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1. Immediate health and economic impact of the Tigray war on internally displaced persons and hosting households

Author: Aregawi Gebreyesus, Afework Mulugeta, Abraha Woldemichael, Akeza Awealom Asgedom, Girmatsion Fisseha, Mache Tsadik, Tesfay Gebregzabher Gebrehiwot, Mengistu Mitiku, Molla Teferi, Hagos Godifay, and Yibrah Alemayehu
Subjects: Medicine, Science
Abstract: Abstract Globally, war is the major cause of displacement from the usual place of the biological environment. The war of Tigray exposed thousands of people to internal displacement and migration. Evidence has shown that displaced people and migrants shoulder the health and economic burden to ensure survival. However, evidence of the impact of the war on health and the economy related to the displaced people and their hosting communities is not documented. Thus, this study aimed to investigate the health and economic impact of the war on displaced people and the hosting community. A community-based survey was conducted among randomly selected 3572 households of 48 woredas/districts from August 06 to 30/2021 in Tigray. Each district had 4 enumeration sites and there were 20 households (HHs) to be sampled per each enumeration site. Data were collected using a pretested structured questionnaire using face-to-face interviews of displaced and hosting household heads. The entered data is exported to SPSS version 26 statistical packages for data analysis. Summary statistics and geo-spatial analysis was computed. The war had a significant impact on the health and economy of the community of Internally Displaced People (cIDPs) and hosting households. There were 12,691 cIDPs and 3572 hosting HHs. About 12.3% had chronic illness12.3% of (cIDP) who had chronic diseases and follow-up medication was forced to stop their medication. 536 (15%) civilian family members of cIDPs were killed at their homes. During the war, 244 (6.83%) of civilian family members faced physical disability. Consequentially, 43.8% and 58.8% of respondents of cIDPs suffered from severe depression and post-traumatic stress disorder. The war had a significant amount of personal resources such as domestic animals, cereals, cars, machinery, and HH furniture was looted and vandalized by the perpetrator forces from the cIDPs and hosting HHs. The range of family size in the hosting households was 3 to 22. The war had a significant health and economic impact on both cIDPs and hosting HHs. cIDPs suffered from various illnesses and disabilities related to the war with no medical access and follow-up care leading them to stressful situations such as depression and PTSD. There was also a huge economic damage and distraction which threatens the survival of the survivors.
Published: 2023
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2. Rape survivors’ experience in Tigray: a qualitative study

Author: Mengistu Welday Gebremichael, Birhane Gebremariam, Mengistu Mitiku, Znabu Hadush, Bisrat Tesfay, Alemseged Gerezgiher, and Muauz Gidey Alemu
Subjects: War, Rape, Sexual abuse, Survivors, Violence, Tigray, Gynecology and obstetrics, RG1-991, Public aspects of medicine, RA1-1270
Abstract: Abstract Introduction As consequences of war, women and girls are the most likely segment of society to be impacted by violence. War also affects the critical facilities and makes the situation worse as victims cannot get the vital basic services. According to media and unpublished reports, Tigrayan women have been victimized by gang rape and sexual violence. Furthermore, there is substantive evidence of intentional destruction and vandalization of health facilities due to the one-year-old-armed conflict. This study aimed to explore experiences of rape survivors in areas hit by armed conflict in the Tigray region of Ethiopia. Methods In this qualitative study, a phenomenological study design was employed among Tigrayan sexual assault survivors in a war-ravaged of Tigray. Survivors were selected purposively and included in the study for an in-depth interview. An interview guide was used to collect the data. Audio records from the in-depth interviews in Tigrigna were transcribed verbatim and then translated into English for analysis. Atlas-ti 7 software was used to code the interview transcripts of the qualitative data, and categorizations and thematizing of the codes were done. Direct quotes were used to describe categories or themes. Results Ten women who were survivors of sexual violence and rape related to the war in Tigray participated in the interview. The age of the women ranged between 16 and 30 years with a mean age of 21.7. Among the participants, five were teenagers, six were single and/or economically dependent on their family or husband, and two did not attend any school and were not able to read and write. This study has generated five major thematic areas: (1) infliction of long-lasting trauma on children (2) effects of the rape (3) means of escaping from rape and killings (4) home remedies as means of life saving in war affected areas, and (5) beyond rape. Conclusions Rape in war-stricken Tigray has been widespread which includes teenagers and it caused immense psychological and physical damage to the survivors and their families. Damage of critical facilities such as the absence of safe houses for survivors and health services was an added complexity to the victims of rape. Hence, a coordinated effort by the government of Tigray and international partners is required to heal, support and rehabilitate the victims and rebuild the damaged health institutions and reequip the health facilities.
Published: 2023
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3. Assessment of Surgery and Anesthesia Services and Patients’ Attitude Towards Informed Consent: The Case of a Specialized and Comprehensive University Hospital in Northern Ethiopia

Author: Mussie Tesfay Atsbeha and Mengistu Mitiku
Subjects: anesthesia, ayder, consent, patients, services, surgery, Medicine
Abstract: Objective: Healthcare providers need to establish close relationships with patients planning to undergo major elective surgery as this helps produce positive patient outcomes. This study aimed at investigating surgery and anesthesia services and patients’ attitude toward informed consent at Ayder comprehensive specialized university hospital, in Northern Ethiopia. Material and Methods: A facility-based cross-sectional study was conducted in the biggest health facility in Northern Ethiopia. Four hundred ten patients with major elective surgery were recruited. A structured questionnaire was used to collect socio-demographics, anesthesia and surgery services and the attitude of patients toward informed consent. Descriptive results were presented using frequencies and tables. Regression analysis was accompanied by an odds ratio and a 95% confidence interval was run to identify factors associated with the outcome variable. Results: Study participants’ mean age was 36.1+11.7. Around two-thirds (71.7%) and one-fourth (26.6%) of the study participants were informed about their proposed surgical procedure and its possible complications, respectively. Two hundred ninety four (66.8%) and 88 (21.5%) were made aware of the type of anesthesia that was going to be administered and possible complications. About half (50.7%) had expressed a positive attitude towards informed consent. Rural residents have about twice (AOR=1.9; 95% CI: 1.06-2.73) higher odds of expressing a positive attitude towards the informed consent than their counterparts. Conclusion: The study revealed that the proportion of patients who were informed about their anesthesia-surgery services was moderate. Besides, patients’ attitude toward informed consent was poor. The residence was a good predictor of positive patients’ attitudes toward informed consent. Thus, healthcare professionals in the surgery department should establish clear and transparent communication with patients about surgery and anesthesia-related services.
Published: 2023
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4. A facility-based study of lipids, glucose levels and their correlates among pregnant women in public hospitals of northern Ethiopia.

Author: Gebregziabher Berihu, Mengistu Mitiku, Selamawit Asfaw Beyene, Letekirstos Gebregziabher, Yohana Gebregiorgis, Mulu Eyasu, Molla Teferi, Tsegay Wellay, Alemtsehay Tewele, and Mussie Tesfay Atsbeha
Subjects: Medicine, Science
Abstract: BackgroundLipids and glucose concentrations in the blood rise during pregnancy period. Poor control of these analytes results in cardio metabolic dysfunction. Despite this, there are no documented studies which investigate lipids and glucose among pregnant women in Tigrai, northern Ethiopia.ObjectiveThe objective of this study was to assess lipid and glucose levels and identify their correlates among pregnant women in Tigrai, northern Ethiopia.MethodWe conducted a facility-based cross sectional study comprising of systematically selected 200 pregnant women from July to October 2021. Those who were severely ill were excluded from the study. We used a structured questionnaire to collect socio-demographic and clinical characteristics of pregnant women. Lipids such as triglycerides, low density lipoprotein, cholesterol and blood glucose were also measured using Cobas C311 chemistry machine from plasma samples. The data were analyzed using SPSS version 25. Logistic regression was performed and statistical significance was declared at p-value < 0.05.ResultProportion of pregnant women with cholesterol, triglyceride, low density lipoprotein and blood glucose levels above the upper limit of the normal range used for clinical decision were 26.5%, 43%, 44.5% and 21%, respectively. Pregnant women's income > = 10,000 ETB (AOR = 3.35; 95%CI: 1.46-7.66), age (AOR = 3.16; 95%CI: 1.03-9.68), gestational age 29-37 weeks (AOR = 8.02; 95%CI: 2.69-23.90) and having systolic blood pressure greater than 120 mmHg (AOR = 3.99; 95%CI: 1.64-9.75) demonstrated statistically significant association with raised levels of lipids.Conclusion and recommendationProportion of pregnant women with out of normal range values of lipids, particularly triglycerides and low density lipoprotein, is high. Gestational age is a strong predictor of increase in blood levels for both lipids. Provision of life style related health education and dietary intake to pregnant mothers matters. Moreover, monitoring lipid profile and glucose level during antenatal care period is essential.
Published: 2023
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5. Prevalence of Orthohantavirus-Reactive Antibodies in Humans and Peri-Domestic Rodents in Northern Ethiopia

Author: Yonas Meheretu, Åsa Granberg, Gebregiorgis Berhane, Hussein Khalil, Olivia Wesula Lwande, Mengistu Mitiku, Kiros Welegerima, Joëlle Goüy de Bellocq, Josef Bryja, Hagos Abreha, Herwig Leirs, Frauke Ecke, and Magnus Evander
Subjects: orthohantavirus, rodents, rural community, risk factors, Ethiopia, Microbiology, QR1-502
Abstract: In 2012, Tigray orthohantavirus was discovered in Ethiopia, but its seasonal infection in small mammals, and whether it poses a risk to humans was unknown. The occurrence of small mammals, rodents and shrews, in human inhabitations in northern Ethiopia is affected by season and presence of stone bunds. We sampled small mammals in two seasons from low- and high-density stone bund fields adjacent to houses and community-protected semi-natural habitats in Atsbi and Hagere Selam, where Tigray orthohantavirus was first discovered. We collected blood samples from both small mammals and residents using filter paper. The presence of orthohantavirus-reactive antibodies in blood was then analyzed using immunofluorescence assay (human samples) and enzyme linked immunosorbent assays (small mammal samples) with Puumala orthohantavirus as antigen. Viral RNA was detected by RT-PCR using small mammal blood samples. Total orthohantavirus prevalence (antibodies or virus RNA) in the small mammals was 3.37%. The positive animals were three Stenocephalemys albipes rats (prevalence in this species = 13.04%). The low prevalence made it impossible to determine whether season and stone bunds were associated with orthohantavirus prevalence in the small mammals. In humans, we report the first detection of orthohantavirus-reactive IgG antibodies in Ethiopia (seroprevalence = 5.26%). S. albipes lives in close proximity to humans, likely increasing the risk of zoonotic transmission.
Published: 2021
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6. Coverage, social mobilization and challenges of mass Zithromax administration campaign in South and South East zones of Tigray, Northern Ethiopia: A cross sectional study.

