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Abstract Introduction Previous works of literatures on the viral load suppression rate of third line antiretroviral therapy in Africa has produced inconsistent and inconclusive results, with rates varying between 62% and 95%. This variability poses challenges for policymakers and healthcare providers in making informed decisions. This systematic review and meta-analysis aimed to determine the overall viral load suppression rate of third line antiretroviral therapy in Africa and to clarify the contradictory relationship between gender and viral load suppression, based on existing primary studies. Methods A systematic review and meta-analysis were conducted using PubMed, Medline, Cochrane Library, Henari, African Journals Online (AJOL), Web of science, and Google Scholar to access studies up to December 6, 2024. The PRISMA guideline, JBI, and Newcastle Ottawa quality assessment scale checklists were used. Heterogeneity was evaluated with Cochrane’s Q and I2 statistics. Publication bias was checked using a funnel plot, Begg’s and Egger’s test, followed by the DerSimonian and Laird random effects model. Meta-regression, subgroup and sensitivity analyses were also performed. The odds ratio with a 95% confidence interval was used to assess the association of gender with the viral load suppression rate in patients on third-line antiretroviral therapy. All analyses were conducted using Stata 18. Results A total of 14 primary studies with a total sample size of 1791 were included. The pooled magnitude of the viral load suppression rate was 79.82% (95%CI: 75.75%, 83.90%). Around 75% of the included studies’ heterogeneity were explained by country, study year, study settings and quality level of the study level variables. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Conclusion and recommendation The pooled magnitude of the viral load suppression rate was 79.82%. There was not statistically significant association of gender with viral load suppression rate of third line antiretroviral therapy. Therefore, to maintain and further improve the strong viral load suppression rates of TLARVT in Africa, it is essential to focus on appropriate regimen selection, patient counseling and switching, adherence support, and regular viral load testing. Future studies with larger sample sizes should explore the association between gender and viral load suppression to provide conclusive findings.

Abstract Background Schistosoma spp. and other intestinal parasites are common in Ethiopia. During pregnancy, SCH increases the risk of adverse birth outcomes. However, its epidemiology among pregnant women and awareness level about the disease are not well addressed in Ethiopia. This study was conducted to address this gap. Methods A cross-sectional study was conducted from April to June 2023 among 422 pregnant women who attended Shewa Robit Health Center. Pregnant women who came to the health center for antenatal care services were enrolled in the study following systematic random sampling technique. Questionnaire data was collected on socio-demographic characteristics, KAP towards SCH, and associated factors. Stool samples were processed using the Kato–Katz technique, while urine samples were tested with urine test strips for hematuria, and filtration and centrifugation methods for detection of S. haematobium. Data were entered and analyzed using SPSS software version 25. Descriptive statistics and logistic regression were performed at a 95% confidence level. Results Among 422 pregnant women, 38 (9.0%) were positive for hematuria, but none were infected by S. haematobium. Schistosoma mansoni was detected in 40 (9.5%; 95% confidence interval (CI): 6.6–12.6) participants. Habit of swimming or bathing (adjusted odds ratio (AOR) = 4.896; 95% CI: 2.193–10.933, p

In impoverished nations, intestinal protozoan infections (IPIs) are a leading cause of diarrhea in children. However, in the majority of afflicted nations, including Ethiopia, the role played by each intestinal protozoa species in causing diarrhea and the risk factors linked with it are not adequately addressed. This would support focused intervention efforts. The prevalence of IPIs and related variables were evaluated between April and May 2023 among 380 under-five children in Borena district of Amhara region, central Ethiopia, by an institution-based cross-sectional survey. Systematic random sampling was used to select study participants. The study included a structured questionnaire to gather data regarding sociodemographic characteristics and perceived risk factors for IPIs. Using saline and iodine wet mounts as well as Richie's modified formol-ethyl acetate concentration technique, stool samples were collected and analyzed under a microscope. SPSS was used to enter and evaluate the data. At a 95 % confidence level, bivariate and multivariate logistic regressions were used to determine the factors linked to intestinal protozoa infection. Among 380 participants, 136 (35.8 %) were tested positive for one or more intestinal parasite species at least by one of the diagnostic methods. 118 (31.1 %; 95 % CI: 26.6–36.1) children were infected by intestinal protozoans.The parasites detected were: G. lamblia 71 (18.7 %) and E. histolytica/disar 54 (14.2 %), E. vermicularis 3 (0.8 %), A. lumbricoides 2 (0.5 %), H. nana 2 (0.5 %) and T. trichiura 1 (0.3 %). Seven (1.8 %) participants were infected by both protozoan species. Children whose mothers/guardians did not attend formal education were at higher risk of IPI (adjusted odds ratio (AOR) = 2.801; 95 %CI: 1.666–4.711, p

IntroductionDiabetes mellitus (DM) is one of the most significant public health problems. Globally, one in ten adults has diabetes, and it results in macro- or microvascular complications, such as diabetic retinopathy (DR). It is one of the most prevalent eye complications associated with DM, and it is the main cause of vision loss. Even though East African countries face a growing burden of diabetes and DR, no study depicts the regional prevalence and its associated factors. Therefore, this study aimed to estimate the pooled prevalence of DR and its associated factors among adults in East African countries.MethodsWe extensively searched PubMed, Embase, Scopus, Google Scholar, and Google for relevant studies. A forest plot was used to estimate the pooled prevalence of diabetic retinopathy using DerSimonian and Laird's random-effects model. We checked publication bias using funnel plots and Egger's regression test. Potential heterogeneity was tested using the I-squared statistic. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also performed. Furthermore, the pooled odds ratios for the associated factors were estimated. The research protocol was registered in PROSPER.ResultsAmong the 29 included studies, the estimated pooled prevalence of DR in East African countries was 28% (95% CI 23.0, 33.0). Besides, age ≥60 (OR = 2.88, 95% CI: 1.55, 5.32), body mass index ≥ 25 (AOR = 2.85; 95% CI: 1.69, 4.81; I2 = 85.4%, p < 0.001), and hemoglobin A1c levels ≥7 (OR = 2.48, 95% CI: 1.46, 4.23) were significantly associated with the prevalence of DR.ConclusionsThe prevalence of DR in East Africa was high, with more than one in four individuals with diabetes developing DR. Besides, advanced age, higher body mass index, and elevated hemoglobin A1c levels were significant factors associated with increased DR prevalence. Therefore, comprehensive diabetes management focusing on optimal glycemic control and healthy weight maintenance is essential to mitigate the problems. Also, the Ministries of Health and policymakers should prioritize and implement targeted strategies to address the identified modifiable risk factors, aiming to reduce the prevalence of DR in the region.Trial registrationSystematic review registration: PROSPERO (2024: ID = CRD42024511437). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024511437.

Abstract Introduction Globally, about 45 million under-five children have suffered from wasting where Asian and African countries have the major share of these wasted children. Despite wasting is affected all types of populations, the long and short term effect is more severe and sensitive in under-two aged children. Hence, this review was intended to assess pooled prevalence and associated factors of wasting among under-two children in Ethiopia. Methods The search was done using electronic data bases (Hinari, PubMed, Google scholar, Scopus) and research repositories from June 19–22/2023. The review included articles published between January 2013 and December 2023.The study included Cross-sectional/case control studies which report the prevalence and associated factors of wasting in under-two aged children. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) quality assessment checklists for observational studies. The presence of heterogeneity between included studies was evaluated using Cochrane Q-test and the I2 statistics. Publication bias was checked through graphical and statistical test. Associated factors were estimated by random effect model using DerSimonian-Laird model weight. Results The pooled prevalence of wasting among under-two children was 10.91% (95% CI: 8.97–12.85; I2 = 86.36%). Absence of maternal antenatal follow up (OR; 3.23: 95%CI: 1.20–5.26), no exclusive breast feeding until six months (OR; 5.30; 95%CI: 1.17–9.43), current illness of the child (OR; 2.58: 95%CI: 1.78–3.37), large family size (OR; 12.38; 95%CI: 1.37–26.13) and low wealth status of the households (OR; 3.91; 95%CI: 1. 54-8.36) were significant factors of wasting among under-two children. Conclusions This study disclosed that the pooled prevalence of wasting among under- two children were high in Ethiopia. Absence of maternal antenatal follow up, no exclusive breast feeding, low wealth status of the households, large family size and current illness of the child were significant factors of wasting. Strictly adherence of maternal antenatal follow up, counsel the parents to feed only breast milk until six months, limit the number of family size to the level of the household income and early treatment of the sick child were recommended. Furthermore, scale up the wealth status and living standard of the family can address the agenda of reducing and eradicating all forms of malnutrition. This review registered at PROSPERO with registration number CRD42023414914 ( https://www.crd.york.ac.uk/prospero/#myprospero ).

