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Yosef Gebretensaie,1,&ast; Abay Atnafu,2,&ast; Yonas Alemu,3 Selfu Girma,2 Kassu Desta4,&ast; 1American Advanced Medical Laboratory, American Medical Center, Addis Ababa, Ethiopia; 2Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 3Department of Microbiology, Immunology, and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Medical Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Yosef Gebretensaie, Tel +251913063450, Email yoseftakelove@gmail.comBackground: Urinary tract infections (UTIs) bring a significant and serious health-related problem. Repeated infections may lead to the development of renal scarring and end-stage renal dysfunction. Therefore, balancing the choices of UTI diagnostic tools depending on the costs versus accuracy can minimize false results that may subject patients to wrong treatments.Objective: The objective of the study was to evaluate the diagnostic performance of LINEAR cromatest and Laboquick URS 10-T dipsticks against conventional urine culture at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia.Methods: A similar cohort of UTI-suspected patients from our previous study, who were prospectively enrolled from Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia, were considered for this analysis. Data analysis was performed using SPSS version 26. The sensitivity, specificity, and predictive value of different dipsticks were calculated using culture as a gold standard. ROC curve analysis was also used to determine diagnostic performance. A test with a P-value of < 0.05 was considered statistically significant.Results: Out of 446 urine samples processed, bacterial growth was observed in 141 (31.6%). Of this figure, 105/141 (74.5%) and 36/141 (25.5%) were from female and male participants, respectively. The sensitivity and specificity of the LINEAR Cromatest dipstick were 83.7% and 67.9%, respectively (P-value < 0.001). The Laboquick URS 10-T dipstick showed sensitivity and specificity of 87.9% and 68.5%, respectively (P-value < 0.001). The ROC analysis showed an AUC of > 0.7 for both dipsticks.Conclusion: In a setting where there is no access to urine culture, the urine dipstick may be considered an alternative diagnostic tool in the diagnosis of UTIs.Keywords: AUC, dipstick test, diagnostic accuracy, sensitivity, urine culture, UTI

Tadesse Gure Eticha,1 Sagni Girma,2 Galana Mamo,3 Fekede Asefa,3 Abdi Birhanu,4 Bedasa Taye,3 Addisu Alemu,3 Kabtamu Nigussie,2 Abel Gedefaw,5 Tinsae Genet,6 Demisew Amenu,7 Thomas Mekuria,8 Abera Kenay Tura2 1Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5School of Medicine, College of Health and Medical Sciences, Hawassa University, Hawassa, Ethiopia; 6School of Medicine, College of Health and Medical Sciences, University of Gondar, Gondar, Ethiopia; 7School of Medicine, College of Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 8School of Medicine, St. Paul’s Millennium Medical College Hospital, Addis Ababa, EthiopiaCorrespondence: Tadesse Gure Eticha, Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia, Tel +251913868714, Email tadebuna@yahoo.comBackground: Although the lactational amenorrhea method (LAM) is one of the most commonly used contraception methods during the first six months of a woman’s postpartum period, there has been little research on its effectiveness in general and particularly in Ethiopia. The purpose of this study was to evaluate the effectiveness of LAM and the experiences of Ethiopian women who used it.Methods: This was a multi-center prospective cohort study of postpartum women from five Ethiopian regions and one city administration. All pregnant women who gave birth in these randomly selected hospitals and five health centers directly referring to the hospitals were invited to the study if they selected LAM and were followed monthly at home. Each month, trained researchers visited the woman at her home and collected information about breast feeding, the return of menses, the resumption of sex, the use of another contraceptive, and a pregnancy test using urine human chorionic gonadotropin (hCG). Women who reported starting new contraceptive methods, resumption of menses, starting complementary feeding, neonatal death, getting pregnant, or refusing were excluded from the cohort. The data were collected using ODK Collect and exported to Stata 14 for analysis.Results: Among the 2162 women who selected LAM as a contraceptive, 2022 were enrolled in the cohort study, and 901 completed the follow-up. At the end of the sixth month, eight women got pregnant, corresponding to an effectiveness of 99.1%. More than half of the cohort were excluded from the follow-up for reasons of transitioning to other types of contraception, resumption of menses, or refusal to follow-up.Conclusion: The effectiveness of LAM is high and should be recommended for postpartum women, with proper counseling provided. A study should be conducted to examine the effectiveness of breast feeding as a contraceptive beyond the Bellagio consensus.Keywords: effectiveness, lactation amenorrhea, contraception, breast-feeding, postpartum Ethiopia

