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This study investigated EFL instructors' beliefs about teaching listening integrated with speaking skills at Hawassa University, Ethiopia through a mixed-methods approach. A comprehensive sampling technique identified survey respondents whereas a purposive sampling technique selected participants for qualitative data. Employing a 5-point Likert scale questionnaires were framed to analyze input and method domains. Conversely, utilizing semi-structured interviews (four themes) and observations (seven themes) were categorized using NVIVO 12 Pro. Descriptive statistics illustrated the importance of input domains (familiar topics, feedback, knowledge elements, authentic materials, technology integration) and method domains (pre-, while and post-listening phases, and task-based instruction). However, qualitative findings showed inconsistencies between beliefs and practices indicating a need for more effective lesson planning, authentic materials, technology integration, and effective implementation of listening phases. Inferential statistics revealed a strong positive relationship between dependent and independent variables, which showed a significant impact. Consequently, a balanced approach to these domains is crucial for effective integration requiring professional development programs to address the finding's disparities. The study recommends practical training, authentic material design, technology integration, and progressive assessment with an emphasis on lesson planning. It further suggests exploring practical interventions, comparative studies, longitudinal studies, and student focused studies to enhance the quality of these findings.

This study investigated EFL instructors' beliefs about teaching listening integrated with speaking skills at Hawassa University, Ethiopia through a mixed-methods approach. A comprehensive sampling technique identified survey respondents whereas a purposive sampling technique selected participants for qualitative data. Employing a 5-point Likert scale questionnaires were framed to analyze input and method domains. Conversely, utilizing semi-structured interviews (four themes) and observations (seven themes) were categorized using NVIVO 12 Pro. Descriptive statistics illustrated the importance of input domains (familiar topics, feedback, knowledge elements, authentic materials, technology integration) and method domains (pre-, while and post-listening phases, and task-based instruction). However, qualitative findings showed inconsistencies between beliefs and practices indicating a need for more effective lesson planning, authentic materials, technology integration, and effective implementation of listening phases. Inferential statistics revealed a strong positive relationship between dependent and independent variables, which showed a significant impact. Consequently, a balanced approach to these domains is crucial for effective integration requiring professional development programs to address the finding's disparities. The study recommends practical training, authentic material design, technology integration, and progressive assessment with an emphasis on lesson planning. It further suggests exploring practical interventions, comparative studies, longitudinal studies, and student focused studies to enhance the quality of these findings. Plain language summary: Beliefs of EFL instructors regarding teaching listening integration with speaking at Hawassa University, Ethiopia The main purpose of the present study was to investigate the beliefs of EFL university instructors about teaching listening in integration with speaking in Ethiopia. The study used a convergent mixed-methods design to collect and analyze data concurrently and merge mixed findings. Both comprehensive and purposive sampling techniques helped to collect quantitative and qualitative data, respectively. The former gives an equal chance to be chosen but the latter provides the researchers to choose participants on purpose to get particular information. The results from the surveys illustrated EFL instructors at Hawassa University believe in the importance of using familiar topics, giving feedback, different types of knowledge, using real listening materials, and using technology for teaching listening integrated with speaking. Moreover, they believe some techniques are helpful for the integration of listening and speaking such as appropriate implementation of pre-, while, and post-listening stages. Contrast-wise, findings from interviews and observations, the study found that the instructors' beliefs and their practices did not match each other. This suggests a need for better planning, using real listening and speaking activities, integrating technology, and carrying out listening lessons effectively. So, to integrate listening and speaking effectively, it is important to balance the aspects of input and method. We recommend training for teachers should emphasize authentic integrated listening and speaking, incorporate technology, and assess the effectiveness of lesson planning. Further research on students' experiences, intervention studies, comparative studies, and longitudinal studies should be focused to enhance integrated skills of listening and speaking. [ABSTRACT FROM AUTHOR]

Biruk Mosisa Gudeta,1 Getu Melesie Taye,1 Teferra Abula,2 Diriba Alemayehu Gadisa1 1Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Department of Pharmacology, School of Medicine, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Biruk Mosisa Gudeta; Getu Melesie TayeDepartment of Pharmacy, College of Medicine and Health Sciences, Ambo University, P.O. Box: 19, Ambo, EthiopiaEmail mail2bruke@gmail.com; getumelese17@gmail.comIntroduction: Diarrhea is a cause of morbidity and mortality, especially in children. Patients with diarrhea have been suffering from limited treatment options due to poor drug tolerance, side effect, and multi-drug resistance to almost all the current drug treatments. Therefore, it is important to search for a new therapeutic medicine that can effectively prevent the disease and safe. Vernonia amygdalina is an indigenous medicinal plant used traditionally for the treatment of diarrhea in Ethiopia. The aim of this study was therefore to confirm the antidiarrheal activities of 80% methanol leaves extract using mice models.Materials and Methods: The antidiarrheal activities of the 80% methanol leaves extract were investigated using castor oil-induced diarrhea, intestinal motility, and enteropooling models in mice. The negative control received distilled water orally, the test groups received three dose levels (100, 200, and 400 mg/kg) of the