Abstract Background Loss to follow-up (LTFU) among under-five children from HIV care profoundly affects the treatment outcomes of this vulnerable population. It is a major factor that negatively affects the benefits of antiretroviral therapy (ART). Current information about LTFU among HIV-positive under-five children on ART is essential for effective treatments. To far, nevertheless, limited research has been done in Ethiopia to address this issue. Thus, this study aimed to assess the incidence and predictors of LTFU among HIV-infected under-five children receiving ART in West Amhara Comprehensive Specialized Referral Hospitals. Methods A multicenter institution-based retrospective follow-up study was conducted among 435 HIV-infected under-five children on ART selected by simple random sampling from January 1, 2010 to December 31, 2019, and data were collected between December 1, 2021, and January 31, 2022. A standardized data extraction tool adapted from the ART entry and follow-up forms was used. The event of interest for this study was LTFU, whereas the absence of LTFU was censored. Before being transferred to STATA version 14 for analysis, the data were entered into Epi-Data version 3.1. The Kaplan‒Meier curve was used to estimate an individual's survival-free probability at each specific point in time. The Cox proportional hazards model was used to identify predictors of LTFU. Results Among the 420 records included in the final analysis, 30 (7.14%) of the individuals were LTFUs. The incidence rate of LTFU was 3.4 per 1000 person-months of observation (95% CI: 2.43–4.87). The survival probabilities of children after 12, 24, 36, and 48 months were 0.97, 0.92, 0.88, and 0.77, respectively. The independent predictors of LTFU were HIV infection in under-five children who lived in rural areas (AHR = 3.64; 95% CI: 1.41, 9.37), poor adherence to ART (AHR = 4.37; 95% CI: 1.59, 12.02), not receiving cotrimoxazole preventive therapy (AHR = 3.75; 95% CI: 1.39, 10.08), not receiving isoniazid prophylaxis (AHR = 3.4; 95% CI: 1.29, 9.01), and having a severe WHO clinical stage (AHR = 5.43; 95% CI: 1.38, 11.43). Conclusion and recommendation The incidence of loss to follow-up was high, especially in the first two years after ART initiation. The risk of LTFU was greater for those who were rural residents, had poor adherence, lacked cotrimoxazole preventive therapy, not given isoniazid prophylaxis, and presented with WHO clinical stages III and IV. Therefore, clinicians should emphasize for cotrimoxazole preventive therapy and isoniazid prophylaxis, for those living in rural areas, who present with poor adherence and WHO clinical stages III and IV.

Globally, intestinal protozoa E. histolytica/dispar and Giardia lamblia are the cause of amoebiasis and giardiasis, respectively. Despite their important medical importance and common occurrence in Ethiopia, they are minimally addressed in terms of their prevalence, sensitive diagnostic methods, and associated risk factors. Infections with E. histolytica/dispar and G. lamblia are often misdiagnosed and underreported in impoverished countries. Thus, the purpose of this study was to ascertain the prevalence of Giardia lamblia and E. histolytica/dispar infections as well as related variables among schoolchildren in the Amhara region. A cross-sectional study was conducted among 844 schoolchildren in the Amhara region from April to December 2019. A stool sample was collected from each study participant and processed via the formol ether concentration technique (FECT) and spontaneous tube sedimentation techniques (STST). Data were entered in EpiData and analysed by SPSS statistical software. The prevalence of E. histolytica and G. lamblia infections using each diagnostic method and composite reference was determined by descriptive statistics. The association of risk factors with E. histolytica/dispar and G. lamblia infections was analysed by logistic regression and variables with p

The tanning industry faces considerable environmental challenges due to effluent load and hazardous chemical generation during processes like tanning and retanning. Therefore, this research work addresses these issues focusing on the pilot scale extraction and application of poultry feather-based keratin hydrolysate (KH) in leather manufacturing. Through pilot-scale experiments, optimal parameters for NaOH concentration, reaction temperature, and time were used to extract KH effectively. The study explored KH's potential application in chrome tanning and retanning stages as a chrome exhaust aid and keratin filler, respectively. During basification, KH was introduced to enhance chromium uptake by creating additional sites through the provision of crosslinking with collagen (modifying collagen) for better interaction and formation of complex with chromium, which not only streamlined the process by reducing the need for additional chemicals but also improved the thermal stability of the resulting leather product and enhance, the quality of leather. The shrinkage temperature of experimental wet blue leather was recorded to be above 107oC compared to the control wet blue leather which start to shrink at 104oc. Similarly, the percentage chromic oxide content of the experimental wet blue leather was observed to be significantly higher (3.89±0.20%) than that of the control wet blue leather (2.59±0.15). Furthermore, KH replaced commercial protein fillers during retanning, resulting in leathers with enhanced mechanical strength and organoleptic properties. The experimental crust leather treated with keratin solution at pH (5.5) was determined to have better tensile strength (23.4 N/mm2) and tear load (38.7 N/mm) than the control leather with tensile strength and tear load of 19.4 N/mm2 and 29.1 N/mm, respectively. Analytical techniques such as FTIR and XRD confirmed the presence of essential functional groups and protein structures in the KH solution, respectively. Leathers treated with 100 % KH substitution at pH value of 5.5 exhibited superior properties, including increased mechanical strength and thermal stability. Environmental impact assessments revealed a significant reduction in total dissolved solids in the spent liquor when KH replaced conventional fillers. Overall, this research demonstrates the potential of poultry feather-based keratin as an efficient, environmentally friendly filler in leather manufacturing, offering promising results in improving product quality and reducing environmental pollution.

Hair burning unhairing and dampening of tannery wastes during the hair-saving unhairing process are becoming significant problems in the tanning industry. Therefore, this research article focuses on the extraction of keratin hydrolysate (KH) and its application as a chrome exhaust aid and keratin filler in leather manufacturing process. The structure, morphology and functional groups of the extract were examined using X-Ray Diffractometer (XRD), scanning electron microscopy (SEM) and Fourier transform infrared spectrometer (FTIR), respectively. To study and contrast the degree of improvement in chromium uptake, the KH solution was applied both before tanning on the pickled pelt and after tanning during basification. The thermal stability, physical strength characteristics and organoleptic properties of the leathers obtained were characterized. Furthermore, the environmental impact of the tanning system was assessed through a comparative analysis of the spent liquors. Finally, experimental retanning process was conducted to replace the commercial protein filler (Celatan F: 50, 75, and 100 %) with KH solution, with concurrent processing of control leather using conventional chrome tanning agent at 6 % dosage of chromium. The FTIR analysis of the extract confirmed the presence of alkyl side chains of amino acids as well as carboxylic, amide, carboxyl group and aldehyde functional groups at 1400-1700 cm−1,3,303.46 cm−1,3270 cm−1 and 2752 cm−1, respectively. XRD spectrum showed two diffraction peaks at 2 theta values of 9.36° and 21.16°, respectively. Leathers with improved mechanical strength, organoleptic properties and thermal stability were obtained with 100 % substitution of Celatan F at pH 6 and 10 % chromium dosage. It was also discovered that the shrinkage temperature of the experimental leather was enhanced to more than 105 °C. Environmental impact evaluation on the spent liquor showed that the complete replacement of Celatan F with KH solution brought about a notable decrease in COD and TDS in the spent liquor. The extraction and application of tannery hair waste-based keratin hydrolysate as an efficient, environmentally friendly chrome exhaust aid and keratin filler has been attempted and established in this research article.

Abstract Background Schistosoma mansoni causes intestinal schistosomiasis (SCH) in all regions of Ethiopia. Despite many years of mass treatment, the prevalence has not dropped significantly. The reduction of SCH transmission demands the integration of deworming with safe water, sanitation, and hygiene (WASH) activities. Adequate knowledge and a positive attitude towards SCH are critical to practicing those interventions. However, data on the knowledge, attitude, and practice (KAP) level in school and community settings is limited in Ethiopia. Methods School and community-based cross-sectional studies were conducted from February to June 2023 among 634 school-aged children (SAC) and 558 adults. A pre-tested questionnaire was used to collect socio-demographic and KAP data. Records were entered and analyzed using SPSS software version 21. Correct responses for each of the KAP questions were scored as one, while incorrect or ‘I don’t know’ responses were scored as zero. Good knowledge, a positive attitude and good practice were declared if percentage scores were ≥ 80%, ≥ 90% and ≥ 75%, respectively. Results Only 229 (19.2%) respondents, comprising 91 (14.4%) SAC and 138 (24.7%) adults, had ever heard of SCH. Adults, males, and urban residents had higher awareness level compared to their respective counterparts (p

BackgroundAcute respiratory infections (ARIs) are the leading cause of death in children under the age of 5 globally. Maternal healthcare-seeking behavior may help minimize mortality associated with ARIs since they make decisions about the kind and frequency of healthcare services for their children. Therefore, this study aimed to predict the absence of maternal healthcare-seeking behavior and identify its associated factors among children under the age 5 in sub-Saharan Africa (SSA) using machine learning models.MethodsThe sub-Saharan African countries’ demographic health survey was the source of the dataset. We used a weighted sample of 16,832 under-five children in this study. The data were processed using Python (version 3.9), and machine learning models such as extreme gradient boosting (XGB), random forest, decision tree, logistic regression, and Naïve Bayes were applied. In this study, we used evaluation metrics, including the AUC ROC curve, accuracy, precision, recall, and F-measure, to assess the performance of the predictive models.ResultIn this study, a weighted sample of 16,832 under-five children was used in the final analysis. Among the proposed machine learning models, the random forest (RF) was the best-predicted model with an accuracy of 88.89%, a precision of 89.5%, an F-measure of 83%, an AUC ROC curve of 95.8%, and a recall of 77.6% in predicting the absence of mothers’ healthcare-seeking behavior for ARIs. The accuracy for Naïve Bayes was the lowest (66.41%) when compared to other proposed models. No media exposure, living in rural areas, not breastfeeding, poor wealth status, home delivery, no ANC visit, no maternal education, mothers’ age group of 35–49 years, and distance to health facilities were significant predictors for the absence of mothers’ healthcare-seeking behaviors for ARIs. On the other hand, undernourished children with stunting, underweight, and wasting status, diarrhea, birth size, married women, being a male or female sex child, and having a maternal occupation were significantly associated with good maternal healthcare-seeking behaviors for ARIs among under-five children.ConclusionThe RF model provides greater predictive power for estimating mothers’ healthcare-seeking behaviors based on ARI risk factors. Machine learning could help achieve early prediction and intervention in children with high-risk ARIs. This leads to a recommendation for policy direction to reduce child mortality due to ARIs in sub-Saharan countries.