Abay Atnafu,1 Liya Wassie,1 Melaku Tilahun,1,&ast; Selfu Girma,1 Yohannes Zenebe,2 Muluye Abebe Beyene,1 Ashenafi Alemu,1 Emnet Fisseha,1 Haymanot Agze,1 Tigist Desta,1 Kassu Desta,3,&ast; Kidist Bobosha1,&ast; 1Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 2Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Abay Atnafu, Tel +251912205822, Email ayatab.ayele7@gmail.comBackground: Extrapulmonary tuberculosis (EPTB), particularly tubercular lymphadenitis (TBLN), remains to pose a huge public health problem in Ethiopia. A significant number of TBLN patients who completed a full course anti-TB treatment regimen were reported to have enlarged lymph nodes and other TB-like clinical presentations. This could either be from a paradoxical reaction or microbiological relapse, possibly due to mono/multi-drug resistance.Objective: To investigate the rate of mono and multidrug resistance patterns of Mycobacterium tuberculosis as a cause of the observed treatment failures in clinically diagnosed and anti-TB treatment (newly or previously)-initiated LN patients.Methods: A cross-sectional study was conducted on 126 TBLN-suspected and previously treated patients between March and September 2022. Data were analyzed using SPSS (Version 26.0). Descriptive statistics were used to determine the frequency, percentage, sensitivity, specificity, and positive and negative predictive values. The level of agreement was determined using Cohen’s kappa and a Chi-square test was used to measure the association between risk factors and laboratory test outcomes. A P-value < 0.05 was considered statistically significant.Results: Mycobacterium tuberculosis was confirmed in 28.6% (N=36) of the 126 cases using BACTEC MGIT 960 culture detection method. Approximately, 13% (N=16) of the samples were collected from previously treated TBLN patients, of which 5/16 (31.3%) were multi-drug resistant, 7/16 were drug-sensitive and 4/16 were culture negative. To rule out other non-tuberculous agents, all samples were grown on blood and Mycosel agar plates, and no growth was detected.Conclusion: The emergence of drug resistant (DR) TB seems to not just be limited to pulmonary form but also to TBLN. In this study we observed a considerable number of microbiologically confirmed relapses among previously treated cases, possibly indicating the need for confirmation of drug resistance using rapid molecular methods or phenotypical methods during treatment follow up.Keywords: tubercular lymphadenitis, relapse, drug sensitivity testing, DST, FNA

Yosef Gebretensaie,1,&ast; Abay Atnafu,2,&ast; Selfu Girma,2 Yonas Alemu,3 Kassu Desta1,&ast; 1Department of Medical Laboratory Science, Addis Ababa University, Addis Ababa, Ethiopia; 2Mycobacterial Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 3Department of Microbiology, Immunology, and Parasitology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Yosef Gebretensaie, Tel +251913063450, Email yoseftakelove@gmail.comBackground: Urinary tract infections (UTIs) brought a significant and serious health-related problem that may lead to the subsequent development of serious indications with the challenge of the emergence of antibiotic resistance. Therefore, the choice of antibiotics depends on the accuracy of the diagnostic tool of UTIs to minimize false results that may subject patients to wrong treatments. This study aimed to determine the prevalence of bacteriuria, associated factors, and AMR pattern of UTI-suspected patients.Methods: A cross-sectional study was conducted from March to May 2022, at Arsho Advanced Medical Laboratory (AAML), Addis Ababa, Ethiopia. Species identification and isolation from bacterial colonies were characterized by gram stain and biochemical properties followed by antibiotic susceptibility testing using the Kirby-Bauer method on Muller-Hinton agar. Logistic regression analysis was carried out to determine the association between the independent variables and significant bacterial growth to identify factors that affect the prevalence of UTI. A test is considered statistically significant that has a P value less than 0.05.Results: Out of 141 (31.6%) which yielded significant bacteriuria, 16 different species of bacterial uropathogens were identified. A total of 105/446 (91 Gram-negative and 14 Gram-positive) of bacterial growth in the female gender and 36/446 (33 Gram-negative and 3 Gram positive) in male were observed with a P value of 0.03. The most predominant bacteria were E. coli followed by Klebsiella pneumoniae. Amoxicillin had shown the highest resistance rate (100%) followed by Ampicillin (98.9%). Females and participants with previous infections were shown to be associated with significant bacterial growth.Conclusion: Based on our study finding, the ordinarily used antibiotics seem to face emerging resistant strains, which needs considerable and due attention to the impact of UTI in developing countries including Ethiopia. History of previous UTIs and female gender were shown to be possible risk factors associated with UTIs.Keywords: prevalence, uropathogen, urinary tract infection, antimicrobial resistance pattern

