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Abstract Background Contraception is a critical service for women to control their reproductive health, allowing them to determine the number and spacing of their children prevent unintended pregnancies, reduce the risk of morbidity and mortality from associated with childbirth, and reduce the likelihood of abortions. Despite its benefits, the utilization of modern contraceptive methods remains low in certain regions of Ethiopia, Particularly in Afar and Somali, which are also experiencing high fertility rates. However, there is a substantial gap in understanding the sociocultural barriers that hinder the adoption of modern contraception in these regions. This study aims to explore these barriers to contraceptive use among women of reproductive age in Afar and Somali regions, providing qualitative insights that are essential for designing effective strategies to improve contraceptive service utilization. Methods Asequential mixed method approach was employed, including scoping review and qualitative interviews. Scoping review focused on qualitative or mixed-methods studies conducted in Ethiopia and published between 2013 and 2023 in English, Selecting 14 articles Additionally, qualitative data were collected from Afar and Somali regions through In-depth interviews with women aged 15–49 who are married or in consensual union, and key informant interviews with health extension workers and contraception providers at health center. A total of 20 in-depth interviews and 07 key informants were conducted. Thematic analysis was used to analyze the data. Result The integrated findings from the scoping review and qualitative study reveal various barriers and determinants influencing contraceptive use among women in Ethiopia. Barriers includes religious or cultural beliefs, myths and misconceptions, fear of side effects, lack of knowledge and misinformation, negative attitude towards contraceptives, partner opposition, socio-cultural factors, fear of being judged by family and friends, and lack of communication between husband and wife, husband altitude, distance from health facility, availability of service and different contraceptive choice, separate room for family planning services, and cost of contraceptive method and transportation. The scoping review corroborates these findings, emphasizing on the role of socio-demographic, economic, cultural, religious, health service, and knowledge-related factors. Higher education, urban residence, higher income, mass media exposure, spousal communication, family size, and access to quality health services were associated with increased utilization, while lack of awareness, misconceptions, myths, side effects, fear of infertility, partner opposition, social stigma, and cultural norms decreased utilization. Conclusion The study recommended promoting contraceptive use, challenging socio-cultural norms through Social Behavioural Communication and Counselling (SBCC), engaging partners and community members, and improving the quality of care.

Abstract Background Female sex workers (FSWs) face an elevated risk of developing mental health disorders and alcohol use disorders (AUD), which in turn increase their vulnerability to HIV and other sexually transmitted infections (STIs) and other negative outcomes. To effectively address both of these health issues, it is crucial to understand the shared key determinants underlying these illnesses, which is a substantial knowledge gap in Ethiopia and elsewhere in the world. Therefore, this study aimed to identify the common key determinants of depression and AUD among FSWs in Ethiopia using a bivariate multivariable ordinal logistic model. Methods We analyzed cross-sectional biobehavioral data collected in 2020 from 16 cities and major towns in Ethiopia using the respondent-driven sampling (RDS) technique, which involved a total of 6,085 FSWs. FSWs who had lived at the study sites for at least a month before the study period were deemed eligible for recruitment. Major depressive disorder (DD) and AUD were screened using the Patient Health Questionnaire (PHQ9) and alcohol use disorder identification test (AUDIT), respectively. We used descriptive statistics to summarize study population characteristics and bivariate multivariable ordinal logistic regression (BMOLR) to identify common determinants of DD and AUD combined and their nonnormal correlation. Results Among 6085 FSWs screened for DD and AUD, 13.5% and 4.0% have met the criteria for moderate and severe depressive disorder, respectively, and 20.3% and 34.7% have met the AUDIT criteria for harmful or hazardous behavior and alcohol dependence, respectively. FSW with experience of inconsistent condom use, condom failure, violence, mobility, use of any drugs, non-paying partners, abortion, and selling sex for more than five years were associated with an increase in the severity of both disorders. A high average income from selling sex and the number of paying partners reduced the severity of depression and increased the level of alcohol dependence. Being HIV positive and ever having anal sex were associated only with an increase in depression. Conclusion Major DD and AUD are prevalent among FSWs in Ethiopia. The findings revealed that common key determinants, which exacerbated the severity of both disorders, were also risk factors for HIV and other STIs. Consequently, integrated STI strategies are essential in the screening, referral, and treatment of depression and AUD. Intervention packages should encompass determinants of depression and AUD, including condom utilization, drug use, mobility between towns, abortion, violence, and counseling services. Additionally, strategies to ensure economic security should be incorporated.

Ensuring safe drinking water remains a significant challenge due to the prevalence of waterborne diseases. While chlorine-based and UV-based methods effectively kill pathogens, they often generate harmful byproducts. Consequently, there's a pressing need for innovative techniques, such as utilizing silver nanoparticles(AgNPs) renowned for their antibacterial properties. In this study, a chemical reduction technique was employed to synthesize AgNPs. Subsequently, these AgNPs underwent comprehensive characterization using techniques such as FTIR, XRD,TGA and XPS. The synthesized nanoparticles were then applied for disinfecting spring water. The experimental design was meticulously planned using the central composite design method (CCD) from Response Surface Methodology (RSM), facilitated by Design Expert software. Three key factors: AgNPs, pH, and contact time were varied across three levels, resulting in a total of 20 designed experiments. These experiments were conducted in accordance with the specified run order, culminating in the achievement of maximum bacteria growth inhibition efficiency of 99.72 % at the optimal conditions of 0.01 mg/100 mL AgNPs dose, a pH of 6, and a contact time of 20 min. Overall, the findings of this study underscore the efficiency of AgNPs in disinfecting spring water.

In order to combat malnutrition and micronutrient deficiencies, Nutrition Sensitive Agriculture (NSA) gives nutrient-dense foods, dietary diversity, and food fortification the highest priority. This micro-intervention project's goal is to increase home-gardening system's contribution to raising women's dietary diversity score (WDDS) by diversifying family farming practices. Methods: In Ethiopia's Boru-Meda Kebele, The authors applied the intervention to 40 specifically chosen female beneficiaries between the ages of 15 and 49. FAO's standardized questionnaire was used as a tool to conduct an initial and end-line dietary diversity survey by giving careful consideration to cultural and religious elements. The qualitative information was also gathered using case studies, key informant interviews, and focus group discussions. Results: The local population's diet was dominated by staple cereal crops, and women were less knowledgeable about home gardening and diverse diets. Before intervention, the average number of food groups produced and consumed was 2.63±1.00 and 3.68±1.16 respectively. The intervention enhanced the WDDS to 6.13±0.76, and the production diversity to 5.63±0.90. The intervention changed the community's consumption and production patterns, especially among women. Conclusion: Home-garden agriculture helps to increase WDDS. As a result, development partners must concentrate on farming system diversification by increasing the accessibility of vegetable seeds and educating local farmers about the contribution of diversified vegetable production and consumption. Strengthening the cooperation among stakeholders and maintaining monitoring of activities should also be given due emphasis

Agriculture is vital to Ethiopia's economy, yet postharvest losses persist, threatening food security and economic growth. The literature indicates that losses range from 15 to 45 %, highlighting the urgency of addressing this issue. Agro-processing offers a promising solution by adding value to raw products. This article examines Ethiopia's potential in agro-processing, aligning with existing agricultural policies. Techniques such as drying, canning, freezing, and packaging can optimize agricultural potential and minimize losses. Despite challenges such as inadequate infrastructure and limited financial resources, Ethiopia can leverage its market-oriented approach to establish integrated agro-processing systems. A holistic approach is necessary, requiring the Ethiopian government to develop an integrated policy framework with incentives for investment and technology adoption. Improving infrastructure, enforcing quality standards, and strengthening market linkages are essential. Climate-smart practices and information technologies can enhance long-term viability. Collaborative efforts can drive sustainable development and prosperity through agro-processing in Ethiopia.

BackgroundGlobally, five million children under the age of five died in 2021. Asia and African countries contributed to 69% and 27.2% of wasting, respectively. In Ethiopia, out of 901 (10.1%) under-five children, 632 (8.1%) were found to be moderately wasted, and 269 (3.0%) were severely wasted. The purpose of this study was to assess the prevalence of wasting and its associated factors among children between the ages of 6 and 59 months in Habro Woreda, Oromia, Eastern Ethiopia.MethodsA community-based cross-sectional study was conducted in Habro Woreda from 25 August to 20 September 2020. In total, 306 participants were included in this study through a systematic sampling technique. Data were collected using a pretested structured questionnaire through a face-to-face interview, entered into EpiData version 3.1, and analyzed using SPSS version 25. Predictors were assessed using a multivariate logistic regression analysis model and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p < 0.05.ResultsOverall, the prevalence of wasting among children aged 6–59 months in the Habro district was 28%, with a 95% confidence interval [26.5, 32.2%]. Factors such as mothers illiterate [AOR = 3.4; 95% CI: 1.14–10.47], households without latrines [AOR = 2.91; 95% CI: 1.33–6.37], food-insecure households [AOR = 4.11; 95% CI: 1.87–9], households that did not receive home visits [AOR = 4.2; 95% CI: 1.92–9.15], did not eat a variety of food [AOR = 7.44; 95% CI: 2.58–21.45], sick children after discharge from the program [AOR = 6.55; 95% CI: 2.85–15.02], readmitted children [AOR = 3.98; 95% CI: 1.43–15.07], and wasting 3.42 [AOR = 3.42; 95% CI: 1.24–9.45] were factors statistically associated with outcome variables.ConclusionThis study noted that the prevalence of wasting among children aged 6–59 months following discharge from the Outpatient Therapeutic Program remains high. Educational status of the mother, availability of a latrine, separate kitchen in the household, household food insecurity, household dietary diversity, home visit, and admission type were significantly associated with wasting of children after discharge from the outpatient therapeutic program. Therefore, efforts that target these factors should be maximized to reduce the occurrence of wasting among children aged 6–59 months after discharge from the outpatient therapeutic program.