Author: Afework Mulugeta, Gebremedhin Berhe Gebregergs, Selamawit Asfaw, Dejen Yemane, Mengistu Mitiku, Beyene Meresa, Goitom Gigar, and Amanuel Kidane
Subjects: Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract: The antibiotic treatment of people with trachoma helps to prevent transmission the disease in a community. Currently, Zithromax is the drug recommended for mass drug administration (MDA). MDA should be carried out annually for three to five years in trachoma endemic areas. Coverage survey is essential to track progress towards program goals and to identify communities with poor coverage in order to permit timely and appropriate actions. We assessed mass Zithromax administration coverage, social mobilization and campaign challenges in south and southeast zones of Tigray, Ethiopia.We conducted a survey in community in Southern and South East zones of Tigray region from August 15 to August 31, 2016. The survey included nine Woredas. It was supported by qualitative methods. A total of 3741 individuals were enrolled from 933 households using multistage sampling. We used structured questionnaire. In-depth interview and focus group discussion were also applied. Descriptive statistics was performed using SPSS version 20.We thematically analyzed the qualitative data using Atlas 7.The overall coverage of Zithromax MDA was 93.3%. It ranges from 90.0% in Seharti Samre to 97.9% in Endamokoni. The coverage was 93.4% for males and 93.1% for females. A higher proportion (98.3%) of children aged 5 to 15 years and 409 (87.8%) under five children took Zithromax. The coverage was 94% in rural and 91.2% in urban. Women development army (43.3%) and health extension workers (32.5%) were the main source of information. Frequent occurrence of drug side effects, rumors, lack of community and leaders' engagement in the campaign, fasting, shortage of human power and short term unavailability of supplies were barriers during the campaign.The Zithromax MDA coverage in the study zones was higher than the minimum WHO set criteria of 80%. There was a wide difference in coverage among Woredas and Kebeles. The MDA coverage was lower in urban than rural. Misconceptions and poor mobilization were common challenges. Thus, proper planning, community mobilization and uniform training will need to be done ahead of the campaign in the future.
Published: 2018
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7. Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia.

Author: Yirga Ebuy, Mussie Alemayehu, Mengistu Mitiku, and Gelila K Goba
Subjects: Medicine, Science
Abstract: Anemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia.This unmatched case-control study involved 264 (88 = cases and 176 = controls) pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value
Published: 2017
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8. Grain mineral nutrient profiling and iron bioavailability of an ancient crop tef ('Eragrostis tef')

Author: Ligaba-Osena, Ayalew, Mengistu, Mitiku, Beyene, Getu, Cushman, John, Glahn, Raymond, and Pineros, Miguel
Published: 2021

9. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

Author: Collaborators, GBD 2016 Healthcare Access and Quality, Fullman, Nancy, Yearwood, Jamal, Abay, Solomon M, Abbafati, Cristiana, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abebe, Zegeye, Abebo, Teshome Abuka, Aboyans, Victor, Abraha, Haftom Niguse, Abreu, Daisy MX, Abu-Raddad, Laith J, Adane, Akilew Awoke, Adedoyin, Rufus Adesoji, Adetokunboh, Olatunji, Adhikari, Tara Ballav, Afarideh, Mohsen, Afshin, Ashkan, Agarwal, Gina, Agius, Dominic, Agrawal, Anurag, Agrawal, Sutapa, Kiadaliri, Aliasghar Ahmad, Aichour, Miloud Taki Eddine, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F, Akseer, Nadia, Lami, Faris Hasan Al, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Tahiya, Alasfoor, Deena, Albittar, Mohammed I, Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Ali, Syed Danish, Alijanzadeh, Mehran, Aljunid, Syed M, Alkerwi, Ala'a, Alla, François, Allebeck, Peter, Allen, Christine, Alomari, Mahmoud A, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A, Alvis-Guzman, Nelson, Amare, Azmeraw T, Amenu, Kebede, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla, Andrei, Catalina Liliana, Androudi, Sofia, Antonio, Carl Abelardo T, Araújo, Valdelaine EM, Aremu, Olatunde, Ärnlöv, Johan, Artaman, Al, Aryal, Krishna Kumar, Asayesh, Hamid, Asfaw, Ephrem Tsegay, Asgedom, Solomon Weldegebreal, Asghar, Rana Jawad, Ashebir, Mengistu Mitiku, Asseffa, Netsanet Abera, Atey, Tesfay Mehari, Atre, Sachin R, Atteraya, Madhu S, Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Ayalew, Animut Alebel, Ayele, Henok Tadesse, Ayer, Rakesh, Ayuk, Tambe Betrand, Azzopardi, Peter, Azzopardi-Muscat, Natasha, Babalola, Tesleem Kayode, Badali, Hamid, Badawi, Alaa, Banach, Maciej, Banerjee, Amitava, Banstola, Amrit, Barber, Ryan M, Barboza, Miguel A, Barker-Collo, Suzanne L, Bärnighausen, Till, Barquera, Simon, Barrero, Lope H, Bassat, Quique, Basu, Sanjay, Baune, Bernhard T, Bazargan-Hejazi, Shahrzad, and Bedi, Neeraj
Subjects: Health Services and Systems, Public Health, Health Sciences, Clinical Research, Biodefense, Prevention, Vaccine Related, Good Health and Well Being, Communicable Diseases, Global Burden of Disease, Health Services Accessibility, Humans, Noncommunicable Diseases, Quality of Health Care, Wounds and Injuries, GBD 2016 Healthcare Access and Quality Collaborators, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract: BackgroundA key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016.MethodsDrawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita.FindingsIn 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries.InterpretationGBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view-and subsequent provision-of quality health care for all populations.FundingBill & Melinda Gates Foundation.
Published: 2018

10. Adverse events of Oxford/AstraZeneca's COVID-19 vaccine among health care workers of Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia

Author: Tequare, Mengistu Hagazi, Abraha, Hiluf Ebuy, Adhana, Mache Tsadik, Tekle, Tesfay Hailu, Belayneh, Eskedar Kebede, Gebresilassie, Kibrom Berhanu, Wolderufael, Abadi Leul, Ebrahim, Mohamedawel Mohamedniguss, Tadele, Berihun Afera, Berhe, Derbew Fikadu, Ashebir, Mengistu Mitiku, Gebrehiwot, Kibrom Gebresilasie, Atsbaha, Merhawit, Berihu, Birhane Alem, Desta, Kibrom Gebresilasie, Atsbaha, Mussie Tesfay, Mengesha, Reiye Esayas, Tsegay, Mehari Abraha, and Sibhatu, Manuel Kassaye
Published: 2021
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11. A Community-Based Study of Level and Determinants of Substance Use: Findings from Children Experiencing Homelessness in Major Cities of Northern Ethiopia

Author: Zinabu Asfaw, Mengistu Mitiku, Haftom Temesgen Abebe, and Mussie Tesfay Atsbeha
Subjects: Substance Abuse and Rehabilitation, Modeling and Simulation
Abstract: Zinabu Asfaw,1 Mengistu Mitiku,2,3 Haftom Temesgen Abebe,2,4 Mussie Tesfay Atsbeha5 1Department of Public Health, Adigrat University, Adigrat City, Tigrai, Ethiopia; 2School of Public Health, Mekelle University, Mekelle City, Tigrai, Ethiopia; 3Research and Community Engagement Coordination Office, Mekelle University, Mekelle City, Tigrai, Ethiopia; 4Laboratory Interdisciplinary Statistical Data Analysis, Mekelle University, Mekelle city, Tigrai, Ethiopia; 5School of Medicine, Mekelle University, Mekelle City, Tigrai, EthiopiaCorrespondence: Zinabu Asfaw, Department of Public Health, Adigrat University, P.O. Box: 50, Adigrat City, Ethiopia, Email zinabu.asfaww@gmail.comBackground: Homelessness among children is a significant problem in most nations of the world. Children who experienced homelessness are most often unable to get secured and adequate housing. Such problems expose them to a range of destructive practices such as substance use. This study, therefore, was designed to evaluate the level and determinants of substance use by children who experienced homelessness in major cities of Northern Ethiopia.Methods: This cross-sectional study was undertaken from October 1, 2019 to February 30, 2020. We conducted street-based outreach searching to get a representative sample of the cityâs children who experienced homelessness and a total of 422 were recruited. The collected data were analyzed using SPSS version 20. Regression analysis was done to identify factors associated with substance use and statistical significance was declared at p < 0.05 and 95% confidence interval.Results: More than 80% of the children who experienced homelessness use alcohol, cigarette or chat. Marriage status of parents before the child experiences homelessness being divorce (AOR = 8.53, 95% CI: 1.87â 38.89), occupational status of mother being a daily laborer (AOR = 2.78, 95% CI: 0.83, 9.31), child relationship status with parents before child experiences homelessness (AOR = 0.08, 95% CI: 0.02â 0.30) and parentsâ residential status before child experiences homelessness being rural (AOR = 5.63, 95% CI: 1.77â 17.89) are the independent variables that established statistically significant association with the outcome variable, substance use.Conclusion and Recommendation: The majority of the children who experienced homelessness are exposed to substance use, particularly alcohol and cigarette. Efforts are needed by concerned bodies of the region to work on factors that predispose to homelessness and strategically safeguard the health and wellbeing of the children.Keywords: homelessness, substance use, children, Northern Ethiopia
Published: 2022
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12. Adverse events of Oxford/AstraZeneca's COVID-19 vaccine among health care workers of Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia

Author: Reiye Esayas Mengesha, Kibrom Berhanu Gebresilassie, Birhane Alem Berihu, Mehari Abraha Tsegay, Berihun Afera Tadele, Abadi Leul Wolderufael, Derbew Fikadu Berhe, Tesfay Hailu Tekle, Eskedar Kebede Belayneh, Mohamedawel Mohamedniguss Ebrahim, Manuel Kassaye Sibhatu, Kibrom Gebresilasie Gebrehiwot, Kibrom Gebresilasie Desta, Mengistu Hagazi Tequare, Mussie Tesfay Atsbaha, Merhawit Atsbaha, Hiluf Ebuy Abraha, Mengistu Mitiku Ashebir, and Mache Tsadik Adhana
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Adverse Events Following Immunization, Odds ratio, COVID vaccine, medicine.disease, Logistic regression, Comorbidity, Article, Vaccination, Oxford/AstraZeneca, Internal medicine, Statistical significance, Health care, medicine, business, Adverse effect
Abstract: Background : The safety of COVID vaccines should be continuously followed. This study reports adverse events of the Oxford/AstraZeneca COVID-19 vaccine. Methods : A prospective single-cohort study design was conducted to assess adverse events following immunization and associated factors of the first dose of Oxford/AstraZeneca's COVID-19 vaccine in Ayder Comprehensive specialized hospital. A structured questionnaire was administered consecutively to 423 participants. Follow-up data were collected 72 hours after vaccination via phone. Bivariate and multivariate logistic regression models were used to find associations between adverse events and independent variables. Statistical significance was declared at P Results : Out of 423 health care workers approached, 395 responded. At least one adverse event (95% CI: 63.58, 72.77) was reported by 270 participants. Local and systemic symptoms occurred in 46.8% (95% CI: 41.94, 51.79) and 58.48% (95% CI: 53.53, 63.26)], respectively. Muscle ache, fatigue, headache and fever were the most common local symptoms. No reports of hospitalization, disability or death. Age (adjusted odds ratio [AOR]=0.97, P=0.048), female sex (AOR=1.84, P=0.028), and comorbidity (AOR=2.28, P=0.040) were independent predictors of adverse events. Conclusion and recommendation : Adverse events following immunization are commonly reported after the first dose of the Oxford/AstraZeneca COVID-19 vaccine; age, female sex and comorbidity are independent predictors.
Published: 2021
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13. Epidemiological and Clinical Characteristics of COVID-19 Patients in Northern Ethiopia: A Retrospective Cohort Study

Author: Haftom Temesgen Abebe, Mengistu Mitiku Ashebir, Mohamedawel Mohamedniguss Ebrahim, Yibrah Berhe Zelelow, Afework Mulugeta Bezabih, Getachew Redae Tefere, Berhane Fseha Teklehaimanot, Solomon Hintsa, and Abadi Leul Welderufael
Subjects: Pharmacology, Infectious Diseases, Infection and Drug Resistance, Pharmacology (medical)
Abstract: Haftom Temesgen Abebe,1,2 Mengistu Mitiku Ashebir,1 Mohamedawel Mohamedniguss Ebrahim,3 Yibrah Berhe Zelelow,3 Afework Mulugeta Bezabih,1 Getachew Redae Tefere,1 Berhane Fseha Teklehaimanot,4 Solomon Hintsa,5 Abadi Leul Welderufael3 1School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Laboratory Interdisciplinary Statistical Data Analysis, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 4Department of Public Health, College of Health Sciences, Adigrat University, Adigrat, Ethiopia; 5Department of Public Health, College of Health Sciences, Axum University, Axum, EthiopiaCorrespondence: Haftom Temesgen Abebe, School of Public Health, College of Health Sciences, Mekelle University, P.O.Box 1871, Mekelle, Ethiopia, Tel +251941982945, Email haftoma@gmail.comPurpose: COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an emerging global public health problem. The disease is believed to affect older people and is accompanied by clinical features such as fever, shortness of breath, and coughing. Currently, there is a lack of information regarding the characteristics of COVID-19 patients in Ethiopia. Thus, this paper aims to evaluate the epidemiological and clinical features of COVID-19 patients in Tigray, Northern Ethiopia.Patients and Methods: A total of 6,637 symptomatic and asymptomatic COVID-19 patients collected from six isolation and treatment centers in Tigray between May 7 and October 28, 2020 were retrospectively analyzed. Chi-square test or Fisherâs exact test was used to compare the epidemiological and clinical characteristics of COVID-19 patients as appropriate. A p-value < 0.05 was considered statistically significant.Results: The mean age of the patients was 31.3Â± 12.8. SARS-CoV-2 infects men more than women with a ratio of 1.85:1. About 16% of the patients were symptomatic, of which 13.3% (95% CI=11.3â 15.4%) were admitted to intensive care units and 6.1% (95% CI=4.5â 7.6%) were non-survivors. The mortality rate was increased up to 40.3% (95% CI=32.1â 48.4%) among patients with severe illness. A higher proportion of deaths were observed in men (73.2%) and 55.4% were in the age group of â¥ 50 years. About 4.3% (282 of 6,637) had one or more coexisting comorbidities; the most common being cardiovascular diseases (30.1%) and diabetes mellitus (23.8%). The comorbidity rate in the non-survivor group was significantly higher than in the survivor group (p-value < 0.001).Conclusion: The proportion of symptomatic patients was low. Non-survival was linked with old age and the existence of comorbidities. The findings of this study can help in the design of appropriate management strategies for COVID-19 patients, such as giving due emphasis to COVID-19 patients who are old and with comorbidities.Keywords: COVID-19, comorbidity, symptomatic, mortality rate
Published: 2022

14. Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: A Retrospective Cohort Study in Tigray, Ethiopia

Author: Abebe, Haftom Temesgen, primary, Zelelow, Yibrah Berhe, additional, Bezabih, Afework Mulugeta, additional, Ashebir, Mengistu Mitiku, additional, Tafere, Getachew Redae, additional, Wuneh, Alem Desta, additional, Araya, Medhanie Gebresilassie, additional, Kiros, Nguse Kahsay, additional, Hiluf, Molla Kahssay, additional, Ebrahim, Mohamedawel Mohamedniguss, additional, Gebrehiwot, Tesfay Gebregzabher, additional, Welderufael, Abadi Leul, additional, and Mohammed, Abrahim Hassen, additional
Published: 2022
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15. Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: A Retrospective Cohort Study in Tigray, Ethiopia

Author: Haftom Temesgen Abebe, Yibrah Berhe Zelelow, Afework Mulugeta Bezabih, Mengistu Mitiku Ashebir, Getachew Redae Tafere, Alem Desta Wuneh, Medhanie Gebresilassie Araya, Nguse Kahsay Kiros, Molla Kahssay Hiluf, Mohamedawel Mohamedniguss Ebrahim, Tesfay Gebregzabher Gebrehiwot, Abadi Leul Welderufael, and Abrahim Hassen Mohammed
Subjects: Journal of Multidisciplinary Healthcare, General Medicine, General Nursing
Abstract: Haftom Temesgen Abebe,1,2 Yibrah Berhe Zelelow,3 Afework Mulugeta Bezabih,4 Mengistu Mitiku Ashebir,5 Getachew Redae Tafere,6 Alem Desta Wuneh,5 Medhanie Gebresilassie Araya,7 Nguse Kahsay Kiros,8 Molla Kahssay Hiluf,9 Mohamedawel Mohamedniguss Ebrahim,10 Tesfay Gebregzabher Gebrehiwot,5 Abadi Leul Welderufael,11 Abrahim Hassen Mohammed12 1Department of Biostatistics, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Laboratory Interdisciplinary Statistical Data Analysis, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3Department of Obstetrics and Gynecology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 4Department of Nutrition, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 5Department of Health System, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 6Department of Environmental and Behavioral Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 7Department of Ear, Nose and Throat, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 8Tigrai Institute of Policy Studies, Mekelle, Ethiopia; 9Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia; 10Department of Surgery, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 11Department of Pediatric and Child Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 12Tigrai Health Bureau, Mekelle, EthiopiaCorrespondence: Haftom Temesgen Abebe, Department of Biostatistics, College of Health Sciences, Mekelle University, P.O. Box 1871, Mekelle, Ethiopia, Email haftoma@gmail.comBackground: COVID-19 is one of the leading causes of morbidity and mortality and is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). A patient infected with SARS-CoV-2 is said to be recovered from the infection following negative test results and when signs and symptoms disappear. Different studies have shown different median recovery time of patients with COVID-19 and it varies across settings and disease status. This study aimed to assess time to recovery and its predictors among severely ill COVID-19 patients in Tigray.Methods: A total of 139 severely ill COVID-19 patients who were hospitalized between May 7, 2020 and October 28, 2020 were retrospectively analyzed. Cox proportional hazard regression model was fitted to identify the risk factors associated with the time duration to recovery from severe COVID-19 illness.Results: The median age of the patients was 35 years (IQR, 27â 60). Eighty-three (59.7%) patients recovered with a median time of 26 days (95% CI: 23â 27). The results from the multivariable analysis showed that the recovery time was lower for severely ill patients who had no underline comorbidity diseases (AHR=2.48, 95% CI: 1.18â 5.24), shortness of breath (AHR=2.08, 95% CI: 1.07â 3.98) and body weakness (AHR=2.62, 95% CI: 1.20â 5.72). Moreover, COVID-19 patients aged younger than 40 years had lower recovery time compared to patients aged 60 and above (AHR=4.09, 95% CI: 1.58â 10.61).Conclusion: The median recovery time of severely ill COVID-19 patients was long, and older age, comorbidity, shortness of breath, and body weakness were significant factors related with the time to recovery among the severely ill COVID-19 patients. Therefore, we recommended that elders and individuals with at least one comorbidity disease have to get due attention to prevent infection by the virus. Moreover, attention should be given in the treatment practice for individuals who had shortness of breath and body weakness symptoms.Keywords: COVID-19, comorbidity, cox proportional hazard regression, adjusted hazard ratio
Published: 2022

16. Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: A Retrospective Cohort Study in Tigray, Ethiopia

Author: Abebe,Haftom Temesgen, Zelelow,Yibrah Berhe, Bezabih,Afework Mulugeta, Ashebir,Mengistu Mitiku, Tafere,Getachew Redae, Wuneh,Alem Desta, Araya,Medhanie Gebresilassie, Kiros,Nguse Kahsay, Hiluf,Molla Kahssay, Ebrahim,Mohamedawel Mohamedniguss, Gebrehiwot,Tesfay Gebregzabher, Welderufael,Abadi Leul, Mohammed,Abrahim Hassen, Abebe,Haftom Temesgen, Zelelow,Yibrah Berhe, Bezabih,Afework Mulugeta, Ashebir,Mengistu Mitiku, Tafere,Getachew Redae, Wuneh,Alem Desta, Araya,Medhanie Gebresilassie, Kiros,Nguse Kahsay, Hiluf,Molla Kahssay, Ebrahim,Mohamedawel Mohamedniguss, Gebrehiwot,Tesfay Gebregzabher, Welderufael,Abadi Leul, and Mohammed,Abrahim Hassen
Abstract: Haftom Temesgen Abebe,1,2 Yibrah Berhe Zelelow,3 Afework Mulugeta Bezabih,4 Mengistu Mitiku Ashebir,5 Getachew Redae Tafere,6 Alem Desta Wuneh,5 Medhanie Gebresilassie Araya,7 Nguse Kahsay Kiros,8 Molla Kahssay Hiluf,9 Mohamedawel Mohamedniguss Ebrahim,10 Tesfay Gebregzabher Gebrehiwot,5 Abadi Leul Welderufael,11 Abrahim Hassen Mohammed12 1Department of Biostatistics, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Laboratory Interdisciplinary Statistical Data Analysis, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3Department of Obstetrics and Gynecology, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 4Department of Nutrition, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 5Department of Health System, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 6Department of Environmental and Behavioral Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 7Department of Ear, Nose and Throat, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 8Tigrai Institute of Policy Studies, Mekelle, Ethiopia; 9Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia; 10Department of Surgery, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 11Department of Pediatric and Child Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 12Tigrai Health Bureau, Mekelle, EthiopiaCorrespondence: Haftom Temesgen Abebe, Department of Biostatistics, College of Health Sciences, Mekelle University, P.O. Box 1871, Mekelle, Ethiopia, Email haftoma@gmail.comBackground: COVID-19 is one of the leading causes of morbidity and mortality and is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). A patient infected with SARS-CoV-2 is said to be recovered from the infection following negative test results and when signs and symptoms disappear. Different studies have shown
Published: 2022

17. Enhancing health facility-based data quality and use for decision making at primary health care units to improve health service delivery of maternal newborn child and adolescent health, Tigray Ethiopia 2018

Author: Kebede Embaye Gezae, Assefa Ayalew Gebreslassie, Molla Teferi Below, Mengistu Mitiku Ashebir, and Mebrahtu Kalayu Chekole
Subjects: Child and adolescent, Health services, Mixed approach, Health facility, Low and middle income countries, Environmental health, Data quality, Primary health care, General Earth and Planetary Sciences, Business, Evidence based decision making, General Environmental Science
Abstract: Objective: information use is fundamental for evidence based decision making but data quality and information use in health facility is limited in low and middle income countries. Therefore, a facility based cross sectional using mixed approach was conducted to assess data quality and use for decision making in 12 selected health facilities of Tigray, Ethiopia, 2018.
Published: 2020
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18. Risk Factors of Birth Asphyxia Among Neonates Born in Public Hospitals of Tigray, Northern Ethiopia

Author: Hareya Gebremedhin Teka, Natnael Etsay Assefa, Mengistu Mitiku, Sumeya Ahmed Mohammednur, Alemtsehay Tewele Welearegay, Lidya Zewdie Berhe, Letekirstos Gebregziabher, Gebregziabher Berihu, Tsegay Wellay, Yodit Zewdie Berhe, and Abel Gidey Kebedom
Subjects: Asphyxia, medicine.medical_specialty, Pregnancy, Obstetrics, business.industry, Odds ratio, medicine.disease, Logistic regression, Confidence interval, Checklist, Cerebral palsy, Perinatal asphyxia, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, 030212 general & internal medicine, medicine.symptom, business
Abstract: Introduction Birth asphyxia is defined by the World Health Organization as not initiating and maintaining default breathing at birth. Approximately 24% of neonatal deaths occurred annually worldwide due to birth asphyxia. About 3% of the 120 million neonates born each year acquire asphyxia in third world countries. Long-term survivors may experience cerebral palsy, delay in growth, vision, hearing and intellectual deficiency, epilepsy, difficulties with communication and behavior. Thus, this study aims to determine the risk factors of birth asphyxia among neonates who were delivered at public hospitals of Tigray, Ethiopia. Materials and methods Hospital-based unmatched case-control study design was implemented on 390 samples from January to February 2018. Data were collected by interviews using a structured questionnaire and checklist. The collected data were coded and entered using EpiData version 3.1 statistical software and transported to statistical package for social science (SPSS) version 20 software for analysis. Cross-tabulation and odds ratio with 95% confidence interval were computed. Bivariate logistic regression and multivariable logistic regression were done. Multicollinearity was checked. Goodness of fit was checked by the Hosmer-Lemeshow test. Results A total of 260 controls and 130 cases were enrolled in the study. Multivariable logistic regression showed that Primi-parity [AOR 5.5 (CI: 2.5, 12.3)], pre-eclamcia/pregnancy-induced hypertension [AOR12.4 (CI: 4.17, 37.15)], post-term pregnancy [AOR 2.73 (CI: 1.00, 7.55)] meconium-stained liquor [AOR 29.2 (CI: 12.0, 71.1)], cord entangled [AOR 5.67 (CI: 1.66,19.3)] and non-vertex presentation [AOR 5.49 (CI: 2.20,13.7)] were found to be risk factors for perinatal birth asphyxia. Conclusion and recommendations Intrapartum factors and neonatal factors in the index pregnancy have an association with perinatal birth asphyxia. The research finding suggests effective antenatal care follow-up and follow-up of labor progress using partograph after labor initiation.
Published: 2020
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19. Grain mineral nutrient profiling and iron bioavailability of an ancient crop tef (Eragrostis tef)

Author: Osena, Ayalew Ligaba-, primary, Mengistu, Mitiku, additional, Beyene, Getu, additional, Cushman, John, additional, Glahn, Raymond, additional, and Piñeros, Miguel, additional
Published: 2021
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20. Prevalence of Orthohantavirus-Reactive Antibodies in Humans and Peri-Domestic Rodents in Northern Ethiopia

Author: Hagos Abreha, Josef Bryja, Kiros Welegerima, Hussein Khalil, Olivia Wesula Lwande, Åsa Granberg, Joëlle Goüy de Bellocq, Herwig Leirs, Yonas Meheretu, Frauke Ecke, Mengistu Mitiku, Gebregiorgis Berhane, and Magnus Evander
Subjects: 0301 basic medicine, Male, Rural Population, Orthohantavirus, Peri, Infektionsmedicin, Antibodies, Viral, Rodent Diseases, 0302 clinical medicine, Risk Factors, Rural community, Prevalence, biology, medicine.diagnostic_test, Ecology, Transmission (medicine), QR1-502, Infectious Diseases, rodents, RNA, Viral, Female, Antibody, Infectious Medicine, rural community, Hantavirus Infections, 030231 tropical medicine, Zoology, Immunofluorescence, Microbiology, Rodents, Virus, Article, Microbiology in the medical area, 03 medical and health sciences, Virology, parasitic diseases, medicine, Seroprevalence, Animals, Humans, Viral rna, Biology, Disease Reservoirs, Ekologi, Rats, 030104 developmental biology, Cross-Sectional Studies, Risk factors, Immunoglobulin G, biology.protein, Human medicine, Ethiopia
Abstract: In 2012, Tigray orthohantavirus was discovered in Ethiopia, but its seasonal infection in small mammals, and whether it poses a risk to humans was unknown. The occurrence of small mammals, rodents and shrews, in human inhabitations in northern Ethiopia is affected by season and presence of stone bunds. We sampled small mammals in two seasons from low- and high-density stone bund fields adjacent to houses and community-protected semi-natural habitats in Atsbi and Hagere Selam, where Tigray orthohantavirus was first discovered. We collected blood samples from both small mammals and residents using filter paper. The presence of orthohantavirus-reactive antibodies in blood was then analyzed using immunofluorescence assay (human samples) and enzyme linked immunosorbent assays (small mammal samples) with Puumala orthohantavirus as antigen. Viral RNA was detected by RT-PCR using small mammal blood samples. Total orthohantavirus prevalence (antibodies or virus RNA) in the small mammals was 3.37%. The positive animals were three Stenocephalemys albipes rats (prevalence in this species = 13.04%). The low prevalence made it impossible to determine whether season and stone bunds were associated with orthohantavirus prevalence in the small mammals. In humans, we report the first detection of orthohantavirus-reactive IgG antibodies in Ethiopia (seroprevalence = 5.26%). S. albipes lives in close proximity to humans, likely increasing the risk of zoonotic transmission.
Published: 2021

21. Epidemiological and Clinical Characteristics of COVID-19 Patients in Northern Ethiopia: A Retrospective Cohort Study.