plant materials, and the positive control is given 3 mg/kg Loperamide orally.Results: In the castor oil-induced diarrheal model, the extract delayed onset of diarrhea and reduced fecal parameters at all tested doses significantly as compared with the negative control. Results from the charcoal meal test revealed that the extract produced a significant anti-motility effect at all tested doses as compared with the negative control. In the enteropooling test, the extract produced a significant decline in the volume and weight of intestinal contents. The observed antidiarrheal activity could be associated with the phytochemicals present in this plant extract. It was also observed that the extracts have shown no acute toxicity at a dose of 2 g/kg.Conclusion: This study provides the antidiarrheal activity of the crude extract in all three models. Hence, the findings provide scientific support for the traditional use of Vernonia amygdalina leaves as treatment of diarrhea.Keywords: antidiarrheal activity, castor oil-induced diarrhea, mice, Vernonia amygdalina

Getu Melesie Taye,1 Lemma Bose,1 Tamirat Bekele Beressa,1 Gosaye Mekonnen Tefera,1 Biruk Mosisa,1 Hunduma Dinsa,1 Adamu Birhanu,2 Gurmu Umeta1 1Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Department of Psychiatry, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaCorrespondence: Getu Melesie TayeDepartment of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaTel +251 933891210Email getumelese17@gmail.comBackground: To confirm effective preventive practice and reduce the risk of COVID-19 data on knowledge, attitude, and preventive practices (KAP) are essential. Therefore, the current study was designed to evaluate the KAP of COVID-19 among people with hypertension (HTN) and/or diabetes mellitus (DM) attending public health facilities in Ambo town.Patients and Methods: Institutional-based cross-sectional study design was done among patients with HTN and/or DM from June 2020 to September 2020 at Ambo University Referral Hospital (AURH) and Ambo General Hospital (AGH). To identify the associated factors with poor practice and knowledge, logistic regression analyses were used.Results: The mean age of the study respondents was 44.6 years (± 9.84) of which the majority were male 235 (55.6%) and 159 (37.59%) of the participants had good knowledge. Concerning attitude, 335 (79.2%) have strongly believed that DM and HTN patients were more at risk of death because of COVID-19. Only 44 (10.4%) of them had a good level of COVID-19 prevention practice measures. Patients who use the source of information daily were 54.4% less likely to have poor knowledge about COVID-19 than those who use it weekly. Participants with no formal education were 3 times more likely to have poor COVID-19 prevention practice than those who were with formal education, and participants who have poor knowledge about COVID-19 were 2 times more likely to have poor COVID-19 prevention practice than those who have knowledge.Conclusion: The prevalence of poor knowledge about COVID-19 was low, and only less than ¾ of the participants strongly believed COVID-19 as a serious disease. A small percentage of participants had a good level of COVID-19 prevention practice. Good knowledge had an association with a good level of prevention practice. So, health sectors should work to increase accessibility of COVID-19 information.Keywords: knowledge, attitude, practice, COVID-19, hypertension, diabetes mellitus

Hunduma Dinsa Ayeno, Kume Megersa Atomsa, Getu Melesie Taye Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaCorrespondence: Hunduma Dinsa Ayeno Email dhunduma@gmail.comBackground: Determining the degree of health-related quality of life (HRQoL) and associated factors in human immunodeficiency virus (HIV)-positive people is of great importance.Objective: The aim of this study was to assess the HRQoL and associated factors among HIV-infected patients who were on highly active antiretroviral therapy (HAART) at Ambo General Hospital.Methods: A study with a cross-sectional design was conducted on 296 HIV-infected patients who were on HAART at Ambo General Hospital from February 20 to May 20, 2019. Patients were recruited by a random sampling technique and a P-value < 0.05 was set as statistically significant. Th main outcome measure was HRQoL.Results: The majority of study participants were female (56.8%). More than half (53%) of the participants had low overall HRQoL. Those who were married and who earned < 1500 ETB were less likely to experience low overall HRQoL than single people (AOR: 4.41, P=0.024) and those who earned more (AOR: 4.27, P=0.000), respectively. Those with current illness and who had no HIV-positive family members were more likely to experience lower overall quality of life than those with no current illness (AOR: 32.29, P=0.000) and with one HIV-positive family member (AOR: 4.03, P=0.003), respectively. Those with recent WHO clinical stage I were less likely to experience a lower overall quality of life than those with stage II (AOR: 0.07, P=0.000).Conclusion: Current illness, recent WHO stage and having no HIV-positive family members were found to be strongly associated with lower quality of life in HIV-positive patients on antiretroviral therapy.Keywords: health-related quality of life, HIV-positive patients, highly active antiretroviral therapy, Ambo General Hospital, WHO stage IV

Getu Melesie Taye,1 Mohammed Bule,1 Diriba Alemayehu Gadisa,1 Frehiwot Teka,2 Teferra Abula3 1Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Directorate of Traditional and Modern Medicine Research, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 3Department of Pharmacology, School of Medicine, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Getu Melesie TayeDepartment of Pharmacy, College of Medicine and Health Sciences, Ambo University, PO Box 19, Ambo, EthiopiaEmail getu.melesie@ambou.edu.etIntroduction: Diabetes mellitus disorder characterized by increase in serum glucose level as a result of change in fat, protein metabolism, and carbohydrate. The aim of the present study was to investigate the effects of the aqueous and hydroalcoholic leaf extract of Thymus. schimperi on blood glucose levels.Methods: The aqueous and 80% methanol extracts of T. schimperi leaves were prepared. Swiss albino mice of either sex weighing 20– 30 g were selected for the experiments. Mice that were made diabetic were divided into seven groups to study the antihyperglycemic effect of the extracts. Diabetes was induced by single intraperitonial injection of alloxan monohydrate (180 mg/kg body weight).Results: After diabetic mice were treated with an extract of solvent at doses of 250 and 500 mg/kg for 21 days, there were significant decreases in fasting blood glucose when compared to diabetic controls. The observed antidiabetic activity could be associated with the phytochemicals present in this plant extract. The extract of solvent also prevented body weight loss of diabetic when compared to diabetic mice group. It was also observed that the extracts have shown no acute toxicity at a dose of 2 g/kg.Conclusion: The aqueous and 80% methanol extracts of T. schimperi leaves have shown blood glucose level lowering effects in diabetic mice. Hence, the present study might support the traditional use of T. schimperi for diabetes mellitus treatment.Keywords: diabetic, antidiabetic, alloxan, in vivo, antihyperglycemic, Thymus schimperi

