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Hiwot Berhanu,1 Berhe Gebremichael,1 Kedir Teji Roba,1 Sisay Moges,2 Merhawi Gebremedhin3 1School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Family Health, Hossana College of Health Sciences, Hossana, Ethiopia; 3School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Sisay Moges, Email sisaymoges55@gmail.comBackground: Ethiopia is one of the developing countries hit by the double burden of malnutrition both under and over nutrition. Inappropriate food choice decisions are among the reasons for the problem, which are poorly investigated in the country, and it is concerned with providing information about the drivers of food choice decision-making process behavior that reflects the behavior of the young population, particularly in college students, which provides a window of opportunity for nutritional interventions. Therefore, this study aims to assess drivers of food choice among college students in Addis Ababa, Ethiopia.Methods and Materials: An institution-based cross-sectional study was conducted among 330 students who were selected using multistage sampling. For analysis, data were input into Epi Info version 7 and exported to STATA version 16.0. To summarize the data, descriptive measures such as frequencies, percentages, and summary measures were employed. Exploratory and confirmatory factor analyses were performed using a structural equation model to identify the driving factors of food choice.Results: Mood, health concern, sensory appeal, price, convenience, and familiarity were identified as drivers of food choice with significant factor loadings (p < 0.001) and acceptable internal consistency of items (α=0.91). However, the naturalness of the dietary composition and weight concerns have received the least attention.Conclusion: The study identified various biological, social, and economic factors that drive food choice decisions. Effective nutrition education and preventive interventions should be implemented to reduce unhealthy food decisions among college students through promoting favorable food choice decisions.Keywords: food drivers, food choice, confirmatory analysis, SEM, Ethiopia, college students

Delayehu Bekele,1 Feiruz Surur,1 Balkachew Nigatu,1 Alula Teklu,2 Tewodros Getinet,3 Munir Kassa,4 Merhawi Gebremedhin,5 Berhe Gebremichael,5 Yonas Abesha6 1Department of Obstetrics and Gynecology, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2Saint Paul’s Hospital Millennium Medical College, Research Office, Addis Ababa, Ethiopia; 3Public Health Department, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 4Federal Ministry of Health, Ministry’s Office, Addis Ababa, Ethiopia; 5School of Public Health, Haramaya University, Harar, Ethiopia; 6Private Consultancy Practice, Addis Ababa, EthiopiaCorrespondence: Merhawi Gebremedhin Email meriget12@gmail.comBackground: Despite recent improvements in the use of contraceptives amongst married women in Ethiopia, the utilization rates are still far below the national figures in the emerging regions of the country. Therefore, there is a need to assess the level of knowledge and attitudes towards family planning, and associated factors among reproductive-age women in the four emerging regions of Ethiopia.Methods: A community-based cross-sectional study was conducted among 2891 reproductive-age women from 01 to 30 June, 2017. The data were collected by open data equipped tablets with kit software using structured questionnaire. The collected data were exported to STATA version 14 for analysis. Knowledge and attitude were assessed using tools containing 12 and 9 questions, respectively. Mean scores were used as cut-off points. Internal consistency of the tool was checked using Cronbach alpha coefficient, and it was 0.87 for knowledge and 0.78 for attitude questions. Bivariate and multivariate analyses were done, and statistical significance was declared at p-value ≤ 0.05.Results: Less than half, 1254 (43.4%), of the participants had good knowledge and 1511 (52.3%) had favorable attitude towards FP. Positive predictors of good knowledge of family planning were: being from Benishangul-Gumuz region, urban residence, older age, high level of education, being Christian and merchant, high household monthly income, and listening/watching radio/TV. On the other hand, high family size and ideal desired children were negative predictors. For a favorable attitude, the positive predictors include older age, high level of partner education, listening/watching radio/TV, being from BG region and having a good knowledge of FP. Desiring high number of ideal children and being a student by occupation were negatively associated with a favorable attitude.Conclusion: The study revealed that significant number of women had poor knowledge and attitude towards FP. Multiple socio-demographic factors contributed to knowledge and attitude of FP. Therefore, the health sectors of the regions and other stakeholders should strengthen the health extension program to disseminate messages related to FP to improve the knowledge and attitude of women.Keywords: attitude, emerging regions, Ethiopia, family planning, knowledge, reproductive-age women

Background: The consequences of the war and siege in Tigray on pertussis cases have not been previously assessed., Method: All children diagnosed with pertussis in Ayder Hospital two years before and during the war and siege of Tigray. Data were collected using ODK software and analysed with SPSS version 22. Descriptive statistics, chi-square tests, and the Mann-Whitney U test were used to assess the impact of the war and siege. A p-value of less than 0.05 was considered statistically significant., Results: Data from a total of 144 children were analysed, most of whom (78.5%, 113/144) had been admitted during the war and siege period. Males accounted for 53.5% of the cases. Statistically significant differences were observed during the war and siege compared to pre-war time with age ( p = 0.043), patient complications ( p = 0.011), vaccination status ( p = 0.015), nutritional status ( p = 0.039), type of pertussis ( p = 0.043), receipt of appropriate treatment ( p = 0.000), and place of treatment ( p = 0.011). Poor outcomes and treatment were more prevalent during the war than before., Conclusion: Pertussis outbreaks during the war and siege in Tigray were associated with poorer outcomes across all age groups.

