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Aberham Abere,1 Yibeltal Aschale,2 Banchamlak Tegegne,3 Tegegne Eshetu,1 Adane Derso1 1Department of Medical Parasitology, School of Biomedical and Laboratory Science, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Amhara Public Health Institute (APHI), Bahir Dar, EthiopiaCorrespondence: Yibeltal Aschale, Tel +251922444340, Email yibeltal.aschale@yahoo.comBackground: Intestinal parasitic infections (IPI) are one of the most significant health issues around the world. Their burden is significant in Ethiopia with an estimated five million cases reported annually. This study aimed to evaluate the 10-year trend of IPIs at the Grarigy Health Center in northwest Ethiopia.Methods: A retrospective analysis was done at Grarigy Health Center to determine the 10-year (2011– 2020) trend of IPIs by reviewing stool examination reports from a laboratory logbook. The data was collected by laboratory personnel using data extraction sheets. Then, entered into EpiData, cleaned and analyzed using SPSS-20 software. The chi-square test was used to test for significant differences between variables.Results: A total of 9541 stool samples were examined over a 10-year period, of which, 5599 (58.7%) were from male participants and 3942 (41.3%) were from female participants. Participants in the study had an average age of 26.11 years. Infection with intestinal parasites was seen in 58.8% of people (n = 5612) (CI: 57.8– 59.8). A significant fluctuating pattern of IPIs was observed from 2011 to 2020 (P < 0.05). The highest peak of IPIs was recorded in 2020 (61.9%; 767 cases) and the lowest peak was observed in 2011 (49%; 99 cases). A total of 10 different genera of intestinal parasites were reported, of which, A. lumbricoides was the predominant (23.5%) followed by E. histolytica/dispar (16.6%). The highest cases of all intestinal parasites were reported between the ages of 5 and 14 years except H. nana (highest case reported in < 5 years).Conclusion: Prevalence of IPIs is substantial at the Grarigy Health Centre. A fluctuating trend was noticed in the past 10 years. A surveillance system should be in place to bring the burden of IPI down to a level where it has no public health effect.Keywords: intestinal parasite infection, trend analysis, Grarigy Health Center, Ethiopia, IPI

Shbre Tsegaw,1 Yemiamrew Getachew,2 Belachew Tegegne3 1Department of Nursing, Dessie Health Science College, Dessie, Ethiopia; 2Department of Community and Mental Health, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 3Department of Comprehensive Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Belachew Tegegne, Email beletegegne@gmail.comBackground: Globally, work-related stress had a significant impact on health-care providers. Private and public health-care institutions are considered intensive work areas for work-related stress. In Ethiopia, most studies were focused on only public hospitals. However, this study aimed to include private and public hospitals.Methods: A hospital-based comparative cross-sectional study was conducted among 304 nurses working in public and private hospitals from 8 April to 7 May 2021. A simple random sampling technique was used to select nurses, and the data were collected using a standardized self-administered questionnaire. Data were entered into Epidata version 4.6.1 and then exported to SPSS version 26 for analysis. Descriptive statistics, bivariable and multivariable binary logistic regression were applied. The final multivariate regression declared significant determinants at a p-value < 0.05 and a 95% confidence interval with an adjusted odds ratio (AOR) to reveal the strength of associated variables.Results: In this study, the overall magnitude of work-related stress among nurses was 48.4% (95% CI: 42.4– 54.6) (51.6% among public hospitals and 46.4% for private hospitals). Bachelor nurses (AOR=0.32,95% CI:0.13,0.76), working in operation room (AOR=7.89, 95% CI:1.46,9.60) and job dissatisfaction (AOR=4.95, 95% CI: 1.94,2.61) were determinants of work-stress in private hospitals whereas being female (AOR = 3.15, 95% CI: 1.43, 6.92), working experience 5 to 10 years (AOR=0.42, 95% CI: 0.18, 0.97), having degree and above (AOR = 0.41, 95% CI: 0.17, 0.99) and working in intensive care unit (AOR = 6.48, 95% CI:1.49, 8.18) were determinants of work-related stress in public hospitals.Conclusion: The overall magnitude of work-related stress among nurses in Dessie city was almost half. In contrast, more work-related stress among nurses working in public hospitals than in private hospitals. Sex, operating (working) unit, working experience, and type of institution were work-related stress determinants in public and private hospitals. Hence, reducing workload and providing stress management training is crucial to reducing work-related stress among nurses.Keywords: determinants, nurses, work related stress

Belachew Tegegne,1 Feruza Yimam,2 Zemen Mengesha Yalew,1 Mekuriaw Wuhib,1 Leul Mekonnen,1 Yibeltal Asmamaw Yitayew,3 Sewunet Ademe,1 Dejen Tsegaye,4 Yeshiambaw Eshetie,5 Muluken Chanie6 1Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Nursing, Tropical College of Medicine, Dessie, Ethiopia; 3Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 4Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia; 5Department of Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 6Department of Nursing, Debre Tabor Health Science College, Debre Tabor, EthiopiaCorrespondence: Zemen Mengesha Yalew, Tel +251 91-805-7019, Email zeme.mengesha141414@gmail.comBackground: Wound infection is caused by pathogenic organisms invading viable tissue surrounding a localized defect or excavation in the skin or underlying soft tissue. Nurses have a critical role in wound care and dressing selection, and they should strive to stay current in this ever-changing field. To prevent wound infection, it is essential to improve wound-care knowledge and practice.Objective: To assess knowledge and practice of wound care and associated factors among nurses working in government hospitals of South Wollo Zone, Ethiopia.Methods: A hospital-based cross-sectional study design was used among 422 randomly selected nurses in government hospitals in South Wollo. A pretested structured self-administered questionnaire was used to collect data. Data were entered in EpiData 4.4.2 and exported to SPSS 25.0 for analysis. Descriptive statistics and bivariate and multivariate logistic regression were applied. Variables with P value < 0.05 were considered statistically significant for knowledge and good practice of wound care.Results: According to the findings, 40.3% and 51.0% had good knowledge and practice of wound care, respectively. Holding a bachelor’s degree or above (AOR 3.27, 95% CI 1.97– 5.43) and training (AOR 3.71, 95% CI 2.37– 5.81) were significantly associated with knowledge of wound care. More than 10 years of experience (AOR 3.15, 95% CI 1.96– 5.04), training (AOR 3.75, 95% CI, 2.38– 5.85), and not having a patient load (AOR 3.15, 95% CI 1.96– 5.04) were significantly associated with wound-care practices.Conclusion: Nurses’ wound-care knowledge and practice were low. Knowledge and practice on wound care were determined by educatio, training, patient load, and experience. Nurses should get training and share experience.Keywords: wound care, knowledge, practice, Ethiopia

Muhammed Siraj,1 Sisay Gedamu,2 Belachew Tegegne2 1Department of Nursing, Tropical College of Medicine, Dessie, Ethiopia; 2Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Belachew Tegegne, Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia, Email beletegegne@gmail.comBackground: Antiretroviral therapy (ART) enhances the survival of HIV-infected patients by reducing viral load and increasing CD4. As CD4 count increases, patients are more protected against opportunistic infections. In developing countries including Ethiopia, there were limited studies about the survival benefit of ART particularly no study in Kombolcha Town. Thus, this study was aimed to address the gap.Methods: A hospital-based retrospective cohort study was employed in Kombolcha town among 510 patients’ records from January 2015 to December 2019. A systematic random sampling technique was used to select patient records. The collected data were checked, coded, and entered into Epidata version 4.6 and exported to Statistical Package for Social Sciences version 26 for data cleaning and analysis. Kaplan–Meier was used to estimate the probability of category of each predictor and a log rank test was used to compare survival curves. Bivariate and multivariate Cox-regression were employed using a 95% CI and variables with p-value < 0.05 were declared as predictors of poor survival time.Results: In this cohort, out of 510 HIV-infected patients, 39 (7.65%) were died, and 471 (92.35%) were censored. Fair drug adherence (AHR=6.88, 95% CI: 4.31– 24.04), Poor drug adherence (AHR=9.58, 95% CI: 8.72– 30.97), CD4 count < 50 cell/μL (AHR=9.38, 95% CI: 1.48– 59.31), CD4 count 50– 99 cell/μL (AHR=9.67, 95% CI: 1.80– 51.73), bedridden (AHR=9.5, 95% CI: 4.49– 18.66), opportunistic infections (AHR=4.58, 95% CI: 1.20– 5.65), weight < 60kg (AHR=2.48, 95% CI:1.59, 10.38), WHO stage III (AHR=3.56, 95% CI: 1.71– 17.89), WHO stage IV (AHR=4.42, 95% CI:1.75– 25.93) were predictors of poor survival time.Conclusion: The Kaplan–Meier result showed that the estimated median survival time of patients after ART initiation in Kombolcha town was higher (32 months) as compared to other studies. Poor drug adherence, WHO stage III & IV, Lower baseline CD4 count, presence of opportunistic infections, weight < 60kg, and being bedridden were predictors of poor survival time. Thus, early initiation of ART ought to be encouraged among HIV-infected patients and good patient counseling on the level of adherence should be strengthened.Keywords: survival time, predictors, Kombolcha, HIV/AIDS

Mekuriaw Wuhib Shumye,1 Belachew Tegegne,1 Sewunet Ademe,1 Moges Workneh,1 Million Abera,2 Gugsa Nemera,2 Fikadu Balcha2 1School of Nursing and Midwifery, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia; 2School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, EthiopiaCorrespondence: Mekuriaw Wuhib Shumye Tel +251 92 126 8193Email eyasuwuhib@gmail.comBackground: Hypertension and diabetes mellitus are the most common comorbid non-communicable chronic diseases that threaten human beings worldwide. Hypertension is associated with an increased risk of diabetes mellitus and vis-a-vis. However, there is limited information on the magnitude of diabetes mellitus in hypertensive patients in sub-Saharan countries. Hence, this study assessed the magnitude of diabetes mellitus and its associated factors among adult hypertensive patients attending a hypertension clinic in Northeast Ethiopia.Methods: Institution-based cross-sectional study conducted on 407 participants from April to June 2019. The participants were included in the study using systematic random sampling. Data were collected using the WHO STEPwise method. We run descriptive statistics to determine the magnitude of diabetes mellitus in hypertensive patients and logistic regression to identify factors associated with diabetes, and statistically significant associations were declared at a P-value of less than 0.05.Results: The magnitude of diabetes mellitus among hypertensive patients was 29.1%, of whom 24% were newly diagnosed. Respondents with a family history of diabetes mellitus (AOR: 4.6, CI: 2.2, 9.48), increased waist-to-height ratio (AOR: 21.5, CI: 5.62,43.67), increased waist circumference (AOR: 3.2, CI: 1.58, 6.53) and primary school educational status (AOR: 3.2, CI: 1.41, 7.25) were more likely to have diabetes. Similarly, respondents with longer hypertension duration (AOR: 4.09, CI: 1.22, 13.64), past daily smoking history (AOR: 10.46, CI: 1.59,6.8), increased diastolic blood pressure (AOR: 4.15, CI: 1.51, 11.37), and increased waist circumference (AOR: 7.5, CI: 4.47,14.95) were more likely to be diagnosed newly for diabetes.Conclusion: Our study indicated around one-third of hypertensive patients had diabetes. Family history of diabetes mellitus, primary educational status and increased waist-to-height ratio and waist circumference were significant predictors of diabetes among hypertensive patients. The finding suggests the need for regular diabetic screening among hypertensive patients.Keywords: magnitude, hypertension, diabetes mellitus, Ethiopia

