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Abstract Objectives This cross-sectional study was conducted on 399 patients at Hawassa University Comprehensive Specialized Hospital from February 15 to March 30/2018 to assess the length of stay (LOS) and its associated factors in emergency departments (EDs). Result About 91.5% patients were stayed in the EDs for greater than 24 h in different reasons. Inadequacy of beds in inpatient wards, overcrowding, absence of different laboratory test profiles and delay in radiological services were showed a significant differences in LOS greater than 24 h when compared to LOS ≤ 24 h in EDs (p

Introduction: Every year, HIV-associated tuberculosis (TB) deprives 350,000 mainly young people of productive and healthy lives. People die because TB is not diagnosed and treated in those with known HIV infection and HIV infection is not diagnosed in thos

Non-compliance is a major problem in the treatment of tuberculosis (TB). This paper assesses the effectiveness of 'TB clubs' in improving compliance with TB treatment and their impact in improving societal attitudes associated with TB. The study utilised both quantitative (cohort study) and qualitative (focus group discussion and an in-depth interview) methods. The cohort study was conducted in two rural districts of Northern Ethiopia. A total of 128 sputum positive pulmonary patients were enrolled and followed, 64 in the TB club and 64 in the comparison groups, to determine treatment outcome of anti-TB therapy. The impact of the TB clubs in changing societal attitudes and behaviour associated with TB was assessed using qualitative methods. The treatment completion rate was significantly better ([X.sup.2] = 5.41, P The complementary results obtained from the quantitative and qualitative components of the study indicate that the TB club approach has a significant impact in improving patients' compliance to anti-TB treatment and in building positive attitudes and practice in the community regarding TB. This study, thus, provides convincing evidences that the TB club approach is useful in delivering TB treatment successfully in rural populations. Further large-scale studies are needed to find out whether this approach is applicable on a national scale and to other developing countries. Keywords: Tuberculosis; Compliance to TB treatment; TB clubs; Ethiopia

Assefa Legesse Sisay,1 Habtamu Abebe Getahun,1 Nigusu Getachew,2 Tadesse Gebremedhin,1 Feyissa Mama Sebero,3 Addis Birhanu,1 Abraham Tamirat Gizaw4 1Department of Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia; 2Department of Health Policy and Management, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia; 3Jimma Emergency Operation Center, Jimma University, Jimma, Ethiopia; 4Department of Health, Behavior and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Assefa Legesse Sisay, Email assefa12161921@gmail.com; assefa.legesse@ju.edu.etBackground: Different vaccines have been approved for use against coronavirus disease and distributed globally in different regions. Efforts should be made on the vaccination to control the spread and impacts of the coronavirus pandemic. However, the general population’s attitudes and intention to uptake coronavirus disease 2019 (COVID-19) vaccinations were poor.Objective: This study aimed to assess the barriers to and intention to be vaccinated against COVID-19 and the associated factors among adults in the Jimma zone, Ethiopia.Methods: A community-based cross-sectional study with multistage sampling was conducted with 621 participants from 16 April to 17 May 2022. Multivariable logistic regression was used to identify factors associated with the outcome of interest. Statistical p-value ≤ 0.05 was set at p ≤ 0.05. Qualitative data were supplemented with quantitative results.Results: The majority of the study participants (382 [61.5%]) intended to uptake the COVID-19 vaccine. In this study, travel history (Adjusted Odds Ratio (AOR) = 2.18, 95% CI 1.23– 3.87), vaccination history (AOR = 2.64, 95% CI 1.69– 4.12), perceptions of infection prevention for COVID-19 (AOR = 1.97, 95% CI 1.28– 3.03), subjective norm (AOR = 2.27, 95% CI 1.52– 3.39), and perceived behavioral control (PBC) (AOR = 2.30, 95% CI 1.55– 3.41) were significantly associated with the intention to be vaccinated against COVID-19.Conclusion: More than half of the adult participants intended to be vaccinated against COVID-19. The study participant’s traveling history, vaccination history, perception of infection prevention for COVID-19, subjective norms, and Perceived Behavioral Control were significantly associated with the intention to be vaccinated.Keywords: barrier, COVID-19 vaccine, intention, theory of planned behavior, vaccine acceptance, Ethiopia

