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Land Use and Land Cover (LULC) assessment is vital for achieving sustainable ecosystems. This study quantified and mapped the spatiotemporal LULC changes in Ado-Odo Ota Local Government Area of Ogun State, Nigeria, between 2015 and 2023. The LULC was classified into water, forest or thick bush, sparse vegetation, built-up, and bare land using Landsat images. Processing, classification, and image analysis were done using the ESRI ArcGIS Pro 3.3. LULC changed from 2015 to 2023, with built-up areas and sparse vegetation increasing by 138.2 km2 and 28.7 km2, respectively. In contrast, forest or thick bush, which had the greatest change among the LULC classes, decreased by 153.7 km2 over this period while bare land and water bodies decreased by 9.5 km2 and 3.8 km2, respectively. Forest or thick bush (201.0 km2) was converted to sparse vegetation, which reflects an increase in agricultural activities in the region. The conversion of about 109.8 km2 of vegetation and 3.7 km2 of water bodies to built-up areas highlights considerable urbanization. Overall, the increase in the built-up area highlights the need for sustainable land use practices to balance urban growth with ecological preservation, achievable through effective management and policy frameworks.

Nebiyu Dereje,1 Kalkidan Moges,2 Yemisrach Nigatu,1 Roger Holland2 1Department of Public Health, Myungsung Medical College, Addis Ababa, Ethiopia; 2Department of Medicine, Myungsung Medical College, Addis Ababa, EthiopiaCorrespondence: Nebiyu DerejeDepartment of Public Health, Myungsung Medical College, P.O. Box 14972, Addis Ababa, EthiopiaTel +251978788638Email neba.jahovy@gmail.comPurpose: Data comparing the burden of the opportunistic infections among the Pre-ART and On-ART HIV-infected patients in Ethiopia are scarce. Therefore, this study aimed to compare the prevalence and predictors of opportunistic infections in Pre-ART and On-ART HIV-infected patients.Methods: A comparative cross-sectional study was conducted among adult patients infected with HIV and who were on Pre-ART or On-ART and followed up from 2012 to 2016 in Zewditu Memorial Hospital, Addis Ababa. Those patients who were infected with HIV, but not eligible for ART were categorized under Pre-ART follow-up (n=192) and those patients who started taking ART were categorized under the On-ART follow-up group (n=192). Patients were included in the study by using simple random sampling technique from the list of the patients registered in the ART follow-up database. The presence of opportunistic infections along with clinical findings and baseline laboratory data was extracted from the ART follow-up database and the medical records of the patients using a standardized checklist. Factors associated with the development of opportunistic infections were analyzed using multi-variable binary logistic regression analysis.Results: The overall prevalence of opportunistic infections was found to be 33.6% (95% CI; 28.9–38.5). The prevalence of opportunistic infections among the Pre-ART group (38%) was higher than On-ART group (29.2%) (P-value = 0.04). Pulmonary tuberculosis was the most common opportunistic infection observed in both Pre-ART and On-ART groups. Being in the WHO clinical Stage III (AOR = 2.1; 95% CI 1.1–3.9) or Stage IV (AOR = 3.6; 95% CI 1.7–7.7) were independent predictors for the development of opportunistic infections.Conclusion: The prevalence of opportunistic infections among the HIV-infected patients who were in Pre-ART was higher than On-ART group. This finding reinforces the need for early initiation of ART for HIV-infected patients irrespective of their CD4 counts.Keywords: opportunistic infections, Pre-ART, On-ART, HIV, PLWHIV, WHO staging

Land Use and Land Cover (LULC) assessment is vital for achieving sustainable ecosystems. This study quantified and mapped the spatiotemporal LULC changes in Ado-Odo Ota Local Government Area of Ogun State, Nigeria, between 2015 and 2023. The LULC was classified into water, forest or thick bush, sparse vegetation, built-up, and bare land using Landsat images. Processing, classification, and image analysis were done using the ESRI ArcGIS Pro 3.3. LULC changed from 2015 to 2023, with built-up areas and sparse vegetation increasing by 138.2 km2 and 28.7 km2, respectively. In contrast, forest or thick bush, which had the greatest change among the LULC classes, decreased by 153.7 km2 over this period while bare land and water bodies decreased by 9.5 km2 and 3.8 km2, respectively. Forest or thick bush (201.0 km2) was converted to sparse vegetation, which reflects an increase in agricultural activities in the region. The conversion of about 109.8 km2 of vegetation and 3.7 km2 of water bodies to built-up areas highlights considerable urbanization. Overall, the increase in the built-up area highlights the need for sustainable land use practices to balance urban growth with ecological preservation, achievable through effective management and policy frameworks. [ABSTRACT FROM AUTHOR]

