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Dinaol Belina,1,2 Tesfaye Gobena,3 Ameha Kebede,2 Meseret Chimdessa,2 Tine Hald4 1College of Veterinary Medicine, Haramaya University, Dire Dawa, Ethiopia; 2School of Biological Sciences and Biotechnology, Haramaya University, Dire Dawa, Ethiopia; 3College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4National Food Institute, Technical University of Denmark, Lyngby, DenmarkCorrespondence: Dinaol Belina, Email belina.dinaol@gmail.comBackground: Antimicrobial resistance (AMR) poses a significant global threat, particularly in low- and middle-income countries, such as Ethiopia, where surveillance is limited. This study aimed to predict and characterize the AMR profiles of diarrheagenic Escherichia coli (DEC) and nontyphoidal Salmonella (NTS) strains isolated from human, animal, food, and environmental samples using whole genome sequencing.Methods: A total of 57 NTS and 50 DEC isolates were sequenced on an Illumina NextSeq 550. The ResFinder and PointFinder tools were employed to identify antimicrobial resistance genes (ARGs) and point mutations. Salmonella serotypes were determined using SeqSero.Results: The analysis identified at least one ARG in every NTS sample and 78% of the DEC isolates, with 22 distinct ARGs in the NTS samples and 40 in the DEC samples. The most prevalent ARGs were aac(6′)-Iaa and aph(3′)-Ib, which predict aminoglycoside resistance in 100% of NTS and 54% of DEC isolates, respectively. Other commonly identified ARGs include sul 2, aph(6)-Id, blaTEM-1B, and tet(A), which confer resistance to folate inhibitors, aminoglycosides, β-lactams, and tetracycline. Some ARGs predicted phenotypic multidrug resistance in both DEC and NTS isolates. All identified β-lactam ARGs, except for blaTEM− 1D, conferred resistance to more than three antibiotics. Interestingly, blaCTX-M-15 was found to confer resistance to nine antibiotics, including third-generation cephalosporins, in 18% of DEC and 3.5% of NTS isolates. DEC isolates from children exhibited the highest ARG diversity. Notably, genes such as aph(3″)-Ib, aph(6)-Id, sul 2, and tet(A) were detected across all sample types, including water sources, although some ARGs were exclusive to specific sample types. Point mutations mediating AMR were detected in several genes, with mutations associated with nucleotide substitution being the most frequent.Conclusion: This genotypic AMR profiling revealed the presence of widespread drug-resistant NTS and DEC strains in Ethiopia. Robust and sustained AMR surveillance is essential for monitoring the emergence and spread of these resistant pathogens.Keywords: antimicrobial resistance, Ethiopia, foodborne pathogens, whole genome sequence

Mohammedawel Abdishu,1 Tesfaye Gobena,2 Melake Damena,2 Hassen Abdi,2 Abdi Birhanu3 1Public Health Emergency Management Officer at Gursum District Health Office, Gursum, Oromia Region, Ethiopia; 2Haramaya University, College of Health and Medical Sciences, School of Public Health, Harar, Ethiopia; 3Haramaya University, College of Health and Medical Sciences, School of Medicine, Harar, EthiopiaCorrespondence: Abdi Birhanu, Email abdiibiree@gmail.comBackground: Understanding the determinants of malaria morbidity offers helpful insights toward the changing malaria situation, which might lead to the adjustment of malaria program activities. Even though the determinants of malaria morbidity remain unknown, school-aged children were the highest malaria morbidity contributors in the East Hararghe Zone. Therefore, this study aimed to assess the determinants of malaria morbidity among school-aged children in the study area from February 1 to May 31, 2020.Methods: A case-control study was conducted among school-aged children living in ten randomly selected low, moderate, and high malaria transmission kebeles. Cases were confirmed as positive for malaria, while controls were confirmed as negative for malaria among randomly selected school-aged children. Rapid diagnostic testing (RDT) and blood film (BF) malaria testing methods were used. Multivariable logistic regression was used to identify association between malaria and its determinants.Results: The determinants of malaria infection were having no formal education (adjusted odds ratio (AOR)=4.91, 95% CI: 1.20– 20.17), low family wealth index (AOR=2.50, 95% CI: 1.22– 5.12), being from rural residence (AOR=2.34, 95% CI: 1.87– 4.12), living near to stagnant water (AOR=2.01, 95% CI: 1.14– 3.54), having a maximum of three family members (AOR=0.37, 95% CI: 0.18– 0.78), using indoor residual spraying (IRS) (AOR=0.15, 95% CI: 0.08– 0.29) and long-lasting insecticide-treated net (LLITN) over the last night (AOR=0.19, 95% CI: 0.10– 0.35), and living in the house surrounded by cultivated land(AOR=0.24, 95%CI: 0.10-0.60) compared with their counterparts.Conclusion: This study revealed that residence, family size, education, wealth index, stagnant water existence, and using LLITN and IRS had significant association with malaria morbidity. Thus, all concerned bodies, including the community should strengthen working on stagnant water elimination around their house to cut the breeding site of the malaria vector mosquito. Moreover, the findings have an important implication for improving interventions targeting the economic status and literacy of the society that may help in the reduction of the risk of malaria in the school-aged children.Keywords: determinants, malaria, school-aged children, Ethiopia

Kasiye Shiferaw,1 Bezatu Mengistie,2 Tesfaye Gobena,3 Merga Dheresa,1 Assefa Seme4 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Kasiye Shiferaw Tel +251256662517Email sifkas.gem2@gmail.comPurpose: This study aimed to identify the extent of antenatal care content received and associated factors among Ethiopian women.Methods: A nationally representative Performance Monitoring for Action 2020 Ethiopian data were used. A multistage cluster sampling design was used to select 2855 pregnant or recently postpartum women nested within 217 enumeration areas. Female resident enumerators collected the data using a semi-structured questionnaire. Researchers dichotomized the number of ANC content received greater than or equal to 75 percentiles as adequate. Otherwise, it was considered inadequate. A multilevel Poisson regression was fitted. The result was reported using an incidence rate ratio with a 95% confidence interval and a p-value less than 0.05 was considered for statistical significance.Results: The study revealed more than a quarter of pregnant women received adequate ANC content (27.8%; 95% CI: 23.8%, 32.2%). Multivariable analysis revealed urban residence (IRR = 1.09, 95% CI: 1.01, 1.21), attending secondary and above formal education (IRR = 1.08, 95% CI: 1.01, 1.16), maternal age 20– 24 years (IRR = 1.10, 95% CI: 1.02, 1.19), and partner’s encouragement to attend clinic for antenatal care (IRR = 1.14, 95% CI: 1.05, 1.24) was significantly associated with receiving higher numbers of antenatal care content.Conclusion: The proportion of women who received adequate antenatal care content in Ethiopia was low. Despite Ethiopia’s effort to improve maternal health services utilization, disparities among regions and between rural and urban exist. This study highlights the importance of ensuring high received antenatal care content, which is crucial for reducing pregnancy-related morbidity and mortality. This implies prompt intersectoral collaboration to promote female education, target older aged women, and rural resident women, encourage partner involvements during the antenatal care process, minimize regional variation, and strengthen the implementation of received ANC content policies and programs with the active participation of the stakeholders are priority issues.Keywords: received, ANC contents, associated factors, Ethiopia

Mehammedamin Jemal,1 Mohammed Abdurke Kure,2 Tesfaye Gobena,3 Biftu Geda2 1Department of Nursing, Hiwot Fana Specialized University Hospital, 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, EthiopiaCorrespondence: Mohammed Abdurke Kure P. O. Box: 235, Harar, EthiopiaTel +251919231736Fax +251256668081Email mameelemo@gmail.comBackground: Nurse–physician communication remains a public health challenge in the health care setting of developing countries. Clear and respectful nurse–physician communication is very crucial for the health of the patients. Numerous studies have shown that inter-professional communication gaps are the leading cause of adverse medical events that compromise the quality of patient care in the clinical setting. Although it has negative consequences and wider effects on patient care, nurse–physician communication in patient care is rarely studied in Africa. In eastern Ethiopia, predictors of nurse–physician communication in patient care have not been studied. Therefore, this study was aimed to assess nurse–physician communication in patient care in public hospitals of Harari Regional State and Dire-Dawa city administration, Eastern Ethiopia.Methods: The multicenter-mixed methods (a quantitative cross-sectional and phenomenological qualitative) were conducted from March 07 to April 07, 2019 in public Hospitals of Eastern Ethiopia. A total of 440 nurses and physicians working in public hospitals in the Harari Regional State and Dire-Dawa administration were enrolled in the study. Participants were approached through a simple random sampling technique. Data were collected using a pretested, self-administered questionnaire and entered into Epi-Data version 3.1, and exported to STATA software (version SE 14) for further analysis. Descriptive statistics were carried out using frequency tables, proportions, and summary measures. Multivariable logistic regression analysis was carried out to identify the true effects of the selected predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at p-value < 0.05. Qualitative data were collected from 10 key informants using a semi-structured questionnaire and analyzed using statistical software, Open Code (version 4.2) by thematic analysis method.Results: Overall, the magnitude of the level of nurse–physician communication in patient care was found to be 53.2% [95% CI (48.9– 58.0)]. In the final model of multivariable analysis, being in the age group of 31– 40 [(AOR=0.42, 95% CI (0.25– 0.72)], ever married nurse or physician [(AOR=2.28, 95% CI(1.41– 3.69)], being a nurse professional [AOR=2.36, 95% CI (1.23– 4.54)], a salary class of 2250– 3562ETB [(AOR=0.25, 95% CI (0.08– 0.84)], higher score for organizational related factors [(AOR=0.58, 95% CI (0.36– 0.92)], and higher score for work-related attitude behaviors [(AOR=0.62, 95% CI(0.39– 0.984)] were factors independently associated with the poor level of nurse–physician communication in patient care. In the qualitative findings, unattractive working environments and negative attitudes of professionals were found to be barriers to nurse–physician communication in patient care.Conclusion: In this study, the nurse–physician communication in patient care was relatively low because more than half of the level of nurse–physician communication was found to be poor. Increasing in age, getting a lower monthly salary, higher report for work-related attitude, and organizational related factors were the potential predictors that would decrease the good level of nurse–physician communication in patient care. This result provides cue due attention to improving nurse–physician communication in patient care through various techniques.Keywords: nurse–physician, communication, patient care, predictors, associated factors, Eastern Ethiopia