This study was aimed at assessing marketing efficiency in the main sites of meat production of calf fattening fields in the private sector due to the importance of meat, especially red meat, which has essential nutrient for human body growth and high commodity prices depending on the measurement indicators used to suit the nature of the research conducted in calves fattening production fields in Gogjali region- Nineveh (2018). The basic source data of the study is obtained from sources on the ongoing ground- marketing questionnaire of three levels, the producer, the wholesaler, the retailer and two fields groups of caste random sample. The first group included (100) fields with imported calves class. The second included (51) fields with local calves class. Whereas, according to the production and marketing costs indicator, the average of marketing efficiency (ME1 ) of marketed meat in both groups of claves fattening fields amounted (92.47, 93.39%) respectively for a kilogram which is a sign of high production costs and, according to the marketing margins indicator, the average of marketing efficiency (ME2 ) of marketed meat in both groups of claves fattening fields amounted (86.89,79.13 %) for per kg which is a sign of high marketing margins. Thus the study concluded a high value of marketing efficiency using the first scale with the fattening period time for both groups while marketing efficiency by using the second scale was characterized by the gradual decline in the imported fattening fields and a gradual rise in the local fattening fields. The study recommends supporting production inputs (fodder, treatment), unifying markets and limiting the importation of red meat importation in order to obtain a good production and currency policy by which the production costs could be reduced to the minimum . [ABSTRACT FROM AUTHOR]

In low and middle-income countries, addressing maternal and child nutrition needs is crucial. Prenatal multiple micronutrient supplementation (MMS) holds promise in reducing low birthweight and preterm births. Ethiopia is considering a transition from the provision of iron-folate supplementation to the provision of MMS in antenatal care, guided by WHO guidelines. This paper explores stakeholders' early perceptions and experiences in piloting that transition in five Ethiopian regions, informing decision making about future policy and scale-up. We used a qualitative study involving interviews and document reviews to assess the MMS pilot, analyzing themes with Nvivo 12 software. Key informant interviews revealed challenges such as supply chain issues and funding constraints, along with proposed improvement strategies such as closer coordination within existing structures. The importance of engaging with communities to create demand was emphasized, as was the need for capacity-building efforts utilizing existing staff in the health system with a clear plan for ongoing refresher training. Finally, enhancing the monitoring and evaluation framework, including a dedicated regional team for supportive supervision, was vital for accountability. In conclusion, prioritizing supply chain strengthening, community engagement through demand creation, coordination, and continuous capacity building for healthcare workers were thought to be crucial for the MMS program's success. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05708183 Registered 01 February 2023-Retrospectively registered, https://classic.clinicaltrials.gov/ct2/show/NCT05708183., (© 2025 The Author(s). Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Appropriate infant feeding is crucial to ensure optimal child growth and survival. We aimed to assess infants' breastfeeding and complementary feeding practices from 0 to 12 months in Ethiopia. This study was a secondary analysis of data from the Ethiopia Performance Monitoring for Action panel study performed from July 2020 to August 2021. One thousand eight hundred and fifty infants were included from five Ethiopian regions: Addis Ababa City Administration, Oromia, Amhara, Afar, and Southern Nations, Nationalities, and Peoples Regions. Appropriate infant feeding practices were assessed using the World Health Organization measurement criteria and descriptive analysis. One-year-old infants were considered to have a diversified diet if they had complementary feeding comprising five or more food groups. Two-thirds (67%, 95% CI: 63, 71) of newborns were put to the breast within 1 h after delivery. The median duration of exclusive breastfeeding was 6.5 months, and 69% (95% CI: 67, 71) were exclusively breastfed at 5 months. Almost all (97%; 95% CI: 96, 98) were still breastfeeding at 12 months. Sixteen percent (95% CI: 13, 19) of infants (boys 15%, girls 16%) aged 12 months had a diversified diet, and 49% (95% CI: 44, 55) consumed sugary foods or beverages. Most Ethiopian infants had appropriate breastfeeding practices, while almost all had poor-quality complementary food at 1 year. Increasing access to high-quality education on infant feeding is crucial to maintaining and enhancing appropriate breastfeeding practices and complementary food quality. Intensifying poverty reduction efforts are essential to improve infants' dietary diversity and nutrient-dense food consumption., (© 2025 The Author(s). Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