The indiscriminate release of chromium-saturated effluent into water bodies has raised concerns regarding its effect on human health and environmental ecology. Therefore, this research aimed to remove hexavalent chromium from an aqueous solution utilizing activated carbon developed from Rumex abyssinicus. The adsorbent was prepared through chemical impregnation with H3PO4 and then thermally activated at 500 °C for 2 h. The optimization of the adsorption experiments was performed using the Box‒Behnken approach of response surface methodology. The characterization of the prepared activated carbon revealed good quality in terms of its amorphous structure, maximum specific surface area of 1722.9 m2/g and porous surface. Furthermore, the optimization results showed that a maximum removal efficiency of 95.97 % was attained at an optimum working pH of 3, a contact time of 60 min, an initial chromium concentration of 70 mg/L and an adsorbent dosage of 0.6 mg/100 mL. The Langmuir isotherm model was found to have the best fit with the experimental data. Moreover, the kinetics study revealed that a pseudo-second-order model fit the data best, indicating the occurrence of chemisorption. Overall, this study suggested that Rumex abyssinicus could be an effective adsorbent for removing hexavalent chromium from aqueous solutions.

This study aimed to develop a cost-effective method for managing chicken feather waste by hydrolyzing it in an alkaline medium to extract keratin hydrolysate. Through a Box-Behnken experimental design, the effects of NaOH solution concentration, temperature, and extraction time on the extraction process were examined. Analysis of the extracted keratin hydrolysate revealed the presence of key functional groups and characteristic protein structures. Optimization efforts identified 0.65 N NaOH solution concentration, 70 °C temperature, and 1-h extraction time as yielding the highest protein yield of 89.71 %. These findings underscore the potential of alkaline hydrolysis as a sustainable approach for both waste management and the extraction of valuable keratin hydrolysate. This research contributes to addressing the challenges faced by poultry farms in waste management while offering avenues for the utilization of keratin in various applications, thereby promoting environmental protection and human health.

IntroductionWomen are more vulnerable to HIV infection due to biological and socioeconomic reasons. Developing a predictive model for these vulnerable populations to estimate individualized risk for HIV infection is relevant for targeted preventive interventions. The objective of the study was to develop and validate a risk prediction model that allows easy estimations of HIV infection risk among sexually active women in Ethiopia.MethodsData from the 2016 Ethiopian Demographic and Health Survey, which comprised 10,253 representative sexually active women, were used for model development. Variables were selected using the least absolute shrinkage and selection operator (LASSO). Variables selected by LASSO were incorporated into the multivariable mixed-effect logistic regression model. Based on the multivariable model, an easy-to-use nomogram was developed to facilitate its applicability. The performance of the nomogram was evaluated using discrimination and calibration abilities, Brier score, sensitivity, and specificity. Internal validation was carried out using the bootstrapping method.ResultsThe model selected seven predictors of HIV infection, namely, age, education, marital status, sex of the household head, age at first sex, multiple sexual partners during their lifetime, and residence. The nomogram had a discriminatory power of 89.7% (95% CI: 88.0, 91.5) and a calibration p-value of 0.536. In addition, the sensitivity and specificity of the nomogram were 74.1% (95% CI: 68.4, 79.2) and 80.9% (95% CI: 80.2, 81.7), respectively. The internally validated model had a discriminatory ability of 89.4% (95% CI: 87.7, 91.1) and a calibration p-value of 0.195. Sensitivity and specificity after validation were 72.9% (95% CI: 67.2, 78.2) and 80.1% (95% CI: 79.3, 80.9), respectively.ConclusionA new prediction model that quantifies the individualized risk of HIV infection has been developed in the form of a nomogram and internally validated. It has very good discriminatory power and good calibration ability. This model can facilitate the identification of sexually active women at high risk of HIV infection for targeted preventive measures.

The surface roughness of fabric is one of the fabric properties that is used to evaluate the sensorial comfort of clothes. However, its objective evaluation requires sophisticated and expensive testing instruments and skilled testing expertise. Developing a predictive model is therefore an alternative approach to overcome such limitations. This study investigated a regression model to predict the surface roughness of 3/1 twill fabric using weft yarn count and weft thread density. Nine samples were produced by varying the weft yarn count and weft thread density at three different levels, while their surface roughness was determined using a Kawabata instrument (KES-FB4) under standard testing conditions. A two-factor predictive model equation was developed using design expert software. Based on the results and findings, the effects of count and density on the roughness of 3/1 twill fabric were found to be statistically significant for the developed model at a confidence interval of 95%. The model was tested by correlating the measured and predicted surface roughness values of 100% cotton 3/1 twill fabric. The results of the model test indicate a significant correlation (R2 = 0.9644) between the measured and predicted surface roughness values of 3/1 twill fabric, with a 95% confidence interval. Model validation was performed, and the study showed that the measured and predicted values of the surface roughness of 3/1 twill fabric have a 0.828 coefficient of determination (R2). This indicates that the surface roughness of 3/1 twill fabric can be predicted well by weft yarn count and weft thread density. This model can be thus used in textile industries and by research institutes for predicting the surface roughness of 3/1 twill fabrics in the new product development process.

Introduction Inadequate counselling of pregnant women regarding pregnancy danger signs contributes to a delay in deciding to seek care, which causes up to 77% of all maternal deaths in developing countries. However, its spatial variation and region-specific predictors have not been studied in Ethiopia. Hence, the current study aimed to model its predictors using geographically weighted regression analysis.Methods The 2019 Ethiopian Mini Demographic and Health Survey data were used. A total weighted sample of 2922 women from 283 clusters was included in the final analysis. The analysis was performed using ArcGIS Pro, STATA V.14.2 and SaTScan V.10.1 software. The spatial variation of inadequate counselling was examined using hotspot analysis. Ordinary least squares regression was used to identify factors for geographical variations. Geographically weighted regression was used to explore the spatial heterogeneity of selected variables to predict inadequate counselling.Results Significant hotspots of inadequate counselling regarding pregnancy danger signs were found in Gambella region, the border between Amhara and Afar regions, Somali region and parts of Oromia region. Antenatal care provided by health extension workers, late first antenatal care initiation and antenatal care follow-up at health centres were spatially varying predictors. The geographically weighted regression model explained about 66% of the variation in the model.Conclusion Inadequate counselling service regarding pregnancy danger signs in Ethiopia varies across regions and there exists within country inequality in the service provision and utilisation. Prioritisation and extra efforts should be made by concerned actors for those underprivileged areas and communities (as shown in the maps), and health extension workers, as they are found in the study.

IntroductionPostnatal care within 2 days after delivery is classified as early postnatal care. Maternal and neonate mortality during the early postnatal period is a global health problem. Sub-Saharan Africa contributes the highest maternal and newborn mortality rates. To reverse this problem, early postnatal care is the best strategy, but there is no study to show the spatial distribution and application of geographical weighted regression to show the effect of each predictor on early postnatal care across the geographic areas in Ethiopia using the recent EDHS 2019 data.ObjectiveTo assess the geospatial distribution and predictors of postnatal care utilization during the critical period in Ethiopia using EDHS 2019.MethodA secondary data analysis of a cross-sectional study was used among 2105 women. The data for this analysis was taken from the 2019 EDHS, and missing data was managed by imputation. The spatial variation of postnatal care during the critical time was assessed using the Getis-Ord Gi* statistic; Moran's I statistics were conducted to test the autocorrelation; and Sat Scan statistics were also used to show the statistically significant clusters of early PNC utilization in Ethiopia. The ordinary least squares method was used to select factors explaining the geographical variation of postnatal care during the critical time. Finally, the geographical weighted regression was used to show the spatial variation of the association between predictors and outcomes. Predictors at 95% CI with a p-value ResultsThe overall prevalence of PNC utilization during critical time was 713 (34%, 95%CI: 31.5%-36.5%). The spatial distribution of postnatal care utilization during critical times was not randomly distributed across the area of Ethiopia. The hotspot areas of postnatal care utilization during the critical period in Ethiopia were found to be in Benishangul, Gumuz, and the western part of Tigray. Whereas, the cold spot area was in the western part of the southern nation and nationality of Ethiopia. Women with antenatal care visits, facility delivery, no education, and media exposure were the predictors of postnatal care utilization during the critical time in the hotspot areas of Ethiopia.Conclusion and recommendationIn Ethiopia, one-third of women utilize the PNC during critical times. Postnatal care utilization during critical times was not randomly distributed across the regions of Ethiopia. Antenatal care visits, facility delivery, lack of education, and media exposure were the predictors of postnatal care utilization during the critical time in Ethiopia. Therefore, encouraging facility delivery, awareness creation by expanding media access, and literacy are highly recommended to improve the utilization of PNC services during this critical time in Ethiopia.