Banchamlak Tegegne,1 Getaneh Alemu2 1Amhara Public Health Institute, Bahir Dar, Ethiopia; 2Department of Medical Laboratory Science, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Getaneh Alemu PO Box 79 Tel +251922842776Email getanehmlt@gmail.comBackground: Leishmaniasis is one of the neglected tropical diseases, yet it is associated with high mortality and morbidity. It is caused by intracellular protozoan parasites of the genus Leishmania. Based on the infecting parasite species and host factors, leishmaniasis could be manifested as cutaneous (localized or diffuse), mucocutaneous or visceral clinical forms. In Ethiopia, L. aethiopica is well known to cause all forms of cutaneous leishmaniasis, the localized form being mostcommon.Case Presentation: An adult patient from Yayu district, west Oromia region of Ethiopia presents with multiple skin lesions on his face, hands and mutilation of nose through both nostrils. Eight years before the present symptoms, he has developed spontaneously healed cutaneous ulcer on his face leaving a permanent scar. Physical examination revealed multiple nodular lesions on his hands, face and nose as well as swelling of the upper lip. Parasitological examination of ulcer lesion revealed presence of amastigotes, and the patient was diagnosed with mucocutaneous leishmaniasis. He was treated with sodium stibogluconate (20 mg/kg/day IM for 30 days) and clinically cured. After two years, he presented with clinical outcomes typical of diffuse cutaneous leishmaniasis. After confirmation by parasitological examination, he was put on sodium stibogluconate (20 mg/kg/day IM for 30 days) and paromomycin (15 mg/kg/day IM for 30 days) combination therapy. As he showed no progress, he was treated with prolonged sodium stibogluconate (20 mg/kg/day IM for 60 days) monotherapy. He was still nonresponsive and discharged uncured.Conclusion: The present case is unusual in Ethiopia with relapse of mucocutaneous leishmaniasis progressing to diffuse form. The later form was nonresponsive for both mono and combination therapy, therefore, formulating new drugs or evaluating other anti-Leishmania drugs is required.Keywords: mucocutaneous leishmaniasis, diffuse cutaneous leishmaniasis, case report

Afework Edmealem, Sewunet Ademe, Belachew Tegegne Department of Nursing, School of Nursing and Midwifery, Wollo University, Dessie, EthiopiaCorrespondence: Afework Edmealem Tel +251921287207Email afeworkyalem@gmail.comBackground: Overweight and obesity results in poor control of chronic illnesses such as diabetes mellitus. The main reason for being overweight and obese among patients with chronic illness is low level of physical activity. Thus, this study aimed to assess level of physical activity and its associated factors among type II diabetes patients at Dessie Referral Hospital, Northeast Ethiopia.Methods: A hospital-based cross-sectional study was employed from October 1 to November 25 2019 in Dessie Referral Hospital. The study utilized systematic sampling technique to recruit the sample population of 364 diabetic patients. Face-to-face exit interview was used to collect the data. The data were presented with text and tables. Bivariable and multivariable binary logistic regression was employed to identify independent predictors of low level of physical activity at a P-value of < 0.05.Results: From the total study participants, 110 (33.1%) of them did not perform health enhancing physical activity. Patients whose body mass index was below 18.5 kg/m2 did not perform health enhancing physical activity twice more likely compared with patients whose weight was normal (AOR=2.36, 95%CI: 0.02– 5.42). Patients who were depressed did not perform health enhancing physical activity five times more likely compared with their counterparts (AOR=4.83, 95%CI: 1.46– 15.96). In addition, being widowed (P=0.037), living in an urban area (P=0.028) and duration of disease (P=0.020) were statistically associated with low level of physical activity.Conclusion and Recommendations: The level of physical activity among patients with type II diabetes was low. Being widowed, living in an urban area, being underweight, duration of disease and being depressed were independent predictors of low level of physical activity. Health education should be given in every visit to patients with type II diabetes. Promotion of physical activity through campaign should be done.Keywords: physical activity, factors, Ethiopia

Bantayehu Addis Tegegne,1 Agumas Alemu Alehegn,2 Mengistie Kassahun3 1Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Pharmacy, Lumame Primary Hospital, Lumame, Ethiopia; Health Supplies and Laboratory Equipments Management Directorate Director, Amhara National Regional State Public Health Institute, Bahirdar, Ethiopia; 3Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Bantayehu Addis Tegegne, Email bantayehuaddis.90@gmail.comBackground: A key strategy for quality improvement is drug use evaluation, which looks at the safe, appropriate use of medication principles. Tenofovir/Lamivudine/Dolutegravir (TLD-FDC) usage has not yet been sufficiently examined in published literature. The purpose of this study was to assess how TLD were used by HIV-positive patients Using WHO drug use evaluation standards in Lumame Primary Hospital, North West Ethiopia.Methods: Using WHO drug use evaluation standards, a retrospective study design was used to evaluate the appropriateness of TLD use. Systematic random sampling was utilized to gather patient medical records containing TLD. Accordingly, 100 records that met the inclusion criteria were selected and reviewed between April 1 and 15, 2021. Five criteria, namely, indication, dose, contraindication, drug interaction, and TLD safety monitoring were used to evaluate the appropriateness of TLD utilization.Results: 80% of patients were transited to TLD from other regimens. The median time on TLD was found to be 13 months with 9 months to 18 months IQR. The latest CD4 count as well as CD4 count at the initiation or transition of TLD was not done for 75% and 89% of the patients, respectively. 3/4 (75%) of the patients were found to have a scheduled medication refill history. TLD dosing, indications, and contraindications were found to be 100% appropriate. No, TLD safety monitoring tests were done for 21% of the patients in this study. However, viral load, liver/kidney function, and serum creatinine tests were done for 77% (95% CI: 74%– 79%), 5% (95% CI: 2%– 8%), and 14% (95% CI: 11%– 17%) of the patients, respectively. More over, In 93% (95% CI: 91%– 95%) of the patients, the TLD interaction was appropriate; in 7%, it was not. All recording, documenting, and reporting technologies were available and used efficiently, except for the Electronic Dispensing Tool.Conclusion: Generally, good adherence to national and WHO guidelines was obtained regarding dose, indication, and contraindications. However, improvement in safety monitoring tests and CPT utilization is recommended. Drug interactions satisfied the majority of the criteria’s threshold, while certain standards were not followed.Keywords: drug use evaluation, lumame primary hospital, Ethiopia, fixed dose combination: tenofovir/lamivudine/dolutegravir

Aderaw Yenet, Getinet Nibret, Bantayehu Addis Tegegne Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Bantayehu Addis Tegegne, Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia, Tel +251 9 13 32 62 85, Email bantayehuaddis.90@gmail.comIntroduction: The availability and affordability of safe, effective, accessible, and high-quality essential medicines is a critical benchmark for achieving the right to good health, and it is also one of the goals of the global health development agenda. To that end, it is critical to conduct rigorous studies to identify the major challenges confronting developing countries, particularly those in Africa.Objective: The purpose of this review was to identify the major challenges that Africans face in obtaining reasonably priced and readily available essential medicines.Methods: Generally the Boolean operators “AND” and “OR” were employed. Making progress also involves using duplicate checks, field definitions, and comparisons of articles and criteria. The analysis included all English-language papers published in any African country between 2005 and 2022, depending on the year of publication. The technique searches electronic databases for key phrases related to essential medication availability and affordability, such as PubMed, Web of Science, Scopus, Science Direct, Plos Medicine, and Google Scholar.Results: A total of 91 articles; by using search engines and handpicking including duplicates, were primarily searched. The electronic database search earned 78 articles while only eleven studies met the criteria for review and were reviewed of which 5 (50%) were from East African countries. Inadequate human resources, financial constraints, high cost of available medications on the market, poor inventory management, manual consumption forecasting, inefficiencies in drug registration, and trade-related aspects of intellectual property rights agreement regulations are all obstacles to the availability of essential medicines in African nations.Conclusion: This review revealed that in Africa, the availability and affordability of essential medicines face numerous challenges. The primary challenge, according to the review research, is a lack of adequate financing to pay for an appropriate set of essential medications, which account for a significant portion of household spending.Keywords: African countries, availability, affordability, essential medicines, challenges

Nega Getachew Tegegne,1 Demeke Yilkal Fentie,2 Biresaw Ayen Tegegne,2 Belete Muluadam Admassie2 1Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Anesthesia, School of medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Biresaw Ayen Tegegne, Tel +251-9-27-60-14-27, Email ayenbiresaw@gmail.comBackground: Traumatic brain injury is a major list of health and socioeconomic problems especially in low- and middle-income countries which influences productive age groups. Differences in patient characteristics, socioeconomic status, intensive care unit admission thresholds, health-care systems, and the availability of varying numbers of intensive care unit (ICU) beds among hospitals had shown to be the causes for the variation on the incidence in mortality following traumatic brain injury across different continents. The aim of this study was to assess the incidence and predictors of mortality among patients with traumatic brain injury at University of Gondar Comprehensive Specialized Hospital.Methods: A retrospective follow-up study was conducted based on chart review and selected patient charts admitted from January, 2017 to January, 2022. Participants in the study were chosen using a simple random sample procedure that was computer generated. Data was entered with epi-data version 4.6 and analyzed using SPSS version 26. Both bivariate and multivariate logistic regression analyses were used, and in multivariate logistic regression analysis, P-value < 0.05 with 95% CI was considered statistically significant.Results: The magnitude of mortality was 28.8%. Most of the injuries were caused by assault followed by road traffic accident (RTA). About 30% of the subjects presented with severe head injuries and epidural hematoma (EDH) followed by skull fracture were the most common diagnoses on admission. The independent predictors of mortality were male sex (AOR: 6.12, CI: 1.82, 20.5), severe class injury with Glasco coma scale (GCS < 9) (AOR: 5.96, CI: 2.07, 17.12), intraoperative hypoxia episode (AOR: 10.5, CI: 2.6– 42.1), hyperthermia (AOR: 25, CI: 5.54, 115.16), lack of pre-hospital care (AOR: 2.64 CI: 1.6– 4.2), abnormal appearance on both eyes (AOR: 13.4, CI: 5.1– 34.6), in-hospital hypoxia episode and having extra-cranial concomitant injury were positively associated with mortality, while on admission, systolic blood pressure (SBP) of 100– 149 (AOR: 0.086, CI: 0.016– 0.46) was negatively associated with mortality.Conclusion: The overall mortality rate was considerably high. As a result, traumatic brain injury management should be focused on modifiable factors that increase patient mortality, such as on-admission hypotension, a lack of pre-hospital care, post-operative complications, an intraoperative hypoxia episode, and hyperthermia.Keywords: head injury, mortality, trauma, injury