Understanding soil property and crop yield responses to variations in land use and topographic gradient is vital for designing targeted soil and agronomic management practices. This study investigated the interrelationships between land use, topographic position, soil properties, and crop yield. Three replicates of three land use types - enset agroforestry, cropland (annual crop), and grazing land - were selected along a toposequence (upper, middle and lower) for the study. A total of 54 composite soil samples were collected and analyzed. Grain yield and above ground biomass were also gathered from the cropland and analyzed. Soil profile descriptions revealed notable variations in soil physical properties, including soil texture, bulk density, color, horizons, and depth among the pedons of the three topographic positions. Clay and silt fractions exhibited significant differences between land uses and topographic positions, while the sand fraction was influenced by topographic position alone. Crop and grazing lands displayed higher clay content compared to the enset field. A decreasing trend in clay fraction was observed from upper to lower topographic positions. The enset field had significantly higher soil pH, OC, TN, and K+ contents than crop field. A significantly higher available P of 16.61 mg kg−1 was measured from lower slope position followed by 14.08 mg kg−1 in middle slope. The upper slope position had the highest exchangeable acidity of 3.09 cmol(+) kg−1), followed by middle slope with 2.77 cmol(+) kg−1), 2.45 cmol(+) kg−1) in the lower slope position. Grain yield and above ground biomass decreased from lower slope to middle slope and upper slope positions. These observed variations in soil properties and crop yield among land uses and topographic positions underscore the necessity for tailored soil management strategies and agronomic practices specific to land use types and the specific localized topographic conditions to optimize agricultural productivity.

Abstract Background Female sex workers (FSWs) are a marginalized group notoriously having limited healthcare access and poor-quality care. Inevitably, they are vulnerable to sexually transmitted infections including hepatitis B virus. However; Hepatitis B virus infection is one of the most serious infections and major public health problem considered to be at soaring risk for transmission and acquisition of the infection. Hence, this study was aimed to assess the prevalence and associated factors of HBV infections among FSWs in southern Ethiopia. Methods A cross-sectional study was conducted from November to February 2019 at Hawassa city in ISHDO confidential clinic among 383 FSWs. Respondent-driven consecutive sampling was used to select study participants using a standardized questionnaire. Blood sample was collected and viral surface antigen was detected using ELISA from separated serum. Data were entered to SPSS version 21.0. Descriptive and logistic regression analyses were used. Result The overall prevalence of FSWs who were tested for HBV using ELISA was 35(9.2%) (95% CI: 6.3–12.1). Among 381 FSWs 249(65.4%) were stayed for 2–5 years in sexual work and 240(63%) of them were used condom consistently during sexual practice. In multivariate logistic regression analysis, FSWs who didn’t use condom were six and two times more risk full to acquire HBV than those who used condom commonly (AOR = 6.38, CI 2.04–18.51) and condom breakage (AOR = 2.10, CI 1.95–4.65), during sexual practice respectively. Similarly, use of stimulants (AOR = 3.25, CI 1.59–18.63), previous history of STI (AOR = 2.15, CI 1.02–6.93), genital ulcer (AOR = 4.64, CI 1.31–11.35), number of sexual partners (AOR = 3.25, CI 1.59–7.47), sex during menses (AOR = 5.85, CI (1.29–21.44), sexual assault (AOR = 2.93, CI 1.23–9.01), sharp material sharing, (AOR = 4.98, CI 1.34–10.95) and history of abortion, (AOR = 2.46, CI 1.18, 12.19), were statistically associated with HBV infection. Factors such as age, residence, and alcohol consumption were not associated with HBV infection. Conclusion The prevalence of HBV infection in this study was relatively high compared to the general population. Factors like sociodemographic, behavioral, and previous history-related information were associated with HBV infection shows the need for ongoing screening of high-risk population to inform planning for vaccination and preventive measures.

Soil acidity is one of the major crop production constraints in the highlands of Ethiopia. Liming is becoming a common practice to amend soil acidity, but its effects on soil properties, crop yield, and farm income are not well studied. In this study, an on-farm liming experiment was conducted for two consecutive years (2020-2021) on acidic Nitisols (pH

Soil fertility is the ability of the soil to provide favorable chemical, physical and biological characteristics to sustain plant growth. Its physicochemical properties are greatly influenced by altitude and farmer wealth status. This study aimed to examine the differences in selected soil physicochemical properties under three agroecological zone based on altitude gradient (upper, middle, and lower) and wealth class (rich, medium, and poor) in the organic agriculture dominant area of the Gedeo zone, southern Ethiopia. Soil samples were collected from the field under organic agriculture. A total of 216 composite soil samples 3(altitude) 12 (wealth class) 3(replication) and 2 soil depth (0–30 and 30–60 cm) were collected and analyzed for some selected soil physical and chemical properties using standard soil analytical procedures. Data were subjected to a two-way analysis of variance to determine the effects of agroecological zones and wealth status of households on the soil properties. The result showed that soil physical properties such as sand (p < 0.01), clay (p < 0.05) and bulk density (BD) (p < 0.01) were significantly affected by altitudinal gradients. Soil organic carbon (SOC), cation exchange capacity (CEC), total nitrogen (TN) and phosphorus (P) were in the suitable range for agricultural soil, suggesting that the organic agricultural practices employed in the study area might be contributed to improved soil fertility. Soil pH (H2O, (p < 0.01), CEC (p < 0.05), SOC % (p < 0.001), TN % (p < 0.05), P(p < 0.001) and K (p < 0.05) were significantly varied due to difference in agroecological zone. Similarly, wealth class of farmer had significant influence on soil pH (H2O) (p < 0.001), SOC (p < 0.001) and P (p < 0.001). The results highlight the importance of the agroecological zone and wealth status of farmer households on soil fertility improvements in the study area. Hence, during the implementation of the soil fertility policy, considering the altitude and wealth status of the farmer is recommended to improve soil fertility.

