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: Introduction: World Health Organization (WHO) guidelines have shifted over time to recommend earlier initiation of antiretroviral therapy (ART) and now encourage ART initiation on the day of HIV diagnosis, if possible. However, barriers to ART access may delay initiation in resource‐limited settings. We characterized temporal trends and other factors influencing the interval between HIV diagnosis and ART initiation among participants enrolled in a clinic‐based cohort across four African countries. Methods: The African Cohort Study enrols adults engaged in care at 12 sites in Uganda, Kenya, Tanzania and Nigeria. Participants provide a medical history, complete a physical examination and undergo laboratory assessments every six months. Participants with recorded dates of HIV diagnosis were categorized by WHO guideline era ( Results and discussion: From January 2013 to September 2019, a total of 2888 adults living with HIV enrolled with known diagnosis dates. Median time to ART initiation decreased from 22.0 months (interquartile range (IQR) 4.0 to 77.3) among participants diagnosed prior to 2006 to 0.5 months (IQR 0.2 to 1.8) among those diagnosed in 2016 and later. Comparing those same periods, CD4 nadir increased from a median of 166 cells/mm[sup.3] (IQR: 81 to 286) to 298 cells/mm[sup.3] (IQR: 151 to 501). In the final adjusted model, participants diagnosed in each subsequent WHO guideline era had increased rates of ART initiation compared to those diagnosed before 2006. CD4 nadir ≥500 cells/mm[sup.3] was independently associated with a lower rate of ART initiation as compared to CD4 nadir 50 years at diagnosis was independently associated with shorter time to ART initiation as compared to 18 to 29 years (HR: 1.38; 95% CI: 1.19 to 1.61). Conclusions: Consistent with changing guidelines, the interval between diagnosis and ART initiation has decreased over time. Still, many adults living with HIV initiated treatment with low CD4, highlighting the need to diagnose HIV earlier while improving access to immediate ART after diagnosis., Introduction The introduction of antiretroviral therapy (ART) proved a turning point in the fight against HIV, leading to dramatic decreases in HIV‐related morbidity and mortality. However, the first ART regimens [...]

ABSTRACT Hemocytes constitute the cellular part of the mollusc immune system and are involved in phagocytosis; the production of toxic oxygen radicals, antimicrobial peptides, opsonizing molecules, and lysozymes; digestion, excretion, [...]

Summary: Purpose: The emergence of antimicrobial resistance is a major global health challenge and becoming an urgent priority for policymakers. There is a paucity of scientific studies presenting the multidrug resistance pattern from one health perspective in Ethiopia. Therefore, a systematic review and meta-analysis aimed to determine the pooled prevalence of multidrug resistance in bacteria from human, animal, food, and environmental sources. Methods: In this systematic review and meta-analysis, an electronic search was made in PubMed & Google scholar using different keywords. The studies conducted in all areas of Ethiopia, published from 2015 to 2020 in peer-reviewed journals, English full-length papers were included. The meta-analysis was done on STATA version 14. The pooled prevalence of multidrug resistance for each bacterium was analysed using the random-effects model; Cochran Q statistics and the I2 statistic was used to analyse heterogeneity and considered significant at p

Randolph soybean [Glycine max (L.) Merr.] (Reg. no. CV-473, PI 633424), a maturity group (MG) VI cultivar, was developed jointly by the Virginia State University, Agricultural Research Station and the [...]

'Asmara' soybean [Glycine max (L.) Merr.] (Reg. no. CV-470, PI 633049), a maturity group (MG) VI cultivar, was developed jointly by the Virginia State University, Agricultural Research Station and the [...]

Soybean [Glycine max (L.) Merr.] germplasm lines VS9411 (Reg. no. GP-297, PI 632747), VS94-12 (Reg. no. GP-29 PI 632748), and VS94-21 (Reg. no. GP-299, PI 632749) wit resistance to corn [...]