Sintayehu Girma,1 Gizachew Abebe,2 Aklilu Tamire,3 Hamdi Fekredin,3 Bedasa Taye3 1Fred Hollows Foundation, Addis Ababa, Ethiopia; 2Gutazer Health Center, Gurage Zone, South Nation Nationalities and People, Walkite, Ethiopia; 3School of Public Health, College of Health and Medical Science, Haramaya University, Harar, EthiopiaCorrespondence: Aklilu Tamire, Email aklilutamire11@gmail.comBackground: Most developing nations lag behind in maintaining their populations’ health. These nations are characterized by under-financing, low health cost protection mechanisms for the poor, and lack of risk pooling and cost sharing methods. To tackle this challenge, Ethiopia proposed social health insurance in 2010 even though its implementation was delayed. Hence, the purpose of this study was to assess teachers’ willingness to pay for the newly proposed social health insurance and its associated factors.Methods: A cross-sectional study was conducted and a stratified sampling technique was used to select government and private schools. After data were collected using a semi-structured self-administered questionnaire, binary and multivariate logistic regressions were done to examine determinants of willingness to pay for social health insurance.Results: Among participants who faced illness six months prior to the study, 85.7% reported that they paid “out of their pocket”. About 59.2% and 54% of the teachers had a positive attitude and good knowledge toward health insurance schemes respectively. Of the total study respondents, 89.5% were willing to pay for the suggested insurance scheme. Forty eight percent of participants agreed to pay greater than or equal to 4% of their monthly salary. Willingness to pay was more likely among those who taught in secondary schools, had a positive attitude and good knowledge.Conclusion: Nearly three fourths of the teachers showed willingness to pay for social health insurance. Participants with good knowledge, a positive attitude and from primary schools were more likely to be willing to pay for social health insurance. Equipping all public facilities’ employees with necessary knowledge of social health insurance is essential to reduce catastrophic health care costs. Future researchers need to consider qualitative studies to support these findings.Keywords: social health insurance, Harar, Eastern Ethiopia, willingness to pay

Ashenafi Alemu,1 Selfu Girma,1 Solomon H Mariam1,2 1Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 2Infectious Diseases Program, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Solomon H Mariam, Email solomon.hm@aau.edu.etBackground: Infectious diseases caused by pathogenic members of the family Enterobacteriaceae cause mortality and morbidity in humans. These are mediated mainly via toxins or virulence factors in combination with multiple antimicrobial resistance (MAR) against antimicrobials intended to treat infections. Resistance can be transferred to other bacteria, possibly also in association with other resistance determinants and/or virulence properties. Food-borne bacterial infections are one of the major causes of infections in humans. The level of scientific information about foodborne bacterial infections in Ethiopia is very limited at best.Methods: Bacteria were isolated from commercial dairy foods. These were cultured in appropriate media for identification at the family level (Enterobacteriaceae) based on Gram-negative, catalase-positive, oxidase-negative, and urease-negative phenotypes, followed by testing for the presence of virulence factors and resistance determinants to various antimicrobial classes using phenotypic and molecular tests.Results: Twenty Gram-negative bacteria isolated from the foods were found to be resistant to almost all antimicrobials belonging to the phenicol, aminoglycoside, fluoroquinolone, monobactam, and β-lactam classes. All of them were multiple-drug-resistant. The resistance to the β-lactams was due to the production of β-lactamases and were also mostly resistant to some of the β-lactam/β-lactamase inhibitor combinations. Some isolates also contained toxins.Conclusion: This small-scale study demonstrated the presence, in the isolates, of high levels of virulence factors and resistance to major antimicrobials that are in clinical use. Most treatment being empirical, there can be not only a high degree of treatment failure but also the likelihood for further development and dissemination of antimicrobial resistance. Since dairy foods are animal products, there is an urgent need to control animal-food-human transmission mechanisms, restrict antimicrobial use in animal agriculture, and improve clinical treatment from the usual empirical treatment to more targeted and effective treatment.Keywords: dairy isolates, gram-negative bacteria, multiple antimicrobial resistance, virulence, β-lactamase inhibitor