We studied the effects of Acacia albida on the growth and yield of wheat, maize, and teff with increasing distance from trees in Ethiopia in the 2014/2015 cropping season. The treatments comprised four radial distances of 1.5m, 3.5m, 5.5m, and 12.5m as a control away from the tree with three replications. Results showed that higher wheat yields were recorded at 5.5m and 3.5m than at 12.5m, with yield increments of 11 and 12%, respectively compared to 12.5m. The highest maize yield was obtained from 3.5m, with a yield advantage of 12.3% compared to 12.5m. Teff yield increased with increasing distance from the tree trunk. Wheat and maize yield gains near the canopies may be associated with higher organic matter and soil nutrients, while their yield reduction with decreasing distance from the tree may be associated with the shading effect of tree canopies. Wheat was the most compatible crop when integrated with A. albida under shade conditions followed by maize, while teff was highly susceptible to shading effect. We suggest that integrating A. albida with the right crops and appropriate tree management could enhance crop yield. Lopping is required before sowing teff and maize with A. albida to minimize shading effects

Abstract Characterization and prioritization of watersheds has gained importance for proper planning and management of natural resources in sustainable development. Implementation of management practices over a larger area at the same time is inaccessible and uneconomical. So, it has required applying a viable technique for prioritization of critical sub-watersheds. Thus, the present study was aimed to prioritizing erosion-prone sub-watersheds using morphometric analysis. Advanced space-borne thermal emission and reflection radiometer of 30m resolution DEM has used to generate drainage networks and delineation of sub-watersheds using ArcGIS software. The important derived morphometric parameters have computed on the base of already developed mathematical formulae and methods. The study area (a watershed) has classified into seven interesting sub-watersheds, which have ordered SW1–SW7. The very important quantitative watershed aspects such as linear, relief and areal have been taken in consideration, and eighteen morphometric parameters have been selected and used for ranking and prioritizing of sub-watersheds. In this regard, sub-watersheds (SW7, SW3 and SW4) and (SW5, SW6 and SW2) have categorized into higher and medium priorities, whereas sub-watershed (SW1) has assigned at lower priority. This implied that SW1 is relatively sustainable than others, on the contrary, SW7 is relatively affected sub-watershed by runoff and soil erosion that needs first priority for management practices. Therefore, the study proposes a useful soil and water conservation practices such as bunds, check dams, micro-basins and multipurpose tree species planting based on suitable location and design parameters. The decision makers should optimally allocate the investments according to this final priority. And it has required to monitor and evaluate due to environmental sound, economical viable and socially acceptable. Also it has required developing an integrated approach for characterizing and prioritizing of sub-watersheds.

Abstract Globally erosion has been considered as an environmental and agricultural problem since the first agricultural revolution. In Ethiopia gully erosion has been recorded as a very serious and common socio-economic and environmental problem of several watersheds. Therefore, the objective of this research was to assess the drivers, dynamics and impacts of gully erosion in case of Tabota Koromo and Koromo Danshe watersheds, South-Central Ethiopia. The intended objectives were achieved by triangulating the image analysis with the data obtained from GPS, group discussion, interview, house hold survey, field observation and field measurement. The result of the study indicated that gully erosion was initiated in the steep slope following the 1970s and 1980s land cover change and other anthropogenic factors. In addition, the soil properties and steep slope (gravity) of the land have contributed in exacerbating the problems. Gully erosion caused physical, social and economic impacts in the area. According to the participants on group discussion and interview, the socio-economic impacts of gully erosion were loss of life for a 12 year boy, injuries of five live stocks, and decline of yields throughout the year. Result from field measurement and observation depicted that loss of soil (1,080,782.6m3) and loss of biodiversity are the major physical impacts of gully erosion. Yet there are promising conditions to rehabilitate the gullied area for sustainable ecosystem services in the watersheds. These promising conditions are the availability of high labour forces, access of transportation, civic societies working on natural resource conservation and the green economy development policy of the country. Therefore, concerned government bodies and the local communities at different level need to set plan and work for implementation in a way to use the existing opportunities.

