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Tadesse Gure Eticha,1 Sagni Girma,2 Galana Mamo,3 Fekede Asefa,3 Abdi Birhanu,4 Bedasa Taye,3 Addisu Alemu,3 Kabtamu Nigussie,2 Abel Gedefaw,5 Tinsae Genet,6 Demisew Amenu,7 Thomas Mekuria,8 Abera Kenay Tura2 1Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5School of Medicine, College of Health and Medical Sciences, Hawassa University, Hawassa, Ethiopia; 6School of Medicine, College of Health and Medical Sciences, University of Gondar, Gondar, Ethiopia; 7School of Medicine, College of Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 8School of Medicine, St. Paul’s Millennium Medical College Hospital, Addis Ababa, EthiopiaCorrespondence: Tadesse Gure Eticha, Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia, Tel +251913868714, Email tadebuna@yahoo.comBackground: Although the lactational amenorrhea method (LAM) is one of the most commonly used contraception methods during the first six months of a woman’s postpartum period, there has been little research on its effectiveness in general and particularly in Ethiopia. The purpose of this study was to evaluate the effectiveness of LAM and the experiences of Ethiopian women who used it.Methods: This was a multi-center prospective cohort study of postpartum women from five Ethiopian regions and one city administration. All pregnant women who gave birth in these randomly selected hospitals and five health centers directly referring to the hospitals were invited to the study if they selected LAM and were followed monthly at home. Each month, trained researchers visited the woman at her home and collected information about breast feeding, the return of menses, the resumption of sex, the use of another contraceptive, and a pregnancy test using urine human chorionic gonadotropin (hCG). Women who reported starting new contraceptive methods, resumption of menses, starting complementary feeding, neonatal death, getting pregnant, or refusing were excluded from the cohort. The data were collected using ODK Collect and exported to Stata 14 for analysis.Results: Among the 2162 women who selected LAM as a contraceptive, 2022 were enrolled in the cohort study, and 901 completed the follow-up. At the end of the sixth month, eight women got pregnant, corresponding to an effectiveness of 99.1%. More than half of the cohort were excluded from the follow-up for reasons of transitioning to other types of contraception, resumption of menses, or refusal to follow-up.Conclusion: The effectiveness of LAM is high and should be recommended for postpartum women, with proper counseling provided. A study should be conducted to examine the effectiveness of breast feeding as a contraceptive beyond the Bellagio consensus.Keywords: effectiveness, lactation amenorrhea, contraception, breast-feeding, postpartum Ethiopia

Gebiso Roba Debele,1 Eyasu Shifera,1 Yohannes Lulu Dessie,2 Debela Dereje Jaleta,2 Megersso Urgessa Borena,3 Shuma Gosha Kanfe,4 Kabtamu Nigussie,5 Galana Mamo Ayana,5 Temam Beshir Raru5 1Department of Public Health, College of Health Sciences, Mattu University, Mattu, Ethiopia; 2Department of Nursing, College of Health Sciences, Mattu University, Mattu, Ethiopia; 3Department of Public Health, School of Health Sciences, Shashemene Campus, Madda University, Shashemene, Ethiopia; 4Department of Health Informatics, College of Health Sciences, Mattu University, Mattu, Ethiopia; 5College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Gebiso Roba Debele, Email gebisa.roba123@gmail.comBackground: Even though podoconiosis can cause physical, financial, and social impairments, it is commonly overlooked by organizations, and one-fourth of the predicted worldwide burden will fall on Ethiopia. In spite of this, there are only a few attempts for prevention and control in certain areas in Ethiopia. Updated statistics on prevalence and contributing factors could make local efforts at prevention, control, and rehabilitation more effective. Thus, this study was aimed to assess the prevalence of podoconiosis and its associated factors among Ilu Aba Bor zone residents, South West Ethiopia.Methods: A community-based cross-sectional study was conducted on 491 participants from March 25 to April 25, 2022. Data were entered into Epi-Data version 4.6.0, then exported to SPSS version 25 for final analysis. In the bi-variable regression, variables with P-values less than 0.25 were included in the multivariable model. Finally, multivariable logistic regression was performed to identify factors associated with podoconiosis at a 5% level of significance.Results: In this study area, podoconiosis prevalence was found to be 5.7% [3.6– 7.2]. In multivariable regression model, lower tertile wealth status [AOR=2.09; (95% CI (1.384, 5.343)], no formal education [AOR=2.23; (95% CI; 1.179– 3.820)] and average distance to reach water source to home [AOR=2.061; (95% CI: 1.78– 7.35)] were significantly associated podoconiosis.Conclusion and Recommendation: According to this study, one in every seventeen individuals had podoconiosis, which is a significant prevalence when compared to earlier studies. Podoconiosis was observed to be associated with factors like wealth status, educational attainment, and distance from water source. To address this public health issue, strong preventive and therapeutic treatments should be used.Keywords: prevalence, factors, podoconiosis, Ilu Aba Bor zone

Kumneger Nigussie,1 Genet Degu,1 Habtamu Chanie1 ,† Hayimro Edemealem2 1Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia; 2Department of Statistics, College of Natural and Computational Science, Debre Markos University, Debre Markos, Ethiopia†Mr Habtamu Chanie passed away on April 27, 2020Correspondence: Kumneger NigussieDepartment of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, EthiopiaTel +251939636117Email kumnegernigussie21@gmail.comBackground: Unintended pregnancy is an important public health concern in both developing and developed countries due to its serious consequences for women, infants, families and communities, including the risk of unsafe abortion, delayed prenatal care, poor maternal mental health, poor child health outcomes and unemployment.Objective: The aim of the study was to assess the prevalence and associated factors of unintended pregnancy among pregnant women in the town of Debre Markos in 2019.Methods: The magnitude and associated factors of unintended pregnancy were assessed using a community-based cross-sectional study design. A multi-stage sampling technique was used to select five Kebeles (basic administrative units), and households were selected from the selected Kebeles using simple random sampling. A total of 580 samples were collected through standardized pretested questionnaires. Bivariate and multivariate logistic regression were used to analyze the relationship between the UP and independent variables.Results: Of the pregnant women, 202 (34.8%) (95% CI: 30.9– 38.7) participants had an unintended current pregnancy; of those 144 (24.8%) were mistimed pregnancies. Women aged 24 years were three times more likely to have an unintended pregnancy than those aged 35 years. Divorced and widowed women were four times more likely than women who were currently married to experience an unintended pregnancy. Gravidity 1– 2 and 3– 4 were 94% and 86% less likely than gravidity > 5 to experience an unintended pregnancy, and women who made family planning decisions on their own were less likely to have an unintended pregnancy.Conclusion: According to this study, the prevalence of unintended pregnancy was 34.8% and unintended pregnancy was significantly correlated with women’s age, marital status, gravidity and who made decisions on family planning. There is an obvious need to devise communication strategies on fertility and contraceptive issues between couples through peer education, and to encourage correct use of long-acting modern methods of family planning.Keywords: mistimed pregnancy, unintended pregnancy, unwanted pregnancy, women

Faba beans are leguminous plants that have gained recognition for their significant contributions to sustainable agriculture and climate change mitigation. The experiment was conducted to assess the effect of genotype × environment interaction (GEI) on seed weight stability of faba bean genotypes using 12 genotypes in randomized complete block design with three replications tested at Enewari, Bichena, and Jamma in 2016, 2017, and 2018. The objective of the study is to determine the performance and stability of faba bean genotypes for large seed sizes and comparable seed yield under vertisol areas. The AMMI analyses revealed significant (p

Hagenia abyssinica and Artemisia absinthium are widely distributed tree species in Ethiopia and known for their traditional medicinal uses. The present study was conducted to determine the essential oil and smoke constituents of H. abyssinica and A. absinthium leaves using GC-MS. The main components of the A. absinthium essential oil were valencene (5.48%), bornyl acetate (5.15%), and trans-cinnamic acid (4.34%). 2-Bornanone (18.54%), o-cymene (12.80%), and nerolidol (7.04%) were the dominant components of the MeOH fraction of the smoke derived from the leaves of A. absinthium, while 2-propenoic acid butyl ester (46.49%), heptadecane (10.66%), and 9-octylheptadecane (7.78%) were the major components of the n-hexane fraction. The main components of the H. abyssinica essential oil were cis-davanone (14.73%), Aristolediene (9.31%), and cryptone (6.50%). β-Myrcene (12.59%), neophytadiene (11.54%), and limonene (11.27%) were the dominant components of the MeOH fraction of the smoke derived from the leaves of H. abyssinica. 1,3,5,7-Cyclooctatetraene (33.58%), prehnitene (7.01%), and heptadecane (5.46%) were the dominant components of the n-hexane fraction of the smoke derived from the leaves of H. abyssinica. The smoke components of A. absinthium and H. abyssinica were reported here for the first time.

The efficiency of variety development can be determined with variability and genetic progress of released varieties. The aim of this study was to determine the variability and genetic advancement of common bean varieties. Randomized Completed Block Design was used to evaluate 15 varieties at Koga and Chefa in 2013. Cluster, principal, and biplot analysis including genetic parameter estimation were done following analysis of variance. Significant variation was observed among the varieties, and they are clustered into four groups. Seed color and size were found as an important factors for clustering of the varieties. Hawassa Dume and Nasir have red and small seeded, respectively, and clustered in one group. Similarly, Awash 1 and Awash Melka are both small white and clustered in one group. Hawassa Dume was highly similar to Nasir, and Red Wolayta with Dimitu, while a large distance was recorded between Awash Melka and Haramaya. Deme and Haramaya were found the most divergent and unique among the tested varieties. This is also reflected in biplot drown by principal components 1 and 2, which together accounted for about 82.022. Plant heights, seed weight, days to maturity, and harvest index have the largest contribution to the total variation of the varieties. Most of the traits have a high phenotypic and genotypic coefficient of variation, heritability, and genetic advance, and selection was effective in the breeding program. The breeding program has brought about 0.27 tonnes of seed yield increment or an annual rate of genetic progress of 0.0077 t ha−1 (0.37% ha−1 year−1). However, the breeding program should reconsider the breeding procedure as there are some varieties released in the same year with similar genetic potential.