BackgroundTwo significant etiological factors contributing to iron deficiency anemia, and undernutrition posing substantial public health challenges in Sub-Saharan Africa, are soil-transmitted helminths and malaria. This study carried out the effect of weekly iron-folic acid supplementation (WIFAS) on the nutrition and general health of school-age children and adolescents in Sub-Saharan Africa, a systematic review and meta-analysis have been conducted.MethodsTo find pertinent publications for this study, a thorough search was carried out on May 20, 2023, across five databases: Pubmed (MEDLINE), Web of Science, Scopus, Cochrane Library, and Google Scholar. In addition, a search was conducted on August 23, 2023, to capture any new records. The inclusion criteria for the studies were based on school-age children and adolescent populations, randomized controlled trials, and investigations into the effects of WIFAS. The outcomes of interest were measured through anthropometric changes, malaria, and helminthic reinfection.ResultsA systematic review of 11 articles revealed that WIFAS significantly decreased the risk of schistosomiasis reinfection by 21% among adolescents (risk ratio = 0.79, 95%CI: 0.66, 0.97; heterogeneity I2 = 0.00%, P = 0.02). However, no significant impact was observed on the risk of malaria reinfection (risk ratio = 1.02, 95%CI: 0.92, 1.13; heterogeneity I2 = 0.00%, P = 0.67) or A. Lumbricoides reinfection (risk ratio = 0.95, 95%CI: 0.75, 1.19; heterogeneity I2 = 0.00%, P = 0.65). Moreover, the analysis demonstrated that there is no significant effect of iron-folic acid supplementation in measured height and height for age Z-score (HAZ) of the school-age children (Hedge's g −0.05, 95%CI: −0.3, 0.2; test for heterogeneity I2 = 0.00%, P = 0.7) and (Hedge's g 0.12, 95%CI: −0.13, 0.37; test for heterogeneity I2 = 0.00%, P = 0.36) respectively.ConclusionThe effectiveness of WIFAS in reducing the risk of schistosomiasis reinfection in adolescents has been demonstrated to be greater than that of a placebo or no intervention. Additionally, the narrative synthesis of iron-folic acid supplementation has emerged as a potential public health intervention for promoting weight change. However, there was no significant association between WIFAS and Ascariasis, trichuriasis, and hookworm. Moreover, the certainty of the evidence for the effects of WIFAS on height and malaria is low and therefore inconclusive. Whereas, the certainty of the evidence for the effectiveness of WIFAS on Schistosomiasis is moderate. Even though the mechanisms need further research WIFAS may be implemented as part of a comprehensive public health strategy to address schistosomiasis in adolescents.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023397898, PROSPERO (CRD42023397898).

Abstract Background The HIV prevalence among Ethiopian female sex workers (FSWs) is estimated to be around 18.5%, which implies that FSWs' sexual partners are significantly exposed to HIV infection and that may be a major factor in HIV transmission in the community. However, it has long been known that using condoms correctly and consistently is an extremely cost-effective global method for preventing HIV infection, but inconsistent condom use (ICU) would pose the greatest proximal risk of HIV acquisition and transmission. Understanding the prevalence and associated risk factors of inconsistence condom use among FSWs would inform policymakers to design programmatic interventions in the context of Ethiopia. Methods This analysis used data from the ‘National HIV and STIs Bio-behavioral Survey (NHSBS)’, which was conducted between December 2019 up to May 2020 by using a respondent-driven sampling (RDS) technique among FSWs aged 15 years and older who were selling sex in selected major cities and towns in Ethiopia. A multi-level logistic regression model was fitted to assess town and individual-level variations simultaneously to adjust hierarchical variations. Statistical significance was determined by using a P-value less than 0.05 with a 95% confidence interval (CI) not including one. Results Overall, 6,085 FSWs from 16 cities and towns participated in the study. The prevalence of inconsistent condom use across the 16 cities and towns was 17.1% [95% CI (16.5, 17.8)]. Inconsistent condom use was significantly higher among FSWs who had depression compared to those without depression [AOR = 1.43; 95% CI (1.13,1.82)], used any drug [AOR = 1.43; 95% CI (1.14–1.79)], had history of sexual violence [AOR = 1.75; 95% CI (1.43, 2.16)], changed sex selling location [AOR = 1.27; 95% CI (1.06, 1.51)], longer period of sex selling experience [AOR = 3.01; 95% CI (2.27, 3.99)], ever had anal sex [AOR = 2.74; 95% CI (2.15, 3.5)], had ≥ 2 non-paying sexual partner [AOR = 2.99; 95% CI(2.26, 3.95)], selling sex `in more than two cities [AOR = 3.01;95% CI (2.27, 3.99)], who lacked access to condom [AOR = 2.1; 95% CI (1.69, 2.67)], and did not have HIV knowledge [AOR = 1.39; 95% CI (1.15, 1.68)]. Conclusion Inconsistent condom use among FSWs is prevalent in Ethiopia and is associated with marital status, education status, depression, alcohol drinking, drug use, sexual violence, being raped, lack of knowledge about HIV, practising anal sex, selling sex in different locations, having more than two non-paying sexual partners, working in more than two cities, and lack of access to condom at the workplace. Programme interventions to enhance consistent condoms use among FSWs need to take these factors into consideration.

This paper presents a comprehensive and evidence-based cyber-risk assessment approach specifically designed for Medical Cyber Physical Systems (MCPS)- and Internet-of-Medical Devices (IoMT)-based collaborative digital healthcare systems, which leverage Federated Identity Management (FIM) solutions to manage user identities within this complex environment. While these systems offer advantages like easy data collection and improved collaboration, they also introduce new security challenges due to the interconnected nature of devices and data, as well as vulnerabilities within the FIM and the lack of robust security in IoMT devices. To proactively safeguard the digital healthcare system from cyber attacks with potentially life-threatening consequences, a comprehensive and evidence-based cyber-risk assessment is crucial for mitigating these risks. To this end, this paper proposes a novel cyber-risk assessment approach that leverages a three-dimensional attack landscape analysis, encompassing existing IT infrastructure, medical devices, and Federated Identity Management protocols. By considering their interconnected vulnerabilities, the approach recommends tailored security controls to prioritize and mitigate critical risks, ultimately enhancing system resilience. The proposed approach combines established industry standards like Cyber Resilience Review (CRR) asset management and NIST SP 800-30 for a comprehensive assessment. We have validated our approach using threat modeling with attack trees and detailed attack sequence diagrams on a diverse range of IoMT and MCPS devices from various vendors. The resulting evidence-based cyber-risk assessments and corresponding security control recommendations will significantly support healthcare professionals and providers in improving both patient and medical device safety management within the FIM-enabled healthcare ecosystem.

BackgroundAlthough surgical wound infection remains a serious issue worldwide, the disease burden is greater in developing countries, including Ethiopia. Even though there were primary studies conducted at district levels in Ethiopia, there is little evidence about the pooled incidence of surgical site infections at the national level. Thus, this systematic review and meta-analysis determined the pooled incidence of surgical site infection and its associated factors among cesarean-delivered women in Ethiopia.MethodsWe searched PubMed, CINAHL, African Journals Online, Google Scholar, and higher educational institutional repositories. A random-effects model was used to estimate the pooled effect size with 95% confidence intervals (CIs). Funnel plot and egger tests were computed to determine the existence of publication bias. A subgroup analysis was carried out.ResultsTwenty-three studies were included in the final analysis. The pooled incidence of surgical site infection among women delivered via cesarean section was 12.32% (95% CI: 8.96–16.11%). Rural residence (AOR = 2.51, 95% CI: 1.15–3.87), membrane rupture (AOR = 2.04, 95% CI: 1.24–2.85), chorioammionitis (AOR = 4.13, 95% CI: 1.45–6.8), general anesthesia (AOR = 1.99, 95% CI: 1.22–2.75), post-operative Hgb level less than 11 mg/dL (AOR = 3.25, 95% CI: 1.54–4.96) and membrane rupture greater or equal to 12 h (AOR = 3.93, 95% CI: 1.93–5.92) were independent risk factors for surgical site infections.ConclusionMore than one in 10 women delivered via cesarean section developed surgical site infections in Ethiopia. Women living in rural areas and those with a membrane rupture, chorioammionitis, or anemia should be given special attention. General anesthesia should not be a mandatory procedure.