Yibeltal Aschale,1 Bantayehu Addis Tegegne,2 Wubetu Yihunie2 1Department of Medical Laboratory Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Pharmacy, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Yibeltal Aschale, Tel +251910962733, Email yibea33@gmail.comBackground: Treatment of human and animal ailments using botanical sources has obtained significant attention in Ethiopia. The compounds available in plants comprise a plentiful source of bioactive ingredients able to treat many complications. The review aimed to present an updated list of plants used for managing hepatitis over the past 15 years in Ethiopia.Methods: Systematic, comprehensive search was undertaken from electronic databases (PubMed, Google Scholar, Science Direct, and Scopus) between September 01 and October 15, 2022, using standard search terms. Original researches carried out in Ethiopia, written and published in English between January 01/2007 and December 31/2021, and reported hepatitis as a disease treated by medicinal plants were included in the review. Plants beyond the list of Ethiopian and Eritrean floral were excluded. Data were extracted from texts and tables of original papers on a Microsoft Excel. Quality was assessed by applying the Joanna Briggs Institute Critical Appraisal Checklist.Results: A total of 317 papers were obtained from the database search. After removing duplicates and screening, 15 articles fit the inclusion criteria and selected for final review. Of the 24 plants identified, 35.7% were herbs. Leaf and root (35.7% each) were the predominant plant parts used for remedy preparation. Combined use of leaf and root comprised 10.7%. The families Apocynaceae, Asteraceae, Euphorbiaceae, Cucurbitaceae, and Fabaceae comprise the highest number of plant species. About 89.3% of remedies were administered orally.Conclusion: The majority of plants belong to herbs and the frequently used plant parts are leaf and roots. Evidence generated from the present review indicated that lots of plants have been used to manage hepatitis. Moreover, the findings could serve as preliminary information to formulate new drugs acting against hepatitis. Therefore, it is desirable for scholars to recognize, document, and keep plants and the associated knowledge appropriately.Keywords: hepatitis, medicinal plant, Ethiopia

Wubetu Yihunie,1 Bekalu Kebede,1 Bantayehu Addis Tegegne,1 Melese Getachew,1 Dehnnet Abebe,1 Yibeltal Aschale,2 Habtamu Belew,2 Bereket Bahiru3 1Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Department of Pharmacy, College of Medicine and health sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Wubetu Yihunie, Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia, Tel +251 910112391, Email wubetuyihunie@gmail.comBackground: Emergence of antimalarial drugs and insecticides resistance alarms scientists to develop a safe and effective malaria vaccine. A pre-erythrocytic malaria vaccine called RTS,S has made great strides.Aim: The review was aimed to assess the safety of the candidate malaria vaccine RTS,S with AS01 and AS02 adjuvants using data from Phase I–III randomized controlled clinical trials (RCTs).Methods: This systematic review was conducted based on PRISMA 2020. Regardless of time of publication year, all articles related with safety of RTS,S, RCTs published in the English language were included in the study. The last search of databases, and registry was conducted on 30 May, 2022. Pubmed, Google Scholar, Cochrane Library, Wiley Online Library, and Clinical trials.gov were thoroughly searched for accessible RCTs on the safety of RTS,S malaria vaccine. The studies were screened in three steps: duplicate removal, title and abstract screening, and full-text review. The included studies’ bias risk was assessed using the Cochrane risk of bias tool for RCTs. This systematic review is registered at Prospero (registration number: CRD42021285888). The qualitative descriptive findings from the included published studies were reported stratified by clinical trial phases.Findings: A total of thirty-five eligible safety studies were identified. Injection site pain and swelling, febrile convulsion, fever, headache, meningitis, fatigue, gastroenteritis, myalgia, pneumonia, reactogenicity, and anemia were the most commonly reported adverse events. Despite few clinical trials reported serious adverse events, none of them were related to vaccination.Conclusion: Most of the adverse events observed from RTS,S/AS01 and RTS,S/AS02 malaria vaccines were reported in the control group and shared by other vaccines. Hence, the authors concluded that both RTS,S/AS01 and RTS,S/AS02 malaria vaccines are safe.Keywords: RTS,S/AS01, RTS,S/AS02, safety, systematic review, randomized controlled trials

Bantayehu Addis Tegegne,1 Agumas Alemu Alehegn2 1Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Pharmacy, Lumame Primary Hospital, Lumame, EthiopiaCorrespondence: Bantayehu Addis Tegegne, Email bantayehuaddis.90@gmail.comIntroduction: Since fever is a complicated physiological reaction to an infection or aseptic stimulus, finding safer solutions that are more potent and derived from plants is essential to resolving this issue. Bersama abyssinica (Melianthaceae) is traditionally used to treat fever, though this has yet to be proven scientifically.Objective: The present study aimed to assess the antipyretic potential of leaf extract and solvent fractions of B. abyssinica.Methods: The antipyretic activities of crude extract and solvent fractions of B. abyssinica leaves were evaluated using a yeast-induced pyrexia model at three different dose ranges (100mg/kg, 200mg/kg, and 400mg/kg) methanol extract as well as chloroform, ethyl acetate, and aqueous fractions to mice showing an increase in temperature of ≥ 0.5 °C. The rectal temperature of each mouse was recorded using a digital thermometer. To analyze the data, SPSS version 20 and one-way ANOVA followed by Tukey’s HSD post hoc test to compare results between groups were utilized.Results: The crude extract demonstrated significant antipyretic potential (P< 0.05 by 100 mg/kg and 200 mg/kg as well as P< 0.01 by 400 mg/kg), with a maximum of 95.06% reduction in rectal temperature at 400 mg/kg, comparable to 98.37% at 2.5 hours by the standard drug. Similarly, all doses of the aqueous fraction, as well as 200 mg/kg and 400 mg/kg doses of the ethyl acetate fractions, resulted in a significant (P< 0.05) reduction in rectal temperature when compared to the corresponding value of the negative control group.Conclusion: Extracts of B. abyssinica leaves were found to have a significant antipyretic effect. Thus, the use of the plant for pyrexia in traditional settings has scientific ground.Keywords: antipyretic activity, extract, fraction, B. abyssinica leaves, yeast-induced pyrexia

Bantayehu Addis Tegegne,1 Abebe Basazn Mekuria,2 Eshetie Melese Birru2 1Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaCorrespondence: Bantayehu Addis TegegneDepartment of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia, Tel +251 9 13 32 62 85, Email bantayehuaddis.90@gmail.comBackground: Despite the availability of synthetic antihyperglycaemic medications on the market, diabetes is on the rise. Though not scientifically proven, the Crinum abyssinicum Hochst. ex A. Rich. (Amaryllidaceae) has been used traditionally to treat diabetes. Crinum abyssinicum was tested in mice to see if it had anti-diabetic and anti-hyperlipidemic properties.Methods: The hydro-alcoholic extract of Crinum abyssinicum shoot tips doses (100 mg/kg, 200 mg/kg, and 400 mg/kg) were administered to normoglycemic, oral glucose-loaded mice, and single and repeated dose-treated streptozotocin-induced diabetic model. Then, the blood glucose levels were measured for normoglycemic, oral glucose loaded and single dose treated streptozotocin model. Whereas in repeated dose-treated streptozotocin induced diabetic model, blood glucose level, body weight, and lipid profiles were measured.Results: After oral administration, all extract doses (100 mg/kg (p < 0.01), 200 mg/kg (p < 0.001), and 400 mg/kg (p < 0.001)) significantly reduced blood glucose level of normal mice as compared to the control group. Significant reduction of post-prandial glucose was achieved with crude extract at a tested dose of 100 mg/kg (p < 0.05) both at 1st and 2nd hours; 200 mg/kg (p < 0.01) at the 1st hour and (p < 0.001) 2nd hours, and 400 mg/kg (p < 0.001) at the 1st and 2nd hours as compared to the negative control. In diabetic mice, the crude extract 200 mg/kg and 400 mg/kg; and glibenclamide 5 mg/kg significantly reduced (p < 0.001) blood glucose level on the 14th day as compared to the negative control. All doses of crude extract significantly improved the lipid profiles and the bodyweight of diabetic mice.Conclusion: These findings revealed that the hydro-alcoholic extract of Crinum abyssinicum shoot tips possess significant antihyperglycemic, antihyperlipidemic, and body weight improvements in streptozotocin-induced diabetic mice. Besides, it showed hypoglycaemic and anti-hyperglycaemic activities on normoglycemic and oral glucose loaded mice, respectively. These justify the claimed use of the plant in ameliorating diabetes mellitus in Ethiopian folk medicine.Keywords: antidiabetic, antihyperlipidemic, Crinum abyssinicum, hydro-alcoholic, streptozotocin

Bantayehu Addis Tegegne,1 Agumas Alemu Alehegn2 1Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Pharmacy, Amhara Public Health Institute, Bahir Dar, EthiopiaCorrespondence: Bantayehu Addis Tegegne, Department of Pharmacy, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia, Tel +251913326285, Email bantayehuaddis.90@gmail.com

This study reports the levels of metals in commercially available imported and Ethiopian rice. The levels of thirteen metals (Ca, Mg, K, Na, Fe, Mn, Zn, Cu, Co, Ni, Cr, Cd and Pb) were determined in six varieties of raw rice collected from Addis Ababa supermarkets, Fogera town and Amahara Regional Agricultural Research Institute and in one selected cooked rice by flame atomic absorption spectrometry (FAAS) after digesting the powdered rice samples with HNO3, HClO4 and H2O2 mixture. The validation of optimized digestion procedure was evaluated using spiking method and an acceptable percentage recovery was obtained. The levels of metals found in the imported and Ethiopian rice, respectively, were in the ranges (mg/kg): Ca 75.8- 630, 205-427; Mg 90.6-150, 99.5-2250; K 1680-2150, 1100-3020; Na 70.6-78.6, 26.7-80.9; Fe 48.9-117, 41.3-113; Mn 4.1-15.5, 3.7-16.6; Zn 16.4-25.7, 15.6-140; Cu 2.7-4.9, 3.3-15; Co 12.6-14.6, 8.8-10.4; Ni 2.5-75.1, 41.5-69.7; Cr 2.2-3.12, 2.32-4.82; Cd <0.34, 0.45-2.54; Pb 2.1-5.3, 0.8-3.8. Comparison between levels of metals in the imported and Ethiopian rice showed significant differences for most of the metals. The results indicated that Ethiopian rice is comparatively rich in essential metals than imported one. A statistical analysis of variance (ANOVA) at 95% confidence level for metal determination indicated significant difference between the means of each variety of samples. Comparison between levels of metals in cooked and raw rice showed that the difference in the level is not significant. [ABSTRACT FROM AUTHOR]