Phenotypic traits like plant height are crucial in assessing plant growth and physiological performance. Manual plant height measurement is labor and time-intensive, low throughput, and error-prone. Hence, aerial phenotyping using aerial imagery-based sensors combined with image processing technique is quickly emerging as a more effective alternative to estimate plant height and other morphophysiological parameters. Studies have demonstrated the effectiveness of both RGB and LiDAR images in estimating plant height in several crops. However, there is limited information on their comparison, especially in soybean ( Glycine max [L.] Merr.). As a result, there is not enough information to decide on the appropriate sensor for plant height estimation in soybean. Hence, the study was conducted to identify the most effective sensor for high throughput aerial phenotyping to estimate plant height in soybean. Aerial images were collected in a field experiment at multiple time points during soybean growing season using an Unmanned Aerial Vehicle (UAV or drone) equipped with RGB and LiDAR sensors. Our method established the relationship between manually measured plant height and the height obtained from aerial platforms. We found that the LiDAR sensor had a better performance (R 2 = 0.83) than the RGB camera (R 2 = 0.53) when compared with ground reference height during pod growth and seed filling stages. However, RGB showed more reliability in estimating plant height at physiological maturity when the LiDAR could not capture an accurate plant height measurement. The results from this study contribute to identifying ideal aerial phenotyping sensors to estimate plant height in soybean during different growth stages., Competing Interests: The authors declare that the research was conducted without any commercial or financial relationships that could potentially create a conflict of interest., (Copyright © 2025 Pun Magar, Sandifer, Khatri, Poudel, KC, Gyawali, Gebremedhin and Chiluwal.)

Background: One in three women experienced intimate partner violence (IPV) worldwide which has remained major public health challenge. Women's reproductive health service utilization has been seriously impacted by IPV. There is a paucity of evidence on the magnitude of IPV among contraceptive users in southern Ethiopia. Hence, the main aim of this study was to determine the level of IPV and its associated factors among married women who were contraceptive users in primary health care settings in Adilo Zuria district in southern Ethiopia., Methods: A facility-based cross-sectional study was conducted among systematically recruited 405 married women who were contraceptive users in a primary health care setting in Adilo Zuria district in southern Ethiopia. Data were collected through face-to-face interviews using an adapted tool from existing literature including the World Health Organization IPV survey. Collected data were entered into EpiData 4.6 and exported to SPSS version 26 for cleaning and analysis. Descriptive and logistic regression analyses were performed to determine the level of IPV and identify factors associated with IPV. An adjusted odds ratio (AOR) from multiple logistic regression at a 95% confidence interval (CI) was used to declare a significant association., Results: The prevalence of current IPV among contraceptive users was 72.6% (95% CI; 68.1-76.8%). Current psychological, physical, and sexual violence were 39.3%, 38.5%, and 31.9%, respectively. In multivariable analysis, women's being rural resident (AOR: 3.19, 95%CI: 1.69-6.02), women's formal education (AOR: 0.37, 95%CI: 0.19-0.70), partners alcohol consumption (AOR: 3.32, 95%CI: 1.89-5.84), partners Khat chewing (AOR: 7.22, 95%CI: 4.12-12.65) and poor social support (AOR: 2.47, 95%CI: 1.43-4.27) were significantly associated with current IPV against women., Conclusions: Women's experience of IPV on contraceptive users was found to be unacceptably high in the study area. Women's being rural residents, having poor social support and partners who drank alcohol and Khat chewing were predictors of women's experience of IPV. Thus, interventions in improving women's educational status, strengthen the social support systems, and the behavior of partners who use stimulant substances are highly relevant to tackle IPV among contraceptive users in the primary healthcare setting., Competing Interests: Declarations Ethics approval and consent to participate Ethical clearance to conduct the study was obtained from Haramaya University, College of Health and Medical Sciences Institutional Health Research Ethics Review Committee with reference number (IHRERC/2866/14). The study was conducted in accordance with the declaration of Helsinki. Informed verbal and written consent were obtained from each study participant on voluntary basis to be included in the study. Informed consent from participant/legal guardian and assent from them were obtained from study participants who age younger than 18 years old, and not attended formal education. The collected data had kept confidential anonymously through de-identification of names and other personal identifiers from record/sheet. Parents/guardians in case of minor study participants and legally authorized representatives in case of illiterate participants. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