The uncertainty in climate change and high water demand pose pressure on the natural water resources supply. Not only does this require better understanding but also a call for immediate interventions, mitigation and adaptive measures. This study evaluates catchment water resources in the Luwombwa sub-catchment in Zambia through statistical analysis in the downscaling of past, present and future climatic variables from the CMIP6 climatic model. These variables are then integrated into WEAP - a semi-distributed hydrological and water evaluation model - to perform water demand and allocation scenario modelling. Mult-site calibration and validation were conducted on five selected micro-catchments within Luwombwa sub-catchment. The model performance was assessed usng the R 2 , NSE and PBIAS as the objective functions. Satisfactory values of 92 % for R 2 , 82 % for NSE and 6.9 % for PBIAS were achieved. This allowed for scenario modelling on water demand and allocation among competing users. Three future scenarios (2022-2050) were developed from the historical to baseline (1988-2022) and included state of water resources availability under climate change, expansion of irrigation area and impact of dam construction in the sub-catchment. The study reveals a decrease of 20 % in sub-catchment's water availability resulting from 9.3 % (equivalent to 4 o C) rise in maximum temperature and 4.5 % reduction in rainfall within the entire sub-catchment. This is especially under the persistence of SSP370 climate variability scenario projections downscaled from four GCM models by the year 2050. The study further revealed that the change point for anticipated future climate extremes is likely to occur between 2027 and 2030. The results are indicative of downward trends in streamflow under climate change and socioeconomic development leading to increase in water value and water scarcity. The insights from the study are critical to inform formulation of effective catchment water resources management strategies such as the development of management plans and adapation measures in the face of climate change and the needs for different stakeholders involvement., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Patient loss-to-follow-up (LTFU) in HIV care is a major challenge, especially in low-resource settings. Although the literature has focused on the total rate at which patients disengage from care, it has not sufficiently examined the specific risk periods during which patients are most likely to disengage from care. By addressing this gap, researchers and healthcare providers can develop more targeted interventions to improve patient engagement in HIV care., Methods: We conducted a retrospective cohort study on newly enrolled adult HIV patients at seven randomly selected high-volume health facilities in Ethiopia from May 2022 to April 2024. Data analysis was performed using SPSS version 26, with a focus on the incidence rate of LTFU during the critical risk periods. Cumulative hazard analysis was used to compare event distributions, whereas a Poisson regression model was used to identify factors predicting LTFU, with statistical significance set at p < 0.05., Results: The analysis included 737 individuals newly enrolled in HIV care; 165 participants (22.4%, 95% CI: 19.5-25.2) were LTFU by the end of two years, of which 50.1% occurred within the first 6 months, 29.7% within 7-12 months, and 19.4% from 13 to 24 months on ART. The overall incidence rate of LTFU was 18.3 per 1,000 PMO (95% CI: 15.9-20.6), with rates of 167.7 in the first 6 months, 55.4 in 7-12 months, and 18.1 in 13-24 months. Incomplete addresses lacking a phone number or location information (IRR: 1.61; 95% CI: 1.14, 2.27) and poor adherence (IRR: 1.78; 95% CI: 1.28, 2.48) were factors predicting the incidence rate of LTFU., Conclusion: LTFU peaked in the first 6 months, accounting for approximately half of total losses, remained elevated from months 7-12, and stabilized after the first year of HIV care and treatment. Address information and adherence were predictors of LTFU. To effectively minimize LTFU, efforts should focus on intensive support during the first six months of care, followed by sustained efforts and monitoring in the next six months. Our findings highlight a critical period for targeted interventions to reduce LTFU in HIV care., (© 2024. The Author(s).)

Background: Adherence to infection prevention and control (IPC) standards and guidelines by healthcare workers is essential for reducing the spread of healthcare-associated infections (HAIs). However, IPC practices among healthcare workers in low- and middle-income countries (LMICs), including Ethiopia, are generally inadequate. This research aims to identify the barriers to and facilitators of IPC practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital (TASH) in Ethiopia., Methods: We employed a rapid ethnographic assessment (REA) approach for this study, using focus group discussions (FGDs), in-depth interviews (IDIs), and observations to collect data. Participants were selected from the Pediatrics and Child Health Department of TASH, and data collection took place in March and April 2022. Two FGDs and eight IDIs were conducted in the participants' workplace within the department. Unstructured guides were used to facilitate the FGDs and IDIs. Nvivo version 10 software was used for data organization and analysis. The data were coded deductively through thematic analysis to identify similar ideas and concepts, based on the Systems Engineering Initiative for Patient Safety (SEIPS) model., Result: A total of 23 healthcare workers participated, with 15 in FGDs and 8 in IDIs. The study identified several barriers to IPC practices, including nonadherence to IPC practice protocols, lack of pre-employment training, space constraints, insufficient maintenance and repair of equipment, limited management engagement and support, shortage of resources and budget, incidents of needle stick injuries and infections, high workloads for healthcare workers, shortages of personal protective equipment and water supply, and inadequate waste management. We also identified some facilitators, including the existence of an IPC team and committee, a health education schedule for patients and visitors, morning sessions for healthcare providers, and the presence of television screens in waiting areas. By addressing the identified barriers and leveraging the facilitators, department heads, IPC team leaders, and decision-makers can develop targeted strategies and interventions to improve infection control, reduce the spread of HAIs, and ultimately enhance the quality of healthcare services., Conclusion: This study explored several barriers that contribute to inappropriate and suboptimal IPC practices in the study area. These barriers create significant challenges for healthcare workers and hindering their ability to effectively implement IPC practices. The findings highlight the complex and multifaceted nature of the problems, which not only affect the current working environment but also compromise the overall quality of care. The hospital administrator should address these critical issues to improving IPC practices and ensuring a safer healthcare environment., (© 2024. The Author(s).)