Agumas Alemu Alehegn,1 Robel Gursm Aklilu,1 Kaleab Ayalew Tadesse,1 Bantayehu Addis Tegegne,2 Zemene Demelash Kifle3 1Department of Pharmacy, Lumame Primary Hospital, Lumame, Ethiopia; 2Debremarkos University, College of Medicine and Health Sciences, Pharmacy Department, Debremarkos, Ethiopia; 3University of Gondar, College of Medicine and Health Sciences, School of Pharmacy, Department of Pharmacology, Gondar, EthiopiaCorrespondence: Agumas Alemu Alehegn Lumame, EthiopiaTel +251922719063Email agumasphar28@gmail.comBackground: Irrational use of drugs has been one of the major problems around the globe. However, the degree of the problem is higher in developing countries like Ethiopia. The WHO has developed several indicators to evaluate the practices of drug use. This study aimed to assess the overall drug use practices using standard WHO indicators in Lumame Primary Hospital.Methods: Hospital-based retrospective cross-sectional study was employed to investigate the overall drug use practices at the hospital. Six hundred prescriptions were selected from a total of 19,242 prescriptions by systematic sampling technique over one year from July 1, 2019, to June 30, 2020, in a retrospective review. For the patient care study, 100 patients were selected for collecting the required information. Facility indicators were assessed by checking the availability of STG/formularies and essential drugs. The results were interpreted according to the standard values of WHO.Results: All 600 sampled prescriptions were 100% standard. Weight, dosage form, and quantity were written in 1.5– 13.3% of the prescriptions. Patient address was recorded in 51%, while qualification of prescriber and dispenser were recorded in 71.5% and 56% of the cases, respectively, but all other information were complete in 88.5– 100% of the prescriptions. The mean number of drugs per encounter, generic prescribing, prescribing from essential drug list, encounters with antibiotics and injectable drugs were 2.3, 97.9%, 99.8%, 48.8%, and 11.2%, respectively. The average dispensing time was found to be 171.9 seconds. Percentage of actually dispensed drugs, adequacy of labeling, patient knowledge, and patient satisfaction were 95.3%, 22.6%, 83%, and 88%, respectively. About 92% of tracer drugs and all reading materials, except national drug list and facility-level drug formulary, were available in the study period.Conclusion: Generally, appreciable results were obtained for most of the indicators but improvement in antibiotic prescribing, polypharmacy and labeling practice is recommended.Keywords: rational drug use, Lumame Primary Hospital, WHO indicators

Biresaw Ayen Tegegne, Girmay Fitiwi Lema, Demeke Yilkal Fentie, Yosef Belay Bizuneh Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Girmay Fitiwi LemaDepartment of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaTel +251-9-85-03-15Email tsagir.fitiwi@gmail.comBackground: Wound management is one of the commonly performed procedures in hospitals. It can be a major source of pain and pain may be a frequently experienced but under-considered component of wound management. Therefore, we aimed to determine the severity of wound-related pain and identifying factors associated with it among patients who underwent wound management.Patients and Methods: An institutional-based, cross-sectional study was conducted from March to May, 2020 in the University of Gondar Comprehensive Specialized Hospital. A total of 424 patients were included in this study. Data were collected by direct observation, chart review, and interview of patients by using questionnaires. Statistical analysis had performed using SPSS 25.00 version statistical software. Descriptive statistics were conducted to summarize patients’ information and to determine the prevalence of pain. Bi-variable analysis was performed to determine each of the independent variables and only variables with a P-value< 0.2 were entered into the multivariable analysis. The strength of the association was present by odds ratio and 95% Confidence interval. P-value< 0.05 was consider as statistically significant.Results: The prevalence of moderate-to-severe wound-related pain during wound management was 94.1% (95% CI=91.7– 96.2). Anxiety (AOR=18.16; 95% CI=4.83– 68.23), acute wound (AOR=11.49; 95% CI=1.013– 130.2), baseline pain (AOR=3.51; 95% CI=1.18– 10.46), and analgesia intake (AOR=0.026; 95% CI=0.001– 0.895) were significantly associated with the severity of wound-related pain.Conclusion: The prevalence of moderate-to-severe wound-related pain was considerably high. Anxiety, type of wound, baseline pain, and analgesia intake were the independent risk factors. Therefore, wound care providers should assess the severity of wound-related pain and manage accordingly. Additionally, more emphasis should be given for patients who have baseline pain, anxiety, and acute wound.Keywords: pain assessment, pain management, wound management

IntroductionIn Ethiopia the pharmacy service has had several gaps among these were low patient satisfaction, and poor availability of essential pharmaceuticals. In addition, previous studies showed variation in magnitude of client satisfaction, and there is no previous study in the study area. Therefore, the aim of the study was to determine client satisfaction with outpatient pharmacy service and associated factors among adult clients at Dubti General Hospital in Afar, Ethiopia.MethodsA hospital based cross sectional study design was employed from February 1 to March 30, 2020 at Dubti General Hospital. Participants were selected by systematic random sampling method. Bivariate and multivariate binary logistic regression was computed to assess statistical association between the outcome variable, and independent variables. AOR with 95% CI were used to show statistical Significance at P ResultsThe overall satisfaction towards outpatient pharmacy service was 165(40.5%). Regarding associated factors, service payment insured through their workplace was positively associated with satisfaction (AOR = 3.178, 95% CI: 1.294-7.80) where as availability of some medications (AOR = 0.393, 95% CI: 0.208-0.741), unfair medication cost (AOR = 0.613, 95% CI: 0.607-0.910), and lack of organized pharmacy work flow (AOR = 0.105, 95% CI: 0.049-0.221) were negatively associated with clients' satisfaction.ConclusionThe clients' satisfaction in this study is low that warrants immediate corrective measures. Corrective measures should be taken based on identified gaps such as improving drug availability, pharmacy work flow, and cost of medications.

Introduction: National malaria programmes must weigh the relative benefits of different vector control and elimination tools to prioritise resource allocation with the greatest impact. This study assesses the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (PBO ITN-only arm) compared with the combination of two annual non-pyrethroid indoor residual spraying (IRS) campaigns and standard pyrethroid ITNs (IRS+Standard Pyrethroid ITN arm) in the Amhara region of Ethiopia., Methods: An open-label, stratified block-cluster randomised trial was designed to compare the impacts of the two intervention arms. ITN distribution took place from June to July 2021. IRS campaigns took place from June to July 2021 and again in June 2022. Confirmed malaria cases reported during the high transmission season (September to December) were compared in the 2 years before (2019 and 2020) vs the 2 years after (2021 and 2022) the 2021 campaigns. The difference in An. gambiae s.l. vector density per trap and indoor resting density (IRD) was assessed between the two arms during the high transmission seasons 2 years after the 2021 campaigns., Results: Estimated malaria cases decreased significantly by 53.6% in the postintervention period compared with preintervention in the IRS+Standard Pyrethroid ITN arm (95% CI -72.9%, -29.8%) and by 55.9% in the PBO ITN arm (95% CI -73.0%, -32.5%), with no significant difference between these two arms (95% CI -30.9%, 24.0%). From the first to the second season postintervention, cases decreased non-significantly in the IRS+Standard Pyrethroid ITN arm (incidence rate ratio (IRR) 0.94; 95% CI 0.66, 1.47) but increased significantly in the PBO ITN arm (IRR 1.98; 95% CI 1.49, 2.67). Postintervention vector density and IRD were not found to be significantly different between intervention arms in either 2021 (vector density: IRR 0.78; 95% CI 0.47, 1.31; IRD: IRR 0.80; 95% CI 0.37, 1.75) or 2022 (vector density: IRR 1.27; 95% CI 0.75, 2.12; IRD: IRR 1.02; 95% CI 0.45, 2.28)., Conclusion: These findings suggest a positive impact of non-pyrethroid IRS deployed annually alongside standard pyrethroid ITNs in a setting of confirmed pyrethroid resistance. While an overall positive impact of PBO ITNs was detected, a waning impact of the nets 2 years postdistribution was observed., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Effective nursing management and leadership are essential for the provision of desired patient care that will contribute to the improvement of any country's health indicators. However, nurses' views and experiences on the multitude of personal and organizational factors which may impact their decision-making abilities are often neglected in the literature. The study aimed to assess magnitude of poor decision making and its associated factors among nurse managers in South Wollo Zone Governmental Hospitals, Amhara Regional State, Ethiopia, 2023., Methods: Non experimental cross-sectional study was conducted among 168 nurse managers in South Wollo Zone Public Hospitals from April 01 2023 to May 15/2023. Participants were selected by using a simple random sampling technique. The data were collected by using structured questionnaire from the study participants. Data were entered using EPI data version 4.6 and exported to SPSS version 26 for analysis. The bi-variable logistic regression analysis model was used to identify the potential predictor variable, with p -value <0.25 was fitted into the multivariable logistic regression analysis model; p -value less than 0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare, factors associated with the outcome variable. The model fitness was checked by using the Hosmer and Lemeshow test. Data were presented with frequency tables, graphs, and pie charts., Results: The study found that the overall magnitude of poor decision-making among nurse managers was 35.7%. Being self-confident [AOR = 0.01, 95% CI: (00.002, 0.05)], receiving feedback [AOR = 0.24, 95% CI: 0.08, 0.76], and getting managerial support [AOR = 0.22, 95% CI: (0.06, 0.81)] were negatively associated with poor decision-making among nurse managers., Conclusion: Self-confidence, receiving feedback, and getting managerial support were variables significantly associated with poor decision-making. Authors strongly emphasize providing managerial support for nurse managers, increasing their habit of receiving feedback from colleagues, and encouraging them to build their self-confidence., 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., (© 2025 Abeje, Tegegne, Tefera, Zenebe, Yimam, Desu, Andargie, Amare, Kassa and W/Selassie.)