The use of drones, formally known as unmanned aerial vehicles (UAVs), has significantly increased across a variety of applications over the past few years. This is due to the rapid advancement towards the design and production of inexpensive and dependable UAVs and the growing request for the utilization of such platforms particularly in civil applications. With their intrinsic attributes such as high mobility, rapid deployment and flexible altitude, UAVs have the potential to be utilized in many wireless system applications. On the one hand, UAVs are able to operate as flying mobile terminals within wireless/cellular networks to support a variety of missions such as goods delivery, search and rescue, precision agriculture monitoring, and remote sensing. On the other hand, UAVs can be utilized as aerial base stations to increase wireless communication coverage, reliability, and the capacity of wireless systems without additional investment in wireless systems infrastructure. The aim of this article is to review the current applications of UAVs for civil and commercial purposes. The focus of this paper is on the challenges and communication requirements associated with UAV-based communication systems. This article initially classifies UAVs in terms of various parameters, some of which can impact UAVs’ communication performance. It then provides an overview of aerial networking and investigates UAVs routing protocols specifically, which are considered as one of the challenges in UAV communication. This article later investigates the use of UAV networks in a variety of civil applications and considers many challenges and communication demands of these applications. Subsequently, different types of simulation platforms are investigated from a communication and networking viewpoint. Finally, it identifies areas of future research.

Arefayne Alenko,1 Liyew Agenagnew,1 Girma Beressa,2 Yonas Tesfaye,1 Yohannes Markos Woldesenbet,3 Shimelis Girma1 1Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia; 2Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia; 3School of Medicine, College of Medicine and Health Sciences, Wolaitta Sodo University, Wolaita Sodo, EthiopiaCorrespondence: Arefayne AlenkoJimma University, Institute of Health, Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, EthiopiaTel +251 96 767 0149Email arefeaynealenko@gmail.comBackground: The outbreak of coronavirus disease 2019 (COVID-19) is a stressful and overwhelming situation for health care professionals (HCP), especially, who are caring for patients in the resource-limited health care settings of low-income countries. Due to the increasing number of COVID-19 cases in Ethiopia, HCPs are at risk for COVID-19-related anxiety and associated inadequate nutrition. However, the magnitude of COVID-19-related anxiety and its association with dietary diversity among HCPs is not well studied.Objective: To assess the magnitude of COVID-19-related anxiety and its association with dietary diversity score among health care professionals in Ethiopia.Methods: A web-based cross-sectional survey was conducted among HCPs working in university hospitals, primary hospitals, and health centers in south and southwest Ethiopia. A structured online survey questionnaire was designed on Google forms and carried out from May 15 to June 14, 2020. COVID-19-related anxiety was assessed using the coronavirus anxiety scale. Dietary diversity was measured using 9 items individual dietary diversity score. Data analysis was done using the Statistical Package for Social Sciences version 24. Multiple logistic regression was computed to identify independent factors associated with COVID-19-related anxiety. Statistical significance was set at p< 0.05.Results: The prevalence of COVID-19-related anxiety among health care professionals was found to be 20.2%. COVID-19-related anxiety is significantly associated with a low dietary diversity score [AOR=5.93 (1.67, 21.07)]. The other factors which are independently associated with COVID-19-related anxiety are the presence of depression [AOR=6.98 (2.91– 16.73)] and diploma educational status [AOR=0.16 (0.04– 0.55)].Conclusion: One-fifth of the study participants were found to have probable COVID-19-related anxiety. Designing a screening and intervention strategy for COVID-19-related anxiety among HCPs, particularly to those with low dietary diversity scores and depression, is recommended.Keywords: COVID-19, anxiety, dietary diversity score, health care professionals

