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Aschalew Besha Desta,1 Belete Alemu,1 Addisu Mossie,1 Minda Abebe,1 Adanech Shiferaw,1 Bizuwork Girma,2 Tajera Tageza Ilala,1 Kidanamariam Tamrat Yilma,1 Khalid Mohamed3 1Department of Anesthesia, College of Health Sciences and Medicine, Hawassa University, Hawassa, Ethiopia; 2Department of Anesthesia, College of Health Sciences and Medicine, Selale University, Fiche, Ethiopia; 3Department of Anesthesia, College of Health Sciences and Medicine, Bule Hora University, Bule Hora, EthiopiaCorrespondence: Aschalew Besha Desta, Anesthesia Department, College of Health Sciences and Medicine, Hawassa University, Hawassa, Ethiopia, Email aschalewbesha5@gmail.comBackground: A typical side effect of spinal anaesthesia is post-spinal hypotension. Its overall incidence ranges between 25– 75% in the general population, and it is even higher in pregnant mothers who underwent a caesarean delivery. Post-spinal hypotension-related adverse effects can be prevented by having adequate evidence-based knowledge about their management and prevention. The objective of this review is to determine the effectiveness of leg elevation in preventing post-spinal induced hypotension during elective caesarean sections.Methods: A comprehensive literature search was conducted in PubMed, the Medline database, the Cochrane Review, and Google Scholar from 1993 to 2023. Healthy women with full-term pregnancies who underwent elective caesarean delivery performed with spinal anaesthesia were included, and parturients with co-existing diseases, studies on other population, case reports studies written in non-English languages and studies contain abstract only were excluded. For both interventional and non-interventional research, the methodological strengths of the included studies were evaluated using the Cochrane risk of bias assessment tool.Results: A total of 8158 articles from various electronic databases were found using the search method. After removing duplicates, 247 articles were chosen for screening; 13 were included for critical evaluation, and 6 were eliminated with justifications. The included publications are made up of 7 RCTs on 681 pregnant women in 5 different countries, and it was found that the leg elevated group had a lower incidence of post-spinal hypotension than the control group.Conclusion: A majority of the evidence revealed that leg elevation following spinal anaesthesia in a caesarean delivery was effective in preventing post-spinal-induced hypotension. In addition to prevention, applying leg elevation following spinal anaesthesia is helpful in lowering the incidence of post-spinal hypotension, which is catastrophic. It reduces the requirement for vasopressors and also provides a non-invasive and reversible technique that does not call for any special equipment.Keywords: leg elevation, prevention, hypotension, spinal anesthesia, cesarean section

Worku Ketema,1 Kefyalew Taye,1 Negash Tagesse,1 Mulugeta Sitot Shibeshi,1 Bizuneh Alemayehu,1 Fikre G/tsadik,1 Birhanu Girma,1 Alemwosen Teklehaymanote,2 Alemu Debiso3 1Department of Pediatrics and Child Health, HawassaUniversity, Hawassa, Sidama, Ethiopia; 2Department of Pathology, Hawassa University, Hawassa, Sidama, Ethiopia; 3Department of Public Health, Hawassa University, Hawassa, Sidama, EthiopiaCorrespondence: Worku Ketema, Email workuketema@gmail.comBackground: Schistosomiasis is a neglected tropical disease (NTD) that affects around 200 million people worldwide, the majority of whom are children aged 5 to 15 years. It is one of the most significant public health problems in tropical and subtropical regions. Entamoeba histolytica infection is common in areas where schistosomiasis is endemic because Schistosoma mansoni infection can reduce the host’s immune response, resulting in increased morbidity.Case Presentation: This is the story of a 12-year-old male adolescent from the Guji zone of the Oromia regional state of Ethiopia who presented to Hawassa University Comprehensive Specialized Hospital (HUCSH) complaining of bloody diarrhea of 1 week associated with vomiting of ingested matter of 2 weeks. He also had history of fever, chills, rigors, arthralgia, and weight loss during a 2 weeks period. Further questioning revealed that he had previously swum in a pond and had a self-limited itchy skin condition. The family said that similar cases had occurred in their town that resolved with medications provided at a local health center.Conclusion: Schistosomiasis and amebiasis are major public health issues, especially in impoverished areas. Schistosomiasis presents differently clinically depending on the phase and clinical form in which it manifests, making diagnosis and management challenging. As a result, it necessitates an integrated collaboration involving clinicians, pathologists, and public health professionals. We describe ulcerative colitis (UC) ascribed to schistosomiasis and amoebiasis coinfection, and fulminant hepatitis due to schistosomiasis. As there was no report of liver abscess on sonographic scanning, hepatitis may not be due to coinfection. This case will be an alert to clinicians and public health personnel who are striving for the ultimate eradication of schistosomiasis and also teaches us that treating co-infections of both is beyond just giving praziquantel and antiamebics.Keywords: schistosomiasis, amebiasis, coinfection, ulcerative colitis, fulminant hepatitis