Shimelis Kassa,1 Gudina Egata,2 Tesfaye Gobena,3 Mathewos Mekonnen4 1Shanan Dhuggo District Health Office, West Hararge Zone, Oromia Region, Ethiopia; 2College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Nursing, College of Health Sciences, Salale University, Fiche, EthiopiaCorrespondence: Mathewos MekonnenDepartment of Nursing, College of Health Sciences, Salale University, P.O. Box 245, Fiche, Oromia, EthiopiaTel +251- 917-04-43-69Email matemek2010@gmail.comBackground: Continued feeding and increasing fluids is the cornerstone treatment package for a child with acute diarrhea. However, there is a deficiency of evidence on child feeding practice during a diarrheal episode globally and particularly in low-income countries. This study aimed at assessing feeding practice during diarrheal episodes and associated factors among mothers/caregivers with 6– 59-month-old children visiting health centers in Shanan Dhuggo district, West Hararge zone, Oromia region, Ethiopia.Methodology: A facility-based cross-sectional study was conducted from March 10 to April 25, 2019 on 422 mothers/caregivers of children 6– 59 months of age with diarrhea. Data collection was conducted using a pretested tool. Epi Data version 3.1 was utilized for data entry and it was transported to SPSS version 20 for analysis. Descriptive statistical analysis was conducted, and a relationship between outcome variables and independent variables were examined using logistic regression models.Results: The overall magnitude of appropriate feeding practice during a diarrheal episode was 40.8%. Child’s sex being male [AOR = 2.65 95% CI: (1.34, 5.22)], child’s age < 24 months [AOR = 13.5, 95% CI: (5.98, 30.45), postnatal care visit [AOR = 4.12, 95% CI: (1.78, 9.52)], having only one under-5 child [AOR = 5.65, 95% CI: (2.78, 11.48)], information on child feeding from health workers [AOR = 4.78, 95% CI: (1.05, 21.66)], and good knowledge on child feeding [AOR = 2.96, 95% CI: (1.52, 5.77 were independent predictors of appropriate feeding practice during a diarrheal episode.Conclusion: In the current study, the prevalence of appropriate feeding practice during a diarrheal episode was moderate. However, health education intervention aiming at factors influencing child feeding practices is indispensable to further improve feeding practice during a diarrheal episode.Keywords: feeding practice, diarrheal episode, children and Ethiopia

Wondimu Abuto,1 Admas Abera,2 Tesfaye Gobena,2 Tariku Dingeta,2 Melese Markos3 1Public Health Emergency Management, Kembata Tembaro Zonal Health Department, Durame, Southern Nations Nationalities Peoples’ Region, Ethiopia; 2School of Public Health, Haramaya University, Harar, Ethiopia; 3Department of Public Health, Dire Dawa University, Dire Dawa, EthiopiaCorrespondence: Admas AberaHaramaya University, P.O. Box 235, Harar, EthiopiaEmail admasabera10@gmail.comBackground: Human Immune Deficiency Virus (HIV) infection remains the leading cause of morbidity and mortality. In Ethiopia, despite test and treat all HIV positives are adopted, a significant number of people eligible for Anti-Retroviral Therapy (ART) show up with advanced disease and at lower CD4 count. There is currently paucity of studies conducted that investigate predictors of mortality among adults on ART in the study area.Objective: To explore Survival and predictors of mortality among adult HIV-positive patients on ART in Kambata Tambaro Zone, Ethiopia, from August 2013 to February 2019.Methods: A health facility-based retrospective cohort study was conducted among records of 467 adult HIV-positive patients on ART selected using simple random sampling. Data were collected using standardized abstraction tool. Kaplan–Meier, Log rank tests and Cox regression model was applied to estimate survival status and identify predictors of mortality, respectively.Results: Of the total 467 study subjects, 59 (12.63%) of them died in the study period. The median follow-up time of the cohort was 40.1 (IQR=13.6– 59.0) months. The mortality rate of the cohort was 4.1 per 100 PYO. The overall survival probability of the cohort was 84.38% (95 CI=80.08– 87.82) at 66 months. Bedridden function AHR=3.0 (95% CI, 1.44– 6.64), Fair-adherence AHR=3.3 (95% CI, 1.50– 7.07), Poor-adherence AHR=3.8 (95% CI, 1.88– 7.96), presence of OIs AHR=4.2 (95% CI, 1.98– 8.50), Late diagnosis (CD4 count >/=350) AHR=3.0 (95% CI, 1.91– 6.42) and Immunologic failure AHR=3.5 (95% CI, 1.41– 6.29) were independent predictors of time to death in Cox-Regression.Conclusion: Late Diagnosis, poor adherence, being bedridden, having OI and Immunologic failure were independently associated with time to death. Early diagnosis to start treatment and emphasizing on close follow-up care to improve treatment adherence should be given special emphasis.Keywords: survival, mortality, predictors, HIV/AIDS, HAART, low-resource setting

Aboma Motuma,1 Tesfaye Gobena,2 Kedir Teji Roba,1 Yemane Berhane,3 Alemayehu Worku4 1School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; 4Department of Epidemiology and Biostatistics, School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Aboma MotumaSchool of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, EthiopiaTel +251921454975Fax +251256668081Email abomaabdi1@gmail.comPurpose: Metabolic syndrome (MetS) has become a public health challenge in low-income countries due to changing lifestyle and the food environment. However, studies on the prevalence of metabolic syndrome and associated factors are limited in Ethiopia. Therefore, this study assessed the prevalence of MetS and its associated factors among working adults in eastern Ethiopia.Methods: A cross-sectional study was conducted involving 1,164 working adults from December 2018 to February 2019. Data were collected following the World Health Organization (WHO) STEPwise approach. The data collection tools include a structured questionnaire, anthropometric, and biochemical measurements. Prevalence was calculated using International Diabetes Federation criteria. A Poisson regression model with robust variance estimation was used to investigate the independent variable’s association with MetS. An adjusted prevalence ratio with 95% confidence interval was reported to show associations.Results: The prevalence of MetS was 20.1% (95% CI=17.8– 22.4) among the participants. It was more prevalent among females (APR:=1.62, 95% CI=1.31– 2.00), those of 35– 44 years of age (APR:=3.14, 95% CI=1.19– 8.28), 45– 54 years of age (APR=4.42, 95% CI=1.66– 11.77), and 55– 64 years of age (APR=6.03, 95% CI=2.27– 16.06), khat chewers (APR=1.30, 95% CI=1.06– 1.60), those with 8 or more hours of sedentary behavior (APR=2.29, 95% CI=1.88– 2.80), and those consuming alcohol 5– 6 days per week (APR=1.81, 95% CI=1.20– 2.74). The prevalence was significantly lower in those eating five or more fruits and vegetables servings per day (APR=0.04, 95% CI=0.01– 0.27).Conclusion: A high prevalence of MetS was observed among working adults in eastern Ethiopia. Strengthening workplace health promotion programs is necessary to reduce the negative consequences of MetS in workplaces and protect productivity.Keywords: prevalence, associated factors, metabolic syndrome, working adults, Ethiopia

Melkamu Tilahun,1 Teshome Gobena,2 Diriba Dereje,2 Mengistu Welde,2 Getachew Yideg3 1Department of Biomedical Sciences (Medical Physiology), College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Biomedical Sciences, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia; 3Department of Biomedical Sciences (Medical Physiology), College of Medicine and Health Sciences, Debre Tabur University, Debre Tabur, EthiopiaCorrespondence: Melkamu TilahunDepartment of Biomedical Sciences (Medical Physiology), College of Medicine and Health Sciences, Debre Markos University, PO Box 269, Debre Markos, EthiopiaTel +251 93-355-5884Fax + 0587780673Email melkamutilahunalamir@gmail.comBackground: Diabetic retinopathy is a well-known sight-threatening microvascular complication of diabetes mellitus. Currently, 93 million people live with diabetic retinopathy worldwide. There are insufficient studies addressing the prevalence of diabetic retinopathy and risk factors in Ethiopia.Objective: To assess the prevalence of diabetic retinopathy and its associated factors among diabetic patients on follow-up at Debre Markos Referral Hospital, northwest Ethiopia, 2019.Methods: This institution- based cross-sectional study was conducted among 302 patients. They were selected through systematic sampling. Explanatory data were extracted from medical records and interviews. Blood pressure, weight, height, and visual acuity tests were assessed. Retinal examination was performed with a Topcon TRC-NW7SF fundus camera. Data were entered in EpiData 3.1 and exported in to SPSS 20 for analyses. Binary logistic regression with 95% CIs was used for analyses. Simple binary logistic regression followed by multiple binary logistic regression analysis was conducted to identify associated factors.Results: There were 302 patients in this study, of which 57 (18.9%) had diabetic retinopathy. Among the diabetic retinopathy patients, 75.4% had the preproliferative type. Four in ten (37.7%) of the patients had visual acuity problems. Poor glycemic control (AOR 4.58, 95% CI 1.86– 11.31), > 10 years’ diabetes duration (AOR 3.91, 95% CI 1.86– 8.23), body-mass index > 25 kg/m2 (AOR 3.74, 95% CI 1.83– 7.66), and hypertension (AOR 3.39, 95% CI 1.64– 7.02) were factors significantly associated with diabetic retinopathy.Conclusion: About a-fifth of diabetic patients had diabetic retinopathy. Diabetic retinopathy was significantly associated with glycemic control, hypertension, body-mass index, and duration of illness. Routine assessment and early control of those associated factors may be important in reducing both the prevalence and impact of diabetic retinopathy, as evidenced in the current study.Keywords: diabetes mellitus, diabetic retinopathy, associated factor, Ethiopia