Sosina Ayalew,1,2 Teklu Wegayehu,2 Hawult Taye,1 Liya Wassie,1 Selfu Girma,1 Stefan Berg,3 Adane Mihret1 1Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 2Department of Biology, College of Natural Sciences, Arba Minch University (AMU), Arba Minch, Ethiopia; 3Bacteriology Department, Animal and Plant Health Agency, Weybridge, UKCorrespondence: Sosina Ayalew Tel +251 912166324Email absosina2011@gmail.comBackground: Tuberculosis lymphadenitis (TBLN) is a growing public health concern in Ethiopia. However, there is limited information available on gene mutations conferring drug resistance and genetic diversity of M. tuberculosis isolates from TBLN patients.Methods: Drug resistance and genetic diversity analysis were done on 91 M. tuberculosis isolates from culture positive TBLN patients collected between 2016 and 2017. Detection of mutations conferring resistance was carried out using GenoType MTBDRplus VER 2.0. Thereafter, isolates were typed using spoligotyping.Results: Out of the 91 strains, mutations conferring resistance to rifampicin (RIF) and isoniazid (INH) were observed in two (2.2%) and six (6.6%) isolates, respectively. The two RIF resistant isolates displayed a mutation at codon 531 in the rpoB gene with amino acid change of S531L. Among the six INH resistant strains, four isolates had shown mutation at the KatG gene at codon 315 with amino acid change of S315T, one isolate had a mutation at the inhA gene at codon 15 with amino acid change of C15T and one isolate had a mutation at the inhA gene with unknown amino acid change. All drug resistant isolates were from treatment naive TBLN patients. The dominantly identified Spoligo International Types (SITs) were SIT25, SIT149, and SIT53, respectively; these accounted for 43% of the total number of strains. The isolates were grouped into four main lineages; Lineage 1 (2, 2.2%), Lineage 3 (38, 41.7%), Lineage 4 (49, 53.8%) and Lineage 7 (2, 2.2%). Four out of six (66.7%) isolates with drug resistance conferring mutations belonged to clustered strains (strains with shared SIT).Conclusion: The detection of drug resistant conferring mutation in treatment naïve TBLN patients together with detection of drug resistant isolates among clustered strains might suggest resistant strains’ transmission in the community. This needs to be carefully considered to prevent the spread of drug resistant clones in the country.Keywords: drug resistant, genetic diversity, mutation, tuberculosis lymphadenitis

Sewnet Girma,1 Tsion Teshome,1 Meseret Worku,1 Tinbit Solomon,1 Selam Kehulu,1 Reyana Aman,1 Mitiku Bonsa,2 Tesfaye Assefa,1 Habtamu Gezahegn3 1Madda Walabu University Goba Referral Hospital, School of Health Sciences, Department of Nursing, Goba, Bale, Ethiopia; 2Madda Walabu University Goba Referral Hospital, School of Health Sciences, Department of Public Health, Goba, Bale, Ethiopia; 3Madda Walabu University Goba Referral Hospital, School of Medicine, Medical Physiology Unit, Goba, Bale, EthiopiaCorrespondence: Habtamu GezahegnMadda Walabu University Goba Referral Hospital, School of Medicine, Medical Physiology Unit, P. O Box 302, Goba, Bale, EthiopiaTel +25112306248Email habgez47@gmail.comBackground: Globally, anemia is a public health problem, particularly in developing countries, including Ethiopia. Pregnant women are at a higher risk for anemia and anemic pregnant women often develop complications. Early diagnosis of pregnant women for anemia saves both the life of the newborn and hers. Therefore, the present study intended to assess anemia and its associated factors among pregnant women attending at Madda Walabu University Goba referral hospital.Methods: An institutional-based cross-sectional study was conducted from April 3 to May 3, 2019, among pregnant women attending Madda Walabu University Goba referral hospital. A total of 353 respondents were included in the study by using systematic random sampling techniques. Data were collected using both face-to-face interview and hemoglobin measurement. The collected data were entered into SPSS and analyzed using both bi-variable and multiple logistic regressions. Finally, statistical significance was declared at a p-value of less than 0.05 in the multiple logistic regressions.Results: In this study, the prevalence of anemia was 46.2% (95%CI: 40.9%, 51.5%). Factors significantly associated with anemia were positive stool examination for parasites (AOR=2.9, 95%CI 1.255– 6.856), lower consumption of fruits and vegetables (AOR=2.7, 95%CI 1.47– 4.86), no iron supplementation (AOR=2.2, 95%CI 1.07– 4.45), large family size (AOR=2.1, 95%CI 1.13– 3.77), and absence of abortion history (AOR=0.4, 95%CI 0.24– 0.77).Conclusions and Recommendation: Prevalence of anemia among pregnant women was high. Pregnant women with a previous history of abortion, positive stool for parasite, lower consumption of fruits and vegetables, no iron supplementation and large family size above five were risk factors for anemia. Therefore, encouraging pregnant women to take iron supplementation and to eat fruits and vegetables are important.Keywords: anemia, pregnant women, hemoglobin, Ethiopia