The armed conflict in Tigray, which spanned from November 2020 to November 2022, along with the accompanying siege, led to the near-total collapse of Tigray's healthcare system. Type 1 Diabetes Mellitus, the most common chronic condition in children, requires significant lifestyle adjustments, including daily insulin injections, regular glucose monitoring, and dietary modifications; all of which are severely impacted by war and siege. This study compared Type 1 diabetes care for children at the Ayder Comprehensive Specialized Hospital, Tigray, during the conflict and siege period with that of the pre-war period. We conducted a retrospective cross-sectional survey, analyzing data from September 2019 to August 2020 (pre-war period) and comparing it with data from September 2021 to August 2022 (war and siege period). Descriptive statistics, including frequencies and percentages, were employed, and Pearson's or Spearman's correlation analyses were used to evaluate correlations where appropriate. We identified 143 pediatric patients admitted (56 during the pre-war period and 87 during the war and siege period), with a mean age of 109 months in both periods. During the war and siege, a higher proportion of diabetes admissions were due to diabetic ketoacidosis (DKA) (90%) compared to the pre-war period (75%). In the pre-war period, the most common trigger for DKA was infections (35%), while in the war and siege period, it shifted to malnutrition (47%), infections (46%), lack of access to healthcare facilities (31%), and running out of medicines (24%). Complications such as death, renal failure, cerebral edema, and shock were more prevalent during the war and siege periods. The case fatality rate was significantly higher during the war and siege (9%) compared to the pre-war period (0%), correlating strongly with the severity of DKA, the degree of hypokalemia, the presence of complications, and admission during the war and siege. Our study showed the negative impact of war and siege on diabetes care in children demonstrating a high rate of DKA admissions with increased severity, complications, malnutrition, and case fatality rates. People with diabetes especially type 1 deserve great attention during such a crisis as the lack of insulin could lead to severe complications including death., (© 2024. The Author(s).)

Attention is required for most higher-order cognitive functions. Prior studies have revealed functional roles for the prefrontal cortex and its extended circuits to enabling attention, but the underlying molecular processes and their impacts on cellular and circuit function remain poorly understood. To develop insights, we here took an unbiased forward genetics approach to identify single genes of large effect on attention. We studied 200 genetically diverse mice on measures of pre-attentive processing and through genetic mapping identified a small locus on chromosome 13 (95%CI: 92.22-94.09 Mb) driving substantial variation (19%) in this trait. Further characterization of the locus revealed a causative gene, Homer1, encoding a synaptic protein, where down-regulation of its short isoforms in prefrontal cortex (PFC) during early postnatal development led to improvements in multiple measures of attention in the adult. Subsequent mechanistic studies revealed that prefrontal Homer1 down-regulation is associated with GABAergic receptor up-regulation in those same cells. This enhanced inhibitory influence, together with dynamic neuromodulatory coupling, led to strikingly low PFC activity at baseline periods of the task but targeted elevations at cue onset, predicting short-latency correct choices. Notably high- Homer1 , low-attentional performers, exhibited uniformly elevated PFC activity throughout the task. We thus identify a single gene of large effect on attention - Homer1 - and find that it improves prefrontal inhibitory tone and signal-to-noise (SNR) to enhance attentional performance. A therapeutic strategy focused on reducing prefrontal activity and increasing SNR, rather than uniformly elevating PFC activity, may complement the use of stimulants to improve attention., Competing Interests: DECLARATION OF INTERESTS The authors declare no competing interests.

Background: The Ethiopian health extension program (HEP) is an innovative community-based strategy aimed at disease prevention and health promotion. While health extension workers (HEWs) are its front-line workers, the involvement of clinicians remains an integral part. The goals of this study were to: (1) assess the correlation of clinician attitude with predictors and (2) assess the reliability and validity of the survey instrument., Methods: A cross-sectional study design was utilized to collect data from a sample of 1239 clinicians using 28 items of attitude questions. Exploratory factor analysis (EFA) was applied to create the latent variables. Oblique Promax type rotation with factor loading (> 0.5) was used. Cronbach's alpha was used to assess reliability, with a level of > 0.7 suggesting good reliability. Confirmatory factor analysis (CFA) was undertaken, with the values of Root Mean Square Error Administration (RMSEA) < 0.08, Standardized Root Mean Square Residual (SRMR) < 0.05, comparative fit index (CFI) 0.9-0.95, and Tucker-Lewis index (TLI) 0.9-0.95 suggesting acceptable model fit. A linear regression analysis was conducted., Results: EFA produced two latent variables which explained 93.2% of the total variance. The latent variables were labeled as perceived attitude towards the skill of HEWs (F1), and perceived attitude towards the impact of HEP (F2). Internal reliability for the 28 items was reported with a Cronbach's alpha of 0.94, and for F1 and F2 it was 0.91 and 0.90, respectively. CFA was done and RMSEA was reported at 0.04, SRMR was 0.03, and CFI and TLI were each 0.97. The value of clinician attitude increased by 3.5, 95% CI (1.5, 5.3), P-value < 0.001 for those who have been exposed to the HEP program than non-exposed. Similarly, clinician attitude was lower for degree holders compared to those with diplomas by - 2.7, 95% CI (- 4.4, - 0.94), P-value < 0.002., Conclusion: Clinician attitude increased as exposure to HEP increased. Clinician attitude towards HEP has two latent variables. Furthermore, the assessment tool demonstrated good reliability and validity. In conclusion, it is worthy valued for clinicians to receive orientation about HEP, and researchers and program evaluators can use this assessment tool., (© 2022. The Author(s).)