Background: Client satisfaction has been recognized as an essential component in evaluating healthcare quality. In Wolaita Zone, there was a lack of research on the myths, misconceptions, and elements linked to client satisfaction with family planning. This study aimed to assess the myths and misconceptions of family planning and the factors associated with women's satisfaction with family planning services., Methods: We used a mixed methods study design (cross-sectional study design with a phenomenological design of the qualitative study). For the survey, 777 women were selected using multistage sampling, while purposive sampling was used to recruit in-depth interview participants. We used STATA version 15 and NVIVO version 12 software., Results: Only two-thirds, 534 (68.7 %) [95 % CI = 65.4%-71 %] clients, were satisfied with the family planning service. Clients who attended secondary education and above (AOR = 1.84; 95 % CI: 1.07, 3.23) and (AOR = 3.04; 95 % CI: 1.37, 6.72) did not wait to get the service (AOR = 5.11; 95 % CI: 1.98, 13.20), attended family planning service in a facility with convenient working hours (AOR = 4.43; 95 % CI: 2.25-8.74) and with posters in the waiting room (AOR = 3.48; 95 % CI: 1.22-9.94), comfortable with the cleanliness of clinic (AOR = 2.08; 95 % CI: 1.20, 3.94), whose Privacy was maintained (AOR = 9.56; 95 % CI: 5.02, 18.20), who were given information on the possible side effects of a method (AOR = 2.77; 95 % CI: 1.75-4.39), and on how the method works (AOR = 2.57; 95 % CI: 1.49-4.43 ) had higher odds of satisfaction. Also, various myths and misconceptions, such as implants moving to other parts of the body, implants causing paralysis, affecting routine activities, "womb of the woman may not hold the baby", etc., were identified in a qualitative study., Conclusions: Client satisfaction in this study is low. An improved provider approach that suits on-site advocacy and the quality of counselling during the family planning service is needed. There is also a need to improve waiting time, working hours, cleanliness, awareness creation for both couples, and maintaining clients' privacy., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mengistu Meskele reports financial support was provided by EngenderHealth Inc. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Objective: It was necessary to understand the determinants of severe COVID-19 in order to deliver targeted healthcare services to prevent further complications and mortality. Identifying the factors associated with severe COVID-19 in Addis Ababa, Ethiopia, is the aim of this study., Design: A case-control study was conducted from October 2021 to March 2022., Setting: The study was conducted at three public COVID-19 treatment centres including Ekka Kotebe General, St. Peter Hospital and St. Paul's Hospital., Participants: The study participants were COVID-19 patients admitted to three COVID-19 treatment centres. Cases were patients admitted with severe COVID-19, and controls were patients with mild or moderate COVID-19. A total of 306 patients (153 cases and 153 controls) selected by simple random sampling technique participated in this study., Outcome Measures and Analysis: Data were collected by a face-to-face or telephone interviewer using a structured questionnaire. COVID-19 admission category, clinical and biomedical characteristics and comorbidity-related data were extracted from the participant's medical record. Multivariable binary logistic regression analysis was used to identify predictors of COVID-19 severity., Results: The odds of being old were 4.54 times higher among severe COVID-19 cases (adjusted odds ratio (AOR)=4.54, 95% CI=2.499 to 8.24), the odds of being male were 2.72 times higher among severe COVID-19 cases (AOR=2.72, 95% CI=1.46 to 5.057), being vaccinated for COVID-19 decreases the severity by 55.1% (AOR=0.449, 95% CI=0.251 to 0.801), having good knowledge about COVID-19 decreases by 65% (AOR=0.35%, 95% CI=0.195 to 0.63) among patients with severe COVID-19, the odds of being diabetic were 10.2 times higher among severe COVID-19 cases (AOR=10.2, 95% CI=4.596 to 22.61) and the odds of being hypertensive were 2.3 times higher among severe COVID-19 cases (AOR=2.26, 95% CI=1.092 to 4.685)., Conclusion: Male, older age, diabetes or hypertension comorbidity, COVID-19 vaccination and having inadequate knowledge about COVID-19 were determinant factors of severe COVID-19., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Standard precautions are the minimum standard of infection control to prevent transmission of infectious agents, protect healthcare workers, patients, and visitors regardless of infection status. The consistent implementation of standard precautions is highly effective in reducing transmission of pathogens that cause HAIs. Despite their effectiveness, compliance, resources, patient behavior, and time constraints are some of the challenges that can arise when implementing standard precautions. The main objective of this meta-analysis was to show the pooled prevalence of safe standard precaution practices among healthcare workers in Low and Middle Income Countries (LMICs)., Methods: A systematic review and meta-analysis was conducted for this study. We systematically searched observational study articles from PubMed Central and Google Scholar. We included articles published any year and involving healthcare workers. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The random effect model was used to estimate the pooled prevalence. The meta-analysis, sensitivity analysis, subgroup analysis, and publication bias (funnel plot, and Egger's tests) were conducted., Results: A total of 46 articles were included in this study. The pooled prevalence of standard precautions practices among healthcare workers in LMICs was 53%, with a 95% CI of (47, 59). These studies had a total sample size of 14061 with a minimum sample size of 17 and a maximum sample size of 2086. The majority of the studies (82.6%) were conducted in hospitals only (all kinds), and the remaining 17.4% were conducted in all health facilities, including hospitals., Conclusions: The pooled prevalence of standard precautions practices among healthcare workers in LMICs was suboptimal. The findings of this study can have substantial implication for healthcare practice and policy making by providing robust evidence with synthesized and pooled evidence from multiple studies., Trial Registration: Registered on PROSPERO with record ID: CRD42023395129, on the 9th Feb. 2023., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yilma 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: Antenatal care (ANC) is a principal component of safe motherhood and reproductive health strategies across the continuum of care. Although the coverage of antenatal care visits has increased in Ethiopia, there needs to be more evidence of effective coverage of antenatal care. The 'effective coverage' concept can pinpoint where action is required to improve high-quality coverage in Ethiopia. Effective coverage indicates a health system's performance by incorporating need, utilization, and quality into a single measurement. The concept includes the number of contacts, facility readiness, interventions received, and components of services received. This study aimed to measure effective antenatal care coverage in Ethiopia., Methods: A two-stage cluster sampling method was used and included 2714 women aged 15-49 years and 462 health facilities from six Ethiopian regions from October 2019 to January 2020. The effective coverage cascade was analyzed among the targeted women by computing the proportion who received four or more antenatal care visits where the necessary inputs were available, received iron-folate supplementation and two doses of tetanus vaccination according to process quality components of antenatal care services., Results: Of all women, 40% (95%CI; 38, 43) had four or more visits, ranging from 3% in Afar to 74% in Addis Ababa. The overall mean health facility readiness score of the facilities serving these women was 70%, the vaccination and iron-folate supplementation coverage was 26%, and the ANC process quality was 64%. As reported by women, the least score was given to the quality component of discussing birth preparedness and complication readiness with providers. In the effective coverage cascade, the input-adjusted, intervention-adjusted, and quality-adjusted antenatal coverage estimates were 28%, 18%, and 12%, respectively., Conclusion: The overall effective ANC coverage was low, primarily due to a considerable drop in the proportion of women who completed four or more ANC visits. Improving quality of services is crucial to increase ANC up take and completion of the recommended visits along with interventions increasing women's awareness., (© 2024. The Author(s).)