Abstract Background Intestinal parasitic (IP) infections caused by helminths are among the most significant public health concerns that mainly affect deprived people in Sub-Sahara African countries. The current study aimed to determine the prevalence and associated risk factors of intestinal parasitic helminths among patients attending Mekaneselam hospital. Method In this cross-sectional study conducted from August 2022 to February 2023, stool specimens were collected and examined microscopically to detect intestinal helminths using direct wet-mount and formal-ether concentration techniques. A structured questionnaire was employed to obtain information regarding the socio-demographic characteristics and associated risk factors. Data were analyzed via appropriate univariate and multivariable logistic regression methods using SPSS version 25.0. Result The overall prevalence of the parasitic helminths was 51 (12.6%) out of 404 patients attending in Mekaneselam town during the study period. In this study, seven species of intestinal helminths were detected, with Ascaris lumbricoides (5.7%) being the most prevalent followed by Trichuris trichiura (2.2%). Significant positive associations were observed between intestinal helminths infection and the socio-demographic characteristics including marital status (χ2 = 7.97, p = 0.047), educational level (χ2 = 9.34, p = 0.025) and residence (χ2 = 3.90, p = 0.048). The odds of being infected with IP were three times higher among divorced patients than married individuals (AOR = 3.21, CI = 1.15–8.96, p = 0.03). Illiterate individuals were three times (AOR = 2.61, CI = 1.24–5.49, p = 0.011) and those who attended primary school were two times (AOR = 2.3, CI = 1.029–5.143, p = 0.042), more likely to have helminthic infections. Participants who did not wash their hands after using the toilet were five times more likely to acquire IP helminths than those who did (AOR = 4.36, CI = 2.83–6.72, p = 0.000). In the case of the feeding habit, study subjects who ate unwashed vegetables were more likely to acquire helminths than those who did not eat unwashed vegetables (AOR = 5. 43, CI = 4.33–23.77, p = 0.000). Conclusion This study highlighted a substantial prevalence of intestinal helminths infections (12.6%) in the study area, warranting the urgent need for attention and interventions from relevant public health authorities.

BackgroundPrenatal vitamin and mineral supplements are commonly advised as clinical practice standard of care. In spite of Ethiopian government focus on maternal nutrition programmes targeting pregnant and lactating women, Micronutrient deficiencies are still quite common and are regarded as a serious public health issue and also little is known regarding utilization and barriers to prenatal vitamin use during pregnancy. This study aimed to assess utilization and associated factors of prenatal vitamins among pregnant women attending antenatal care at public hospitals in the south Gondar zone, 2024MethodsMulti center crossectional study design was conducted among 416 pregnant women from March 1 to May 30, 2024. Systematic sampling technique was used to select the study participants. Data was collected using Interviewer administered questionnaire. After data, SPSS version 26 software was used for analysis. Factors associated with utilization of prenatal vitamins were identified using bi-variable and multi variable logistic regression models. Statistical significance was declared at 95%CI and p-value

Ethiopia is the largest teff (Eragrostis teff Zucc) producer in the world. This research was intended to determine the levels of mineral nutrients and non-essential metals in the teff samples. After optimization, the samples were wet-digested using reagents (5 mL HNO3 and 1 mL HClO4), at a temperature of 230 °C for 2:30 h. Inductively coupled plasma optical emission spectrometry was used for the analysis of mineral nutrients and toxic metals in the teff samples. Under the optimum procedure, the coefficients of determination (R2) ranged between 0.9980 and 0.9999. The limits of detections (LODs) and limits of quantifications (LOQs) were in the range of 0.036–14.49 mg/kg and 0.111–43.93 mg/kg, respectively. The recovery ranged from 80.72 % to 107.79 %. The overall mean concentration in the three types of teff samples determined (mg/kg) was in the range of P (3890–4853), K (3040–3784), Ca (1906–1959), Mg (1402–1698), Fe (128–305), Mn (64–127.8), Na (50–136.5), Zn (19.8–27.3), B (1.8–21.9), Cu (4.17–6.9), Ni (2.6–4.05), Hg (1.8–4.0), Pb (0.048–3.7), Cd (0.012–2.09), As (0.02–0.24), with% RSD ranging between 0.017 and 11.1 %. The results obtained revealed that teff grain is a good source of minerals and contains a significant amount of toxic elements like Cd, Hg, As, and Pb.