IntroductionZero-dose vaccine status refers to a child who has not yet received any childhood vaccines. Globally, zero-dose vaccination status is the major public health problem. In sub-Saharan African countries, among five children, one child did not access the vaccines. The efforts to identify the factors contributing to the zero-dose vaccine have not yet been addressed in Ethiopia.ObjectivesTo assess the distribution and determinants of zero dose vaccination status hot spots among children in Ethiopia using Ethiopian demographic health survey 2019.MethodsA secondary analysis of a cross-sectional study was used among a total of 3208 participants. Stata-14, Arc geographic information system-10.3, and Sat Scan software were used to analyze the data. Moran's I statistic was used to assess the non-random distribution of zero-dose vaccination status. Spatial and geographically weighted regression was used to map the distribution and determinants of zero-dose vaccination status in Ethiopia. The Getis-Ord-statistics and Sat Scan analysis were also used to identify the hot spot area and significant clusters respectively. To identify significant factors, a p-value ResultsThe prevalence of zero-dose vaccination status among children aged 12-35 months old was 16.3% (95%CI, 15%-17.6%). The distribution of zero-dose vaccination status in Ethiopia was not randomly distributed across the area (Moran's I value = 0.4, pConclusionThe zero dose child in Ethiopia was low. Geographically, the highest proportion of zero-dose vaccination status among children was in the Somali and Afar regions. Home delivery had the highest and most positive effect on zero-dose vaccination status in Afar, Somalia, and the Tigray region. Additionally, the poor wealth index had the highest and most positive effect in Somalia and the Afar region. Expanding delivery at the health facility and economic empowerment of women are recommended to improve vaccination in Ethiopia.

BackgroundFemale sex workers (FSWs) are marginalized groups of the population who have limited access to healthcare and a higher risk of HIV infection due to biobehavioral and structural risk factors. Although it is known that the Eastern and Southern African region is affected by the highest HIV incidence and prevalence, understanding the burden among FSWs in the region remains limited. We aimed to assess the pooled prevalence and associated factors of HIV in this vulnerable population.MethodsRelevant studies were searched on PubMed, Embase, Scopus, ScienceDirect, Hinari, African Journals Online (AJOL), Google, and Google Scholar. The searching mechanism was constructed using keywords identified by CoCoPop (Condition, Context, and Population) framework and medical subject heading terms to recruit studies published between January 1, 2015 and March 30, 2024. Observational studies that estimate the prevalence or incidence or associated factors of HIV among FSWs, even if FSWs were not the main focus of the study, were included. The quality of included studies was assessed using Joana Brigg's Institute checklist. Data were extracted and analyzed using STATA 17 software. To estimate the pooled effect sizes with their 95% confidence intervals, a random effect model was fitted. The I2 statistic was used to evaluate heterogeneity. Funnel plot and Egger's regression test were utilized to assess the small study effect. Publication bias was managed using trim-and-fill analysis. Subgroup and sensitivity analysis were considered to handle heterogeneity among studies.ResultsA total of 54 articles with 78,747 FSWs who had successful HIV biological test were included in the analysis. The pooled prevalence of HIV among FSWs in Eastern and Southern Africa was 36.0% (95% CI: 31.0%-41.0%). Regionally, the pooled prevalence was 59.0% (95% CI: 53.0%-64.0%) and 29.0% (95% CI: 25.0%-34.0%) in Southern and Eastern Africa, respectively. Age above 35 (POR = 7.35; 95% CI: 5.26, 10.28) and 25-34 years (POR = 2.91; 95% CI: 2.02, 4.21), being married (POR = 1.33; 95% CI: 1.07, 1.66), divorced (POR = 1.72; 95% CI: 1.39, 2.13), and widowed (POR = 2.70; 95% CI: 2.09, 3.49), primary education (POR = 1.29; 95% CI:1.08, 1.55), history of sexually transmitted infection (POR = 1.51; 95% CI: 1.20, 1.90), syphilis (POR = 2.57; 95% CI: 1.66, 3.98), Hepatitis B infection (POR = 2.60; 95% CI: 1.07,6.32), drinking alcohol (POR = 1.21; 95% CI: 1.01, 1.45) and injectable drug use before sex (POR = 1.75; 95% CI: 1.24, 2.47) were found significantly associated with the increased risk of HIV infection among FSWs.ConclusionThese data suggest an urgent need to improve access to HIV prevention programs for FSWs. Providing behavioral interventions including reduction of alcohol and injectable drug use before sex, initiating tailored healthcare services, strengthening the psychosocial and legal support network, and fostering partnership might reduce the burden in the region. Clinicians could facilitate early detection and treatment of STIs, and Hepatitis B virus infection.Trial registrationProtocol registration: The protocol for this systematic review and meta-analysis was registered in the PROSPERO with registration number CRD42024509200.

The replacement of the conventional chromium tanning system with an eco-benign tanning systems has received great attention owing to stringent environmental regulations. In this specific study, a chrome-free combination tanning system based on chestnut and tetrakis (hydroxymethyl) phosphonium sulfate (THPS) was developed and presented as an effective alternative cleaner tanning technology. Processing of the tanning trials were carried out varying the percentages of chestnut as a tannage, followed by THPS as a re-tannage for process optimization. The leathers obtained were characterized for their thermal stability, grain surface properties using a scanning electron microscope, physical strength characteristics, comfort, and organoleptic properties. Finally, the environmental impact of the tanning systems was assessed through the comparative analysis of their spent liquors. The chestnut-THPS combination system tanned leathers using 20 % chestnut followed by 2 % THPS resulted in maximum shrinkage temperature of 95OC. The hydrothermal stability of the leathers tanned using this combination tanning system were found to be better than those tanned using chestnut and THPS tanning systems alone, respectively. The strength and comfort properties of the leathers produced using the developed combination tanning system were found to be on par with or better than those of conventionally tanned leathers, and the scanning electron microscopic study depicted that the grain surface of the leathers produced were observed to be free of surface deposition. The environmental impact assessment showed that the combination tanning system used resulted in a significant reduction in TS, TDS, TSS, and BOD in the wastewater. This research article has attempted and established the use of chestnut-THPS-based combination tanning systems as an effective, eco-friendly alternative tanning process technology.

BackgroundDespite integrated prevention and control measures, the prevalence of hookworm is still high in Ethiopia. The re-infection rates and predictors are poorly addressed. Therefore, this study aimed to determine the patterns of hookworm re-infection rates and predictors among schoolchildren in northwest Ethiopia.MethodsA prospective follow-up study was conducted among 86 schoolchildren from May to December 2022. Data on predictors was collected using a questionnaire. Stool samples were collected and processed via Kato-Katz, McMaster, and spontaneous tube sedimentation techniques. All hookworm-infected children were treated with albendazole and followed for six months. The re-infection rates of hookworm were checked in the 4th and 6th months. Data was entered into Epi-data version 3.1 and analysed using SPSS version 25. Descriptive statistics were used to compute the re-infection rate. The associations of predictors with hookworm re-infection rates were calculated by logistic regression. Variables with a p-value < 0.05 were considered statistically significant.ResultsOf the 86, 81 schoolchildren completed the study. The prevalence of hookworm re-infection in the 4th and 6th months was 23.5% and 33.3%, respectively. Living with family members greater than five (p = .017), poor utilization of latrine (p = .008), infrequent shoe wear (p = .039), and participating in irrigation (p = .020) were the predictors significantly associated with hookworm re-infections.ConclusionsThe re-infection rate was high during the fourth and sixth months. Participating in irrigation, infrequent shoe wear, and poor latrine utilization were predictors of hookworm re-infection. Therefore, mass drug administration, regular shoe wearing, and health education should be advocated.

IntroductionHepatitis B virus (HBV) is one of the major public health problems globally and needs an urgent response. It is one of the most responsible causes of mortality among the five hepatitis viruses, and it affects almost every class of individuals. Different studies were conducted on the prevalence of HBV among pregnant women in East African countries, but none of them showed the pooled prevalence of HBV among the pregnant women. Thus, the main objective of this study was to determine the pooled prevalence and its determinants among pregnant women in East Africa.MethodsWe searched studies using PubMed, Scopus, Embase, ScienceDirect, Google Scholar and grey literature that were published between January 01/2020 to January 30/2024. The studies were assessed using the Newcastle Ottawa Scale (NOS) quality assessment scale. The random-effect (DerSimonian) model was used to determine the pooled prevalence and associated factors of HBV among pregnant women. Heterogeneity were assessed by I2 statistic, sub-group analysis, and sensitivity analysis. Publication bias was assessed by Egger test, and the analysis was done using STATA version 17.ResultA total of 45 studies with 35639 pregnant women were included in this systematic review and meta-analysis. The overall pooled prevalence of HBV among pregnant women in East Africa was 6.0% (95% CI: 6.0%-7.0%, I2 = 89.7%). The highest prevalence of 8% ((95% CI: 6%, 10%), I2 = 91.08%) was seen in 2021, and the lowest prevalence 5% ((95% CI: 4%, 6%) I2 = 52.52%) was observed in 2022. A pooled meta-analysis showed that history of surgical procedure (OR = 2.14 (95% CI: 1.27, 3.61)), having multiple sexual partners (OR = 3.87 (95% CI: 2.52, 5.95), history of body tattooing (OR = 2.55 (95% CI: 1.62, 4.01)), history of tooth extraction (OR = 2.09 (95% CI: 1.29, 3.39)), abortion history(OR = 2.20(95% CI: 1.38, 3.50)), history of sharing sharp material (OR = 1.88 (95% CI: 1.07, 3.31)), blood transfusion (OR = 2.41 (95% CI: 1.62, 3.57)), family history of HBV (OR = 4.87 (95% CI: 2.95, 8.05)) and history needle injury (OR = 2.62 (95% CI: 1.20, 5.72)) were significant risk factors associated with HBV infection among pregnant women.ConclusionsThe pooled prevalence of HBV infection among pregnant women in East Africa was an intermediate level and different across countries ranging from 1.5% to 22.2%. The result of this pooled prevalence was an indication of the need for screening, prevention, and control of HBV infection among pregnant women in the region. Therefore, early identification of risk factors, awareness creation on the mode of transmission HBV and implementation of preventive measures are essential in reducing the burden of HBV infection among pregnant women.