Background: Delayed tuberculosis (TB) diagnosis and treatment increase morbidity, mortality, expenditure, and transmission in the community. Early diagnosis and initiation of treatment are essential for effective TB control., Objective: The main objective of this study was to assess the magnitude and factors associated with health system delay among tuberculosis patients in Gamo Zone, Southern Ethiopia., Methods: A cross-sectional study was conducted in Gamo Zone, Southern Ethiopia from February to April 2019. Fifteen health facilities in the study area were selected randomly and 255 TB patients who were ≥ 18 years of age were included. Data were collected using a questionnaire through face-to-face interviews and analyzed using SPSS version 20.0. Health system delay was analyzed using the median as a cut-off. Logistic regression analysis was performed to investigate factors of delays. A p-value of ≤ 0.05 at multivariable analysis was considered statistically significant., Results: The median (inter-quartile range) of health system delays was 14(6-30) days. About 54.5% of patients had prolonged health system delays. Patients who had multiple healthcare contacts (AOR: 5.74; 95% CI: 2.47, 13.34) and aged between 25 and 44 years old (AOR: 1.98; 95% CI: 1.02, 3.86) and aged ≥ 45 years (AOR: 3.54; 95% CI: 2.17, 14.27) were significantly associated with longer health system's delay. However, female gender (AOR: 0.46; 95% CI: 0.25, 0.87) and patients presenting symptoms [Hemoptysis (AOR: 0.27; 95%CI: 0.11, 0.65) and Chest pain (AOR: 0.28; 95%CI; 0.14, 0.56)] were significantly associated with reduced health system's delay., Conclusion: In this study, it was observed that a significant proportion of patients experienced more than the acceptable level for health system delay. The number of health care contact, presenting symptoms, age and sex were factors associated with health system delay. Hence, increasing clinician awareness of TB clinical presentation, implementing systems enabling early case detection, and ensuring rapid diagnosis of TB are required to achieve further TB control. Finally, maintenance of a high index of suspicion for tuberculosis in the vulnerable population could reduce long health system delays in the management of TB., 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., (© 2022 The Author(s).)

Background: Ideation refers to the ideas and views that people hold; it has been identified as an important explanation for differences in contraceptive use within and across countries. This study aimed to identify ideational factors that influence intention to use family planning (FP) methods among women of reproductive age (WRA) in the four emerging regions of Ethiopia., Methods: A quantitative cross-sectional survey of 2891 WRA was carried out in the four emerging regions of Ethiopia. A multistage, stratified systematic random sampling technique was employed to select the study participants. Data were collected by trained enumerators, using tablets equipped with Open Data Kit. To assess the impact of ideation on intention to use FP, the research team used 41 items distributed across five broad ideational factors: contraception awareness, self-efficacy, rejection of myth and rumor, intra-family discussion and family support. Confirmatory factor analysis was employed to test the fit of these items into the five ideational factors. A multiple binary logistic regression analysis was employed to assess the combined effect of these ideational factors with different sociodemographic variables on intention to use contraceptive methods. In all the statistical analysis, a p-value < 0.05 was considered statistically significant., Results: Different proportions of women in the four regions intended to use contraceptives in the future: 74.9% in Benishangul-Gumuz, 50.1% in Gambela, 21.8% in Afar, and 20.1% in Somali. The proportion of women who intended to use contraceptives varied with ideation scores. The multiple binary logistic regression revealed that self-efficacy was an important ideational factor of intention to use contraception in all four regions. Rejection of myth and rumor was also an important factor in all regions except in Somali. Contraception awareness and family support were significant predictors of intention to use contraception in the Afar region only. Intra-family discussion was not found significant in any region., Conclusions: Regional/district health offices should focus on increasing self-efficacy for FP use. Demystifying rumors would contribute to improved intention to use FP among women in Afar, Benishangul-Gumuz, and Gambela regions. Raising contraception awareness and encouraging family support would improve intention to use FP in Afar region., (© 2022. The Author(s).)