Abstract Introduction Intestinal parasites are amongst the major public health challenges facing Sub-Saharan Africa. The aim of the study was to determine the prevalence of intestinal parasites and its associated factors among food handlers in Medebay Zana District, Tigray, Ethiopia. Methods A cross-sectional study was conducted among 401 food handler individuals selected by systematic random sampling. Binary and multivariable logistic regression was used to determine the possible association between the independent variable and outcome variables. Statistical significance was declared at p-value

Abstract Background Worldwide cervical cancer is the third most common malignancy in women. It usually arises from the cervical area which is susceptible to Human Papilloma virus induced malignancy changes. In low-resource setting visual inspection with acetic acid (VIA) is an alternative sensitive cervical screening method. Therefore the aim of this study was to assess the magnitude and associated factors of VIA positive test results for Cervical Cancer screening among Eritrean refugee women aged 25–49 years in northern Ethiopia refugee camps. Methods A community based cross-sectional study was conducted among 412 Eritrean refugee women aged 25–49 years from august 10 to September 25, 2018. Study subjects were selected by simple random sampling method. Data were collected using pretested structured questioner through Face-to-face interview and cervical examination. Data were coded and entered to Epi info software version 7 and then exported to Statistical package for Social Science (SPSS) version 21 for analysis. Bivariable and multivariable logistic regression analysis was made to test the association between the independent variables and the outcome variable. P-value of less than 0.05 with 95% CI was considered to declare statistical significance. Result In this study the magnitude of VIA positive precancerous cervical lesions was 9% (95% CI: 6.3–11.8%). Previous history of sexually transmitted infections (STI) [AOR (95%CI) = 2.84(1.07–7.53)] and presence of STI during cervical examination [AOR (95%CI) =3.97(1.75–9.00)] were found significantly associated with VIA positive precancerous cervical lesions. Conclusions In this study the magnitude of VIA positive precancerous cervical lesions was high. Previous history of sexually transmitted infections (STI) and presence of STI during cervical examination were found associated with VIA positive precancerous cervical lesions. Efforts such as early screening for sexually transmitted disease shall be done to prevent precancerous cervical lesions.

Abstract Objective Migration is a contemporary global issue and the exodus of refugees may potentially posit new social health challenges in the host communities. Ethiopia is a host to the second largest refugee population in Africa. The aim of this study was to explore the health impacts by the Eritrean refugees in May-ayni camp, North West Tigrai on the host community. The research used a qualitative exploratory approach. Participants were recruited using a purposive sampling technique. The primary sources of the data were in-depth interviews of 20 key informants, and focus group discussions with 30 refugees and 30 members of the host community. Transcription and translation was done verbatim and finally thematic analysis was done using an inductive approach. Results The findings of this research indicated that the refugees in the May-ayni camp created actual social and health threats to the members of the host communities. The socio-cultural norms of the host peoples were disrupted in terms of their social insecurity and introduction of health related challenges such as the spread of sexually transmitted infections and other reproductive health problems.

Abstract Background Adequate nutrition during early childhood ensures growth and development of children and breast milk is better than any other products given to a child. However, studies on exclusive breastfeeding practice are limited in Somaliland. Therefore, this study was aimed to assess exclusive breastfeeding for the first 6 months of life and its associated factors among children 6–24 months of age in Burao district, Somaliland. Methods A community-based cross-sectional study was conducted from 26 August to 10 October 2018, in Burao district among randomly, selected 464 mothers with children 6–24 months of age. Data were collected through face-to-face interview using pretested structured questionnaire. Results The prevalence of exclusive breastfeeding was 20.47% (95% CI 18.84, 23.63%). Exclusive breastfeeding practice was associated with: having female child (AOR 0.48; 95% CI 0.29, 0.80)), lack of formal education (AOR 0.32; 95% CI 0.19, 0.53), household monthly income 100$-200$ (AOR 0.35;95% CI 0.18, 0.68), lack of husband’s support (AOR 0.32; 95% CI 0.19, 0.53), and mothers who were not counselled on breastfeeding during antenatal care (AOR = 0.33; 95% CI 0.16, 0.66). Conclusions Exclusive breastfeeding practice was very low as compared to recommendations of infant and young child practice (IYCF) which recommends children to exclusively breastfeed for the first 6 months of life. Exclusive breastfeeding practice was associated with a mother’s lack of formal education, monthly income less than 100$, being a female child, lack of advice on exclusive breastfeeding during antenatal care and lack of husband support. The promotion of education for women, husband’s engagement, encouraging antenatal care follow-up and counseling of exclusive breastfeeding during antenatal care was recommended to improve exclusive breastfeeding practice.

