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Background Due to their propensity for pregnancy, childrearing, and caring for others, women are twice more likely than males to develop depression during their lifetime. Social stresses like poverty, intimate partner abuse, a history of miscarriage, and unwanted pregnancy are risk factors for postpartum depression, and these factors have a negative impact on maternal health. The mother and her children may suffer long-term negative effects if postpartum depression is left untreated. This research aims to address the gap in studies in Oromia region and contribute to building strong and a more representative evidence for postpartum depression in Ethiopia. Methods The study is a health facility-based cross-sectional study, among postnatal mothers visiting Batu health center. Descriptive and analytical cross-sectional study design was used among postnatal women who have given birth within the past 12 months. The Edinburgh postpartum depression scale was used to assess postpartum depression. Social support was assessed using the maternal social support scale. Chi-square test analysis was used to determine the association of post-partum depressive symptoms with socio-demographic, obstetric and psychosocial factors. Results Based on the cut-off points of Edinburgh Postnatal Depression Scale (≥11), 24.6 percent of the total respondents had post-partum depression whereas 75.4 percent did not have depressive symptoms. Among the mothers who had postpartum depression, majority (85.4%) had not even heard about the disease before. Among those mothers who had postpartum depression, 25% had low social support. Significant association was found between abortion history, unplanned pregnancy, history of mental illness, family history of mental illness, social support and PPD. Conclusions Despite the high magnitude of postpartum depression, measures to help depressed mothers are not brought to action. This highlights the need to advocate for postpartum depression services. Although the mothers with postpartum depression have made it to the health center, our study showed that they go back unnoticed. Postpartum depression screening is a simple but profound step that can be implemented. Moreover, antenatal care visits can be used as an opportunity to give health education on postpartum depression.

Background Annually, more than 313 million procedures are conducted worldwide. However, only 6% are conducted in the low-income countries where a third of the world population lives. In Low- and Middle-Income Countries (LMICs) only, more than 143 million additional surgeries are needed to save lives and avoid disability. Overall global postoperative mortality is 7.7%, and half of these deaths occur in LMICs. In Ethiopia, about 250,000 procedures are being conducted annually. This is less than 5% of what is actually needed according to recommendation of 5000 procedures per 100,000 population per year. Methods This study is a retrospective review of surgical services, including surgical admissions, procedures, and outpatient visits. The study encompassed surgical activities from January 1, 2021 to December 30, 2021 and was conducted in Tikur Anbessa Specialized hospital. Data were collected from operative logbooks, clinic registrars, liaison office, ward registries and from monthly audit reports of each division. Results The majority of the admissions were elective, constituting 2589 (64.1%). The most frequent elective surgeries performed in the study year were great saphenous interposition graft (bypass) consisting of 12.4% of elective surgeries. Emergency admissions constitute 1449 (35.9%) of all admissions. The most frequent emergency procedures performed in the previous year were tracheostomy (35.7%). Mortality rate was available only from the general surgery division. Average mortality rates were was 0.07% for elective procedures and 2.1% for emergency procedures. Most common causes of mortality were septicemia and anastomotic leak. There were 508 cancellations in the one-year study period with lack of oxygen, Covid and lack of investigations being main reasons. Conclusion This study showed most of surgical procedures were done on elective basis. The most commonly performed procedures also are relatively more complex than previous report from the same country, reflecting the tertiary nature of the hospital. Overall, the outcome of both elective and emergency surgeries was favorable. However, all divisions should report morbidity and mortality, preferably with similar format. The cancellation rate is also high and needs intervention from the hospital and department leaders.