Fentabil Getnet,1,2 Meaza Demissie,3 Alemayehu Worku,3,4 Tesfaye Gobena,2 Rea Tschopp,5– 7 Berhanu Seyoum5 1College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia; 2School of Public Health, Haramaya University, Harar, Ethiopia; 3Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; 4School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia; 5Armauer Hansen Research Institute, Addis Ababa, Ethiopia; 6Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; 7University of Basel, Basel, SwitzerlandCorrespondence: Fentabil GetnetJigjiga University, P. O. Box 1020, Jigjiga, EthiopiaTel +251 913 289 380Email b.infen4ever@gmail.comPurpose: This study aimed to assess the extent of patient, health system and total delays in diagnosis and treatment of pulmonary tuberculosis (TB) in Somali pastoralist setting, Ethiopia.Patients and Methods: A cross-sectional study among 444 confirmed new pulmonary TB patients aged ≥ 15 years in 5 TB care units was conducted between December 2017 and October 2018. Data were collected using a structured questionnaire and record review. We measured delays from symptom onset to provider visit, provider visit to diagnosis and diagnosis to treatment initiation. Delays were summarized using median days. Mann–Whitney and Kruskal–Wallis tests were used to compare delays between categories of explanatory variables. The Log-binomial regression model was used to reveal factors associated with health system delay ≥ 15 days, presented in adjusted prevalence ratio (APR) with 95% confidence interval (CI).Results: The median age of patients was 30 years, ranged from 15 to 82. The majority (62.4%) were male, and nearly half (46.4%) were pastoralists. The median patient, health system and total delays were 30 (19– 48.5), 14 (4.5– 29.5) and 50 (35– 73.5) days, respectively. The median patient delay (35.5 days) and total delay (58.5 days) among pastoralists were substantially higher than the equivalent delays among non-pastoralists [p< 0.001]. Of all, 3.8% of patients (16 of 18 were pastoralists) delayed longer than 6 months without initiating treatment. Factors associated with health system delay ≥ 15 days were mild symptoms [APR (95% CI) = 1.4 (1.1– 1.7)], smear-negativity [APR (95% CI) = 1.2 (1.01– 1.5)], first visit to health centers [APR (95% CI) = 1.6 (1.3– 2.0)] and multiple provider contacts [APR (95% CI) = 5.8 (3.5– 9.6)].Conclusion: Delay in diagnosis and treatment remains a major challenge of tuberculosis control targets in pastoralist settings of Ethiopia. Efforts to expand services tailored to transhumance patterns and diagnostic capacity of primary healthcare units need to be prioritized.Keywords: patient delay, health system delay, total delay, tuberculosis, pastoralist

Dereje Gemeda Tesema,1 Teshome Gobena,2 Almaz Ayalew2 1Mettu University, Faculty of Medical Sciences, Department of Biomedical Sciences, Mettu, Ethiopia; 2Jimma University, Institute of Health, Faculty of Medical Sciences, Department of Biomedical Sciences, Jimma, EthiopiaCorrespondence: Almaz AyalewJimma University, Institute of Health, Faculty of Medical Sciences, Department of Biomedical Sciences, Jimma, EthiopiaTel +251 17239525Email almiay2005@gmail.comBackground: The presence of widespread lung microvascular circulation and abundant connective tissue with a large reserve raises the possibility that the lung may be a target organ of the pathologic processes induced by type 2 diabetes. Pulmonary function tests (PFTs) are noninvasive medical tests that show how well the lungs are working.Objective: The aim was to compare pulmonary function tests (PFTs) and their associated factors among type 2 diabetic patients and non-diabetics at Jimma Medical Center (JMC).Methods: A comparative cross-sectional study was conducted at JMC, Jimma, Southwest Ethiopia among 298 study participants from April 1 to May 30, 2019. A face-to-face interview with semi-structured questionnaire was conducted. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of FEV1/FVC, peak expiratory flow (PEF), and forced expiratory flow (FEF25− 75) were recorded by using a digital Spirometer. Independent samples t-test, simple and multiple linear regression analysis were used.Results: The present study indicated that means of the PFTs among type 2 diabetics were significantly reduced when compared to their matched non-diabetics (FVC (%) (m=73.7± 13.8 vs m=93.8± 12.3), FEV1 (%) (m=76.4± 13.4 vs m=93.3± 12.4), FEV1/FVC (%) (m=78.99± 11.4 vs m=96.6± 9.33), PEF (L/s) (m=3.91± 0.28 vs m=5.03± 0.35), and FEF25– 75 (L/s) (m=2.89± 0.75 vs m=3.39± 0.82)). This study also indicated that body mass index (BMI) (β=− 1.93, P< 0.001) and fasting blood sugar (FBS) (β=− 0.22, P< 0.001) were negative predictors of FVC%. BMI (β=− 1.93, P< 0.001) and FBS (β=− 0.29, P< 0.001) were negative predictors of FEV1%. BMI (β=− 1.403, P< 0.001) was a negative predictor of mean FEV1/FVC. BMI (β=− 1.39 P< 0.001) and FBS (β=− 0.15, P< 0.001) were negative predictors of mean PEF (L/s). BMI (β=− 0.075, P< 0.001) and FBS (β=− 0.075, P< 0.001) were negative predictors of FEF25– 75 (L/s).Conclusion: The present study showed that there were significantly reduced mean scores of FVC, FEV1, FEV1/FVC, PEF, and FEF25– 75 among type 2 diabetic patients as compared to non-diabetic participants. The FBS and BMI were independent risk factors of the PFTs among the diabetics, unlike among non-diabetic participants.Keywords: type 2 DM, PFTs, associated factors, Jimma Medical Center

Ayichew Seyoum,1 Kedir Urgessa,1 Tesfaye Gobena2 1Department of Medical Laboratory Sciences, 2Department of Environmental Health Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia Background: Ethiopia constitutes approximately 1% of the world’s population but it contributes to 7% of the world’s HIV/AIDS cases. Malaria is the most important disease of humans in terms of mortality, morbidity, and long-term effects upon quality of life, especially in Ethiopia. Despite the ongoing efforts and progress in fighting HIV/AIDS and malaria, these diseases remain the leading cause of morbidity and mortality in the country. In this study, we assessed community knowledge and the role of health extension workers on integrated diseases among households in East Hararghe Zone, Ethiopia. Methods: A community-based multistage stratified cross-sectional study was conducted from February to March 2014 among six woredas of the East Hararghe Zone, Ethiopia. The data were collected from 2,319 households using structured questionnaires. A total of 12 well trained data collectors conducted a face-to-face interview with the head female of each household. The data entered on Epi-Data version 3 were then exported for analysis on STATA version 11. Results: Multivariable logistic regression showed that among the 1,967 (92.7%) study participants who scored above the mean value in regard to the overall knowledge of HIV/AIDS, study participants who could read/write (adjusted odd ratios [AOR] =2.54, 95% confidence interval [CI]: 1.15–5.61, P=0.021) and worked as a daily laborer (AOR =0.40, 95% CI: 0.17–0.91, P=0.029) were significantly associated with comprehensive knowledge about HIV/AIDS. Meanwhile, out of the 2,172 eligible study participants for the malaria interview, 934 (43%) scored above the mean in regard to the overall knowledge about malaria. Rural residents (AOR =0.27, 95% CI: 0.17–0.44, P45 years of age (AOR =1.44, 95% CI: 1.04–1.99, P=0.030), and single marital status (AOR =3.81, 95% CI: 1.97–7.37, P

The importance of community-based watershed management for food security and rural development is increasingly recognized. However, the comprehensive nature of the strategy is not well understood. The study examined the perspectives of different stakeholders and their level of coordination in implementing the watershed approach. Data was collected from 63 individuals with diverse professional backgrounds at different organizational hierarchies and 337 farmers from three different micro watersheds. The findings of the study showed that professionals and farmers have different views. About 36.0% of professionals and 12.6% of farmers see it as a holistic strategy for rural development, 7.0% of professionals and 40.0% of farmers see it as a way to conserve soil and water, and the rest see it as natural resource management. The chi-square test analysis revealed significant correlations between organizational affiliation, hierarchies, work experience, and field of study among professionals at significance levels of 0.05 and 0.01, with no significant differences observed among farmers in the three micro watersheds. The diverse viewpoints of professionals and farmers highlight the inadequate understanding and lack of consensus among stakeholders regarding watershed management principles, hindering the transformation of this strategy into a comprehensive food security initiative. The study also revealed limited collaboration among various organizations and departments in supporting the management of local watersheds, which can be attributed to the lack of accountability. This highlighted the need for improved collaboration and communication among different groups involved in implementing watershed management plans. The study also identified the need for capacity-building to enhance the knowledge and skills of professionals and farmers involved in watershed management. To effectively use the watershed approach as a holistic strategy to address food security, fostering greater coordination and communication among stakeholders, robust institutional arrangement, education, and awareness-creation initiatives must be strengthened at all levels. [ABSTRACT FROM AUTHOR]

Abstract Background In Ethiopia, despite the increasing availability of long-lasting insecticide treated nets (LLINs), the LLINs use among LLINs owning households has not been satisfactory. Identifying the circumstances and the associated factors is necessary to achieve the Millennium Development Goal targets. We aimed to assess barriers related with LLIN use at the household level. Methods A cross sectional survey was conducted in Kersa Demographic Surveillance and Health Research Center (KDS-HRC) from October to November 2010. A total of 2867 households were selected from a surveillance database using a simple random sampling technique. The data were collected by interviewing women, direct observation of LLINs conditions and use, and in-depth interviewing of key informants. Multivariate analysis was used to determine independent predictors of LLIN non-use. Results Of the total surveyed households, 65.5% (1879) had at least one LLIN, but 33.5% (630) LLINs owned households had used at least one LLIN the night before the survey. Low educational level of women, low awareness on malaria prevention, unavailability of separate sleeping room, LLIN colour preference, and unavailability of enough LLINs to the household members were the main barriers to LLIN use. A supplementary qualitative interview with key informants also identified that poor condition of LLINs; undermining the extent of malaria; and using the LLIN for other purposes as the main reasons for non-use. Conclusions This study indicates that only about one third of LLIN owned households are actually using at least one LLIN for protection against mosquito bite. Thus, majority of the residents are at higher risk of mosquito bite and acquiring of malaria infection. Households living in fringe zone are not benefiting from the LLIN protection. Further progress in malaria prevention can be achieved by specifically targeting populations in fringe zones and conducting focused public education to increase LLIN use.