Soil fertility in smallholder farms remains a major issue in Ethiopia and for many developing countries where more than 90% of the population's food is provided by smallholder farmers. This study was aimed to identify determinants of soil fertility management practices in smallholder farmers of the Gedeo zone, southern Ethiopia where the agricultural landscapes dominated by coffee and enset crops. The study is based on cross-sectional data obtained from a total of 270 randomly selected households. Data were collected using a structured survey questionnaire and focus group discussion (FGD) held with key informants from each sample kebele. The data collected were analyzed using descriptive and inferential statistics, and a logistic regression model. The result of the study showed that to maintain soil fertility the majority of farmers relied on a number of organic farming practices that take full advantage of the nutrient cycles. The commonly used soil fertility management practices were green manure (98.1%), mulching (71.9%), minimum tillage (97.4%) and multilayered agroforestry (100%). The results showed that the socioeconomic status of farmers had an effect on the adoption of soil fertility management practices. Logistic regression analysis showed that the family size of the household had a positive significant (p < 0.05) effect on the adoption of compost and farmyard manure while the dependency ratio of the farmer households had a negative impact on both compost and farmyard manure adoption. The differences in education status of household head and coffee shrubs holding had a strong positive relationship with farmers' mulch adoption. The study also shows that livestock holding of the household was significant (p < 0.01) positive association with the adoption of farmyard manure. Moreover, the coefficient for the agriculture annual income and differences in agroecological zones had strong positive effects on the adoption of compost at and cover cropping. The findings suggest that soil fertility management practices in the study area could be enhanced by improving the income of farmers and targeting young families where all spouses and working-age household members work on farms. Moreover, attention should be given to enhancing intensive livestock management systems that support more livestock for the provision of farmyard manure and advising farmers to possess a manageable number of coffee shrubs.

Abstract Background Postpartum depressive symptoms are the occurrence of major depressive episode within 4 weeks following delivery. Globally, 10%–20% of mothers suffer from depressive symptoms during their postpartum course. Therefore, assessing postpartum depressive symptoms has a pivotal role in ensuring that their mental health needs are met. Methods An institution-based cross-sectional study was conducted including 511 mothers coming for postnatal care service in public health centers in Bahir Dar Town. Data were collected using a pre-tested, structured, and interviewer-administered questionnaire, while the Edinburgh Postnatal Depression Scale (EPDS) was used to assess individuals’ depressive symptoms. The systematic random sampling technique was employed to recruit the study participants. Adjusted odds ratio with a 95% confidence interval (CI) was used to declare the statistical significance of the factors. Results Postpartum depressive symptoms among mothers were found to be 22.1 (95%, CI 18.6%, 25.8%). In multivariate logistic regression, stressful life events (AOR = 4.46, 95% CI 2.64, 7.54), domestic decision making (AOR = 4.26, 95% CI 2.54, 7.14), unplanned pregnancy (AOR = 1.86, 95% CI 1.02, 3.41), partner violence (AOR = 3.16, 95% CI 1.76, 5.67), and hospitalization of their babies (AOR = 2.24, 95% CI 1.17, 4.310) were factors significantly associated with postpartum depressive symptoms. Conclusions Postpartum depressive symptoms among mothers were common in the study area. Stressful life events, lack of empowerment in domestic decision making, intimate partner violence, unplanned pregnancy, and hospitalization of their baby were factors significantly associated with postpartum depression. The Ministry of Health needs to give training on how to screen postpartum depressive symptoms among mothers, and interventions that would address the above factors would benefit in tackling further complications.

In Ethiopia institutional and extensive soil and water conservation (SWC) started in the 1970s. Due to several factors, most SWC works have not fully achieved the intended objectives. The disparity between dimensions of the implemented SWC work and the standard is the main factor. Therefore, this research work aimed to assess the design and constraints of SWC in the Gidabo sub-basin, of the Ethiopian rift valley. Data were generated through field observation, field measurements, household survey, interview, group discussion, and Arc GIS. According to the result, about 47.3% of the physical design of the implemented SWC structures failed to meet the standard dimension. In addition, the SWC lacks the standard supportive activities, such as the cut of the drain, check dam, biological work, and frequent maintenance. FGD and KII showed about 71.3% of the farmers accepted SWC technologies, but they have constraints for SWC. These were small land size, food insecurity, lack of resources, technical skill, field guidance, poor maintenance, as well as young migration. The researchers used the chi-square test for the significant variation of constraints along with different agro ecology. According to the chi-square result, significant association was observed between land size, access to fertilizers, seeds, pesticides, construction materials, technical skill, and maintenance of the structures versus agro ecology. Therefore, the implementation of SWC practices should be focused on the way to avoid/lower the observed mismatch of the structures against the standard. Also the constraints in different agro ecology should be solved through full community participation in order to follow the standard SWC measures for sustainable socio-economic and environmental development.