Introduction: Birth companionship is one strategy for improving maternal and neonatal quality of care, as well as their outcomes. It is a low-cost and effective care that provide mothers with evidence-based practices throughout labor and delivery in health facilities. WHO has suggested that birth companionship can be given by a family member, spouse, friend, and doula. They support laboring mothers by offering comfort via touch, massage, warm baths, encouraging mobility, promoting fluid intake and output, supplying information about the status of labor and suggestions for coping strategies, and providing a communication channel between mothers and their caregivers that helps to reduce mother and newborn mortality on a globally and regionally. Despite this benefit, no systematic review and meta-analysis studies have been conducted on this topic in study area. Therefore, this study may give the pooled utilization and associated factors of birth companionship among laboring mothers during facility birth in Sub-Saharan Africa., Methods and Materials: A systematic review and meta-analysis was conducted using preferred reporting items for systematic review and meta-analysis guidelines. Data base such as PubMed with Medline, Cochrane library, direct science, google scholar and different gray works of literature/email were used on the utilization of birth companionship and associated factors of studies from 2010 to 2023 in sub-Saharan Africa. A weighted inverse variance random effect model with DerSimonian-Laird method was used to estimate pooled utilization of birth companionship Cochrane Q -test, I 2 , and p -value were computed to detect heterogeneity. Egger test and funnel plot were used to detect the evidence of publication bias. We did subgroup analysis, sensitivity analysis, and meta regression to identify source heterogeneity. The protocol has been registered in PROSPERO database "CRD42024503048.", Results: In sub-Saharan Africa, laboring mothers giving delivery in a facility utilized birth companionship at a rate of 34% (95% CI: 26-42, I 2  = 98.90%, p  < 0.01). Subgroup analysis revealed that South Africa had the largest pooled utilization of birth companionship (49%), while Rwanda had the lowest (14.5%). Having ANC (AOR = 2.69, 95% CI: 1.66-3.73, I 2  = 10.36%), having an obstetric complication (AOR = 2.55, 95% CI: 1.69-3.4, I 2  = 0%), desiring birth companionship (AOR = 2.46, 95% CI: 1.17-3.74, I 2  = 38.46%), and being prime para (AOR = 2.51, 95% CI: 1.83-3.19, I 2  = 0%) were significantly associated with pooled utilization of birth companionship., Conclusions: There is low pooled utilization of birth companionship among laboring mothers giving delivery in an institution in sub-Saharan Africa. Factors linked to the use of birth companionship included being primipara, having antenatal care, having complications during pregnancy, and desiring companionship. The management team and healthcare personnel must take the initiative to educate mothers during antenatal care about the benefits of having a birth companion., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: The World Health Organization (WHO) recommended isoniazid preventive therapy (IPT) to decrease the effects of tuberculosis (TB) on human immunodeficiency virus (HIV) patients. However, not enough research has been conducted to determine the impact of IPT on TB incidence and their predictors. Therefore, the goal of this study was to evaluate how IPT affects the incidence of TB and identify factors that are predictive of TB among HIV/AIDS patients. Methods: A total of 588 patients at Debre Tabor General Hospital (DTGH) who had taken IPT between December 2009 and January 2016 participated in the current study, which then followed them for 3 years and compared them to patients who did not receive IPT during the study period. The data were gathered from patient registries and charts. IPT users' and nonusers' TB-free survival curves were compared using log-rank testing. Predictors were identified using bivariate and multivariate Cox proportional hazards models. Results: In this study, 1656 person-years (PYs) follow-ups on 588 patients found 82 additional TB cases, with an overall incidence rate (IR) of 4.95/100 PY. When compared to individuals who were not on IPT, the TB IR among patients living with human immunodeficiency virus (PLHIV) on IPT was significantly lower (1.94/100 PY vs. 8.32/100 PY). A baseline CD4 cell count < 200 cells/uL, history of TB, Hgb level < 10 g/dL, BMI < 18.5 kg/m 2 , and not receiving IPT are independent predictors of TB among HIV/AIDS patients. Conclusion: The frequency of TB was high among PLHIV patients who did not receive IPT. It was discovered that a low CD4 cell count at baseline, a history of TB, IPT status, Hgb level, and BMI independently predicted the presence of TB. Therefore, addressing the independent predictors that are connected to a higher risk of TB in PLHIV as well as isoniazid (INH) prophylaxis has a significant impact on reducing the incidence of TB., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Kedir Nigussie et al.)

Background: Mobile health (mHealth) offers significant benefits for patients with stroke, facilitating remote monitoring and personalized health care solutions beyond traditional settings. However, there is a dearth of comprehensive data, particularly qualitative insights, on the barriers to mHealth access. Understanding these barriers is crucial for devising strategies to enhance mHealth use among patients with stroke., Objective: This study aims to examine the recent literature focusing on barriers to mHealth access among patients with stroke., Methods: A systematic search of PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text was conducted for literature published between 2017 and 2023. Abstracts and full texts were independently screened based on predetermined inclusion and exclusion criteria. Data synthesis was performed using the convergent integrated analysis framework recommended by the Joanna Briggs Institute., Results: A total of 12 studies met the inclusion criteria. The majority were qualitative studies (about 42%), followed by mixed methods (25%), pilot studies (about 17%), nonrandomized controlled trials (about 8%), and observational studies (about 8%). Participants included patients with stroke, caregivers, and various health care professionals. The most common mHealth practices were home-based telerehabilitation (30%) and poststroke mHealth and telecare services (20%). Identified barriers were categorized into two primary themes: (1) at the patient level and (2) at the health provider-patient-device interaction level. The first theme includes 2 subthemes: health-related issues and patient acceptability. The second theme encompassed 3 subthemes: infrastructure challenges (including software, networking, and hardware), support system deficiencies, and time constraints., Conclusions: This systematic review underscores significant barriers to mHealth adoption among patients with stroke. Addressing these barriers in future research is imperative to ensure that mHealth solutions effectively meet patients' needs., (©Atsadaporn Niyomyart, Suebsarn Ruksakulpiwat, Chitchanok Benjasirisan, Lalipat Phianhasin, Kabtamu Nigussie, Sutthinee Thorngthip, Gazi Shamita, Jai Thampakkul, Lidya Begashaw. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 22.08.2024.)

Background: Disability influences activities of daily living, leading to unsafe conditions, poor quality of life, and dependence on others and assistive technologies. Despite limited access and unmet needs, assistive technology enables users to participate in education and be independent members of their community. Students with disabilities in higher education face many challenges in their day-to-day activities and evidence is limited in the study area. Therefore, this study aimed to explore assistive technology experience and daily living challenges among students with disabilities in higher education., Method: A descriptive qualitative study design was employed at the University of Gondar, Gondar, Ethiopia, between December 20, 2022, and January 20, 2023. A purposive sampling method was employed to recruit 14 students with disabilities. An in-depth interview was employed using semi-structured questionnaires. Open Code version 4 software for coding and reflexive thematic analysis approach was employed for the analysis., Result: A total of 14 students with disabilities were included in an in-depth interview. Four main themes emerged, which included activities of daily living, attitudes toward people with disabilities, barriers to accessibility, and access to assistive technology., Conclusion: Barriers to activities of daily living among students with disabilities were poor accessibility of infrastructural facilities, lack of teaching/learning materials in an accessible format, and negative attitudes. The present study's finding is needed to support students in higher education for their academic achievement and to design appropriate rehabilitation strategies and policies on the accessibility of physical infrastructures, inclusive education, and the provision of assistive technology.