BackgroundIn Ethiopia, recent evidence revealed that over a quarter (27%) of households (HHs) defecated openly in bush or fields, which play a central role as the source of many water-borne infectious diseases, including cholera. Ethiopia is not on the best track to achieve the SDG of being open-defecation-free by 2030. Therefore, this study aimed to explore the spatial variation and geographical inequalities of open defecation (OD) among HHs in Ethiopia.MethodsThis was a country-wide community-based cross-sectional study among a weighted sample of 8663 HHs in Ethiopia. The global spatial autocorrelation was explored using the global Moran's-I, and the local spatial autocorrelation was presented by Anselin Local Moran's-I to evaluate the spatial patterns of OD practice in Ethiopia. Hot spot and cold spot areas of OD were detected using ArcGIS 10.8. The most likely high and low rates of clusters with OD were explored using SaTScan 10.1. Geographical weighted regression analysis (GWR) was fitted to explore the geographically varying coefficients of factors associated with OD.ResultsThe prevalence of OD in Ethiopia was 27.10% (95% CI: 22.85-31.79). It was clustered across enumeration areas (Global Moran's I = 0.45, Z-score = 9.88, P-value ≤ 0.001). Anselin Local Moran's I analysis showed that there was high-high clustering of OD at Tigray, Afar, Northern Amhara, Somali, and Gambela regions, while low-low clustering of OD was observed at Addis Ababa, Dire-Dawa, Harari, SNNPR, and Southwest Oromia. Hotspot areas of OD were detected in the Tigray, Afar, eastern Amhara, Gambela, and Somali regions. Tigray, Afar, northern Amhara, eastern Oromia, and Somali regions were explored as having high rates of OD. The GWR model explained 75.20% of the geographical variation of OD among HHs in Ethiopia. It revealed that as the coefficients of being rural residents, female HH heads, having no educational attainment, having no radio, and being the poorest HHs increased, the prevalence of OD also increased.ConclusionThe prevalence of OD in Ethiopia was higher than the pooled prevalence in sub-Saharan Africa. Tigray, Afar, northern Amhara, eastern Oromia, and Somali regions had high rates of OD. Rural residents, being female HH heads, HHs with no educational attainment, HHs with no radio, and the poorest HHs were spatially varying determinants that affected OD. Therefore, the government of Ethiopia and stakeholders need to design interventions in hot spots and high-risk clusters. The program managers should plan interventions and strategies like encouraging health extension programs, which aid in facilitating basic sanitation facilities in rural areas and the poorest HHs, including female HHs, as well as community mobilization with awareness creation, especially for those who are uneducated and who do not have radios.

BackgroundReports showed that Amhara Region is accounting for 31% of Ethiopia`s malaria burden. Reports also depicted that despite the existing malaria vector control tools implemented by the regional government, currently there is an increment in malaria prevalence in the region. This might be due to lack of entomological monitoring and comprehensive information on the prevailing species composition, infection rate and feeding presences of An. mosquito species in the study areas. Therefore, this study aimed to address this information.MethodsA community-based cross-sectional study was conducted from 18 February to 30 March 2023 at three districts of the west Amhara Region. For this, six CDC light traps (three indoor and three outdoor) were used to collect adult female An. mosquito species. In this study, 261 An. mosquito species comprising seven species were collected. Their morphological identification and abdominal status determination were carried out using standard morphological identification keys under a dissection microscope. While their infection rates and blood meal sources were determined, using circumsporozoite protein-ELISA and blood meal-ELISA based on the standard protocol. Data were entered to SPSS versions 20 for analysis and p- value < 0.05 was considered as statistically significant.ResultsIn our study, total of 261 An. mosquito species were identified. An. demeilloni was the most abundant species accounted for 112(42.9%) of all captures. It was also the most predominant species at Ayehu-Guagusa followed by Jabitehnan districts. An. demeilloni and An. cinereus altogether accounting for infection rate of 3(1.1%) for P. vivax parasite. Furthermore, our study showed that more than 50% of An. mosquito species collected fed on cattle blood showing shifting of feeding behaviors.ConclusionsOur study depicted that An. demeilloni and An. cinereus were the most abundant species and infected with P. vivax parasite. Therefore, further comprehensive study should be done in the future.

The Tarcha coal deposit, located beneath the Omo trachyte flows in the Omo-Gibe River basin of southern Ethiopia, is actively mined using open-pit methods for energy resources. However, these mines face significant slope instability issues. This study aims to assess and enhance the stability of the selected open-pit coal mine quarries through field and laboratory analyses, supported by the limit equilibrium method (LEM) and the finite element method (FEM). Fieldwork involved detailed measurements of slope geometry and orientation, in situ rock testing, and soil and rock sampling for laboratory analysis. Results indicated that the rock quality designation (RQD) of the rocks ranged from 22 to 57.5, indicating rock quality from very poor to fair. Schmidt hammer tests revealed uniaxial compressive strength (UCS) values between 14.79 and 29.31 MPa. Soil analysis classified the soils as sand with low to high plasticity (8.89% to 31.86%) and a liquid limit range of 21% to 62.63%. Stability analyses using LEM and FEM on two critical slopes (MS-1 and MS-2) under saturated, unloading, and loading conditions indicated instability. However, geometric adjustments, such as reducing slope angle, decreasing slope height, and implementing benching, were found to significantly improve slope stability.

Background. Schistosomiasis is a common public health problem throughout the world and Schistosoma mansoni is the most prevalent species in Africa. Most endemic countries use the Kato–Katz (KK) stool smear examination for diagnosis, mapping, and monitoring of intervention programs. However, its poor sensitivity calls for an urgency to evaluate and use more accurate diagnostic tools, of which detection of circulating cathodic antigen (CCA) in urine seems promising. Methods. Studies published until May 2022 were searched from PubMed, Google Scholar, and grey literature for systematic review and meta-analysis following the PRISMA guideline. Eligible studies were selected based on preset inclusion and exclusion criteria. Quality of included studies was assessed using the QUADAS-2 tool. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics. Data were analyzed using Review Manager 5.4.1 and Meta-DiSc 1.4 software programs. Results. Thirty-seven studies published in 29 papers and enrolling 21159 study participants were included for analysis. Overall analysis of Point-of-Care Circulating Cathodic Antigen (POC-CCA) test against KK reference standard revealed a pooled sensitivity and specificity of 0.86 (95% CI: 0.85–0.87) and 0.66 (95% CI: 0.65–0.67), respectively. Subgroup analysis among 24 studies comparing single POC-CCA with test single KK revealed a high sensitivity (0.88) but low specificity (0.66). Based on findings of 24 studies, the area under the curve (AUC) for the systematic receiver operating characteristic (SROC) curve was 0.7805, indicating that the POC-CCA test effectively separates those with the disease from those who do not have it. Higher sensitivity estimates of 0.93 and 0.90 were reported when comparisons were made between test results of 2 urine and 1 stool samples, and 3 urine and 3 stool samples, respectively. Single POC-CCA test resulted in a pooled sensitivity estimate of 0.81 (95% CI: 0.78–0.84) as evaluated by the polymerase chain reaction (PCR) reference test. Conclusions. The POC-CCA test has higher sensitivity than KK and may serve as a routine diagnostic alternative for disease diagnosis, mapping, and monitoring of interventions. However, its accuracy should further be evaluated at different transmission settings and infection intensity.

Abstract Background Ethiopia is one of the top 10 countries in the world where 90% visceral leishmaniasis cases are reported. Metema-Humera lowlands are the most important foci in Ethiopia. Blood transfusion in visceral leishmaniasis endemic foci in Ethiopia does not consider screening of visceral leishmaniasis during blood donation. The aim of this study is therefore, was to assess asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia. Methods A Health facility based cross-sectional study was conducted at Metema Blood Bank from February to March 2020. A total of 205 blood donors were eligible and participated in this study. Structured questionnaire were used to collect data on socio-demographic characteristics and perceived risk factors associated with asymptomatic visceral leishmaniasis among blood donors. Blood donors were screened using both rK39 and direct agglutination tests based on the manufactures’ instructions. Data were analyzed using SPSS version 20.0. Chi-square test was used to assess associations of Leishmania donovani infection with predisposing factors. Associations were considered statstically significant on P-value