In this research, a brick kiln integrated with pollutant emission control technology was designed and applied in order to produce charcoal from Eucalyptus Globules wood. The batch operation carbonization of wood biomass was undertaken in a 1.25 m3 volume brick kiln. A wet-packed scrubber was designed and constructed by filling gravels in a depth of 40 cm with aggregate sizes of 48–60 mm, 27–33 mm and 16–20 mm from the bottom to the top respectively aiming to treat emission from the charcoal-producing unit. The characteristics of the charcoal produced were determined to be composed of 9% moisture content, 1.5% ash content, 38% charcoal yield and a heating value of 27.53 MJ/kg. On the other hand, the wet scrubber integrated into a brick kiln was found to remove Hydrocarbons, CO2 and CO by 97.8%, 98.5% and 99% respectively, which makes it efficient and practical way of controlling the gasses released during producing of charcoal.

BackgroundThe COVID-19 mortality rate continues to be high in low-income countries like Ethiopia as the new variant’s transmission expands and the countries’ limited capacity to combat the disease causes severe outcomes, including deaths. The aim of this study is to determine the magnitude of the COVID-19 mortality rate and its determinants in Ethiopia.MethodsThe main electronic databases searched were PubMed, CINAHL, Google Scholar, and African journals online. The included studies’ qualities were assessed independently using the Newcastle-Ottawa scale. The data was extracted in Microsoft Excel spreadsheet format. The pooled effect size and odds ratios with 95% confidence intervals across studies were determined using the random-effects model. I2 is used to estimate the percentage of overall variation across studies due to heterogeneity. Egger’s test and funnel plot were used to find the published bias. A subgroup analysis was conducted. The effect of a single study on the overall estimation was determined by sensitivity analysis.ResultsA total of 21 studies with 42,307 study participants were included in the final analysis. The pooled prevalence of COVID-19 mortality was 14.44% (95% CI: 10.35–19.08%), with high significant heterogeneity (I2 = 98.92%, p

Abstract This study delves into the realm of sentiment analysis in the Amharic language, focusing on political sentences extracted from social media platforms in Ethiopia. The research employs deep learning techniques, including Convolutional Neural Networks (CNN), Bidirectional Long Short-Term Memory (Bi-LSTM), and a hybrid model combining CNN with Bi-LSTM to analyze and classify sentiments. The hybrid CNN-Bi-LSTM model emerges as the top performer, achieving an impressive accuracy of 91.60%. While these results mark a significant milestone, challenges persist, such as the need for a more extensive and diverse dataset and the identification of nuanced sentiments like sarcasm and figurative speech. The study underscores the importance of transitioning from binary sentiment analysis to a multi-class classification approach, enabling a finer-grained understanding of sentiments. Moreover, the establishment of a standardized corpus for Amharic sentiment analysis emerges as a critical endeavor with broad applicability beyond politics, spanning domains like agriculture, industry, tourism, sports, entertainment, and satisfaction analysis. The exploration of sarcastic comments in the Amharic language stands out as a promising avenue for future research.

Abstract The supply chain network is one of the most important areas of focus in the majority of business circumstances. Blockchain technology is a feasible choice for secure information sharing in a supply chain network. Despite the fact that maintaining security at all levels of the blockchain is difficult, cryptographic methods are commonly used in existing works. Effective supply chain management (SCM) offers various benefits to organizations, such as enhanced customer satisfaction, increased operational efficiency, competitive advantage, and cost reduction. Potential SCM for agricultural and food supply chains needs distributors, coordination and collaboration among farmers, retailers, and stakeholders. The use of technology like Block Chain (BC), sensors, and data analytics, can boost traceability and visibility, decrease waste, and ensure safety and quality throughout the supply chain. Therefore, this study develops a Hunger Games Search Optimization with Deep Learning Model for Sustainable agricultural and food Supply Chain Management (HGSODL-ASCM) technique. The fundamental goal of the HGSODL-ASCM technique is to improve decision-making processes for agricultural and food commodity production and storage in order to optimise revenue. In the provided HGSODL-ASCM technique, a bidirectional long short-term memory (Bi-LSTM) model is built to determine the amount of productivity and storage required to maximise profit. In order to boost the performance of the Bi-LSTM classification process, the HGSO algorithm has been utilized in this work. The presented HGSODL-ASCM technique can independently achieve the SCM policies via interaction with complicated and adaptive environments. A brief set of simulations were performed to ensure the improved performance of the HGSODL-ASCM technique. The simulation results demonstrated how superior the HGSODL-ASCM method is to other methods already in use.

Abstract The environmental pollution and human health impacts associated with the discharge of massive dye-containing effluents necessitate a search for cost-effective treatment technology. Therefore, this research work is conducted with the objective of investigating the potential of Rumex abyssinicus-derived activated carbon (RAAC) for the adsorption of Brilliant Blue Reactive (BBR) dye from aqueous solutions. Chemical activation with H3PO4 followed by pyrolysis was used to prepare the adsorbent. Characterization of the developed adsorbent was done using proximate analysis, pH point of zero charge (pHpzc), scanning electron microscope (SEM), Fourier transform infrared spectrometer (FTIR), Brunauer, Emmett, and Teller (BET), and X-ray diffraction (XRD). The experimental design and the effect of independent variables including pH (2, 6, and 10), initial dye concentration (50, 100, and 150 mg/L), adsorbent dosage (0.05, 0.1, and 0.15 g/100 mL), and contact time (20, 50, and 80 min) were optimized using the response surface methodology (RSM) coupled with Box Behnken design (BBD). The analysis results revealed the exitance of high specific surface area of 524 m2/g, morphological cracks, and the presence of multiple functional groups like –OH, C=C, alkene, and amorphous structure. Maximum removal efficiency of 99.98% was attained at optimum working conditions of pH 2, contact time of 50 min, dye concentration of 100 mg/L, and adsorbent dosage of 0.15 mg/100 mL, reducing the pollutant concentration from 100 to 0.02 mg/L. Evaluation of the experimental data was done using Langmuir, Freundlich, Temkin, and Sips isotherm models, in which the Langmuir model was found to be the best fit with the experimental data at R2 0.986. This shows that the adsorbent surface is homogeneous and mono-layered. Furthermore, the kinetic study confirmed that the pseudo second-order model best describes the experimental data with R2 = 0.999. In general, the research work showed that the low cost, environmental friendliness and high adsorption capabilities of the activated carbon derived from Rumex abyssinicus could be taken as an effective nt for the removal of BBR dye from aqueous solutions.

Abstract Background Leukemic patients are prone to infectious agents such as viruses due to dysregulated immune system resulting from infiltration of the bone marrow by malignant cells, chronic stimulation, reactivation of some viruses and viral pathogenicity as well as rarely from acquisition of a new infections leading to severe complications. However, the prevalence of these infections has not been systematically documented in resource-limited settings such as Ethiopia. Objective To determine the prevalence of HBV, HCV, and HIV among adult and adolescent in-patients with acute leukemia before the administration of chemotherapy, at the Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Methods A cross sectional study was conducted on 176 adult and adolescent inpatient Ethiopians, who were diagnosed with acute leukemia from April 2019 to June 2021. Socio-demographic characteristics and relevant clinical data were collected. Peripheral blood samples were collected and tested for HBV, HIV, and HCV using Enzyme-Linked Immunosorbent Assay (ELISA) and real-time PCR. Chi-square tests were used to assess associations between variables. Results Of the 176 patients, 109(62%) were males. The median age was 25[IQR,18–35] yr, with a range from 13 to 76 year. The prevalence of HBV (positivity for HBsAg plus HBV DNA), HCV and HIV was 21.6%, 1.7%, and 1.7%, respectively. HBsAg was positive in 19 cases (10.8%). Among 157 HBsAg negative patients, 52(33.1%) were positive for Anti-HBcAg; of these seropositive cases, 47.5% were positive for HBV DNA. Most DNA positive, HBsAg negative cases (79.0%) had DNA concentrations below 200 IU/ml indicating true occult HBV infection (OBI). Of the 176 cases, 122 had a history of blood transfusions, but no statistically significant association was found between HBV infection and blood product transfusion history (P = 0.963). Conclusions The prevalence of HBV, HIV and HCV in patients with acute leukemia was similar to the national prevalence level of these infections. Given the HBsAg positivity and the high prevalence of occult hepatitis B infection in our study, these patients may be at increased risk for chemotherapy related hepatitis flares. Hence, clinicians caring these patients are strongly advised to screen their patients for HBV and also for HIV and HCV infections routinely.