Author: Abebe, Haftom Temesgen, Ashebir, Mengistu Mitiku, Ebrahim, Mohamedawel Mohamedniguss, Zelelow, Yibrah Berhe, Bezabih, Afework Mulugeta, Tefere, Getachew Redae, Teklehaimanot, Berhane Fseha, Hintsa, Solomon, and Welderufael, Abadi Leul
Subjects: COVID-19, SARS-CoV-2, HEALTH facilities
Abstract: aimanot,4 Solomon Hintsa,5 Abadi Leul Welderufael31School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 2Laboratory Interdisciplinary Statistical Data Analysis, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 3School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia; 4Department of Public Health, College of Health Sciences, Adigrat University, Adigrat, Ethiopia; 5Department of Public Health, College of Health Sciences, Axum University, Axum, EthiopiaCorrespondence: Haftom Temesgen Abebe, School of Public Health, College of Health Sciences, Mekelle University, P.O.Box 1871, Mekelle, Ethiopia, Tel +251941982945, Email [email protected] Purpose: COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an emerging global public health problem. The disease is believed to affect older people and is accompanied by clinical features such as fever, shortness of breath, and coughing. Currently, there is a lack of information regarding the characteristics of COVID-19 patients in Ethiopia. Thus, this paper aims to evaluate the epidemiological and clinical features of COVID-19 patients in Tigray, Northern Ethiopia. Patients and Methods: A total of 6,637 symptomatic and asymptomatic COVID-19 patients collected from six isolation and treatment centers in Tigray between May 7 and October 28, 2020 were retrospectively analyzed. Chi-square test or Fisher's exact test was used to compare the epidemiological and clinical characteristics of COVID-19 patients as appropriate. A p-value < 0.05 was considered statistically significant. Results: The mean age of the patients was 31.3± 12.8. SARS-CoV-2 infects men more than women with a ratio of 1.85:1. About 16% of the patients were symptomatic, of which 13.3% (95% CI=11.3– 15.4%) were admitted to intensive care units and 6.1% (95% CI=4.5– 7.6%) were non-survivors. The mortality rate was increased up to 40.3% (95% CI=32.1– 48.4%) among patients with severe illness. A higher proportion of deaths were observed in men (73.2%) and 55.4% were in the age group of ≥ 50 years. About 4.3% (282 of 6,637) had one or more coexisting comorbidities; the most common being cardiovascular diseases (30.1%) and diabetes mellitus (23.8%). The comorbidity rate in the non-survivor group was significantly higher than in the survivor group (p-value < 0.001). Conclusion: The proportion of symptomatic patients was low. Non-survival was linked with old age and the existence of comorbidities. The findings of this study can help in the design of appropriate management strategies for COVID-19 patients, such as giving due emphasis to COVID-19 patients who are old and with comorbidities. [ABSTRACT FROM AUTHOR]
Published: 2022
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22. A facility-based study of factors associated with perinatal mortality in Tigray, northern Ethiopia

Author: Kimberly A. Kim, Gelila Goba, Mengistu Mitiku, Gebremedhin Berhe Gebregergs, Mussie Alemayehu, and Hailesilassie Tsegay
Subjects: Adult, medicine.medical_specialty, Perinatal Death, Psychological intervention, Logistic regression, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Risk Factors, Odds Ratio, medicine, Humans, Childbirth, 030212 general & internal medicine, Perinatal Mortality, Retrospective Studies, Labor, Obstetric, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, Perinatal mortality, Postpartum Period, Infant, Newborn, Parturition, Obstetrics and Gynecology, Prenatal Care, General Medicine, Odds ratio, Stillbirth, Confidence interval, Case-Control Studies, Dietary Supplements, Iron supplementation, Female, Ethiopia, Health Facilities, Neonatal death, business
Abstract: OBJECTIVE To identify perinatal mortality risk factors in the Southern Zone of Tigray, northern Ethiopia. METHODS The present unmatched case-control study included data from 20 health facilities; stillbirths and neonatal deaths were included as a case group and patients with neonates who survived until discharge or day 7 postpartum were included as a control group. Perinatal mortality risk factors were investigated using bivariate and multivariate logistic regression analyses. RESULTS There were 126 and 252 patients included in the case and control groups, respectively. Prematurity (adjusted odds ratio [AOR] 12.2; 95% confidence interval [CI] 3.46-43.17; P
Published: 2018
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23. Five-Year Field Trial of Eight Camelina sativa Cultivars for Biomass to be Used in Biofuel under Irrigated Conditions in a Semi-Arid Climate

Author: Lohaus, Richard H., primary, Neupane, Dhurba, additional, Mengistu, Mitiku A., additional, Solomon, Juan K.Q., additional, and Cushman, John C., additional
Published: 2020
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24. Enhancing health facility-based data quality and use for decision making at primary health care units to improve health service delivery of maternal newborn child and adolescent health, Tigray Ethiopia 2018

Author: Assefa Ayalew, Gebreslassie, primary, Molla Teferi, Below, additional, Mengistu Mitiku, Ashebir, additional, Kebede Embaye, Gezae, additional, and Mebrahtu Kalayu, Chekole, additional
Published: 2020
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25. Process Evaluation of Decontamination, Cleaning and Sterilization of medical instruments at public health centers of Mekelle zone, Tigray, Ethiopia, 2018

Author: Byin Tewolde Gebremichael, Alem Desta Wuneh, and Mengistu Mitiku Ashebr
Abstract: Background: In Ethiopia, the prevalence of health care associated infection is high. Thus, implementing infection prevention activities has an important role in minimizing those infections. One of the activities of infection prevention is proper decontamination, cleaning and sterilization of medical instruments. In order to improve the quality of this intervention, generating evidences through monitoring and evaluation is indispensible. Therefore the key stakeholders have reached an agreement to conduct this process evaluation. Objective: To assess the implementation status of decontamination, cleaning and sterilization process of medical instruments in the public health centers of Mekelle zone, Tigray. Method: Descriptive study design was employed in this evaluation study. The evaluation was conducted in public health centers of Mekelle zone from January, 2017 to June, 2017. For the quantitative part, observation of health care workers’ practice using pre tested questionnaire was conducted. As a complement, key informant interviews were also conducted. Collected quantitative data were checked, coded and entered into SPSS version 20 for analysis. Frequencies, Mean, percentage, tables were used for results presentation and qualitative data were coded, categorized and finally conceptualized/give meaning. Result: Availability, compliance and safety of health care workers were used to evaluate the implementation of the intervention. Accordingly, availability of resources in the studied health centers has been rated as good ( 74.2%). And compliance level of health care workers has found to be fair ( 66.1% ). However, health care workers had poor practice in separating soiled from clean instruments, immersing of contaminated instruments in 0.5% chlorine solution for the correct duration and using oldest packs first. About practice of safety by the health care workers has found to be poor ( 48% ). In general, the overall implementation status of the service had been judged as fair ( 63.4 ). Conclusion: According the judgment criteria, the overall implementation
Published: 2019
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26. Patient Safety Culture Status and Its Predictors among Healthcare Workers

Author: Tesfay Hailu, Mengistu Mitiku, and Alemseged Aregay
Subjects: medicine.medical_specialty, Nutrition and Dietetics, Health (social science), Health care workers, Health professionals, business.industry, Health Policy, Northern Ethiopia, Public Health, Environmental and Occupational Health, Medicine (miscellaneous), Simple random sample, Logistic regression, Confidence interval, Patient safety, Hospital, Statistical significance, Family medicine, Health care, Safety culture, Medicine, Mekelle city, business
Abstract: Good patient safety culture of healthcare professionals brings about fine consequences for patients. This study, therefore, aimed in evaluating the current status and predictors of safety culture among healthcare workers in Mekelle Zone hospitals, Tigray, Northern Ethiopia. A cross-sectional survey was conducted among 325 healthcare workers in three hospitals of Mekelle city from February to May, 2017. Simple random sampling technique was employed to select study subjects. Data was analyzed using SPSS. Logistic regression was used to determine the predictors of patient safety culture among healthcare workers at 95% confidence level and 5% level of significance. Statistical significance was set at p
Published: 2018

27. Characterization of Slow Rusting Resistance Against Stem Rust (Puccinia graminis f. sp. tritici) in Selected Bread Wheat Cultivars of Ethiopia

Author: Mengistu Mitiku, Netsanet Bacha Hei, and Merkuz Abera
Subjects: 0106 biological sciences, Puccinia graminis F.Sp. tritici, biology, Resistance (ecology), 04 agricultural and veterinary sciences, Stem rust, biology.organism_classification, 01 natural sciences, Horticulture, 040103 agronomy & agriculture, 0401 agriculture, forestry, and fisheries, Pharmacology (medical), Cultivar, 010606 plant biology & botany
Published: 2018
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28. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

