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Fisha GebreEyesus,1 Dagninet Mitku,2 Tadesse Tarekegn,1 Bogale Temere,1 Tamene Terefe,1 Amsalu Belete,2 Getasew Legas,2 Dejen Feleke,2 Moges Gelaw Taye,2 Nega Baye,2 Fitalew Admasu,2 Enyew Dagnew,2 Tewachew Liyeh,2 Melkamu Jimma,3 Ermias Chanie2 1Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia; 2DebreTabor University, DebreTabor, Ethiopia; 3Department of Nursing, College of Health Sciences, Assosa University, Assosa, EthiopiaCorrespondence: Fisha GebreEyesus Email fishalebel@gmail.comBackground: Despite the increased availability of antiretroviral therapy (ART), its success depends on a high level of adherence to a life-long antiretroviral therapy. However, the extent and factors associated with adherence to ART are not well known, especially in the current study setup. Therefore, this study aimed to assess the level of adherence and associated factors among children on ART in Northwest, Ethiopia.Methods: A retrospective follow-up study was conducted on human immunodeficiency virus (HIV)-infected children receiving ART at South Gondar public hospitals. Children receiving ART from January 1, 2015, to November 30, 2020, were included in the study. A computer-generated simple random sampling technique was employed. The data were entered into the EpiData version 3.1 and analyzed by STATA 14 statistical software. Bivariable logistic regression was fitted for each predictor variable. Moreover, those variables having a p-value ≤ 0.25 in bivariate analysis were fitted into a multivariable logistic regression model. P-value < 0.05 was used to declare significance.Results: A total of 363 HIV-infected children were involved in the study. From 363 HIV-infected children, the level of adherence to ART was found to be 78.2%, 95% CI (73.6, 82.2). TB co-infection [adjusted odds ratio (AOR) = 3.8, 95% CI (1.41, 10.1)], short duration on ART (AOR = 3.4, 95% CI (1.60, 7.20)), treatment failure (AOR = 10.2, 95% CI (3.95, 26.2)), and Zidovudine containing ART regimen (AOR = 3.5, 95% CI (1.1, 10.9)) were significant predictors of poor adherence.Conclusion: The current study showed that the level of adherence to ART was found to be low TB co-infection, short duration of ART, Zidovudine-containing ART regimen, and treatment failure were found to be significantly associated with poor adherence. Further studies on adherence rate and its determinants with multiple adherence measurements using prospective and multicenter studies were recommended.Keywords: adherence, ART, children, Ethiopia

Abstract This study was designed with the aim of assessing the effectiveness of decentralization of disaster risk management in Borana zone and South-West Shawa zone of Oromia region. A mixed research approach was used to collect data from federal, regional, zonal, district (woreda), and ward (kebele) representatives. Focus group discussions and key informant interviews were the qualitative methods used to collect data, while survey questionnaires were distributed to experts to collect quantitative data. The qualitative data were analyzed using content analysis whereas the quantitative data were analyzed using STATA software version 14. The findings of the research have shown that, the actors are aware of Busa Gonofa as a new indigenous self-help institution. The policy on decentralization of disaster risk reduction was better understood at the federal, regional, and zonal levels of the government tiers than at the woreda and kebele levels. Administrative decentralization was found to be more effective than fiscal and political decentralization. The decentralization of Ethiopian disaster risk reduction is incomplete with limited effectiveness. There exists significant difference between Borana and South-West Shawa zones in decentralization of disaster risk management. The implementation of decentralization was constrained by training, technology, collaboration, financial resources, skill and knowledge, institutional arrangement, and local capacity. Hence, there is a need to address these challenges and make continuous efforts to focus on local-level capacity building in terms of empowerment of actors through training, technology, and financial resources for adaptation and mitigation to drought in Borana and flood in South-West Shawa zones respectively.