Childhood anemia is a significant global public health problem. It influences the physical and cognitive development, as well as immunity of affected children. This in turn leads to poor academic performance, low working potential, and increased morbidity and mortality. There is limited facility-based data on the magnitude and predictors of anemia among under-five children. This study aimed to determine the prevalence and associated factors of anemia among under-five children attending public Hospitals in Harari Regional State, eastern Ethiopia. Institution-based cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized University Hospital and Jugal Hospital from July 1, 2022, to August 31, 2022. A total of 330 under-five children were involved by systematic random sampling technique. Data on sociodemographic characteristics and other possible factors were collected through face-to-face interviews with children's parents/legal guardians. Four milliliters of venous blood samples were collected for a complete blood cell count. Collected data were checked for completeness, entered into Epi-Data Statistical Software Version 4.6, and exported into the Statistical Package for Social Sciences version 25 for analysis. Bivariable and multivariable logistic regression was conducted and P < .05 were considered statistically significant. The overall prevalence of anemia was 33% (95% confidence interval [CI]: 27.9%-37.9%). Age of children 6 to 11 months (adjusted odd ratio [AOR] = 3.94, 95% CI: 1.55-10.01) and 12 to 23 months (AOR = 2.93, 95% CI: 1.15-7.43), no maternal education (AOR = 4.34, 95% CI: 1.53-12.35), not exclusively breastfeeding (AOR = 1.98, 95% CI: 1.11-3.52), being severely stunted (AOR = 3.39, 95 CI: 1.70-6.75), and underweight (AOR = 2.1, 95% CI: 1.12-3.87) were significantly associated with anemia among under-five children. In this study, anemia among under-five children is a moderate public health problem. This study revealed that young child age, maternal education level, early initiation of complementary feeding, and child undernutrition were factors associated with anemia. Thus, efforts should be made to improve the child's nutritional status as well as enhance maternal awareness of nutrition and child-feeding practice through health education. Regular childhood nutritional screening and appropriate intervention for malnutrition are needed. Besides, further studies assessing serum micronutrient levels should be conducted to differentiate the specific cause and type of anemia., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Suicide is a global issue. It is the third responsible for death among the reproductive age group. Pregnancy is a complicated event and crucial in the life of a woman with considerable physiological, hormonal changes, social, and mental changes. However, third-world countries like Ethiopia have not been investigated well. Therefore, the study planned to assess the magnitude and factors associated with suicidal ideation. Furthermore, it will identify the role of hyperemesis gravidarum on suicidal ideation., Method: A Cross-sectional study was employed for 543 pregnant participants attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal General Hospital, Harari regional state, eastern Ethiopia from June 1 to August 1, 2022. The recruited participants were selected by systematic random sampling method. Suicide was assessed using Composite International Diagnostic by interview methods data collection. Epi data and STATA version 14.1 were used for data entry and analysis respectively. Candidate variables were entered into a multivariate logistic regression then those variables that have p-value < 0.05 were considered as significantly associated., Results: The magnitude of suicidal ideation in this study was found to be 11.15% at (95% CI: 8.75-14.11). Regarding the associated factor, unwanted pregnancy (AOR = 3.39: at 95% CI = 1.58-7.27), Hyperemesis gravidarum (AOR = 3.65: at 95% CI = 1.81-7.34), having depressive symptoms (AOR = 2.79: at 95% CI = 1.49-5.23), having anxiety symptoms (AOR = 3.37; at 95% CI = 1.69-6.68), experiencing intimate partner violence (AOR = 2.88: at 95% CI = 1.11-7.46), and having stress (AOR = 3.46; at 95% CI = 1.75-6.86) were significantly associated variable with suicidal ideation among pregnant women., Conclusion and Recommendation: This study revealed that suicidal ideation is common among pregnant women. Regarding the associated factors unwanted pregnancy, hyperemesis gravidarum, having depressive and anxiety symptoms, experiencing intimate partner violence, and stress were significantly associated with suicidal ideation. Thus, giving awareness and early screening and interferences for antenatal suicide should be warranted., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bete et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Depressive disorder is one of the severe and common mental illnesses in the general population. Bipolar disorder is a severe, persistent mental illness associated with significant morbidity and mortality. However, there is a paucity of data on the prevalence of depressive disorder, and bipolar disorder in our study area., Objective: This study aimed to assess the prevalence of depressive and bipolar disorders among adults in Kersa, Haramaya, and Harar Health and Demographic Surveillance Sites in Eastern Ethiopia., Methods: A community-based cross-sectional study was conducted among 1,416 participants. A multi-stage sampling was employed to select the participants. DSM-5 diagnostic criteria was used to assess depressive disorder and bipolar disorder. Data was collected using a standard questionnaire. Data were entered into Epi-Data 3.1 and analyzed using SPSS version 26. Both binary and multivariate logistic regression analyses were done. Those with a p-value < 0.05 in the final model were considered statistically significant., Results: The overall prevalence of depressive and bipolar disorders among our study participants was 6.7% (95% CI: 5.40, 8.20) and 2.1% (95% CI: (1.40, 3.00), respectively. The independent predictors of depressive disorder included a family history of mental illness, chronic medical illnesses, unemployment, low educational status, divorced or widowed, poor social support, and current alcohol use or khat chewing. Single, males, divorced or widowed, and current consumers of alcohol were independent predictors for bipolar disorder., Conclusions and Recommendation: The results of our investigation showed that bipolar illness and depression were significant public health issues. It was shown that although bipolar disorder is highly prevalent in the society, depression is a widespread concern. As a result, it is imperative that the relevant body grow and enhance the provision of mental health services. Furthermore, research on the effects and burdens of bipolar disorder in the community is required., (© 2023. The Author(s).)

Objective: To assess diabetes knowledge and foot care practices among type 2 diabetes patients., Design: An institution-based cross-sectional study was undertaken from 1 January to 31 January 2021., Setting: Eastern Ethiopia., Participants: Randomly selected type 2 diabetes patients who were available during the data collection period were included., Outcomes: Patients' diabetes knowledge was assessed with the revised diabetes knowledge test questionnaire. Five items were used to evaluate foot self-care practices., Results: The study population comprised of 549 patients. About 52.5% of the patients had adequate diabetes knowledge (95% CI: 48.2% to 56.7%). Patients with an educational level of secondary school and above (adjusted OR (AOR): 2.04, 95% CI: 1.13 to 3.71), (AOR: 5.28, 95% CI: 2.28 to 12.22), and those with medium and above wealth status (AOR: 3.81, 95% CI: 2.24 to 6.47), (AOR: 3.46, 95% CI: 1.98 to 6.04), were found to have better odds of having adequate diabetes knowledge. However, those aged >55 years (AOR: 0.47, 95% CI: 0.22 to 0.99) were found to have lower odds of adequate diabetes knowledge.Of the total included patients, 20.2% (95% CI: 16.9% to 23.8%) had good foot care practices. Knowledge of the target fasting plasma glucose (AOR: 3.18, 95% CI: 1.94 to 5.22) and adequate diabetes knowledge (AOR: 3.40, 95% CI: 1.95 to 5.91) were significantly associated with good foot care practices., Conclusion: According to this study, about half of individuals with type 2 diabetes have adequate levels of knowledge about the disease. In addition, only one out of every five patients has good foot care habits. Diabetes education should emphasise the significance of rigorous adherence to daily foot care practices., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Alcohol consumption during the pregnancy period is high despite the well-established evidence of its harmful effects on pregnancy and infant development. Early identification and behavioral modification are of great significance. This study aimed to assess the prevalence and associated factors of alcohol consumption among pregnant women attending antenatal care at governmental hospitals in the Harari regional state, Eastern Ethiopia., Method: From April 1/2022-May 1/2022, an institutional-based cross-sectional survey was conducted among 589 pregnant women attending antenatal care governmental hospitals in Harari regional state. A systematic random sampling technique was used to select study participants during the study period. Data were collected through face-to-face interview methods using AUDIT-C. The collected data were coded, entered into Epi-data data version 3.1, and analyzed by SPSS Version 26. Binary logistic regression was carried out to identify independent predictors of alcohol consumption at a 95% confidence level., Results: From a total of 617 eligible participants, 589 participated in the study with a response rate of 95.46%. The overall prevalence of alcohol consumption among pregnant women in Harari regional state governmental hospitals was 21.2% (95% CI:17.8, 24.4). In multivariate analysis, single marital status (AOR = 5.18;95% CI (2.66,10.11), previous history of abortion(AOR = 4.07;95% CI(2.06,8.04), family history of mental illness (AOR = 4.79;95% CI (1.94,11.83), depression (AOR 2.79; 95%CI(1.35,5.76), and anxiety(AOR = 2.51; 95% CI (1.23, 5.12) were variables found to have a statistically significant association with alcohol consumption during pregnancy in Harari regional state governmental hospitals., Conclusion: In comparison to the majority of other research, the prevalence of alcohol usage during pregnancy was high in this study. This study observed that single marital status, previous history of abortion, family history of mental illness, depression, and anxiety were highly associated with alcohol consumption during pregnancy. Hence, responsible bodies working on mother and child health should try to mitigate or remove the above-mentioned risks when developing interventions., (© 2023. The Author(s).)

Background: Internet addiction affects cognitive function, has a harmful impact on students' academic performance, and increases their risk of experiencing psychological crises., Objectives: Examining the prevalence of internet addiction and its contributing factors among regular undergraduate students at Jimma University in south-west Ethiopia., Methods: An institutional-based cross-sectional study was conducted among study participants between August 1 and August 30, 2021. A total of 772 Participants were involved in the study using a multistage random sampling technique. Data was collected using pretested and structured questionnaires with self-administered techniques. The Young Internet Addiction Test (YIAT) was used to measure internet addiction. The data was entered into the computer using Epi Data version 4.6, and then it was exported to the Statistical Package for Social Science (SPSS) version 25 for analysis. The association between each independent variable and the outcome variable was examined using bivariate analysis. Variables with a p-value of less than 0.25 in bivariate analysis were included in the multivariate logistic regression model to determine how each independent variable affected the outcome variable., Result: The prevalence of internet addiction among study participants was 53.6% (95% Confidence Interval (CI)) (49.99%, 57.15%). Findings from multivariate logistic regression analysis suggested a variety of related factors had significant associations with internet addiction. Being dissatisfied with a major study, having a cumulative grade point average of a promoted grade report, using the internet for entertainment, using the internet for Facebook, using the internet for telegram, depression, social anxiety, and poor social support., Conclusion: This study revealed a comparatively high frequency of internet addiction among study participants. Internet addiction has been linked to psychosocial, academic, and purpose-related aspects of internet use. As a result, incorporating stakeholders' efforts to improve the identified variables would be a helpful start toward lowering this high incidence., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: This study aimed to determine the level of adherence to foot care recommendations and associated factors among people with diabetes on follow-up in public hospitals in Eastern Ethiopia., Setting: An institutional-based cross-sectional study was conducted in public hospitals found in Eastern Ethiopia from 25 February to 25 March 2022., Participants: A total of 419 patients with chronic diabetes who visited diabetic clinics in public hospitals in Eastern Ethiopia for follow-up were included., Main Outcome Measure: The level of adherence to diabetic foot care recommendations and associated factors., Results: The findings indicated that 44.3% (95% CI: 39.3, 49.0) of people with diabetes had inadequate adherence to diabetic foot care recommendations. Age between 28-37 (adjusted OR (AOR)=1.10; 95% CI: 1.27, 5.63) and 38-47 years (AOR=2.19; 95% CI: 2.74, 8.89), rural residence (AOR=1.71; 95% CI: 1.15, 2.57), absence of comorbidity (AOR=2.22; 95% CI:1.34, 5.14), obesity (AOR=1.43; 95% CI: 1.10, 5.05) and inadequate foot care knowledge (AOR=2.10; 95% CI: 1.52, 4.35) were factors significantly associated with inadequate adherence to diabetic foot care recommendations., Conclusion: More than two-fifths of people with diabetes had inadequate adherence to diabetic foot care recommendations. Younger age, rural residence, absence of comorbidity, obesity and inadequate foot care knowledge were significantly associated with inadequate adherence to diabetic foot care recommendations. It is very essential to educate people with diabetes about the importance of foot care recommendations in preventing and delaying the risks of foot-related problems and complications., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Preconception care is an important preventive intervention for adverse pregnancy outcomes. It is recognized as a strategy to optimize women's health and pregnancy outcomes in Western countries. However, preconception care is underutilized in sub-Saharan Africa, like Ethiopia, where maternal mortality is high. Evidence is scarce in the study area about the prevalence and factors associated with preconception care utilization. Therefore this study aimed to assess the proportion of preconception care utilization and associated factors among pregnant mothers in Fiche town, central Ethiopia, 2021., Method: A community-based cross-sectional study was done from May 10 to June 25, 2021. A systematic random sample technique was used to choose 393 pregnant women for the study. A structured, pre-tested, interviewer-administered questionnaire was used to collect data. The data were entered into Epi Data version 3.1 and then exported into SPSS version 25 for analysis. A Bivariable and multivariable logistic regression analysis was used to check for the association. Odds ratio along with 95% was used to describe the association. Finally, a significant association was declared at a p -value less than 0.05., Results: 388 respondents participated in this study, making the response rate 98.7%. Of total study participants only 84 (21.6%; 95% CI, 18, 25.8) utilized preconception care. The study found that diploma or higher level of education (AOR = 3.47, 95% CI: 1.27, 9.53), psychological and financial support from a partner (AOR = 3.86, 95% CI: 2.1, 7.10), joint discussion and plan with a partner (AOR = 3.32, 95% CI: 1.55, 7.13), history of chronic disease (AOR = 3.47, 95% CI: 1.67, 7.25), and good knowledge about preconception care (AOR = 2.42, 95% CI: 1.34, 4.38) were significantly associated with preconception care utilization., Conclusions: Overall, less than a quarter of the pregnant mothers utilized preconception care, indicating that awareness is very low. Pregnant mothers who have a higher educational level, have good communication and support from their partners, have chronic health problems, and have good knowledge about preconception care were more likely to utilize the service. Preconception care is a better opportunity to intervene and maintain the mother in the continuum of care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Fetena, Negash, Kebede, Sertsu, Nega, Nigussie, Lami, Yadeta, Dereje, Tamire, Tolessa and Tadele.)