Background: Ethiopia is the second most populous country in Africa, known for its high fertility and low contraceptive use. The magnitude of contraceptive use in the emerging regions of the country is below the national average. However, there is a paucity of evidence regarding the reasons for low contraceptive use in these regions. Therefore, this study aimed to assess contraceptive use and associated factors in the emerging regions of Ethiopia., Methods: For the quantitative part, a community based cross-sectional study was conducted among 2891 reproductive age women who were selected by multistage sampling technique. Data were collected face to face using an open data kit software, and STATA version 14 was used for data analysis. Frequencies, percentages, summary measures and tables were used to summarize and present the data. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with contraceptive use, by computing odds ratio with 95% confidence interval. Level of significance was considered at p-value < 0.05. For the qualitative part, phenomenological study was conducted among 252 health care workers and community members who were selected purposely. The data were collected by focused group discussions, in-depth interviews and key informant interviews. The data were audio-recorded in the local languages, and then translated to English verbatim. NVivo version 11 was used to analyze the data through a thematic analysis method., Results: The overall contraceptive prevalence rate was 22.2%; with 11.7, 38.6, 25.5 and 8.8% for Afar, Benshangul Gumuz, Gambela and Somali Regions, respectively. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. Additionally, the qualitative study identified three themes as barriers to contraceptive use: individual, health care system and sociocultural factors., Conclusions: Contraceptive prevalence rate was low in this study compared to the national average. Age, religion, education, marital status, family size, ideal children, knowledge and attitude were significantly associated with contraceptive use. From the qualitative aspect, individual, health care system and sociocultural factors were identified as barriers to contraceptive use. Therefore, the emerging regions of Ethiopia need special focus in increasing contraceptive use through behavioral influence/change.

Background: An intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate postpartum family planning (PPFP) services need to be emphasized when the woman leaves the hospital. Despite the accepted demand for PPFP, many women do not access the services. Therefore, this study aimed to assess acceptability and factors associated with immediate postpartum intrauterine contraceptive device use among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia., Methods: A cross-sectional study was conducted from March 1 to 30, 2019 with 452 participants studied using systematic random sampling technique. Data was collected using a pretested interviewer-administered questionnaire from March 1 to 30, 2019. The data were coded, cleaned and entered into Epi-data manager version 4.2.2.1 and exported to SPSS version 23 for advanced analysis. Binary logistic regression was performed to identify associated factors of immediate PPIUCD acceptability., Results: This study revealed that about 161 (35.6%) in 95% CI (31.0, 39.6) of the study participants accepted immediate PPIUCD. Multiparty (AOR = 2.33, 95% CI, (1.29, 4.20)), completed antenatal follow up (AOR = 3.65, 95% CI, (2.22, 5.99)), counselling (AOR= 8.38, 95% CI, (4.85, 14.48)) and prior discussion (AOR=2.57, 95% CI, (1.51, 4.36)) were statistically significant., Conclusion and Recommendation: Even though 58% of the mothers were counselled about PPIUCD during the important cascade of pregnancy and 53% of the mothers completed antenatal service, efforts need to improve antenatal care services and integrate counselling services through the whole cascade of pregnancy., Competing Interests: The authors declare that they have no competing interests., (© 2021 Gebremedhin Jnr et al.)

The study examined the degradation of riot control agents (RCAs): 2-chloroacetophenone (CN), 2-chlorobenzalmalononitrile (CS), and capsaicin, using the Reactive Skin Decontamination Lotion Kit (RSDL®) lotion and evaluated the the direct liquid phase reactivity of the RSDL lotion component with each RCA. RSDL lotion was mixed with the selected RCAs at different molar ratios. Reactivity of the active ingredient potassium 2,3-butanedione monoximate (KBDO) with the RCA was observed for one hour. Samples of 10 μL were taken and quenched, analyzed for residual RCA using LC-MS. CN, was degraded at molar ratios of two and above in less than 2 min. At a molar ratio of 1:1 KBDO:CN, ∼90 % of CN was degraded within 2 min, the remaining 10 % residual CN was observed for one hour without any change. CS, degradation of more than 68 % of CS was achieved at 20:1 M ratio of KBDO:CS within 1 h of reaction time. For capsaicin, no degradation was observed regardless of the higher molar ratios of up to 20:1 and longer reaction times of up to one hour. This study provides evaluation of neutralizing action of the RSDL lotion without assessment of the physical removal component by the RSDL Kit., Competing Interests: Declaration of Competing Interest 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., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: One-fourth of neonatal death is due to neonatal sepsis and nearly 98% of these deaths are occurring at low- and middle-income countries. In Ethiopia, forty percent of under-five mortality occurs during the neonatal period, of which neonatal sepsis accounts for 30-35% of neonatal deaths next to prematurity and its complications. On the other side, among the survived neonates with neonatal sepsis, there exist as vulnerable to short and long-term neurological and developmental morbidity impacting the overall productivity of the child as adult., Methods: A longitudinal prospective cohort study was conducted among selected 289 neonates with neonatal sepsis who were admitted in the neonatal intensive care unit at public hospitals in Ethiopia from 1 st March 2018 to 31 st December 2019. Data were entered into Epi data version 3.02 and exported to SPSS V 25 for analysis. The Kaplan-Meier survival curve together with log-rank test was used to estimate the survival time of the neonates. Variables which had p value < 0.05 in multivariable analysis using the cox proportional hazard model were declared as statistically significant predictors of mortality., Results: The study was conducted with a total of 289 neonates admitted with neonatal sepsis. The cumulative proportion of surviving at the end of the fourth day was 99.5%, and it was 98.2% at the end of the fifth day. In addition, it was 96.6%, 93.5%, and 91.1% at the end of the sixth, seventh, and eighth day, respectively. The incidence of mortality was 8.65 per 100 neonates admitted with neonatal sepsis. Having a history of intrapartum fever (AHR: 14.5; 95% CI: 4.25, 49.5), history of chorioamnionitis (AHR: 5.7; 95% CI: 2.29, 13.98), induced labor (AHR: 7; 95% CI: 2.32, 21.08), and not initiating exclusive breastfeeding within one hour (AHR: 3.4; 95% CI: 1.34, 12.63) were the independent predictors of mortality., Conclusion: The survival status of neonates among neonates admitted with neonatal sepsis was high at the early admission days and high cumulative proportion of death as the admission period increased. The risk of mortality was high among the neonates with early onset of neonatal sepsis as compared with late onset of neonatal sepsis and history of intrapartum fever, history of diagnosed chorioamnionitis, onset of labor, and EBF initiation within one hour were the independent predictors of mortality among neonates admitted with neonatal sepsis., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2020 Samuel Dessu et al.)