Background: In order to reduce stillbirth and perinatal mortality, world health organization recommended eight or more antenatal care contacts which is named as WHO 2016 ANC model recently. However, the effectiveness of the model depends on the adherence of pregnant mother and studies are absent as far as our search in Ethiopia. Therefore the aim of this study is to assess Non-adherence of WHO 2016 ANC model and associated factors among mothers who gave birth at south Gondar public hospitals. Methods: Multi-center crossectional study design was conducted among 412 postnatal and laboring mothers from September 01-November/30/2023. Participants were selected with systematic sampling technique. Interviewer administered questioner was used to collect the data. Factors associated with non-adherence of antenatal care were identified using bi-variable and multi variable logistic regression models. Statistical significance was defined at 95 %CI and p-value 2 hrs (AOR=4.84; CI: 2.33–10.06) and women who had poor knowledge on danger signs (AOR=3.29; CI: 1.49–7.26) were significantly associated with non-adherence of WHO 2016 ANC model. Conclusion: The magnitude of non-adherence to antenatal care contact is high. Accessing health facilities, empowering women, and educating them on danger signs are important.

Fincha watershed is characterized by the presence of large scale government development projects, such as hydroelectric dam and sugarcane plantation. Within this watershed, land use/land cover (LULC) changes and its linkages with ecosystem services were analyzed for a period of more than three decades (1987–2019). The study first assessed LULC dynamics using ArcGIS software with a standard method. After data on LULC change was obtained, the study used a globally developed values coefficients to estimate the Ecosystem Service Values (ESVs) of the study watershed. The findings revealed that; cultivated land, water body, settlement and sugar cane plantation increased at a rate of 579.8 ha/yr, 199.7 ha/yr, 141.2 ha/yr and 137.1 ha/yr, respectively, whereas wetland, forest land and bare land reduced by 600 ha/y, 328.7 ha/yr and 60.3 ha/yr, respectively, for the study period (1987–2019) considered in the watershed. The increase in water body and sugar cane plantation is mainly attributed to large scale government development projects, while the increase in settlement and cultivated land is the result of small scale farming in the area. Both subsistence farming practices and large scale government projects compete on forest land and wetland. This has resulted in the decrease of the total NCV (Natural Capital Value) by 13.2%. The total ecosystem service values were dominated by cultivated land, which contributed 42.9% of the values in 2019. Elasticity of ESV change in relation to LULC showed the dominance of cultivated land in the overall values of the natural capital. To optimize the values of natural capital at the watershed, making synergies and tradeoffs between land uses is vital by all concerned stakeholders involved in modification of the land uses.

The data presented in this article show changes in land use/land cover and fragmentation of land at a landscape level for a period of 45 years (1973-2018) in Ambo district of the central highlands of Ethiopia. Data generated from satellite images of Multispectral Scanner (MSS), Enhanced Thematic Mapper (ETM) and Operational Land Image (OLI) with path/raw value of 181/54, 169/54 and169/54 for each images respectively were analyzed by Arc GIS 10.1 software using a standard method. The precision of the images were verified by data collected from ground control points by using Geographic Positioning System (GPS) receiver. A raster data of LULC was used as an input in to FRAGSTAT software to analyze fragmentation at the landscape level. The data presented in this article showed that cultivated land and settlement increased by 45.7% (376.5ha/yr) and 111% (78.3ha/yr) for 1973-2018 periods respectively. Forest land, shrub land and bare land shrunk by 38% (147.5ha/yr), 17.1% (88.5ha/yr) and 63.9% (218ha/yr) respectively over the periods considered. Transition matrix indicated that 64781.86ha of land unchanged over the years (1973-2018). Number of patches increased by 143% while largest patch index increased by 226% in the years (1973-2018). In contrast, however, Aggregation index has shown a negative value (9.3%) and other metrics such as SIDI (12) and IJI (8.1) has shown an overall decreasing trend.