Introduction: Nurses require good knowledge about professional values to provide quality nursing care. Implementing professional values in clinical areas improves the quality of patients care. Even though applying professional values had significant impact on the continuity and quality of nursing care, there is scarcity of study on professional values in Ethiopia., Objective: The study was aimed to identify the level of nurses' professional values and related factors among nurses employed in South Wollo Zone public hospitals., Methods: A hospital-based, cross-sectional study was conducted among 422 nurses working in South Wollo Zone public hospitals from May to June 2023. Participants were selected by using simple random sampling technique. Nursing Professional Values Scale-Revised was used to measure the professional values. Data entry was performed using Epidata version 4.6.1 and then exported to Statistical Package for Social Sciences version 23.0 for analysis. To identify the strength of association between outcome and independent variables, binary logistic regression was applied. From the final model, those variables having p  < .05 and adjusted odds ratio with 95% confidence interval were reported as statistically significant., Results: The mean (±standard deviation) age was 32.29 (±7.01), with 63% of nurses being males. Less than half, 47.9% (95% confidence interval [CI]: 43.2, 53.4), of nurses had good professional values. Monthly income (adjusted odds ratio [AOR]  = 0.33; 95% CI: 0.16, 0.72), position (AOR  = 0.22, 95% CI: 0.13, 0.38), training (AOR = 0.56, 95% CI: 0.34, 0.92), promotion (AOR = 3.06, 95% CI: 1.84, 5.1), and respect from one's profession (AOR = 0.48, 95% CI: 0.29, 0.78) were statistically associated with professional values., Conclusion: The majority of nurses demonstrated poor professional values. Professional values were substantially correlated with monthly income, position, training, promotion, and professional esteem. In order to ensure the quality and continuity of patient care, we advised nurses to be aware of nursing professional values and apply them in clinical settings., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Malaria poses a significant public health threat globally, particularly in African regions, where asymptomatic malaria is a considerable logistic problem. Individuals with asymptomatic malaria do not seek treatment, and thus they are invisible to health facilities and represent a substantial hidden reservoir of Plasmodium species. This study aimed to determine the prevalence of asymptomatic malaria and its associated factors in Gorgora, western Dembia district, Northwest Ethiopia., Methods: A community-based cross-sectional study was conducted from May to June 2023 in the Gorgora area, Western Dembia district, Northwest Ethiopia. Data were collected using a semi-structured questionnaire. Giemsa-stained blood smear microscopy was employed for the diagnosis of Plasmodium species. The data were entered into Epi Data version 4.6 and exported to SPSS version 25 for analysis. Bivariate and multivariable binary logistic regression analyses were conducted to identify associated factors., Results: Among the 357 individuals who participated in this study, 9.2% (33/357) [95% CI 6.40-12.70: p = 0.000] were confirmed to be infected with Plasmodium species. Plasmodium falciparum and Plasmodium vivax accounted for 66.7% and 33.3%, respectively. Not using bed nets [AOR = 7.3, 95% CI 2.08-23.46, p = 0.006)], previous malaria history [AOR = 2.6, 95% CI 1.01-6.45, p = 0.041], outdoor activities at night [AOR = 8.3, 95% CI 3.21-21.30, p = 0.000], and family size [AOR = 3.3, 95% CI 1.18-9.22, p = 0.023] were significantly associated with asymptomatic malaria (p < 0.05)., Conclusions: A considerable proportion of asymptomatic Plasmodium infections was found which likely act as a reservoir of transmission. This has implications for ongoing malaria control programmes that are based on the treatment of symptomatic patients and highlight the need for intervention strategies targeting asymptomatic carriers. Not using bed nets, engaging in outdoor activities at night, and having a family size of more than five increased the odds of developing asymptomatic malaria. The district health office and health extension workers should collaborate to promote the regular use of mosquito bed nets among community residents., Competing Interests: Declarations. Ethics approval and consent to participate: Prior to commencing the study, ethical clearance was obtained from the ethical review committee of the School of Biomedical and Laboratory Sciences, University of Gondar, with reference number SBMLS/516. Additionally, permission was obtained from the Western Dembia district health office and Kebele administrators, where the data were collected. Written informed consent was obtained from eligible study participants who willingly agreed to be part of the study after being informed about the purpose, procedures, benefits, and risks involved. For eligible children, verbal assent was sought before obtaining written informed consent from their parents/legal guardians. The study participants were informed that participation in the study was voluntary, and the confidentiality of their information was ensured by using codes instead of names and identification in the data collection form. Finally, malaria-positive asymptomatic study participants were referred to nearby health centers for appropriate treatment. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Evidence-based practice is clinical decision-making using the best evidence available in the context of individual patients' preferences and clinical expertise. It is serving as a crucial instrument for the health science disciplines to minimize the theory-practice gap although the level of practice is unknown. Thus, this study aimed to assess nurses' implementation of evidence-based practice in nursing process and its associated factors in South Wollo Zone Public Hospitals., Methods: An explanatory sequential mixed method was employed from April 1 to May 29, 2023, among 419 nurses for the quantitative part and 15 others for the qualitative part. The data were collected using structured, pretested, self-administered questionnaires. Simple random and purposive sampling techniques were used to select participants for the quantitative and qualitative studies, respectively. The bivariable analysis was done primarily, and variables with a p-value < 0.25 were further examined using a multivariable logistic regression model to control con-founders. Then, variables having a p-value less than 0.05 with a 95% CI were used to declare significantly associated factors. The key informants were interviewed using pre-made interview guidelines, and then open code software was utilized to conduct a thematic analysis., Result: Nurses who had poor implementation of evidence-based practice in the nursing process were 228 [54.42%; 95% CI: (49.8-59.3)]. Similarly, the key informants concluded that the implementation of evidence-based practice in the nursing process was low. Participants who were 31- 40 years old [AOR = 0.61, 95% CI: (0.38-0.99)], 41-50 years [AOR = 0.32, 95% CI: (0.15-0.65)], working at general hospitals [AOR = 3.37, 95% CI: (1.39-8.18)] and comprehensive specialized hospitals [AOR = 7.29, 95% CI: (3.06 - 17.31)], lack of training about evidence-based practice (AOR = 2.50, 95% CI: (1.36-4.56)], and lack of internet access [AOR = 2.46, 95% CI: (1.43-4.23)] were factors associated with poor levels of nurses' implementation of evidence-based practice in the nursing process. The absence of computers, libraries, and updated guidelines were other factors identified on the quality analysis., Conclusion: Nurses' implementation of evidence-based practice in the nursing process was low. Age, working in general hospitals, and comprehensive and specialized hospitals, lack of training, and internet access were factors that had significant associations. Hence, hospital managers should give an attention to internet access and training about utilization of evidence-based practice in nursing process, particularly for those aged above thirty years old., (© 2024. The Author(s).)

Background: Reports showed that Amhara Region is accounting for 31% of Ethiopia`s malaria burden. Reports also depicted that despite the existing malaria vector control tools implemented by the regional government, currently there is an increment in malaria prevalence in the region. This might be due to lack of entomological monitoring and comprehensive information on the prevailing species composition, infection rate and feeding presences of An. mosquito species in the study areas. Therefore, this study aimed to address this information., Methods: A community-based cross-sectional study was conducted from 18 February to 30 March 2023 at three districts of the west Amhara Region. For this, six CDC light traps (three indoor and three outdoor) were used to collect adult female An. mosquito species. In this study, 261 An. mosquito species comprising seven species were collected. Their morphological identification and abdominal status determination were carried out using standard morphological identification keys under a dissection microscope. While their infection rates and blood meal sources were determined, using circumsporozoite protein-ELISA and blood meal-ELISA based on the standard protocol. Data were entered to SPSS versions 20 for analysis and p- value < 0.05 was considered as statistically significant., Results: In our study, total of 261 An. mosquito species were identified. An. demeilloni was the most abundant species accounted for 112(42.9%) of all captures. It was also the most predominant species at Ayehu-Guagusa followed by Jabitehnan districts. An. demeilloni and An. cinereus altogether accounting for infection rate of 3(1.1%) for P. vivax parasite. Furthermore, our study showed that more than 50% of An. mosquito species collected fed on cattle blood showing shifting of feeding behaviors., Conclusions: Our study depicted that An. demeilloni and An. cinereus were the most abundant species and infected with P. vivax parasite. Therefore, further comprehensive study should be done in the future., Competing Interests: he authors have declared that no competing interests exist., (Copyright: © 2024 Yimer 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: Malaria is the disease caused by intracellular parasites known as Plasmodium species and is mainly transmitted by blood sucking female Anopheles mosquitoes. During pregnancy, malaria results in severe complications to the mother, the fetus and the newborn. Symptoms of malaria, such as fever, malaise, headache, nausea and vomiting, in pregnant women can be mistakenly attributed solely to pregnancy. In Ethiopia, the prevalence of malaria in asymptomatic pregnant women has been well documented. However, studies indicating the prevalence and clinical presentation of malaria in pregnant women are lacking. Therefore, there is little information on the prevalence of malaria and significantly associated signs and symptoms in pregnant women. The aim of this cross-sectional study was to determine the prevalence of malaria and identify clinical signs and symptoms associated with malaria which suggest presence of malaria in pregnant women at Hamusit Health Center, Northwest Ethiopia., Methods: A health facility-based cross-sectional study was conducted on 231 malaria symptomatic pregnant women from April to June 2023. A convenience sampling technique was employed. The socio demographic and clinical data of the study participants was collected through face-to-face interview using questionnaire. Thick and thin blood films were prepared from capillary blood and stained with 10 % Giemsa. The stained blood smear was washed with clean water, air dried and examined under a light microscope. The Statistical Package for Social Sciences software version 20 (SPSS 20) was used to analyses data. Logistic regression was used to assess signs and symptoms associated with malaria. An adjusted odds ratio with a 95 % confidence interval was calculated, and a P value < 0.05 was considered statistically significant., Results: The overall prevalence of malaria among symptomatic pregnant women in the study area was 22.9 % (53/231) (95 % CI: 17.3-29 %). The most prevalent species was P. falciparum, with a frequency of 14.3 % (33/231) (95 % CI: 10 %-18.6 %), followed by P. vivax, 5.2 % (12/231) (95 % CI: (2.6 %-8.2 %). The remaining 3.5 % (8/231) (95 % CI: 1.8 %-6.7 %) were mixed infections of P. falciparum & P. vivax . Primigravidae (62.3 %) and first trimester pregnancies (52.8 %) were more affected. Malaria signs and symptoms mainly, fever [(P = 0.002, AOR (95%CI); 5.1(1.84, 14.30)], joint pain [(P = 0.001, AOR (95%CI); 7.8(2.24, 27.32)], vomiting [(P = 0.007, AOR (95%CI); 2.9(1.34, 6.43)], malaise [(P = 0.005, AOR (95%CI); 3.6(1.48, 8.67)] and fatigue [(P = 0.0039, AOR (95%CI); 2.1(1.04, 4.37)], were significantly associated with malaria infection in pregnant women., Conclusions: Malaria positivity in pregnant women with fever, joint pain, vomiting, malaise and fatigue is considerably high in the study area. These signs and symptoms in pregnant women are strong indicators of malaria infection., Competing Interests: In addition, we the authors affirm that this manuscript is original and neither submitted for publication nor published elsewhere in any language. Furthermore, all authors have read and approved the final version of the manuscript had full access to all of the data in this study and takes complete responsibility for the integrity of the data and the accuracy of the data analysis., (© 2024 The Authors.)