Background: Occupational or work-related injuries are mostly common among hospitals' sanitary workers (SWs) in developing countries like Ethiopia. This is due to improper practiced of devices, unhygienic workplace, neglected and undermined risk factors, as well as due to lack of policy initiatives; but not studied well., Objective: The aim of the study was to assess the occupational injuries and its associated factors among SWs in public hospitals, eastern Ethiopia: A Modified Poisson regression Model Analysis., Methods: An institution-based cross-sectional study was conducted in eight public hospitals in eastern Ethiopia from May 2023 to August 30th, 2023. Out of fourteen hospitals, eight of them were selected randomly. Eight data collectors and 4 supervisors were assigned. Face-to-face interview was conducted. Eight hundred hospital SWs were recruited for the study. Occupational injury was measured using Boolean logic questionnaire either YES [1] or NO [0] for the last 12 months and the 7 days. Descriptive statistical was used for means, medians, standard deviations, and frequencies, proportions, and percentages. Modified Poisson regression was used to explore the relationship of outcome and independent variables. Accordingly, bi-variable analysis was performed to estimate unadjusted prevalence ratio (UPR). While, multi-variable model was used adjusted PR(APR) for those variables have significant values of p ≤0.20 at bi-variate analysis with confidence interval of 95% (CI:95%)., Result: Out of eight hundred nine SWs, 729(90.1%) were participated on the study. Self-reported occupational injuries among SWs in the last 12 months were 44.0% (95% CI: 40.4, 47.7). Of these, 92.2% (95%CI: 88.7,94.90%) and 7.8% (95%CI: 5.1, 11.3%) occupational injuries was reported from the cleaners and waste collectors, respectively. The model found that SWs those acquired diseases after recruited in the hospitals (APR:1.3;95%CI:1.1,1.6), those had sleeping disorder (APR:1.2;95%CI:1.0,1.), those had workload (APR:1.3; 95%CI:1.0, 1.8), those exposed with occupational hazards (APR:1.4; 95%CI:1.3, 1.7) were at the risk of occupational injuries as compared to their counter parts. Meanwhile, SWs those didn't get supervision (APR: 1.0;95%CI: 1.0, 1.2) and those non-adherence to personal protective equipment (PPE) (APR:1.3;95%CI:1.0,1.5) were more likely to at the risk of occupational injuries., Conclusion: The current study concluded that there was a high prevalence of occupational injuries among SWs in the current selected public hospitals. The study also found that non-compliant with PPE, work load, sleeping disorders, attitude towards workplace safety and unsupervised activities and working in high-risk environment tends to increase the risk for occupational injuries. In addition to occupational injuries the study found that SWs those acquired occupational diseases such as asthma, respiratory tract problems, allergy, infections, kidney problems and dermatology problems after recruited in hospitals., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tolera 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.)

Background: Hospital cleaners face a complex and varied work environment due to several potentially dangerous circumstances, including the risk of getting injured by sharp objects and being subjected to various ergonomic and physical risks. They thus acquire a combination or co-occurrence of outcomes associated to their line of work. In this study it stands for occurrence of occupational injuries and musculoskeletal disorders (MSDs) during study period, which has not been explored in developing countries like Ethiopia, particularly among hospital cleaners., Objective: To assess the prevalence of co-occurrence of occupational outcomes and associated factors among hospital cleaners, Eastern Ethiopia., Methods: A cross sectional study was conducted on 741 cleaners in eight hospitals in eastern Ethiopia from May, 2023 to 30th August, 2023. Face-to-face interview was conducted. The data quality was maintained by designing standard questions that preserved both external and internal validity. The entered data was exported from Epi-Data 3.1 to Stata 17MP. Descriptive statistic was used to characterize one variable, While, binary logistic regression was used to explore the relationship of the predictors. At binary analysis variables having a p-value of < 0.20 were candidates for multivariate logistic regression. The crude odds ratio and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were presented. Those variables having < 0.05 were reported. The variance inflation factor used to test multicollinearity. While, Hosmer-Lemeshow goodness-of-fit-test was applied for model fit., Result: From total of 741 hospital cleaners, 679 (91.63%) of them were responded. The prevalence co-occurrence of occupational outcome among cleaners was 25.04% (95%CI: 21.82, 28.47). The multivariate logistic regression shows that those had workload (AOR:2.78, 95%CI: 1.25,6.17), those worked more than 8r/day (AOR:3.45, 95%CI:2.34,6.32), those have sleeping disorders (AOR: 4.61,95%CI: 2.89, 8.03), those had work stress (AOR:2.05, 95%CI:0.98,4.29), those highly exposed with hazards (AOR: 4.22, 95%CI:2.40, 7.45) and those had poor knowledge of risk (AOR:2.41, 95%CI:1.06, 5.50) were more likely increase the odds of co-occurrence of occupational outcome as compared to their counterparts., Conclusion: The current study concluded that one-fourth of the co-occurrence of occupational outcomes was reported among hospital cleaners. The study also found that lack of supervision, workload, working more hours per a day, severely presence of occupational hazards, lack of regular job rotation, the sleeping disorders and having work stress all increased the odds of co-occurrence occupational outcome., Competing Interests: Declarations Consent for publication Not applicable. Methods The authors declared that all methods were carried out accordance with relevant guidelines and regulations and valid previous studies. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: The quality of health data is not satisfactory in Low and Middle Income Countries (LMICs). Haramaya University, in collaboration with Ministry of Health and Regional Health Bureau, conducted an implementation research in selected public health facilities and administrative units. This research was aimed to test the onsite training-mentoring (OTM) intervention and adaptation of the implementation strategy to improve the routine health information system (RHIS) data quality in the context of public health sector., Methods: An interrupted time series design with an onsite training-mentoring intervention was used to improve data quality in public health sector of Jigjiga Woreda, eastern Ethiopia from July 2021 to June 2022. Both the pre and post intervention assessments data were collected by experienced and trained public health professionals using interviewer guided self-administered interview, record review and observation data collection techniques. Data were analyzed using descriptive, bivariate, and multivariate logistic models to identify predictors of data quality., Results: The overall data accuracy was increased from 88.12% before to 95.0% after intervention; and it was above 90% in all the facilities. The overall data content completeness was increased from 75.75% to 89.9%, though it varied among the facilities. The timeliness and report completeness were 100% in all the facilities. The odds of those health workers who had poor knowledge were less likely to ensure data quality (AOR = 0.39; 95%CI: 0.19, 0.83) than their counterparts., Conclusions: The intervention was brought substantial changes of data quality in the study setting. Knowledge of the workers towards data quality is a crucial factor to ensure data quality in the sector. Thus, collective efforts is required to continue this tested intervention to ensure the quality of the routine health information system in the lower levels of the sector., Competing Interests: Declarations Ethics approval and consent to participate The Haramaya University College of Health and Medical Sciences Institutional Health Study Ethics Review Committee (IHRERC) granted ethical approval () and permission for this research project. Permission was obtained from all concerned health facilities and offices. All of study participants were involved, after obtaining their informed consent; and confidentiality were ensured during and after the data collection. This study was conducted in consideration of COVID 19 pandemic intervention measures. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Campylobacter is a major zoonotic foodborne pathogen that poses a significant public health threat, particularly among children and immunocompromised individuals. However, data on the occurrence and sources of Campylobacter infection remain scarce in Ethiopia. This study assessed the occurrence, diversity, and relationships between Campylobacter from diarrheic children and potential exposure sources using whole-genome sequencing. Through case-based tracing, animal, food, and environmental samples were collected from Harar town and Kersa district between November 2021 and January 2023. Campylobacter was identified using selective media, and DNA was extracted and sequenced with the Illumina NextSeq 550 instrument. Sequence reads were analysed using bioinformatics tools. The overall Campylobacter prevalence in the exposure sources was 5.5%, with 6.0% in urban and 5.0% in rural settings. Campylobacter detection was 1.8 times more likely in household samples (8.7%; OR = 1.8; 95% CI: 0.7-4.5) than in samples from marketplaces. The occurrence of Campylobacter in food was 4.2%, with no significant differences across the meat, milk, and other food categories. The likelihood of Campylobacter contamination in the environment was 5.8 times higher in the presence of poultry (17.7%; OR = 5.8; CI: 1.1-30.6) compared to shoats. Sequence analysis identified a low Campylobacter spp. diversity comprising only C. jejuni and C. coli, which were characterized by 8 distinct sequence types (STs). Phylogenetically, the majority of the sequenced case isolates were clustered with isolates from either caretakers, environmental exposures, or both. In conclusion, Campylobacter was detected in various exposure sources of diarrheic children, and its occurrence did not differ significantly between Kersa and Harar or among food items. The majority of isolates shared MLST profiles and clustered together, demonstrating the involvement of multiple vectors in the transmission of the pathogen. Genome-based integrated studies supported by an attribution model are recommended to determine the relative contribution of each source., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Belina 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.)

Foodborne pathogens (FBPs) are transmitted principally through the consumption of contaminated food or drinking water and pose a remarkable public health risk, particularly in low-income countries. A cross-sectional study was conducted between November 2021 and January 2023 to estimate the prevalence, co-occurrence, and monthly patterns of FBPs in the physical exposures of children with diarrhea in Harar town and Kersa district, Ethiopia. Animal, food, and environmental samples were collected from direct or indirect contact sites of children with diarrhea. The isolation and identification of FBPs, including nontyphoidal Salmonella (NTS), diarrheagenic E. coli (DEC), and Shigella , was performed using selective and deferential culture media and a series of biochemical tests. Among the 438 analyzed samples, the overall prevalence of these pathogens was 18.3%, with 3.9% co-occurrence and 14.4% single pathogen occurrence rates. The highest prevalence was observed in wastewater (40.9%; AOR = 3.3; 95% CI: 1.1-10.1). The pathogen detection rate in food was 17.9% (AOR = 1.2; 95% CI: 0.4-3.6), with no significant difference between animal-sourced and other food categories. The occurrence rates of NTS, DEC, and Shigella in the meat samples were 13.9%, 5.4%, and 6.5%, respectively. Interestingly, DEC and Shigella were detected in cooked food. Moreover, Shigella was detected in drinking water (5%) and other water sources (10%). A significantly higher prevalence of FBPs was detected in poultry than in cattle and camel feces. This study revealed fluctuations in the monthly occurrence patterns of FBPs, with a peak of 37.1% during the dry season. In conclusion, the study revealed a high prevalence of FBPs, with no significant differences between rural and urban areas or food and water sources, highlighting the need for food safety measures in both settings. Further studies with larger sample sizes and advanced diagnostics are recommended to determine the relative contribution of each source., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: In the sanitation sector, occupational injuries among sanitary workers (SWs) are prevalent due to hazardous working conditions and poor environmental surroundings. Despite the significant risks faced by these workers, the issue has received limited attention, and no comprehensive global meta-analysis on occupational injuries among sanitary workers has been conducted to date., Objective: In this study, we aimed to conduct a systematic review and meta-analysis of occupational injuries among sanitary workers globally from 2000 to 2023., Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed for the screening process, and the Population, Intervention, Comparison, Outcome and Study (PICOS) framework was to formulate search questions. Published articles from 2000 to 2023 were retrieved using various search engines. The keywords used were as follows: "Occupation Job Injuries" *OR "Work Injuries" *OR "Occupational Injuries" AND "Sanitary workers" ("Street sweepers" [SS] *OR "health facilities cleaners" [HCFC]) *OR "Solid waste collectors" [SWCs] *OR "Sewage workers" [STW] were used. Data analysis was performed using Stata Version 17MP. The overall effect size was calculated using the random-effects model combined with the restricted maximum likelihood (REML) approach, known as the Random-Effect REML Model. A 95% confidence interval (CI: 95%) was applied, and a p -value of less than 0.05 was considered statistically significant., Results: Studies were sourced from PubMed ( n  = 34), Medline ( n  = 39), Embase ( n  = 23), Global Health ( n  = 37), other databases ( n  = 54), and review studies ( n  = 10), resulting in a total of 197 studies. Of these, only 23 studies fully met the inclusion criteria. Among 8,138 sanitary workers (SWs), 4,469 (55%) were solid waste collectors (SWCs), 2,317 (28%) were street sweepers (SS), 1,144 (14%) were health facility cleaners (HCFC), and 208 (3%) were a combination of SS and SWCs. Globally, the pooled prevalence of occupational injuries among SWs was 36.49% (95%CI: 0.29-0.45). Specifically, 39.14% (95%CI: 0.24-0.53) prevalence was observed in high-income countries, while 35.22% (95%CI: 0.36-0.44) was reported in low-income countries. Year-by-year analysis showed a prevalence of 36.70% (95%CI:0.28-0.46) from 2001 to 2015 and 36.45% (95% CI:0.25-0.48) from 2016 to 2022. The overall heterogeneity of the studies was substantial, with an I-squared value of 90.03% and a heterogeneity index of 214.43 ( p < 0.05), indicating statistically significant heterogeneity among the eligible studies., Conclusion: This systematic review and meta-analysis revealed that sanitation and hygiene workers face an increased risk of occupational injuries, largely due to insufficient attention to occupational safety and health services in their work environments. To mitigate these risks, the review recommends policy amendments, national regulations, and international initiatives aimed at improving occupational health and safety (OHS) services for these workers. These measures are crucial for reducing the prevalence of work-related injuries in the sanitation sector., 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 Tolera, Gobena, Assefa and Geremew.)

