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Ephrem Mebrahtu Araya,1 Haylay Araya Gebrezgabiher,1 Gebretsadkan Hintsa Tekulu,2 Niguse Meles Alema,1 Desalegn Getnet,1 Hirut Teame Gebru,3 Betelhem Anteneh Adamu4 1Department of Pharmacy, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 2Department of Pharmacognosy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3Department of Public Health, Colleges of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 4Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Ephrem Mebrahtu ArayaDepartment of Pharmacy, College of Medicine and Health Sciences, Adigrat University, Adigrat, Tigrai, EthiopiaTel +251 914425760Email ephremcfc@gmail.comIntroduction: Medication non-adherence is a major public health problem among diabetes mellitus patients. However, there is a lack of data regarding its magnitude and the factors contributing to Ethiopia’s non-adherence, especially in the Tigrai region. This study was conducted to assess the magnitude of non-adherence and its contributing factors among diabetes mellitus patients in the Eastern Zone of Tigrai, Northern Ethiopia.Materials and Methods: A hospital-based cross-sectional study was conducted at Adigrat and Wukro General Hospitals using a pre-tested, self-administered, semi-structured questionnaire developed from the relevant literature and a checklist developed to review patient medical cards for the period of the 15th of March to the 15th of July, 2019. Data were analyzed using Statistical Package for Social Sciences version 20. Association between the dependent and the independent variable was performed using logistic regression and a p-value of < 0.05 was considered significant.Results: From a total of 321 study participants, 63.9% of the patients were non-adherent to their medications. Two-month dose issued on each visit (AOR = 2.865, 95% CI 1.380– 5.949), dose issued for more than three months (AOR = 4.314, 95% CI 1.526– 12.195), monthly income below 500 birr (AOR = 5.048, 95% CI 2.094– 12.168), monthly income between 500 and 2000 birr (AOR = 2.593, 95% CI 1.032– 6.517), distance greater than 24 kilometers from hospital to home (AOR = 10.091, 95% CI 3.509– 29.020), more than four prescribed medications per visit (AOR=7.192, 95% CI= 2.171– 23.824), never receiving counseling (AOR=22.334, 95% CI= 9.270– 53.810), and diabetes-related admission (AOR=0.248, 95% CI= 0.078– 0.789) were significantly associated with patients’ non-adherence to diabetes mellitus medications.Conclusion: The level of diabetic medication adherence was suboptimal, and our study highlights that better monthly earning, nearby health-care accessibility, fewer prescribed medication, and getting appropriate counseling about diabetes mellitus were predictive of adherence to medications. Hence, an urgent intervention targeting the development of guidelines that involve these determinates should be employed to improve health care.Keywords: diabetes mellitus, Ethiopia, medication non-adherence, patients

This study examined the effect of transactional leadership behaviors on research productivity in public universities, with organizational learning capability serving as a mediating factor. A quantitative research approach focusing on correlational design was utilized. Data were collected through a survey questionnaire administered to 519 respondents. Both measurement and structural model analyses were conducted, with deans, colleges, and individual academics serving as units of analysis. The findings revealed that deans’ contingent reward leadership behaviors significantly and positively influenced the research productivity of academics and colleges, even when controlling for workplace learning capability. Furthermore, the study demonstrated that deans’ contingent rewards and active-by-exception behaviors significantly and positively impacted workplace learning capability, accounting for 44.5% of the variance, with moderate and small effect sizes, respectively. Additionally, organizational learning capability exhibited a significant positive effect, explaining 54% of the variance in research productivity and demonstrating a moderate effect size, which indicates an unexplained variance of 46%. Bootstrapping tests confirmed that workplace learning capability partially and fully mediates the relationship between deans’ transactional leadership behaviors and research productivity. Consequently, it is imperative for college deans to enhance their contingent reward leadership behaviors and foster workplace learning capabilities to maximize their impact on research productivity.