Assessing and quantifying the current forest resources status underpins sustainable forest resources planning and management. To this end, this study was conducted to analyze the dynamics of land use cover change (LUCC) and explore their drivers at the central highlands of Dry Afromontane Chilimo-Gaji forest for the study period (1973-2015) under consideration. The result of the study indicated that landscape trends have occurred in Chilimo-Gaji forest over the last 43 years and five classes of LUCC namely shrub land, rural settlement, bare land and road, forest land and agricultural land were identified. The most commonly reported drivers of deforestation in the study area were expansion of agricultural land, rural settlements, population growth, insecurity of the tenure and rights over the land, timber production and fuel wood collection. Surprisingly, the increasing demand for agricultural land and human settlement for increasing human population underpinned by expansion of agricultural activities led to the clearing of forest land in the study area. The study reveals that the forest land cover type has lost 922.14 hectares (26.96 %) which were changed into other land cover types such as agriculture and settlement for the study period under consideration with an annually rate of 21.45 ha. However, deforestation rates showed declining trend between the time periods 2008-2015 as a result of introduction of Participatory Forest Management (PFM) schemes (1996) which involve the local community in management and sharing of the benefit obtained from the management. In order to promote sustainable forest resources management in the study area in the years to come, integrated land use planning and management and addressing key drivers of deforestation were recommended.

Abstract Background Determination of the genetic diversity of malaria parasites can inform the intensity of transmission and identify potential deficiencies in malaria control programmes. This study was conducted to characterize the genetic diversity and allele frequencies of Plasmodium falciparum in Northwest Ethiopia along the Eritrea and Sudan border. Methods A total of 90 isolates from patients presenting to the local health centre with uncomplicated P. falciparum were collected from October 2014 to January 2015. DNA was extracted and the polymorphic regions of the msp-1, msp-2 and glurp loci were genotyped by nested polymerase chain reactions followed by gel electrophoresis for fragment analysis. Results Allelic variation in msp-1, msp-2 and glurp were identified in 90 blood samples. A total of 34 msp alleles (12 for msp-1 and 22 for msp-2) were detected. For msp-1 97.8% (88/90), msp-2 82.2% (74/90) and glurp 46.7% (42/90) were detected. In msp-1, MAD20 was the predominant allelic family detected in 47.7% (42/88) of the isolates followed by RO33 and K1. For msp-2, the frequency of FC27 and IC/3D7 were 77% (57/74) and 76% (56/74), respectively. Nine glurp RII region genotypes were identified. Seventy percent of isolates had multiple genotypes and the overall mean multiplicity of infection was 2.6 (95% CI 2.25–2.97). The heterozygosity index was 0.82, 0.62 and 0.20 for msp-1, msp-2 and glurp, respectively. There was no significant association between multiplicity of infection and age or parasite density. Conclusions There was a high degree of genetic diversity with multiple clones in P. falciparum isolates from Northwest Ethiopia suggesting that there is a need for improved malaria control efforts in this region.

Abstract Background Building on the declining trend of malaria in Ethiopia, the Federal Ministry of Health aims to eliminate malaria by 2030. As Plasmodium falciparum and Plasmodium vivax are co-endemic in Ethiopia, the use of primaquine is indicated for both transmission interruption and radical cure, respectively. However, the limited knowledge of the local prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency and its associated variants has hindered the use of primaquine. Methods Some 11,138 dried blood spot (DBS) samples were collected in 2011 as part of a national, household Malaria Indicator Survey, a multi-stage nationally representative survey of all malaria-endemic areas of Ethiopia. A randomly selected sub-set of 1414 DBS samples was successfully genotyped by polymerase chain reaction–restriction fragment length polymorphism (PCR–RFLP) technique. Considering the geographical position and ethnic mix of the country, three common variants: G6PD*A (A376G), G6PD*A− (G202A) and Mediterranean (C563T) were investigated. Results Of the 1998 randomly selected individuals, 1429 (71.5%) DBS samples were genotyped and merged to the database, of which 53.5% were from females. G6PD*A (A376G) was the only genotype detected. No sample was positive for either G6PD*A− (G202A) or Mediterranean (C563T) variants. The prevalence of G6PD*A (A376G) was 8.9% [95% confidence interval (CI) 6.7–11.2] ranging from 12.2% in the Southern Nations, Nationalities and Peoples’ (95% CI 5.7–18.7) to none in Dire Dawa/Harari Region. Conclusion The common G6PD*A− (G202A) or Mediterranean (C563T) variants were not observed in this nationwide study. The observed G6PD*A (A376G) mutation has little or no clinical significance. These findings supported the adoption of primaquine for P. falciparum transmission interruption and radical cure of P. vivax in Ethiopia. As the presence of other clinically important, less common variants cannot be ruled out, the implementation of radical cure will be accompanied by active haematological and adverse events monitoring in Ethiopia.