Plastic pollution poses a significant threat to the environment and human health on a global level. This study aimed to investigate plastic pollution in the Harari region of Ethiopia. The result indicated that 62% of respondents demonstrated good knowledge about plastic waste, and 59% of them perceived plastic waste as harmful. Polyethylene terephthalate, high-density polyethylene, polyvinyl chloride, low-density polyethylene, polypropylene, polystyrene, and polycarbonates were the types of plastic waste identified. Being female (AOR = 1.82), aged 15-45 (AOR = 1.82), married (AOR = 1.83), and having families >3 (AOR = 2.15) were significantly positively associated with good plastic waste management practice. Being illiterate (AOR = 0.52), and having poor knowledge about plastic waste (AOR = 0.54) were significantly negatively associated with poor management practice. The findings indicated that the Harari region is prone to adverse health and environmental effects from plastic pollution. Policies restricting plastic use, training municipal waste collectors and health extension workers, and improving public awareness are indispensable.

Background: Foodborne diseases (FBDs) represent a significant risk to public health, with nearly one in ten people falling ill every year globally. The large incidence of foodborne diseases in African low- and middle-income countries (LMIC) shows the immediate need for action, but there is still far to a robust and efficient outbreak detection system. The detection of outbreak heavily relies on clinical diagnosis, which are often delayed or ignored due to resource limitations and inadequate surveillance systems., Methods: In total, 68 samples of non-typhoidal Salmonella isolates from human, animal and environmental sources collected between November 2021 and January 2023 were analyzed using sequencing methods to infer phylogenetic relationships between the samples. A source attribution model using a machine-learning logit-boost that predicted the likely source of infection for 20 cases of human salmonellosis was also run and compared with the results of the cluster detection., Results: Three clusters of samples with close relation (SNP difference < 30) were identified as non-typhoidal Salmonella in Harar town and Kersa district, Ethiopia. These three clusters were comprised of isolates from different sources, including at least two human isolates. The isolates within each cluster showed identical serovar and sequence type (ST), with few exceptions in cluster 3. The close proximity of the samples suggested the occurrence of three potential outbreaks of non-typhoidal Salmonella in the region. The results of the source attribution model found that human cases of salmonellosis could primarily be attributed to bovine meat, which the results of the phylogenetic analysis corroborated., Conclusions: The findings of this study suggested the occurrence of three possible outbreaks of non-typhoidal Salmonella in eastern Ethiopia, emphasizing the importance of targeted intervention of food safety protocols in LMICs. It also highlighted the potential of integrated surveillance for detecting outbreak and identifying the most probable source. Source attribution models in combination with other epidemiological methods is recommended as part of a more robust and integrated surveillance system for foodborne diseases., (© 2024. The Author(s).)

Background: Best practice of infection prevention and control (IPC) is a hallmark for the patient care in health care settings, but it is a major problem in developing countries like Ethiopia where resources are limited. Ethiopia Federal Ministry of Health working to strengthen its IPC program, but still it there is no organized study conducted on assessment of performance gaps and implementation challenges of IPC practice faced by hospital staffs particularly among sanitary workers (SWs) at public hospitals inline to national and international guidelines., Aim: This study focuses on compliance and determinants of IPC among sanitary worker in public hospitals in eastern Ethiopia: A cross sectional study design., Method: A cross-sectional study was conducted among 809 SWs and eight IPC experts in public hospitals, eastern Ethiopia, from May to August 2023. A standard questionnaire was used to collect data. Face-to-face interview was conducted. Ten (10) question pursued to answer YES/NO were prepared. The cut point for categories of IPC practice was 1: Good (16-20 scores), 2: Fair (10-15 scores), and 3: Poor (<10 scores). The cut point for compliance and noncompliance of IPC practice among hospitals was mean (500.1). Multi-level ordinal logistic regression models was applied to explore the association of dependent and independent variables at individual level (Model 1), hospital level (Model 2) and at both (Model 3). Crude odds ratio (COR) and adjusted odds ratio (AOR) at 95% confidence interval (CI) were used to report the result., Result: The compliance of IPC practice among SWs was 36.21% (32.72, 39.82%). The Multilevel ordinal logistic regression model shows that SWs who have good knowledge of IPC trend (AOR: 4.70, 95% CI: 2.11-10.46), SWs who are not addictive with alcohol (AOR: 2.35, 95% CI: 1.15,4.78) and chew Khat (AOR: 1.62, 95% CI: 1.06,2.46) and smoke cigarette (AOR: 3.15, 95% CI: 2.35-5.41), and SWs without job stress (AOR: 1.46, 95% CI: 0.86-2.48) were more compliant to IPC practice. Similarly, those who do not have workload (AOR: 2.74, 95% CI: 1.56-4.82), work <8 h/day (AOR: 1.46, 95% CI: 0.92-2.30), and those who have good social recognition in hospitals (AOR: 6.08, 95% CI: 4.24-8.71) were more likely to increase the compliance of IPC practice among SWs. The multilevel random-effect model revealed 93.71% of the variability of compliance of IPC practice explained by both individual and hospital level factors., Conclusion: The overall study found that inadequate IPC practice was reported among SWs as well as by IPC experts due to poor knowledge of IPC trend and individual behaviors and working environment. Thus, the study advised that hospitals have to develop and establish IPC implementation guidelines in order to solve the concerns among these groups; national IPC office should follow its implementation across health care settings particularly at public hospitals., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Background: Hospital sanitation workers (SWs) are exposed to numerous occupational hazards due to workplace conditions such as unsafe and unhygienic working environment in the hospitals. Therefore, knowing magnitude, types and source of occupational hazard exposures with their determinants are very significant for further mitigations., Methods: Hospital based cross-sectional study design was conducted in public hospitals, eastern Ethiopia from 1st May to August 30th, 2023. 809 SWs participated. Data was entered into Epi Data Version 3.1 and Stata 17MP version used for analysis. Descriptive analysis was applied to describe the data. While, multilevel logistic regression was explored to determine the association between outcome and independents among at individual level (model 1), at hospitals (model 2) and combination of the two (model 3). The crude odds ratio (COR) and adjusted odds ratio (AOR) for models 2 and 3 were reported. Variables with an AOR with a 95% confidence interval (CI) at a p-value < 0.05 were reported., Result: Out of 809 SWs, 729 (90.11%) responded. The overall magnitude of self-reported occupational hazard exposures among SWs was 63.65% (95% CI 0.60-0.67). Of this, biological, chemical, and ergonomic hazards accounted for 82.44%, 74.76%, and 70.92%, respectively. The multilevel logistic regression shows that having social recognition (AOR: 0.37, 95% CI 0.14, 0.91), neutral attitude (AOR: 0.48, 95% CI 0.17, 1.41) as compared to negative attitude. The model also found that SWs those supervised could reduce the likelihood of occupational hazard exposures by 50% times (AOR: 0.50, 95% CI 0.18, 1.38) as compared to non-supervised SWs. The final model predicted the variation of occupational hazard exposures among sanitary workers from the hospitals to hospitals was 26.59%., Conclusions: The concluded that hospital sanitary workers are facing biological, chemical, ergonomic, physical, psychological, mechanical, and electrical hazards. This study's findings predicted that dissatisfied with their environment, working more than 8 hr per a day,  a negative attitude towards workplace risks and inadequate supervision may serve as contributing factors for the likelihood of occupational hazard exposures among these groups. Thus, the study suggested that hospitals could reduce these hazard risks if they implement the Risk Assessment and Safety Management (RASM) model, which includes multi-modal strategies, indicators and tripartite philosophy., (© 2024. The Author(s).)

Background: Schistosomiasis is a neglected tropical disease and an important parasite negatively impacting socio-economic factors. Ethiopia's Federal Ministry of Health targeted the elimination of schistosomiasis infection in school-aged children by 2020. However, Schistosoma mansoni still affects approximately 12.3 million school-aged children in Ethiopia. Although the study was conducted in some regions of the country, previous studies were conducted on urban school children and were limited to the burden of infection. Overall, there is a lack of information about schistosomiasis in eastern Ethiopia, particularly among school children. Therefore, this study aimed to assess the prevalence and factors associated with Schistosoma mansoni infection among primary school children in Kersa district, Eastern Ethiopia., Methods: A cross-sectional study was conducted among 419 school children using systematic random sampling from April 10 to May 09, 2019. The stool samples were collected and examined using the Keto-Katz method. A structured and pretested questionnaire was used to collect data from participants. Data were entered using Epi-Data version 3.1 and analysed using SPSS version 24. A bivariable and multivariable logistic regression analyses were used to identify factors associated with Schistosoma mansoni infection. P-value < 0.05 and adjusted odds ratio (AOR) (95% confidence interval (CI)) were used to identify statistically significant associations., Results: This study's overall prevalence of S. mansoni was 19.4% (95% CI [16-23]). Absence of the latrines in household (AOR = 2.35, 95% CI [1.25-4.38]), swimming in the river (AOR = 2.82, 95% CI [1.33-5.88]), unprotected water sources (AOR = 3.5, 95% CI [1.72-7.10]), irregular shoe wearing habits (AOR = 2.81, 95% CI [1.51-5.23]), and water contact during cross of river (AOR = 2.192; 95% CI [1.113-4.318]) were factors independently associated with S. mansoni infection., Conclusion: Schistosoma mansoni infection remains a public health problem in the study area. Using a latrine in each household, using protected water, wearing shoes regularly, and reducing water contact were necessary to control Schistosoma mansoni infection., Competing Interests: The authors declare there are no competing interests., (©2024 Aliyi et al.)