Background: Food and nutrition insecurities continue to be significant issues for communities in developed and developing countries, even when there are plentiful harvests. In Ethiopia, climate change and other human-induced challenges are key factors contributing to this insecurity. Research and development experts suggest that implementing sustainable livelihood diversification strategies could be a viable solution. Objectives: The objective of the study was to analyze the determinants of choice of livelihood diversification strategies and its impact on food and nutrition security among smallholder farmers in the West Shoa zone, Oromia region, Ethiopia. Methods: The research employed quantitative approaches for data gathering and analysis. A multistage sampling method was utilized to choose the study locations. A total of 385 smallholder farming households (215 diversifiers and 170 nondiversifiers) were randomly chosen as participants from the 2 districts and 7 rural villages in the area. Descriptive statistics (frequencies, percentages, and cross-tabs) and econometric models [multinomial logit model and multinomial endogenous switching regression (MESR) model] were employed to analyze the quantitative data. Results: More than half (56%) of the farming households were able to diversify their livelihoods, whereas the remaining 44% were unable to do so, indicating a lack of means to engage in any form of livelihood diversification activity beyond agriculture. The results of the multinomial logit regression model revealed that various factors such as gender, age, family size, education level, farm experience, social norms, land ownership, livestock possession, access to credit, access to extension services, working capital, government policies, climate variability, livelihood training, and proximity to markets significantly influenced smallholder farming households’ choices and adoption of diversification strategies. The MESR model demonstrated that engaging in farming and off-farming activities could increase food and nutrition security for farm households by 74.6% and 33.3%, respectively. Similarly, participating in farming and nonfarming activities was associated with a 71.3% improvement in food security and a 42.3% enhancement in nutrition security. However, combining farming with both nonfarm and off-farm activities did not have a significant impact on food security, but it did lead to a 15.2% increase in nutrition security. Conclusions: Involving smallholder farmers in livelihood diversification reduces poverty, food insecurity, and unemployment. This study shows that diversifying livelihoods positively impacts food and nutrition security by enabling farmers to produce more for consumption and income generation.

This study was conducted to estimate the impact of land use/land cover (LULC) changes on the ecosystem service value (ESV) in the Upper Blue Nile basin over three-decade (1986–2020). The findings revealed that there is a decline in total ESV from US$ 492.77 × 106 in 1986 to US$ 400.65 × 106 for the year 2020. The ESV lost between 1986 and 2020 was about US$ 92.11 × 106. In terms of the individual ecosystem services, the contribution of all service values declined except food production and biological control. Among the major contributors of ESVs, food production, water regulation, erosion control, climate regulation, nutrient cycling, waste treatment, and water supply represent 89%, 88%, 86% in 1986, 2003, and 2020, respectively. Soil erosion and sediment transport under environmental pressure significantly contributed for the loss of ecosystem services (ES) in the sub-basin. In addition, FGD and KII ranked provisioning ecosystem services first in order of importance for communities in the study area. Therefore, it is important to pay attention to the sustainable conservation and restoration of natural resources through natural vegetation protection, enhanced vegetation cover, conservation practices and wetland management to enhance the natural capital and ecosystem services in the Muger Sub-basin.

The feasibility of using converter basic slag (CBS) as a source of Mg for gypsum-amended acidic soils was studied in a Plinthic Palexerult from western Spain. An experimental farm was established and the Ap horizon of the soil was amended with limestone (L), phosphogypsum (PG), or red gypsum (RG) to alleviate Al toxicity. The PG and RG were supplied at 8.0 and 8.8 Mg [ha.sup.-1], respectively. In addition, the gypsum-amended plots received either CBS at 0.9 Mg [ha.sup.-1] or limestone at 1.1 Mg [ha.sup.-1]. We studied the effects of the treatments on the exchange complex, soil solution, and the biomass production of 'Jabato' wheat (Triticum aestivum L.) under field and greenhouse conditions. The CBS proved highly effective in replenishing Mg lost from the soil through application of gypsum amendments. In the field experiment, only the RG + CBS treatment resulted in a statistically significant increase of biomass production relative to the control. In the greenhouse experiment, all treatments resulted in significantly increased production relative to the control, the largest (26 times) by RG + CBS. The PG + CBS and RG + CBS treatments resulted in significantly increased production relative to PG + L and RG + L, which testifies to the favorable effect of the Mg supplied by CBS. Also, the treatments including RG resulted in significantly increased production with respect to those including PG; the increased productivity is tentatively ascribed to a potential toxic effect of M-F ion pairs, which were more abundant in the soil solution of PG-treated soil. Abbreviations: AAS, atomic absorption spectrophotometry; AES, atomic emission spectrophotometry; CBS, converter basic slag; ECEC, effective cation exchange capacity; ICP-AES, inductively coupled plasma atomic emission spectroscopy; L, lime; PG, phosphogypsum; Pw, water-soluble phosphorus; RG, red gypsum.