The central highlands of Ethiopia are characterized as a region of high rates of land degradation and soil erosion. This study aimed to estimate total amount of soil loss and sediment yield using RUSLE model within GIS environment. LULC maps of 1973–2015 were used to evaluate the impact of land use change on soil loss and sediment yield. Each model parameter and sediment deliver ration was computed by using Williams and Berndt empirical equation. The net soil erosion and sediment yield at the Guder river mouth and soil risk map was estimated for the watershed. LULC dynamic for the study period and watershed have shown that there existed a rapid conversion of vegetated land uses to human modified land uses. The study revealed that the mean soil loss from the watershed ranges between 25 and 30 t/ha−1 yr−1 which accounted 25.8, 28.7 and 30.3 t/ha/yr for 1973, 1995 and 2015 periods respectively. The estimated total soil loss in 1973, 1995 and 2015 periods were 198Mt yr-1, 221Mt yr-1 and 239Mt yr-1 respectively. The mean sediment yield estimated was 6.79, 8.65 and 9.44t ha-1 yr-1 for 1973, 1995 and 2015 periods respectively. The sediment deliver ratio (SDR) of the watershed ranged between 0 and 0.26. The spatial distribution of SDR showed that the highest value was recorded on central and eastern part of the watershed. Prioritizing erosion host spot areas is recommended to rehabilitate degraded lands using suitable soil and water conservation structures.

[This corrects the article DOI: 10.1371/journal.pmed.1002299.].

A total of 416 actinomycete cultures were isolated from various unique environments in Ethiopia and tested for bioactivity. Six isolates with pronounced antimicrobial activity were chosen for taxonomic identification and further investigation. Morphological and cultural properties of the isolates were found to be consistent with those of the genus Streptomyces, which was further confirmed by phylogenetic analysis based on 16S rRNA gene sequences. One of the isolates, designated Streptomyces sp. Go-475, which displayed potent activity against both pathogenic yeasts and Gram-positive bacteria, was chosen for further investigation. Metabolite profiles and bioactivity of Go-475 incubated on wheat bran-based solid and soya flour-based liquid media were compared using high-resolution LC-MS. This allowed identification of several known compounds, and suggested the ability of Go-475 to produce new secondary metabolites. Major anti-bacterial compounds were purified from liquid cultures of Go-475, and their structures elucidated by NMR and HRMS as 8-O-methyltetrangomycin and 8-O-methyltetrangulol. In addition, many potentially novel metabolites were detected, the majority of which were produced in solid media-based fermentation. The genome sequence of Streptomyces sp. Go-475 was obtained using a hybrid assembly approach of high quality Illumina short read and low quality Oxford Nanopore long read data. The complete linear chromosome of 8,570,609 bp, featuring a G+C content of 71.96%, contains 7,571 predicted coding sequences, 83 t(m)RNA genes, and six rrn operons. Analysis of the genome for secondary metabolite biosynthesis gene clusters further confirmed potential of this isolate to synthesize chemically diverse natural products, and allowed to connect certain clusters with experimentally confirmed molecules.

BackgroundRecent efforts in malaria control have resulted in great gains in reducing the burden of Plasmodium falciparum, but P. vivax has been more refractory. Its ability to form dormant liver stages confounds control and elimination efforts. To compare the efficacy and safety of primaquine regimens for radical cure, we undertook a randomized controlled trial in Ethiopia.Methods and findingsPatients with normal glucose-6-phosphate dehydrogenase status with symptomatic P. vivax mono-infection were enrolled and randomly assigned to receive either chloroquine (CQ) or artemether-lumefantrine (AL), alone or in combination with 14 d of semi-supervised primaquine (PQ) (3.5 mg/kg total). A total of 398 patients (n = 104 in the CQ arm, n = 100 in the AL arm, n = 102 in the CQ+PQ arm, and n = 92 in the AL+PQ arm) were followed for 1 y, and recurrent episodes were treated with the same treatment allocated at enrolment. The primary endpoints were the risk of P. vivax recurrence at day 28 and at day 42. The risk of recurrent P. vivax infection at day 28 was 4.0% (95% CI 1.5%-10.4%) after CQ treatment and 0% (95% CI 0%-4.0%) after CQ+PQ. The corresponding risks were 12.0% (95% CI 6.8%-20.6%) following AL alone and 2.3% (95% CI 0.6%-9.0%) following AL+PQ. On day 42, the risk was 18.7% (95% CI 12.2%-28.0%) after CQ, 1.2% (95% CI 0.2%-8.0%) after CQ+PQ, 29.9% (95% CI 21.6%-40.5%) after AL, and 5.9% (95% CI 2.4%-13.5%) after AL+PQ (overall p < 0.001). In those not prescribed PQ, the risk of recurrence by day 42 appeared greater following AL treatment than CQ treatment (HR = 1.8 [95% CI 1.0-3.2]; p = 0.059). At the end of follow-up, the incidence rate of P. vivax was 2.2 episodes/person-year for patients treated with CQ compared to 0.4 for patients treated with CQ+PQ (rate ratio: 5.1 [95% CI 2.9-9.1]; p < 0.001) and 2.3 episodes/person-year for AL compared to 0.5 for AL+PQ (rate ratio: 6.4 [95% CI 3.6-11.3]; p < 0.001). There was no difference in the occurrence of adverse events between treatment arms. The main limitations of the study were the early termination of the trial and the omission of haemoglobin measurement after day 42, resulting in an inability to estimate the cumulative risk of anaemia.ConclusionsDespite evidence of CQ-resistant P. vivax, the risk of recurrence in this study was greater following treatment with AL unless it was combined with a supervised course of PQ. PQ combined with either CQ or AL was well tolerated and reduced recurrence of vivax malaria by 5-fold at 1 y.Trial registrationClinicalTrials.gov NCT01680406.