Assefa Kumsa, Shimelis Girma, Bezaye Alemu, Liyew Agenagnew Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Liyew AgenagnewJimma University, 378, Jimma, EthiopiaTel +251 912806976Email liyew2003@gmail.comBackground: Tardive dyskinesia (TD) remains a significant burden especially among patients taking psychotropic medications, and it is associated with adverse effects that can lead to subjective suffering, stigma, poor compliance to medication, and poor quality of life. However, it is unrecognized and overlooked in clinical settings. So, this study aimed to assess the magnitude of tardive dyskinesia and associated factors among mentally ill patients attending follow-up treatment at Jimma University Medical Center Psychiatry clinic, Jimma, Southwest Ethiopia, 2019.Methods: Institutional-based cross-sectional study design was conducted in 417 samples. Participants were selected by systematic random sampling techniques. Data were collected by a semi-structured interviewer-administered questionnaire, and the document was reviewed to obtain the patient’s profile. Tardive dyskinesia was assessed by using the Extrapyramidal Symptom Rating Scale after informed consent was obtained from respondents. Data entry was done by EpiData version 3.1, and analysis was done by using SPSS 22.0 statistical software. Binary logistic regression and multivariate logistic regression were used to see the association and to identify independent factors at a p-value of < 0.05.Results: Prevalence of drug-induced tardive dyskinesia was 15.4% (CI 95%: 12.0, 19.3). Female, age range between 30 and 44 years, having a diagnosis of major depressive disorder with the psychotic feature, taking chlorpromazine equivalent dose ˃600mg, and taking anticholinergic medications were variables positively associated with tardive dyskinesia, whereas cigarette smoking was negatively associated with tardive dyskinesia.Conclusion: The prevalence of drug-induced tardive dyskinesia in this study was high. Prescribing medications less than 600mg equivalent dose of chlorpromazine, giving attention for female patients, patients having a diagnosis of major depressive disorder, and reducing giving anticholinergic medications will be important measures for clinicians to reduce the occurrence of tardive dyskinesia.Keywords: mental illness, antipsychotics, tardive dyskinesia, Jimma

Shimelis Girma,1 Arefayne Alenko,1 Liyew Agenagnew2 1Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia; 2Department of Psychiatry, Jimma University, Jimma, EthiopiaCorrespondence: Shimelis Girma Email shimelisgirma@gmail.comBackground: The novel coronavirus disease, COVID-19, causes massive death, threatens the life and health of the world population. Thousands of health professionals were died and tested positive.Objective: This study was designed to determine knowledge and precautionary behavior practice for coronavirus disease-19 among health professionals working in public university hospitals in Ethiopia.Methods: A web-based online survey was conducted on health professionals working in Ethiopian public university hospitals. A survey questionnaire consisted of socio-demographic, coronavirus disease knowledge questions and precautionary behavioral practice. The survey questions were designed using Google form. All health professionals working (academic and clinical staff) in university hospitals were invited to participate in the online survey carried out from May 1 to 14, 2020. The data were analyzed using the Statistical Package for Social Sciences version 24.0. Descriptive statistics were computed, and tables and figures were used to present the results. Linear regression analysis was used to identify knowledge-related factors independently associated with precautionary behavior practice.Results: A total of 273 health professionals participated in this study. The mean (± SD) age of participants was 31.03 ± 5.11. Two-third (61.5%) and one-fourth (26%) of participants attended second degree and medical doctors, respectively. More than one-fourth of the study participants (27.5%) reported social media as the source of information. In this study, we found a significant gap between the level of knowledge and practical implementation of the recommended precautionary measures, especially for wearing masks and gloves. The final multiple linear regression analysis indicated a positive association between knowledge of the source of infection, incubation period, and mode of disease transmission with recommended behavioral practice.Conclusion and Recommendation: There was a significant gap in the implementation of the behavioral practice, especially for wearing masks and gloves. Therefore, there is a need to motivate and monitor health professionals’ adherence to recommended precautionary measures.Keywords: COVID-19, knowledge, precautionary health behavior, Ethiopia