Background: Suicide is one of the most common public health problems and the second leading cause of death among individuals 15-29 years of age. Suicidal ideation and attempt are one of the common psychiatric emergence in patients with cancer that needs early detection and management before patients end their lives. Therefore, the aim of the study was to assess the magnitude of suicidal ideation, attempts, and associated factors among people with cancer in Eastern Ethiopia., Methods: An institutional-based cross-sectional study design was conducted among 362 participants. A composite international diagnostic interview was used to evaluate suicidal ideation and attempt. Epi-Data version 4.6.2 was used for data entry, and SPSS version 20 was used for analysis. Logistic regression analysis was done to identify associated factors for both suicidal ideation and attempt. p -values less than 0.05 are considered statistically significant, and the strength of the association will be represented by an adjusted odds ratio with a 95% confidence interval., Results: The magnitude of suicidal ideation and attempt among people with in this study was 22.9% [95% CI, 18.7-27.4] and 9.8% [95%CI, 6.7-12.8] respectively. Being living alone [AOR = 4.90, 95% CI, 2.08-11.90], and having depressive symptoms [AOR = 3.28, 95% CI, 1.37-7.73], female ([AOR = 1.53, 95% CI, 1.30-3.23], anxiety symptoms [AOR = 3.06, 95% CI, 1.35-6.73)] and having poor social support [AOR = 3.08, 95% CI, 1.72-5.05], were significantly associated suicidal ideation whereas, Being living alone [AOR = 2.89, 95% CI, 1.09-7.65], having a depressive symptoms [AOR = 4.88, 95% CI, 1.45-13.28], being divorced/widowed [AOR = 3.46, 95% CI, 1.09-10.09] and stage four cancer [AOR = 5.53, 95% CI 2.97-7.47] were significantly associated with suicidal attempt., Conclusion: Nearly one-quarter and one-tenth of people with cancer have suicide ideation and attempt, respectively. Suicidal behavior among cancer patients was found in this study to be a common problem. Living alone, having depressive and anxiety symptoms, being a female, having poor social support, and being in forth stage of cancer were risk factors for suicide. Therefore, early screening, diagnosing, and treating suicide and its factors will be mandatory and expected from health care providers and non-governmental organizations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nigussie, Tesfaye, Abdisa, Tolosa, Bete, Gemechu, Negash, Sertsu, Dereje, Debele and Dechasa.)

Background: Khat is a huge, evergreen tree that grows at high altitudes throughout the Arabian Peninsula and in the region stretching from eastern to southern Africa. Cathinone, cathine, and norephedrine are psychoactive ingredients contained in khat. Ethiopian teenagers, especially those in secondary school, frequently use khat. This use of khat may lead to students frequently missing class and experiencing subpar academic performance. However, the study area lacks information regarding the prevalence of khat use and the factors associated with it., Objective: This study's primary goal is to determine the prevalence of khat chewing and related factors among secondary school students in public schools in Harar, Eastern Ethiopia, in 2022., Methods: A multicenter cross-sectional study design was employed from June 01-June 30, 2022, in three public secondary schools in Harar town in a sample of 485 students. Systematic random sampling was used to choose the study sample. Data were gathered using self-administered questionnaires, and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess khat chewing. Epidata version 4.6 was used to enter the data, while STATA version 14 was used to analyze them. To determine the factors related to khat chewing, bivariate and multivariate logistic regression analysis was conducted, and statistical significance was determined at a 95% confidence level with a P -value under 0.05., Results: Out of 485 eligible participants, 455 responded to this survey, giving a response rate of 93.8%. Overall, 33.2% (95% CI: 29.2%-37.6%) of the sample's participants reported currently chewing khat. Age ranged from 20 to 25 years (AOR = 2.04; 95% CI: 1.19-3.48), male students (AOR = 7.03; 95% CI: 4.35-12.57), current alcohol user (AOR 6.48; 95% CI: 2.30-18.28), presence of chewer friends (AOR 3.86; 95% CI: 2.38-6.24), and depression (AOR 1.84, 95%CI: 1.02-3.30), were strongly associated with khat chewing at a p -value of < 0.05., Conclusion: Khat chewing was very common among students in Eastern Ethiopia's public secondary schools. Ages between 20 and 25 years, being a male, being current alcohol users, having chewer buddies, and depression are all significantly linked to khat use. Thus, schools should create and implement audience-specific behavioral change communication to deter and stop students from chewing khat. Additionally, it is important to ban the sale of khat to young adults and adolescents, promote medical care for khat users, and foster peer advocacy for support services., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nigussie, Negash, Sertsu, Mulugeta, Tamire, Kassa, Abdeta and Dereje.)

Background: One of the most challenging problems in developing countries including Ethiopia is improving maternal health. About 303,000 mothers die globally, and one in every 180 is at risk from maternal causes. Developing regions account for 99% of maternal deaths. Maternal near miss (MNM) resulted in long-term consequences. A systematic review and meta-analysis was performed to assess the prevalence and predictors of maternal near miss in Ethiopia from January 2015 to March 2023., Methods: A systematic review and meta-analysis cover both published and unpublished studies from different databases (PubMed, CINHAL, Scopus, Science Direct, and the Cochrane Library) to search for published studies whilst searches for unpublished studies were conducted using Google Scholar and Google searches. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Duplicated studies were removed using Endnote X8. The paper quality was also assessed based on the JBI checklist. Finally, 21 studies were included in the study. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Forest plots were used to present the pooled prevalence using the random effect model. Heterogeneity and publication bias was evaluated using Cochran's Q test, (Q) and I squared test (I 2 ). Subgroup analysis based on study region and year of publication was performed., Result: From a total of 705 obtained studies, twenty-one studies involving 701,997 pregnant or postpartum mothers were included in the final analysis. The national pooled prevalence of MNM in Ethiopia was 140/1000 [95% CI: 80, 190]. Lack of formal education [AOR = 2.10, 95% CI: 1.09, 3.10], Lack of antenatal care [AOR = 2.18, 95% CI: 1.33, 3.03], history of cesarean section [AOR = 4.07, 95% CI: 2.91, 5.24], anemia [AOR = 4.86, 95% CI: 3.24, 6.47], and having chronic medical disorder [AOR = 2.41, 95% CI: 1.53, 3.29] were among the predictors of maternal near misses from the pooled estimate., Conclusion: The national prevalence of maternal near miss was still substantial. Antenatal care is found to be protective against maternal near miss. Emphasizing antenatal care to prevent anemia and modifying other chronic medical conditions is recommended as prevention strategies. Avoiding primary cesarean section is recommended unless a clear indication is present. Finally, the country should place more emphasis on strategies for reducing MNM and its consequences, with the hope of improving women's health., (© 2023. The Author(s).)

Background: Common mental disorders are highly prevalent in the population, affecting people across all regions of the world. In Ethiopia, mental disorders are the leading non-communicable disorders. World Health Organization (WHO) report shows that 4,480,113 (4.7%) and 3,139,003 (3.3%) people in Ethiopia are estimated to suffer from depression and anxiety, respectively. However, there are only limited studies conducted on common mental disorders in Africa including Ethiopia. Even if there was a previous study conducted among Harari regional state residents 7 years back, nowadays there are many possible factors that could increase the prevalence of common mental disorders in the community like the novel coronavirus pandemic, ethnic war, and current socio-economic crises in Ethiopia., Objective: To assess the prevalence of common mental disorders and associated factors among adult residents of Harari regional state, eastern Ethiopia., Methods: A community-based cross-sectional study was conducted from March 1 to March 30, 2022. A systematic random sampling technique was used to select 1,192 study participants. Data were collected by interviewer-administered structured and semi-structured questionnaires. A common mental disorder was assessed by the Self-Reporting Questionnaire of 20-Item (SRQ-20) questionnaire. Data were entered into Epi Data version 3.2 and exported to Stata Version 16 for analysis. The multivariable binary logistic regression analysis with a 95% confidence interval and p  < 0.05 was used to identify factors associated with common mental disorders., Result: From a total of 1,192 eligible participants, 1,168 responded to this survey, giving a response rate of 97.98%. The prevalence of common mental disorders among adults in the Harari Region of this study was 21.31% (95% CI, 18.8-23.60). Being female with Adjusted Odds Ratios (AOR = 1.31, 95%CI, 1.09-2.09), single (AOR = 2.03, 95%CI, 1.37-3.01), divorced (AOR = 3.06, 95%CI, 1.97-4.76), widowed (AOR = 1.79, 95%CI, 1.23-3.26), unemployed (AOR = 1.97, 95%CI, 1.18-3.31), having family history of mental illness (AOR = 3.17, 95%CI, 1.54-6.96) and age greater or equal to 55 years (AOR = 105, 95%CI, 1.69-3.54) were statistically associated with common mental disorders., Conclusion: The prevalence of common mental disorder in the study area was sharply increased. Being female, single, divorced, widowed, family history of mental illness, being unemployed and age greater or equal to 55 years old were statistically positively associated with common mental disorder. Considering these determinants, screening, early identification, and providing appropriate intervention for common mental disorders in the community should be of great concern., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Abdeta, Birhanu, Kibret, Alemu, Bayu, Bogale, Meseret, Dechasa, Wondimneh, Abinew, Lami, Wedaje, Bete, Gemechu, Nigussie, Negash, Dirirsa, Berhanu, Husen, Eyeberu, Godana, Dessie, Sertsu, Hiko, Asfaw, Dereje and Nigussie.)