Mitikie Wondmagegn,1 Yitayih Wondimeneh,2 Alem Getaneh,2 Getnet Ayalew2 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Getnet Ayalew, Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O.Box: 196, Gondar, Ethiopia, Tel +251-918-73-00-13, Email aget2289@gmail.comBackground: Sexually transmitted infections (STIs) are a public health problem worldwide. Hepatitis B virus infection (HBV), hepatitis C virus infection (HCV), and syphilis are among the STIs. Female sex workers (FSWs) continue to be a high-risk group for STIs due to a variety of factors, including exposure to unsafe sexual practices. Therefore, this study determines the seroprevalence of HBV, HCV, Treponema palladium, and associated factors among FSWs in Gondar town, Northwest Ethiopia.Methods: A cross-sectional study was conducted on 194 FSWs from March to June 2021 in Gondar town. Socio-demographic and behavioral data were collected using a questionnaire. Five milliliters (5mL) of venous blood was collected and tested for hepatitis B surface antigens, anti-hepatitis C antibodies, and anti-syphilis antibodies using an enzyme-linked immunosorbent assay. Logistic regression, univariate, and multivariate analyses were carried out. A p-value of < 0.05 at a 95% confidence interval was considered statistically significant.Results: A total of 194 FSWs were included in the study. The seroprevalence rates of HBV infection, HCV infection, and syphilis were 23 (11.9%), 13 (6.7%), and 22 (11.3%), respectively. All three infections were statistically associated with inconsistent condom use (AOR = 1.72, 95% CI: 1.95– 5.07, p = 0.03); (AOR = 10.51, 95% CI: 1.62– 68.26, p = 0.014); and (AOR = 17.3, 95% CI: 4.55– 65.6, p = 0.001). Whereas sex stimulant drug use (AOR = 9.4, 95% CI: 1.002– 88.14), intravenous drug use (AOR = 15.53, 95% CI: 1.9– 127.99, p=0.011), and sex while having a vaginal ulcer (AOR = 5.72, 95% CI: 1.13– 28.9, p=0.035) were all statistically associated with HCV infection.Conclusion: The prevalence of HBV infection, HCV infection, and syphilis was comparatively higher. Regular screening, health education, and other preventative strategies are advised to lower the STI burden among FSWs.Keywords: HBV, HCV, syphilis, STIs, FSWs, Gondar town

BackgroundGlobally, Pneumonia continues to be the leading cause of mortality among under-five children. Ethiopia ranks fourth out of 15 countries worldwide in terms of the highest death rate of under-five children due to severe community-acquired pneumonia (SCAP). However, to date, there is no recent study that shows survival status and predictors of mortality from SCAP. Therefore, this study aimed to determine survival status and predictors of mortality from this dangerous disease among under-five children.MethodsA facility-based prospective cohort study was conducted from 1 November 2021 to 31 October 2022 at Debre Tabor comprehensive specialized hospital. All under-five children with SCAP admitted during the study period were included. Participants were selected using a systematic sampling technique. The collected data were coded, edited, and entered into epi-data version 4.2 and then exported to STATA version 17 for further analysis. The Kaplan Meier failure estimate with log-rank test was employed to determine the survival estimates. A cox-proportional hazard regression model was fitted to identify significant variables.ResultsThe overall incidence density rate of mortality was 5.7 /1000 children with a median hospital stay of 8.2 days. Heart disease (AHR: 4.37; 95%CI: 1.68–11.32), previous admission of SCAP (AHR: 3.87; 95% CI: 1.31–11.43), WFL

Background: Husbands' participation in maternal health care, as seen by an appropriate birth plan and readiness for complications, reduces maternal death by avoiding delays in recognizing danger signs, reaching a site of care, and seeking aid. As a result, this study aimed to determine the husband's participation in birth preparation and complication readiness, as well as its predictors, among men whose wives were referred to obstetric referral in the South Gondar Zone of North West Ethiopia. Methods: A hospital-based cross-sectional study was conducted among husbands whose wives were admitted with obstetric referrals in the selected hospitals from February to March 2021. A total of 393 individuals were chosen proportionally from the selected hospitals using a systematic random sampling technique. An interviewer-administered structured questionnaire was used to collect data, which was then entered into Epi Data Version 3.1 and exported to Stata version 14 for analysis. To find predictors of the outcome variable, a binary logistic regression model was used. The final model's results were expressed as adjusted odds ratios, 95% confidence intervals, and P-values. Result: The magnitude of husband participation in birth preparedness and complication readiness among obstetric referrals was 282 (71.8%). Planned pregnancy [AOR, 95% CI: 2.78 (1.68–4.62)], discussion with their wife [AOR, 95% CI: 2.85 (1.72–4.71)], and good knowledge of danger signs during pregnancy, delivery, and postpartum [AOR, 95%CI:2.71 (1.67–4.42)] were significantly associated with husband participation as compared to its counterparts. Conclusion and Recommendation: The husband's participation in birth preparedness and complication readiness for obstetric referrals in the South Gondar zone were reasonably good. For good husband participation in birth preparedness and complication readiness, knowledge of danger signs, pregnancy planning status, and discussion with wife about pregnancy were responsible. Healthcare providers should support mothers in discussing the danger signs of pregnancy, birth preparedness, and complication readiness with their husbands during ANC visits.

Abstract Background Even though treatment failure is higher among TB and HIV infected children in a resource-limited setting, there is no prior evidence in general and in the study area in particular. Hence, this study was aimed at determining the half-life time prediction of developing first-line antiretroviral treatment failure and its risk factors among TB and HIV co-infected children. Methods A historical follow-up study was employed among 239 TB and HIV co-infected children from January 2010-December 2020. The data was entered into Epi data version 4.2.2 and exported to STATA 14.0 Software for analysis. The Kaplan-Meier plot was used to estimate the half-life time to develop treatment failure. The required assumption was fulfilled for each predictor variable. Additionally, those variables having a p-value ≤0.25 in the bivariable analysis were fitted into a multivariable Cox-proportional hazards regression model. P-value,

Tazeb Alemu Anteneh,1 Abayneh Aklilu Solomon,1 Animut Tagele Tamiru,2 Nebiyu Solomon Tibebu,1 Haymanot Nigatu Alemu,1 Selam Yibeltal Desalegn,3 Hiwotie Getaneh Ayalew,3 Marta Yimam Abegaz,1 Azmeraw Ambachew Kebede1 1Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of midwifery, School of nursing and midwifery, College of Medicine and Health Sciences, Wollo university, Dessie, EthiopiaCorrespondence: Tazeb Alemu Anteneh, Tel +251 936299984, Email tazebalemu05@gmail.comBackground: The use of herbal medicine is increasing globally, particularly in developing countries including Ethiopia, yet little is known regarding its effect and safety during pregnancy. Pregnant women prefer herbal medicine due to easy accessibility, traditional and cultural beliefs, and comparatively low cost. This study aimed to assess women’s knowledge and attitude towards the effects of herbal medicine usage during pregnancy and associated factors among women who gave birth in the last twelve months in Dega Damot district.Methods: A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 women were selected using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance.Results: Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was 49.1% (95% CI: 46– 52) and 57.3% (95% CI: 54– 61), respectively. Access to media, had antenatal care visit, being urban dweller, history of herbal medicine usage, and a short distance to reach the nearby health facility were significantly associated with women’s knowledge about effects of herbal medicine usage. Besides, being primiparous and short traveling time to reach the nearby health facility was significantly associated with women’s attitude towards the effects of herbal medicine usage during pregnancy.Conclusion: Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was low. It is important to design strategies to improve the accessibilities of maternal health services, and expand access to media will have a great role in improving women’s knowledge and attitude towards herbal medicine usage during pregnancy.Keywords: attitude, Ethiopia, herbal medicine, knowledge, pregnancy

Plain Language summary Antenatal care visits during the first trimester of the pregnancy stage provide opportunities for women to improve their health, prevent disease, and identify and manage pregnancy and childbirth complications. However, delayed first antenatal care visit is a major leading cause of pregnancy and childbirth complications, and many women in Ethiopia still start ANC visits late. Hence, we aimed to examine the trends in delayed first antenatal care visits and identify the contributing factors for the trend change in delayed first antenatal care visits in Ethiopia over the study period (2000–2016). We obtained data on women aged 15–49 years from four consecutive Ethiopian Demographic and Health Surveys (EDHSs) conducted in 2000, 2005, 2011, and 2016. We extracted both response and independent variables for this study from the Kids Record (KR file) data set. The prevalence of delayed first ANC visit has significantly decreased from 76.8% [95% CI 75.1, 78.6] in 2000 to 67.3% [95% CI 65.9, 68.6] in 2016 over the last sixteen years in Ethiopia. The overall trend change in delayed first antenatal care visits over the study periods was due to the difference in women's composition of selected characteristics and women's behavioral changes on ANC initiation. More than halves (61%) decline in delayed first ANC visits among reproductive-aged women was due to women's behavioral change, and 39% was due to change in women's composition over time. The significant contributing factors for the decline in delayed first antenatal care visits over the study period were residence, husband's educational level, mass media exposure, ever told about pregnancy complications, cesarean delivery and family sizes. Changes in the composition of women's characteristics according to residence areas, media exposure, ever told about pregnancy complications, cesarean delivery and family sizes were statistically significant variables for the decline in delayed first ANC visit over time. Only husbands who had secondary and above education were attributable to women’s behavioral change on ANC services.

Objective: This study aimed to assess the risky driving behavior and associated factors among drivers in Debre Tabor town, Ethiopia, 2020. Methods: This study was a mixed type community-based cross-sectional survey of 564 and 11 participants for quantitative and qualitative study by using a self-administered questionnaire and an interview method, respectively, and the analysis was carried out in 2021. Results: Eighty-two-point one percent (82.1%) of drivers were engaged in risky driving behavior. Driving at night, never attending religious events/ceremonies, driving >8 h/day, believing income is insufficient, weak law enforcement, training institutions problem, being Bajaj driver, and being a non-governmental-driver were significantly associated with risky driving behavior. Conclusion: Risky driving behavior was high among drivers. Being non-governmental driver was the protective factor of risky driving behavior however the rest variables were the risk factors for risky driving behavior. To overcome the problem, appropriate law enforcement measures should be taken.