In this study, we assessed the efficacy of the Reactive Skin Decontamination Lotion (RSDL®) Kit against parathion and aldicarb pesticide dermal exposure in a guinea pig model. The pesticides inhibit acetylcholinesterase (AChE) leading to signs and symptoms of hyperactivity of organs due to accumulation of acetylcholine. The RSDL Kit has been shown to physically remove and chemically degrade chemical warfare agents. Degradation occurs from a nucleophilic substitution reaction between an active ingredient in the RSDL lotion, potassium 2,3-butanedione monoximate (KBDO), with susceptible sites in these compounds. In the present study, guinea pigs dermally exposed to parathion and aldicarb were decontaminated with RSDL to mitigate the toxic effects of the pesticides. It is observed that animals exposed to 749 mg/kg of parathion (n = 3) died within 24 h without RSDL decontamination; however, RSDL-treated animals (n = 3) showed only mild signs of neurotoxicity. The RSDL-treated animals had an AChE inhibition of 0-58% while the untreated animals had up to 86% inhibition. Similarly, RSDL has been demostrated to prevent aldicarb neurotoxicity effects. The percent inhibition of AChE activity during the 24 h post challenge of 9 mg aldicarb/kg of animal weight ranged from 25% to 61% with severe signs of intoxication while only up to 5% with mild or no signs of intoxication in the case of RSDL-decontaminated animals. Generally, it has been shown that the toxic effects of the organophosphate and carbamate pesticides can be prevented via decontamination using the RSDL Kit., Competing Interests: Declaration of competing interest 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., (Copyright © 2020 Elsevier B.V. All rights reserved.)