Introduction: Child marriage is a union before the age of 18 and a violation of human right. Around 21% of young women in the world married before reaching the age of 18. Every year, 10 million girls under the age of 18 are married. Child marriage causes lifetime suffering, and its abolition was one component of the Sustainable Development Goal to achieve gender equality and empower women and girls. However; abolition of child marriage by 2030 will not happen because its prevalence in the community has remained stable., Objective: To assess the prevalence of child marriage and its associated factors among reproductive-age women from March 7 to April 5, 2022 in Harari Regional State, eastern Ethiopia., Methods: Community-based cross-sectional study was conducted from March 7 to April 5, 2022 among the reproductive age group in the Harari Region state, Eastern Ethiopia. A systematic random sampling technique was used to find study participants. Data were obtained by face-to-face interview using a pre-tested structured questionnaire, input into EpiData version 3.1 and analyzed using Stata version 16. The proportion with 95% confidence interval (CI) and the summery measure were used to report the prevalence. A multivariable logistic regression analysis model was used to examine associated factors, and the results were provided as an adjusted odds ratio (AOR) with a 95% confidence interval., Result: In this study 986 were responded to the interview, making response rate of 99.6%. The median age of study participants was 22 years. The prevalence of child marriage was 33.7% [95% CI: 30.8-36.7] in this study. Being a Muslim (AOR = 2.30, 95% CI = 1.26, 4.19), diploma or higher level of education (AOR = 0.26, 95%CI = .10, 0.70), rural residence (AOR = 5.39, 95% CI = 3.71, 7.82), a marriage arranged by others (AOR = 2.68, 95% CI = 1.49, 4.82) and not knowing legal age of marriage (AOR = 4.49, 95% CI = 2.57, 7.85) were significantly associated with child marriage., Conclusion: According to this report, nearly one out of every three women engages in child marriage. The practice was more common among those with lower educational attainment, those who lived in rural areas, people who were unaware of the legal age of marriage, and those whose engagement was decided by others. Focusing on strategies that allow for intervention in these factors is beneficial in ending child marriage, which has a direct and indirect impact on women's health and educational achievement., (© 2023. The Author(s).)

Background: Suicide is a major public health issue across the globe. It is the second leading cause of death in adolescents. Even though the rate of suicide has increased, no study has been conducted to investigate the determinants of suicide in the study area. Therefore, this study aimed to assess the magnitude of suicidal ideation, suicide attempts, and its associated factors among secondary school students in the Harari regional state of Eastern Ethiopia., Methods: An institutional-based cross-sectional study was conducted among randomly selected 1,666 secondary school students. A structured-self-administered questionnaire was used for data collection. The WHO Composite International Diagnostic Interview (CIDI) was used to assess suicidal ideation and suicide attempts. The Depression Anxiety and Stress Scale (DASS) was also used to assess depression, anxiety, and stress. Data were entered into EpiData version 3.1 and exported to Stata version 14.0 for the analysis. A logistic regression analysis was performed to determine the association between the outcome and independent variables and the statistical significance was declared at a p -value of < 0.05., Result: The overall magnitude of suicidal ideation and attempts was 13.82% at 95% confidence interval (CI): 12.16-15.66 and 7.61% at 95% CI: 6.37-9.07, respectively. Suicidal ideations and suicide attempts were significantly associated with undergoing depressive symptoms (adjusted odds ratio [AOR]: 1.54; 95% CI: 1.08-2.19 and AOR: 2.37; 95% CI: 1.46-3.86, respectively), experiencing anxiety symptoms (AOR: 1.80; 95% CI: 1.25-2.59 and AOR: 1.89; 95% CI: 2.14-10.65, respectively), being exposed to sexual violence (AOR: 3.36; 95% CI: 1.65-6.84), and having a family history of suicidal attempts (AOR: 2.12; 95% CI: 1.21-3.69 and AOR: 4.74; 95% CI: 2.14-10.65, respectively), whereas living in a rural residence (AOR: 1.65 95%, CI: 1.08-2.55) was significantly associated only with suicide attempts., Conclusion and Recommendations: Nearly one in six secondary school students had both suicidal ideation and attempted to take their own life. Suicide is one of the psychiatric emergencies that need immediate action. Therefore, the concerned body from either a governmental or a non-governmental organization should work in setting strategies to minimize sexual violence as well as depressive and anxiety symptoms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bete, Birhanu, Negash, Yadeta, Lemi, Balcha, Sertsu, Birhanu, Nigussie, Gemechu, Meseret, Mohammed, Alemu, Dechasa, Asmerom, Arkew, Shewangizaw, Mohamed, Ahemed, Wodaje, Dessie, Debella, Getachew, Nigussie and Eyeberu.)

Objective: Immunization is still one of the best ways to reduce viral-related morbidity and mortality . Therefore, this study aimed to assess COVID-19 vaccine acceptance and associated factors among adult clients at public hospitals in Eastern Ethiopia., Method: A multicentred facility-based cross-sectional study design was utilised. The systematic random sampling technique was used to select 420 study participants. The characteristics of individuals were described using descriptive statistical analysis such as frequency, median and IQR. Mean was used for health belief model components. The association was assessed using bivariate and multivariable logistic regression and described by the OR along with a 95% CI. Finally, a p-value<0.05 in the adjusted analysis was used to declare a significant association., Outcome Measure: COVID-19 vaccine acceptance and associated factors., Result: A total of 412 adult clients were interviewed, with a response rate of 98.1%. Of the total study participants, 225 (54.6%; 95% CI: 50.0% to -59.7%) were willing to accept the COVID-19 vaccine. Age≥46 (adjusted OR, AOR=3.64, 95% CI: 1.35- to 9.86), college and above level of education (AOR=2.50, 95% CI: 1.30- to 4.81), having health insurance (AOR=1.79, 95% CI: 1.11- to 2.87) and experiencing chronic disease (AOR=1.96, 95% CI: 1.02- to 3.77) were predictor variables. Also, components of the health belief model were significantly associated with COVID-19 vaccine acceptance., Conclusion: COVID-19 vaccine acceptance among the adult population was low compared to other study. Factors associated with COVID-19 vaccine acceptance were age, college and above level of education, having a chronic disease, having health insurance, perceived susceptibility, perceived severity, perceived benefit and perceived barrier.Improving awareness about COVID-19 among all sections of the population is crucial to improving vaccine acceptability., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Giving care to someone who is experiencing mental distress is a difficult and challenging task that could be detrimental to the caregiver's overall quality of life. Numerous studies show that caregivers frequently experience mental distress and feel stigmatized. However, there is limited study done on this topic in our country., Objective: To determine the magnitude and associated factors of perceived stigma and common mental disorder among primary caregivers of adults with mental illness in public hospitals at Harari regional state, Eastern Ethiopia, 2022., Methods: A cross-sectional study design was conducted. A total of 419 participants were recruited by a systematic random sampling technique. The data was collected by using a face-to-face interview and by reviewing patients' charts. Perceived stigma and common mental disorder were assessed by Family Interview Schedule and Self-Reporting Questionnaire, respectively. Epi-data version 4.6.2 was used to enter data, and SPSS version 20 was used to analyze. Bivariable and multivariable logistic regression were performed. P -values < 0.05 were considered statistically significant., Result: The magnitude of perceived stigma and common mental disorder were 42.5% (95% CI, 37.7-47.3) and 39.4% (95% CI, 34.8-44.0) respectively. Age of caregiver between 26 and 33 [AOR = 3.13, 95% CI: (1.71-8.93)], no formal education [AOR = 3.85, 95% CI: (1.81-8.15)], illness duration ≥7 years [AOR = 1.93, 95% CI: (1.04-3.57)], family history of mental illness [AOR = 1.92, 95% CI: (1.09-3.39)] and poor social support [AOR = 4.87, 95% CI: (3.74-12.71)] were significantly associated with perceived stigma. Being female [AOR = 1.92, 95% CI: (1.31-3.34)], having no formal education [AOR = 4.04, 95% CI: (2.15-10.01)], having a family history of mental illness [AOR = 2.26, 95% CI: (1.29-4.00)], having comorbid other illness [AOR = 2.13, 95% CI: (1.15-3.94)], and having poor social support [AOR = 4.58, 95% CI: (2.53-8.28)] were significantly associated with common mental disorder., Conclusion: The magnitude of perceived stigma and common mental disorder was high among primary caregivers of patients with mental illness compared with other studies. Age of caregiver between 26 and 33, no formal education, duration of illness ≥7 years, family history of mental illness and poor social support were associated with perceived stigma and being female, no formal education, family history of mental illness, comorbid other illness and poor social support were associated with common mental disorder., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Nigussie, Tesfaye, Bete and Asfaw.)