Blean Girma,1 Dóra Körmendiné Farkas,2 Kristina Laugesen,2 Nils Skajaa,2 Victor W Henderson,2,3 Paolo Boffetta,4,5 Henrik Toft Sørensen2 1Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA; 2Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark; 3Departments of Epidemiology & Population Health and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA; 4Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA; 5Department of Medical and Surgical Sciences, University of Bologna, Bologna, ItalyCorrespondence: Henrik Toft Sørensen, Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Olof Palmes Allé 43-45, Aarhus, 8200, Denmark, Tel +45 87 16 82 15, Email hts@clin.au.dkIntroduction: It is unclear whether Guillain–Barré syndrome (GBS) can be a marker of a paraneoplastic syndrome. We examined whether GBS is associated with cancer and whether the prognosis of GBS patients with cancer differs from that of other cancer patients.Materials and Methods: We conducted a population-based cohort study of patients diagnosed with GBS between 1978 and 2017 using Danish registry-data. Main outcome measures were cancer incidence and mortality after cancer diagnosis. We calculated absolute risks of a cancer diagnosis, treating death as competing risk, and standardized incidence ratios (SIRs) as measures of relative risk. We matched each GBS cancer patient with up to 10 cancer patients without a GBS diagnosis and examined the six-month survival after cancer diagnosis using Cox regression analysis.Results: We identified 7897 patients (58% male, median age 57 years) with GBS. During a median follow-up of 9.5 years, the one-year risk of cancer was 2.7% (95% confidence interval (CI), 2.4– 3.1). The SIR was increased throughout follow-up, but most noticeably during the first year after diagnosis (SIR: 3.35, 2.92– 3.83). SIRs were particularly elevated for hematologic cancers (SIR: 8.67, 6.49– 11.34), smoking-related cancers (SIR: 3.57, 2.81– 4.47), and cancers of neurological origin (SIR: 8.60, 5.01– 13.77). Lung cancer was the main contributor to the overall excess risk, which persisted after 36 months of follow-up (SIR: 1.17, 1.09– 1.25). The mortality rate ratio comparing patients diagnosed with any cancer within one year of their GBS diagnosis and matched GBS-free cancer cohort members was 1.56 (95% CI, 1.27– 1.90).Conclusion: GBS patients had a three-fold increased risk of cancer diagnosis in the first year of follow-up. The absolute cancer risk was almost 3.0%. A GBS diagnosis was an adverse prognostic marker for survival following cancer diagnosis. Clinicians should consider occult cancer in patients hospitalized with GBS.Keywords: Guillain–Barré syndrome, cancer, paraneoplastic syndrome, survival, risk, cohort

Amare Teshome Tefera,1 Biruk Girma,1 Aynishet Adane,2 Abebe Muche,3 Tadesse Awoke Ayele,4 Kefyalew Ayalew Getahun,5 Zelallem Aniley,1 Semira Ali,6 Simegnew Handebo7 1Department of Dentistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Biostatistics and Epidemiology, Institute of Public health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 5Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 6Department of special need and inclusive education, College of Education, University of Gondar, Gondar, Ethiopia; 7Department of health education and Behavioral Sciences, Institute of Public health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Amare Teshome TeferaDepartment of Dentistry, School of Medicine, College of Medicine and Health Science, University of Gondar, P.O.Box 196, Gondar, Ethiopia, Tel +251-910517002, Email teferaden@gmail.comBackground: Oral health care is the most common unmet need among individuals with a disability. Individuals with a disability may have compromised oral health needs due to neglect from parents, socioeconomic problems, and communication barriers. In Ethiopia, there is a lack of data on oral health status of the hearing-impaired population. Therefore, this study aimed to assess the oral health status of hearing-impaired students in the Amhara region, Ethiopia.Methods: A cross-sectional study was conducted from November 2020 to April 2021 on hearing-impaired students in Amhara region, Ethiopia. Data were collected using a pretested interview administered questionnaire and clinical examination. Oral cavity was evaluated using the simplified oral hygiene index, decayed, missed and filled teeth, and community periodontal index. Data analysis was done using SPSS 26.0, and logistic regression analysis was done to identify the risk factors of dental caries and periodontal disease.Results: A total of 149 hearing impaired students with an age range of 7– 30 years were involved in the study. The prevalence of periodontal disease and dental caries was 22.8% (95% CI: 16.8, 30.4) and 38.9% (95% CI; 32.2, 46.9), respectively. Being grade 1– 4 student (AOR = 3.94, 95%: 1.16, 13.38), lack of formal education (AOR = 4.98, 95% CI: 1.00, 24.65), dental caries (AOR = 2.51, 95% CI: 1.08, 5.08) and bleeding on probing (AOR = 9.98, 95% CI: 3.69, 26.64) were statistically significant with periodontal disease. Grade level, parents’ support during brushing, oral health status, and medication intake were independent factors for dental caries.Conclusion: In the present study, a significant number of hearing-impaired students had periodontal disease and dental caries. School oral health programs and caregivers assisted oral hygiene practices are essential to combat oral health problems in hearing-impaired students. Moreover, a nationwide prospective study with a large sample size will be required to reflect the oral health status of hearing-impaired individuals in the country.Keywords: oral health status, hearing impairment, dental caries, periodontal disease, DMFT