BACKGROUND:In malaria endemic regions, Plasmodium falciparum infection is characterized by extensive genetic diversity. Describing this diversity provides important information about the local malaria situation. This study was conducted to evaluate the extent of genetic diversity of P. falciparum in Pawe district, North West Ethiopia, using the highly polymorphic merozoite surface protein 2 gene. METHODS:Atotal of 92 isolates from patients with uncomplicated P. falciparum attending Pawe Health Centre were collected from September to December 2013. Genomic DNA was extracted using the Chelex method and analyzed by length polymorphism following gel electrophoresis of DNA products from nested PCR of msp2 (block 3), targeting allelic families of FC27 and 3D7/IC. RESULTS:There were twenty-two different msp2 alleles, 11 corresponding to the 3D7/ IC and 11 to the FC27 allelic family. The frequency of isolates of the msp2 3D7/IC allelic familywas higher (51%) compared to FC27 (49%). The majority of the isolates (76%) contained multiple infections andthe overall mean multiplicity of infection was 2.8 (CI 95% 2.55-3.03). The heterozygosity index was 0.66 for msp2. There was no statically significant difference in the multiplicity of infection by age or parasite density. CONCLUSIONS:The results of this study show that P.falciparum polymorphismsare extensive in Northwest Ethiopia and most of the infections are composed of multiple clones.

Malaria, particularly due to Plasmodium falciparum, remains a major public health threat in Ethiopia. Artemether-lumefantine (AL) has been the first-line antimalarial drug against uncomplicated P. falciparum malaria in the country since 2004. Regular monitoring of antimalarial drugs is recommended by the World Health Organization (WHO) to help early detection of drug resistant strains of the parasite and contain their rapid spread. The objective of this study was to assess the therapeutic efficacy of AL in a high-transmission setting in Ethiopia. The study site was Setit Humera, northwest Ethiopia. Single-arm prospective study of a 28-day follow-up was conducted from October 2014 to January 2015 according to the revised WHO 2009 drug efficacy study protocol. Study end-points were classified into primary end-point and secondary end-point. While the primary end-point was the day-28 adequate clinical and parasitological response the secondary end-points were clinical and parasitological evaluations (parasite, fever and gametocyte clearance rate, incidence of drug adverse events) and the relative increment in hemoglobin (Hb) level from baseline to day (D) 14 and D28. A total of 92 patients were enrolled and 79 had completed the 28-day follow-up period. The overall cure rate was 98.8% with 95% confidence interval of 0.915-0.998 without polymerase chain reaction correction. The parasite clearance rate was high with fast resolution of clinical symptoms; 100% of the study participants cleared parasitaemia and fever on D3. Gametocyte carriage was reduced from 7% on D0 to 1% on D3 and complete clearance was achieved on D14. Mean Hb concentration significantly increased on D28 compared to that on D14. There was no serious adverse event. AL was efficacious and safe in a high-transmission setting for treatment of uncomplicated falciparum malaria.