Background: Type 2 diabetes mellitus is the most common health problem globally. Depression and anxiety can exacerbate disease complications, make patients suffer more, and increase healthcare costs. Even though, depression and anxiety are common among type 2 diabetes mellitus patients, there have been limited studies conducted about the determinants of depression and anxiety in Ethiopia. Therefore, the purpose of this study was to assess the magnitude and determinants of depression and anxiety symptoms among Type 2 diabetes mellitus patients, attending out-patient treatment at Harari regional state government hospitals, Eastern Ethiopia., Method: An institutional based cross-sectional study was conducted from March to April at Harari regional state government hospitals in eastern Ethiopia. A total of 421 participants were recruited using the systematic sampling technique. Data was collected by using Afan Oromo version of interviewer-administered structured and semi-structured questionnaires. Depression and Anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale. Bivariate and multivariate logistic regression analysis was done to identify variables related to both depression and anxiety symptoms. The association was described using an adjusted odds ratio and a 95% confidence interval (CI), with P-values of 0.05 used as a cutoff for a significant association in the adjusted analysis., Result: Out of the 416 participants included in this study, 42.3%, 40.4% had depression and anxiety symptoms, respectively. Being female (Adjusted Odds Ratio = 1.85(1.09-3.15)), no formal education (Adjusted Odds Ratio = 2.65, (1.04-6.73)), age ≥ 70 (Adjusted Odds Ratio = 2.88 (1.28-6.48)), family history of mental illness (Adjusted Odds Ratio = 1.71 (1.35-3.82)) and poor social support (Adjusted Odds Ratio = 2.35(1.12-6.03)) were statistically associated with depression. While having a family history of mental illness (AOR 1.74(1.03-2.95)), being widowed (AOR = 3.45(1.49-8.01)), and having poor social support (AOR = 2.15(1.12, 4.89)) were statistically significant associated with anxiety at a p-value < 0.05., Conclusion: Current study results showed that the magnitude of depression and anxiety were relatively high among type 2 diabetes mellitus patients.Having a family history of mental illness and poor social support were statistically associated with both depression and anxiety symptoms. Screening, early detection, and appropriate treatment of depression and anxiety symptoms in type 2 diabetes mellitus patients should be prioritized by health care providers., (© 2023. The Author(s).)

Physical inactivity has been viewed as an emerging public health problem in developing countries including Ethiopia. Diabetes mellitus (DM) is a group metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion, function, or both. Its prevalence increases with changing lifestyles including physical inactivity across the globe. However, there is limited research, and not yet received attention in Ethiopia. This study aimed to assess the prevalence and associated factors of physical inactivity among adult diabetic patients in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. An institutional-based cross-sectional study design was conducted among 308 participants from February to June 2018 at Felege Hiwot Referral Hospital. A face-to-face interview was conducted using a structured questionnaire by trained data collectors. Participants were selected through a systematic random sampling technique. Physical inactivity was assessed by the international physical activity questionnaire (IPAQ). Collected data were entered in Epi info version 7 and transferred to SPSS version 20 for analysis. A summary of descriptive statistics and multiple binary logistic regression analyses were computed to identify associated factors of physical inactivity among adult diabetic patients. P < 0.05 with 95% CI was considered statistically significant. The overall prevalence of physical inactivity among diabetic patients was 30.5% ( 95% CI: 22.8-33.5%). Gender (AOR = 1.5, 95% CI: 1.1, 3.62), Old age (AOR = 18.17, 95% CI: 22.7, 61.9) Residence (AOR = 4.24, 95% CI: 1,12,16.028), Low self-efficacy (AOR = 20.59, 95% CI: 10.598, 41.608), Poor attitude (AOR = 2.75, 95%CI: 1.44,5.28), and Lack of social support (AOR = 4.22, 95% CI: 1.28,4.07) were found significantly predictor factors of physical inactivity. The prevalence of physical inactivity in this study was high. Being female, old age, dwelling in an urban, having low efficacy, poor attitude, and lack of social support was greater risk factors for being physically inactive. Diabetic education should focus on engagement in physical activity by overcoming barriers to performing physical activity. Government and health professionals should emphasize that evidence-based physical activity important to change their attitudes and require reaching a consensus on social support by their families., (© 2023. The Author(s).)

Objective: The study aimed to assess the magnitude and determinants of neonatal hypoglycemia among neonates admitted to the Neonatal Intensive Care Unit at Hiwot Fana Specialized University Hospital, Eastern Ethiopia., Methods: An institutional-based cross-sectional study was conducted among 698 randomly selected neonates at Hiwot Fana Comprehensive Specialized Hospital from 1 January 2018 to 31 December 2020. By looking at the charts, data were gleaned from the medical records. Data were entered into Epi-Data version 3.1 and analysis was performed using SPSS version 22. Bivariable and multivariable logistic regression analyses were conducted to identify determinant factors of neonatal hypoglycemia. Association was described using an adjusted odds ratio along with a 95% CI. Finally, a p -value <0.05 in the adjusted analysis was considered to declare a statistically significant association., Results: Out of 698 neonates, 148 (21.2%; 95% CI: 18.3, 24.5) neonates had hypoglycemia. Preterm birth (AOR = 3.06; 95% CI: 1.02, 9.17), hypothermia (AOR = 2.65; 95% CI: 1.22, 5.75), neonatal sepsis (AOR = 2.61; 95% CI: 1.03, 6.59), diabetic mother (AOR = 2.34; 95% CI: 1.03, 5.33), and delay in initiation of breastfeeding for more than 1 h (AOR = 3.89; 95% CI: 1.17, 12.89) were identified as determinant factors of neonatal hypoglycemia., Conclusion: The magnitude of neonatal hypoglycemia was quite common among neonates. Neonatal hypoglycemia was found to be predicted by preterm birth, hypothermia, neonatal sepsis, maternal diabetes mellitus, and delay in starting nursing. We therefore strongly suggest health-care workers work in the postnatal unit to manage and control these and other determinant factors of hypoglycemia to prevent the occurrence of neonatal hypoglycemia., 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.)

Background: Psychoactive substance use becomes a major public health and socioeconomic problem worldwide. Despite its burden and consequences, there is no community-based study conducted on psychoactive substance use and associated factors in eastern Ethiopia. Therefore, this study aimed to assess the magnitude and determinants of current alcohol, tobacco, and khat among adults living in Harari regional state, eastern Ethiopia., Methods: A community-based cross-sectional study was conducted on 955 adults living in Harari regional state. Participants were randomly recruited using a simple random sampling technique. Data were collected by interviewer-administered structured and semi-structured questionnaires. Data were entered into Epi Data version 3.1 and exported to Stata version 14.0 for analysis. Logistic regression analysis was performed to determine the association between the outcome and independent variables, and the statistical significance was declared at a p < 0.5., Results: Of 955 eligible participants, 95.29% participated in the study. The overall prevalence of current alcohol use, tobacco use, and khat use in this study was 8.24, 14.5, and 63.30%, respectively. The availability of alcohol, being unemployed, and being a current khat user were significantly associated with current alcohol use. Being male, having a low level of education, having peer pressure, having a common mental disorder, being a current alcohol user, and being a khat user were identified as significant predictors for current tobacco use. The age between 31 and 40 years, being a Muslim religion follower, being a farmer, being a current tobacco user, and availability of khat were significantly associated with current khat use., Conclusion and Recommendations: The prevalence of psychoactive substance use in the study area was relatively high compared with that of previous studies. By considering these determinants, screening, early identification, and developing appropriate intervention strategies to prevent and tackle current alcohol, tobacco, and khat use in the community should be of great concern., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Bete, Lami, Negash, Eyeberu, Birhanu, Berhanu, Abdeta, Nigussie, Dechasa, Gemechu, Wedaje, Alemu, Kibret, Bayu, Meseret, Abinew, Wondimneh, Dirirsa, Godana, Husen, Alemu, Nigussie, Heluf, Bogale and Dessie.)

Background: Severe mental illnesses affect about 4% of the adult population worldwide. The illness is highly related to the relapse rate and can cause cognitive, social, and functional deterioration in patients. While there are some factors that are known to be protective of the occurrence of relapse in schizophrenia, having good social support is found to be one of the strongest factors. Therefore, the aim of this study was to identify the association between relapse and poor social support in patients with schizophrenia., Methods: With unmatched case-control (case-patients with schizophrenia with poor social support and controls-patients with schizophrenia with good social support), the study included 408 patients with schizophrenia on a follow-up at Amanuel Mental Specialized Hospital from March to May; 2020. The convenience sampling technique was used to draw the participants. Social support was assessed by the Oslo social support scale (Oslo-3), whereas Family Emotional Involvement and Criticism Scale and Medication Adherence Rating Scale-10 (MARS-10) were used to assess the emotion expressed and adherence to medication, respectively. Epidemiological Information (Epi Info) version 7 was used for data coding and entry, which were then exported to the Statistical Package for Social Sciences version 22 for analysis. Unconditioned binary logistic regression analysis and bivariate correlation analysis were carried out., Results: Out of 408 samples, 396 participants, of which 194 were cases and 202 were controls, were included in the study with a response rate of 97.06%. The mean and standard deviation (SD) age of the participants was 36.06 ± 9.842 years. From 194 cases, 61.1% of them were reported to have poor social support. In multiple logistic regression, only social support was found to be statistically significant [ p < 0.001, adjusted odds ratio (AOR) = 3.102, confidence interval (CI) (95%) = (1.985-4.848)]. Hence, the odds of having relapse were 3.102 higher in those who have poor social support when compared to those with good social support. Emotional involvement, financial problems, and stressful life events were found to indirectly affect relapse by having a negative correlation with social support., Conclusion: The present study showed that there was a relationship between relapse and social support, and this indicates that social support can be a good predictor of schizophrenia relapse. The caregivers and clinicians of the patients should increase their support to the patients, while hospitals with mental health services have to encourage formation of better social support for the patients, including psychosocial interventions which will be performed to enhance the social support system., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Samuel, Nigussie, Mirkena and Azale.)