Arefayne Alenko,1 Sisay Dejene,2 Shimelis Girma1 1Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia; 2Department of Health Service Management, College of Medicine and Health Sciences, Hawassa University, Hawassa, EthiopiaCorrespondence: Arefayne AlenkoDepartment of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, PO Box 378, Jimma, EthiopiaTel +251967670149Email arefeaynealenko@gmail.comBackground: Worldwide, 10– 20% of women experience depression during pregnancy. In sub-Saharan countries, depression during pregnancy is estimated to be 15– 57%. Even though there is a high burden of depression during pregnancy, little attention has been given to identify sociodemographic and obstetric determinants in diverse populations like Ethiopia.Objective: To identify sociodemographic and obstetric determinants of antenatal depression among women attending an antenatal clinic at Jimma Medical Center, southwest Ethiopia.Patients and Methods: A case–control study was conducted among 246 pregnant mothers (82 cases and 164 controls) attending an antenatal clinic in Jimma Medical Center from June 1 to August 30, 2019. Antenatal depression was assessed using the Beck Depression Inventory-II. Epidata 3.1 and SPSS v24 were used for data entry and analysis, respectively. Adjusted odds ratios (AOR) and 95%CIs were estimated using logistic regression models. Statistical significance was set at P< 0.05.Results: Married mothers were 67% (AOR=0.33, 95%CI: 0.15– 0.75), housewives were 97% (AOR=0.03, 95%CI: 0.01– 0.14), private workers were 87% (AOR=0.13, 95%CI: 0.04– 0.44), and government employees were 84% (AOR=0.16, 95%CI: 0.05– 0.46), less likely to develop antenatal depression. Multigravida were 88% (AOR=0.12, 95%CI: 0.04– 0.37) less likely to develop antenatal depression. Third trimester pregnancy was four times (AOR=4.04, 95%CI: 1.51– 10.81) more likely to have depression. Mothers who having wanted pregnancy were 83% (AOR=0.17, 95%CI: 0.04– 0.81) less likely to develop antenatal depression compared with mothers having unwanted pregnancy.Conclusion and Recommendation: Being married, multigravida, having wanted pregnancy and occupation status (housewives, private workers and government employees) can protect mothers from developing antenatal depression. Mothers with third trimester pregnancy were four times more likely to have depression. Designing a screening and intervention strategy for antenatal depression must consider the aforementioned protective and risk factors.Keywords: antenatal depression, determinants, Ethiopia

Shimelis Girma, Arefayne Alenko Department of Psychiatry, Faculty of Medicine, Institute of Health, Jimma University, Jimma, Oromia, EthiopiaCorrespondence: Shimelis Girma 378, Jimma University, Jimma, EthiopiaTel +251 911721438Email shimelisgirma@gmail.comBackground: Global acute malnutrition is one of the major contributors to the death of young children. It accounts for about 35% to 55% of all childhood deaths in low- and middle-income countries. However, there have been limited studies examining the relationship between global acute malnutrition and women’s involvement in decision-making, and nutrition-related knowledge in the locality.Patients and Methods: A case–control study was conducted from March to April 2018. The sample size was determined using Epi Info statistical software, and a total of 234 children with their parents involved in the study. Childs’ height was measured using a stadiometer, and a digital weight scale was used to measure child weight. Weight-for-height Z-score (WHZ) was computed using the World Health Organization (WHO) Anthro Software. Women’s involvement in household decision-making was assessed using the household decision-making index. Socio-demographic and maternal nutrition-related knowledge were assessed using a structured questionnaire. Data entry and statistical analysis were done using EpiData 3.1 and Statistical Package for Social Science 24.0 (SPSS). Statistically, a significant association was declared by adjusted odds ratio (AOR), 95% confidence interval (CI), and P-value less than or equal to 0.05.Results: About three-fifths of mothers whose children were cases had poor nutrition-related knowledge regarding optimal child feeding. The study found poor maternal nutrition-related knowledge (AOR 5.16, 95% CI (1.9, 13.96)), not attending formal education (AOR 4.98, 95% CI (2.09, 11.82)), lack of maternal involvement in household decision-making (AOR 4.68, 95% CI (1.99, 10.97)), and lowest wealth index (AOR 3.76, 95% CI (1.24, 11.38)) as independent predictors.Conclusion and Recommendation: Maternal nutrition-related knowledge, maternal educational status, and involvement in household decision-making were found to be independent predictors of child global acute malnutrition. Emphasis needs to be given in strengthening girls’ education, nutrition education, household economic strengthening activities, and women empowerment in decision-making.Keywords: global acute malnutrition, Southwest Ethiopia, household-related factors