Background. Soil-transmitted helminths are parasitic nematodes found in the intestine. They are more prevalent in the tropics and subtropics, including Ethiopia. However, low-sensitive direct wet mount microscopy fails to detect soil-transmitted helminths among infected cases. Therefore, more sensitive and cost-effective diagnostic methods are urgently needed to minimize soil-transmitted helminthiasis morbidity. Objective. This study aimed to compare and evaluate the performance of diagnostic methods for soil-transmitted helminths against the “gold” standard. Methods. An institution-based cross-sectional study was conducted among 421 schoolchildren from May to July, 2022 in the Amhara Region. Study participants were selected using a systematic random sampling technique. Stool samples were processed via Kato–Katz, McMaster, and spontaneous tube sedimentation techniques. Data were entered into epi-data version 3.1 and analyzed using SPSS version 25. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated against the combined result as a “gold” standard. The strength of agreement between the diagnostic methods was determined by the Kappa value. Results. The overall prevalence of soil-transmitted helminths was 32.8% (95% CI: 28.2–37.8%) using a combination of methods. The detection rates of Kato–Katz, McMaster, and spontaneous tube sedimentation were 28.5% (95% CI: 24.2–33.2%), 30% (95% CI: 25.6–34.8%), and 30.5% (95% CI: 26.1–35.3%), respectively. Sensitivity and negative predictive values were 87.1% (95% CI: 80.2–92.3%) and 95.1% (95% CI: 92.6–96.8%) for Kato–Katz; 91.7% (95% CI: 85.6–95.6%) and 96.5% (95% CI: 94.1–98.0%) for McMaster; and 93.2% (95% CI: 87.5–96.8%) and 97.1% (95% CI: 94.7–98.4%) for spontaneous tube sedimentation. Kappa values of Kato–Katz, McMaster, and spontaneous tube sedimentation for the diagnosis of soil-transmitted helminths were 0.901, 0.937, and 0.948, respectively. Conclusion. Kato–Katz, McMaster, and spontaneous tube sedimentation techniques had comparable sensitivity with almost perfect agreement for the detection of soil-transmitted helminths. Therefore, the spontaneous tube sedimentation technique can be used as an alternative diagnostic method for soil-transmitted helminth infections in endemic countries.

Alem Getaneh, Getnet Ayalew, Debaka Belete, Mohabaw Jemal, Sirak Biset Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Sirak Biset 196 Tel +251-911-598-568Email serbis33@gmail.comBackground: An ear infection is responsible for up to 40% of preventable hearing impairment; one of the reasons for frequent and unwise antibiotic usage, especially in the developing world. Since the incidence of antibiotic resistance is increasing, especially in resource-limited countries, up-to-date knowledge on the susceptibility of ear-discharge isolates to antibiotic is important for better patient treatment. Therefore, this study aimed at determining the bacterial etiologies and their antibiotic susceptibility profiles among patients suspected with ear infections.Methods: We collected retrospective data from bacteriological results of ear discharge samples from 2013 to 2018. Sample collection, culture preparation, and bacterial identification were performed using standard microbiological techniques. Antimicrobial susceptibility testing was performed following Clinical and Laboratory Standard Institute (CLSI) guidelines. We extracted and inputted the data using Epi-info version 7 and exported it to SPSS version 20 for analysis.Results: The overall ear-discharge culture positivity rate was 283/369 (76.7%) (95% CI = 72.4– 81.3), with 14/283 (4.95%) mixed infections. Staphylococcus aureus (27.9%), Proteus spps (20.8%), Streptococcus spps (10%), and Pseudomonas spps (8.92%) were the main isolates. High-level resistance rates for tetracycline (77.6%), penicillins (67.2%), erythromycin (52.6%), and co-trimoxazole (52%), and low-level resistance rates for fluoroquinolones (23.3%), aminoglycosides (23.7%), and cephalosporins (29.8%) were observed. More than 45% of isolates, with 50.9% of Gram-negative and 37.3% of Gram-positive, were multidrug-resistant.Conclusion: Staphylococcus aureus, Proteus mirabilis, Proteus vulgaris, Escherichia coli, and Pseudomonas aeruginosa were the leading cause of ear infections. The presence of high number of multidrug-resistant strains calls for the need for periodic and continuous follow-up of antibiotic usage in the study area. Further studies are recommended to explore the types of ear infections, with their etiologic agents and possible risk factors.Keywords: ear infection, bacterial etiologies, antibiotic susceptibility, Gondar, Ethiopia

Leykun Berhanu,1,&ast; Habib Bedru,2,&ast; Beje Gume,3 Tadele Tolosa,4 Tesfaye Kassa,5 Assegid Getaneh,4 Seid Tiku Mereta3 1Department of Environmental Health, Wollo University, Dessie, Ethiopia; 2Department of Livestock and Fishery Development, Jimma, Ethiopia; 3Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia; 4School of Veterinary Medicine, Jimma University, Jimma, Ethiopia; 5School of Medical Laboratory Science, Jimma University, Jimma, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Leykun Berhanu Email leyberhanuwu.edu.et@gmail.comBackground: Although Campylobacter jejuni (C. jejuni) and Campylobacter coli (C. coli) cause acute diarrheal diseases in people all over the world, they are most commonly seen in other mammalian species and are a seemingly healthy carrier condition. Humans in Ethiopia, on the other hand, are largely unaware of the existence of Campylobacter in food animals as potential sources of infection.Objective: To determine the occurrence, risk factors, and antimicrobial susceptibility pattern of thermophilic Campylobacter species in bovine raw meat from the abattoir and butcher shops.Methods: Swab samples were collected from 177 cattle carcasses (from abattoir 93 and butcher shops 84) and cultured using standard methods. An antimicrobial susceptibility test was performed using the disk diffusion method towards eleven antimicrobial agents.Results: The overall prevalence of thermophilic Campylobacter species was 14 (7.9%). From these, 11 (78.6%) were identified to be C. jejuni and 3 (21.4%) were C. coli. Lack of handwashing before meat processing and after visiting the toilet, meat contact with floors, walls, or soiling during preparation, and lack of training were the most important factors independently associated with (p< 0.05) the prevalence of Campylobacter species contamination. The highest level of antimicrobial resistance of the Campylobacter isolates was recorded to ampicillin (10μg) (100%), followed by amoxicillin (30μg) (78.6%) and sulphamethoxazole-trimethoprim (57.1%) while the least resisted antimicrobials were streptomycin (25μg), erythromycin (15μg), oxytetracycline (30μg) (each 28.6%), kanamycin (30μg) 14.3%, chloramphenicol (30μg) and gentamycin (10μg) (each 7.1%).Conclusion: Despite the low prevalence of thermophilic Campylobacter in the current investigation, it may pose a significant public health threat. As a result, it is vital to give retailers and customers extensive education, training, and knowledge about the correct handling and cooking of animal-derived goods. Furthermore, antimicrobials should be used with caution in both veterinary and human treatment regimens as well as a wider examination of antimicrobial resistance patterns for the use of well-targeted antimicrobials.Keywords: antimicrobial resistance, cattle carcass, thermophilic Campylobacter, Jimma town

Abstract Background Both capillary and venous blood samples have been interchangeably used for the diagnosis of malaria in Ethiopia. However, Plasmodium parasites are thought to be more concentrated in capillary than in venous blood. Hence, selecting a sample source where parasites are more concentrated is indispensable approach in order to maximize the accuracy of blood film microscopy. Therefore, the present study aimed to compare the detection rate and the parasitemia level of Plasmodium species from conventional capillary and venous blood films, and buffy coat preparations. Methods A facility based cross-sectional study was conducted from Feburary to March 2020 among 210 febrile patients attending Hamusite health center, northwest Ethiopia. Capillary and venous blood samples were collected and buffy coat was prepared from each sample. Thin and thick blood films were prepared, stained, and examined microscopically following standard protocol. Data were analysed using Statistical Package for Social Sciences Software version 20 and Med-Calc software version 19.3. Results Capillary blood buffy coat (61/210, 29.0%) had significantly higher detection rate as compared to capillary (48/210, 22.9%) and venous (42/210, 20.0%) blood films (p

Leykun Berhanu,1 Seid Tiku Mereta,2 Beje Gume,2 Tesfaye Kassa,3 Gete Berihun,1 Lelisa Sena Dadi,4 Sultan Suleman,5 Dechassa Tegegne,6 Assegid Getaneh,6 Habib Bedru7 1Department of Environmental Health Science, Wollo University, Dessie, Ethiopia; 2Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia; 3School of Medical Laboratory Science, Jimma, Ethiopia; 4Department of Epidemiology, Jimma University, Jimma, Ethiopia; 5Department of Pharmacy, Jimma University, Jimma, Ethiopia; 6Department of Veterinary Medicine, Jimma University, Jimma, Ethiopia; 7Jimma Zone Livestock and Fishery Development Office, Jimma, EthiopiaCorrespondence: Leykun Berhanu Email leyberhanuwu.edu.et@gmail.comBackground: In most cases, people pay more attention to the microbial quality of drinking water than the quality of water they used to wash hands. This may lead to the occurrence of various foodborne illnesses through the introduction of pathogenic microbes during preparation and serving of food.Objective: To determine the effect of microbial quality of washing water on the hand hygiene status of food handlers in Jimma town.Methods: Laboratory-based cross-sectional study design was used. A total of 150 food handlers were selected randomly for hand hygiene examination, and 150 water samples were collected aseptically from water storage tanks, food handlers used to wash their hands. The samples were subjected for microbiological analysis using standardized protocol. Descriptive statistics and Pearson correlation coefficient were used to summarize the data and to determine the effect of microbial quality of water on hand hygiene of food handlers, respectively.Results: Among 150 food handlers included in the study, 104 (69.0%) of them were males and 64 (43.0%) of them aged between 35 and 50 years. On the other hand, 64 (42.7%) of the study participants had not attended formal education. About three-fourth of them used stored water to wash their hands, and almost similar proportion of them were waiters. The mean coliform bacteria of water and hand rinsate samples were 4.2 ± 0.8 and 4.1 ± 0.8 log CFU/mL, respectively.Conclusion: The study revealed that the microbial quality of water used to wash hands significantly affects the hand hygiene status of the food handlers. Hence, improving the microbial quality of washing water is important to improve the hand hygiene status of food handlers and consequently to prevent the occurrence of food-borne illness in the town.Keywords: Jimma town, hand hygiene, stored water, food handler, hand rinsate