Agerie Aynalem Mewahegn, Betelhem Tadesse, Fisha Alebel GebreEyesus, Tadesse Tsehay Tarekegn, Baye Tsegaye Amlak, Mamo Solomon Emeria, Bogale Chekole Temere, Tamene Fetene Terefe, Bitew Tefera Zewudie, Haymanot Abebe Geletie, Shegaw Tesfe Mengist Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, EthiopiaCorrespondence: Agerie Aynalem Mewahegn, Department of Nursing Ethiopia, College of Medicine and Health Sciences, Wolkite University, PO Box 07, Wolkite, Ethiopia, Tel +251 915715727, Email aynalemagerie21@gmail.comBackground: Peripheral intravenous cannulas are routinely used in hospital-admitted children requiring intravenous therapy. The majority of peripheral IVC lines are removed before completion of therapy due to cannula complications in children. Peripheral intravenous cannula securing is a painful procedure for children, so recognizing the variables associated with the peripheral intravenous cannula lifespan would help decrease the complications and increase the duration of cannula patency.Objective: The main aim of this study was to determine the lifespan and associated factors of peripheral intravenous cannula among hospitalized children in Gurage zone public hospitals, Ethiopia, 2021.Methods: We conducted an institution-based cross-sectional study design among 422 admitted children in public hospitals of the Gurage zone using a systematic random sampling technique. We collected data from interviews of parents using structured questionnaires and direct observations using checklists. The data was coded and entered into EPI-DATA version 3.1 and exported to SPSS version 25 for analysis. Bivariable and multivariable analysis was used by using a binary logistic regression model. Finally, the variables with a p-value of < 0.05 with a 95% confidence interval (CI) from the multivariable analysis were considered statistically significant.Results: One hundred and sixty-six children (41.4%) had a short cannula lifespan (below 30 h). Multivariable logistic regression analysis showed that neonatal intensive care unit (NICU) [AOR = 4.975; 95% CI (2.811– 8.805)], reason for removal (complication) [AOR = 3.277; 95% CI (1.924– 5.583)], fluid [AOR = 2.285; 95% CI (1.274– 4.100)], and blood transfusion [AOR = 2.407; 95% CI (1.005– 5.572)] were the statistically significant variables associated with the lifespan of a peripheral intravenous cannula.Conclusion and Recommendation: The proportion of the short lifespan of the peripheral intravenous cannula was higher in hospitalized children and health care providers better to use low concentration electrolytes, low osmotic pressure, and weak alkalinity fluid. The cannula access might be the responsibility of the health-trained staff, and conserving immediate removal upon the presence of a signal that indicates a complication.Keywords: lifespan, peripheral intravenous cannula, associated factors, hospitalized children

Kiddus Yitbarek,1 Zewdie Birhanu,2 Gudina Terefe Tucho,3 Susan Anand,4 Liyew Agenagnew,5 Gutema Ahmed Snr,5 Masrie Getnet,6 Yonas Tesfaye5 1Departemnt of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 2Department of Health Behaviors and Society, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 3Department of Environmental Health and Technology, Faculty of Public Health, Jimma University, Jimma, Ethiopia; 4Department of Nursing, Faculty Health Sciences, Jimma University, Jimma, Ethiopia; 5Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia; 6Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, EthiopiaCorrespondence: Yonas Tesfaye Po Box: 378 Tel +251910107507Email yonastesfaye71@yahoo.comPurpose: The Ethiopian Ministry of Health has integrated mental health services into the community health service, but it has not yet been implemented. Therefore, this study aimed to explore the barriers and facilitators of mental health service implementation in the Ethiopian community health program.Methods: A qualitative case study was conducted in the Ethiopian primary health care system in 2019. We have conducted about eight key informant interviews with policymakers, service managers, and service providers. The interviews were tape-recorded, transcribed, translated, and analyzed manually using the World Health Organization building blocks framework.Results: The Health Ministry of Ethiopia has recently included mental health services into the health extension package but not yet implemented as part of integrated services. The identified barriers were low political commitment, shortage of resources, non-functional referral system, lack of interest from private health service organizations, attitudinal problems from both the society and service providers, and lack of consistent reporting system of the mental health problems. However, the well-designed primary health care system, trained health extension workers, changing political commitment and attitude of the community could facilitate the mental health service implementation.Conclusion: A series of activities are expected, especially from the healthcare system managers to implement, follow, and evaluate mental health services implementation at the health extension programs.Keywords: mental health services, health extension workers, primary health care, Ethiopia

Phenotypic and genotypic evaluation of wheat genetic resources and development of segregating populations are pre-requisites for identifying rust resistance genes. The objectives of this study were to assess adult plant resistance (APR) of selected wheat genotypes to leaf rust and stem rust and to develop segregating populations for resistance breeding. Eight selected Kenyan cultivars with known resistance to stem rust, together with local checks were evaluated for leaf rust and stem rust resistance at seedling stage and also across several environments. Selected diagnostic markers were used to determine the presence of known genes. All eight cultivars were crossed with local checks using a bi-parental mating design. Seedling tests revealed that parents exhibited differential infection types against wheat rust races. Cultivars Paka and Popo consistently showed resistant infection types at seedling stage, while Gem, Romany, Pasa, Fahari, Kudu, Ngiri and Kariega varied for resistant and susceptible infection types depending on the pathogen race used. The control cultivars Morocco and McNair consistently showed susceptible infection types as expected. In the field, all cultivars except for Morocco showed moderate to high levels of resistance, indicating the presence of effective resistance genes. Using diagnostic markers, presence of Lr34 was confirmed in Gem, Fahari, Kudu, Ngiri and Kariega, while Sr2 was present in Gem, Romany, Paka and Kudu. Seedling resistance gene, Sr35, was only detected in cultivar Popo. Overall, the study developed 909 F6:8 recombinant inbred lines (RILs) as part of the nested mating design and are useful genetic resources for further studies and for mapping wheat rust resistance genes. [ABSTRACT FROM AUTHOR]