Culture plays a significant role in protecting the environments and critical ecosystems. The purpose of this study was to explore the relevance’s of indigenous beliefs, sacred sites, cultural practices and traditional rules (seera) in promoting environmental conservation and sociocultural values. The study further addresses the cultural interconnection between plants and people (ethnobotanical myths of Gedeo). The study employed broadly a qualitative approach with an anthropological design. The study was used key informant interviews, focus groups, participant observation and descriptive ecological inventory. The results revealed that, songo indigenous institutions, traditional beliefs, taboos, and local rules (seera) have been playing an enormous role in promoting environmental protections and cultural conservation. The setting aside sacred forest for ritual purposes also well entrenched traditions as indigenous mechanism of tree biodiversity conservation. Due to the prohibition systems (taboos), traditionally protected area (e.g. amba sacred forest) has highest tree diversity and well preserved than adjacent non-sacred farming habitats. Social taboos as indigenous belief systems have limiting people from cutting down trees from sacred sites, killing birds and injuring nature carelessly. Trees in sacred forest were not axed except when it is needed for public uses like local bridge constructions and chopping its woods for ritual purposes with consent of cultural elders. Broadly speaking, these cultural practices and prohibition mechanisms informally enhance ecosystem conservation and protection via limiting local people from destroying nature carelessly. Hence, due to the banishment, the sacred forest havens critical threatened plants or trees not found elsewhere special in non-sacred farming habitats. For instance, Aningeriaadolfi-friedeicii, Podocarpus falcatus, Cordia africana, Prunus africanum, O. welwitschii, and Syzygium guineense native tree species were abundantly counted in sacred forest while critically threatened in non-sacred adjacent landscape. The current study concludes that indigenous knowledge (IK) expressed through local practices, indigenous beliefs, social banishment, customary laws (seera) and prohibition systems is very useful tools in conservation of degraded tropical ecosystems and resilient for adverse climate change. In contrast, religious monotheism, changes in social norms, erosion in ancestral beliefs and lack of proper documentation of IK were some of the main factors that contributing towards the degradation and erosion of indigenous mechanisms of environmental protections which need to be looked into and formal law enforcement should be needed to safeguard the sacred forests.

BackgroundThere is a paucity of research on the prevalence of diagnosed as well as undiagnosed neurological disorders with episodic manifestations such as epilepsy and migraine headaches in people with severe psychiatric disorders (SPD). To the best of our knowledge, this is the first study analyzing and comparing the prevalence of diagnosed and undiagnosed chronic neurological disorders with episodic manifestations including epilepsy and migraine headache in people with SPD.MethodThis quantitative cross-sectional survey was undertaken among 309 patients with SPD selected by a systematic random sampling technique. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to confirm SPD among the participants. The International Classification of Headache Disorders (ICHD-3) and International League Against Epilepsy (ILAE) were used to define migraine headache and epilepsy, respectively]. Risk factors for chronic neurologic disorders were explored by using logistic regression models.ResultIn this study, the prevalence of overall neurological disorders, epilepsy, and migraine headache among people with SPD were found to be 5.2% (95%CI 3.2-8.3), 1.6% (95%CI 0.7-3.9), and 3.9% (95%CI 2.2-6.7), respectively. We found that a considerably higher proportion of people with SPD had undiagnosed overall neurological disorder (87.5%; 14/16), epilepsy (60%; 3/5), as well as migraine headaches (100%; 12/12). On the other hand, in this study, 12.5%, 40%, and 0% of patients with overall neurologic disorder, epilepsy, and migraine headaches respectively were diagnosed by the professionals. Higher disability score (WHODAS score) was associated with increased odds of having neurological disorders compared with the lower WHODAS score [OR = 1.30 (95% CI 1.02-1.66)].ConclusionWhilst the prevalence estimates of neurological disorders with episodic manifestations including epilepsy and migraine headache was high among people with SPD, the vast majority of them remained undiagnosed. The diagnosis rates of those disorders were significantly low, perhaps surprisingly zero for migraine headache. High WHODAS score was associated with increased odds of having neurological disorders. Routine screening and management of epilepsy and migraine headache are imperative among people with SPD.