Belachew Umeta,1 Biniyam Girma2 1School of Pharmacy, Department of Pharmaceutical Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia; 2School of Pharmacy, Department of Pharmacology, Institute of Health, Jimma University, Jimma, Oromia, EthiopiaCorrespondence: Belachew Umeta Tel +251901649597Email belachew.umeta@ju.edu.etPurpose: To assess health extension workers knowledge of child immunization schedules and associated factors.Methods: A cross-sectional study design was conducted among health extension workers working in Bako Tibe Woreda. The data were collected by using semi-structured questionnaires, and descriptive statistics were used to summarize the data. Chi-square (χ2) was used to identify factors associated with the knowledge of health extension workers on the immunization schedules.Results: The response rate of the study was 92.1% (58/63). All of the health extension workers included in the study were females. The majority of health extension workers 45 (77.59%) had satisfactory knowledge of the child immunization schedule. Educational status (χ2 = 11.05; P= 0.001), work experience of as health extension workers (χ2 = 6.22; P= 0.045), on job training on immunization (χ2 = 11.12; P= 0.002), marital status (χ2 = 6.30; P= 0.019) were factors associated with health extension workers knowledge.Conclusion: The majority of health extension workers had satisfactory knowledge of the child immunization schedule. Educational status, work experience as health extension worker, on job training on immunization, and marital status were factors associated with the knowledge of health extension workers on the child immunization schedule.Keywords: health extension workers, immunization schedule, vaccination, community health workers

Wondimagegn Wondimu,1 Bethlehem Girma2 1Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Aman, Ethiopia; 2Department of Health Extension Program, Mizan Aman Health Science College, Mizan Aman, EthiopiaCorrespondence: Wondimagegn Wondimu(MPH in Epidemiology), Mizan-Tepi University, College of Medicine and Health Sciences, Department of Public Health, P.O. Box: 260, Mizan Aman, EthiopiaEmail wonde1983.ww@gmail.comAbstract: Difficult situations bring not only challenges but also fruitful opportunities. The pandemic of COVID-19 by itself and the related governmental or individual level measures have their own challenges and opportunities to the community, which even might be directly or indirectly related to the control and prevention of the pandemic. The silver linings of the pandemic of COVID-19 should be uncovered to encourage the community not only to focus on the black side of the disease but also to enjoy the opportunities. This can contribute to facilitate the control of the disease and avoid the related panics. In this review, we have discussed the challenges of COVID-19 in Ethiopia in terms of health, economy, and social life, and the silver linings in terms of research opportunities, technological transformation, reading culture, and family discussion. The literatures used in this review were published and unpublished articles, reports, and working papers from Google Scholar, PubMed, MedRxiv, BioRxiv, and official websites of national and international organizations.Keywords: challenges, opportunities, silver linings, Ethiopia, coronavirus disease, COVID-19