Background: Heart failure is a serious medical condition that occurs when the heart is unable to pump sufficient blood to meet the needs of the tissues. Good self-care is an essential behavior in long term management and maintenance of physiologic stability, better medical and person-centered outcomes. Poor self-care behavior deteriorates the outcomes of heart failure patients. However, there were no sufficient evidences that illustrate the topic in the country, including the study area., Methodology: Institutional based cross-sectional study was conducted among 250 heart failure patients from July 5-August 4, 2021. All adult heart failure patients who fulfill the inclusion criteria and have appointment during study period were included in the study. Interview and medical chart review was used to collect data. Epidata version 3.1 and SPSS version 20 were used for data entry and analysis respectively. Bivariate and multivariable analysis was computed. The model fitness was checked by Hosmer and Lemeshow test., Results: From the total patients, 240 were interviewed with the response rate of 96%. Among these, 140(58.3%) [95% CI: 52.6, 64.9] had poor self-care behavior. Age>54: 9.891 [2.228, 43.922], poor knowledge: 6.980[1.065, 45.727], depression: 4.973[1.107, 22.338], low social support: 6.060[1.373, 26.739], insomnia: 4.801[1.019, 22.622] and duration with heart failure <1 year: 5.782[1.438, 23.247] were factors associated with poor self-care behavior., Conclusion: In this study, more than half of participants attending at Wachemo University Nigist Eleni Comprehensive Specialized Hospital in outpatient cardiac follow-up unit had poor self-care behavior. Of the study variables, older age, poor knowledge, depressive symptoms, low social support, insomnia and short duration with heart failure were related with poor self-care behavior. Thus, the findings highlight importance of assessing level of self-care behavior and implicate direction to take action to enhance level of self-care behavior., (© 2024. The Author(s).)

Background: Hyperglycemia in pregnancy (HIP) is a significant medical complication affecting pregnant women globally and is considered a public health burden due to the negative outcomes it can cause for both mother and infant. The aim of this systematic review and meta-analysis was to examine the prevalence, risk factors, and feto-maternal outcomes of HIP in Ethiopia., Methods: To gather relevant information for this study, both published and unpublished studies were searched for in several major databases, including PubMed, Embase, HINARI, Web of Science direct, and Google Scholar, as well as other sources. The Joanna Briggs Institute (JBI) tool was used to evaluate the methodological quality of the findings from these studies. Data was then extracted and summarized using a template in Microsoft Excel software, and the extracted data was analyzed using Stata software version 16.0. If significant heterogeneity was found between studies, subgroup analyses were conducted to further examine the data., Result: Eighteen studies were included in this systematic review and meta-analysis, involving a total sample size of 50,816 pregnant women in Ethiopia. The prevalence of HIP among pregnant women varied considerably across the primary studies, ranging from 0.4 to 26.2%. The pooled prevalence of HIP among pregnant women in Ethiopia was found to be 6.9% (95% C 2.2-11.6). Pregnant women with a family history of diabetes had 2.5 times higher odds of developing HIP compared to those without a family history of diabetes (OR = 2.49; 95% CI = 2.02, 2.96). However, there was no significant association found between HIP and maternal obesity (OR 2.31, 95% CI = 0.85, 3.78) or previous history of abortion (OR 3.89; 95% CI 0.85, 6.94). The common fetal outcomes associated with HIP were admission to the intensive care unit (46.2; 95% CI 27.4, 65.1), macrosomia (27.3%; 95% CI 9.4%, 45.1%), and preterm birth (16.9; 95% CI 12.5, 21.3). Additionally, hypertensive disorders of pregnancy (28.0%; 95% CI 15.2, 40.8) and operative delivery (51.4%; 95% CI 35.9, 66.8) were more common among women with HIP in Ethiopia., Conclusion: Although there was some variation between studies, the meta-analysis revealed that approximately seven out of 100 pregnant women in Ethiopia had HIP. A family history of diabetes was found to be a significant predictor of HIP in Ethiopia. Additionally, HIP was associated with various serious adverse outcomes for both mothers and infants in Ethiopia. These findings highlight the need for national guidelines to ensure that pregnant women are uniformly screened for HIP., (© 2024. The Author(s).)

Background: There is a concern that job dissatisfaction among health extension workers (HEWs) reduces the benefit of investment in the execution of health extension programs. Hence, the purpose of this study was to explore the level of job satisfaction and factors affecting it among the HEWs in the West Hararghe Zone, Oromia Regional State, eastern Ethiopia., Method: An institutional-based cross-sectional study was conducted among 416 randomly selected health extension workers from 20 September 2020 to 20 October 2020. A pretested, structured questionnaire was used to collect the data. STATA 14.2 was used for data analysis. Bivariable and multivariable binary logistic regression analyses were also performed. Statistical significance was set at P  < 0.05., Results: The overall level of satisfaction of health extension workers was 51.8% [95% confidence interval (CI): 46.97%, 56.6%]. Earning more than 5,260 ETB as salary [adjusted odds ratio (AOR) = 1.69, 95% CI: 1.01, 2.85], working more than 10 km from the district town (AOR = 1.59, 95% CI: 1.01, 2.53), receiving supportive supervision (AOR = 1.64, 95% CI: 1.06, 2.55), and not living with parents (AOR = 1.94, 95% CI: 1.24, 3.04) were significantly associated factors with HEW job satisfaction., Conclusion: Nearly half of the health extension workers were dissatisfied with their jobs. Supportive supervision, compensation, distance, and parental home location were all predictors of job satisfaction. It is critical to establish intervention tactics that may satisfy and motivate HEWs to expand health coverage, strengthen health extension programs, and improve service delivery., 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., (© 2024 Aman, Gobena, Hawulte, Maruta, Debella, Eyeberu, Abrahim, Wakjira and Mussa.)

Objectives . Sanitary workers are more likely to experience musculoskeletal disorders (MSDs) due to a lack of ergonomics principles and poor job design. Thus, this systematic review and meta-analysis aimed to quantify MSDs among sanitary workers. Methods . The PRISMA and PICOS protocols were used for flow diagrams and review questions, respectively. Articles published between 2000 and 2022 were eligible. The keywords '(Musculoskeletal Disorders) AND (Solid waste collectors *OR Street sweepers *OR Sewage workers *OR health facilities cleaners)' and MeSH terms were utilized. The data were analyzed using STATA version 17 with a 95% confidence interval (CI). Results . A total of 158 papers were qualified, with 26 studies from 17 countries and a total of 6586 sanitary workers. The global prevalence of MSDs among sanitation workers was 40.52% (95% CI [32.47, 48.67]; p  < 0.05). It was 43.32% (95% CI [31.98, 54.68]; p  < 0.05) in high-income countries and 38.58% (95% CI [26.94, 50.18]; p  < 0.05) in low-income countries. By subgroup analysis, it was 45.12% (95% CI [32.57, 57.67]; p  < 0.05) for solid waste collectors, which is the highest prevalence among other workers. Conclusion. Current evidence shows that sanitation workers have a higher prevalence of occupationally associated MSDs, which might be lowered by using ergonomic work design principles.

Background: Chronic kidney disease (CKD) is the leading cause of morbidity and mortality in diabetic patients. However, limited evidence is available about its incidence and predictors in Ethiopia, specifically in the Harari region., Methods: A retrospective follow-up study was conducted among 520 diabetes patients who followed their treatment at governmental hospitals in the Harari region between 1 September 2012, and 30 May 2022. The risk of developing CKD was calculated with a 95% CI, and the risk was stratified by type of diabetes mellitus. Predictors of CKD were determined using the Gompertz regression model with the baseline Cox model., Results: Data from 494 patients were included in the final analysis with 26 (5%) excluded. A total of 51 patients (10.32%) developed CKD over the 10-year follow-up period with an incidence rate of 2.16 cases (95% CI 1.64-2.84) per 100 person-years of observation. The risk of CKD was increased by three times (AHR: 3.09, 45 95% CI: 1.56, 6.14) among patients older than 60 years and by more than three times (AHR: 3.53, 95% CI: 1.43, 8.71) among patients with diabetes mellitus for longer than 5 years of stay with the diabetes mellitus. Moreover, the risk of CKD was increased four-fold among patients with high-density lipoprotein cholesterol (HDL-C) levels <40 mg/dL (AHR: 3.84, 95% CI, 1.80-8.18) and those with positive baseline proteinuria (AHR: 3.77, 95% CI: 1.43-8.71)., Conclusion: We found that one in ten diabetic patients had developed CKD within 10 years of the diabetes mellitus diagnosis. Advanced age, longer duration of diabetes, lower baseline HDL-C level, and proteinuria had increased the hazards of developing CKD. We recommend a more focused follow-up of older adult patients with advanced disease status at baseline for optimal control of diabetes mellitus that prevents its furthering to CKD., 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 Cheru, Edessa, Regassa and Gobena.)