The 2014–2016 West Africa Ebola Virus Disease (EVD) Epidemic devastated Guinea’s health system and constituted a public health emergency of international concern. Following the crisis, Guinea invested in the establishment of basic health system reforms and crucial legal instruments for strengthening national health security in line with the WHO’s recommendations for ensuring better preparedness for (and, therefore, a response to) health emergencies. The investments included the scaling up of Integrated Disease Surveillance and Response; Joint External Evaluation of International Health Regulation capacities; National Action Plan for Health Security; Simulation Exercises; One Health platforms; creation of decentralised structures such as regional and prefectural Emergency Operation Centres; Risk assessment and hazard identification; Expanding human resources capacity; Early Warning Alert System and community preparedness. These investments were tested in the subsequent 2021 EVD outbreak and other epidemics. In this case, there was a timely declaration and response to the 2021 EVD epidemic, a lower-case burden and mortality rate, a shorter duration of the epidemic and a significant reduction in the cost of the response. Similarly, there was timely detection, response and containment of other epidemics including Lassa fever and Marburg virus disease. Findings suggest the utility of the preparedness activities for the early detection and efficient containment of outbreaks, which, therefore, underlines the need for all countries at risk of infectious disease epidemics to invest in similar reforms. Doing so promises to be not only cost-effective but also lifesaving.

At the end of the 2013-2016 Ebola virus disease outbreak in Guinea, we implemented an alert system for early detection of Ebola resurgence among survivors. Survivors were asked to report health alerts in their household and provide body fluid specimens for laboratory testing. During April-September 2016, a total of 1,075 (88%) of 1,215 survivors participated in the system; follow up occurred at a median of 16 months after discharge (interquartile range 14-18 months). Of these, 784 acted as focal points and reported 1,136 alerts (including 4 deaths among survivors). A total of 372 (91%) of 408 eligible survivors had >1 semen specimen tested; of 817 semen specimens, 5 samples from 4 survivors were positive up to 512 days after discharge. No lochia (0/7) or breast milk (0/69) specimens tested positive. Our findings underscore the importance of long-term monitoring of survivors' semen samples in an Ebola-affected country.

Summary Background A record number of people survived Ebola virus infection in the 2013–16 outbreak in west Africa, and the number of survivors has increased after subsequent outbreaks. A range of post-Ebola sequelae have been reported in survivors, but little is known about subsequent mortality. We aimed to investigate subsequent mortality among people discharged from Ebola treatment units. Methods From Dec 8, 2015, Surveillance Active en ceinture, the Guinean national survivors' monitoring programme, attempted to contact and follow-up all survivors of Ebola virus disease who were discharged from Ebola treatment units. Survivors were followed up until Sept 30, 2016, and deaths up to this timepoint were recorded. Verbal autopsies were done to gain information about survivors of Ebola virus disease who subsequently died from their closest family members. We calculated the age-standardised mortality ratio compared with the general Guinean population, and assessed risk factors for mortality using survival analysis and a Cox proportional hazards regression model. Findings Of the 1270 survivors of Ebola virus disease who were discharged from Ebola treatment units in Guinea, information was retrieved for 1130 (89%). Compared with the general Guinean population, survivors of Ebola virus disease had a more than five-times increased risk of mortality up to Dec 31, 2015 (age-standardised mortality ratio 5·2 [95% CI 4·0–6·8]), a mean of 1 year of follow-up after discharge. Thereafter (ie, from Jan 1–Sept 30, 2016), mortality did not differ between survivors of Ebola virus disease and the general population. (0·6 [95% CI 0·2–1·4]). Overall, 59 deaths were reported, and the cause of death was tentatively attributed to renal failure in 37 cases, mostly on the basis of reported anuria. Longer stays (ie, equal to or longer than the median stay) in Ebola treatment units were associated with an increased risk of late death compared with shorter stays (adjusted hazard ratio 2·62 [95% CI 1·43–4·79]). Interpretation Mortality was high in people who recovered from Ebola virus disease and were discharged from Ebola treatment units in Guinea. The finding that survivors who were hospitalised for longer during primary infection had an increased risk of death, could help to guide current and future survivors' programmes and in the prioritisation of funds in resource-constrained settings. The role of renal failure in late deaths after recovery from Ebola virus disease should be investigated. Funding WHO, International Medical Corps, and the Guinean Red Cross.