Netsanet Fekadu, Hirut Basha, Asfaw Meresa, Sileshi Degu, Biruktawit Girma, Bekesho Geleta Directorate of Traditional and Modern Medicine Research, Ethiopian Public Health Institute, Addis Ababa, Ethiopia Abstract: Moringa stenopetala (Baker f.) Cufod. is a medicinal plant that has been used for the treatment of different ailments such as hypertension and diabetes in Ethiopia. This study aims to assess the diuretic activity of the aqueous crude extract and hot tea infusion of M. stenopetala leaves in saline-loaded rats. Male Wistar rats were divided into ten groups (n = 5). The control group received distilled water (5 mL/kg), whereas the reference group received Furosemide (10 mg/kg). Groups III–X orally received different doses of aqueous crude extract (62.5, 125, 250, and 500 mg/kg) and hot tea infusion (1, 2, 4, and 6 teaspoons [Tsp]) based on community use. Urine volume was recorded every hour until the end of the 5th hour, and total urine volume of each animal was calculated. The diuretic activity and diuretic action were determined based on the urine output. Additionally, concentration of urinary sodium, chloride, and potassium ions was determined. The urinary Na+/K+ ratio and carbonyl anhydrase activity (Cl−/(Na+/K+)) were also assessed. The findings verified that the aqueous crude extract as well as the hot tea infusion of the leaves of M. stenopetala possesses significant (P < 0.01) diuretic, natriuretic, and kaliuretic effects. The aqueous crude extract (125 mg/kg) and hot tea infusion (2 Tsp) displayed the highest diuretic activity (101% and 96%, respectively) comparable to the reference drug, Furosemide (10 mg/kg). They also displayed a good natriuretic activity. The aqueous crude extract and hot tea infusion revealed a significant Na+ urinary excretion (P < 0.001) and Na+/K+ ratio (P < 0.05) at all test doses. There was also a significant (P < 0.01) Cl− urinary excretion at all test doses of aqueous crude extract except 62.5 mg/kg and all test doses of hot tea infusion except higher doses (4 and 6 Tsp). Thus, the aqueous crude extract as well as the hot tea infusion of the leaves of M. stenopetala causes a plausible increase in the urine volume and concentration of urinary electrolytes in rats. Keywords: Moringa stenopetala, urine volume, electrolyte excretion, diuretic activity, rats, dose simulation

This work aims to inspect tomato features and classify them based on color and morphological features into the three predefined regions using artificial neural networks (ANN). Different learning methods were analyzed for the task of inspecting tomatoes using image processing software in MATLAB. Tomatoes were collected from the eastern parts of Ethiopia. The neural classification was done by the shape and size feature alone. The ANN classifier on the selected color feature alone showed that from the total test examples of 180 images, 168 (93.3 %) were correctly classified and 12 (6.7 %) were misclassified. The ANN classifier on all features taken together showed that all the test images were correctly classified. This result is similar to the morphology (shape and size) features result, but if the number of data points is high, the result may vary significantly. The overall result revealed that shape and size features have more discriminating power than color features, and the discrimination power increases when individual features are trained together with shape and size features. This may be because the discriminating factor increases due to the increase in the number of included features. It was observed that the proposed method was successful as quantified by the cumulative error (CE) and percentage error (%E) of training, testing, and validation of color features: 6.35 %, 3.70 %, and 11.11 %, respectively, in evaluating the quality of tomatoes. [ABSTRACT FROM AUTHOR]

Introduction: Postnatal weight gain in very low birth weight infants remains a challenge during the neonatal period in low and middle-income countries like Ethiopia, where no feeding alternatives and follow-up charts are available. Although extrauterine growth retardation is a common problem in preterm very low birth weight infants, there is a lack of evidence in resource-limited countries regarding patterns of postnatal weight gain. Therefore, this study aimed to assess the patterns of postnatal weight gain and its predictors among preterm very low birth weight infants in Ethiopia., Methods: A cross-sectional study was conducted on a randomly selected sample of 412 neonates in Ethiopia. Data were collected using structured questionnaires and analyzed with Stata version 14.0 software. Bivariable and multivariable logistic regression analyses were performed to identify significant predictors. Model fitness and assumptions were assessed. Associations were reported using adjusted odds ratios (AOR) with 95% confidence intervals., Results: In the current study, 14.6% (95% CI: 10.4-20.1) of neonates had adequate postnatal weight gain at discharge. Spontaneous vaginal delivery [AOR: 2.54; 95% CI (1.17, 5.54)], birth Z-score > -1.29 [AOR: 4.51; 95% CI (1.43, 14.16)], early feeding initiation time [AOR: 3.36; 95% CI (1.63, 6.92)], and respiratory distress syndrome [AOR: 0.31; 95% CI (0.12, 0.78)] were significant predictors for postnatal weight gain among very low birth weight neonates in Ethiopia., Conclusion: The postnatal weight gain reported in this study was low as compared to the national figure. Mode of delivery, birth z-score, initiation time of the first feeding, and respiratory distress syndrome were associated with postnatal weight gain. The Federal Ministry of Health, stakeholders, national neonatal associations, and non-governmental organizations should work collaboratively to promote vaginal delivery and early initiation of feeding and develop guidelines specifically tailored for this special population. Furthermore, healthcare providers should prioritize and focus on neonates who have respiratory distress and low Z-scores., Competing Interests: The authors declare that there is no competing interest., (Copyright: © 2025 Dessie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Excessive daytime sleepiness is a common finding among type 2 diabetes mellitus patients. However there is scarce data that shows the magnitude of excessive daytime sleepiness, & its association with type 2 diabetes mellitus. Hence, the study aimed to assess the prevalence of excessive daytime sleepiness and its associated factors among type 2 diabetes mellitus patients at Wolkite University Specialized Hospital. A Hospital-based cross-sectional study was employed from January 15 to March 15, 2022, among 229 Type 2 diabetes mellitus patients. Data was collected by semi-structured questionnaires, then entered into the Epi data version 4.6 and exported to SPSS version 25.0 for analysis. Binary and multiple logistic regression analysis was used to assess factors associated with excessive daytime sleepiness and statistical significance was set at P-value < 0.05. The prevalence of Excessive daytime sleepiness among type 2 diabetes mellitus was 27.1%. Age (AOR: 1.08; 95%CI: 1.03, 1.12), frequent snoring (AOR: 2.9; 95%CI: 1.24, 6.80), comorbid hypertension (AOR: 2.64; 95%CI: 1.17, 5.96), obesity (AOR: 2.7; 95%CI: 1.03, 7.13), and poor glycemic control (AOR: 6.68; 95%CI: 1.83, 24.41) were independently associated with Excessive daytime sleepiness among type 2 diabetes mellitus patients. Excessive daytime sleepiness was reported in more than a quarter of type 2 diabetes mellitus patients. Age, frequent snoring, hypertension, obesity, and poor glycemic control were significantly associated with Excessive daytime sleepiness among type 2 diabetes mellitus patients. Therefore health care providers should assess not only for how well their patients' diabetes is controlled but also for excessive daytime sleepiness., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