Acute childhood diarrhea is one of the leading causes of childhood morbidity and mortality in sub-Saharan African countries. Entamoeba histolytica and Giardia lamblia are the common cause of childhood diarrhea in the region. However, there are only few studies on protozoa causing diarrhea in sub-Saharan African countries. This study was conducted to investigate the relative prevalence and explore risk factors of E. histolytica and G. lamblia among diarrheic children of under 5 years in a public hospital of Ethiopia. A retrospective study was conducted among diarrheic children at Hiwot Fana hospital, Ethiopia. Records of all diarrheic children less than 5 years who had sought medical treatment in the hospital from September 1, 2020 to December 31, 2022 were included. Data were collected from 1257 medical records of the children using a structured data-collection format. Data were entered into an Excel sheet and exported into SPSS version 22 for data processing and analysis. Descriptive statistical tests, Chi-square, and logistic region analysis were applied to determine predictors of protozoa infections. Of the 1257 cases, 962 (76.5%) had watery diarrhea and the remaining 239 (19.0%) had dysentery. The combined prevalence of E. histolytica and G. lamblia among diarrheic children was 11.8% (95% CI: 9.6-13.4). As the age of children increased, the frequency of these two protozoan infections was significantly increased compared to children with other causes. There were more diarrhea cases during the summer season including those associated with E. histolytica and G. lamblia . This study revealed that 1 in 10 causes of diarhhea among young children in the study area was likely caused by E. histolytica and G. lamblia . These findings call for community-based safe water and food safety interventions in order to reduce childhood diarrhea caused by protozoan infections in resource-poor settings., 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: People living with HIV (PLHIV) have a greater risk of developing respiratory disorders. The problems are linked to poor socio-economic status, high viral load, low CD4 counts, and antiretroviral therapy. Despite the high prevalence of respiratory disorders, the association between HIV infection and pulmonary function status, as well as the associated factors, is not well established in resource-limited countries., Methods: A comparative cross-sectional study was conducted from September 24 to October 15 2020 at Jimma Medical Center among people living with HIV who were arranged into an age-sex-matched comparison group. Data were collected using a pretested structured questionnaire administered via face-to-face interviews. The collected data included socio-demographic, respiratory, HIV infection, and substance use variables. Pulmonary function tests were conducted using an SP10 spirometer. The collected data were entered and analyzed using SPSS version 26. Independent t-test and multiple linear regressions were carried out to identify factors associated with the pulmonary function status of the study participants., Results: A total of 96 PLHIV and 96 matched control individuals participated in the study. The mean of pulmonary function test parameters among the PLHIV respondents was FVC (l) (67.35 ± 19.12, p0.003), FEV1 s (l) (61.76 ± 16.04, p0.001), and PEFR (50.14 ± 23.32, p0.001), with a significant lowering in the study group. Female sex, respiratory symptoms, duration of HIV, duration of treatment, and khat chewing were associated with lowered FEV1s (l) ( p  < 0.05) in HIV-positive respondents., Conclusion: PLHIV had significantly lower mean lung function parameters than HIV-uninfected participants . As a result, health providers should screen HIV-positive patients with respiratory symptoms, prolonged duration of HIV infection, prolonged treatment, and khat chewing for non-infectious lung disorders while treating them., 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., (© 2023 Azezew, Gobena, Mengstie and Mulat.)

Introduction: Dyslipidemia is a modifiable major risk factor for coronary heart disease. Although, the prevalence of dyslipidemia in high-income countries has been well documented, there is dearth of information about the dyslipidemia among working adults in sub-Saharan African countries including Ethiopia. Therefore, this study aimed to determine the magnitude of dyslipidemia and its associated factors among Haramaya University employees, in Eastern Ethiopia., Methods: A cross-sectional study was conducted among 1,200 university employees aged 20 to 60 years. Study participants were selected using a simple random sampling method. Data were collected face-to-face interview using a semi-structured questionnaire. Dyslipidemia was defined as unhealthy levels of one or more lipid profile such as high-density lipoprotein, low-density lipoprotein, triglycerides or total cholesterol. Data were entered into Epidata version 3.1 and analyzed using STATA version 16.1 software. Modified Poisson regression with robust variance was used to estimate adjusted prevalence ratios (APR) with its 95% confidence intervals. Statistical significance was declared at P-value < 0.05., Results: Of 1,164 participants, 59.6% participants had at least one lipid abnormality (i.e., 57.9% among men and 61.5% among women). Of which, 36.8% had high total cholesterol (TC), 21.6% had low high density lipoprotein cholesterol (HDL-c), 22.4% had high low density lipoprotein cholesterol (LDL-c), and 32.6% had high triglyceride (TG). We found that overweight/obesity, sedentary behavior, alcohol consumption, having hypertension and age 45 and above years were significant predictors of dyslipidemia. However, those who served fruit and vegetables more than five per day had significantly reduced prevalence ratio of dyslipidemia., Conclusions: The high prevalent dyslipidemia among university employees is an important public health problem. Hence, tailored interventions to reduce overweight/obesity, hypertension, alcohol consumption and low fruit and vegetable intake have paramount importance to tackle dyslipidemia particularly among older age., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Motuma 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.)

Diarrheagenic Escherichia coli , Campylobacter , Nontyphoidal Salmonella , and Shigella are common cause of childhood diarrhea in countries like Ethiopia, but data on their sources and coinfection profiles is limited. A cross sectional study was conducted from November 2021 to January 2023 to determine the prevalence, coinfection, and monthly occurrence rates of major diarrheagenic bacteria in diarrheic under five children and asymptomatic contacts at urban and rural settings in Ethiopia. A total of 345 stool samples were collected from; 262 diarrheic children visiting Hiwot Fana Hospital, Kersa, and Adelle Health Centers; and 83 caretakers and siblings through case based contact tracing. Samples were analyzed using standard laboratory procedures and the overall prevalence of enteric pathogens was 26.96%, with the highest isolation rate during the winter and peaks of 73.91% in February. The occurrence of the pathogens in children and tracked contacts was 27.86 and 24.09%, respectively. In our study, 8.53% coinfection and 23.66% single pathogen infection was recorded in diarrheic children. The study also showed 4.51 and 3.88% of diarrhea in children from urban and rural had attributed to bacterial coinfection, respectively. The most prevalent pathogen in diarrheic children was Diarrheagenic E. coli (10.31%), and followed by Campylobacter . On the other hand, Diarrheagenic E. coli was the second dominant bacteria following Shigella in the traced contacts, with prevalence of 8.43% and 9.64%, respectively. Based on the study site, the prevalence of Diarrheagenic E. coli and Nontyphoidal Salmonella was higher in children from urban than those from rural. However, the occurrence of each pathogen had no significant differences ( P  > .05) between settings. The high pathogens occurrence rate in the current study indicates the need for strong control strategies and better child carrying and treatment of diarrheal diseases at both urban and rural settings. Further studies on possible sources and factors attributing to the occurrence of enteric pathogens in children are also recommended., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: Breakfast is regarded as "the most important meal of the day," suggested to positively affect learning in children and adolescent in terms of cognitive and school performance. Yet, studies in LMIC settings are few and show very inconsistent results., Objective: To assess the prevalence and correlates of breakfast skipping and its association with school performance among randomly selected in-school adolescents in Hidhabu Abote Wereda, North Shewa Zone, Central Ethiopia., Methods: A cross-sectional study was conducted from November to December 2020. A total of 422 participants were selected randomly from high schools of Hidhabu Abote Wereda. Data were entered in to Epiata version 3.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate binary logistic regression analysis identified factors that were significantly associated with the breakfast skipping. Odds ratio along with 95% Confidence interval was estimated to measure the strength of the association and level of statistical significance declared at p-value less than 0.05., Results: The magnitude of breakfast skipping was 41.3%, (95% CI (36.6-46.0)]. There was statistically significant association between breakfast skipping and overall academic performance [AOR: 5.18, 95% CI (1.54-7.46)], mathematics performance (3.88, 95% CI (1.34-11.22)], and English language performance scores [2.92, 95% CI (1.38-7.58)]. Being female [AOR = 1.857, 95% CI (1.05-3.27)], household food insecurity [AOR: 2.478, 95% CI (1.36-4.51)], and less maternal education [AOR 1.89, 95% CL (3.38-7.77)] were independently associated with breakfast skipping. The primary reasons given for breakfast skipping were lack of time, lack of appetite in morning, and concerns around weight gain., Conclusion: Nearly half of in-school adolescents were skipped breakfast meals, and reportedly in most cases for reasons unrelated to lack of food access. Students who skipped breakfast had lower levels of school performance., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Both hypertension (HTN) and diabetes are public health concerns in low- and middle-income countries, particularly in sub-Saharan African countries. The co-occurrence of HTN and diabetes is associated with an increased risk of mortality, morbidity, and reduced productivity in the working force. In Ethiopia, there is limited evidence on the co-occurrence of HTN and type 2 diabetes (T2DM). Therefore, this study was conducted to assess the co-occurrence of HTN and T2DM and their associated factors among Haramaya University employees in Eastern Ethiopia., Methods: A cross-sectional survey was conducted among 1,200 employees at Haramaya University using a simple random sampling technique from December 2018 to February 2019. Demographic and behavioral factors were collected on a semi-structured questionnaire, followed by measurement of anthropometry and blood pressure. Blood glucose and lipid profile measurements were performed by collecting 6 ml of venous blood samples after 8 h of overnight fasting. Data were entered into EpiData 3.1 version and analyzed using Stata 16 software. Bivariable and multivariable logistic regressions were applied to observe the association between independent variables with co-occurrence of HPN and T2DM using odds ratio, 95% confidence interval (CI), and p -values of ≤ 0.05 were considered statistically significant., Results: The prevalence of HTN and T2DM was 27.3 and 7.4%, respectively. The co-occurrence of HTN and T2DM was 3.8%. The study found that being older (AOR = 3.97; 95 % CI: 1.80-8.74), khat chewing (AOR = 2.76; 95 % CI: 1.23-6.18), body mass index ≥ 25 kg/m 2 (AOR = 5.11; 95 % CI: 2.06-12.66), and sedentary behavior ≥8 h per day (AOR = 6.44; 95 % CI: 2.89-14.34) were statistically associated with co-occurrence of HTN and T2DM. On the other hand, consuming fruits and vegetables (AOR = 0.10; 95 % CI: 0.04-0.22) and a higher level of education (AOR = 0.39; 95% CI: 0.17-0.89) were negatively statistically associated with the co-occurrence of HTN and T2DM., Conclusion: The co-occurrence of HTN and T2DM was prevalent among the study participants. This may create a substantial load on the healthcare system as an end result of increased demand for healthcare services. Therefore, rigorous efforts are needed to develop strategies for screening employees to tackle the alarming increase in HTN and T2DM in university employees., 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 © 2023 Motuma, Gobena, Roba, Berhane, Worku, Regassa and Tolera.)

Sedentary time is associated with increased risks of detrimental health outcomes. Prolonged sedentary time associates with cardiometabolic risk factors and increased mortality regardless of physical activity. Therefore, the purpose of this study was to examine the associations of sedentary time and cardiometabolic risk factors among university employees in Eastern Ethiopia. A cross-sectional study was conducted among 1200 participants. Data were collected using the World Health Organization STEPS survey instrument, and sedentary behavior questionnaire in hour per day. Sedentary time is the time spent for any duration (minutes per day or hours per day) by considering a local context. Study participants were asked how many minutes or hours they spent in sedentary time at work, their leisure time and in transportation. Finally, the total sedentary time was calculated by the sum of the individual spent in sedentary time at work, leisure, and transportation. Cardiometabolic risk factors were assessed with blood samples analysis and anthropometric measurements. The associations between sedentary time and cardiometabolic risk factors were examined using linear regression models. An adjusted coefficient (β) with the 95% confidence interval (CI) was used to report the results. p value < 0.05 was considered for statistical significance. The mean age of the study participants were (35 ± 9.4 years). Almost half of the study participants, 566 (48.6) were women and 598 (51.4%) were men. As the total sedentary time was increased by one unit, the body mass index increased by β = 0.61; (95% CI 0.49-0.71),waist circumference increased by β = 1.48; (95% CI 1.14-1.82), diastolic blood pressure increased by β = 0.87; (95% CI 0.56-1.18), systolic blood pressure increased by β = 0.95; (95% CI 0.45-1.48), triglycerides increased by β = 7.07; (95% CI 4.01-10.14), total cholesterol increased by β = 3.52; (95% CI 2.02-5.02), fasting plasma glucose increased by β = 4.15; (95% CI 5.31-4.98) and low-density lipoprotein cholesterol increased by β = 2.14; (95% CI 0.96-3.33) with the effects of other variables maintain constant. These findings depict the need for strategies that policymakers should promote physical activity and encouraging the breaking up of prolonged sedentary time to reduce cardiometabolic risk factors among university employees in Ethiopia., (© 2022. The Author(s).)