Background: Use of local data for health system planning and decision-making in maternal, newborn and child health services is limited in low-income and middle-income countries, despite decentralisation and advances in data gathering. An improved culture of data-sharing and collaborative planning is needed. The Data-Informed Platform for Health is a system-strengthening strategy which promotes structured decision-making by district health officials using local data. Here, we describe implementation including process evaluation at district level in Ethiopia, and evaluation through a cluster-randomised trial., Methods: We supported district health teams in 4-month cycles of data-driven decision-making by: (a) defining problems using a health system framework; (b) reviewing data; (c) considering possible solutions; (d) value-based prioritising; and (e) a consultative process to develop, commit to and follow up on action plans. 12 districts were randomly selected from 24 in the North Shewa zone of Ethiopia between October 2020 and June 2022. The remaining districts formed the trial's comparison arm. Outcomes included health information system performance and governance of data-driven decision-making. Analysis was conducted using difference-in-differences., Results: 58 4-month cycles were implemented, four or five in each district. Each focused on a health service delivery challenge at district level. Administrators' practice of, and competence in, data-driven decision-making showed a net increase of 77% (95% CI: 40%, 114%) in the regularity of monthly reviews of service performance, and 48% (95% CI: 9%, 87%) in data-based feedback to health facilities. Statistically significant improvement was also found in administrators' use of information to appraise services. Qualitative findings also suggested that district health staff reported enhanced data use and collaborative decision-making., Conclusions: This study generated robust evidence that 20 months' implementation of the Data-Informed Platform for Health strengthened health management through better data use and appraisal practices, systemised problem analysis to follow up on action points and improved stakeholder engagement., Trial Registration Number: NCT05310682., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Infection prevention and control (IPC) is a set of practices that are designed to minimize the risk of healthcare-associated infections (HAIs) spreading among patients, healthcare workers, and visitors. Implementation of IPC is essential for reducing infection incidences, preventing antibiotic use, and minimizing antimicrobial resistance (AMR). The aim of the study was to assess IPC practices and associated factors in Pediatrics and Child Health at Tikur Anbessa Specialized Hospital., Methods: In this study, we used a cross-sectional study design with a simple random sampling method. We determined the sample size using a single population proportion formula with the assumption of a 55% good IPC practice, a 5% accepted margin of error, and a 15% non-response rate and adjusted with the correction formula. The final sample size was 284 healthcare workers. The binary logistic regression model was used for analysis. The World Health Organization (WHO) Infection Prevention and Control Assessment Framework (IPCAF) tool was used to assess IPC core components., Result: A total of 272 healthcare workers participated in the study, with a response rate of 96%. Of the total participants, 65.8% were female and 75.7% were nurses. The overall composite score showed that the prevalence of good IPC practices among healthcare workers was 50.4% (95% CI: 44.3-56.5). The final model revealed that nursing professionals and healthcare workers who received IPC training had AORs of 2.84 (95% CI: 1.34-6.05) and 2.48 (95% CI: 1.36-4.52), respectively. The final average total IPCAF score for the IPC level was 247.5 out of 800 points., Conclusion: The prevalence of good IPC practice was suboptimal. The study participants, who were nursing professionals and healthcare workers who received IPC training, showed a statistically significant association with the IPC practice level. The facility-level IPCAF result showed a "Basic" level of practice based on the WHO categorization. These evidences can inform healthcare workers and decision-makers to identify areas for improvement in IPC practice at all levels. Training of healthcare workers and effective implementation of the eight IPC core components should be strengthened to improve suboptimal 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 © 2024 Yilma, Taye, Tefera, Tassew, Fentie and Abebe.)

Objective: To measure the gap between expectations of patients with cancer for oncology services and their perceptions of the actual service and to identify associated factors at the oncology centre of Tikur Anbessa Specialized Hospital, Ethiopia., Design: An institutional-based cross-sectional study design was conducted using the service quality (SERVQUAL) tool from March to April 2022 on a sample of 256 hospitalised patients with cancer at the oncology centre of Tikur Anbessa Specialized Hospital. A paired Wilcoxon test and Kruskal-Wallis tests were used to determine the statistically significant difference between expectation and perception and to quantify the strength of association between the level of gap in the quality of oncology service and dependent variables, respectively., Results: Out of 256 patients with cancer included in the study, all of them agreed and participated, making the response rate 100%. The overall gap in service quality explained by the mean and SD is -1.42 (±0.41). The overall score for expectation and perception is 4.24 (±0.31) and 2.82 (±0.37), respectively. Being female, age greater than 65, having a college degree and above, being a patient with cervical cancer, patients with stage 4 cancer and patients who waited for more than 12 months for radiotherapy were found to have a statistically significant higher expectation compared with their perceived care in one or more dimensions of the SERVQUAL tool., Conclusion: Patient perceptions of the quality of service they received were lower than their expectations of the quality of service in all service quality aspects at Tikur Anbessa Specialized Hospital's oncology centre, implying unmet quality expectations from the oncology service users, with tangibility, assurance and empathy being the dimensions with the highest gap recorded, respectively. Therefore, the hospital and other stakeholders should strive to exceed patient expectations and the overall quality of care., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Cervical cancer (CCa) is the second most common type of cancer and a leading cause of death among adult women in Ethiopia. However, at the moment, there is a lack of evidence that can be generalizable as a whole to the country regarding the uptake of cervical cancer screening., Objective: The aim of this review was to assess