QTc interval prolongation, which is linked to cardiac arrhythmia and sudden cardiac death, is common in HIV-infected patients. This prolongation can be attributed to the side effects of antiretroviral medications, the direct impact of HIV on the heart, and chronic inflammatory responses that disrupt cardiac electrical activity. This study aimed at assessing QTc interval prolongation and associated factors among HIV-infected adults on ART. A cross-sectional study was conducted among consecutively selected 298 HIV-infected patients at Mettu Karl Specialized Hospital, southwest Ethiopia. A face-to-face interview with a structured and pretested questionnaire was employed to collect socio-demographic and behavioural characteristics data. Electrocardiography was done using a 12-lead electrocardiograph, and interpreted by a cardiologist. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 25. Multivariable logistic regression analyses were done at a significance level of P < 0.05. QTc prolongation was prevalent in 12.4% of participants. Being on PIs containing HAART regimen (AOR = 5.7, 95%CI 2.54-12.8), having recent CD4 count of < 350 cells/mm 3 (AOR = 4.8, 95%CI 2.19-10.5), and recent viral load of ≥ 1000coppies/ml (AOR = 2.8, 95%CI 1.24-6.42) were significantly associated with QTc prolongation. According to this study, one of the ten HIV-infected patients on ART had QTc prolongation. Therefore, we suggest that HIV-positive patients receiving treatment should undergo screening for QTc interval prolongation., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Initiation of breast feeding within one hour of birth is the easiest and most cost-effective intervention to reduce the risk of neonatal morbidity and mortality. Conducting studies immediately after an hour of birth for the timely initiation of breastfeeding has the significance of initiating breastfeeding and acting immediately. However, there was a paucity of information in the region as well as in the country at large. Therefore, the aim of this study was to assess the magnitude of timely initiation of breastfeeding and its associated factors among immediate postpartum mother-newborn pairs in Debre Tabor comprehensive specialized hospital, northwest Ethiopia, in 2024., Method: An institutional-based cross-sectional study was conducted from October 25, 2023, to January 25, 2024, at Debre Tabor Comprehensive Specialized Hospital. A total of 478 immediate postpartum mothers were selected at birth using systematic random sampling techniques. Data were collected using chart reviews, interviewer-administered questionnaires, and through observation. Data entry and analysis was performed by Epi-Data version 4.6.02 and Statistical Package for Social Sciences version 25(SPSS) soft war respectively. Descriptive statistics were computed to determine the frequency of variables. After doing a binary logistic regression analysis, a p-value less than 0.25 indicated a potential candidate for multivariable analysis aimed at identifying statistically relevant factors. Both crude and adjusted odds ratios (AOR) were computed, and the levels of significance were declared based on the AOR with a 95% confidence interval (CI) at a p-value < 0.05., Results: In this study, the prevalence of timely initiation of breastfeeding was 73.7% with a 95% CI (69.65%, 77.67%). Being multiparous (AOR: 2.25, 95% CI: 1.32, 3.84), receiving counseling immediately after delivery (AOR: 4.19, 95% CI: 2.20, 7.98), receiving support and guidance from health care providers (AOR: 1.95, 95% CI: 1.01, 3.77), having no obstetric complications during and immediately after delivery (AOR: 4.44, 95% CI: 2.34, 8.42), and practicing rooming-in (AOR: 3.65, 95% CI: 2.05, 6.51) were significantly associated variables with timely initiation of breast feeding., Conclusion: The overall timely initiation of breastfeeding in this study was lower than the World Health Organization's recommendations. Therefore, interventions need to focus on mothers who developed obstetric complications, primiparous mothers, improper rooming-in, a lack of advice immediately after delivery, and the support and guidance of mothers on the timely initiation of breastfeeding to improve the timely initiation of breastfeeding practice., (© 2024. The Author(s).)