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

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

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

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

A walking machine (robot) is a type of locomotion that operates by means of legs and/or wheels on rough terrain or flat surface. The performance of legged machines is greater than wheeled or tracked walking machines on an unstructured terrain. These types of machines are used for data collections in a variety of areas such as large agricultural sector, dangerous and rescue areas for a human. The leg mechanism of a walking machine has a different joint in which a number of motors are used to actuate all degrees of freedom of the legs. In the synthesis of walking machine reported in this article, the leg mechanism is developed using integration of linkages to reduce the complexity of the design and it enables the robot to walk on a rough terrain. The dimensional synthesis is carried out analytically to develop a parametric equation and the geometry of the developed leg mechanism is modelled. The mechanism used is found effective for rough terrain areas because it is capable to walk on terrain of different amplitudes due to surface roughness and aerodynamics.

BACKGROUND:Drug promotion by medical representatives is one of the factors that influence physicians' prescribing decisions and choice of drugs. OBJECTIVE:To assess the influence of medical representatives on prescribing practice of physicians in health facilities, Mekelle, Northern Ethiopia. MATERIALS AND METHODS:Facility-based cross-sectional study was conducted enrolling all physicians working in public and private health facilities. All public and private health facilities were included and similarly, all physicians rendering services in these facilities were sampled in the study. The data were collected from February to March, 2015. Data were then entered into Epidata Version 3.1 and transferred to STATA version 12 for analysis. Both bivariable and multivariable logistic regressions were used to determine predictors. RESULTS:Of the ninety physicians approached in this study, 40 (48.2%) of the physicians believed that their prescribing decisions were influenced by visits of medical representatives (MRs). The odds of physicians who received gifts from MRs being influenced to prescribe their respective products was six times higher than those who reported not accepting any gifts [AOR = 6.56, 95% CI: 2.25, 19.13]. Stationery materials 23(35.4%) and drug samples 20(54.2%) were the commonest kinds of gifts given to physicians and face to face talking 45(54.2%) was the most frequent promotional methods. The finding of this study showed that around thirty-nine percent of MRs have had negative attitude toward competitors' product. Moreover, working in private health facility was also another predictor of influence of prescribing decision in the study area [AOR = 12.78, 95% CI: 1.31, 124.56]. CONCLUSION:Nearly half of the physicians working in Mekelle reported that their prescribing decisions were influenced by MRs in the last 12 months. Accepting gifts and working in private health facilities were predictors of influencing prescribing decisions. However, most MRs fails to provide adequate and accurate information regarding their products and they had a negative attitude towards the competitors' product(s).