Background: Poor sleep quality impedes the progression of chronic illnesses, while chronic illnesses themselves are caused by poor sleep quality. Despite this fact, there is no research that has been conducted in Ethiopia that provides a thorough estimate of the self-reported sleep quality among patients with chronic illnesses. In order to present a complete picture of poor sleep quality among diabetes, hypertension, heart failure, cancer, HIV/AIDS and epilepsy patients, this systematic review and meta-analysis was carried out., Methods: Systematic review and meta-analysis was conducted to estimate the quality of sleep among patients with chronic illness in Ethiopia. The Preferred Reporting Items for Systematic Review and Meta Analysis standard was followed in the reporting of this systematic review and meta-analysis. An extensive exploration of digital repositories, including PubMed, EMBASE, Cochrane, Africa Journal of Online, Google Scholar, and an advanced Google search, was conducted to obtain published studies until December 1st, 2023 detailing poor sleep quality of patients with chronic illness. STATA version 17 commands were used to create the pooled estimate. The I 2 test and Egger's test, respectively, were used to identify the presence of heterogeneity and publication bias. To manage heterogeneity, a subgroup analysis and random effect model were used., Results: A total 21 articles with a total of 7393 participants were included in the final systematic review and meta-analysis. The pooled estimate of poor sleep quality among patients with chronic illness was 52% (95% of CI: 48%, 59%; I 2 = 97.26%). In subgroup analysis, the highest pooled estimate of poor sleep quality was observed in cancer patients 63% (95% CI: (95% CI: 45% - 80%). Regarding to data collection period, the highest pooled estimate of poor sleep quality was seen during spring 68% (95% CI: 42% - 94%)., Conclusions: Patients with chronic illnesses in Ethiopia had a high pooled estimate of poor sleep quality. Patients with cancer had the highest pooled estimate of poor-quality sleep compared with other patients. Patients with chronic illnesses had trouble sleeping in the spring, according to this systematic review and meta-analysis. Therefore, attention and intervention should be given to enhance the quality of sleep for patients with chronic illnesses., 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 Edmealem, Tegegne, Alem, Zeleke, Ayenew, Ayenew, Sisay Gebeyew, Tomiso, Getahun, Wondie and Liknaw.)

Background: Malaria in pregnancy remains a major public health problem in the globe, especially in sub-Saharan Africa. In malaria endemic areas, most pregnant women remain asymptomatic, but malaria could still cause complications on the mother and her offspring; as well as serve as reservoirs to transmit infection. Despite these effects, no attention is given to the diagnosis of asymptomatic Plasmodium infections (APIs) using highly sensitive and specific laboratory diagnostic tools in Ethiopia. Therefore, the goal of this study was to compare the performance of Rapid Diagnostic Test (RDT), microscopy and real-time polymerase chain reaction (RT-PCR) to detect APIs among pregnant women., Methods: A health facility based cross -sectional study was conducted among pregnant women attending antenatal care at Fendeka town health facilities Jawi district, northwest Ethiopia from February to March, 2019. A total of 166 participants were enrolled by using convenient sampling technique. Socio-demographic features were collected using a semi structured questionnaire. Dried blood spot (DBS) samples were collected for molecular analysis. Asymptomatic Plasmodium infection on pregnant women was diagnosed using RDT, microscopy and RT-PCR. Descriptive statistics were used to determine the prevalence of APIs. Method comparison was performed, and Cohen's kappa coefficient (k) was used to determine the degree of agreement among the diagnostic methods. Parasite densities were also calculated., Results: The prevalence of API was 9.6%, 11.4% and 18.7% using RDT, microscopy and RT-PCR, respectively. The overall proportion of API was 19.3%. Sensitivity of the RDT was 83.3% as compared with microscopy. Rapid Diagnostic Test and microscopy also showed sensitivity of 50% and 60%, respectively, as compared with RT-PCR. The mean parasite density was 3213 parasites/µl for P falciparum and 1140 parasites/µl of blood for P. vivax., Conclusion: Prevalence of API in the study area was high. Both RDT and microscopy had lower sensitivity when compared with RT-PCR. Therefore, routine laboratory diagnosis of API among pregnant women should be given attention and done with better sensitive and specific laboratory diagnostic tools., (© 2024. The Author(s).)

Introduction: Dyslipidemia is a common public health problem in people living with human immunodeficiency virus (HIV) who are receiving antiretroviral therapy and increases the risk of cardiovascular disease. Although evidence indicates that the prevalence of dyslipidemia is high, estimated pooled data are not well documented. Therefore, we aimed to estimate the pooled prevalence of dyslipidemia in adult people living with HIV receiving antiretroviral therapy in Ethiopia., Method: We conducted a systematic review and meta-analysis of the literature. The following databases and grey literature were searched: PubMed, WorldCat, ScienceDirect, DOAG, African Journals Online, Google Scholar, and African Index Medicine. We included all comparative epidemiological studies that reported the prevalence of high concentration of total cholesterol, triglycerides, and low density lipoprotein, and low concentration of high density lipoprotein cholesterol that were published between January 2003 and July 2023. The random effects model was used to pool the outcome of interest. Additionally, subgrouping, sensitivity analyses, and funnel plots were performed. R software Version 4.2.1 was used for statistical analysis., Result: Seventeen studies with a total of 3929 participants were included in the meta-analysis. The pooled prevalence of dyslipidemia, high total cholesterol, high triglyceride, elevated level of low density lipoprotein and low level of high density lipoprotein cholesterol were 69.32% (95% CI: 63.33, 74.72), 39.78% (95%CI: 32.12, 47.96), 40.32% (95%CI: 34.56, 46.36), 28.58% (95%CI: 21.81, 36.46), and 36.17% (95%CI: 28.82, 44.24), respectively. Age and body mass index were associated with high total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels., Conclusion: The authors concluded that the prevalence of dyslipidemia in Ethiopia is high in people living with HIV receiving antiretroviral therapy. Early detection of dyslipidemia and its integration into treatment are essential for preventing cardiovascular disease., Trial Registration: Protocol registered with PROSPERO (CRD42023440125)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Belete 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: Leishmaniasis is a common neglected tropical disease in Ethiopia. Visceral leishmaniasis (VL) caused by Leishmania donovani presents in the lowlands, while cutaneous leishmaniasis (CL) affects people living in the highlands. Although CL is described as being caused by Leishmania aethiopica, there is also evidence of L. tropica and L. major isolated from a patient, sand flies and potential reservoirs. Information on species causing CL in Ethiopia is patchy, and no nation-wide study has ever been done. Understanding which species are causing CL in Ethiopia can have important implications for patient management and disease prevention., Methods: We analyzed stored routine samples and biobanked DNA isolates from previously conducted studies of CL patients from different centers in the north, center and south of Ethiopia. Species typing was performed using ITS-1 PCR with high-resolution melt (HRM) analysis, followed by HSP70 amplicon sequencing on a selection of the samples. Additionally, sociodemographic, clinical and laboratory data of patients were analyzed., Results: Of the 226 CL samples collected, the Leishmania species could be determined for 105 (45.5%). Leishmania aethiopica was identified in 101 (96.2%) samples from across the country. In four samples originating from Amhara region, northwestern Ethiopia, L. donovani was identified by ITS-1 HRM PCR, of which two were confirmed with HSP70 sequences. While none of these four patients had symptoms of VL, two originated from known VL endemic areas., Conclusions: The majority of CL was caused by L. aethiopica, but CL due to L. tropica and L. major cannot be ruled out. Our study is the first to our knowledge to demonstrate CL patients caused by L. donovani in Ethiopia. This should spark future research to investigate where, how and to which extent such transmission takes place, how it differs genetically from L. donovani causing VL and whether such patients can be diagnosed and treated successfully with the currently available tools and drugs., (© 2023. The Author(s).)

Background: Ethiopia is one of the top 10 countries in the world where 90% visceral leishmaniasis cases are reported. Metema-Humera lowlands are the most important foci in Ethiopia. Blood transfusion in visceral leishmaniasis endemic foci in Ethiopia does not consider screening of visceral leishmaniasis during blood donation. The aim of this study is therefore, was to assess asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia., Methods: A Health facility based cross-sectional study was conducted at Metema Blood Bank from February to March 2020. A total of 205 blood donors were eligible and participated in this study. Structured questionnaire were used to collect data on socio-demographic characteristics and perceived risk factors associated with asymptomatic visceral leishmaniasis among blood donors. Blood donors were screened using both rK39 and direct agglutination tests based on the manufactures' instructions. Data were analyzed using SPSS version 20.0. Chi-square test was used to assess associations of Leishmania donovani infection with predisposing factors. Associations were considered statstically significant on P-value < 0.05 at 95% confidence level., Results: Of the total 205 participants, 32(15.6%) were positive for asymptomatic Leishmania donovani infection at least by one of the diagnostic tests used. Eight (3.9%) and 30(14.6%) of the participants` were positive by the rK39 and direct agglutination tests, respectively. Six (2.9%) donors were tested positive by both diagnostic tests. Family history of visceral leishmaniasis (X²=11.334, P = 0.003) and having neighbors with history of visceral leishmaniasis (X²=5.923, P = 0.015) were significantly associated with asymptomatic Leishmania donovani infection among blood donors., Conclusions: The prevalence of asymptomatic Leishmania donovani infection was 15.6%. Asymptomatic visceral leishmaniasis was significantly associated with donors' family and neighbors' history of infection. Therefore, laboratory screening of blood donors for visceral leishmaniasis in endemic areas will be mandatory. Moreover, this study will give base line information for future study in the country., (© 2023. The Author(s).)