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

Environmental racism poses a significant threat to child health. It is a major contributor to disproportionate exposure to environmental hazards that are linked to adverse health outcomes. This narrative review shows the profound impact that environmental racism poses to healthy child development through 3 examples. Historical redlining provides compelling evidence of how historical policies continue to influence neighborhoods' physical and social conditions. Exploring chemicals in beauty products reveals how anti-Black perceptions of beauty work to expose children of color to endocrine-disrupting chemicals. Finally, by exploring childhood lead exposure, we see how decades of inequitable implementation of lead exposure prevention policies contribute to persistent disparities in the United States today. Fixing these structural issues is complex and will require political will and investment. Yet, individual clinicians play an important role in their local communities in protecting children from the harms of environmental racism, through education, genuine collaboration with the community, and advocacy., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)

Background: Neonatal mortality poses a significant public health challenge in sub-Saharan Africa, with congenital heart disease emerging as the leading cause of morbidity and mortality among neonates, especially in countries like Ethiopia. Despite efforts to reduce neonatal mortality rates, Ethiopia continues to experience an increased mortality rate, particularly among neonates with congenital heart disease. This study aims to investigate the incidence and predictors of mortality in this vulnerable population within Ethiopia., Method: A retrospective cohort study was conducted at an institution, involving 583 randomly selected neonates diagnosed with congenital heart disease. In the current study, the dependent variable was survival status. Data entry utilized EpiData data version 4.6, and analysis was performed using STATA version 16. Probability of death was compared using the log-rank test and Kaplan-Meier failure curve. Significant predictors were identified using bivariable and multivariate Cox regression. Model fitness and proportional hazard assumptions were evaluated using the Cox-Snell graph and Global test, respectively. Associations were assessed by adjusted hazard ratios with 95% confidence intervals., Results: The study participants were followed for 4844 days. The mortality rate was 9.9%. The incidence density was 11.9 per 1000 person-days of observation. Neonatal sepsis (AHR: 2.24; 95% CI [1.18-4.23]), cyanotic congenital heart disease (AHR: 3.49; 95% CI [1.93-6.28]), home delivery (AHR: 1.9; 95% CI [1.06-3.6]), maternal history of gestational diabetes mellitus (AHR: 1.94; 95% CI [1.04-3.61]), and having additional congenital malformations (AHR: 2.49; 95% CI [1.33-4.67]) were significant predictors for neonatal mortality., Conclusion and Recommendation: The incidence density of mortality was high compared to studies conducted in developed countries. Neonatal sepsis, type of congenital heart disease, place of delivery, maternal history of gestational diabetes mellitus, and having an additional congenital malformation were significant predictors of mortality among neonates with congenital heart disease. Therefore, healthcare providers should pay special attention to patients with identified predictors. Furthermore, the Federal Ministry of Health, stakeholders, and policymakers should collaborate to address this issue., (© 2024. The Author(s).)

Background: Chronic sacroiliitis has variable etiologies with numerous treatments of varying efficacy. In recent years, a novel posterior approach utilizing bone matrix has been developed although to date, there is limited data in the literature regarding efficacy and safety through this approach. Benefits described include reduced adverse outcomes and quicker recovery when compared to the lateral approach., Objective: The present investigation focused on sacroiliac joint fusion through the posterior approach and outcomes including disability, pain, and use of analgesics post-surgery., Study Design: This retrospective, single-center study was conducted evaluating safety and efficacy of sacroiliac fusion allograft implants (LinQ Implant System from PainTEQ; PsiF System from Omnia Medical)., Methods: A total of 72 posterior approach sacroiliac joint fusions were performed. Fifty-three individuals were enrolled and followed at LSU Health Shreveport as the sole investigational site between August 2020 and June 2024. Selected participant age ranged between 28 and 79 years, with a mean age of 53.4 years. The LinQ Implant System was the primary surgical hardware selected for implantation (83.0%), with the PsiF System chosen in the remaining cases., Outcome Measures: VAS Scores, disability changes, adverse outcomes, and analgesic use were compared after sacroiliac joint fusion via the posterior approach., Results: Mean VAS Scores for SIJ Pain Intensity significantly decreased by 3.6 cm from a baseline score of 9.5 cm by the Specified End (June 1st, 2024). In this regard, 65.4% of patients experienced a 20% or greater improvement in pain, 38.5% of patients experienced a 50% or greater improvement in pain, and 26.9% of patients experienced a 70% or greater improvement in pain.  Zero (0) procedure-related adverse events nor intra- or post-operative complications occurred throughout the duration of the investigation., Limitations: Retrospective nature of the study without a control group. Fifty-four percent (39 of 72) completed minimum one year follow up. Further, the withdrawal rate was 26%., Conclusion: The results of the present investigation demonstrated effective outcomes with minimal adverse effects and improvements in disability over a three-year period in the largest single center study to date involving posterior approach sacroiliac joint fusion.