Background: Health professionals are burn out syndrome prone occupational group. In Ethiopia there are limited evidences about burnout syndrome and work related determinant factors resulting in Burnout syndrome. Therefore, this study aimed to determine the prevalence of burnout syndrome and associated factors of burnout syndrome among health professionals working in university hospitals found in Sidama region and Southern Ethiopia 2023., Methods: An institution based multi-center cross-sectional study was conducted on 362 health professionals working in three university hospital from February 15 to February 30, 2023. Study participants were recruited using Simple random sampling technique. A standard self-administered Maslach Burn out Inventory questionnaire were used to collect data. Data entered into Epi-info version 7.2.5.0 and exported to stata version 17 for analysis. Multivariate logistic regression was used to identify factors associated with burnout syndrome and adjusted odds ratio with a 95% confidence interval were used to describe factors associated significantly. Variables with a P value of less than 0.05 were considered statistically significant., Result: A total of 362 health professionals were enrolled in the study with a response rate of 100%. The prevalence of burnout syndrome among health professionals was found to be 198 (54.7%) with a 95% CI of 49.51-59.77%. Alcohol dependence (AOR = 6.41, 95% CI = 2.37- 17.29), Sleep problem (AOR = 3.88, 95% CI = 2.33-6.46), poor social support (AOR = 4.71, 95% CI = 2.21-10.01) and intermediate social support (AOR = 2.41, 95% CI = 1.07-5.42) were factors significantly associated with burnout syndrome., Conclusion: This study revealed that a high proportion of health professionals working in university hospitals of sidama and southern part of Ethiopia suffer from burnout syndrome. Alcohol dependence, sleep problem, getting poor and intermediate social support were significantly associated predictor variable with burnout syndrome., Recommendation: Higher officials of university hospitals and human resource department should design strategies to reduce alcohol dependence, promote healthy sleep habit and advocate strong social support among health professionals., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was made by Hawassa University institutional review Board (IRB) with Ethical clearance reference number of IRB/181/15 and consent to participate was obtained from all the participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Globally, road traffic accidents are the eighth-leading cause of death for all age groups. The estimated number of road traffic deaths in low income countries was more than three times as high as in high-income countries. Africa had the highest rate of fatalities attributed to road traffic accidents. Ethiopia has the highest number of road traffic fatalities among Sub-Saharan African countries. The main objective of this study was to determine the incidence and predictors of mortality among road traffic victims admitted to hospitals in Hawassa City., Methods: A facility-based retrospective cohort study was conducted using secondary data from hospital records. A total of 398 road traffic accident victims admitted to selected hospitals in Hawassa city from January 2019 to December 2021 participated in the study. Data were analyzed using STATA version 14.1. The Cox regression model was used to determine the predictors of mortality. A hazard ratio with a 95% confidence interval and a cut-off value of P<0.05 was used to declare the risk and statistical significance, respectively., Result: The incidence rate of mortality for road traffic accident victims was 7.34 per 10,000 person-hours. The predictors of mortality were the value of GCS at admission <8 (aHR = 5.86; 95% CI: 2.00-17.19), GCS at admission 9-12 (aHR = 3.27; 95% CI: 1.28-8.40), the value of SBP at admission ≤89mmHg (aHR = 4.41; 95% CI: 2.22-8.77), admission to the ICU (aHR = 3.89; 95% CI: 1.83-8.28) and complications (aHR = 5.48; 95% CI: 2.74-10.01)., Conclusion: The incidence of mortality among road traffic victims admitted to hospitals in Hawassa city was high. Thus, thorough follow-up and intensive management should be given to victims with critical health conditions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ayele 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: Because of the multidrug resistance features of Acinetobacter baumannii, endurance to diverse conditions, and causing health fatalities in healthcare settings, the global health system is looking for the development of new antimicrobials for such bacteria. As the new antimicrobial drugs pipeline is running dry, it is imperative to look for eco-friendly bio-control strategies. In this regard, phages are one to combat the biofilm producer and MDR A. baumannii. Thus, the study aimed to isolate and examine the role of phages against biofilm producers and MDR A. baumannii from inanimate objects at Jimma Medical Center (JMC), Ethiopia., Method: Institution-based cross-sectional study was conducted from June to November 2019. A total of 309 swab samples were collected from inanimate objects and the environment in JMC. Isolation of A. baumannii, antimicrobial susceptibility testing, and biofilm detection were carried out according to standard protocol. Kirby Bauer disk diffusion and microliter plate were methods for AST and biofilm detection, respectively. Specific phage was isolated and characterized from sewage at JMC compound. The data were analyzed by SPSS version 25.0, and chi-square (X 2 ) cross-tabulation was used to determine the correlation of variables. A P-value of < 0.05 was considered a statistically significant association., Result: A. baumannii from inanimate objects and surfaces of different environments at JMC was detected in 6.5% of the samples. From 20 of the isolates, 85% were biofilm producers, and 60% were MDR. The lytic phage isolated specifically against A. baumannii was found host specific, and thermally stable ranging from 10-50°C. The phage was active against 42% of MDR A. baumannii, 40% of both biofilm-producing and MDR A. baumannii (MDRAB), and 35.3% of the biofilm-producing isolates., Conclusion: The good activity of phages towards MDRAB isolates, its biofilm degradation capability, thermal stability, and host specificity in our study encourages viewing the potential use of phages as a bio-control agent besides the routine cleansing agents. Therefore, we recommend isolation of specific phages in the eradication of MDRAB from health facilities with additional efforts to characterize in detail and assess their efficacy in animal models., (© 2023. The Author(s).)

Background: School closures in response to the COVID-19 impacted children's education, protection, and wellbeing. After understanding these impacts and that children were not super spreaders, countries including Ethiopia decided to reopen schools with specified preconditions. But when deciding to reopen schools, the benefits and risks across education, public health and socio-economic factors have to be evaluated. However, there was information gap on status of schools as per preconditions. Hence, this study was designed to investigate status of schools in Southern Ethiopia., Methods: School based cross-sectional study was conducted in October 2020 in Southern Ethiopia. Sample of 430 schools were included. National school reopening guideline was used to develop checklist for assessment. Data was collected by public health experts at regional emergency operation center. Descriptive analysis was performed to summarize data., Results: A total of 430 schools were included. More than two thirds, 298 (69.3%), of schools were from rural areas while 132 (30.7%) were from urban settings. The general infection prevention and water, sanitation and hygiene (IPC-WASH) status of schools were poor and COVID-19 specific preparations were inadequate to meet national preconditions to reopen schools during the pandemic. Total score from 24 items observed ranged from 3 to 22 points with mean score of 11.75 (SD±4.02). No school scored 100% and only 41 (9.5%) scored above 75% while 216 (50.2%%) scored below half point that is 12 items., Conclusion: Both the basic and COVID-19 specific IPC-WASH status of schools were inadequate to implement national school reopening preconditions and general standards. Some of strategies planned to accommodate teaching process and preconditions maximized inequalities in education. Although COVID-19 impact lessened due to vaccination and other factors, it is rational to consider fulfilling water and basic sanitation facilities to schools to prevent communicable diseases of public health importance., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Endriyas 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.)