Background and Aims Phosphorus (P) availability is often limiting for rice (Oryza sativa) production. Improving internal P-use efficiency (PUE) is crucial to sustainable food production, particularly in low-input systems. A critical aspect of PUE in plants, and one that remains poorly understood, is the investment of leaf P in different chemical P fractions (nucleic acid-P, lipid-P, inorganic-P, metabolite-P and residual-P). The overarching objective of this study was to understand how these key P fractions influence PUE. Methods Three high-PUE and two low-PUE rice genotypes were grown in hydroponics with contrasting P supplies. We measured PUE, total P, P fractions, photosynthesis and biomass. Key Results Low investment in lipid-P was strongly associated with increased photosynthetic PUE (PPUE), achieved by reducing total leaf P concentration while maintaining rapid photosynthetic rates. All low-P plants exhibited a low investment in inorganic-P and lipid-P, but not nucleic acid-P. In addition, whole-plant PUE was strongly associated with reduced total P concentration, increased biomass and increased preferential allocation of resources to the youngest mature leaves. Conclusions Lipid remodelling has been shown in rice before, but we show for the first time that reduced lipid-P investment improves PUE in rice without reducing photosynthesis. This presents a novel pathway for increasing PUE by targeting varieties with reduced lipid-P investment. This will benefit rice production in low-P soils and in areas where fertilizer use is limited, improving global food security by reducing P fertilizer demands and food production costs. [ABSTRACT FROM AUTHOR]

Background Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients. Methods A systematic review was conducted using the “Preferred Reporting Results of Systematic Reviews and Meta-Analyses” guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle–Ottawa Scale. Results In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL. Conclusions The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL.

Climate change and related extreme events have become global challenges in ensuring sustainable development. This affects water availability and agricultural production, particularly in developing countries. This study explored the factors affecting farmers' adaptation mechanisms to climate change in different agro-ecological zones of the Bure Zuria district of northwestern Ethiopia. A household survey, focus group discussion, key informant interviews, and observations were used to acquire primary data on farmers' socioeconomic and demographic characteristics, adaptation strategies and potential barriers. About 190 randomly selected households from different agro-ecologies were included in this study. Moreover, reports and published sources were used to acquire secondary data. Data were analyzed using a multinomial logit regression model and descriptive statistics. The results indicated that soil and water conservation practices (26.7%) were the main adaptation responses in highland agro-ecology. In contrast, supplementary feeding for livestock (56%) was the main adaptation response to the adverse effects of climate extremes in lowland agro-ecology. Farmers identified land scarcity (25.84%) and shortage of water for irrigation (28.57%) as major barriers to adaptation in the highland and lowland agro-ecologies, respectively. In addition, agro-ecology, education level, age, active labor, number of livestock (TLU), off-farm income, frequency of extension contacts, credit access, and market access were decisive factors affecting farmers’ adaptation mechanisms to withstand extreme climatic events. In conclusion, soil and water conservation practices are more practiced in highland areas than in lowland areas. Because the steepness of farmlands and erodible soils increase farmers' vulnerability to flood hazards in highland areas than in lowland areas. It is suggested that investigations on the climate change-induced gender-differentiated impacts shall be conducted to design all-inclusive and effective responses.

