wealth index, and those who have experienced bullying., (© 2024. The Author(s).)

Background: Given that antipsychotic medication is a cornerstone for treating and preventing relapse in people with schizophrenia, non-adherence has been indicated as a big challenge. This study aimed to assess antipsychotic medication non-adherence and factors associated among patients with schizophrenia in eastern Ethiopia., Methods: We conducted an institution-based cross-sectional study in two public hospitals in Eastern Ethiopia from December 1, 2022, to January 31, 2023. Antipsychotic medication adherence was assessed using MOrisky medication adherence rating scale questionnaire, and insight was measured using the self-report insight scale for Psychosis (ISP). Multiple stepwise logistic regression models with Adjusted Odds Ratio (AOR) and 95% confidence interval (CI) were applied to identify the factors. Statistical significance was considered at p-value ≤ 0.05., Results: We found that 44.57% of patients with schizophrenia experienced non-adherence to their antipsychotic medication. Being single (AOR = 2.48, 95% confidence interval [CI]:1.71, 3.58), alcohol users (AOR = 2.00, 95% confidence interval [CI]:1.46, 2.72), Khat chewers (AOR = 2.84, 95% confidence interval [CI]; 2.06, 3.90) and having no insight to their illness (AOR = 2.1, 95% confidence interval [CI]:1.52, 2.90) were more likely to be non-adherent to their antipsychotic medications., Conclusions: Our study revealed that antipsychotic medication non-adherence was high among individuals suffering from schizophrenia and that it was influenced by various factors such as single marital status, alcohol usage, Khat chewing, and having no understanding of their condition. As a result, comprehensive intervention methods should be developed to address the factors associated with psychotropic medication non-adherence among patients. Healthcare professionals should pay attention to these aspects and consider developing specific strategies to promote adherence to medications while treating individuals with schizophrenia., (© 2024. The Author(s).)

Background: The 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., Methods: A 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 < 0.05., Results: The women in the young age group (AOR = 2.33, 95% CI: 1.03, 5.26), missed their antenatal care visits (AOR = 2.23, 95% CI: 1.18, 4.21), failed to utilize postpartum contraceptives (AOR = 5.98, 95% CI: 3.62, 9.89), did not attend postnatal care visit (AOR = 1.86, 95% CI: 1.13, 3.05), nonexclusive breastfed (AOR = 4.05, 95% CI: 2.18, 7.52), short and medium period of breastfeeding (AOR = 4.00, 95% CI: 1.34, 12.10) and (AOR = 3.56, 95% CI: 1.62, 7.82), respectively and female sex of preceding child (AOR = 1.92, 95% CI: 1.18, 3.12) were the important risk factors of short birth interval., Conclusions: Women's age, antenatal care visits, postnatal care attendance, utilization of postpartum contraceptives, exclusive breastfeeding practice, duration of breastfeeding, and sex of the preceding child were the primary predictors of short birth intervals. Improving the utilization of maternal healthcare services in health facilities would be imperative to prevent and reduce short birth intervals, and its negative consequences., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Aleye, Usso, Mengistie, Dessie, Adem, Alemu, Yuya and Mohammed.)

Background: The cost of maternal complications is considered as an important factor hindering the utilization of maternal health care services. However, information of estimate of spending on maternal complication was lacking. This study was aimed to estimate the cost of maternal complications and associated factors among mother's attending Hawassa public hospitals, Sidama Regional state, Ethiopia., Methods: A cross-sectional study design was conducted among 348 randomly selected mothers attending public hospitals in Hawassa from November 15 to December 15, 2021. Data was coded and entered into Epi Data version 3.1 and exported to STATA version 16.0 for analysis. Simple and multiple linear regression analysis was done. Correlation coefficient along with 95% CI was used to present the finding and p  < 0.05 was used to declare statistical significance., Results: This study found that total median cost of maternal complications was 4895.5 (IQR = 3779) ETB. The total median direct medical cost was 1765.5 (IQR = 1649.5) ETB. Number of days absent [( R  = 0.028; 95% CI: (0.023, 0.033)], distance from facility [( R  = 0.001; 95% CI: (0.000, 0.002)], site of laboratory diagnosis [( R  = 0.230; 95% CI: (0.140, 0.320)], number of laboratory test conducted [( R  = 0.045; 95% CI: (0.021, 0.069)] were found to be significance