Objectives: Malnutrition is very common among older adults. In rural Ethiopia, around 25% of women and 34% of men ≥65 y of age are malnourished. However, the risk factors for malnutrition among older adults in rural areas are not well understood. The aim of this study was to assess the level of malnutrition and associated factors among community-dwelling rural older adults in Fogera Zuriya district, Northwest Ethiopia., Materials: This was a community-based, cross-sectional study among randomly selected (N = 634) adults ≥65 y of age in Fogera Zuriya rural district. Participants were selected using a multistage sampling technique. A pretested full Mini-Nutritional Assessment (MNA) tool was used to classify as malnourished (MNA score <17), at risk for malnutrition (MNA score 17-23.5), or otherwise normal. A validated Geriatric Depression Scale form (15 items) was used to assess depression. Ordinal logistic regression was employed to identify factors of malnutrition and the PLUM procedure was used to produce an odds ratio (OR). P < 0.05 was considered statistically significant with the dependent variable. Both crude and adjusted ORs (COR and AOR, respectively) with a corresponding 95% confidence interval were computed., Results: This study included 634 older adults. According to the results of the study, the risk for malnutrition was 383 (60%), and being malnourished was 166 (268%). The following factors were significantly associated with the risk for malnutrition and malnutrition: • Age ≥85 y (AOR, 3.47; 95% CI, 1.270-9.465); • Skipping two meals daily (AOR, 6.36; 95% CI, 2.11-19.16); • Skipping 1 meal a day (AOR, 3.05; 95% CI, 1.82-5.12); • Having a poor appetite (AOR, 6.2; 95% CI, 2.50-15.36); • Being depressed (AOR, 4.04; 95% CI, 2.37-6.89); • Low physical activity (AOR, 3.81; 95% CI, 1.50-9.72); • Family size of three of less members (AOR, 1.9; 95% CI, 1.14-3.24); and • Low dietary diversity score (AOR, 1.91; 95% CI, 1.11-3.31) CONCLUSIONS: In this study, the prevalence of malnourished (26%) was almost higher than the national average in Ethiopia (21%). Older age, skipping a meal, poor appetite, depression, low physical activity, and low dietary diversity score were factors significantly associated with the risk for malnutrition and malnutrition. Along with this, improving diet and exercise should be a top priority. Maintaining continuing psychological support, social support, and a balanced family size within the community should be additional interventions., Competing Interests: Declaration of Competing Interest The author declares that they have no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Environmental chemicals are a persistent and pervasive part of everyday life. A subset of environmental chemicals are xenoestrogens, compounds that bind to the estrogen receptor (ER) and drive estrogen-related processes. One such chemical, benzophenone-3 (BP3), is a common chemical in sunscreen. It is a potent UV protectant but also is quickly absorbed through the skin. While it has been approved by the FDA, there is a renewed interest in the safety of BP3, particularly in relation to breast cancer. The focus of this study was to examine the impact that BP3 has on triple negative breast cancer (TNBC) through alterations to cells in the immune microenvironment. In this study, we exposed female mice to one of two doses of BP3 before injecting them with a TNBC cell line. Several immune endpoints were examined both in the primary tissues and from in vitro studies of T cell behavior. Our studies revealed that in the lung tumor microenvironment, exposure to BP3 not only increased the number of metastases, but also the total area of tumor coverage. We also found that BP3 caused alterations in immune populations in a tissue-dependent manner, particularly in T cells. Taken together, our data suggest that while BP3 may not directly affect the proliferation of TNBC, growth and metastasis of TNBC-derived tumors can be altered by BP3 exposures via the alterations in the immune populations of the tumor microenvironment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: Timing to get obstetric care is critical in preventing maternal death and disability. Maternal third delay, the delay in receiving care after reaching health facilities, involves factors related to organization, quality of care, patient referral, and availability of staff and equipment. However, data is limited on maternal third delay and its associated factors at higher health facilities in Ethiopia., Objective: This study is aimed at assessing the magnitude of maternal third delay and associated factors among women admitted for emergency obstetric care in public hospitals in Sidama Regional State, Ethiopia, 2021., Methods: An institution-based cross-sectional study was conducted from September to November 2021. Face-to-face interview with a structured questionnaire and data extraction from medical charts were carried out in selected 542 women (using systematic sampling method). The collected data were coded and entered using EpiData, and bivariable and multivariable logistic regression analyses were done using SPSS version 25. Statistical significances were declared at p value less than 0.05., Results: Maternal third delay was identified among 29.3% (95%CI = 25.2 - 33.5) of the respondents. Additionally, women who arrived with a referral from other health facilities (AOR = 0.311, 95%CI = 0.181 - 0.534), well prepared for birth and its complications (AOR = 2.418, 95%CI = 1.51 - 3.869), self-employed (AOR = 0.223, 95%CI = 0.122 - 0.409), being a government employee (AOR = 0.157, 95%CI = 0.063 - 0.396), having ANC follow-up (AOR = 2.795, 95%CI = 1.318 - 5.928), and absence of health professional (AOR = 4.63, 95%CI = 2.857 - 7.50) were significantly associated with maternal third delay., Conclusion: This study identified that maternal third delay was high, which indicates that women have not received emergency obstetric care in the recommended time range after they arrived at the health facilities., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2023 Esuyawkal Mislu et al.)