Abstract Background Syphilis is a highly contagious sexually transmitted infection posing a significant public health challenge, especially in developing countries, including sub-Saharan Africa. Female sex workers are exposed to sexually transmitted infections, including syphilis, because of their sexual behavior and limited access to health services. However, data on national syphilis prevalence estimates and the associated factors are scarce in Ethiopia. This, as well as our limited knowledge about the extent of clustering among female sex workers in the country, is a critical gap in information we aimed to fill through this analysis. Methods The study was a cross-sectional, bio-behavioral survey conducted among female sex workers in six cities and ten major towns in Ethiopia. Participants were selected using a respondent-driven sampling method. Survey participants provided blood samples for syphilis, HIV, and hepatitis serological testing. Survey data were collected via an interviewer-administered questionnaire. In this analysis, we employed descriptive statistics to summarize data on the study variables. In addition, we used multilevel bivariable and multivariable logistic regression models to examine the association between independent variables and the dependent variable (syphilis prevalence) while accounting for the clustering effect. Result A total of 6085 female sex workers participated in the survey. Their median age [Interquartile Range (IQR) was 25 (8)] years, and a majority (96.1%) were in the 20–24-year-old age group. The prevalence of syphilis among female sex workers in Ethiopia’s six cities and ten major towns was 6.2%. Being in the age group of 30–34 (AOR = 2.64; 95% CI = 1.40, 4.98) and 35–59 (AOR = 4.7; 95% CI = 2.5, 8.86), being divorced/widowed (AOR = 1.37; 95% CI = 1.03, 1.82), having no formal education (AOR = 3.38; 95% CI = 2.34, 5.11), primary 1st cycle (grades 1–4) education (AOR = 2.77; 95% CI = 1.79, 4.30), and having primary 2nd cycle (grades 5–8) education (AOR = 1.80; 95% CI = 1.21, 2.69) were significantly associated with syphilis among female sex workers. Conclusion The prevalence of syphilis among female sex workers was high. Being divorced/widowed or in the older age group and having a low level of education were significantly associated with an increased risk of syphilis. The high prevalence and associated factors identified need to be considered in planning comprehensive interventions to control syphilis among female sex workers in Ethiopia.

BackgroundThe COVID-19 pandemic is one of the most devastating public health emergencies of international concern to have occurred in the past century. To ensure a safe, scalable, and sustainable response, it is imperative to understand the burden of disease, epidemiological trends, and responses to activities that have already been implemented. We aimed to analyze how COVID-19 tests, cases, and deaths varied by time and region in the general population and healthcare workers (HCWs) in Ethiopia.MethodsCOVID-19 data were captured between October 01, 2021, and September 30, 2022, in 64 systematically selected health facilities throughout Ethiopia. The number of health facilities included in the study was proportionally allocated to the regional states of Ethiopia. Data were captured by standardized tools and formats. Analysis of COVID-19 testing performed, cases detected, and deaths registered by region and time was carried out.ResultsWe analyzed 215,024 individuals' data that were captured through COVID-19 surveillance in Ethiopia. Of the 215,024 total tests, 18,964 COVID-19 cases (8.8%, 95% CI: 8.7%- 9.0%) were identified and 534 (2.8%, 95% CI: 2.6%- 3.1%) were deceased. The positivity rate ranged from 1% in the Afar region to 15% in the Sidama region. Eight (1.2%, 95% CI: 0.4%- 2.0%) HCWs died out of 664 infected HCWs, of which 81.5% were from Addis Ababa. Three waves of outbreaks were detected during the analysis period, with the highest positivity rate of 35% during the Omicron period and the highest rate of ICU beds and mechanical ventilators (38%) occupied by COVID-19 patients during the Delta period.ConclusionsThe temporal and regional variations in COVID-19 cases and deaths in Ethiopia underscore the need for concerted efforts to address the disparities in the COVID-19 surveillance and response system. These lessons should be critically considered during the integration of the COVID-19 surveillance system into the routine surveillance system.

SARS-CoV-2 co-infection with the influenza virus or human respiratory syncytial virus (RSV) may complicate its progress and clinical outcomes. However, data on the co-detection of SARS-CoV-2 with other respiratory viruses are limited in Ethiopia and other parts of Africa to inform evidence-based response and decision-making. We analyzed 4,989 patients' data captured from the national severe acute respiratory illness (SARI) and influenza-like illness (ILI) sentinel surveillance sites over 18 months period from January 01, 2021, to June 30, 2022. Laboratory specimens were collected from the patients and tested for viral respiratory pathogens by real-time, reverse transcription polymerase chain reaction (RT-PCR) at the national influenza center. The median age of the patients was 14 years (IQR: 1-35 years), with a slight preponderance of them being at the age of 15 to less than 50 years. SARS-CoV-2 was detected among 459 (9.2%, 95% CI: 8.4-10.0) patients, and 64 (1.3%, 95% CI: 1.0-1.6) of SARS-CoV-2 were co-detected either with Influenza virus (54.7%) or RSV (32.8%) and 12.5% were detected with both of the viruses. A substantial proportion (54.7%) of SARS-CoV-2 co-detection with other respiratory viruses was identified among patients in the age group from 15 to less than 50 years. The multivariable analysis found that the odds of SARS-CoV-2 co-detection was higher among individuals with the age category of 20 to 39 years as compared to those less than 20 years old (AOR: 1.98, 95%CI:1.15-3.42) while the odds of SARS-CoV-2 co-detection was lower among cases from other regions of the country as compared to those from Addis Ababa (AOR:0.16 95%CI:0.07-0.34). Although the SARS-CoV-2 co-detection with other respiratory viral pathogens was minimal, the findings of this study underscore that it is critical to continuously monitor the co-infections to reduce transmission and improve patient outcomes, particularly among the youth and patients with ILI.

BackgroundGender-based violence (GBV) is usually defined as unequal power relations between men and women, which poses a widespread public health problem. The study evaluated the prevalence and factors associated with GBV among female sex workers (FSWs) in Ethiopia.MethodWe used cross-sectional bio-behavioral data collected using respondent-driven sampling (RDS) in 2020 from 16 towns in Ethiopia. Descriptive statistics was analyzed to summarize the study population characteristics and prevalence of GBV, and a multilevel logistic regression model was applied to identify associated factors for GBV. A p-value of ≤0.05 was used as a threshold for statistical significance.ResultOf 6,085 participants, 28.1% had experienced GBV during the last 12 months, among which 12.7% and 22.3% experienced physical and sexual violence, respectively. FSWs aged 15–24, and 25–34 than those 35 years or more, had a non-paying than paying partners, had 31–60, 61–90, and over 91 than those had less than 30 paying partners, ever had anal sex than those not, condom failure than those not, mobile female sex workers when compared with those not mobile at different town; 3–5 and ≥ 6 years than those less than 3 years stayed in selling sex, street-based, and multiple places selling sex than those used other venues were significantly associated with GBV.ConclusionGender-based violence is a substantial problem among FSWs in Ethiopia, with significant implications for program planning on prevention and response to mitigate the occurrence and impact of GBV among FSWs.

IntroductionMicronutrient (MN) deficiencies are a major public health problem in developing countries including Ethiopia, leading to childhood morbidity and mortality. Effective implementation of programs aimed at reducing MN deficiencies requires an understanding of the important drivers of suboptimal MN intake. Therefore, this study aimed to identify important predictors of MN deficiency among children aged 6–23 months in Ethiopia using machine learning algorithms.MethodsThis study employed data from the 2019 Ethiopia Mini Demographic and Health Survey (2019 EMDHS) and included a sample of 1,455 children aged 6–23 months for analysis. Machine Learning (ML) methods including, Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), Neural Network (NN), and Naïve Bayes (NB) were used to prioritize risk factors for MN deficiency prediction. Performance metrics including accuracy, sensitivity, specificity, and Area Under the Receiver Operating Characteristic (AUROC) curves were used to evaluate model prediction performance.ResultsThe prediction performance of the RF model was the best performing ML model in predicting child MN deficiency, with an AUROC of 80.01% and accuracy of 72.41% in the test data. The RF algorithm identified the eastern region of Ethiopia, poorest wealth index, no maternal education, lack of media exposure, home delivery, and younger child age as the top prioritized risk factors in their order of importance for MN deficiency prediction.ConclusionThe RF algorithm outperformed other ML algorithms in predicting child MN deficiency in Ethiopia. Based on the findings of this study, improving women’s education, increasing exposure to mass media, introducing MN-rich foods in early childhood, enhancing access to health services, and targeted intervention in the eastern region are strongly recommended to significantly reduce child MN deficiency.

Ethiopia is experiencing considerable impact of climate change and variability in the last five decades. Analyzing climate trends and variability is essential to develop effective adaptation strategies, particularly for countries vulnerable to climate change. This study analyzed trends and variabilities of climate (rainfall, maximum temperature (Tmax), and minimum temperature (Tmin)) at local and regional scales in Ethiopia. The local analysis was carried out considering each meteorological station, while the regional analyses were based on agro-ecological zones (AEZs). This study used observations from 47 rainfall and 37 temperature stations obtained from the Ethiopian Meteorological Institute (EMI) for the period of 1986 to 2020. The Modified Mann-Kendall (MMK) trend test and Theil Sen's slope estimator were used to analyze the trends and magnitudes of change, respectively, in rainfall as well as temperature. The coefficient of variation (CV) and standardized anomaly index (SAI) were also employed to evaluate rainfall and temperature variabilities. The local level analysis revealed that Bega (dry season), Kiremt (main rainy season), and annual rainfall showed increasing trend, albeit no significant, in most stations, but the rainfall in Belg (small rainy) season showed a non-significant decreasing trend. The regional levels analysis also indicated an increasing trend of Bega, Kiremt, and annual rainfall in most AEZs, while Belg rainfall showed a decreasing trend in the greater number of AEZs. The result of both local and regional levels of analysis discerned a spatially and temporally more homogeneous warming trend. Both Tmax and Tmin revealed an increasing trend in annual and seasonal scales at most meteorological stations. Likewise, an increase was recorded for mean Tmax and Tmin in entire/most AEZs. The observed trends and variabilities of rainfall and temperature have several implications for climate change adaptations. For example, the decrease in Belg rainfall in most AEZs would have a negative impact on areas that heavily depend on Belg season's rainfall for crop production. Some climate adaptation options include identifying short maturing crop varieties, soil moisture conservation, and supplemental irrigation of crops using harvested water during the main rainy season. Conversely, since the first three months of Bega season (October to December) are crop harvest season in most parts of Ethiopia, the increase in Bega rainfall would increase crop harvest loss, and hence, early planting date and identifying short maturing crops during the main rainy season are some climate adaptation strategies. Because of the increase in temperature, water demand for irrigation during Bega season will increase due to increased evapotranspiration. On the other hand, the increase in Kiremt rainfall can be harvested and used for supplemental irrigation during Bega as well as the small rainy season, particularly for early planting. In view of these findings, it is imperative to develop and implement effective climate-smart agricultural strategies specific to each agro-ecological zone (AEZ) to adapt to rainfall and temperature changes and variabilities.