Abstract Background Sexual dysfunction is remarkably prevalent amongst psychiatric patients than general population. This might be due to either the nature of the illness itself or the unwanted effect of the medication they are taking for the illness which limits the capability of forming interpersonal and sexual relationships. This issue is rarely raised in developing countries, and the aim of this study was to assess magnitude and factors contributing to sexual dysfunction among patients with Schizophrenia. Method Hospital based cross sectional study was conducted at Amanuel Mental Specialized Hospital from January to June 2017. The sample required for this study was determined by using single population proportion formula and the final sample size was 423; and systematic random sampling was used to select participants. We used Change in Sexual Functioning Questionnaire to measure sexual dysfunction. The collected data was cleaned, interred in to Epi data and transferred to SPSS version 20 for farther analysis. The OR with 95% CI was used to measure association and P-value

The purpose of the study was mainly to document the farmer’s indigenous knowledge (IK) systems on tree conservation and farming practices. The research further assesses the traditional way of soil acidity amendment in highland (dega) agroecological zone. This study combines broadly qualitative methods of anthropological approach to document farmers’ IK in tree conservation, and acidic soil amendments. Data were collected by using the semi-structured interviews, key informant interviews, participatory observation, and focused group discussion. The semi-structured interviews were conducted with a sample of 60 respondents in different agroecological zones to assess the traditional farming practices and tree conservation. The study revealed that, farmers had entrenched and sound local knowledge of tree conservation and acidic soil amendment practices. The “baabbo” and “Mona” are traditional ways of tree conservation and soil acidity amendment practices in mid-land and highland agroecological zones, respectively. The “baabbo” is native and multipurpose tree conservation and retaining traditions on farms. The farmers are deliberately retained indigenous “baabbo” trees in and around the farms for various benefits (such as shading, soil fertility, flooding control, fuelwood, constructions, and fodder). The main and first benefit of “baabbo” conservation is ”shading for crop productivity’’ ranked followed by uses for “soil fertility’’, “fuelwood’’, and ”construction materials’’ and ”cultural values’’. In addition, “mona” is an indigenous way of soil acidity amendment with indigenous fertilizer (organic) in highland agroclimate area (Dega). It is bedding places for animals (cattle and horses) which built near to farmer’s houses or farm-fields for collection of indigenous fertilizer (animal manure). This traditional approach of acidic soil amendment is enabling the farmers to sustain their livelihoods under unfavorable condition without adversely affecting the environment. Therefore, ‘mona’ as well as ‘baabbo’ is an indigenous farming practice that had used by local people to improve their livelihoods and novel approaches to maintain environmental sustainability.

Abstract Background Following health sector reform, Ethiopia started training new categories of health workers. This study addresses students' perspectives regarding their training and career plans. Methods A cross sectional questionnaire was administered to 145 students in the three schools of the Amhara regional state of Ethiopia. Results The majority of students were male (62%) and originally from urban areas (76%). Job search was the most common reason for enrolling in the training for almost half (48%) of the respondents, followed by a desire to help the sick (46%). Once trained, the majority (98%) of graduates preferred to serve in the government sector and in rural health institutions (84%). Females were more willing to work in rural settings [χ2 (df 1)= 7.37; P = 0.007]. The majority (98%) of students felt the training period should be extended. 12% of graduates lacked confidence in their competencies after completing the training. A substantial proportion of the respondents (29%) did not feel the social science courses (Anthropology, Ecology and Psychology) were useful. Conclusions This study demonstrates that mid-level health professional students are highly motivated, wish to address the health needs of rural communities, and are interested in professional development. However, students do not feel the training programs are fully addressing their needs. The students found that the duration of the training, the time for theory and practice, the availability of teaching materials, the course contents and their teachers were inadequate. This study suggests that the current training programs have serious inadequacies that need to be addressed.