Background: Neural tube defects are a significant cause of morbidity and mortality that can occur in the early pregnancy periods. Though the burden is high, it gains only limited attention. In Ethiopia, the estimated number of neural tube defect cases was significantly higher. So, identifying factors contributing to it would be significant for planning risk reduction and preventive strategies. Therefore, identifying the possible determinants was aimed at this study., Methods: A hospital-based, unmatched case-control study was conducted on 104 cases and 208 controls selected from neonatal intensive care units of teaching hospitals in Gedeo Zone and Sidama Region, southern Ethiopia from December 2021 to November 2022. All neural tube defect cases were included consecutively and controls were selected by using a simple random sampling method. Data were collected using interviewer-administered semistructured questionnaires. Data analysis was done by using SPSS V.25. Binary logistic regression was used, and variables with a p value less than 0.25 in bivariate analysis were entered into the multivariable logistic regression model. An adjusted OR with a 95% CI was estimated, and finally, variables that show a level of p value less than 0.05 in multivariable analysis were declared statistically significant., Result: After controlling confounders, factors such as unplanned pregnancy 2.20 (95% CI 1.20 to 4.041), history of abortions 2.09 (95% CI 1.19 to 3.67), khat chewing 6.67 (95% CI 2.95 to 15.06), antipyretic and analgesic medications 2.87 (95% CI 1.47 to 5.56) and, being a female neonate 2.11 (95% CI 1.21 to 3.67) were significantly associated with a neural tube defect., Conclusion: This study has identified some determinants of neural tube defects. Hence, the behavioural, medical and obstetrical conditions of mothers need serious evaluation in the prepregnancy period. So, improving preconception counselling and prenatal care practices would have a significant role in reducing the risk of neural tube defects., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Ethiopian honey wine, Tej, is the most popular traditionally fermented alcoholic beverage in Ethiopia. Owing to the spontaneous fermentation process, the final product is neither predictable nor consistent in quality. Attempts have not been made before to solve this problem. Thus, the aim of this study was to develop a potential mixed starter culture of yeast and lactic acid bacteria isolated from Tej samples for the production of Tej with consistent quality. One hundred seventy-seven lactic acid bacteria and 194 yeasts were isolated from 30 Tej samples collected from southwest Ethiopia. After sequentially testing the isolates towards physiological stress tolerance and desired metabolic products, 10 lactic acid bacteria and 10 yeast isolates were screened. Later, four lactic acid bacteria and four yeast isolates were found to be compatible in co-culture tests. Finally, the combination of lactic acid bacteria and yeast isolates was formulated using the design of expert version 7.0.0 software, and six formulates (F #1-6) were designed. Controlled Tej fermentation was performed under laboratory conditions using six lactic acid bacteria-yeast starter culture formulations. The sensory attributes, in terms of color, flavor, odor, turbidity, and overall acceptance analysis scored 4.8/5.0 (F #2) and 4.7/5.0 (F #6), with mean significant variations ( p  < 0.05) among the other formulates. These two formulates were considered the best-mixed starter cultures compared to the control and other formulates. Matrix-assisted laser desorption ionization-time of flight analysis revealed that the lactic acid bacteria starters (AAUL7 and AAUL10) belonged to Lactobacillus paracasei . While the yeast starters (AAUY2 and AAUY8) belonged to Saccharomyces cerevisiae . These mixed lactic acid bacteria-yeast starter cultures could be used as the best starter culture for the fermentation of Ethiopian honey wine, Tej, with consistent quality., Competing Interests: DECLARATION OF CONFLICTING INTERESTSThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Common mental disorders describe the physical, mental, and social disturbances that are more prevalent in low and middle-income countries. Mothers are among the more vulnerable groups especially mothers having children with under-nutrition. However, there are limited studies about the magnitude of common mental disorders among mothers of undernourished children in Ethiopia. Therefore, we aimed to assess the magnitude of common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia., Methods: A cross-sectional study was employed on 405 systematically selected participants. The outcome variable was assessed by a self-reporting questionnaire (SRQ-20) which was applicable and validated in Ethiopia. Data were entered and analyzed by EPi data version 5 software and SPSS version 25 respectively. Model fitness was checked by Hosmer Lemeshow's test. Logistic regression was employed to identify significant determinants. A p-value < 0.05 was used to declare association and expressed by odds ratio with a 95% CI., Result: In this study, the magnitude of common mental disorders was 33.16% (95% CI [28.5-38])). In multivariable analysis, six factors poor social support [AOR: 14.0, 95% CI (5.45, 35.9)], educational status [AOR: 1.95, 95% CI (1.07. 3.55)], cigarette smoking [AOR: 10.9, 95% CI (1.78, 67.01)], mother of a child with another chronic disease [AOR: 3.19, 95% CI (1.13, 8.99)], sexual violence [AOR: 4.14, 95% CI (1.38, 12.4)] and mothers with chronic disease [AOR: 3.44, 95% CI (1.72, 6.86)] were significantly associated with common mental disorders., Conclusion: The magnitude of common mental disorders was high. Six factors were significantly associated with common mental disorders; social support, sexual violence, maternal chronic illness, educational status, smoking, and mother of child with other chronic disease. Community awareness regarding the effect of violence, substance use, and social support on mental health should be created by the local stakeholders., (© 2024. The Author(s).)