Article Highlights The annual precipitation of the sub-basin has shown an increasing trend. A considerable upward trend in the annual average temperature was found. The observed rainfall and temperature trends are associated with the hydro-climate trends.

BackgroundSexually transmitted infections (STIs) remain a major public health problem worldwide, with the burden of these infections being high among female sex workers (FSWs), who are often not aware of their infection status. This study aimed to determine the factors that are associated with the number of STIs among FSWs in Ethiopia.MethodsA cross-sectional bio-behavioral study involving respondent-driven sampling (RDS) was conducted among 6,085 FSWs in 16 towns in Ethiopia. The hurdle Poisson regression model was fitted using STATA Version 16.2. The incident rate ratio and adjusted odds ratio with a 95% confidence interval were employed to show the strength and direction of the association. A p-value of ≤0.05 was used as a threshold for statistical significance.ResultsAt least one STI was identified in 1,444 (23.64%) of the FSWs. Age group 35–49 years [IRR = 2.32; 95% CI (1.43, 3.74)], forced first sex [IRR = 1.32; 95% CI (1.01, 1.74)], condom breakage [IRR = 1.32; 95% CI (1.01, 1.74)], and a history of depression [IRR = 1.55; 95% CI (1.12, 2.18)] increase the number of STIs. FSWs aged 25–34 years [AOR = 2.99; % CI (2.54, 3.52)] and 35 = 59 years [AOR = 8.05; % CI (6.54, 9.91)], who were selling sex for 5–10 years [AOR = 1.30; 95% CI (1.1, 1.55)], and above 11 years [AOR = 1.21; 95% CI (1.03, 1.43)] were more likely to get STIs.ConclusionSTIs are common in Ethiopia. The covariates age, educational status, monthly income, condom failure, age at the first sexual encounter, and long duration of sexual practice are significant predictors of STIs. Health interventions among FSWs need to include awareness generation about the prevention and control of STIs and address the determinants identified in this analysis.

Video Surveillance Systems (VSSs) are used in a wide range of applications including public safety and perimeter security. They are deployed in places such as markets, hospitals, schools, banks, shopping malls, offices, and smart cities. VSSs generate a massive amount of surveillance data, and significant research has been published on the use of machine learning algorithms to handle surveillance data. In this paper, we present an extensive overview and a thorough analysis of cutting-edge learning methods used in VSSs. Existing surveys on learning approaches in video surveillance have some drawbacks, such as a lack of in-depth analysis of the learning algorithms, omission of certain methodologies, insufficient critical evaluation, and absence of recent learning algorithms. To fill these gaps, this survey provides a thorough examination of the most recent learning algorithms for anomaly detection. A critical assessment of the algorithms including their strengths, weaknesses, and applicability as well as tailored classifications of anomaly types for different domains are provided. Our study also offers insights into the future development of learning techniques in VSS, positioning itself as a valuable resource for both researchers and practitioners in the field. Finally, we share our thoughts on what we learned and how it can help with new developments in the future.

Abstract Background Treatment as prevention evolved into the universal HIV test-and-treat (UTT) strategy, which entails testing to the general population and treatment to every people living with HIV. We investigated universal testing (UT) performance and its determinants in urban Ethiopia and explore magnitude of late diagnosis and its impact on disease stages. Method We used data from the Ethiopia Population Based HIV Impact assessment (EPHIA), conducted in 2017/2018 which was a cross-sectional and household-based study. For current analysis, we considered self-report first diagnosis to estimate universal testing irrespective of their serostatus and also consider HIV LAg avidity vs viral load vs plasma antiretroviral drug level algorithm to categorize the late diagnosis. We finally evaluate disease stages using CD4 count and viral load. A 2-level multilevel mixed-effect logistic regression model was employed. The effects of individual-level predictors were quantified by the estimates from the fixed-effect part of the model with p-value

Abstract Background Successful linkage to HIV services and initiation of antiretroviral treatment (ART) for children living with HIV (CLHIV) is critical to improve pediatric ART coverage. We aimed to assess confirmatory testing, linkage, and rapid ART initiation among newly diagnosed CLHIV in Ethiopia from the perspectives of caregivers and healthcare workers (HCWs). Methods We conducted standardized surveys with HCWs and caregivers of children 2–14 years who were diagnosed with HIV but not yet on ART who had been identified during a cross-sectional study in Ethiopia from May 2017–March 2018. Eight health facilities based on their HIV caseload and testing volume and 21 extension sites were included. Forty-one children, 34 care givers and 40 healthcare workers were included in this study. Three months after study enrollment, caregivers were surveyed about timing and experiences with HIV service enrollment, confirmatory testing, and ART initiation. Data collected from HCWs included perceptions of confirmatory testing in CLHIV before ART initiation. SPSS was used to conduct descriptive statistics. Results The majority of the 41 CLHIV were enrolled to HIV services (n = 34, 83%) and initiated ART by three months (n = 32, 94%). Median time from diagnosis to ART initiation was 12 days (interquartile range 5–18). Five children died before the follow-up interview. Confirmatory HIV testing was conducted in 34 children and found no discordant results; the majority (n = 23, 68%) received it within one week of HIV diagnosis. Almost all HCWs (n = 39/40, 98%) and caregivers (n = 31/34, 91%) felt better/the same about test results after conducting confirmatory testing. Conclusion Opportunities remain to strengthen linkage for newly diagnosed CLHIV in Ethiopia through intensifying early follow-up to ensure prompt confirmatory testing and rapid ART initiation. Additional services could help caregivers with decision-making around treatment initiation for their children.

BackgroundThere is improved access to Sever Acute Malnutrition management in Ethiopia; however, studies have revealed an alarming rate of defaulters’ poor recovery and deaths, emphasizing the importance of researching to identify major causes. As a result, the goal of this research is to identify treatment outcome determinants and associated factors in severely malnourished children aged 6–59 months admitted to public hospitals in Eastern Ethiopia’s stabilization centers.MethodsThis study used an institutional-based retrospective cohort study design with 712 children aged 6 to 59 months. Data was gathered using a Sever Acute Malnutrition registration logbook and patient charts. Participants were chosen at random from their respective healthcare facilities based on population proportion. Epi-data was entered and analyzed using STATA version 14. To identify associated factors, the Cox proportional hazard Ratio was calculated, and a p-value of 0.05 at the 95% confidence interval was considered statistically significant.ResultsThis study revealed that only 70.65% (95% CI = 67.19, 73.88) of the children were cured while 17.84% defaulted from the management and 5.90% died. Children who did not have tuberculosis (AHR = 1.58, 95%CI:1.04, 2.40), anemia (AHR = 1.31, 95% CI:1.03, 1.68), Kwash dermatosis (AHR = 1.41, 95%CI:1.04, 1.91), or on NG-tube (AHR = 1.71, 95%CI:1.41, 2.08) were more likely to be cured from SAM.ConclusionThis study discovered that the cure rate is extremely low and the defaulter rate is extremely high. As a result, intervention modalities that address the identified factor are strongly recommended to accelerate the rate of recovery in Eastern Ethiopia.

Objectives We aimed to estimate the prevalence of folate deficiency and contributing factors among pregnant women.Design A community-based, cross-sectional study.Setting Haramaya District, Eastern Ethiopia.Participants Four hundred and forty-six pregnant women participated in the study.Primary outcome measure The prevalence of folate deficiency and risk factors.Results Overall, the prevalence of folate deficiency was 49.3% (95% CI 44.6% to 54.1%). Pregnant women with iron deficiency anaemia were 2.94 times more likely to develop folate deficiency (adjusted OR (AOR)=2.9, 95% CI 1.9 to 4.7). Respondents with good knowledge of folate-rich foods (AOR=0.3, 95% CI 0.1 to 0.7) and those who took iron and folic acid supplementation (AOR=0.6, 95% CI 0.4 to 0.9) during their pregnancy were less likely to develop folate deficiency.Conclusions In this study, a considerable proportion of pregnant women had folate deficiency during their pregnancy. Therefore, it is critical that nutritional treatment, education and counselling be strengthened to facilitate iron and folic acid supplementation during pregnancy.