Abstract Background Ethiopia initiated antiretroviral therapy early in 2005. Managing and detecting antiretroviral treatment response is important to monitor the effectiveness of medication and possible drug switching for low immune reconstitution. There is less recovery of CD4+ T cells among human immunodeficiency virus patients infected with tuberculosis. Hence, we aimed to assess the effect of tuberculosis and other determinant factors of immunological response among human immunodeficiency virus patients on highly active antiretroviral therapy. A retrospective follow up study was conducted from October to July 2019. A total of 393 participants were enrolled. An interviewer based questionnaire was used for data collection. Patient charts were used to extract clinical data and follow up results of the CD4+ T cell. Current CD4+ T cell counts of patients were performed. STATA 13 software was used to analyze the data. A p-value ≤0.05 was considered a statistically significant association. Results The mean age of study participants was 39.2 years (SD: + 12.2 years) with 8.32 mean years of follow up. The overall prevalence of immune reconstitution failure was 24.7% (97/393). Highest failure rate occurred within the first year of follow up time, 15.7 per 100 Person-year. Failure of CD4+ T cells reconstitution was higher among tuberculosis coinfected patients (48.8%) than mono-infected patients (13.7%). Living in an urban residence, baseline CD4+ T cell count ≤250 cells/mm3, poor treatment adherence and tuberculosis infection were significantly associated with the immunological failure. Conclusions There was a high rate of CD4+ T cells reconstitution failure among our study participants. Tuberculosis infection increased the rate of failure. Factors like low CD4+ T cell baseline count, poor adherence and urban residence were associated with the immunological failure. There should be strict monitoring of CD4+ T cell counts among individuals with tuberculosis coinfection.

Abstract Background Infants are in a state of rapid development and maturation; the growth rate is most rapid during the first 4 to 6 months of life. Few studies indicated that in developing countries including Ethiopia the prevalence and duration of breastfeeding is declining and being replaced by formula milk. Therefore, this study aimed to assess the formula-feeding practice and its associated factors among urban and rural mothers with infants 0–6 months of age in the Jimma Zone, Western Ethiopia. Methods A community-based cross-sectional study was conducted from November 7, 2015, to January 10, 2016, in the Jimma Zone. The quantitative data were collected from a sample of 714 respondents using a multistage sampling technique. Data were collected through a structured questionnaire and the multivariate logistic regression model was used to show predictors of the formula-feeding practice among mothers with infants 0–6 months of age. Result The proportion of mothers who feed their baby formula-based was 47.2%, of which 34.5% were living in rural areas and 65.5% were living in urban areas. Among the mothers living in urban areas, the likelihood of formula-feeding was significantly associated with maternal educational status and attitude towards formula-feeding. On the other hand, being attended by relatives/friends and the traditional birth attendant was significantly associated with the formula-feeding practice among mothers who live in rural areas. Conclusion Nearly half of the mothers in the study area practice formula-feeding for their infant. Therefore, sustained community based nutritional health education is recommended for pregnant and lactating mothers to reduce the practice of formula-feeding for infants.

Abstract Objective Accidental occupational injuries to health care workers (HCWs) continue to have a significant problem in the healthcare system. Thus, the aim of this study was to assess prevalence of needle sticks and sharp injury and associated factors among health care workers working in Central Zone Tigray northern Ethiopia. Result The prevalence of needle stick and sharp injury in the past 12 months preceding the study and entire job were 25.9% and 38.5% respectively. Nearly one-third (31%) of the injuries occurred in emergency unit and 122 (71.3%) of the materials caused injury were used on patients. Practice of needle recap, ever used cigarette in last 12 months, training, work hours > 40 per week, job dissatisfaction and work experience less than 5 years were found factors significantly associated with needle stick and sharp injury for health care workers. The magnitude of Needle stick and sharp injury is high in the study area. Policy makers should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.

Abstract Objective Premarital sexual practice during adolescence time may lead to different sexual and reproductive health problems including HIV/AIDS. This study was aimed to assess the prevalence of premarital sexual practice and associated factors among adolescents living in the refugee camps in Tigray, northern Ethiopia. Result The prevalence of premarital sexual practice was 47.6% [95% CI (43.3%, 51.9%)]. The age (mean ± SD) of the study participants was 17.4 ± 2.71 (15–24 years) and 68.8% of them were males. Being in the age group 14–19 years [AOR = 4.50, 95% CI (2.29–8.84)] or 20–24 years [AOR = 9.76, CI (4.58–20.82)], living with friends [AOR = 5.24, 95% CI (2.28–12.05)] or alone [AOR = 5.72, 95% CI (2.69–12.19)], being in primary school [AOR = 6.93, 95% CI (3.08–15.57)] or college [AOR = 4.33, CI (1.44–13.02)], getting pocket money [AOR = 4.14, 95% CI (2.31–7.41)], parents being either divorced [AOR = 5.11, 95% CI (2.42–10.80)] or widowed [AOR = 3.52, 95% CI (1.69–7.33)], alcohol consumption [AOR = 1.99, 95% CI (1.20–3.38)] were independent predictors of premarital sexual practice among the adolescents.