Background: Developmental delay is a public health problem in low- and middle-income countries. However, there is no summarized evidence in low- and middle-income countries on developmental delay, and primary studies on this issue show varied and inconclusive results. This systematic review and meta-analysis aimed to assess the pooled magnitude of confirmed developmental delay and its determinants among children in low- and middle-income countries., Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to write this systematic review and meta-analysis. Primary studies were searched from PubMed, PsycINFO, Hinari, Science Direct, African Journal of Online, Web of Science, and Google Scholar databases. The Newcastle-Ottawa Scale, adapted for the cross-sectional studies, was used to assess the quality of the included studies. Heterogeneity and publication bias were assessed by the I 2 and Eggers tests, respectively. Due to the high heterogeneity, the random effects model was used for analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to show the association between developmental delay and its determinants., Results: The pooled prevalence of confirmed developmental delay was 18.83, 95% CI (15.53-22.12). In the subgroup analysis, a high prevalence of developmental delay [26.69% (95% CI, 15.78-37.60)] was observed in studies performed in Africa. Maternal education [3.04; 95% CI (2.05, 4.52)] and low birth weight [3.61; 95% CI (1.72, 7.57)] were significant determinants of developmental delay., Conclusion: The pooled prevalence of developmental delay in low- and middle-income countries was high as compared to that in high-income countries. Maternal education level and weight at birth were significantly associated with developmental delays. Therefore, strategies should be designed to decrease the rate of low birth weight and the number of illiterate mothers living in low- and middle-income countries., Systematic Review Registration: PROSPERO, CRD42024513060., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wondmagegn, Girma and Habtemariam.)

Background: Access to maternal and reproductive health services has been one of the most affected components by armed conflict. Understanding how fragility and conflict may restrict access to maternal health services and promoting situation-specific policy options are crucial for reducing the effects. As a result, this study intends to assess the antenatal care service usage and associated factors in vulnerable and conflict-affected situations in Sekota zuria district, Northern Ethiopia., Methods: A community-based cross-sectional study design was employed on 593 mothers who had given birth in the past two years preceding the survey in the Sekota zuria district from October 15 to 30, 2022. The data were collected by using an interviewer-administered structured and pretested questionnaire. To pinpoint the determining factors, a bivariable and multivariable logistic regression model was applied. For both steps, variables were deemed significant if they had a P-value of lower than 0.05. We use adjusted odds ratios to measure how strongly the dependent and outcome variables are related., Results: The prevalence of antenatal care service utilization in the study area was 54.5%, 95% CI: 50.0-58.0%. Considering prenatal visits as routine prenatal checkups (AOR = 2.54, 95% CI: 1.74-3.69), using healthcare providers as a source of information (AOR = 2.30, 95% CI: 1.38-3.81), planned pregnancies (AOR = 1.74, 95% CI: 1.07-2.82), were positively associated with utilization of antenatal care. Whereas, respondents' restricted movement because of insecurity negatively affected the service utilization (AOR = 0.30, 95% CI: 0.18-0.49) CONCLUSIONS: The antenatal care utilization in the study area was 54.5%. Respondents' restricted movement because of insecurity negatively affected the service utilization during the fragile and conflict-affected situation. So it demands designing context and vulnerable group-specific healthcare policies and strategies in fragile and conflict-affected situations. It is also very important to strengthen the availability and accessibility of maternal healthcare services in conflict-affected areas through outreach initiatives and mobile clinics., Competing Interests: Declaration of Competing Interest The authors declared that there are no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)