Background: Syphilis infection is a major public health problem in developing countries including Ethiopia. Thus, this study aimed to assess the seroprevalence of syphilis and associated factors among pregnant women attending Antenatal Care (ANC) in Public health facilities in Shashemene town, southern Ethiopia. Method: An institutional-based cross-sectional study design was conducted among 230 pregnant women from the 27th of August to the 30th of September 2018. Data were collected using a structured interviewer-administered questionnaire. Data were entered into Epi-Info 7 and analyzed with SPSS Version 21. A multivariate logistic regression model was used to investigate factors associated with syphilis infection. A p-value of

This study analyzed the impact of technology adoption decisions on the yields of smallholder households in the study area. The data used for the study were obtained from 191 randomly selected sample households in the study area. The average treatment effect of adoption on household yield was estimated by using the propensity score matching method. The propensity score matching estimation showed that the average yields of adopters are greater than that of non-adopters. Since income and income proxy variables have a significant influence on the likelihood of farmers’ adoption income diversification interventions could have a pay-off. The PSM result showed that the positive effects of chemical fertilizer adoption on farm household yields. Since adopters are in a better position; appropriate strategies that increase the intensity of use for the adopter and encourage non-adopter to use chemical fertilizer on their farmland should be promoted and that there is a large scope for enhancing the role of chemical fertilizer in contributing to promoting production.

Abstract Background Adolescents and youths in Ethiopia have limited access to reproductive health services designed to address their needs. Therefore, the study aims to assess adolescents' and youth’s sexual practice, contraceptive use, and behavioral patterns towards safe sexual exercise. Methods A quantitative cross-sectional study design was used on 374 students selected from high school and vocational colleges to assess their sexual experience and contraceptive use and related perceptions using pre-tested self-administered semi-structured questionnaires. We used descriptive analyses to report their sexual and reproductive health status and logistic regression to examine the association between contraceptive use and other variables. Results The results show that 52.7% of the respondents (students) migrated or moved from rural to urban to continue their high school and college education at urban. 41.7% of the respondents were with less than 18 years, of which 75.9% of them already initiated sexual intercourse. Of all the students who started sexual intercourse (51.1%), only 30.9% used contraceptives, but condom use accounts for 49.2%. Overall, 84.8% of those who practiced sexual intercourse were at risk of acquiring sexually transmitted diseases due to not using a condom. About 3% of the respondents reported unwanted pregnancy experiences, of which 64% of these pregnancies were reported to be aborted. Conclusion Adolescents and youths attending high schools and College are at increased risk of acquiring HIV and unwanted pregnancy due to low levels of contraceptive use. Specifically, a designed youths-friendly reproductive health service is needed to avert related problems and contribute to sustainable development goals.

Fixing and implementing water charges in the irrigation sector is considered an important task for recovering operation and maintenance costs and promoting the efficient use of water. This study aims at developing an implementation strategy for water charges in the Central Rift Valley, Ethiopia. The study sets the agenda for this strategy by explaining why promoting the concept of fixing irrigation charges is necessary. Then it develops a conceptual framework, draws key lessons from global experiences, explores whether the new pricing policy is well aligned with national water policies and the roles and responsibilities of various actors and stakeholders involved, and identifies the factors for the successful implementation of this strategy. The study is mainly qualitative in nature, based on a review of the literature and consultations of key stakeholders. The study results call for clearly defining the key objectives of the policy, political commitment, and community participation, re-examining the role of institutions, capacity building, and establishing a multistakeholder platform. Basin-level implementation of this policy requires piloting and maintaining policy dynamics through adaptive management. The results provide generic lessons for other basins within Ethiopia and for sub-Saharan Africa (SSA). HIGHLIGHTS This study is based on a literature review and consultations of key stakeholders.; The water charge policy is well anchored in Ethiopia's water policies.; Its implementation requires developing the necessary modalities, redressing stakeholder grievances, addressing the issue of effective fee collection, recovering operation and maintenance costs, and providing improved services.; The piloting of the water charge policy in the Central Rift Valley, requiring the establishment of a multistakeholder platform (MSP), is critical for the upscaling of the policy.;

Abstract Background The consequence of the Great Ethiopian Famine (1983–1985) on mortality had been well documented. However, the long term assaults of the famine on adulthood health, particularly on the risk of hypertension, has never been documented. The aim of this study was twofold: to examine the association of prenatal-exposure to the Great Ethiopian Famine and hypertension in adulthood and investigate if there existed sex difference in the risk estimate. Methods Participants were recruited using multistage stratified random sampling and grouped as prenatal famine exposed and non-exposed cohorts based on their reported date of birth and current age. Independent sample T test was employed to compare continuous outcomes between the groups. A multivariable logistic regression was used to examine the association between prenatal famine exposure and risk of hypertension in adults. Results Compared to the non-exposed groups, prenatal famine exposed cohorts had higher systolic blood pressure by 1.05 mmHg, (95% CI 0.29, 4.42) and diastolic by 2.47 mmHg (95% CI 1.01, 3.95). In multivariable logistic regression analysis, both unadjusted (COR = 2.50; 1.575, 3.989) and adjusted model for covariates (OR: 2.306 95% CI (1.426, 3.72) indicated a positive association between prenatal famine exposure and the risk of adult hypertension. However, in sex disaggregated analysis, the positive association was only significant in females (AOR = 3.95 95% CI 1.76, 8.85) indicating nearly four folds of odds of hypertension among females, while the corresponding figure for males was not significant (AOR = 1.201 (0.69, 2.07). Conclusions Famine exposure during prenatal period could have differential impact on the development of hypertension based on sex, where adult exposed females had higher risk of hypertension as compared to males. Contextualized primary prevention programs with special focus on gender is critical undertaking in hunger spots and regions with historical famine.

Abstract Background Implementing effective and efficient case-finding strategies is crucial to increasing pediatric antiretroviral therapy coverage. In Ethiopia, universal HIV testing is conducted for children presenting at high-risk entry points including malnutrition treatment, inpatient wards, tuberculosis (TB) clinics, index testing for children of positive adults, and referral of orphans and vulnerable children (OVC); however, low positivity rates observed at inpatient, malnutrition and OVC entry points warrant re-assessing current case-finding strategies. The aim of this study is to develop HIV risk screening tool applicable for testing children presenting at inpatient, malnutrition and OVC entry points in low-HIV prevalence settings. Methods The study was conducted from May 2017–March 2018 at 29 public health facilities in Amhara and Addis Ababa regions of Ethiopia. All children 2–14 years presenting to five high-risk entry points including malnutrition treatment, inpatient wards, tuberculosis (TB) clinics, index testing for children of positive adults, and referral of orphans and vulnerable children (OVC) were enrolled after consent. Data were collected from registers, medical records, and caregiver interviews. Screening tools were constructed using predictors of HIV positivity as screening items by applying both logistic regression and an unweighted method. Sensitivity, specificity and number needed to test (NNT) to identify one new child living with HIV (CLHIV) were estimated for each tool. Results The screening tools had similar sensitivity of 95%. However, the specificities of tools produced by logistic regression methods (61.4 and 65.6%) which are practically applicable were higher than those achieved by the unweighted method (53.6). Applying these tools could result in 58‒63% reduction in the NNT compared to universal testing approach while maintaining the overall number of CLHIV identified. Conclusion The screening tools developed using logistic regression method could significantly improve HIV testing efficiency among children presenting to malnutrition, inpatient, and OVC entry points in Ethiopia while maintaining case identification. These tools are simplified to practically implement and can potentially be validated for use at various entry points. HIV programs in low-prevalence countries can also further investigate and optimize these tools in their settings.

BackgroundSeveral research studies have demonstrated the potential of mobile health apps in supporting health management. However, the design and development process of these apps are rarely presented.ObjectiveWe present the design and development of a smartphone-based lifestyle app integrating a wearable device for hypertension management.MethodsWe used an intervention mapping approach for the development of theory- and evidence-based intervention in hypertension management. This consisted of six fundamental steps: needs assessment, matrices, theoretical methods and practical strategies, program design, adoption and implementation plan, and evaluation plan. To design the contents of the intervention, we performed a literature review to determine the preferences of people with hypertension (Step 1) and necessary objectives toward the promotion of self-management behaviors (Step 2). Based on these findings, we implemented theoretical and practical strategies in consultation with stakeholders and researchers (Steps 3), which was used to identify the functionality and develop an mHealth app (Step 4). The adoption (Step 5) and evaluation (Step 6) of the mHealth app will be conducted in a future study.ResultsThrough the needs analysis, we identified that people with hypertension preferred having education, medication or treatment adherence, lifestyle modification, alcohol and smoking cessation and blood pressure monitoring support. We utilized MoSCoW analysis to consider four key elements, i.e., education, medication or treatment adherence, lifestyle modification and blood pressure support based on past experiences, and its potential benefits in hypertension management. Theoretical models such as (i) the information, motivation, and behavior skills model, and (ii) the patient health engagement model was implemented in the intervention development to ensure positive engagement and health behavior. Our app provides health education to people with hypertension related to their condition, while utilizing wearable devices to promote lifestyle modification and blood pressure management. The app also contains a clinician portal with rules and medication lists titrated by the clinician to ensure treatment adherence, with regular push notifications to prompt behavioral change. In addition, the app data can be reviewed by patients and clinicians as needed.ConclusionsThis is the first study describing the design and development of an app that integrates a wearable blood pressure device and provides lifestyle support and hypertension management. Our theory-driven intervention for hypertension management is founded on the critical needs of people with hypertension to ensure treatment adherence and supports medication review and titration by clinicians. The intervention will be clinically evaluated in future studies to determine its effectiveness and usability.