predictors of maternal complications costs., Conclusions: Total median cost of maternal complications in current study was high. Respondents' site of diagnosis, number of days missed from work, number of laboratory tests, and distance from hospitals were independent predictors of maternal complications cost. Thus, we will recommend governments to introduce strategies that specifically help mothers with maternal complications., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Objective: To assess diabetes knowledge and foot care practices among type 2 diabetes patients., Design: An institution-based cross-sectional study was undertaken from 1 January to 31 January 2021., Setting: Eastern Ethiopia., Participants: Randomly selected type 2 diabetes patients who were available during the data collection period were included., Outcomes: Patients' diabetes knowledge was assessed with the revised diabetes knowledge test questionnaire. Five items were used to evaluate foot self-care practices., Results: The study population comprised of 549 patients. About 52.5% of the patients had adequate diabetes knowledge (95% CI: 48.2% to 56.7%). Patients with an educational level of secondary school and above (adjusted OR (AOR): 2.04, 95% CI: 1.13 to 3.71), (AOR: 5.28, 95% CI: 2.28 to 12.22), and those with medium and above wealth status (AOR: 3.81, 95% CI: 2.24 to 6.47), (AOR: 3.46, 95% CI: 1.98 to 6.04), were found to have better odds of having adequate diabetes knowledge. However, those aged >55 years (AOR: 0.47, 95% CI: 0.22 to 0.99) were found to have lower odds of adequate diabetes knowledge.Of the total included patients, 20.2% (95% CI: 16.9% to 23.8%) had good foot care practices. Knowledge of the target fasting plasma glucose (AOR: 3.18, 95% CI: 1.94 to 5.22) and adequate diabetes knowledge (AOR: 3.40, 95% CI: 1.95 to 5.91) were significantly associated with good foot care practices., Conclusion: According to this study, about half of individuals with type 2 diabetes have adequate levels of knowledge about the disease. In addition, only one out of every five patients has good foot care habits. Diabetes education should emphasise the significance of rigorous adherence to daily foot care practices., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: In Ethiopia, there is limited evidence on the effect of dietary protein intake on women's body mass index. Therefore, this study investigated the association between dietary protein intake, diet quality, and overweight and obesity., Methods: A cross-sectional study was conducted among 897 women of reproductive age. Food frequency questionnaires were used to assess 7-day dietary intake. It was converted into protein and other macro-nutrient intakes, Minimum Dietary Diversity for Women, and Global Dietary Quality Score. Body Mass Index (BMI) of overweight & obese women were defined as ≥25 kg/m 2 . An adjusted odds ratio with a 95% confidence interval (in a multivariate logistic regression model) was used to determine the strength of the association between BMI and dietary protein intake, adjusting for potential confounders., Results: The median dietary protein intake was 41.3 (32.9, 52.6) grams/day or 0.8 (0.6, 1.0) grams/kilogram of body weight/day. The prevalence of overweight and obesity was 7.5% ( n  = 67). Only 220 (24.5%) women could meet the recommended minimum dietary diversity of five or more food groups out of 10 per day. Furthermore, only 255 (28.4%) women were found to have a low risk for nutrient adequacy. Interestingly, women who consumed moderate dietary protein had a significantly lower likelihood of being overweight or obese, with AOR of 0.21 (95% CI 0.10-0.48). Similarly, those who consumed a high amount of protein had even lower odds, with AOR of 0.03 (95% CI 0.01-0.14), compared to those who consumed a low amount of dietary protein. Age of 40-49 years (AOR = 3.33, 95% CI 1.24-8.95) compared to 18-29 years, non-farmers (AOR = 3.21, 95% CI 1.55-6.62), higher consumption of food from unhealthy groups (AOR = 1.30, 95% CI 1.05-1.61), and high fat intake (AOR = 1.06, 95% CI 1.04-1.09) were associated with overweight and obesity., Conclusions and Recommendations: The study indicated an inverse relationship between BMI and dietary protein intake. It also revealed that women who consumed foods from unhealthy or unhealthy when consumed in excessive amounts were more likely to be overweight or obese. Increasing dietary protein consumption can help reproductive-age women reduce the odds of obesity and overweight. Furthermore, community-based educational programs, policy changes, and healthcare services can support this effort., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Roba, Assefa, Roba, Dessie, Hamler and Fawzi.)