Plant-microbe interactions are a phenomenal display of symbiotic/parasitic relationships between living organisms. Plant growth-promoting rhizobacteria (PGPR) are some of the most widely investigated plant-beneficial microbes due to their capabilities in stimulating plant growth and development and conferring protection to plants against biotic and abiotic stresses. As such, PGPR-mediated plant priming/induced systemic resistance (ISR) has become a hot topic among researchers, particularly with prospects of applications in sustainable agriculture. The current study applies untargeted ultra-high performance liquid chromatography-high-definition mass spectrometry (UHPLC-HDMS) to investigate PGPR-based metabolic reconfigurations in the metabolome of primed wheat plants against Puccinia striiformis f. sp. tricti ( Pst ). A seed bio-priming approach was adopted, where seeds were coated with two PGPR strains namely Bacillus subtilis and Paenibacillus alvei (T22) and grown under controlled conditions in a glasshouse. The plants were infected with Pst one-week post-germination, followed by weekly harvesting of leaf material. Subsequent metabolite extraction was carried out for analysis on a UHPLC-HDMS system for data acquisition. The data was chemometrically processed to reveal the underlying trends and data structures as well as potential signatory biomarkers for priming against Pst . Results showed notable metabolic reprogramming in primary and secondary metabolism, where the amino acid and organic acid content of primed-control, primed-challenged and non-primed-challenged plants were differentially reprogrammed. Similar trends were observed from the secondary metabolism, in which primed plants (particularly primed-challenged) showed an up-regulation of phenolic compounds (flavonoids, hydroxycinnamic acids-HCAs- and HCA amides) compared to the non-primed plants. The metabolomics-based semi-quantitative and qualitative assessment of the plant metabolomes revealed a time-dependent metabolic reprogramming in primed-challenged and primed-unchallenged plants, indicating the metabolic adaptations of the plants to stripe rust infection over time., Competing Interests: Author FT was employed by company Omnia Group, Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mashabela, Tugizimana, Steenkamp, Piater, Dubery, Terefe and Mhlongo.)

Background: In several African nations, including Ethiopia, improving mother and child health is a top public health concern. Unfortunately, there is a dearth of study on pregnant women in Ethiopia who concomitantly utilize pharmaceutical drugs and medicinal plants. Hence, the objective of this research was to assess the concomitant use of pharmaceutical drugs and medicinal plants among pregnant women in Southern Ethiopia in 2021., Methods: A community-based cross-sectional study was conducted among systematically selected 400 pregnant women in Shashamane town, Southern Ethiopia, from July 1-30/2021. An interviewer-administered structured questionnaire was used to collect data. Binary logistic regression was performed to examine the association between a dependent variable and independent variables., Results: According to this study, among those who self-medicated, 90 (22.5%) reported using at least one pharmaceutical drug, while 180 (45%) reported using at least one medicinal plant. Moreover, 68 (17%) of the participants who had taken drugs while pregnant also used pharmaceutical drugs and medicinal plants concomitantly. Having a medical condition during pregnancy (AOR = 5.6, 95% CI: 2.7-11.6), not having ANC follow up (AOR = 2.9, 95% CI: 1.3-6.2), gestational age (AOR = 4.2, 95% CI: 1.6-10.7), and not having a formal education (AOR = 4.2, 95% CI: 1.3-13.4) were all significantly associated with concomitant use of pharmaceutical drugs and medicinal plants during pregnancy., Conclusion: This study showed that nearly one in five pregnant women used medicinal plants concomitantly with pharmaceutical drugs. Mother's educational status, medical illness during pregnancy, having ANC follow up and gestational period were significantly associated with concomitant use of medicinal plants and pharmaceutical drugs. Therefore, health care providers and concerned stakeholders should consider these factors to minimize the risks associated with drug use during pregnancy on both mother and fetus., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors.)