Breast cancer is the most frequent malignancy among women in both developed and developing countries. Early detection of breast cancer using breast self-examination plays a substantial role in reducing its morbidity and mortality. Despite improved availability of health information the morbidity and mortality caused by breast cancer among females were increasing from time to time and there is no information regarding the practice of breast self-examination in our study area., Objective: This study was aimed at assessing breast self-examination practice and associated factors among female health professionals who were working in public hospitals of Harari Regional State in 2022., Methods: Institutional-based quantitative cross-sectional study design was used to assess the practice of breast self-examination and associated factors among female health professionals who have been working in a public hospital in Harari regional state from March 25 to April 05, 2022. The study subjects were selected using a simple random sampling technique and data were collected by a self-administered and structured questionnaire. The collected data was edited, cleaned, coded, and entered into Epi-Data version 3.1 software and analyzed using the statistical package for social science software version 20. Bivariable and multivariable logistic regression analysis was carried out to see the association between independent and dependent variables. Variable with P-value less than 0.05 at final model were regarded as statistically significant., Result: Among a total of 362 female health professionals, 171 (47.2%) respondents were ever practiced breast self-examination, 229(63.3%) had good knowledge of breast self-examination and 252(69.6%) had a favorable attitude toward breast self-examination. Work experience of ≥5 year (AOR = 2.51; 95% CI: 1.31-4.82), educational status of degree and above (AOR = 7.2; 95% CI: 3.82-10.58), good knowledge about breast self-examination (AOR = 3.4; 95% CI: 1.41-5.40) and favorable attitude toward breast self-examination (AOR = 3.1; 95% CI: 2.11-4.10) were significantly associated with breast self-examination practice., Conclusion: The finding of this study implies that the practice of breast self-examination among female health professionals is low. Work experience of ≥5 year, educational status of degree and above, having a good knowledge and favorable attitude toward breast self-examination were significantly associated with breast self-examination., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Dechasa, Asfaw, Abdisa, Dessie, Bete, Sertsu, Hiko, Balcha, Eyeberu, Nigussie and Tamiru.)

Background: Coronavirus disease (COVID-19) is a viral-borne infection caused by the SARS-CoV-2 virus. Aside from the morbidity and mortality effects, it leaves the majority of hypertensive patients untreated and vulnerable to uncontrolled hypertension., Objective: The purpose of this study was to assess follow-up conditions of care and its associated factors among adult hypertensive patients during COVID-19 in public health facilities of West Arsi, Southeastern Ethiopia., Methods: A health facility-based retrospective cross-sectional study was conducted among 423 adult hypertensive patients in the West Arsi public health facilities from July 5 to August 6, 2021. A systematic random sampling technique was used to recruit the study participants. A pretested structured face-to-face interviewer and medical records were used to collect sociodemographic variables, basic clinical features, and follow-up data. The follow-up conditions of care were assessed using 12 items with "yes or no" questions. Then, based on the mean value of the items, the follow-up conditions of care were dichotomized into good and poor. As a result, the follow-up condition was good if the score was greater or equal to the mean, and poor unless otherwise. To investigate parameters related with follow-up conditions of care, bivariable and multivariable logistic regression analyses were used. A 95% confidence interval and a p -value of 0.05 were used to indicate a significant association., Results: The rate of poor follow-up conditions of care during COVID-19 was 29% (95% confidence interval: 24.9-33.4%), according to this study. Age ≥ 60 years (AOR = 3.55; 95% CI: 2.09-6.03), transportation problem (AOR = 2.43; 95% CI: 1.28-4.61), fear of COVID-19 (AOR = 3.34; 95% CI: 1.59-7.01), co-morbidity (AOR = 1.93; 95% CI: 1.14-3.26) and physical distancing (AOR = 2.43; 95% CI: 1.44-4.12) were significantly associated with poor follow-up conditions of care., Conclusions: In our study, 29% of the participants had poor follow-up care conditions. When compared to WHO recommendations, the findings of this study may explain poor follow-up care conditions. To enhance patients' follow-up treatment, evidence-based target interventions should be designed and executed, taking into account individuals at high risks, such as those over the age of 60 and those with comorbidities, and identifying additional risk factors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hiko, Assefa, Ataro, Sertsu, Yadeta, Balcha, Amano, Asfaw, Dechasa, Nigussie and Abdisa.)

Background: People with hypertension have a high risk of developing mental disorders, such as depression and/or anxiety. However, there is a paucity of data regarding comorbid depression and anxiety symptoms among people with hypertension in study settings., Objective: The study determined the prevalence and associated factors of depression, and anxiety symptoms among people with hypertension on follow-up at public hospitals, in Eastern Ethiopia., Materials and Methods: A cross-sectional study was carried out among 471 people with hypertension who were randomly chosen from four public hospitals in Harar town and the Dire Dawa Administration. The data were collected by interviewer-administered structured questionnaires. A validated nine-item Patient Health Questionnaire and Generalized Anxiety Disorder scales were used to assess depression and anxiety symptoms, respectively. A logistic regression model was used to identify the association among depression, anxiety, and their predictors. An adjusted odds ratio and a 95% confidence interval were used to report the association. The statistical significance was set at a p -value of < 0.05., Results: Depression and anxiety symptoms were present in 27.2 and 32.7% of people with hypertension, respectively. Being women (AOR = 1.74, 1.09-2.78), having no formal education (AOR = 2.19, 1.19-4.81), presence of other medical illnesses (AOR = 2.23, 1.39-3.56), having a family history of depression (AOR = 2.01, 1.25-3.19), and poor social support (AOR = 2.80, 1.60-5.22) were statistically associated with depressive symptoms, whereas being women (AOR = 1.54, 1.01-2.35), widowed and divorced (AOR = 2.22, 1.41-3.52), presence of other medical illnesses (AOR = 1.64, 1.06-2.53), and poor social support (AOR = 3.54, 2.09-6.01) were statistically associated with anxiety symptoms., Conclusion: More than a quarter of people with hypertension reported symptoms of depression and anxiety. Findings demonstrated that being a woman, having an additional medical illness and having poor social support were statistically associated with depressive and anxiety symptoms. Regular screening, early detection, and offering the proper intervention should be on top priorities for healthcare professionals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abdisa, Letta and Nigussie.)

Background: Despite currently available, scientifically proven treatments and national guideline, the SAM recovery rate is still considerably behind expectations, and it continues to have a devastating impact on under-five children. Identifying predictors of time to recovery might help to reach the minimal criterion established by the WHO and the national Sphere which decreases child mortality. Therefore, the current study assessed time to recovery and its predictors among children aged 6-59 months admitted with SAM in the Healthcare Setting of Southwest Ethiopia, 2021., Methods: An institutional-based multicenter retrospective follow-up study was conducted on 486 children aged 6 to 59 months admitted with SAM cases. Data were entered into Epi-Data version 4.6 and exported to Stata version 14 for further analysis. Cox-Snell residual plot was used to assess the final model's overall goodness of fit. Finally, a significant predictor of time to recovery was identified using Weibull survival regression model, at 0.05 significance level., Result: Overall, 68.72 (95% CI 64.8, 73) of the children recovered and 4.32% died. The overall incidence density was 3.35/100-person day. Independent predictors of time to recovery were, starting complementary feeding at six months (AHR = 1.44; 95%, CI 1.073, 1.935), pneumonia at baseline (AHR = 1.33, 95%, CI 1.049, 1.696), amoxicillin (AHR = 1.31, 95%, CI 1.021, 1.685), and folic acid supplementation (AHR = 1.82, 95% CI 1,237, 2.665)., Conclusion: The recovery from SAM at study area after a maximum of 60 days of treatment was below the accepted minimum standard. Complementary feeding, pneumonia, treated by amoxicillin, and folic acid supplementation were predictors of time to recovery. Therefore, providing folic acid and amoxicillin for those in need as well as the earliest possible treatment of concomitant conditions like pneumonia is highly recommended., (© 2022. The Author(s).)

Introduction: Acceptance of COVID-19 vaccination among Health Care Workers is mandatory to lessen and curve the spread of transmission of COVID-19. Even though the Health Belief Model is one of the most widely used models for understanding vaccination behavior against COVID-19 disease, COVID-19 vaccine acceptance among Health Care Workers in Ethiopia was not adequately explored by using the Health Belief Model domains., Purpose: This study aimed to assess COVID-19 vaccine acceptance and associated factors among Health care workers in eastern, Ethiopia., Methods: Institutional-based cross-sectional study design was used among 417 health care workers selected by a systematic random sampling method from June 1- 30/2021. The data were collected by face-to-face interviews using semi-structured questionnaires and analyzed using STATA version 14 statistical software. Multivariable binary logistic regression analysis with a 95% confidence interval was carried out to identify factors associated with willingness to COVID-19 vaccine acceptance and a statistical significance was declared at a P -value < 0.05., Results: The willingness of health care workers to accept the COVID-19 vaccine was 35.6%. Age 30-39 (AOR = 4.16;95% CI: 2.51, 6.88), age ≥ 40 years (AOR = 3.29;95% CI: 1.47, 7.39), good attitude (AOR = 1.97; 95% CI: 1.00, 3.55), perceived susceptibility (AOR = 1.93; 95% CI: 1.12, 3.32), and perceived severity (AOR = 1.78; 95% CI: 1.03, 3.10) were factors significantly associated with Health Care Workers acceptance of COVID-19 vaccine., Conclusion: The willingness to accept the COVID-19 vaccine among HCWs was low. Factors significantly associated with the willingness to accept the COVID-19 vaccine were age, good attitude, perceived susceptibility, and perceived severity of the disease. The low willingness of Health Care Workers to accept the COVID-19 vaccine was alarming and it needs more emphasis from the government in collaboration with other stakeholders to provide reliable information to avert misconceptions and rumors about the vaccine to improve the vaccine status of Health Care Workers to protect the communities., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Getachew, Lami, Eyeberu, Balis, Debella, Eshetu, Degefa, Mesfin, Negash, Bekele, Turiye, Tamiru, Nigussie, Asfaw, Dessie, Alemu and Sertsu.)