Land use/land cover (LULC) change is one of the most important environmental phenomena that have affected the earth’s system and its ecosystem services. This study was conducted to assess the impacts of LULC change on ecosystem services in the Jimma Rare district for over four decades (1974–2019). To understand the spatial and temporal changes of LULC, a four-time period of satellite images (1974, 1991, 2005, and 2019) were obtained. In addition, respondent interviews, focus group discussions (FGD) and field observations were employed to identify the drivers of land use changes. Moreover, the ecosystem service value coefficients developed at a global level were used to assess the impacts of LULC on the ecosystem service provision of the study area. The study showed that grassland decreased from 4518.87 ha (13.09%) to 902.42 ha (2.61%), forest land 3287.79 ha (9.52%) to 2506.63 ha (7.26%) and wetlands from 1182.08 ha (3.42%) to 562.37 ha (1.63%) in the study period. The most remarkable expansion of cultivated land and settlement area occurred from 1974 to 1991. The total ecosystem service value was reduced from 662.75 million $/ha/yr to 577.03 million $/ha/yr in the period, indicating the impact of LULC on ecosystem service values. From this study, it is possible to conclude that Jimma Rare District has experienced a significant change in LULC and ecosystem service over the past 45 years. Hence, appropriate land use policy packages are required to curb the impacts of such LULC changes on vital ecosystem services thereby enhancing sustainable flow of ecosystem services in the study district.

BACKGROUND:As per the WHO recommendation, the development of resistance by P. falciparum to most artemisinin combination therapies (ACTs) triggered the need for routine monitoring of the efficacy of the drugs every two years in all malaria endemic countries. Hence, this study was carried out to assess the therapeutic efficacy of Artemether-Lumefantrine (Coartem®) in treating the uncomplicated falciparum malaria, after 9 years of its introduction in the Metehara, Eastern Ethiopia. METHOD:This is part of the therapeutic efficacy studies by the Federal Ministry of Health Ethiopia, which were conducted in regionally representative sentinel sites in the country from October 2014 to January 2015. Based on the study criteria set by WHO, febrile and malaria suspected outpatients in the health center were consecutively recruited to study. A standard six-dose regimen of AL was administered over three days and followed up for measuring therapeutic responses over 28 days. Data entry and analysis was done by using the WHO designed Excel spreadsheet and SPSS version 20 for Windows. Statistical significant was considered for P-value less than 0.05. RESULT:Of the 91 patients enrolled, the day-28 analysis showed 83 adequate clinical and parasitological responses (ACPRs). Per protocol analysis, PCR-uncorrected & corrected cure rates of Coartem® among the study participants were 97.6% (95%CI: 93.6-99.5) and 98.8% (CI: 93.5-100%), respectively. No parasite detected on day 3 and onwards. Fever clearance was above 91% on day-3. Mean hemoglobin was significantly increased (P

Antimalarial drug resistance is one of the major challenges in global efforts of malaria control and elimination. In 1998, chloroquine was abandoned and replaced with sulfadoxine/pyrimethamine, which in turn was replaced with artemether/lumefantrine for the treatment of uncomplicated falciparum malaria in 2004. Sulfadoxine/pyrimethamine resistance is associated with mutations in dihydrofolate reductase (Pfdhfr) and dihydropteroate synthase (Pfdhps) genes. The prevalence of mutation in Pfdhfr and Pfdhps genes were evaluated and compared for a total of 159 isolates collected in two different time points, 2005 and 2007/08, from Pawe hospital, in North Western Ethiopia. The frequency of triple Pfdhfr mutation decreased significantly from 50.8% (32/63) to 15.9% (10/63) (P

BackgroundIn vivo efficacy assessments of antimalarials are essential for ensuring effective case management. In Ethiopia, chloroquine (CQ) without primaquine is the first-line treatment for Plasmodium vivax in malarious areas, but artemether-lumefantrine (AL) is also commonly used.Methods and findingsIn 2009, we conducted a 42-day efficacy study of AL or CQ for P. vivax in Oromia Regional State, Ethiopia. Individuals with P. vivax monoinfection were enrolled. Primary endpoint was day 28 cure rate. In patients with recurrent parasitemia, drug level and genotyping using microsatellite markers were assessed. Using survival analysis, uncorrected patient cure rates at day 28 were 75.7% (95% confidence interval (CI) 66.8-82.5) for AL and 90.8% (95% CI 83.6-94.9) for CQ. During the 42 days of follow-up, 41.6% (47/113) of patients in the AL arm and 31.8% (34/107) in the CQ arm presented with recurrent P. vivax infection, with the median number of days to recurrence of 28 compared to 35 days in the AL and CQ arm, respectively. Using microsatellite markers to reclassify recurrent parasitemias with a different genotype as non-treatment failures, day 28 cure rates were genotype adjusted to 91.1% (95% CI 84.1-95.1) for AL and to 97.2% (91.6-99.1) for CQ. Three patients (2.8%) with recurrent parasitemia by day 28 in the CQ arm were noted to have drug levels above 100 ng/ml.ConclusionsIn the short term, both AL and CQ were effective and well-tolerated for P. vivax malaria, but high rates of recurrent parasitemia were noted with both drugs. CQ provided longer post-treatment prophylaxis than AL, resulting in delayed recurrence of parasitemia. Although the current policy of species-specific treatment can be maintained for Ethiopia, the co-administration of primaquine for treatment of P. vivax malaria needs to be urgently considered to prevent relapse infections.Trial registrationClinicalTrials.gov NCT01052584.