Objectives: To investigate the relationship between pediatric obstructive sleep apnea (OSA) severity and quality of life (QOL)., Study Design: This study was a cross-sectional survey., Methods: Patients aged 2-18 years being evaluated for OSA were recruited from a pediatric otolaryngology clinic and sleep center. Participants completed the Obstructive Sleep Apnea Questionnaire (OSA-18) and the PedsQL™ Multidimensional Fatigue Score (MFS)., Results: Responses of 18 control participants without OSA, 26 participants with clinically resolved OSA, 19 with non-obstructive sleep disordered breathing (SDB), 29 with mild OSA, 21 with moderate OSA, and 27 with severe OSA were analyzed. OSA-18 scores for controls were lower (indicating higher QOL) than patients with SDB (mean difference [MD] = -31.1; 95% CI -42.7 to -19.5), mild OSA (MD = -30.4; 95% CI -40.1 to -20.7), moderate OSA (MD = -23.6; 95% CI -34.5 to -12.7), or severe OSA (MD = -40.1; 95% CI -50.0 to -30.2). Participants with resolved OSA also had lower OSA-18 scores than participants in the SDB and OSA groups. Few differences were observed between the SDB, mild OSA, moderate OSA, and severe OSA groups on either the OSA-18 or PedsQL MFS, and these did not demonstrate a clear pattern. Linear regression of apnea hypopnea index (AHI) and OSA-18 or PedsQL MFS scores revealed weak relationships (R 2  < 0.1)., Conclusion: Using both an OSA-specific measure and generic fatigue measure, no consistent differences in QOL scores were found between children with varying OSA severities. Therefore, disease burden in pediatric patients with mild OSA and SDB should not be underestimated., Level of Evidence: Level 3 Laryngoscope, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Background: The problem of medicine expiration presents a notable obstacle, resulting in considerable financial losses. Nevertheless, there is currently limited data indicating that certain medications do not experience a significant decrease in effectiveness after their expiration date. Therefore, the aim of the study was to assess the physico-chemical quality of expired fluoroquinolone antibiotics., Methods: The expired samples of fluoroquinolone antibiotics were purposively collected from public hospitals in the Jimma zone of the Oromia regional state, Ethiopia. A World Health Organization quality evaluation sampling strategy was employed. Then, simple random sampling techniques were utilized for the selection of tablets for the laboratory quality control test. The assay, identification, and dissolution were performed in accordance with the United States Pharmacopeia (USP) guidelines, as well as failure mode and effect analysis (FMEA) techniques., Results: The finding revealed that about 100% (7/7) expired samples passed pharmacopeia quality specifications for identity and assay tests. However, of the seven expired brands, about 14.3% (1/7) of the sample (Code-002) was unable to release its API content within the USP criteria of 30 min. The risk-based quality evaluation revealed that assay was the most critical quality attributed to ciprofloxacin tablets (RPN = 189), followed by identity (RPN = 100). Assay was also the most critical quality attribute (RPN = 378), followed by identity (RPN = 100) for Norfloxacin tablets. The risk-based desirability function approach showed that 75% (3/4) of ciprofloxacin products were of good quality, and 25% (1) were found to be of acceptable quality, while the desirability function of norfloxacin tablets was found to be excellent 1 (33.3%), good 1 (33.3%), and acceptable 1 (33.3%)., Conclusion: The study revealed that medications can maintain their quality beyond their labeled expiration date. By combining pharmacopeial standards with risk-based approaches like failure mode and effect analysis (FMEA), the study provides a comprehensive evaluation framework. This approach not only confirms the continued effectiveness of expired fluoroquinolone antibiotics but also underscores the potential waste reduction and cost-saving benefits. This could significantly contribute to addressing healthcare challenges in low-resource settings, promoting more efficient pharmaceutical resource utilization., 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 Getahun, Belew, Hasen, Tefera, Mekasha and Suleman.)

Background: The coronavirus disease 2019 is highly infectious and patients with coronavirus diseases demonstrated a series of clinical symptoms caused by severe acute respiratory syndrome coronavirus-2. Without a break of the wave's hematological profile of the patients is still ambiguous and differs from wave to wave., Objective: This study aimed to assess the hematological profile among coronavirus disease 2019 patients during the first and the second waves in Ethiopia., Methods: A multi-centered facility-based retrospective cohort study design was conducted at six coronavirus disease 2019 treatment centers. A total of 538 study participants were enrolled in the selected coronavirus disease 2019 treatment centers during the first and second waves of the pandemic. The demographic characteristics, underlying diseases, symptoms, and hematological parameters of patients were recorded. Data were entered into Epi-Data Manager 4.6 and analyzed using STATA 14.2. An independent sample t -test was used to assess the mean differences in hematological parameters across waves. Associations between categorical variables across waves were also determined using Chi-square and Fisher exact tests., Results: Among the total study participants, 240 (44.6%) and 298 (55.4%) patients were taken from wave-1 and wave-2, respectively. The average age of the study participants was 56.44 ± 16.25 years. The most frequent comorbidities in this study were hypertension, diabetes mellitus, ischemic heart disease, and asthma. The most presenting symptoms of COVID-19 infection across the two waves were presented. In the first wave, dry cough 166 (69.2%), fatigue 153 (63.75%), shortness of breath 148 (61.67%), and fever accounted 116 (48.33%), while during the second wave, dry cough 242 (81.2%), fatigue 244 (81.88%) shortness of breath 204 (68.47%) and fever account 180 (60.40%). White blood cells (WBC), neutrophils, and lymphocytes had shown increment during the first wave. Platelet count and platelet distribution width ( p  < 0.001) had significant mean differences across the two waves, while the other had no significant mean difference., Conclusion: In the present study, dry cough, fatigue, shortness of breath, and fever were found to be the most presenting symptoms of COVID-19 infection across the two waves. Only the platelet count and platelet distribution width had significant mean differences across the two waves, while the other had no significant mean difference across waves., 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.)