Author: Fullman, Nancy, Yearwood, Jamal, Abay, Solomon M., Abbafati, Cristiana, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abebe, Zegeye, Abebo, Teshome Abuka, Aboyans, Victor, Abraha, Haftom Niguse, Abreu, Daisy M. X., Abu-Raddad, Laith J., Adane, Akilew Awoke, Adedoyin, Rufus Adesoji, Adetokunboh, Olatunji, Adhikari, Tara Ballav, Afarideh, Mohsen, Afshin, Ashkan, Agarwal, Gina, Agius, Dominic, Agrawal, Anurag, Agrawal, Sutapa, Kiadaliri, Aliasghar Ahmad, Aichour, Miloud Taki Eddine, Akibu, Mohammed, Akinyemi, Rufus Olusola, Akinyemiju, Tomi F., Akseer, Nadia, Al Lami, Faris Hasan, Alahdab, Fares, Al-Aly, Ziyad, Alam, Khurshid, Alam, Tahiya, Alasfoor, Deena, Albittar, Mohammed I., Alene, Kefyalew Addis, Al-Eyadhy, Ayman, Ali, Syed Danish, Alijanzadeh, Mehran, Aljunid, Syed M., Alkerwi, Ala'a, Alla, Francois, Allebeck, Peter, Allen, Christine, Alomari, Mahmoud A., Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A., Alvis-Guzman, Nelson, Amare, Azmeraw T., Amenu, Kebede, Ammar, Walid, Amoako, Yaw Ampem, Anber, Nahla, Andrei, Catalina Liliana, Androudi, Sofia, Antonio, Carl Abelardo T., Araujo, Valdelaine E. M., Aremu, Olatunde, Arnlöv, Johan, Artaman, Al, Aryal, Krishna Kumar, Asayesh, Hamid, Asfaw, Ephrem Tsegay, Asgedom, Solomon Weldegebreal, Asghar, Rana Jawad, Ashebir, Mengistu Mitiku, Asseffa, Netsanet Abera, Atey, Tesfay Mehari, Atre, Sachin R., Atteraya, Madhu S., Avila-Burgos, Leticia, Avokpaho, Euripide Frinel G. Arthur, Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Ayalew, Animut Alebel, Ayele, Henok Tadesse, Ayer, Rakesh, Ayuk, Tambe Betrand, Azzopardi, Peter, Azzopardi-Muscat, Natasha, Babalola, Tesleem Kayode, Badali, Hamid, Badawi, Alaa, Banach, Maciej, Banerjee, Amitava, Banstola, Amrit, Barber, Ryan M., Barboza, Miguel A., Barker-Collo, Suzanne L., Bärnighausen, Till, Barquera, Simon, Barrero, Lope H., Bassat, Quique, Basu, Sanjay, Baune, Bernhard T., Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Htet, Aung Soe, Kisa, Adnan, Norheim, Ole Frithjof, Savic, Miloje, Skirbekk, Vegard Fykse, Vollset, Stein Emil, Weiderpass, Elisabete, and Winkler, Andrea Sylvia
Abstract: Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8–98·1) in Iceland, followed by 96·6 (94·9–97·9) in Norway and 96·1 (94·5–97·3) in the Netherlands, to values as low as 18·6 (13·1–24·4) in the Central African Republic, 19·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1–93·6) in Beijing to 48·0 (43·4–53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6–68·8) in Goa to 34·0 (30·3–38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations. publishedVersion
Published: 2018

29. Process Evaluation of Decontamination, Cleaning and Sterilization of medical instruments at public health centers of Mekelle zone, Tigray, Ethiopia, 2018

Author: Gebremichael, Byin Tewolde, primary, Wuneh, Alem Desta, additional, and Ashebr, Mengistu Mitiku, additional
Published: 2019
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30. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

Author: Fullman, N, Yearwood, J, Abay, S, Abbafati, C, Abd-Allah, F, Abdela, J, Abdelalim, A, Abebe, Z, Abebo, T, Aboyans, V, Abraha, H, Abreu, D, Abu-Raddad, L, Adane, A, Adedoyin, R, Adetokunboh, O, Adhikari, T, Afarideh, M, Afshin, A, Agarwal, G, Agius, D, Agrawal, A, Agrawal, S, Ahmad Kiadaliri, A, Aichour, M, Akibu, M, Akinyemi, R, Akinyemiju, T, Akseer, N, Al Lami, F, Alahdab, F, Al-Aly, Z, Alam, K, Alam, T, Alasfoor, D, Albittar, M, Alene, K, Al-Eyadhy, A, Ali, S, Alijanzadeh, M, Aljunid, S, Alkerwi, A, Alla, F, Allebeck, P, Allen, C, Alomari, M, Al-Raddadi, R, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Amare, A, Amenu, K, Ammar, W, Amoako, Y, Anber, N, Andrei, C, Androudi, S, Antonio, C, Araújo, V, Aremu, O, Ärnlöv, J, Artaman, A, Aryal, K, Asayesh, H, Asfaw, E, Asgedom, S, Asghar, R, Ashebir, M, Asseffa, N, Atey, T, Atre, S, Atteraya, M, Avila-Burgos, L, Avokpaho, E, Awasthi, A, Ayala Quintanilla, B, Ayalew, A, Ayele, H, Ayer, R, Ayuk, T, Azzopardi, P, Azzopardi-Muscat, N, Babalola, T, Badali, H, Badawi, A, Banach, M, Banerjee, A, Banstola, A, Barber, R, Barboza, M, Barker-Collo, S, Bärnighausen, T, Barquera, S, Barrero, L, Bassat, Q, Basu, S, Baune, B, Bazargan-Hejazi, S, Bedi, N, Beghi, E, Behzadifar, M, Bekele, B, Belachew, A, Belay, S, Belay, Y, Bell, M, Bello, A, Bennett, D, Bennett, J, Bensenor, I, Berhe, D, Bernabé, E, Bernstein, R, Beuran, M, Bhalla, A, Bhatt, P, Bhaumik, S, Bhutta, Z, Biadgo, B, Bijani, A, Bikbov, B, Birungi, C, Biryukov, S, Bizuneh, H, Bolliger, I, Bolt, K, Bou-Orm, I, Bozorgmehr, K, Brady, O, Brazinova, A, Breitborde, N, Brenner, H, Britton, G, Brugha, T, Butt, Z, Cahuana-Hurtado, L, Campos-Nonato, I, Campuzano, J, Car, J, Car, M, Cárdenas, R, Carrero, J, Carvalho, F, Castañeda-Orjuela, C, Castillo Rivas, J, Catalá-López, F, Cercy, K, Chalek, J, Chang, H, Chang, J, Chattopadhyay, A, Chaturvedi, P, Chiang, P, Chisumpa, V, Choi, J, Christensen, H, Christopher, D, Chung, S, Ciobanu, L, Cirillo, M, Colombara, D, Conti, S, Cooper, C, Cornaby, L, Cortesi, P, Cortinovis, M, Costa Pereira, A, Cousin, E, Criqui, M, Cromwell, E, Crowe, C, Crump, J, Daba, A, Dachew, B, Dadi, A, Dandona, L, Dandona, R, Dargan, P, Daryani, A, Daryani, M, Das, J, Das, S, das Neves, J, Davis Weaver, N, Davletov, K, de Courten, B, De Leo, D, De Neve, J, Dellavalle, R, Demoz, G, Deribe, K, Des Jarlais, D, Dey, S, Dharmaratne, S, Dhimal, M, Djalalinia, S, Doku, D, Dolan, K, Dorsey, E, dos Santos, K, Doyle, K, Driscoll, T, Dubey, M, Dubljanin, E, Duncan, B, Echko, M, Edessa, D, Edvardsson, D, Ehrlich, J, Eldrenkamp, E, El-Khatib, Z, Endres, M, Endries, A, Eshrati, B, Eskandarieh, S, Esteghamati, A, Fakhar, M, Farag, T, Faramarzi, M, Faraon, E, Faro, A, Farzadfar, F, Fatusi, A, Fazeli, M, Feigin, V, Feigl, A, Fentahun, N, Fereshtehnejad, S, Fernandes, E, Fernandes, J, Fijabi, D, Filip, I, Fischer, F, Fitzmaurice, C, Flaxman, A, Flor, L, Foigt, N, Foreman, K, Frostad, J, Fürst, T, Futran, N, Gakidou, E, Gallus, S, Gambashidze, K, 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Stefanos, Uchendu, Uche S, Ukwaja, Kingsley N, Ullah, Irfan, Updike, Rachel, Uthman, Olalekan A, Uzochukwu, Benjamin S Chudi, Valdez, Pascual Rubén, van Boven, Job F M, Varughese, Santosh, Vasankari, Tommi, Violante, Francesco S, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wagnew, Fasil, Waheed, Yasir, Wallin, Mitchell T, Walson, Judd L, Wang, Yafeng, Wang, Yuan-Pang, Wassie, Molla Mesele, Weaver, Marcia R, Weiderpass, Elisabete, Weintraub, Robert G, Weiss, Jordan, Weldegwergs, Kidu Gidey, Werdecker, Andrea, West, T Eoin, Westerman, Ronny, White, Richard G, Whiteford, Harvey A, Widecka, Justyna, Winkler, Andrea Sylvia, Wiysonge, Charles Shey, Wolfe, Charles DA, Wondimkun, Yohanes Ayele, Workicho, Abdulhalik, Wyper, Grant M A, Xavier, Denis, Xu, Gelin, Yan, Lijing L, Yano, Yuichiro, Yaseri, Mehdi, Yimer, Nigus Bililign, Yin, Peng, Yip, Paul, Yirsaw, Biruck Desalegn, Yonemoto, Naohiro, Yonga, Gerald, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yu, Chuanhua, Zadnik, Vesna, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Zaman, Sojib Bin, Zamani, Mohammad, Zenebe, Zerihun Menlkalew, Zhou, Maigeng, Zhu, Jun, Zimsen, Stephanie R M, Zipkin, Ben, Zodpey, Sanjay, Zuhlke, Liesl Joanna, Murray, Christopher J L, and Lozano, Rafael
Abstract: Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods: Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derive
Published: 2018

31. Coverage, social mobilization and challenges of mass Zithromax administration campaign in South and South East zones of Tigray, Northern Ethiopia: A cross sectional study