Background: Hypertension is a silent killer that causes serious health issues in all parts of the world. It is risk factor for cardiovascular disease, stroke and kidney disease. Self-monitoring practice has been identified as an important component of hypertension management. Hence, this study aimed to assess blood pressure (BP) self-monitoring practice and associated factors among adult hypertensive patients on follow-up in South Wollo Zone public hospitals, Northeast Ethiopia., Methods: Hospital-based cross-sectional study was conducted from 1 June 2022 to 30 June 2022, among 336 adult hypertensive patients on follow-up at selected South Wollo Zone public hospitals. Data were collected by using self-administered pretested structured questionnaires; the collected data were entered into Epi-data V.4.6 and then exported to SPSS V.25 software for analysis. Descriptive statistics such as frequency and percentage were used to describe the study participants. Tables and texts were used for data presentation. Binary logistic regression was conducted to test the association between the independent and dependent variables. Adjusted OR (AOR) with 95% CI was estimated to identify the factors associated with BP self-monitoring and the level of significance was declared at p<0.05., Results: The proportion (95% CI) of BP self-monitoring practice among hypertensive patients in South Wollo Zone Public Hospitals was 8.93% (95% CI 6.3% to 12.5%). In the multivariable analysis, urban residence (AOR 3.97, 95% CI (1.11 to 14.20)), comorbidity (AOR 4.80, 95% CI (1.23 to 18.69)), regular healthcare professional visit (AOR 4.64, 95% CI (1.02 to 21.14)), advice on the type of devices used for BP self-monitoring (AOR 5.26, 95% CI (1.49 to 18.58)) and knowledge on hypertension self-care (AOR 13.13, 95% CI (4.21 to 40.99)) were positively associated with BP self-monitoring practice., Conclusion: The proportion of BP self-monitoring practice was low. Living in urban areas, comorbidity, regular healthcare professional visits, advice on the type of devices used for BP self-monitoring, and knowledge of hypertension self-care were positively associated with BP self-monitoring practice., 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.)

Cutaneous leishmaniasis is a continually spreading health problem in Amhara Region, Ethiopia. Despite this, up- to-date information on referral laboratory facility has been not yet reported. Therefore, this study was aimed at reporting up-to-date information about eight year's cutaneous leishmaniasis trend status. Data on referred cases from 2013 to 2020 were collected at Amhara Public Health Institute Parasitology department by reviewing log book. Of the 243 suspected cases, 114 (46.9%) were positive (confirmed) with microscope and cultured results showed that most of them were negatives. Most of the suspected cases were from 16 to 30 years and males by age and sex, respectively. Trend status by year depicted that largest numbers of suspected and confirmed cases were reported in 2013, 2015, and 2019 years. Finally, the trend status by zone showed that most cases were reported from South Gondar and Awi zones, respectively., Competing Interests: There are no competing interests to declare., (Copyright © 2022 Banchamlak Tegegne et al.)

Introduction: Malaria is one of the major public health problems in sub-Saharan Africa. It contributes significantly to maternal and fetal morbidity and mortality in affected countries. This study aims to evaluate the impact of enhanced case detection using molecular testing called loop-mediated isothermal amplification (LAMP) on birth outcomes in a prospective study design., Methods and Analysis: A pragmatic randomised diagnostic outcomes trial will be conducted in several health institutes in different Ethiopian regions. Women (n=2583) in their first and second trimesters of pregnancy will be included in the study and individually randomised to the standard of care or enhanced case detection arms, and followed until delivery. Enrolment will encompass the malaria peak transmission seasons. In the standard of care arm, a venous blood sample will be collected for malaria diagnosis only in symptomatic patients. In contrast, in the intervention arm, mothers will be tested by a commercially available Conformité Européene (CE)-approved LAMP malaria test, microscopy and rapid diagnostic test for malaria regardless of their symptoms at each antenatal care visit. The primary outcome of the study is to measure birth weight., Ethics and Dissemination: The study was approved by the following ethical research boards: Armauer Hansen Research Institute/ALERT Ethics Review Committee (FORM AF-10-015.1, Protocol number PO/05/20), the Ethiopia Ministry of Science and Higher Education National Research Ethics Review Committee (approval SRA/11.7/7115/20), the Ethiopia Food and Drug Administration (approval 02/25/33/I), UCalgary Conjoint Health Research Ethics Board (REB21-0234). The study results will be shared with the institutions and stakeholders such as the Ethiopia Ministry of Health, the Foundation for Innovative Diagnostics, WHO's Multilateral initiative on Malaria - Tropical Diseases Research (TDR-MIM), Roll Back Malaria and the Malaria in Pregnancy Consortium. The study results will also be published in peer-reviewed journals and presented at international conferences., Trial Registration Number: NCT03754322., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Inadequate water, sanitation, and hygiene (WASH) in healthcare facilities (HCFs) have an impact on the transmission of infectious diseases, including COVID-19 pandemic. But, there is limited data on the status of WASH facilities in the healthcare settings of Ethiopia. Therefore, this study aimed to assess WASH facilities and related challenges in the HCFs of Northeastern Ethiopia during the early phase of COVID-19 pandemic., Methods: An institution-based cross-sectional study was conducted from July to August 2020. About 70 HCFs were selected using a simple random sampling technique. We used a mixed approach of qualitative and quantitative study. The quantitative data were collected by an interviewer-administered structured questionnaire and observational checklist, whereas the qualitative data were collected using a key-informant interview from the head of HCFs, janitors, and WASH coordinator of the HCFs. The quantitative data were entered in EpiData version 4.6 and exported to Statistical Package for Social Sciences (SPSS) version 25.0 for data cleaning and analysis. The quantitative data on access to WASH facilities was reported using WHO ladder guidelines, which include no access, limited access, and basic access, whereas the qualitative data on challenges to WASH facilities were triangulated with the quantitative result., Results: From the survey of 70 HCFs, three-fourths 53 (75.7%) were clinics, 12 (17.2%) were health centers, and 5 (7.1%) were hospitals. Most (88.6%) of the HCFs had basic access to water supply. The absence of a specific budget for WASH facilities, non-functional water pipes, the absence of water-quality monitoring systems, and frequent water interruptions were the major problems with water supply, which occurred primarily in clinics and health centers. Due to the absence of separate latrine designated for disabled people, none of the HCFs possessed basic sanitary facilities. Half (51.5%) of the HCFs had limited access to sanitation facilities. The major problems were the absence of separate latrines for healthcare workers and clients, as well as female and male staffs, an unbalanced number of functional latrines for the number of clients, non-functional latrines, poor cleanliness and misuse of the latrine. Less than a quarter of the HCFs 15 (21.4%) had basic access to handwashing facilities, while half 35 (50%) of the HCFs did not. The lack of functional handwashing facilities at expected sites and misuse of the facilities around the latrine, including theft of supplies by visitors, were the two most serious problems with hygiene facilities., Conclusion: Despite the fact that the majority of HCFs had basic access to water, there were problems in their sanitation and handwashing facilities. The lack of physical infrastructure, poor quality of facilities, lack of separate budget to maintain WASH facilities, and inappropriate utilization of WASH facilities were the main problems in HCFs. Further investigation should be done to assess the enabling factors and constraints for the provision, use, and maintenance of WASH infrastructure at HCFs., Competing Interests: The authors have declared that no competing interests exist.

Background: Malaria is the leading vector-borne parasitic disease that is causing high morbidity and mortality worldwide. So far huge efforts to control and eliminate malaria are hindered by the occurrence of asymptomatic carriers that are a potential source of infection. Yet, there is a scarcity of data nationally and in the current study area as well. Therefore, this study was aimed to assess the prevalence of asymptomatic malaria in Northeast Ethiopia., Methods: A community-based cross-sectional study was conducted in 2019 involving a total of 270 study participants recruited via purposive non-probability sampling technique. A structured questionnaire was used to collect data on sociodemographic characteristics, individual and household factors related to asymptomatic malaria. Data were entered in Epi Data 3.1 version and analyzed by using SPSS version 20, and p< 0.05 was considered statistically significant., Results: The overall prevalence of asymptomatic malaria was 7.0%, with 3.0%, 5.2%, and 12.0%, respectively by Rapid diagnostic tests (RDT), Microscopy and Polymerase chain reaction (PCR). The majority of infections (73.7%) were identified from index households. Previous malaria history (AOR: 4.030, 95% CI: 1.021-15.903), living with index cases (AOR: 3.880, 95% CI: 1.275-11.806) and family size > 6 members (AOR: 4.820, 95% CI: 1.260-18.437) were significant predictors of asymptomatic malaria., Conclusion: Reactive case detection had identified considerably higher asymptomatic malaria cases in the community. Therefore, active case investigation should be established in the community by tracking the symptomatic cases at the health facilities., (© 2022 Yimer Melese Megbaru, et al.)

Objective: Antimicrobial resistance is one of the serious threats in the world, including Ethiopia. Even though several studies were conducted to estimate common bacteria and their antibiotic-resistance profile in Ethiopia, it is difficult to estimate the overall resistant patterns due to the lack of a nationwide study. This systematic review aimed to determine the prevalence of gram-negative bacteria isolates and their antibiotic-resistance profile among pediatrics patients in Ethiopia., Methods: A web-based search using PubMed, EMBASE, Science Direct, the Cochrane Database for Systematic Reviews, Scopus, Hinari, Sci-Hub, African Journals Online Library, and free-text web searches using Google Scholar was conducted from August to September 16, 2021. Each of the original articles was searched by Boolean search technique using various keywords and was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The data were extracted using Microsoft Excel format and exported to STATA 14.0 for statistical analyses., Results: The database search delivered a total of 2,684 studies. After articles were removed by duplications, title, reading the abstract, and assessed for eligibility criteria, 19 articles were included in the systematic review. Of a total of 1372 (16.77%) culture-positive samples, 735 (53.57%) were gram-negative. Escherichia coli was the most frequently isolated bacteria followed by Klebsiella species, 139/1372 (10.13%), and 125/1372(9.11%), respectively. More than 66.67% of isolates were resistant to ampicillin except for Neisseria meningitidis which was 32.35% (11/34). Pseudomonas aeruginosa , Klebsiela species, and Citrobacter species were 100% resistance for cefepime. Haemophilus influenzae was 100% resistant to meropenem. Salmonella species were 93.30%, 78.26%, and 63.64% resistant to tetracycline, chloramphenicol, and cotrimoxazole, respectively., Conclusion: Gram-negative bacteria were identified as the common pathogen causing infection in pediatrics and the level of resistance to commonly prescribed antibiotics was significantly higher in Ethiopia. Culture and susceptibility tests and well-designed infection control programs are important measures., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