Introduction: Hypertension is a silent killer that causes serious health issues in all parts of the world. Hypertension is a risk factor for cardiovascular disease, stroke, and kidney disease. Self-care practices have been identified as an important component of hypertension management. Despite the government's commitment and the interventions of various stakeholders, the burden of hypertension and its sequel remain unabated. A recent study showed that hypertension self-care practices play a vital role in controlling and managing high blood pressure, even though there is poor self-practice among hypertensive patients in Ethiopia. Therefore, this study assessed the level of self-care practices and associated factors among hypertension patients in public hospitals in Harari regional state and Dire Dawa City Administration, Eastern Ethiopia., Methods: Hospital-based cross-sectional study was conducted from June 15 to July 15/2021 among 415 adult hypertensive patients on follow-up. The participants were selected using systematic sampling. Hypertension Self-Care Activity Level Effects (H-SCALE) was used to collect data through face-to-face interviews. The SPSS version 24 was used for analysis. Logistic regression analyses were done to determine the association between the outcome and independent variables. For multivariate logistic regression models, variables having a P < 0.25 during bivariate analysis were candidates. The strength of the association was estimated using AOR and 95% CI. The level of statistical significance was declared at a p < 0.05., Results: This study revealed that 52% (95% CI, 48.2-58%) had good level of self-care practices. Formal education (AOR = 3.45, 95% CI: 2.1-4.85), good knowledge about hypertension (AOR = 1.5, 95% CI: 1.17-2.1) 1.5, abstain from chewing khat (AOR = 2.01, 95% CI: 1.44-3.94), strong social support (AOR= 1.9, 95% CI: 1.16-3.1), and absence of depression (AOR = 2.03, 95% CI: 1.43-3.92) were statistically associated with a good level of self-care practices., Conclusions: This study pointed out that about half of the participants had a good level of self-care practices. Formal education, good knowledge about hypertension, abstaining from khat chewing, good social support, and absence of depression showed associations with a good level of self-care practices. Therefore, public health interventions on hypertension self-care practices, and strengthening non-communicable diseases control programs are vital. Moreover, the provision of targeted education to patients can improve disease knowledge and self-care practices., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abdisa, Balis, Shiferaw, Debella, Bekele, Girma, Mechal, Amare, Kechine, Tari, Nigussie, Assefa and Letta.)

Objectives: To assess University students' intention to seek help for depression from health professional and associated factors among University of Gondar students, Northwest, Ethiopia., Methods: An institution-based cross-sectional study was conducted among 487 students. Multistage sampling technique was used to select study participants. Self-administered questionnaire was employed to collect the data. General help seeking questionnaire with major depressive disorder case vignette was used to assess students' intention to seek help for depression. The collected data was analyzed using SPSS version 20. Simple and multiple linear regression analysis were performed to identify factors for intention to seek help for depression. Association was described by using adjusted unstandardized β coefficient along with 95% confidence interval. Finally, P-values < 0.05 in adjusted analysis were taken as a cut off for significant association., Results: The mean score of intention to seek help from health professionals was 3.84 (±0.76)with a range of (1 "very unlikely" to 5 "very likely"). About 67.8% of the study participants would seek help from health professionals if they would have depressive symptoms which was depicted in the case vignette. In the multiple linear regression analyses, student age (unstandardized ß = 0.07, 95% CI: (0.05, 0.10)), good attitude towards seeking professional help (ß = 0.03, 95% CI: (0.02, 0.04)) were factors positively associated with intention to seek help., Conclusion: The current study showed that more than three-fifth of the study participants reported they were likely or very likely to seek help for depression from health professionals. Increased age and favorable attitude were factors associated with intention to seek help for depression. Working on awareness creation and attitude change towards depression would be necessary to increase students' intention to seek help for depression from health professional., Competing Interests: The authors have declared that no competing interests exist.

Objectives: To determine the prevalence and associated factors of unrecognized depression among patients who visit non-psychiatric outpatient departments in the University of Gondar specialized teaching hospital. North West Ethiopia., Methods: An institution-based cross-sectional study was conducted among Medical outpatient departments in the University of Gondar specialized referral hospital from March to April 2019. We collected data through face-to-face interviews. We recruited 314 participants for face-to-face interviews using the systematic random sampling technique. The patient health questionnaire (PHQ-9) was used to measure depression. Coded variables were entered into Epi Info version 7 and exported to SPSS version 20 for analysis. Descriptive statistics and multivariable logistic regression analysis were used. Adjusted odds ratios (AOR) with a 95% confidence interval were used to calculate significance., Results: A total of 314 participants were interviewed with a response rate of 100%. The prevalence of depression was 15.9% with (95% CI (12.1-20.1)). In the multivariate logistic regression revealed that, able to read and write (AOR = 0.24, 95% CI (0.67-0.84)), secondary education (AOR = 0.34, 95% CI (0.12-0.91)), education in college and university level (AOR = 0.32, 95% CI (0.13-0.78)), poor social support (AOR = 7.78, 95% CI (2.74-22.09)), current cigarette smokers(AOR = 12.65, 95% CI (1.79-89.14)) were associated with depression., Conclusion: The prevalence of depression among outpatient attendees was high. We recommend an early depression screening be carried out by health professionals., Competing Interests: The authors have declared that no competing interests exist.

Objective: To assess the magnitude and factors associated with depression and anxiety among people with epilepsy and attending out-patient treatment at central Gondar zone primary public hospitals, northwest, Ethiopia., Method: An institutional based cross-sectional study was conducted from May-June, 2020 at central Gondar zone primary public hospitals. A total of 589 participants were chosen by systematic sampling technique. Data was collected by utilizing Amharic version interviewer-administered structured and semi-structured questioners. Depression and anxiety were assessed by using hospital anxiety and depression scale. Bivariate and multivariate logistic regression analysis was done to recognize variables related to both depression and anxiety. Association was described by using "adjusted odds ratio" (AOR) along with 95% full Confidence interval (CI). Finally, P-values < 0.05 in adjusted analysis were taken as a cut off for significant association., Result: Out of 556 participants included in the study, 30.9%, 33.1% had depression and anxiety respectively. Being divorced/widowed (AOR = 2.43, 95% CI, 1.18-4.99), using two and above number of antiepileptic medications (AOR = 1.77,95% CI,1.02-3.09), very frequent seizure frequency (AOR = 2.68, 95% CI,1.30-5.51), current substance use (AOR = 1.82, 95% CI, 1.03-3.22), perceived stigma (AOR = 5.67,95% CI,3.14-8.18), and hazardous alcohol use (AOR = 2.84, 95% CI,1.32-6.09) were statistically associated with depression. While, being a single (AOR = 1.65, 95% CI, 1.04-2.63), using two and above number of antiepileptic medications (AOR = 2.27, 95% CI, 1.42-3.62), duration of illness ≥16 years (AOR = 2.82, 95% CI, 1.26-6.31), and perceived stigma (AOR = 2.49, 95% CI, 1.63-3.82) were statistically associated with anxiety at a p-value < 0.05., Conclusion: This study showed that the magnitude of depression and anxiety were relatively high among people with epilepsy. Using two and above number of antiepileptic medications and perceived stigma were statistically associated with both depression and anxiety. Screening, early identification and providing appropriate intervention of depression and anxiety among people with epilepsy should be great concern for the health care providers., Competing Interests: The authors have declared that no competing interests exist.

Objective: This study aimed to assess magnitude and associated factors of suicidal ideation and attempt among people with epilepsy attending outpatient treatment at primary public hospitals, northwest Ethiopia using suicide module of World Mental Health Survey initiative version of the WHO, composite international diagnostic interview., Design: Multicentre-based cross-sectional study was used., Setting: Data were collected using face to face interview from patients with epilepsy who attended outpatient treatment at primary public hospitals at northwest Ethiopia., Participants: Adult patients with epilepsy (n=563) who came to attend outpatient treatment during the study period were included in the study using systematic random sampling technique., Outcome Measures: Suicidal ideation, suicidal attempt and factors associated with suicidal ideation and attempt., Results: The overall magnitude of suicidal ideation and attempt was 26.5% and 12.6%, respectively. Being woman adjusted OR ((AOR)=1.68, 95% CI 1.09 to 3.23), living alone (AOR=2.4, 95% CI 1.47 to 3.92), divorced/widowed/(AOR=2.2, 95% CI 1.09 to 7.8), family history of suicidal attempt (AOR=2.53, 95% CI 1.34 to 4.79), depression (AOR=3.18, 95% CI 1.85 to 5.45), anxiety (AOR=2.92, 95% CI 1.68 to 5.09), comorbid medical illness (AOR=2.60, 95% CI 1.17 to 5.82) and poor social support (AOR=2.35, 95% CI 1.26 to 4.40) were statistically associated with suicidal ideation. Depression (AOR=4.87, 95% CI 2.56 to 9.28) living alone (AOR=2.66, 95% CI 1.62 to 5.41), family history of committed suicide (AOR=2.80, 95% CI 1.24 to 6.39), taking medication for mental illness (AOR=2.17, 95% CI 1.06 to 4.46), hazardous alcohol use (AOR=2.10, 95% CI 1.05 to 4.23) were statistically associated with suicidal attempts at a p value <0.05., Conclusion: This study showed that the magnitude of suicidal ideation and attempt was high among people with epilepsy. Being woman, living alone, having depression and anxiety, single, divorced/widowed in marital status, family history of suicidal attempt and poor social support were statistically associated with suicidal ideation. Having depression, living alone, family history of suicide attempt, hazardous alcohol use and drug taking for mental illness were statistically associated with suicidal attempt. Based on the findings of this study early screening, detection and management of suicide were recommended in people with epilepsy., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Work-related musculoskeletal disorders impose a significant and most often underappreciated burden to the individual, nation, healthcare system, and society as a whole. To the best of our knowledge, there is a lack of reliable estimates on the prevalence of work-related musculoskeletal disorders in Ethiopia. The objective of this study will be to assess the existing literature on the prevalence rates and determinant factors of work-related musculoskeletal disorders in Ethiopia., Method: We will search PubMed/MEDLINE, Embase, SCOPUS, PsycINFO, PEDro, and Ebsco (from January 2000 onwards). Gray literature will be identified through searching Google Scholar and dissertation databases. Observational studies reporting on the prevalence of work-related musculoskeletal disorders among adult Ethiopians will be included. The primary outcome will be the prevalence of work-related musculoskeletal disorders. Secondary outcomes will be the prevalence of any risk factors in association with work-related musculoskeletal disorders. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis of observational data. Subgroup analyses will be conducted to explore the potential sources of heterogeneity (e.g., gender, sample size, type of occupation). Publication bias and heterogeneity between the included studies will also be assessed and reported., Discussion: This systematic review will provide a synthesis of the literature on the prevalence of work-related musculoskeletal disorders and their risk factors in Ethiopia. The results of this review could help the policymakers in occupational health and healthcare sectors in identifying priority areas for interventions in work-related musculoskeletal disorders and will also serve as a baseline for the decision-making processes of musculoskeletal health promotion, work exposure implementations, and prevention programs in workplaces., Systematic Review Registration: PROSPERO, CRD42020164240.