Author: Mengistu Mitiku, Afework Mulugeta, Goitom Gigar, Selamawit Asfaw, Gebremedhin Berhe Gebregergs, Dejen Yemane, Beyene Meresa, and Amanuel Kidane
Subjects: Bacterial Diseases, Male, Rural Population, 0301 basic medicine, Eye Diseases, Cross-sectional study, Maternal Health, Social Sciences, Azithromycin, Geographical Locations, Governments, 0302 clinical medicine, Pregnancy, Surveys and Questionnaires, Medicine and Health Sciences, Child, Socioeconomics, Family Characteristics, Pharmaceutics, lcsh:Public aspects of medicine, Drug Information, Obstetrics and Gynecology, Anti-Bacterial Agents, Infectious Diseases, Geography, Health Education and Awareness, Trachoma, Child, Preschool, Multistage sampling, Mass Drug Administration, Female, Research Article, Neglected Tropical Diseases, Adult, Drug Administration, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, Political Science, 030231 tropical medicine, Young Adult, 03 medical and health sciences, Drug Therapy, Adverse Reactions, medicine, Humans, Mass drug administration, Pharmacology, Descriptive statistics, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Tropical Diseases, medicine.disease, Focus group, Social Mobility, Health Care, Ophthalmology, Cross-Sectional Studies, 030104 developmental biology, Community mobilization, People and Places, Africa, Women's Health, Ethiopia, Armed Forces, Qualitative research
Abstract: Background The antibiotic treatment of people with trachoma helps to prevent transmission the disease in a community. Currently, Zithromax is the drug recommended for mass drug administration (MDA). MDA should be carried out annually for three to five years in trachoma endemic areas. Coverage survey is essential to track progress towards program goals and to identify communities with poor coverage in order to permit timely and appropriate actions. We assessed mass Zithromax administration coverage, social mobilization and campaign challenges in south and southeast zones of Tigray, Ethiopia. Method We conducted a survey in community in Southern and South East zones of Tigray region from August 15 to August 31, 2016. The survey included nine Woredas. It was supported by qualitative methods. A total of 3741 individuals were enrolled from 933 households using multistage sampling. We used structured questionnaire. In-depth interview and focus group discussion were also applied. Descriptive statistics was performed using SPSS version 20.We thematically analyzed the qualitative data using Atlas 7. Result The overall coverage of Zithromax MDA was 93.3%. It ranges from 90.0% in Seharti Samre to 97.9% in Endamokoni. The coverage was 93.4% for males and 93.1% for females. A higher proportion (98.3%) of children aged 5 to 15 years and 409 (87.8%) under five children took Zithromax. The coverage was 94% in rural and 91.2% in urban. Women development army (43.3%) and health extension workers (32.5%) were the main source of information. Frequent occurrence of drug side effects, rumors, lack of community and leaders’ engagement in the campaign, fasting, shortage of human power and short term unavailability of supplies were barriers during the campaign. Conclusion The Zithromax MDA coverage in the study zones was higher than the minimum WHO set criteria of 80%. There was a wide difference in coverage among Woredas and Kebeles. The MDA coverage was lower in urban than rural. Misconceptions and poor mobilization were common challenges. Thus, proper planning, community mobilization and uniform training will need to be done ahead of the campaign in the future., Author summary Ethiopia has the world's highest burden of trachoma. The disease causes significant blindness and visual impairment, particularly in poorer communities. To prevent the transmission of active trachoma, mass administration of Zithromax is given every year, which is implemented for consecutive three to five years in endemic and hyper endemic areas of the country. We have shown that the mass administration coverage of Zithromax, in 2016, was greater than 90% in the South and Southeastern zones of Tigray, Ethiopia. However, it was accompanied by a number of program challenges and social barriers.Women development armies and health extension workers were key players in community mobilization and drug provision, respectively.
Published: 2018
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32. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

Author: Nancy, Fullman, Jamal, Yearwood, Solomon, M, Abay, Cristiana, Abbafati, Foad, Abd-Allah, Jemal, Abdela, Ahmed, Abdelalim, Zegeye, Abebe, Teshome, Abuka, Abebo, Victor, Aboyans, Haftom, Niguse, Abraha, Daisy, M, X, Abreu, Laith, Abu-Raddad, J, Akilew, Awoke, Adane, Rufus, Adesoji, Adedoyin, Olatunji, Adetokunboh, Tara, Ballav, Adhikari, Mohsen, Afarideh, Ashkan, Afshin, Gina, Agarwal, Dominic, Agius, Anurag, Agrawal, Sutapa, Agrawal, Aliasghar, Ahmad, Kiadaliri, Miloud, Taki, Eddine, Aichour, Mohammed, Akibu, Rufus, Olusola, Akinyemi, Tomi, Akinyemiju, F, Nadia, Akseer, Faris, Hasan, Lami, Al, Fares, Alahdab, Ziyad, Al-Aly, Khurshid, Alam, Tahiya, Alam, Deena, Alasfoor, Mohammed, I, Albittar, Kefyalew, Addis, Alene, Ayman, Al-Eyadhy, Syed, Danish, Ali, Mehran, Alijanzadeh, Syed, M, Aljunid, Ala’A, Alkerwi, François, Alla, Peter, Allebeck, Christine, Allen, Mahmoud, A, Alomari, Rajaa, Al-Raddadi, Ubai, Alsharif, Khalid, A, Altirkawi, Nelson, Alvis-Guzman, Azmeraw, T, Amare, Kebede, Amenu, Walid, Ammar, Yaw, Ampem, Amoako, Nahla, Anber, Catalina, Liliana, Andrei, Sofia, Androudi, Carl, Abelardo, Antonio, T, Valdelaine, E, Araújo, M, Olatunde, Aremu, Johan, Ärnlöv, Artaman, Al, Krishna, Kumar, Aryal, Hamid, Asayesh, Ephrem, Tsegay, Asfaw, Solomon, Weldegebreal, Asgedom, Rana, Jawad, Asghar, Mengistu, Mitiku, Ashebir, Netsanet, Abera, Asseffa, Tesfay, Mehari, Atey, Sachin, R, Atre, Madhu, Atteraya, S, Leticia, Avila-Burgos, Euripide, Frinel, Arthur, G, Avokpaho, Ashish, Awasthi, Beatriz, Paulina, Ayala, Quintanilla, Animut, Alebel, Ayalew, Henok, Tadesse, Ayele, Rakesh, Ayer, Tambe, Betrand, Ayuk, Peter, Azzopardi, Natasha, Azzopardi-Muscat, Tesleem, Kayode, Babalola, Hamid, Badali, Alaa, Badawi, Maciej, Banach, Amitava, Banerjee, Amrit, Banstola, Ryan, M, Barber, Miguel, Barboza, A, Suzanne, L, Barker-Collo, Till, Bärnighausen, Simon, Barquera, Lope, H, Barrero, Quique, Bassat, Sanjay, Basu, Bernhard, T, Baune, Shahrzad, Bazargan-Hejazi, Neeraj, Bedi, Ettore, Beghi, Masoud, Behzadifar, Meysam, Behzadifar, Bayu, Begashaw, Bekele, Abate, Bekele, Belachew, Saba, Abraham, Belay, Yihalem, Abebe, Belay, Michelle, L, Bell, Aminu, Bello, K, Derrick, A, Bennett, James, Bennett, R, Isabela, M, Bensenor, Derbew, Fikadu, Berhe, Eduardo, Bernabé, Robert, Steven, Bernstein, Mircea, Beuran, Ashish, Bhalla, Paurvi, Bhatt, Soumyadeep, Bhaumik, Zulfiqar, A, Bhutta, Belete, Biadgo, Ali, Bijani, Boris, Bikbov, Charles, Birungi, Stan, Biryukov, Hailemichael, Bizuneh, Ian, W, Bolliger, Kaylin, Bolt, Ibrahim, R, Bou-Orm, Kayvan, Bozorgmehr, Oliver, Jerome, Brady, Alexandra, Brazinova, Nicholas, J, Breitborde, K, Hermann, Brenner, Gabrielle, Britton, Traolach, S, Brugha, Zahid, Butt, A, Lucero, Cahuana-Hurtado, Ismael, Ricardo, Campos-Nonato, Julio, Cesar, Campuzano, Josip, Car, Mate, Car, Rosario, Cárdenas, Juan, Jesus, Carrero, Felix, Carvalho, Carlos, A, Castañeda-Orjuela, Jacqueline, Castillo, Rivas, Ferrán, Catalá-López, Kelly, Cercy, Julian, Chalek, 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Maria Jesu, Rivera, Juan A., Roever, Leonardo, Ronfani, Luca, Roshandel, Gholamreza, Rostami, Ali, Roth, Gregory A., Rothenbacher, Dietrich, Roy, Ambuj, Roy, Nobhojit, Ruhago, George Mugambage, Sabde, Yogesh Damodar, Sachdev, Perminder S., Sadat, Nafi, Safdarian, Mahdi, Safiri, Saeid, Sagar, Rajesh, Sahebkar, Amirhossein, Sahraian, Mohammad Ali, Sajadi, Haniye Sadat, Salama, Joseph, Salamati, Payman, De Freitas Saldanha, Raphael, Salimzadeh, Hamideh, Salomon, Joshua A., Samy, Abdallah M., Sanabria, Juan Ramon, Sancheti, Parag K., Sanchez-Niño, Maria Dolore, Santomauro, Damian, Santos, Itamar S., Santric Milicevic, Milena M., Sarker, Abdur Razzaque, Sarrafzadegan, Nizal, Sartorius, Benn, Satpathy, Maheswar, Savic, Miloje, Sawhney, Monika, Saxena, Sonia, Saylan, Mete I., Schaeffner, Elke, Schmidhuber, Josef, Schmidt, Maria Inê, Schneider, Ione J.C., Schumacher, Austin E., Schutte, Aletta E., Schwebel, David C., Schwendicke, Falk, Sekerija, Mario, Sepanlou, Sadaf G., Servan-Mori, Edson 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Subjects: Peformance, Coverage, Dánartíðni, Lífslíkur, Life expectancy, GBD, Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0–100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best), universal health coverage, Article, access quality health care, health care access and quality index, Nations, Healthcare Acce, Cause-specific mortality, Psychology, Healthcare Access and Quality Index, Mælitæki, States, Medicine (all), Health care, Þjóðir, Public Health, Global Health, Social Medicine and Epidemiology, Quality, Heilbrigðisþjónusta, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Sálfræði, Indicator, Amenable mortality, Transition, we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0–100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8–98·1) in Iceland, followed by 96·6 (94·9–97·9) in Norway and 96·1 (94·5–97·3) in the Netherlands, to values as low as 18·6 (13·1–24·4) in the Central African Republic, 19·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1–93·6) in Beijing to 48·0 (43·4–53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6–68·8) in Goa to 34·0 (30·3–38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view—and subsequent provision—of quality health care for all populations, Trends, Inequalities
Abstract: Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations., Bill & Melinda Gates Foundation. Barbora de Courten is supported by a National Heart Foundation Future Leader Fellowship (100864). Ai Koyanagi’s work is supported by the Miguel Servet contract financed by the CP13/00150 and PI15/00862 projects, integrated into the National R + D + I and funded by the ISCIII —General Branch Evaluation and Promotion of Health Research—and the European Regional Development Fund (ERDF-FEDER). Alberto Ortiz was supported by Spanish Government (Instituto de Salud Carlos III RETIC REDINREN RD16/0019 FEDER funds). Ashish Awasthi acknowledges funding support from Department of Science and Technology, Government of India through INSPIRE Faculty scheme Boris Bikbov has received funding from the European Union’s Horizon 2020 research and innovation programme under Marie Sklodowska-Curie grant agreement No. 703226. Boris Bikbov acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Panniyammakal Jeemon acknowledges support from the clinical and public health intermediate fellowship from the Wellcome Trust and Department of Biotechnology, India Alliance (2015–20). Job F M van Boven was supported by the Department of Clinical Pharmacy & Pharmacology of the University Medical Center Groningen, University of Groningen, Netherlands. Olanrewaju Oladimeji is an African Research Fellow hosted by Human Sciences Research Council (HSRC), South Africa and he also has honorary affiliations with Walter Sisulu University (WSU), Eastern Cape, South Africa and School of Public Health, University of Namibia (UNAM), Namibia. He is indeed grateful for support from HSRC, WSU and UNAM. EUI is supported in part by the South African National Research Foundation (NRF UID: 86003). Ulrich Mueller acknowledges funding by the German National Cohort Study grant No 01ER1511/D, Gabrielle B Britton is supported by Secretaría Nacional de Ciencia, Tecnología e Innovación and Sistema Nacional de Investigación de Panamá. Giuseppe Remuzzi acknowledges that the work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Behzad Heibati would like to acknowledge Air pollution Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran. Syed Aljunid acknowledges the National University of Malaysia for providing the approval to participate in this GBD Project. Azeem Majeed and Imperial College London are grateful for support from the Northwest London National Insititute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research & Care. Tambe Ayuk acknowledges the Institute of Medical Research and Medicinal Plant Studies for office space provided. José das Neves was supported in his contribution to this work by a Fellowship from Fundação para a Ciência e a Tecnologia, Portugal (SFRH/BPD/92934/2013). João Fernandes gratefully acknowledges funding from FCT–Fundação para a Ciência e a Tecnologia (grant number UID/Multi/50016/2013). Jan-Walter De Neve was supported by the Alexander von Humboldt Foundation. Kebede Deribe is funded by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine (201900). Kazem Rahimi was supported by grants from the Oxford Martin School, the NIHR Oxford BRC and the RCUK Global Challenges Research Fund. Laith J Abu-Raddad acknowledges the support of Qatar National Research Fund (NPRP 9-040-3-008) who provided the main funding for generating the data provided to the GBD-IHME effort. Liesl Zuhlke is funded by the national research foundation of South Africa and the Medical Research Council of South Africa. Monica Cortinovis acknowledges that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group. Chuanhua Yu acknowleges support from the National Natural Science Foundation of China (grant number 81773552 and grant number 81273179) Norberto Perico acknowledges that work related to this paper has been done on behalf of the GBD Genitourinary Disease Expert Group. Charles Shey Wiysonge’s work is supported by the South African Medical Research Council and the National Research Foundation of South Africa (grant numbers 106035 and 108571). John J McGrath is supported by grant APP1056929 from the John Cade Fellowship from the National Health and Medical Research Council and the Danish National Research Foundation (Niels Bohr Professorship). Quique Bassat is an ICREA (Catalan Institution for Research and Advanced Studies) research professor at ISGlobal. Richard G White is funded by the UK MRC and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement that is also part of the EDCTP2 programme supported by the European Union (MR/P002404/1), the Bill & Melinda Gates Foundation (TB Modelling and Analysis Consortium: OPP1084276/OPP1135288, CORTIS: OPP1137034/OPP1151915, Vaccines: OPP1160830), and UNITAID (4214-LSHTM-Sept15; PO 8477-0-600). Rafael Tabarés-Seisdedos was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. Mihajlo Jakovljevic acknowleges contribution from the Serbian Ministry of Education Science and Technological Development of the Republic of Serbia (grant OI 175 014). Shariful Islam is funded by a Senior Fellowship from Institute for Physical Activity and Nutrition, Deakin University and received career transition grants from High Blood Pressure Research Council of Australia. Sonia Saxena is funded by various grants from the NIHR. Stefanos Tyrovolas was supported by the Foundation for Education and European Culture, the Sara Borrell postdoctoral program (reference number CD15/00019 from the Instituto de Salud Carlos III (ISCIII–Spain) and the Fondos Europeo de Desarrollo Regional. Stefanos was awarded with a 6 months visiting fellowship funding at IHME from M-AES (reference no. MV16/00035 from the Instituto de Salud Carlos III). S Vittal Katikreddi was funded by a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the MRC (MC_UU_12017/13 & MC_ UU_12017/15) and the Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15). Traolach S Brugha has received funding from NHS Digital UK to collect data used in this study. The work of Hamid Badali was financially supported by Mazandaran University of Medical Sciences, Sari, Iran. The work of Stefan Lorkowski is funded by the German Federal Ministry of Education and Research (nutriCARD, Grant agreement number 01EA1411A). Mariam Molokhia’s research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. We also thank the countless individuals who have contributed to GBD 2016 in various capacities.
Published: 2018