Abstract Background Though cervical cancer is largely preventable, it is still the second most common female cancer globally and the leading cause of cancer deaths among females in African. Though many efforts have been done to study the burden of the disease in Ethiopia, primary studies examining the prevalence of precancerous cervical lesions are fragmented. Hence, this systematic review and meta-analysis is aimed at estimating the pooled prevalence of precancerous cervical lesion and its trends in Ethiopia. Methods This systematic review and meta-analysis was conducted using the following electronic databases. PubMed, Web of Science, SCOPUS, Science Direct, Google Scholar, African Index Medicus (AIM), African Journals Online databases, and Addis Ababa and Bahir Dar Universities research repositories were searched following the Preferred Items for Systematic Review and Meta-analysis (PRISMA) Guideline. STATA 15 statistical software was used to analyze the data. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) quality appraisal tool for meta-analysis. Heterogeneity between studies was assessed using the Cochrane Q test and I 2 test statistics based on the random effects model. A random effects model was computed to estimate the pooled prevalence of precancerous cervical lesion in Ethiopia. Finally, the trend of precancerous cervical lesion in the country was presented. Result Seventeen studies with a total of 26,112 participants were included in the analysis. The pooled prevalence of precancerous cervical lesion was 15.16 (95% CI 10.16–19.70). The subgroup analysis by region showed the highest prevalence of precancerous cervical lesion at the Southern Nations and Nationalities Peoples Region (19.65%; 95% CI 15.51–23.80). The trend of precancerous cervical lesion prevalence showed an increased pattern over time. Conclusion Approximately one among six of the study participants had precancerous cervical lesion. The trend also showed that there is still an increasing precancerous cervical lesion in Ethiopia. Best practices in achieving high vaccination coverage shall be informed by practices in other successful countries.

BackgroundAnemia is a major public health problem worldwide which accounts 24.8% of the population. Subsequently, anemia is a leading killer of people living with human immunodeficiency virus and many of these deaths occur in developing countries including Ethiopia. Cross sectional studies have done on anemia and human immunodeficiency virus. However, there is limited study on incidence of anemia and its predictors among adults on HIV care, especially no survival study has been conducted in the study area.ObjectiveTo assess incidence and predictors of anemia among adults on Human immunodeficiency virus care.MethodsAn institution-based retrospective cohort study was conducted among 434 adults on HIV care from January 1st 2015 to December 30th 2019 at Debre Tabor Referral Hospital. A computer-generated simple random sampling technique was employed to select the study participants. Ethical clearance was obtained from the Institutional Review Board of Bahir Dar University, and also, we got implied consent to review charts from the concerned bodies in the hospital. Data were entered using Epi-data version 3.1 and analyzed by using STATA version 14.0. A Kaplan Meier survival curve was utilized to estimate anemia free survival time. Bivariable and Multivariable Cox proportional hazards model were fitted to identify predictors of anemia.ResultsThe overall incidence density rate of anemia was 6.27 (95% CI: 0.051, 0.077) per 100 person years. Clinical stage III/IV (AHR = 1.04; 95% CI = 1.02, 1.06), Body Mass Index less than 18.5 kg/m2 (AHR = 3.11; 95% CI = 1.56, 6.22), serum creatinine greater than 1.1 IU/L(AHR = 2.07; 95% CI = 1.12, 3.81) and fair/poor level of adherence(AHR = 1.05; 95% CI = 1.03, 1.07) were statistically significant predictors of anemia while increased anti-retroviral treatment duration (AHR = 0.98; 95% CI = 0.97, 0.99) decrease the risk of anemia at 95% confidence level.ConclusionThe overall incidence density rate of anemia was high. Patients with clinical stage III/IV, body mass index < 18.5 kg/m2, serum creatinine greater than 1.1 IU/L and fair/poor level of adherence were significant predictors of anemia while increased antiretroviral treatment duration had decreased the risk of anemia.RecommendationEven if the overall incidence rate of anemia was lower as compared to previous studies in Ethiopia, still the incidence of anemia was high. So, prevention measures should be taken beside with HIV care especially within 6-months ART initiation.