Abstract Background Homeless women are a highly vulnerable group for risks of pregnancy and childbirth-related complications. They may also face multiple challenges to access and utilize maternity healthcare services. This study was aimed to explore the experience of homeless women on maternity healthcare service utilization and associated challenges in Aksum Town, Northern Ethiopia. Methods An exploratory qualitative study was employed using in-depth interviews among 22 study participants from February to March 2016. Purposive sampling was used to recruit 12 homeless mothers who gave birth when being homeless in the last 12 months and 10 healthcare providers as key informants. Data were captured using audio recorders and field notes and transcribed, translated verbatim and thematic analysis approach was facilitated using ATLAS.ti7 software. Results The finding reveals that homeless women did not use any of the basic maternity health care services, namely antenatal care, skilled birth attendance, and postnatal care. Lack of permanent place and awareness, and fear of stigma and discrimination were some reasons hindering homeless women from using the services. Conclusions Even though maternity health service utilization is the most crucial intervention to reduce maternal and newborn deaths, this finding shows that maternity health service utilization among homeless women was limited. Socio-cultural, socioeconomic and healthcare-related factors contributed to the non-use of these services. Efforts should be made to address the challenges faced by homeless women to utilize maternity health services.

Abstract Objectives Most maternal and newborn deaths occur during labour and delivery. Birth preparedness and complication readiness practice getting early services when problems may arise is the most achievable components of safe motherhood strategies. However, there is limited evidence found particularly in the study area. Thus, a community based cross-sectional study was conducted from May 17 to June 30, 2017, to assess birth preparedness practice and associated factors among pregnant women in Medebay Zana district in Northern Ethiopia. Result The finding showed that about 176 (32%) of the respondents were prepared for birth based on the criteria set in this study. Preparation for birth was higher among married women (AOR = 4.14, 95% CI (1.47–11.64)), among governmental employed women (AOR = 2.69, 95% CI (1.19–6.05)), those who attend antenatal care service (AOR, 0.11, 95% CI (0.05–0.22)), planned pregnancy (AOR = 0.06, 95% CI (0.03–0.15), those who had saving habit (AOR = 15.81, 95% CI (7.20–34.72), duration of pregnancy near to 9 month (AOR = 5.86, 95% CI (3.25–10.58). Preparation for birth was lower among illiterate mothers (AOR = 0.15, 95% CI (0.07–0.30), among mothers who attended primary education (AOR = 0.01, 95% CI (0.01–0.04)). The prevalence of birth preparedness practice in the study area was low. Community-based health education about preparation for birth is important.

Abstract Background Toxoplasma gondii infection is a great health concern to pregnant women and the developing fetus. The aim of this study was to determine the seroprevalence of T. gondii and its associated factors in Adwa district. Methods A facility based cross-sectional study was conducted from January to June 2018 in Adwa district. Structured, a pre-tested questionnaire was used to collect the demographic and risk factor related data. Serum sample, collected from each of the study subjects was tested for IgG and IgM anti T.godii specific antibodies using Enzyme-Linked Immunosorbent Assay. A bivariable and multivariable logistic regression model was applied to show association between the dependent and independent variables considering P

Abstract Background The geographical distribution of intestinal parasites with conditions of poverty in most countries of sub-Saharan Africa coincides with that of HIV/AIDS. However, there is paucity of studies investigating the relationship between intestinal parasitic infections with CD4 counts and anemia in HIV/AIDS patients starting Antiretroviral Therapy (ART) in this region particularly and in Ethiopia in general. The aim of this study was to determine the prevalence of intestinal parasitic infections in relation to CD4 count and anemia among ART-initiated patients in St. Mary Aksum General Hospital, Tigray, Ethiopia. Methods A cross-sectional study was conducted among randomly selected 242 ART-initiated participants during February to April 2017 in St. Mary Aksum General hospital. Data was collected using structured questionnaire and laboratory examination. Logistic regression was applied to assess any association between explanatory factors and outcome variables (P values