This study examined the degradation of organophosphate (OP) and carbamate pesticides using RSDL ® (Reactive Skin Decontamination Lotion Kit) lotion. Degradation occurs from a nucleophilic substitution (SN) reaction between an ingredient in the RSDL lotion, potassium 2,3-butanedione monoximate (KBDO), with susceptible sites in the pesticides. Evaluation at several molar ratios of KBDO:test articles using liquid chromatography-mass spectrometry (LC-MS) techniques was performed. The OP test articles, parathion, paraoxon, parathion-methyl, paraoxon-methyl and chlorpyrifos were effectively degraded at molar ratios of four and above in less than 6min contact time. Malathion and malaoxon were similarly converted to inactive by-products at molar ratios as low as two in less than 4min. A minimum molar ratio of nine was found to be effective against the carbamate pesticide carbofuran. In the case of aldicarb, complete destruction was achieved at a molar ratio of fifteen and a reaction time of one hour. It is important to note that these studies are based on a direct liquid phase RSDL lotion reaction with the toxic chemicals without the added physical removal decontamination efficacy component provided by the sponge component of the RSDL kit. The RSDL kit is intended to be used to remove or neutralize chemical warfare agents (CWA) and T-2 toxin from the skin. In actual use, the majority of the CWA decontamination occurs through the combined action of the sponge in both removing the chemical from the skin, and in rapidly mixing the chemicals at a high molar ratio of KBDO:CWA within the pores of the sponge to enhance rapid neutralization of the chemical., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Unsafe abortion is a neglected public health problem contributing for 13% of maternal death worldwide. In Africa, 99% of abortions are unsafe resulting in one maternal death per 150 cases. The prevalence of unsafe abortion is associated with restricted abortion law, poor quality of health service, and low community awareness. Hence, the aim of this systematic review and meta-analysis is to identify and summarize the available evidence to generate an abridged evidence on the prevalence of unsafe abortion and its associated factors in Sub-Saharan Africa., Methods: The development of the systematic review methodology has followed the procedural guideline depicted in the preferred reporting items for systematic review and meta-analysis protocol statement. Observational studies that have been conducted from January 1, 1994, up to December 31, 2017, in Sub-Saharan African countries will be included in the systematic review and meta-analysis. MEDLINE (via PubMed), EMBASE, CINAHL, and PopLine will be searched to retrieve available studies. Relevant studies will be retrieved using the search strings applied to different sources. The Joanna Briggs Institute quality assessment tool will be used to critically appraise the methodological robustness and validity of the finding to avoid erroneous data due to confounded or biased statistics. Data extraction template will be prepared to record abstracted information from selected studies. The selection of relevant studies, data extraction, and quality assessment of studies will be carried out by two authors. Meta-analysis using Mantel-Haenszel random effects model will be carried out. The presence of heterogeneity between studies will be checked using the I 2 value., Discussion: Unsafe abortion is not yet reduced significantly in Sub-Saharan Africa, and maternal death rate due to unsafe abortion remains high. Currently, there is a gap in availability of abridged evidence on unsafe abortion and this negatively influenced the current service delivery. This finding will help stakeholders to design appropriate strategy. The finding of this systematic review and meta-analysis will be helpful to inform policy-makers, programmers, planners, clinician's decision making, researchers, and women clients at large., Systematic Review Registration: PROSPERO 2017: CRD42017081437 .

Objective: The study was conducted on 313 model and 313 non model households to assess latrine utilization and factors affecting among model and non-model families., Result: About 225 (71.9%) model and 144 (46%) non-model participants declared that they utilize their latrine which gave the overall utilization rate of 369 (58.9%). Households with primary and above education were two times (AOR = 2.03, 95% CI 1.427, 4.638) more likely to utilize latrine as compared with illiterate households. Cleanness of the latrine was also found to be associated with latrine utilization in both model and non-model families. Age, type of latrine, latrine supper structure, cleanness and observable soap near the latrine in model families and age, educational status, occupation, latrine privacy and cleanness in non-model families were identified as a statistical significant factor for latrine utilization.

Background: Poor nutritional status of women has been a serious problem in Ethiopia. Rural women are more likely to be undernourished than urban women. Afar region is the most likely to be undernourished (43.5%). Despite the humanitarian and food aid, food insecurity and maternal underweight are very high in the region. Household food insecurity is not adequately studied in Afar region. The aim of this study was to assess the prevalence of household food insecurity and underweight status and its association among reproductive age women., Method: The study was conducted in Assayita district in June 2015. Community-based cross-sectional study design was used among nonpregnant women. Household data was collected using structured questionnaire. Multistage cluster sampling procedure was applied. Two pastoral and two agropastoral Kebeles have been selected by simple random sampling. Systematic random sampling was used to select respondents. The total sample size was 549 households. Household Food Insecurity Access Scale (HFIAS) and anthropometric data were used to determine food insecurity and underweight, respectively. Multivariate regression models were used to measure associations., Results: Prevalence of HFIAS was 70.4 with a mean of 7.0 (3.6 ± SD); 26.1%, 30.20%, and 14.1% were mild, moderate, and severe food insecurity, respectively. Underweight prevalence (BMI < 18.5) was 41.1% with prevalence of mild, moderate, and severe underweight being 34.5%, 3.9%, and 2.7%, respectively. Age, parity, and having >2 children below five years of age were statistically associated with household food insecurity and maternal underweight., Conclusion: Household food insecurity and maternal underweight were very high. Age, parity, and having ≥2 children below five years of age were associated with household food insecurity. Maternal underweight was associated with maternal age, marital status, parity, number of children below 5 years, household food insecurity, and vocation of the respondents.