Objectives: To compare the postoperative analgesia efficacy of dexamethasone added to low-dose high-volume bupivacaine in ultrasound-guided supraclavicular brachial plexus block for adult patients who underwent upper limb orthopedic surgeries at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia., Methods: An observational prospective cohort study was conducted from 1 September 2021 to 30 January 2022. Using a systematic random sampling technique, 56 patients (equal groups of 28 patients) aged 18-60 years scheduled for elective upper limb orthopedic surgeries under supraclavicular block were recruited. According to the discretion of anesthetists' management plan of supraclavicular block, those patients who received 38 mL of 0.25% bupivacaine with 2 mL (8 mg) dexamethasone as the case group (DB) while those patients who received 40 mL of 0.25% bupivacaine alone as the cohort group (B). Time to first analgesic request, onset of sensory and motor, and motor block duration were analyzed with Student's t -test whereas pain severity and analgesic consumption were assessed using the Mann-Whitney U test. Categorical variables were analyzed using chi-square test. p -value less than 0.05 considered statistically significant., Results: Postoperative analgesia had significantly prolonged in the dexamethasone bupivacaine group with a mean duration of 1098.00 ± 195.90 min compared to 464.29 ± 113.75 min in the bupivacaine alone group, p -value < 0.001. Moreover, the dexamethasone bupivacaine group significantly consumed less total tramadol and diclofenac than bupivacaine alone, with a median dose of 0 (0-50) versus 50 (21.25-78.75) mg and 40 (0-50) versus 65 (47.50-77.50) mg, respectively. The median visual analogue scale scores were significantly reduced at 6th, 8th, 12th, and 24th hour in the dexamethasone bupivacaine group., Conclusion: Dexamethasone added to low-dose high-volume of bupivacaine in supraclavicular brachial plexus block significantly prolonged the duration of analgesia., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Competing Interests: Conflicts of interest The authors declare no conflicts of interest.

Background: An emerging respiratory disease abbreviated as coronavirus disease 2019 was first reported in December 2019 in Wuhan city of China. The virus is zoonotic and tends to be transmitted between animals to humans and humans to humans. The major route of transmission of coronavirus disease 2019 is droplet and close contact. The Ethiopian Ministry of Health has initiated training for health care workers at a different level. Thus, the main objective of this study is to assess the knowledge, attitudes, and practices of health workers in Ethiopia toward coronavirus disease 2019 and its prevention techniques., Method: An institution-based multicenter cross-sectional study was conducted in each of eight teaching and referral hospitals. A total of 422 Ethiopian healthcare workers were selected for the assessment of knowledge, attitude, and practice toward coronavirus disease 2019. Data were collected using a structured questionnaire. A logistic regression model was used to identify factors associated with the attitude and knowledge of healthcare workers toward coronavirus disease 2019 at a significance level of p < 0.05., Result: Three hundred ninety-seven healthcare workers participated in the study, with a response rate of 94%. Among these, 88.2% and 94.7% of respondents had good knowledge and positive attitudes, respectively. A respondent with a history of chronic medical illness (odds ratio: 0.193, 95% confidence interval: 0.063-0.593), social media, telecommunication, and television/radio as a source of information were significantly associated with knowledge (odds ratio: 3.4, 95% confidence interval: 1.5-7.4, OR: 4.3, 95% confidence interval: 1.3-14.3 and odds ratio: 3.2, 95% confidence interval: 1.4-7.2). In addition, respondents with a history of chronic medical illness were significantly associated with a negative attitude toward coronavirus disease 2019., Conclusion: The knowledge and attitude were good while; the practice was relatively low. Sources of information such as social media, telecommunication, and television/radio were positively associated with healthcare workers' knowledge about coronavirus disease 2019., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)