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32 results on '"Mengistu Mitiku"'

1. Immediate health and economic impact of the Tigray war on internally displaced persons and hosting households

2. Rape survivors’ experience in Tigray: a qualitative study

3. Assessment of Surgery and Anesthesia Services and Patients’ Attitude Towards Informed Consent: The Case of a Specialized and Comprehensive University Hospital in Northern Ethiopia

4. A facility-based study of lipids, glucose levels and their correlates among pregnant women in public hospitals of northern Ethiopia.

5. Prevalence of Orthohantavirus-Reactive Antibodies in Humans and Peri-Domestic Rodents in Northern Ethiopia

6. Coverage, social mobilization and challenges of mass Zithromax administration campaign in South and South East zones of Tigray, Northern Ethiopia: A cross sectional study.

7. Determinants of severe anemia among laboring mothers in Mekelle city public hospitals, Tigray region, Ethiopia.

8. Grain mineral nutrient profiling and iron bioavailability of an ancient crop tef ('Eragrostis tef')

9. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

10. Adverse events of Oxford/AstraZeneca's COVID-19 vaccine among health care workers of Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia

11. A Community-Based Study of Level and Determinants of Substance Use: Findings from Children Experiencing Homelessness in Major Cities of Northern Ethiopia

12. Adverse events of Oxford/AstraZeneca's COVID-19 vaccine among health care workers of Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia

13. Epidemiological and Clinical Characteristics of COVID-19 Patients in Northern Ethiopia: A Retrospective Cohort Study

14. Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: A Retrospective Cohort Study in Tigray, Ethiopia

15. Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: A Retrospective Cohort Study in Tigray, Ethiopia

16. Time to Recovery of Severely Ill COVID-19 Patients and its Predictors: A Retrospective Cohort Study in Tigray, Ethiopia

17. Enhancing health facility-based data quality and use for decision making at primary health care units to improve health service delivery of maternal newborn child and adolescent health, Tigray Ethiopia 2018

18. Risk Factors of Birth Asphyxia Among Neonates Born in Public Hospitals of Tigray, Northern Ethiopia

19. Grain mineral nutrient profiling and iron bioavailability of an ancient crop tef (Eragrostis tef)

20. Prevalence of Orthohantavirus-Reactive Antibodies in Humans and Peri-Domestic Rodents in Northern Ethiopia

21. Epidemiological and Clinical Characteristics of COVID-19 Patients in Northern Ethiopia: A Retrospective Cohort Study.

22. A facility-based study of factors associated with perinatal mortality in Tigray, northern Ethiopia

23. Five-Year Field Trial of Eight Camelina sativa Cultivars for Biomass to be Used in Biofuel under Irrigated Conditions in a Semi-Arid Climate

24. Enhancing health facility-based data quality and use for decision making at primary health care units to improve health service delivery of maternal newborn child and adolescent health, Tigray Ethiopia 2018

25. Process Evaluation of Decontamination, Cleaning and Sterilization of medical instruments at public health centers of Mekelle zone, Tigray, Ethiopia, 2018

26. Patient Safety Culture Status and Its Predictors among Healthcare Workers

27. Characterization of Slow Rusting Resistance Against Stem Rust (Puccinia graminis f. sp. tritici) in Selected Bread Wheat Cultivars of Ethiopia

28. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

29. Process Evaluation of Decontamination, Cleaning and Sterilization of medical instruments at public health centers of Mekelle zone, Tigray, Ethiopia, 2018

30. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

31. Coverage, social mobilization and challenges of mass Zithromax administration campaign in South and South East zones of Tigray, Northern Ethiopia: A cross sectional study

32. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

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