The ongoing Ebola outbreak in the eastern Democratic Republic of the Congo is facing unprecedented levels of insecurity and violence. We evaluate the likely impact in terms of added transmissibility and cases of major security incidents in the Butembo coordination hub. We also show that despite this additional burden, an adapted response strategy involving enlarged ring vaccination around clusters of cases and enhanced community engagement managed to bring this main hotspot under control.

The 2014–2016 Ebola virus (EBOV) disease outbreak affected over 29000 people and left behind the biggest cohort (over 17000 individuals) of Ebola survivors in history. Although the persistence of EBOV in body fluids of survivors was reported before the recent outbreak, new evidence revealed that the virus can be detected up to 18 months in the semen, which represents the biggest risk of Ebola resurgence in affected communities. In this study, we review the knowledge on the Ebola flare-ups that occurred after the peak of the 2014–2016 Ebola epidemic in West Africa.

The capital and neighboring areas remain a focal point of transmission, requiring continued public health vigilance., In 2014, Ebola virus disease (EVD) in West Africa was first reported during March in 3 southeastern prefectures in Guinea; from there, the disease rapidly spread across West Africa. We describe the epidemiology of EVD cases reported in Guinea’s capital, Conakry, and 4 surrounding prefectures (Coyah, Dubreka, Forecariah, and Kindia), encompassing a full year of the epidemic. A total of 1,355 EVD cases, representing ≈40% of cases reported in Guinea, originated from these areas. Overall, Forecariah had the highest cumulative incidence (4× higher than that in Conakry). Case-fatality percentage ranged from 40% in Conakry to 60% in Kindia. Cumulative incidence was slightly higher among male than female residents, although incidences by prefecture and commune differed by sex. Over the course of the year, Conakry and neighboring prefectures became the EVD epicenter in Guinea.

We report on an Ebola virus disease (EVD) survivor who showed Ebola virus (EBOV) in seminal fluid 531 days after onset of disease. The persisting virus was sexually transmitted in February 2016, about 470 days after onset of symptoms, and caused a new cluster of EVD in Guinea and Liberia.

We compared the efficiency of clearance of a simulated clot from a bladder model using a 6-hole irrigation catheter, a traditional Malecot catheter and a modified Malecot catheter with additional side holes.Latex balloons 12 inches in diameter served as the bladder model. They were filled with 300 cc Jell-O® gelatin, which had been partially solidified for 8 hours at 36F. Five manual irrigation/aspiration cycles with a 60 cc catheter tip syringe were performed to remove simulated clot from the bladder models and the amount of clot removed was measured. Five bladder models were used to test the efficiency of clot removal for each 22Fr catheter design, including a standard 22Fr Model 361222 Malecot latex 4-wing catheter (Rusch, High Wycombe, United Kingdom) and a 22Fr Bardex® Model 606118-22 latex 6-hole catheter. Two modified versions of the Malecot catheter design involving 2 and 4 additional holes were also tested to determine the effect of a hybrid 6-hole/Malecot design.The 6-hole catheter was more efficient for clot evacuation than the Malecot catheter (p = 0.014). The modified Malecot catheter with 4 additional holes was more efficient than the original Malecot catheter (p = 0.020). However, it was not significantly better than the 6-hole catheter. After 5 irrigation/aspiration cycles 77.0% of residual clot remained in the bladder with the Malecot catheter compared to 60.4% and 54.0% for the 6-hole and modified 4-hole Malecot catheters, respectively.The 6-hole catheter showed an advantage in clot removal over the Malecot catheter design. The enhanced ability of the 6-hole design to remove simulated clot may be attributable to the larger area covered by the holes at the catheter tip. Further investigation to determine the effect of spacing between the holes and the number of holes on the ability to break apart and remove clot is recommended for a more thorough understanding of differences among catheter models and methods of improvement.