Visceral leishmaniasis (VL) is a vector-borne protozoan neglected tropical disease. In some parts of Ethiopia, it is a public health problem and its main causative agent is the Leishmania donovani complex . The objective of the study was to determine the seroprevalence of VL and factors associated among the asymptomatic pastoral community of Dire District, Borena Zone, Oromia Region, Ethiopia. A community-based study was conducted among 432 pastoralist communities from June to July 2021. A systematic random sampling method was used to select households. Pretested structured questionnaires and face-to-face interviews were used to collect data. A single finger-prick blood sample was collected and tested for Leishmania donovani complex using an immune-chromatographic test (rk39-ICT). A logistic regression model was used to assess factors associated with VL infection and a p -value of < 0.05 was considered statistically significant. A total of 432 study participants were included (their mean age was 26.69) and 218 (50.5%) were females. The overall seroprevalence of VL was 33/432(7.6%) (95%CI: 5.32-15.60). Sero-prevalence was significantly associated with high family size (>5) (adjusted odds ratios (AOR) = 5.134; 95% CI: 2.032-9.748), sleeping or/and staying under acacia tree (AOR = 2.984; 95%CI = 1.074-8.288), presence of cracked house walls (AOR = 1.801; 95%CI: 1.026-4.926), presence of termite hills (AOR = 1.938; 95%CL: 1.002-7.050), availability of water points (AOR = 3.893; 95%CI: 1.034-7.426) and presence of domestic animals (AOR = 2.124; 95% CI: 2.341-5.108). It is recommended that community awareness on the transmission and prevention methods of Leishmania donovani complex and taking appropriate interventions on the identified factors play a greater role to prevent and control infection in the area. Further investigation is also needed to characterize the pathogens and risk factors and tackle the problem., 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 © 2022 Ketema, Weldegebreal, Gemechu and Gobena.)

Background: In 2018, nearly 90% of the global children living with human immunodeficiency virus (HIV) were in sub-Saharan Africa (SSA). Compared to the adult population, antiretroviral therapy (ART) coverage among children was limited. However, adherence remained a problem among children though they had limited access to ART. This study was conducted to identify the risk factors of non-adherence to ART among children aged 6 to 17 years., Methods: This case-control study was conducted in 2020 using data obtained from clinical record reviews and self-reported data from 272 caregivers of HIV-infected children aged 6-17 years. Cases and controls represented children with poor versus children with good adherence to ART, respectively. Good adherence was defined based on a past 30-day physician adherence evaluation of taking ≥ 95% of the prescribed doses. Binary logistic regression was used to identify factors associated with non-adherence to ART. All statistical tests are defined as statistically significant at P-values < 0.05., Results: Of the 272 children, for whom data were obtained, 78 were cases and 194 were controls; females accounted for 56.3%, 32% attended secondary school, and for 83.1%, the reporting caregivers were biological parents. Non-adherent children had higher odds of association with the following risk factors: a caregiver who is a current substance user (aOR = 2.87, 95% CI: 1.44, 5.71), using AZT-and ABC-based regimen compared to the TDF-regimen (AZT-based, aOR = 4.12, 95% CI: 1.43, 11.86; ABC-based, aOR = 5.58, 95% CI: 1.70, 18.30), and had an increase in viral load from baseline compared to those remained undetectable (remained at or decreased to < 1000, aOR = 4.87, 95% CI: 1.65, 14.33; remained at ≥ 1000, aOR = 9.30, 95% CI: 3.69, 23.46). In contrast, non-adherent children had 66% lower odds of being at early adolescent age compared to 6-9 years old (10-14 years, aOR = 0.34, 95% CI: 0.12, 0.99) and had 70% lower odds of being aware of their HIV status (aOR = 0.30, 95% CI: 0.13, 0.73)., Conclusion: Technical support to caregivers to build disclosure self-efficacy, identifying the appropriate regimen for children, counseling on viral load suppression on subsequent visits, and helping caregivers avoid or reduce substance use may help improve the problem of children's non-adherence to ART., (© 2022. The Author(s).)

Background: Hand washing with soap and water reduces the risk of diarrheal episode by 28-48% and acute respiratory infection by 20-50%. However, there is limited evidence on hand washing practices among students in Eastern Ethiopia, particularly in Harari town. Therefore, this study aimed to determine hand washing practice among primary school students and associated factors in Harar town, Eastern Ethiopia., Methods: An institution-based cross-sectional study was applied among 670 students in Harar town from June 1 to 30, 2021. A multi-stage sampling was employed; 6 out of 20 schools were selected through simple random sampling, while eligible children from each school was selected by probability proportional to size sampling method. Data were collected using a pre-tested questionnaire with a face-to-face interview technique and via observation. The data were analyzed using SPSS software version 23. Binary and mult-variable analysis were used to determine the association between factors and outcome variable. Finally, a p -value of < 0.05 was considered to declare a statistically significant association., Results: A total of 670 participants were included in the study, of which 248 (37.0%) had washed their hands [95% CI: 33.3-40.06]. Being in grade 8 Adjusted Odd Ratio[AOR = 4.9; 95% Confidence Interval (CI): 2.28-10.52], living in an urban area [AOR = 3.49; 95% CI: 1.29-9.40], having role models (parents [AOR = 4.41; 95% CI: 1.79-10.86], teachers [AOR = 3.69; 95% CI: 1.39-8.81], and health professionals [AOR = 3.17, 95% CI: 1.17-8.63]), availability of hand washing facility [AOR = 3.62; 95% CI: 1.57-8.34], access to soap and water [AOR = 2.89; 95% CI: 1.39-5.98] and being membership of water sanitation and hygiene (WASH) club [AOR = 2.39; 95% CI: 1.41-4.03] were found to be significantly associated with hand washing practice., Conclusions: The current study found that nearly a third of students practiced proper hand washing. Hand washing practice was influenced by students' grade level, residence, referents (role models for hand washing), presence of a hand washing facility, access to water and soap, and membership of WASH club. Therefore, the finding revealed that there is a need to improve hand-washing practices in schools by concerned agencies., 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 © 2022 Berhanu, Mengistu, Temesgen, Mulat, Dirirsa, Alemu, Mangasha, Gobena and Geremew.)

Objective: The major aim of this study was to assess the level of District health information system 2 (DHIS 2) implementation in the public health facilities (HFs) in Dire Dawa City Administration., Methods: This study was employed both quantitative (cross-sectional) and qualitative (phenomenological) study designs. All public HFs found in Dire Dawa City Administration and health workers were participated in the study. Quantitative data were collected using a pre-tested, structured, self-administered questionnaire. The collected data were entered into Epi-Data and analyzed using STATA version 14 software. A descriptive summary was computed using proportion and frequencies. Qualitative data were collected from in-depth interview with key informants (KIs), and the results were then analyzed thematically., Results: The overall implementation level of DHIS 2 was 80%, which shows good implementation. The main difficulties encountered in implementing DHIS 2 were a lack of power backup (64.3%), unreliable internet connectivity (43%), and a lack of training (34.6%). According to an in-depth interview with a 32-year-old professional, "…there is offline and online DHIS 2 software for data collection and reporting that is an opportunity for the health center, but there is a challenge of interruption of electricity lost unsaved data and hinder data to enter and view for making a decision….", Conclusion: The level of DHIS 2 implementation in this study was good compared to other studies in Ethiopia. However, more than half of the HFs require infrastructure maintenance and support., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Objective: Sustained adherence to highly active antiretroviral therapy is necessary to suppress viral replication and improve immunological and clinical outcomes. Although different studies tried to identify factors affecting adherence to highly active antiretroviral therapy, there are few studies after initiation of test and start strategy and the first-line drug regimen change in the study area. Therefore, this study aimed to determine the level of adherence to highly active antiretroviral therapy and associated factors among people living with HIV in Eastern Ethiopia., Methods: Institutional-based cross-sectional study design was conducted from 2 March 2020, to 30 March 2020. A total of 501 study participants were recruited using systematic random sampling. Data were collected using face-to-face interviews at the end of the clinic visit and a review of participants' medical records. The level of adherence to highly active antiretroviral therapy was measured using the eight-item Morisky Medication Adherence Scale. The score ranges from 0 to 8, and a score of less than 8 indicates poor adherence. The data were entered into EpiData and exported to STATA for further analysis. The binary logistic regression analysis model was employed to identify associated factors. The association was reported with an adjusted odds ratio and a 95% confidence level. The significance level was declared at p = 0.05., Results: A total of 501 participants participated in the study, giving a response rate of 98.2%. The majority (314 or 62.7%) of study participants were females. The participants' mean (standard deviation) age was 38.17 (8.75). The level of poor adherence to highly active antiretroviral therapy was found to be 33.73% (confidence interval: 29.70, 38.00). Age category 35 to 44 (1.65 (confidence interval: 1.02, 2.69)), no shortage of highly active antiretroviral therapy (0.46 (confidence interval: 0.28, 0.75)), substance use (1.67 (confidence interval: 1.11, 2.25)), having moderate depressive symptoms (4.00 (confidence interval: 1.94, 8.48)), and moderate anxiety symptoms (5.22 (confidence interval: 2.31, 8.84)) were significantly associated with the poor adherence to highly active antiretroviral therapy among adult people living with HIV., Conclusion: The level of poor adherence to highly active antiretroviral therapy was found to be high in this study. Poor adherence to highly active antiretroviral therapy was significantly associated with age, availability of highly active antiretroviral therapy drugs, substance usage, depressive symptoms, and anxiety symptoms. Improving the adherence levels requires stringent counseling, assuring continuous drug availability, and timely screening and management of depression and anxiety., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)