Background: Malaria is the disease caused by Plasmodium species and primarily transmitted by the bite of female Anopheles mosquitoes. During pregnancy, malaria causes life threatening outcomes to the mother, the fetus and the new born. Even though, malaria symptomatic pregnant women highly attract mosquitoes and have higher potential of transmitting the disease in communities, most of the previous studies focused on pregnant women with asymptomatic Plasmodium infections. Therefore, the aim of this study was to assess the prevalence of malaria and associated factors among symptomatic pregnant women attending antenatal care at three health centers in northwest Ethiopia., Methods: A health facility based cross-sectional study was conducted from February to April, 2021. A total of 312 malaria symptomatic pregnant women were involved from three health centers and enrolled by convenient sampling technique. A questionnaire was used to collect socio demographic and clinical data through face to face interview. Capillary blood samples were collected and used to prepare thin and thick blood smears, which were then stained using 10% Giemsa and examined under light microscope. Logistic regression was used to assess factors associated with malaria. Adjusted odds ratio with 95% confidence interval was calculated and P-value < 0.05 was considered statistically significant., Results: The prevalence of malaria among symptomatic pregnant women was 20.8% (65/312) of which 12.2% (38/312), 4.8% (15/312) and 3.8% (12/312) were P. falciparum, P. vivax and mixed infections, respectively. Being illiterate (p< 0.001), first trimester (p = 0.036), primigravidae (p<0.001), living far from health center (p<0.001), not sleeping under long lasting insecticide treated nets (p<0.001) and living near irrigation areas (p = 0.006) were significantly associated with prevalence of malaria in malaria symptomatic pregnant women., Conclusions: Even though prevalence of malaria is decreasing in the country because of scale-up of intervention and prevention measures, this study showed that, malaria is still the major public health problem among pregnant women. Being illiterate, first trimester, primigravidae, living far from health centers, not sleeping under long lasting insecticide treated nets and living near irrigation areas were factors that increased the prevalence of malaria in malaria symptomatic pregnant women. Therefore, special attention should be given to pregnant women prone to these factors., Competing Interests: he authors have declared that no competing interests exist.

Potatoes are the world's most important root and tuber crop. It is grown in over 125 countries and consumed by over a billion people daily. Millions of people in impoverished countries rely on potatoes product to their survival. Today, developing countries are the world's major producers and distributors of potatoes and potato products. Potato can be effective produce for allowing smallholder families to achieve their food security. Ethiopia has probably the maximum prospective country for potato production. However, in Ethiopia, various factors influence potato production and commercialization. It is the main tuber crop produced in Farta District. Potato production and value chain status are not studied well. Hence the main aim of this study was to evaluate the value chains of potatoes in the Farta district, Ethiopia. 123 sample potato farmers were chosen using a two-stage random sampling technique in four kebeles. Descriptive, inferential, value chain approach and econometrics analysis were employed. In addition, Heckman's two-stage selection econometrics model was employed to analyze the determinants of potato market participation and sales quantity. Producers, traders, chain supports, chain enablers, and final consumers were the main value chain actors for potato in the study area. Wholesalers control the potato value chain due to their finances advantage. Probit model estimation result provides that: distance to the nearby market, family size, oxen owned by farmers, market information, land size allocated for potato production, and quantity of inorganic fertilizer were the significant variables affecting the decision to market participation positively except family size. The OLS estimation result provides that: the education level of the farmers, farming experience, the number of extension contact, the land size allocated for potatoes, and the quantity of inorganic fertilizer is the significant variables influencing the amount of potato market supply positively. The main constraints for potato production and commercialization in study area were: Shortage of improved seed, lack of capacity building training to the post-harvest management approach, price fluctuation, shortage of market information, absence of policy framework in price-setting strategy was produced and marketing constraints of potatoes. Therefore, the study suggests that; increasing access to farm inputs, introducing new and improved crop varieties, establishing suitable post-harvest management facilities. In addition, follow up misconduct practice for price-setting strategies, strengthening market information service, facilitating conditions that can promote the smallholder farmers for participating in the market and minimize those constraints which impede the complete value chain in potato production and development., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Background: Cases of coronavirus disease (COVID-19) are increasing at an alarming rate throughout the world, including Ethiopia. Food handlers in food and drink establishments are at high risk of exposure to the virus due to their many daily contacts with customers. Since there is a paucity of evidence about infection prevention practices and associated factors among this high-risk group in Ethiopia including in Dessie City and Kombolcha Town, this study was designed to address this gap., Method: An institution-based cross-sectional study was conducted among 422 food handlers in Dessie City and Kombolcha Town food and drink establishments in July and August 2020. The study participants were selected using a simple random sampling technique. Data were collected by trained data collectors using a pretested structured questionnaire and an on-the-spot observational checklist. Data were entered into EpiData version 4.6 and exported to STATA version 14.0 for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression model at 95% confidence interval (CI). From the bivariable analysis, variables with a p-value <0.25 were retained into multivariable analysis. Finally, variables that had a p-value <0.05 were declared as factors significantly associated with good infection prevention practices of COVID-19 among food handlers., Main Findings: The overall rate of good practice in infection prevention among food handlers was 43.9% (95% CI: 39.2-48.4%). Among the total 401 food handlers, 79.8% had good knowledge and 58.4% had a favorable attitude about COVID-19 infection prevention. Factors significantly associated with good COVID-19 infection prevention practices were: educational status of college or above (AOR = 1.97; 95% CI: 1.32-3.75), food handling work experience greater than five years (AOR = 2.55; 95% CI: 1.43-5.77), availability of written guidelines within the food and drink establishment (AOR = 2.68; 95% CI: 1.52-4.75), and taking training about infection prevention (AOR = 3.26; 95% CI: 1.61-6.61)., Conclusion: Our findings showed that around one-third of food handlers had good infection prevention practices. Thus, to reduce COVID-19 transmission, integrated work is urgently needed to further improve food handlers' good practices, knowledge and attitude about infection prevention through providing health education, training and by making written infection prevention guidelines available in food and drink establishments., Competing Interests: The authors have declared that no competing interests exist.

Cutaneous leishmaniasis is spreading in Ethiopia and outbreaks have been recorded at new foci. In the Ankesha-Guagsa district, from September 24 to 28, 2020, 39 suspected cases were screened, and amastigote stages were identified in lesion samples of 34 (87.2%) cases.

Background: While rapid diagnostic tests are an alternative diagnostic tests for microscopy in the diagnosis of malaria in rural settings, their performance has been inconsistent. Performance of rapid diagnostic tests might be affected by manufacturing process, transportation and storage, parasitemia level, and skill of personnel who perform the tests. Therefore, periodic evaluation of the local field performance of rapid diagnostic tests is mandatory in order to make early corrections in case of decreased performance., Methods: A facility-based cross-sectional study was conducted from January to May 2020 among 257 malaria-suspected patients attending selected health centers in Bahir Dar Zuria district. Capillary blood was collected from each participant and tested for Plasmodium infection by CareStart™ rapid diagnostic test kit and thin and thick blood film microscopy. Data were analyzed using statistical software for social sciences version 20 and MedCalc software version 19.3. Sensitivity, specificity, positive and negative predictive values, and kappa value were calculated to evaluate the performance of rapid diagnostic tests against microscopy., Results: Among 257 study participants, 47 (18.3%) were tested positive for Plasmodium infection by at least one of the diagnostic methods. Rapid diagnostic tests revealed 3 false positive and 3 false negative results. The sensitivity and specificity of CareStart Malaria Pf/Pv Combo test were 93.2% and 98.6%, respectively (kappa = 0.918)., Conclusion: CareStart™ rapid diagnostic test has comparable performance with microscopy for malaria diagnosis. We recommend continued use of CareStart Malaria Pf/Pv Combo test at health posts in Ethiopia where microscopy is not available., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2021 Zelalem Dejazmach et al.)

Background: Control and prevention activities have brought substantial decline of malaria incidence in the last two decades in Ethiopia. However, lack of local data on the disease transmission and community knowledge, attitude, and practice about malaria are thought to reverse the trend of malaria in certain areas. Therefore, assessment of the prevalence and community awareness towards malaria plays pivotal role for the success of malaria control and prevention., Objective: To assess malaria prevalence and knowledge, attitude, and practice about malaria among febrile patients in Bahir Dar Zuria district, Northwest Ethiopia., Methods: A facility based crosssectional study was conducted from January to March 2020 among 149 febrile patients attending selected health centers in Bahir Dar Zuria district. Data about knowledge, attitude, and practice about malaria were collected using semistructured questionnaire. Blood sample from each participant was tested for Plasmodium species through malaria rapid diagnostic tests and blood film microscopy. Data were analyzed using statistical software for social sciences version 20., Results: Among 149 participants, 22 (14.8%) were positive for Plasmodium infection at least by one diagnostic methods. Prevalence of P. falciparum and P. vivax was 3.4% and 10.1%, respectively, while that of mixed infection was 1.3%. From the total study participants, 29.5% have good knowledge, 77.2% have positive attitude, and 34.9% have good practice towards malaria. Statistically significant associations were observed on knowledge with age group ( X 2 = 10.377, P = 0.035), educational level ( X 2 = 15.075, P = 0.001), family size ( X 2 = 7.601, P = 0.022), attitude level and practice level. Participants with family size < 5 were 6.841 (95% CI: 2.570-18.206, P ≤ 0.001) times more likely to have negative attitude as compared to those with family size ≥ 5., Conclusions: Prevalence of malaria in the study area was relatively high. Study participants had encouraging attitude; however, their knowledge and practice towards malaria were poor. Therefore, the existing malaria control activities should be supplemented with continuous health educations, aware the community, and ensure participation in the control and prevention activities., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Zelalem Dejazmach et al.)

Background: Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia., Methods: An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs., Main Findings: The prevalence of NSSIs was 29.5% (95% CI: 24.2-35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18-4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10-5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13-4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14-4.41)., Conclusion: This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs., Competing Interests: The authors have declared that no competing interests exist.

Anopheles mosquitoes are the main vectors of malaria. There is little information on the current entomological aspects of Anopheles mosquitoes in Amhara region of northwestern Ethiopia. Therefore, the aim of this study was to assess the prevailing species composition, parous rate, and infection rate of Anopheles mosquitoes in the Bahir Dar city administration. A community-based cross-sectional study was conducted from January through July 2020. For this, six Centers for Disease Control and Prevention light traps (three traps indoor and three traps outdoor) were used to collect adult female Anopheles mosquitoes. The species were morphologically identified, and the parous and infection rates were determined via dissection of ovaries and salivary gland, respectively. A total of 378 adult female Anopheles mosquitoes comprised of three species (Anopheles d'thali, Anopheles rhodesiensis, and Anopheles gambiae complex) were collected and identified at the study sites. Anopheles rhodesiensis was the predominant species accounting for 90% of all collections at the Zenzelima site, followed by An. gambiae complex (6.5%). In contrast, An. gambiae complex was the predominant species at the Tis Abay site, comprising 94% of captures. The overall parous and infection rates were 35 (62.5%) and 1 (2.9%), respectively., (© The Author(s) 2021. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)