There is a need to identify risk factors, including nutrition-related factors, for depressive disorders among sub-Saharan African (SSA) adolescents. We examined the association of multiple measures with depressive symptoms among adolescents living across six SSA countries. Building on previous analyses, we used data from a cross-sectional study conducted from 2015 to 2017 among adolescents aged 10-19 years in six SSA countries (N = 7512). Depressive symptoms were defined as highest tertile of the 6-item Kutcher Adolescent Depression Scale score. Using mixed-effects Poisson regression models, we pooled data across sites and examined the association of sociodemographic, nutrition, and other indices with depressive symptoms. We additionally assessed effect modification by sex, age, and school-going status. We observed higher risk of depressive symptoms among girls (adjusted risk ratio [RR]: 1.29, 95 % confidence interval [95 % CI]: 1.05-1.58, P  = 0.016), older adolescents (RR for 18-19 years: 1.59, 95 % CI: 1.44-1.76, P  < 0.001), and adolescents experiencing bullying (RR: 1.43, 95 % CI: 1.26-1.62, P  < 0.001) or violence (RR: 1.34, 95 % CI: 1.24-1.45, P  < 0.001). Adolescents experiencing food insecurity also had a higher risk of depressive symptoms (RR: 1.90, 95 % CI: 1.64-2.19, P  < 0.001) along with those consuming ≥ 5 servings of fruit and vegetables per day (RR: 1.18, 95 % CI: 1.03-1.34, P  = 0.015); conversely, those who consumed grains, roots and tubers in the past day were at decreased risk (RR: 0.73, 95 % CI: 0.69-0.77, P  < 0.001). There was no strong evidence of effect modification of associations. This study reinforces the potential role of multiple sociodemographic and nutrition-related measures on risk of depressive symptoms in these populations., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Vitamin A deficiency (VAD) during pregnancy is a public health challenge in low-income countries. There are inconsistent findings that can affect policy in planning appropriate intervention. This systematic review and meta-analysis were conducted to summarize the evidence in order to identify existing gaps and propose strategies to reduce VAD during pregnancy in Ethiopia., Methods: This study included published and unpublished observational studies searched from different databases (PubMed, CINHAL [EBSCO], Embase, Google Scholar, Directory of Open Access Journals, Web of Sciences, MEDLINE, Cochrane Library, Scopus, Google Search and MedNar). Statistical analysis was conducted using Stata version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effects model., Results: A total of 37 618 pregnant women from 15 studies were included. The overall pooled prevalence of VAD was 29% (95% confidence interval 21 to 36) with I2=99.67% and p<0.001. Socio-economic and sociodemographic factors were identified as affecting vitamin A deficiencies among pregnant women., Conclusions: Nearly one-third of pregnant women in Ethiopia had VAD. Strengthening intervention modalities that aimed to increase the uptake of vitamin A-rich foods can avert VAD among pregnant women in Ethiopia., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

In this study, zinc oxide nanoparticles (ZnO NPs) were synthesized using an aqueous extract of the Ocimum lamifolium ( O. lamifolium ) plant. The I-optimal coordinate exchange randomized response surface methodology (RSM) was used to optimize the effect of the zinc acetate precursor, temperature, and time on ZnO NPs by designing nine runs. From ANOVA analysis, the significance and validity of the designed model showed that the optimal values of the zinc acetate precursor, temperature, and time during ZnO NPs synthesis were found to be ∼0.06 M, ∼30 °C, and ∼1.35 h, respectively. The obtained ZnO NPs under these optimized conditions were characterized and explored by UV-vis, TGA/DTA, FTIR, XRD, SEM-EDX, TEM, HRTEM, and SAED. Furthermore, the electrocatalytic performance of ZnO NPs was performed for sulfamethoxazole (SMZ) sensing activity with a 0.3528 μM (S/N = 3) limit of detection (LOD). In addition, an antibacterial study revealed that ZnO NPs confirmed an excellent zone of inhibition against E. coli , S. aureus , P. aeruginosa , and S. pyogen pathogenic drug resistance bacterial strains at concentrations of 50, 75, and 100 μg/mL. Thus, ZnO NPs synthesized using the O. lamifolium leaf have a potential electrocatalytic activity for diverse organic pollutant detection as well as a desirable material for such drug resistance antimicrobial strains., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Background: Common mental disorders are highly prevalent in the population, affecting people across all regions of the world. In Ethiopia, mental disorders are the leading non-communicable disorders. World Health Organization (WHO) report shows that 4,480,113 (4.7%) and 3,139,003 (3.3%) people in Ethiopia are estimated to suffer from depression and anxiety, respectively. However, there are only limited studies conducted on common mental disorders in Africa including Ethiopia. Even if there was a previous study conducted among Harari regional state residents 7 years back, nowadays there are many possible factors that could increase the prevalence of common mental disorders in the community like the novel coronavirus pandemic, ethnic