Abstract Background Ethiopia has been experiencing a high prevalence of communicable diseases, which resulted in high morbidity, mortality, and hospital admission rates. One of the highest contributing factors for this is lower level of latrine utilization. There had been significantly varying finding reports with regard to the level of latrine utilization and its association with education level from different pocket studies in the country. Therefore, this systematic review and meta-analysis was aimed to estimate the pooled prevalence of household latrine utilization and its association with education status of household heads, in Ethiopia using available studies. Methods This systematic review and meta-analysis was conducted using available data from the international databases, including PubMed, Google Scholar, Science direct, Cochrane library and unpublished reports. All observational studies reporting the prevalence of latrine utilization in Ethiopia were included. Four authors independently extracted all necessary data using a standardized data extraction format. STATA 13 statistical software was used to analyze the data. The Cochrane Q test statistics and I 2 test were used to assess the heterogeneity between the studies. A random effect model was computed to estimate the pooled level of latrine utilization in Ethiopia. In addition, the association between latrine utilization and the educational level of the users was analyzed. Results After reviewing of 1608 studies, 17 studies were finally included in our meta-analysis. The result of 16 studies revealed that the pooled prevalence of latrine utilization level in Ethiopia was 50.02% (95%CI: 40.23, 59.81%). The highest level (67.4%) of latrine utilization was reported from Southern Nations Nationality and People regional state, followed by Amhara regional state (50.1%). Participants who completed their high school and above education were more likely (OR: 1.79, 95%CI: 1.05, 3.05) to utilize latrine compared to those who did not attend formal education. Conclusion In Ethiopia, only half of the households utilize latrine and the level of utilization has significant association with educational status.

Introduction: Sepsis is one of the leading causes of death in military and civilian hospitals. Rapid identification of involved pathogens is a key step for appropriate diagnosis, treatment and ultimately survival. Current diagnostics tools are either very bulky and not deployment ready, or require a long time to provide results. Given these obstacles, new solutions are urgently needed. Optomagnetic Imaging Spectroscopy (OMIS) is novel technology successfully used for the detection of cancer cells and viruses. OMIS has high sensitivity due to recording the unpaired and paired electrons of sample material. Furthermore, machine learning that uses the algorithms random forest (RF) classifier and artificial neural network (ANN) is integrated into the technology to enhance detection. Here we evaluated the feasibility of OMIS for the detection of bacteria in blood. Methods: We used commercially available human blood spiked with a defined concentration multidrug resistant Staphylococcus aureus derived from a clinical isolate. Final concentrations of bacteria of 1 × 106, 1 × 105 and 1 × 104 CFU/mL corresponding to High (H), Medium (M) and Low (L) concentrations respectively. A total of 240 samples (60 samples per concentration as well as 60 samples of sterile blood (N)) was imaged, and the data were analyzed using random forest classifier and artificial neural network. Images for the training set and validation sets were separately obtained and used for comparison against true positive values (confirmatory plating on the nutrient agar). Results: The average score of classification samples in the correct category (N, L, M, H) one-by-one was 94% for the ANN algorithm, while for the RF algorithm accuracy was 93% (average means that three times different 40 samples (of 240 samples) were chosen, and each prediction test had different sample mixtures). The closeness of the two values of accuracy strongly indicates that the input data (interaction of light with paired and unpaired electrons) and output data (classification N, L, M, H concentration of bacteria) are correlated.

Phosphorus (P) is an essential macronutrient for plant growth and development. Phosphorus is usually applied as fertilizer obtained from rock phosphate which is a non-renewable resource. Therefore, developing rice varieties that can use P more efficiently is crucial. Here, we investigated genotypic differences in traits related to internal Phosphorus Utilization Efficiency (PUE) in five rice genotypes grown under P-deficient conditions. P-efficient rice genotypes showed higher total biomass. This was partly due to higher root biomass, which in turn relied on preferential allocation of P to roots in these genotypes. Changes in P content and tissue P concentrations were analyzed in individual leaves at different time points. Genotypes belonging to the high-PUE group responded more quickly to P starvation in terms of reducing leaf P concentrations and they were able to reduce these concentrations to a lower level compared to the low-PUE group. Changes in P concentrations were reflected in gene expression levels for genes involved in lipid remodeling. Sulfolipid (OsSQD2) and galactolipid (OsMGD and OsDGD) synthesis-related genes were generally induced due to P starvation with most pronounced up-regulation in OsDGD1 and OsMGD3, but patterns differed between genotypes. A significantly higher expression of OsDGD5 and OsMGD1 & 2 was detected in the youngest fully expanded leaf of the high-PUE genotype group, whereas expression levels were reversed in older leaves. This pattern would confirm that P efficient genotypes react faster to P starvation in terms of freeing P for redistribution to growing tissues and replacing phospholipids with galactolipids in younger leaves may contribute to this aspect.