Abstract In the past decade, in low-income countries, there have been a rapid rise in prevalence of diabetes among adult population. Hence, understanding the context specific drivers of this change including the impacts of childhood nutrition adversaries on adult metabolic conditions is critical undertaking. This study investigates the potential effects of prenatal famine exposure to the Ethiopian great famine (1983–1985) on adulthood blood glucose level of survivors. A total of 441 adults (222 exposed and 219 controls) were included in the study. Self-reported place of birth and, date of birth and/or age were used to identify participants. A multivariable linear regression analysis was used to analyze the impact of prenatal famine exposure on the level of fasting blood glucose. In linear regression, unadjusted model (Model 1), fasting blood glucose level was increased by 4.13 (β = 4.13; 95% CI .41, 7.42) points in prenatal famine exposed groups, compared with non-exposed. Similarly, the positive association of prenatal famine exposure and fasting blood glucose level was maintained after adjusted for sex (Model 2) (β = . 4.08 95% CI .056, 7.50). Further adjusted for age, residence, educational status, wealth index and family size (Model 3) resulted in 4.10 (β = . 4.10 95% CI .45, 7.56) points increases in fasting blood glucose level. In model 4 adjusting for dietary pattern, physical activity level and family history of diabetes, alcohol and cigarette smoking resulted in 3.90 (β = 3.90, 95% CI 039, 7.52) points increase in fasting glucose level. In the he full adjusted model (Model 5) prenatal exposure to famine was resulted in 3.78 (β = 3.78, 95% CI .22, 7.34) increases in fasting blood glucose level after adjusted for BMI and waist to height ratio. There existed a positive association of prenatal famine exposure and adulthood blood glucose levels. In this population, establishing effective overweight/obesity prevention programs to minimize the co-impact of early famine exposure on blood glucose control are important.

Magarsa Bayissa Deressa,1,2 Tamirat Bekele Beressa,2 Awol Jemal1 1School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia; 2Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaCorrespondence: Tamirat Bekele Beressa, Email tamiratbekele12@gmail.comBackground: The medical materials, medical supplies, and medicines cover about one-third of the annual health care organization’s budget. Effective inventory management is required to balance inventory expenditure against demands for medications. The study aimed to analyze the pharmaceuticals inventory management using ABC-VEN Matrix in selected health facilities of the West Shewa zone.Methods: A facility-based cross-sectional study was conducted in health facilities of the West Shewa zone from March 15, 2019, to May 31, 2019, and analyzed by using an MS Excel spreadsheet.Results: At selected public health facilities of West Shewa zone in three years between September 12, 2015, and September 5, 2018, about 539 pharmaceutical items were utilized and consumed 30,837,628.61 ETB. ABC analysis indicated that 64 (11.9%), 68 (13.74%), and 38 (11.14%) of items were classified as the class “A” items and consumed around 70% of the total pharmaceutical expenditures (TPE) at selected health facilities (aggregated), hospitals, and health centers (HC), respectively. VEN analysis revealed that 115 (35.94%), 99 (35.61%), and 40 (20.83%) items were categorized as vitals and consumed 53.9%, 51.59%, and 36.93% of TPE at selected health facilities. ABC-VEN matrix analysis indicated that category I items consumed 85% of TPE.Conclusion: ABC-VEN matrix analysis of present study showed that the category I pharmaceuticals consumed a majority of TPE that need great attention for control.Keywords: ABC analysis, VEN analysis, ABC-VEN matrix analysis, West Shewa, Oromia, Ethiopia

With the emergence of microblogging platforms and social media applications, large amounts of user-generated data in the form of comments, reviews, and brief text messages are produced every day. Microblog data is typically of poor quality; hence improving the quality of the data is a significant scientific and practical challenge. In spite of the relevance of the problem, there has been not much work so far, especially in regard to microblog data quality for Short-Text Topic Modelling (STTM) purposes. This paper addresses this problem and proposes an approach called the Social Media Data Cleansing Model (SMDCM) to improve data quality for STTM. We evaluate SMDCM using six topic modelling methods, namely the Latent Dirichlet Allocation (LDA), Word-Network Topic Model (WNTM), Pseudo-document-based Topic Modelling (PTM), Biterm Topic Model (BTM), Global and Local word embedding-based Topic Modeling (GLTM), and Fuzzy Topic modelling (FTM). We used the Real-world Cyberbullying Twitter (RW-CB-Twitter) and the Cyberbullying Mendeley (CB-MNDLY) datasets in the evaluation. The results proved the efficiency of the GLTM and WNTM over the other STTM models when applying the SMDCM techniques, which achieved optimum topic coherence and high accuracy values on RW-CB-Twitter and CB-MNDLY datasets.

Tafesse Gizaw,1 Awol Jemal,2 Tadesse Gudeta2 1Quantification and Market Shaping Office, Ethiopian Pharmaceuticals Supply Agency, Jimma, Ethiopia; 2Department of Social and Administrative Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Tafesse GizawQuantification and Market Shaping Office, Ethiopian Pharmaceuticals Supply Agency, PO Box 359, Jimma, EthiopiaEmail tafessegizaw@gmail.comBackground: Coronavirus disease 2019 (Covid-19) has had an unprecedented impact on the health products delivery system. To maintain routine health services, tracer pharmaceuticals (TPs) should always be available and accessible in healthcare institutions. Thus, this study aimed to explore the influence of the Covid-19 on TPs availability and distribution trends in the context of the Covid-19 pandemic in Ethiopia.Methods: An institution-based comparative study was undertaken on 25 TPs in the pharmaceutical supply agency. From the agency’s logistical data, we collated the amount of TPs ordered, received, and distributed, as well as the stock status, by using an observation checklist. The collated data were recorded in Microsoft Excel and transferred to SPSS for analysis. A frequency and percentage analysis were performed to evaluate the fill rate, product availability, and stock-out duration. A dependent t-test was used to compare if there was a significant mean difference in TPs distribution before and after the Covid-19 at a p-value less than 5%.Results: Before Covid-19, 18 (72%) of the TPs were refilled above 80% of amount ordered. After the pandemic, however, the fill rate dropped to 48%. The availability of TPs during the Covid-19 was 60%. During the six months of Covid-19, the average stock-out duration for all TPs was 34.68 days, with Cimetidine 200mg/mL injectable (line-item fill rate = 0, days out of stock = 180 days) being the most stocked-out item. Tracer pharmaceuticals distribution before Covid-19 (M = 81,317, SD = 139,274) were significantly different after the pandemic (M = 60,212, SD = 94,966) at the 5% significance level (t (24) = 2.289, p = 0.031).Conclusion: This survey reveals how Covid-19 has influenced service providers’ logistics systems. Following the pandemic, the line fill rate fell below half with a three-fifths availability of products. To effectively manage supply chain disruptions experienced in Covid-19 and beyond, the agency in collaboration with stakeholders should make an effort to enhance end-to-end inventory visibility, establish a resilient logistics system, strengthen domestic manufacturers’ capabilities, and develop contingency plans with supplying partners.Keywords: Covid-19, tracer pharmaceutical, availability, distribution, pharmaceutical supply agency, Ethiopia

Cyberbullying (CB) has become increasingly prevalent in social media platforms. With the popularity and widespread use of social media by individuals of all ages, it is vital to make social media platforms safer from cyberbullying. This paper presents a hybrid deep learning model, called DEA-RNN, to detect CB on Twitter social media network. The proposed DEA-RNN model combines Elman type Recurrent Neural Networks (RNN) with an optimized Dolphin Echolocation Algorithm (DEA) for fine-tuning the Elman RNN’s parameters and reducing training time. We evaluated DEA-RNN thoroughly utilizing a dataset of 10000 tweets and compared its performance to those of state-of-the-art algorithms such as Bi-directional long short term memory (Bi-LSTM), RNN, SVM, Multinomial Naive Bayes (MNB), Random Forests (RF). The experimental results show that DEA-RNN was found to be superior in all the scenarios. It outperformed the considered existing approaches in detecting CB on Twitter platform. DEA-RNN was more efficient in scenario 3, where it has achieved an average of 90.45% accuracy, 89.52% precision, 88.98% recall, 89.25% F1-score, and 90.94% specificity.

[This corrects the article DOI: 10.1371/journal.pone.0269510.].