Arefayne Alenko,1 Hiwot Berhanu,2 Amare Abera Tareke,2 Wondu Reta,2 Moyeta Bariso,2 Elias Mulat,2 Chala Kenenisa,2 Wondwossen Debebe,2 Kumale Tolesa,3 Shimelis Girma1 1Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia; 2Department of Biomedical Sciences, Faculty of Medical Science, Institute of Health,, Jimma University, Jimma, Ethiopia; 3Department of Ophthalmology, Faculty of Medical Science, Institute of Health , Jimma University, Jimma, EthiopiaCorrespondence: Arefayne AlenkoJimma University, Institute of Health, Department of Psychiatry, Faculty of Medical Science, Institute of Health, Jimma University, Jimma, Ethiopia Tel +251 96 767 0149Email arefeaynealenko@gmail.comBackground: Road traffic crashes (RTCs) can cause serious and long-lasting consequences for drivers, both in terms of physical and mental health outcomes. Posttraumatic stress disorder (PTSD) is the most frequent mental disorder occurring after traumatic exposure. Ethiopian drivers experience RTCs more frequently than other sub-Saharan countries. Despite this prevailing phenomenon, limited attention has been given to PTSD among drivers.Objective: To determine the prevalence of PTSD and associated factors among drivers surviving RTCs in southwest Ethiopia.Methods: A cross-sectional quantitative study was conducted among 402 male drivers who had survived RTCs. The study was conducted in Jimma zone, southwest Ethiopia from March to June, 2019. All drivers who had survived RTCs in the last year were included in the study. The Trauma Screening Questionnaire was used to determine the prevalence of PTSD. Data were entered in EpiData 3.1 and exported to SPSS 24 for analysis.Results: The response rate of the study was 398(99%). Fifty of 398 (12.6%, 95% CI 9.5%–16.1%) met PTSD criteria based on the questionnaire. A history of near-miss RTCs (AOR 3.49, 95% CI 1.89–6.43), depression (AOR 3.32, 95% CI 1.36–5.12), and severe-risk cannabis use (AOR 2.51, 95% CI 1.96–7.52) were significantly associated with PTSD.Conclusion and recommendation: The prevalence of PTSD among drivers surviving RTCs was high compared to the general population. A record of near-miss RTCs, depression, and severe-risk cannabis use shown significant associations with PTSD. Strategies and guidelines must be developed to screen and treat PTSD among drivers surviving RTCs. Drivers with experience of near-miss RTCs, depression, and severe-risk cannabis use should be given priority when screening for PTSD.Keywords: stress disorders, posttraumatic, traffic crash, prevalence, drivers, Ethiopia

With recent advances in robotics along with sensor technologies, robots have richer features and can be used in more diverse applications. However, onboard microcontrollers in robots often take full responsibility for processing data acquired from sensors, controlling actuators, and other tasks. This prohibits us from implementing complex algorithms in microcontrollers. To address this issue, we present a novel design of a network robotic framework using a smartphone-based robotic platform. The design was implemented using a smartphone as a network bridge to distribute computationally burdensome tasks into multiple networked computational resources, as well as, a sensor package that allows the mobile robot to navigate. One of the most practical benefits derived from the outsourced computations is the simplicity in a robot's design. This provides a sturdy robot that consumes less power. With interaction capabilities to networked resources, more diverse robotic applications can be developed. To demonstrate the feasibility of the proposed network robotic framework, several experiments were conducted for indoor localization and navigation using a novel smartphone-based robotic platform.

Abstract Background When malaria transmission is very low, investigation of passively detected malaria cases and reactive focal testing and treatment (FTAT) in the case and neighbouring households can identify and contain the source and spread of infections. Methods Case investigation with reactive FTAT for malaria was implemented in 10 villages in Amhara Region, Ethiopia during the 2014/2015 malaria transmission season. Intervention villages were purposively selected based on the incidence of passively detected Plasmodium falciparum and mixed infections (P. falciparum and Plasmodium vivax) during the 2013 transmission season. A passively detected P. falciparum or mixed index case triggered an investigation that targeted the index case household and the closest 10 neighbouring households in a 100-m radius. All consenting household members received a rapid diagnostic test (RDT) and RDT-positive individuals received artemether–lumefantrine (P. falciparum, mixed) or chloroquine (P. vivax). Results From October 2014 to February 2015, 407 P. falciparum or mixed index cases (approximately 6.5 per 1000 population) were passively detected. Of these, 220 (54.1%) were investigated, of which 87.3% were male, 61.8% were age 20–39 years [median age: 27 years (range 1–90)], and 58.6% spent ≥ 1 night away from home in the past month (ranging from 0.0 to 94.1% by village). Among the 4077 residents in the 914 households investigated, 3243 (79.5%) received an RDT and 127 (3.9%) were RDT-positive (2.2% P. falciparum, 0.5% P. vivax, 1.2% mixed). Three epidemiological patterns were found. In six villages, there were almost no cases, with less than 10 index and secondary cases. In three villages, most index cases had a history of travel (> 62%), but there were a small number of secondary cases (