the pooled estimated uptake of CCa and to identify the major barriers to cervical cancer screening (CCS) uptake among adult women in Ethiopia., Method: The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with a registration number of CRD42022353954. The data were searched electronically using Google Scholar, PubMed, Medline, and Web of Science search engines. The heterogeneity of the literature was assessed using Cochran's (Q) test and Higgin's and Thomson's (I 2 ) statistic. The Rosenthal approach, Fail-safe N method, Egger's test with a P -value <0.05, and funnel plot symmetry were used to detect publication bias. Random effect analysis was used to find out the pooled effect size. The Stata 17 software was used to perform analysis., Result: The pooled estimated uptake of CCS was 13.08% (POR 13.08; 95% CI: 10.24, 15.93; I 2 = 81.93%). Common factors associated with uptake of CCS were adequacy of knowledge (POR = 3.48; 95% CI: 2.74, 4.23; I 2 = 0%), attitudes of women (POR = 3.51; 95% CI: 2.96, 4.07; I 2 = 0%), and perceived susceptibility (POR = 4.03; CI: 2.68, 5.39; I 2 = 46.38%). A slightly high degree of overlap of studies was observed., Conclusion and Recommendation: The pooled estimated CCS is low. Factors like adequacy of knowledge of CCa, attitudes of women, and perception of susceptibility among women showed a significant association with cervical cancer screening uptake. Creating a platform where women can get adequate and focused information about cervical cancer and screening is crucial., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Esophageal cancer was the eighth and sixth leading cause of morbidity of all cancers in the world, and the 15th and 12th in Ethiopia, respectively. There is a lack of comprehensive data regarding Ethiopia's esophageal cancer hotspot, treatment outcome clustering, and other factors., Objective: This scoping review was designed to understand the extent and type of existing evidence regarding spatiotemporal distribution, time to treatment outcome clustering, and determinants of esophageal cancer in Ethiopia up to March 28, 2023., Methods: Three-step search strategies were employed for the scoping review from March 15 to 28, 2023. Targeted databases included PubMed/Medline, PubMed Central (PMC), Google Scholar, Hinari, and Cochrane for published studies and different websites for unpublished studies for evidence synthesis. Data were extracted using the Joanna Briggs Institute (JBI) manual format., Results: Our final analysis comprised 17 (16 quantitative a nd 1 q ualitative) studies. Three studies attempted to depict the country's temporal distribution, whereas 12 studies showed the spatial distribution of esophageal cancer by proportion. The regional state of Oromia recorded a high percentage of cases. Numerous risk factors linked to the tumor have been identified in 8 investigations. Similarly, 5 studies went into detail regarding the likelihood of survival and the factors that contribute to malignancy, while 2 studies covered the results of disease-related treatments., Conclusions: The substantial body of data that underpins this finding supports the fact that esophageal cancer has several risk factors and that its prevalence varies greatly across the country and among regions. Surgery, radiotherapy, or chemotherapy helped the patient live longer. However, no research has investigated which treatment is best for boosting patient survival and survival clustering. Therefore, research with robust models for regional distribution, clustering of time to treatment outcomes, and drivers of esophageal cancer will be needed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Soil erosion by water and wind is among the most crucial land degradation processes in Ethiopia. This is also the case for Alage watershed located in the cental Rift Valley system. This study aimed at assessment of soil erosion hazard and its relation to land use land cover change in the watershed during the period from 1984 to 2016 for a better land management. The study is based on application of Remote Sensing (RS) and Geographical Information System (GIS) to extract inputs factor values for the Revised Universal Soil Loss Equation (RUSLE). Time-series satellite imageries of Landsat TM 1984, ETM+ 2000 and OLI 2016 were used for land use land cover change detection and determination of cover management (C) factor of the RUSLE. Biophysical data such as rainfall, soil properties, land management practices including soil and water conservation measures within the watershed were collected using field survey and secondary data sources. Slope steepness and slope length factors were derived using Digital Elevaition Model (DEM). Long-term average annual soil loss rates were estimated by the RUSLE integrated with GIS for 1984, 2000 and 2016. Using satellite imageries, the land use land cover and changes within the watershed during the three periods were obtained through a supervised classification with maximum likelihood algorithim. The results of land use land cover change indicated that the proportion of rain-fed cropland, bare land and built up areas increased by 17.4%, 5.9% and 2.9% respectively over the three study period. In contrast the proportion of bush/shrub land, irrigated cropland, grass land, forested areas and waterbodies decresaed by 15.5%, 4.7%, 3.4%, 2.3% and 0.3% respectively during the same period. Estimated average annual soil loss rates showed an increasing trend from 24.3 ton ha -1 yr -1 in 1984 to 38 ton ha -1 yr -1 in 2016. Increasing trends of average annual soil loss rate is attributed to increased proportion of cropland, bare land and built up areas during those periods leading to decreased protective vegetation cover. Hotspot areas within the watershed require implementation of land management practices to prevent further degradation and expansion of gullies. This study is relevant to demonstrate environmental implication of land use land cover change for future land management practices and land use policy in the Rift Valley of central Ethiopia., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