This study aimed to determine antimicrobial- resistance (AMR) enteric bacterial load and associated factors among Food Handlers (FHs) ofMass Catering Center (MCC), Ethiopia. From January to June 2020, a laboratory-based cross-sectional study was conducted using the standard Swab microbiological analysis method and the Kirby-Bauer disc diffusion method on 160 randomly selected FHs and food serving areas and analyzed with RStudio- 1.2.5033 for contamination, resistance level, and source determination. The contamination of AMR Escherichia coli was 33.3% (95% CI, 31.5%, 36.4%), Salmonella 30% (95% CI, 29.8%, 36.0%) and Shigella 20% (95% CI, 19.2%, 26.9%) among the hand of FHs serving in MCC. The contamination was more likely associated with low work experience [AOR, 1.42 (95% CI: 1.22-1.87)], a low educational level [AOR, 1.62 (95% CI: 1.52-189)], irrational drug use characteristics [AOR, 1.75(95% CI: 1.64-2.00)], lack of sufficient food safety knowledge [AOR, 1.52 (95% CI: 1.32-1, 67)] of the FHs and the sanitary condition of the food serving area [AOR:1.98 (95% CI, 1.45, 2.53)]. The contamination of the hand of FHs serving in the MCC with AMR enteric FBB at the University cafeteria could indicate the likelihood of the occurrence of foodborne outbreaks.

Introduction Malaria is one of the major public health problems in sub-Saharan Africa. It contributes significantly to maternal and fetal morbidity and mortality in affected countries. This study aims to evaluate the impact of enhanced case detection using molecular testing called loop-mediated isothermal amplification (LAMP) on birth outcomes in a prospective study design.Methods and analysis A pragmatic randomised diagnostic outcomes trial will be conducted in several health institutes in different Ethiopian regions. Women (n=2583) in their first and second trimesters of pregnancy will be included in the study and individually randomised to the standard of care or enhanced case detection arms, and followed until delivery. Enrolment will encompass the malaria peak transmission seasons. In the standard of care arm, a venous blood sample will be collected for malaria diagnosis only in symptomatic patients. In contrast, in the intervention arm, mothers will be tested by a commercially available Conformité Européene (CE)-approved LAMP malaria test, microscopy and rapid diagnostic test for malaria regardless of their symptoms at each antenatal care visit. The primary outcome of the study is to measure birth weight.Ethics and dissemination The study was approved by the following ethical research boards: Armauer Hansen Research Institute/ALERT Ethics Review Committee (FORM AF-10-015.1, Protocol number PO/05/20), the Ethiopia Ministry of Science and Higher Education National Research Ethics Review Committee (approval SRA/11.7/7115/20), the Ethiopia Food and Drug Administration (approval 02/25/33/I), UCalgary Conjoint Health Research Ethics Board (REB21-0234). The study results will be shared with the institutions and stakeholders such as the Ethiopia Ministry of Health, the Foundation for Innovative Diagnostics, WHO’s Multilateral initiative on Malaria - Tropical Diseases Research (TDR-MIM), Roll Back Malaria and the Malaria in Pregnancy Consortium. The study results will also be published in peer-reviewed journals and presented at international conferences.Trial registration number NCT03754322.

Abstract In this study, we report antibacterial activity of metalloporphyrins; 5, 10, 15, 20-tetrakis (para-X phenyl)porphyrinato M (II) [where X = H, NH2 and COOMe for M = Cu and X = COOH and OMe for M = Co]. The activity study of the as-synthesized metalloporphyrins toward two Gram-positive (S. aureus and S. pyogenes) and two Gram-negative (E. coli and K. pneumoniae) bacteria showed a promising inhibitory activity. Among the complexes under study, the highest antibacterial activity is observed for 5, 10, 15, 20-tetrakis (p-carboxyphenyl)porphyrinato cobalt (II), with inhibition zone of 16.5 mm against Staphylococcus aureus (S. aureus). This activity could be attributed to the high binding ability of COOH group to cellular components, membranes, proteins, and DNA as well as the lipophilicity of the complex. Moreover, consistent with literature report, the study revealed that metalloporphyrins with electron withdrawing group at para-positions have better antibacterial activity than metalloporphyrin which possess electron donating group at para position.

Abstract Background Microscopic examination of peripheral blood smear produces reliable results both about the malaria infection status and level of parasitemia. However, test results are affected by skill of the laboratory personnel, workload, condition of microscopes and quality of laboratory supplies. Therefore, continuous monitoring of the performance of laboratories is of pivotal importance in order to make timely correction. Methods A facility based cross-sectional study was conducted from July 2017 to July 2019 to assess malaria microscopy performance among thirty malaria diagnostic laboratories in west Amhara region. Thirty slides were collected from participating laboratories every quarter. Collected slides were taken to Amhara Public Health Institute reference laboratory and re-checked by malaria microscopists who were blind to the results from health facilities. Percentage of test agreement, rates of false positive, false negative and species misdiagnosis were calculated using Excel 2010. Results Among a total of 6689 slides re-checked, results of 6146 slides were the same with that of participating laboratories. The test agreement was 97.31 and 94.6% for parasite detection and species identification, respectively. Variations in the overall performance of individual laboratories were seen within a range of 81.55 to 97.27% test agreement. Results of 543 (8.12%) slides were discordant, of which 363 (5.4%), 93 (1.4%) and 87 (1.3%) slides were due to species misdiagnosis, false positive and false negative results, respectively. Conclusion There was good test agreement between participated laboratories and Amhara Public Health Institute. More accurate performance is expected as the country is tracking to malaria elimination. Hence, further strengthening the external quality assurance program is recommended.

Mitikie Wondmagegn,1,&ast; Yitayih Wondimeneh,2 Alem Getaneh,2 Getnet Ayalew2,&ast; 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Getnet Ayalew, Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, Ethiopia, Tel +251-918-73-00-13, Email aget2289@gmail.com

The aim of the study was to investigate the effectiveness of mind mapping on Ethiopian secondary school students' English collocation learning. The study specifically tried to check the effectiveness of mind mapping on adjective-preposition and verb-noun combination collocations. A sample of 110 grade 12 students who were learning in two sections at Majete General Secondary School, North Shoa Zone, Ethiopia, participated in the study. One of the two sections was randomly assigned to an experimental group, while the other one was labeled as a control group. A pre-test and two post-tests were used as data-gathering instruments. The data were analyzed by using mean scores, paired samples, and independent sample t-tests. The results revealed that although the two sections had no significant difference in their pre-test results, in the immediate and delayed post-tests, the score of adjective-preposition & verb-noun collocations of the experimental group students was significantly higher than the score of the control group students who learnt those collocations without mind map. Based on this, it could be concluded that using mind map was an effective strategy to improve EFL high-school students' collocations learning. Accordingly, it is recommended that EFL teachers and students should use mind-map during their collocations lessons.

Background: Adoption of organic fertilization is low among farmers in rural areas of Ethiopia, affecting yields and general food security in the region. This study aimed to identify the determinants of the utilization of organic fertilizers among smallholder farmers in the South Gondar Zone, Amhara National Regional State (ANRS), Northwest Ethiopia. Methods: A community-based cross-sectional study was used among smallholder farmers in the South Gondar Zone, ANRS, Northwest Ethiopia. Primary data were collected from 420 sample respondents using multistage sampling with a combination of both simple random and cluster sampling techniques. The binary logistic regression model was used to assess the use of organic fertilizers among smallholder farmers in the South Gondar Zone. The results are presented as adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals. Results: head of household age (AOR = 1.099, 95% CI 1.018-1.187), married marital status (AOR = 10.506, 95% CI 1.355-81.427), literate head of household (AOR = 3.323, 95% CI 1.571-7.029), number of laborers (AOR = 1.442, 95% CI 1.060-1.962), farming experience (AOR = 1.132, 95% CI 1.041-1.232), farm size (AOR = 1.063, 95% CI 1.008-1.121), and number of livestock (AOR = 1.368, 95% CI 1.115-1.677) were positively associated with the utilization of organic fertilizer while single marital status (AOR = 0.062, 95% CI 0.004-0.851), cost of laborer (AOR = 0.965, 95% CI 0.951-0.978), household income (AOR = 0.880, 95% CI 0.824-0.939), medium soil fertility (AOR = 0.039, 95% CI 0.007-0.229), fertile soil (AOR = 0.020, 95% CI 0.003-0.120), and home to farm distance (AOR = 0.219, 95% CI 0.067-0.717) were negatively associated with the utilization of organic fertilizer. Conclusions: This finding showed that multiple variables have an effect to determining the use of organic fertilizer by smallholder farmers. Therefore, the finding is important to adopt programs to encourage the use of organic fertilizer, implement policies in an attempt to adapt the use of organic fertilizer among the South Gondar Zone, and critically consider these factors. Furthermore, extension workers should focus on raising awareness about the importance of organic fertilizers to encourage or expand their use among smallholder farmers.