Background: Long acting and permanent contraceptive methods are the most effective family planning (FP) methods to prevent pregnancy and thereby averting adverse consequences of too many and ill-timed pregnancies. However, long acting and permanent contraceptive methods (LAPMs) are underutilized in Ethiopia for little documented reasons. Therefore, this study is aimed to assess magnitude and factors associated with desire for birth spacing for at least 2 years or limiting child bearing and non-use of LAPMs among married women of reproductive age in Aksum town, Northern Ethiopia., Methods: A community-based cross-sectional study was conducted in Aksum town, North Ethiopia from May to June, 2015 among 779 randomly selected married women of reproductive age. Data were collected using interviewer administered pre-tested questionnaire. Data were entered using Epi-Info version 6.04 and exported to SPSS version 16 for analysis. Multivariate logistic regression models were fitted to identify factors associated with desire for birth spacing or limiting and not using LAPMs., Results: The total desire for birth spacing or limiting was 69 % and amongst those women 85.2 % were not using LAPM. Education, occupation, husband's attitude towards LAPMs, age, number of pregnancy, regular media exposure and decider on the number of children to bear were significantly associated with desire for birth spacing or limiting. Moreover; education, occupation, husband's attitude towards LAPMs, discussion on family planning with husband, knowledge, attitude and intention to use LAPMs were significantly associated with not using LAPMs., Conclusion: Desire for birth spacing or limiting and not using LAPMs is very high in the study area. Therefore, increasing access to family planning information and services with special emphasis on LAPMs and male involvement in the program are very important.

Background: Birth weight is an important determinant of child survival and development. So far, the prevalence and traditional maternal feeding practice correlates of low birth weight have not been explored well in Ethiopia. Therefore, the purpose of this study was to determine the prevalence and associated factors of low birth weight among mothers who delivered at governmental hospitals, Northern, Ethiopia., Methods: A cross-sectional mixed study design was carried out in 3 zonal hospitals among 308 mothers and their respective live born baby consecutively using interviewer administered piloted questionnaire and 3 focus group discussions were conducted for the qualitative part. The mothers were interviewed and assessed within 6 hours of delivery; all babies were weighed on standard beam balance from Aug 2 to Sep 12. Data were entered, cleaned and analyzed using SPSS version 16.0. Bivariate and multivariate logistic regression was employed to identify the predictors at p < 0.05. For the qualitative study design, following iterative hearing of the discussions verbatim interpretation was done & categorized in to themes and finally triangulated with the quantitative results., Results: The prevalence of low birth weight was found to be 14.6% (95 % CI = 12.56-16.61) and the mean and standard deviations of the birth weights were 3094.9 ± 587.6 grams. Low birth weight was associated with rural place of residence (AOR = 4.34 (95 % CI = 1.99-9.48)), preterm birth/gestational age less than 37 weeks (AOR = 18.5 (95 % CI = 4.94-69.4)), presence of any chronic medical illness (AOR = 5.3 (95 % CI = 1.12-25.45) and maternal weight <50 kg (AOR = 2.26 (95 % CI = 1.06-4.80)). It was found that tradition of selection and preference of nutritionally poor food items during pregnancy was deep-rooted in the community., Conclusion: The prevalence of low birth weight was found to be high and it was associated with rural place of residence, gestational age <37 wks, presence of any chronic medical illness & maternal weight <50 kg. Emphasis should be given to nutritional counseling and disease specific ANC provision by skilled health professionals; Discussions with the community and religious leaders are mandatory aspect on the tradition of feeding of pregnant mothers to tackle the problem. This study also calls for community based further studies.

Objective: To introduce clinical audit into a referral hospital in Ethiopia, and whether clinical standards can be improved as a result., Background: Clinical audit is a method of checking that patient care is delivered to the highest possible level by health care professionals. Practice is measured against agreed guidelines, and is then adjusted to meet the required standard., Methods: Audit was introduced into Gondar University Hospital. All departments took part including Paediatrica, Obstetrics, Medicine, Surgery, Nursing, and the Laboratory. A Lead Clinician was nominated and an audit clerk appointed Hospital staff received training. Topics were chosen according to need, for example: obstructed labour in Obstetrics; management of acute diarrhoea in children; and medical record-keeping., Results: 20 audits have been commenced--7 are completed 11 in progress and 2 are awaiting analysis. Excellent clinical practice has been highlighted such as treatment of common paediatric emergencies and documentation in patient records. Areas for improvement were discovered such as glucose-testing on the children's ward. Adjustments will be made to current practice where indicated by audit results, thus improving patient care. Local guidelines have been written to further ensure adherence to evidence-based clinical care., Conclusion: It is possible to set up audit in a busy Ethiopian hospital, and use the results to improve the standard of patient care.

Four pregnant Rhesus monkeys were given a 1 week protein restricted diet with the objective to monitor possible effects on transplacental transfer of [11CH3]-L-methionine with positron emission tomography (PET). The weight was reduced in all monkeys, two of which later had an intrauterine fetal death. The mean venous serum concentrations of free methionine in the mothers were not significantly changed during the study period, although a tendency towards lower values during protein restriction was noted like in the majority of the amino acids. The uptake of trace amount of [11CH3]-L-methionine in the fetus was studied with PET before the reduced diet, after 1 week on the reduced diet and after the return to a habitual diet. Our results indicate an increase in the uptake of radioactivity in the amniotic cavity after protein restriction. The PET-technique in its present form seems to be a useful method in the investigation of transplacental transfer of several natural amino acids as well as of other compounds labelled with 11C.