Soil acidity is challenging agricultural production in Ethiopia. Above 43% of the farmland is under soil acidity problem and it leads to low crop yields and production losses. Ag-lime is widely considered as an effective remedy for amending soil acidity. This study assesses the current structure of ag-lime value chain and its functionality focusing on central parts of Ethiopia where lime is produced and channeled to acidity affected areas. The study uses Ethiopia as a case study and applies qualitative methods such as key informant interviews and focus group discussions to collect data from different actors in the ag-lime value chain. Key findings indicate that both public and private ag-lime producing factories are operating below their capacity. Due to limited enabling environments, the engagement of private sector in ag-lime value chain is minimal. In addition, farmers have a good awareness of soil acidity problem on their farms, and its causes and mitigation strategies in all regions. However, the adoption of ag-lime by smallholders was minimal. Overall, the current structure of the ag-lime value chain appears fragmented and needs improvement. Addressing soil acidity challenge through efficient ag-lime value chain could narrow lime supply-demand mismatches and increase widespread adoption by farmers to enhance crop productivity and food security in acidity-prone areas of the country., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Globally, tuberculosis (TB) and anemia are public health problems related with high morbidity and mortality. Furthermore, anemia is frequently manifested among people with TB in Africa, prevalence ranging from 25 to 99%. The presence of anemia is associated with an increase in individuals' susceptibility to TB and poor treatment outcomes. Studies have reported heterogeneous estimate of prevalence of anemia among people with TB in Africa. This review aimed to estimate the prevalence of anemia among newly diagnosed people with TB n Africa. We searched studies in Medline/PubMed, Cochrane library, ScienceDirect, JBI database, the Web of Science, Google Scholar, WorldCat, Open Grey, Scopus, Agency for Healthcare Research and Quality, ProQuest, and African Journals Online that reported the prevalence of anemia at TB diagnosis. Two reviewers performed data extraction with pre-defined inclusion criteria. A random-effects logistic regression model was used to pool the prevalence of anemia and levels of anemia with a 95% confidence interval (CI) in STATA version 14. Heterogeneity and publication biases were explored. A total of 1408 studies were initially identified, and seventeen studies with 4555 people with TB were included in the analysis. The prevalence of anemia among people with TB in Africa was 69% (95% CI 60.57-77.51). The pooled prevalence of anemia of chronic disease was 48% (95% CI 13.31-82.75) and normocytic normochromic anemia was 32% (95% CI 13.74-50.94) while mild anemia was 34% (95% CI 20.44-46.86). Females were more anemic than males at TB diagnosis in Africa (74% vs. 66%). The finding indicates that anemia is a common co-morbidity present among people with TB, especially among females. Mild anemia and normocytic normochromic anemia were more common at TB diagnosis. The finding indicates that anemia is a common co-morbidity present among people with TB in Africa region. Hence, it is recommended to instigate a routine anemia screening at TB diagnosis to improve treatment outcomes., (© 2023. The Author(s).)

Soil erosion by water is a major cause of land degradation in the highlands of Ethiopia and anywhere else in the world, but its magnitude and variability are rarely documented across land uses and climatological conditions. The purpose of this study was to examine runoff and soil loss responses under cropland (CL) and grazing land (GL) management practices in three climatic regions of the Ethiopian highlands: semi-arid (Mayleba), dry sub-humid (Gumara), and humid (Guder). We measured runoff and soil loss using runoff plots with and without soil and water conservation (SWC) measures (trenches, stone/soil bunds [embankments] with trenches on the upslope side, and exclosure) during the rainy season (July-September). The results revealed significant variation in runoff and soil loss amounts across land uses, SWC measures, and climatic regions. At Mayleba, seasonal runoff and soil loss in control plot were far higher from GL (280 mm, 26.5 t ha -1 ) than from CL (108 mm, 7.0 t ha -1 ) largely due to lack of protective vegetation cover and soil disruption because of intense grazing. In contrast, at Gumara and Guder, seasonal soil loss values were much higher from CL (21.4-71.2 t ha -1 ) than from GL (0.6-24.2 t ha -1 ) irrespective of runoff values. This was attributed to the excessive tillage/weeding operations involved in cultivation of teff (cereal crop) at Gumara and potato at Guder. Although SWC measures (practices) substantially reduced runoff and soil loss (decreased by 23%-86%) relative to control plot, seasonal soil loss under GL uses with trenches at Mayleba (12.6 t ha -1 ), CL with soil bunds and trenches at Gumara (22.1 t ha -1 ), and Guder (21.4 t ha -1 ) remained higher than the average tolerable soil loss rate (10 t ha -1 year -1 ) proposed for the Ethiopian highlands. This suggests that SWC measures should be carefully designed and evaluated specific to land use and climatic conditions. Overall, the results of this study can help improve SWC planning in regions where land use and climate impact on soil erosion vary across geographical areas, as they do in Ethiopia and anywhere else. However, further investigation is crucial with replication of measurements over years and locations to provide more accurate information on land use, management and climate controls on hydrological and soil erosion processes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The quality of natural waters could be deteriorated by organic pollutants which can impose a risk to the ecosystem as well as human health. These organic contaminants are often needed to be removed with adequate techniques. In this study, the photocatalysts of CdO nanoparticles (NPs), Ag-CdO nanocomposites (NCs), and Ag-CdO/polyaniline (PANI) NCs were successfully synthesized in order to investigate their degradation performance against 3',3″,5',5″-tetrabromophenolsulfonphthalein (bromophenol blue, BPB) dye. The crystal structure, functional groups, morphological change, and degradation efficiency of as-synthesized photocatalysts were characterized using XRD, FTIR, SEM and UV-Visible spectroscopic techniques respectively. The SEM result showed that the surface morphology of the nanomaterials seems the agglomerated micron-scaled grains as compared to CdO NPs and Ag-CdO NCs. The FT-IR spectrum demonstrated the absorption peaks which strongly confirmed that Ag-CdO NCs surface was successfully modified with PANI. The highly sharp and intensive XRD patterns attributed to the cubic structure for CdO NPs and Ag-CdO NCs structures with decreasing crystalline size from 40.58 nm to 36.43 nm and 10.29 nm upon CdO NPs photocatalyst surface treatment with Ag metal and PANI. The decreased particle size brought about to narrow the bandgap from 2.76 eV to 1.61 eV and 1.58 eV respectively. Among the synthesized photocatalysts, Ag-CdO/PANI NCs exhibited the best degradation efficiency of 97.30 % at pH 6, 10 ppm concentration of dye, 0.140 g of catalyst load, and 210 min irradiation time. Moreover, the kinetics of photodegradation of model dye at optimum conditions followed pseudo-second order reaction with the rate constant of 8.56 × 10-2 M-1min-1. The results suggested that, the developed treatment method for this particular dye could be applicable for the treatment of wastewater samples containing acidic dyes., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)