Introduction: Medicine plays a crucial role in the field of healthcare as a therapeutically significant pharmaceutical product. By effectively preventing diseases, medicine has the power to save countless lives and improve the quality of life for people worldwide. However, despite hospitals' efforts to provide medical care to patients, a significant issue arises from the substantial amount of drugs that go unused due to expiration dates. This problem is particularly prevalent in resource-limited countries like Ethiopia, where the pharmaceutical supply system fails to adequately address the issue of expired drugs in public hospitals, leading to an unsatisfactory situation. Hence, the objective of this study was to assess the economic impact and volume of expired medicines in the selected public hospitals in Jimma Zone, Southwestern Ethiopia., Methods: A hospital-based cross-sectional study design was conducted to assess the economic impact and volume of expired medicines available in the public hospitals in Jimma Zone. All available hospitals that fulfilled the EFDA guidelines were included. The medication expiration rate was calculated by dividing the total monetary value of expired medicines in a year by the total value of medicines received in the same year multiplied by 100. Then, the collected data was cleared, filtered, coded, and quantitatively analyzed using the Microsoft Excel 2010 version., Results: The average medicine waste rate was 4.87% in the fiscal year of 2019/2020 and 2020/2021 in Jimma Zone public hospitals worth 32,453.3 US$. Additionally, the facility wasted an estimated of 2711.44 US$ on the disposal of expired medicines. The expiration of medicines has been linked to several issues, including near-expiry, irrational prescribing practices, and weak participation of clinicians in medicine selection and quantification of the facility. Additionally, only two hospitals had relatively good storage and handling practices., Conclusion: Overall, the expiration rate of medicines in the public hospitals in Jimma Zone was greater than the allowed level of 2%. In order to optimize the allocation of healthcare funds and ensure the appropriate use of pharmacologically significant medications it is vital to conduct a comprehensive examination at the national level within a regional hospitals., 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 Getahun, Belew, Hasen, Tefera Mekasha and Suleman.)

Objective: To investigate the fatigue levels of children with hearing loss (HL) and obstructive sleep apnea (OSA), hypothesizing that the fatigue experienced by children with HL is under-recognized., Study Design: Cross-sectional survey., Methods: We identified children aged 2-18 with HL, OSA, sleep-disordered breathing (SDB), and controls from a pediatric otolaryngology clinic and sleep center. Children and/or parents completed the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS), Hearing Environments And Reflection on Quality of Life (HEAR-QL), and OSA-18., Results: Responses of 50 children with HL, 79 with OSA, and 18 with SDB were compared with those of 49 recruited controls (RC) and literature controls (LC). Children with HL or OSA had higher fatigue than controls in the PedsQL MFS self-reported (HL 65.4, OSA 54.7, RC 71.8, LC 80.5, p < 0.001) and parent-reported (HL 64.6, OSA 59.3, RC 75.2, LC 89.6, p < 0.001). Children with HL had Cognitive Fatigue similar to that of children with OSA (self 60.4 vs. 49.5, p = 0.170; parent 56.0 vs. 56.7, p = 0.998), though with decreased Sleep/Rest Fatigue (self 67.8 vs. 56.3, p = 0.033; parent 69.8 vs. 57.5, p = 0.001). Children with HL or OSA had lower disease-related quality of life (QOL) than controls in the HEAR-QL and OSA-18, respectively. Stratification with disease severity revealed no differences in fatigue., Conclusion: Children with HL or OSA experience higher fatigue and lower QOL than controls. Similar Cognitive Fatigue in both groups suggests under-recognized fatigue in children with HL., Level of Evidence: 3 Laryngoscope, 134:443-451, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Antimicrobial resistance remains a significant global public health threat. Although development of novel antibiotics can be challenging, several new antibiotics with improved activity against multidrug-resistant Gram-negative organisms have recently been commercialised. Expanding access to these antibiotics is a global public health priority that should be coupled with improving access to quality diagnostics, health care with adequately trained professionals, and functional antimicrobial stewardship programmes. This comprehensive approach is essential to ensure responsible use of these new antibiotics., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 World Health Organization. Published by Elsevier Ltd. All rights reserved. This is an Open Access article published under the CC BY NC ND 3.0 IGO license which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is properly cited. This article shall not be used or reproduced in association with the promotion of commercial products, services or any entity. There should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.)