war, and current socio-economic crises in Ethiopia., Objective: To assess the prevalence of common mental disorders and associated factors among adult residents of Harari regional state, eastern Ethiopia., Methods: A community-based cross-sectional study was conducted from March 1 to March 30, 2022. A systematic random sampling technique was used to select 1,192 study participants. Data were collected by interviewer-administered structured and semi-structured questionnaires. A common mental disorder was assessed by the Self-Reporting Questionnaire of 20-Item (SRQ-20) questionnaire. Data were entered into Epi Data version 3.2 and exported to Stata Version 16 for analysis. The multivariable binary logistic regression analysis with a 95% confidence interval and p  < 0.05 was used to identify factors associated with common mental disorders., Result: From a total of 1,192 eligible participants, 1,168 responded to this survey, giving a response rate of 97.98%. The prevalence of common mental disorders among adults in the Harari Region of this study was 21.31% (95% CI, 18.8-23.60). Being female with Adjusted Odds Ratios (AOR = 1.31, 95%CI, 1.09-2.09), single (AOR = 2.03, 95%CI, 1.37-3.01), divorced (AOR = 3.06, 95%CI, 1.97-4.76), widowed (AOR = 1.79, 95%CI, 1.23-3.26), unemployed (AOR = 1.97, 95%CI, 1.18-3.31), having family history of mental illness (AOR = 3.17, 95%CI, 1.54-6.96) and age greater or equal to 55 years (AOR = 105, 95%CI, 1.69-3.54) were statistically associated with common mental disorders., Conclusion: The prevalence of common mental disorder in the study area was sharply increased. Being female, single, divorced, widowed, family history of mental illness, being unemployed and age greater or equal to 55 years old were statistically positively associated with common mental disorder. Considering these determinants, screening, early identification, and providing appropriate intervention for common mental disorders in the community should be of great concern., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Abdeta, Birhanu, Kibret, Alemu, Bayu, Bogale, Meseret, Dechasa, Wondimneh, Abinew, Lami, Wedaje, Bete, Gemechu, Nigussie, Negash, Dirirsa, Berhanu, Husen, Eyeberu, Godana, Dessie, Sertsu, Hiko, Asfaw, Dereje and Nigussie.)

Importance: The number of deaths of children younger than 5 years has been steadily decreasing worldwide, from more than 17 million annual deaths in the 1970s to an estimated 5.3 million in 2019 (with 2.8 million deaths occurring in those aged 1-59 months [53% of all deaths in children aged <5 years]). More detailed characterization of childhood deaths could inform interventions to improve child survival., Objective: To describe causes of postneonatal child deaths across 7 mortality surveillance sentinel sites in Africa and Asia., Design, Setting, and Participants: The Child Health and Mortality Prevention Surveillance (CHAMPS) Network conducts childhood mortality surveillance in sub-Saharan Africa and South Asia using innovative postmortem minimally invasive tissue sampling (MITS). In this cross-sectional study, MITS was conducted in deceased children aged 1 to 59 months at 7 sites in sub-Saharan Africa and South Asia from December 3, 2016, to December 3, 2020. Data analysis was conducted between October and November 2021., Main Outcomes and Measures: The expert panel attributed underlying, intermediate, and immediate conditions in the chain of events leading to death, based on histopathologic analysis, microbiological diagnostics, clinical data, and verbal autopsies., Results: In this study, MITS was performed in 632 deceased children (mean [SD] age at death, 1.3 [0.3] years; 342 [54.1%] male). The 6 most common underlying causes of death were malnutrition (104 [16.5%]), HIV (75 [11.9%]), malaria (71 [11.2%]), congenital birth defects (64 [10.1%]), lower respiratory tract infections (LRTIs; 53 [8.4%]), and diarrheal diseases (46 [7.2%]). When considering immediate causes only, sepsis (191 [36.7%]) and LRTI (129 [24.8%]) were the 2 dominant causes. An infection was present in the causal chain in 549 of 632 deaths (86.9%); pathogens most frequently contributing to infectious deaths included Klebsiella pneumoniae (155 of 549 infectious deaths [28.2%]; 127 [81.9%] considered nosocomial), Plasmodium falciparum (122 of 549 [22.2%]), and Streptococcus pneumoniae (109 of 549 [19.9%]). Other organisms, such as cytomegalovirus (57 [10.4%]) and Acinetobacter baumannii (39 [7.1%]; 35 of 39 [89.7%] considered nosocomial), also played important roles. For the top underlying causes of death, the median number of conditions in the chain of events leading to death was 3 for malnutrition, 3 for HIV, 1 for malaria, 3 for congenital birth defects, and 1 for LRTI. Expert panels considered 494 of 632 deaths (78.2%) preventable and 26 of 632 deaths (4.1%) preventable under certain conditions., Conclusions and Relevance: In this cross-sectional study investigating causes of child mortality in the CHAMPS Network, results indicate that, in these high-mortality settings, infectious diseases continue to cause most deaths in infants and children, often in conjunction with malnutrition. These results also highlight opportunities for action to prevent deaths and reveal common interaction of various causes in the path toward death.