Abstract Objectives HIV remained the major cause of death in women of reproductive age worldwide. There is limited evidence regarding the fertility desire of HIV positive women receiving HIV care in the study area. Therefore, facility based cross-sectional study was conducted from March to April 2017 to assess fertility desire of HIV positive women and associated factors among mothers in receiving HIV care Jimma town, Southwest Ethiopia. Simple random sampling technique was taken to draw the sample after stratification. Data were analyzed using SPSS version 21 and statistical significance was declared at P value less than 0.05. Results This finding showed that, 175 (46.8%) of the Antiretroviral therapy users had fertility desire with those significantly associated factors; women in the age 18–29 years [AOR = 4.05, 95% CI 1.24–13.33], being married [AOR = 0.32, 95% CI (0.13–0.78)], having diploma educational level [AOR = 5.34, 95% CI 1.10, 15.60], having only boys or girls children [AOR = 2.79, 95% CI (1.24–6.25)], having 18–36$ monthly income [AOR = 1.27, 95% CI (1.56–10.67)], Partner’s HIV status [AOR = 3.56, 95% CI (3.02–9.33)] and non use of contraceptives [AOR = 2.57, 95% CI (1.08–6.13)]. Fertility desire in the study area was high. Strengthening PMTCT service should consider fertility desire of mothers living with HIV.

Abstract Background Adolescents especially females in rural area are vulnerable to a wide range of reproductive health problems including sexually transmitted infections, unwanted pregnancies, and unsafe abortion. They have limited access to reproductive health services that focus on the special needs of female adolescents. This study was aimed to assess the determinants of reproductive health service utilization among rural female adolescents of Asgede-Tsimbla district. Methods A community-based cross-sectional study was carried out from February to April 2018, in eight randomly selected sub-districts of Asgede-Tsimbla. A total of 844 female adolescents aged 15–19 were interviewed using a pre-tested structured questionnaire. Data were entered into Epi-info Version 3.5.3 and then exported to SPSS Version 21 for analysis. Bivariate and multivariate logistic regression analysis was carried out to assess the association. Statistical significance was declared by 95% confidence interval of the odds ratio. Result From 844 participants, 95.5% of female adolescents heard about reproductive services from different sources and 69.7% of them utilized the reproductive health services within the last 12 months. Factors like, age of 16–20 years (AOR = 1.85, 95%CI: 1.17–2.92), mother’s educational status (being illiterate (AOR = .33, 95%CI:.14–.77)), discussion about reproductive health services with their family (AOR = 8.02, 9%CI:5.52–11.66), being Merchant (AOR = 2.7995%CI:1.11–6.96), unemployed (AOR = 2.90, 95%CI:1.19–7.06) or student (AOR:2.38, 95%CI:1.04–5.42) in occupation, high perceived severity (AOR = 4.05, 95%CI:2.68–6.11), high perceived barriers (AOR = .44, 95%CI:.30–64) were independent predictors of reproductive health services utilization among female adolescents the study area. Conclusion About 69.7% of the adolescent females were utilizing reproductive health services in the study area though it was very low as compared with the national plan. Introducing messages that increase the perceived threat and decreasing perceived barriers to utilize reproductive health services as well as increasing self-efficacy of adolescent females would help further increase reproductive health services utilization by adolescent females.

Abstract Objective In Asthma management, poor handling of inhalation devices and wrong inhalation technique are associated with decreased medication delivery and poor disease control. The aim of this study was to assess the status of Metered dose inhaler technique, associated factors and its impact on Asthma control among adult patients with Asthma. Results The mean duration of Asthma was 15 ± 13 years. Asthma was uncontrolled in 70.4% of the participants and the poor technique of Asthma inhaler device was observed in 71.4% of the patients. Lack of health education on Metered dose inhaler technique [AOR =4.96; 95% CI (1.08–22.89)], and uncontrolled Asthma [AOR =3.67; 95% CI (1.85–7.23)], was independently associated with poor Metered dose inhaler technique.

Abstract Background Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) are the double burden diseases of the world. The African continent takes a great share of TB-HIV cases worldwide. This study was aimed to determine the prevalence of TB-HIV co-infection in Ethiopia, using a meta-analysis based on a systematic review of published articles. Methods An electronic search was conducted in databases including PubMed, HINARI, EMBASE, Cochrane library and Google Scholar to extract the articles. Articles published between 1995 and November 2017 had been searched for using different keywords. The analysis was performed using MetaXL software and R statistical software (version 3.2.3). Result Our searches returned a total of (n = 26,746) records from 30 articles of which 21 were cross-sectional, 7 were retrospectives and 2 were prospective studies. The range of prevalence of TB-HIV co-infection was found to be from 6 to 52.1% with random effects pooled prevalence of 22% (95% CI 19–24%) and with substantial heterogeneity chi-square (X2 ) = 746.0, p