BackgroundTuberculosis is a global public health problem. One of the overarching dilemmas and challenges facing most tuberculosis program is non-adherence to treatment. However, in Ethiopia there are few studies with variable and inconsistent findings regarding non-adherence to treatment for tuberculosis.MethodsThis systematic review and meta-analysis was conducted to determine the prevalence of non-adherence to tuberculosis treatment and its determinants in Ethiopia. Biomedical databases including PubMed, Google Scholar, Science Direct, HINARI, EMBASE and Cochrane Library were systematically and comprehensively searched. To estimate the pooled prevalence, studies reporting the prevalence of adherence or non-adherence to tuberculosis treatment and its determinants were included. Data were extracted using a standardized data extraction tool prepared in Microsoft Excel and transferred to STATA/se version-14 statistical software for further analyses. To assess heterogeneity, the Cochrane Q test statistics and I2 test were performed. Since the included studies exhibited high heterogeneity, a random effects model meta- analysis was used to estimate the pooled prevalence of non-adherence to tuberculosis treatment. Finally, the association between determinant factors and non-adherence to tuberculosis treatment was assessed.ResultsThe result of 13 studies revealed that the pooled prevalence of non-adherence to tuberculosis treatment in Ethiopia was found to be 21.29% (95% CI: 15.75, 26.68). In the subgroup analysis, the highest prevalence was observed in Southern Nations and Nationalities of Ethiopia, 23.61% (95% CI: 21.05, 26.17) whereas the lowest prevalence was observed in Amhara region, 10.0% (95% CI: 6.48, 13.17.0;). Forgetfulness (OR = 3.22, 95% CI = 2.28, 4.53), fear side effect of the drugs (OR = 1.93, 95% CI = 1.37, 2.74), waiting time ≥ 1 hour during service (OR = 4.88, 95% CI = 3.44, 6.91) and feeling distance to health institution is long (OR = 5.35, 95% CI = 4.00, 7.16) were found to be determinants of non-adherence to tuberculosis treatment.ConclusionIn this meta-analysis, the pooled prevalence of non-adherence to tuberculosis treatment in Ethiopia was high. Forgetfulness, fear of side effect of the drugs, long waiting time (≥1 hour) during service and feeling distance to health institution is long were the main risk factors for non-adherence to tuberculosis treatment in Ethiopia. Early monitoring of the side effects and other reasons which account for missing medication may increase medication adherence in patients with tuberculosis in Ethiopia.

Hypothermia in combination with infection presents a complex challenge in clinical and battlefield medicine. Multifaceted physiological and immunological consequences of hypothermia drastically change the risk, progression, and treatment of a concomitant infection. Managing hypothermia and infection in extreme cold settings is particularly relevant in an era with increased risk of military operations in Polar climates. Here, we discuss the elevated instance of infection during accidental and therapeutic hypothermia and speculate how a compromised immune system may contribute. We focus on skin and soft tissue infections and sepsis, which are among the serious infectious complications of hypothermia and battlefield injuries. We also present the challenges associated with treating infections under hypothermic conditions. Finally, we advocate for a renewed focus on identifying causal relationships between hypothermia and infection risk and assessing established infection treatment regiments in hypothermic patients to enhance trauma management and survival outcomes in hypothermia-related injuries., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CPT Richard Kevorkian reports financial support was provided by US Department of Defense JPC-6 Combat Casualty Care Research Program. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)