Abstract Background One of the strategies to promote child health and reduce child mortality is growth monitoring and promotion services. But, there is limited information on determinants of Growth Monitoring and Promotion service utilization. Objective To identify determinants of growth monitoring and promotion (GMP) service utilization among children 0–23 months of age in Legambo district, South Wollo zone, Northern Ethiopia, 2020. Methods Community based un-matched case-control study was conducted on 363 (91 cases and 272 controls) study participants from March 15 to April 15, 2020. A multi-stage sampling technique was employed to select the study participants. Bivariable and multivariable logistic regressions were performed and an adjusted odds ratio with 95% confidence intervals was estimated to identify determinants of GMP service utilization. Results A total of 358 mothers (89 cases and 269 controls) with 98.6% response rate were included in the study. The mean (±SD) age of child was 11.66(±6.29) months among controls and 15.02 (±6.06) months among cases. Good maternal knowledge (AOR) = 2.42; 95% CI: 1.23, 4.75), favorable attitude (AOR = 2.45; 95% CI; 1.20, 4.98), counseling on GMP (AOR = 2.34; 95% CI; 1.19, 4.56), attending ante natal care services (AOR = 2.46; 95% CI: 1.18, 5.16), index child age 12–17 months (AOR = 3.45; 95% CI: 1.26, 9.41) and 18–23 months (AOR = 4.38; 95% CI: 1.53, 12.49), and short distance to health facilities (AOR = 4.53; 95% CI; 1.99, 10.28) were determinants of GMP service utilization. Conclusion Index child age, good knowledge, favorable attitude, attending antenatal care services, receiving nutritional counseling, and a short distance to health facility were determinants of GMP service utilization. Nutritional interventions should emphasize nutritional counseling and accessibility of growth monitoring and promotion services.

The major objective of this study was to examine the impact of Coffee exports on economic growth in Ethiopia. The study employed an extended generalized Cobb–Douglas production function model using data from the National Bank of Ethiopia and World Bank data base from 1980 to 2017. All the variables were non stationary at level and integrated of order I (1), and then co-integration test was conducted to ensure the existence of long-run relationship using Johansen’s approach. Consequently, all the variables confirmed co-integartion, and the conventional VECM was estimated to extract both short-run and long-run relationships, and finally, Granger causality test was conducted to diagnose the direction of causation. The finding of the study revealed that coffee exports have insignificant short-run impact on economic growth, but significant positive impact in long run. The result from causality exerted bidirectional relationship holds in Ethiopia’s coffee exports, likewise the result from IRF revealed coffee exports has a positive impact on long-run economic growth. Besides, labor force, capital formation, non-coffee exports and real effective exchange rates included in the model were found positive and significant impact in long run. Furthermore, the coefficient of ECT is −0.4883 that shows any deviations from long-run equilibrium is corrected at 48.83% annually and converges towards its long-run equilibrium. Based on the findings, it is recommended that a long-run policy towards exports in general and coffee export in particular is believed to provide significant impact on economic growth. Thus, increasing efficiency of the sector and exporting coffee would enable Ethiopia to sustain domestic economic growth. Besides, values had better be added to coffee beans before exporting and when this is done, it will lead to a higher economic growth in long run.

Ethiopia, a densely populated country with abundant natural resources, is often hit by climate extreme disasters that cause severe damage to life and property every year in one or the other corner. The frequency and intensity of extreme events have increased in the recent decades due to climate change and variability. This study aimed to analyze the changes in observed rainfall and minimum and maximum temperature extremes in the Upper Blue Nile Basin (UBNB) of Ethiopia from 1980 to 2019 periods. The Mann-Kendall (MK) trend test and Theil-Sen's slope estimator were used to estimate annual and seasonal trends. The rainfall and temperature extremes were analyzed using RClimDex, which is a graphical user interface in R software, by selecting ten rainfall and eleven temperature indices. The results showed a positive trend in annual, dry (March–May) and small rain (October–February) seasons rainfall in more than 54% of the stations and a decreasing trend in the main rain (June–September) season rainfall in 65.4% of the stations. Several extreme rainfall indices showed insignificant positive trends in the basin. Although there is a positive trend in extreme rainfall, the number of consecutive wet days (CWD) and the simple daily intensity index (SDII) show insignificant negative trends in most stations. In addition, a warming trend of the annual and seasonal maximum and minimum temperature extreme indices was noted. Overall, the increase in extreme rainfall and a warming trend in the extreme temperature indices indicate signs of climate change in the UBNB. The findings of this study suggests the need for developing climate change adaptation and mitigation strategies in the UBNB.

Hussien Bedru,1 Melaku Fikru,2 Wardofa Niguse,2 Aman Jemal,2 Garoma Getinet,2 Ameni Gobena,3,4 Awraris Hailu,5 Sandy Peter6 1Department of Public Health, Goba Referral Hospital, Madda Walabu University, Goba, Oromia Region, Ethiopia; 2Tuberculosis Unit, Adama Public Health Research Laboratory, Oromia Health Bureau, Adama, Oromia Region, Ethiopia; 3Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Al Ain, United Arab Emirates; 5Department of Public Health, Debre Birhan University, Debre-Birhan, Ethiopia; 6Department of Health Studies, University of South Africa, Pretoria, South AfricaCorrespondence: Hussien BedruGoba Referral Hospital, P.O.Box: 302 Tel +251911997287Fax +25122661-0164Email bedru1964@gmail.comPurpose: Multidrug resistant tuberculosis is an emerging problem in many parts of the world. The aim of this study was to determine the drug resistance pattern of Mycobacterium tuberculosis complex in Oromia Region of Ethiopia.Patients and Methods: A cross-sectional study was conducted from Jan 2017 to June 2018 on 450 pulmonary tuberculosis patients who visited health facilities in nine administrative zones of Oromia Region. Socio-demographic characteristics and relevant clinical information were obtained using a structured questionnaire. Line Probe Assay for first and second line drugs was used to assess the pattern of drug resistance. SPSS version 20 was used for statistical analysis.Results: Median age was 26 years and 240 (53.3%) patients were males. About 24% of them were previously treated for tuberculosis. Thirty-four (7.6%) were HIV co-infected. Line Probe Assay interpretable results were obtained for 387 isolates. Thirty (7.8%) were resistant to rifampicin and isoniazid and thus were multidrug resistant isolates. Among the multidrug resistant samples, three were found to be extensively drug resistant and one was pre-extensively drug resistant. Previous treatment history (AOR 9.94 (95% CI 3.73– 26.51), P < 0.001) and nutritional status below normal (AOR 3.15 (95% CI 1.13– 8.81), P < 0.029) were found to be associated with multidrug resistance. The chi-square tests have shown that there was a significant difference between the BCG vaccinated and the non-vaccinated in developing multidrug resistant tuberculosis at P = 0.027.Conclusion: The proportion of multidrug resistance is above the WHO estimate for the country, Ethiopia, and the fact that some zones were at risk of transmission of extensively drug resistant tuberculosis warrant great attention of the control program holders even though it has to be verified through the conventional method.Keywords: line probe assay, multidrug resistant tuberculosis, extensively drug resistant tuberculosis, Oromia

Abstract Background Effective risk communication is one of the critical strategies in the response to COVID-19. This study examined risk perceptions and attitudinal responses to COVID-19 among the educated section of the society in Ethiopia. Methods An internet-based survey was conducted from April 22 to May 04, 2020, in Ethiopia. A questionnaire addressing the perception of health threat-combination of perceived vulnerability (PV) and perceived seriousness (PS), and perceived efficacy-combinations of perceived response efficacy (PRE), perceived self-efficacy (PSE), and perceived collective efficacy (PCE). The data were analyzed using SPSS 21.0. Descriptive statistics were computed after the standardization of the scores. The scores for overall efficacy and threat were split by median value and response classifications were generated through threat by efficacy interactions. For statistical significance, 95% CI and p-value

IntroductionEthiopia is the second most populous country in Africa. Ethiopia received most of its COVID-19 vaccines through donations. The Oxford AstraZeneca vaccine is the first to be donated to Ethiopia by the COVAX facility. Healthcare workers were the priority population that received the Oxford AstraZeneca COVID-19 vaccine. However, there was no nationwide study on the safety of the vaccine in Ethiopia. This study aimed to measure the prevalence and predictors of self-reported side effects of the Oxford AstraZeneca vaccine.Materials and methodsThe study employed a cross-sectional design. A sample of healthcare workers who took Oxford AstraZeneca COVID-19 vaccine was drawn from four regions of Ethiopia; namely, Amhara, Oromia, Somali, and Southwest. Data were collected on sociodemographic characteristics, medical anamnesis, COVID-19 related anamnesis, and COVID-19 vaccine anamnesis via telephone interview. Descriptive and inferential analyses were done. The software, IBM SPSS Statistics v21.0, was used for analyses of data.ResultsOut of 384 people, 346 responded (response rate: 90.1%). Female accounted for 34.1% of the respondents. The mean age of the respondents was 31.0 years (Standard Deviation (SD) = 7.4). Nurses accounted for 43.7% of the respondents. The prevalence of at least one local- and systemic-side effect was 50.6 and 44.5%, respectively. The most frequent local- and systemic- side effect were injection site pain and headache, respectively. Both types of side effects mostly subsided in the first 3 days. A third of healthcare workers with side effects took at least one medication. Paracetamol followed by diclofenac sodium were taken by healthcare workers to overcome side effects. There was no independent predictor of local side effect. After controlling for age and chronic diseases, the odds of healthcare workers with COVID-19 like symptoms to experience systemic side effects was 1.38 (Confidence Interval (CI): 1.04–1.82) times more than that of healthcare workers without COVID-19 like symptoms.ConclusionsThe prevalence of local- and systemic-side effects of the Oxford AstraZeneca COVID-19 vaccine was modest. As the symptoms were mostly common in the first 3 days, it is preferable to monitor healthcare workers at least in the first 3 days following the administration of the vaccine.