Background: Postpartum family planning is defined as the prevention of unintended pregnancy and closely spaced pregnancies through the first twelve months following childbirth. The immediate postpartum period is particularly favorable time to provide long-acting reversible contraception methods; and postpartum provision is safe and effective. Despite the advantages of long acting reversible contraception methods, they may be infrequently used in Ethiopia., Objective: This study assessed the prevalence and associated factors of long-acting reversible contraceptive methods utilization among counseled mothers in immediate postpartum period., Methods: A cross-sectional study was conducted on 393 women who gave birth at Jimma University Medical Centre from 12 November 2016 to 21 January 2017, Ethiopia. Data were collected by face-to-face interview using pre-tested structured questionnaire and by record reviewing using data compiling form; and analyzed using SPSS version 20. Logistic regression was used to identify associated factors for long acting contraceptive methods use. P-value less than 0.05 at 95% confidence level was taken as significance level., Results: Prevalence of reversible long acting contraceptive methods utilization among immediate postpartum mothers was 53.2% (209/393) and more than three-fourths (78.0%) of participants used implanon. The most common reported reason for not using reversible long acting contraceptive methods was preference of other contraceptive methods like short acting contraceptives (25.5%). Having more than four alive kids (AOR 2.6, 95% CI: 1.15,5.95), high monthly income (≥1000 ETB) (AOR 2.4, 95% CI: 1.08,7.20), planning to delay next pregnancy by more than 2 years (AOR 4.0, 95% CI: 1.60,9.28), mothers with no fertility desire (AOR 2.0, 95% CI: 1.12,3.15), prior use of reversible long acting contraceptive methods (AOR 3.0, 95% CI: 1.30,7.20) and receiving counseling during antenatal care follow-up and before delivery (AOR 2.0, 95% CI: 1.01, 4.73) were associated with immediate postpartum reversible long acting contraceptive methods use., Conclusion and Recommendations: Although the prevalence of reversible long acting contraceptive methods utilization in immediate postpartum was high, counseling mothers during ANC follow-up and before delivery can further increase its utilization. Therefore, the need for providing counseling during ANC follow up and before delivery to increase utilization of immediate postpartum reversible long acting contraceptive methods use is emphasized., (© 2022. The Author(s).)

Background: Moringa stenopetala is used for medicinal and nutritional purposes. This study was, therefore, conducted to assess the contribution of Moringa stenopetala based diet in reducing under nutrition in under-five children in four districts of Southern Ethiopia., Method: A community-based comparative cross-sectional study design was employed from August to September 2016 in randomly selected comparative sites among 732 under five children. Anthropometric measurements of weight and height of children were measured based on the standard measurement protocol. Regarding moringa stenopetala diet, the consumption habit was collected by using a seven days food frequency questionnaire. Amount of moringa stenopetala leaf biomass portion size consumption was measured with local measurement and converted to kilograms. Anthropometric data were analyzed using WHO Anthro software to determine the nutritional status of the child. An independent t-test was conducted to compare the mean difference of WHO-Z score of child nutritional index. Statistical mean significance difference was measured based on p-value less than 0.05 with 95% confidence level. In addition chi-square test with a p-value, less than 0.05 with a 95% confidence level was used to compare the prevalence of stunting, wasting, and underweight in moringa stenopetala based diet and non- moringa stenopetala based diet consuming area., Result: The prevalence of stunting was 19% vs. 28.8%, wasting 4.7% vs. 9.6%, and underweight 12.19% vs 13.71% in moringa stenopetala based diet consuming and non-consuming participants respectively. There was a significant difference in stunting and wasting (p < 0.05) among moringa stenopetala based diet-consuming and non-consuming participants. Conclusion: The present study showed that moringa stenopetala based diet consumption had a significant contribution in reducing under-nutrition in under-five children., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors.)

The design and evaluation of national HIV programs often rely on aggregated national data, which may obscure localized HIV epidemics. In Ethiopia, even though the national adult HIV prevalence has decreased, little information is available about local areas and subpopulations. To inform HIV prevention efforts for specific populations, we identified geographic locations and drivers of HIV transmission. We used data from adults aged 15-64 years who participated in the Ethiopian Population-based HIV Impact Assessment survey (October 2017-April 2018). Location-related information for the survey clusters was obtained from the 2007 Ethiopia population census. Spatial autocorrelation of HIV prevalence data were analyzed via a Global Moran's I test. Geographically weighted regression analysis was used to show the relationship of covariates. The finding indicated that uncircumcised men in certain hotspot towns and divorced or widowed individuals in hotspot woredas/towns might have contributed to the average increase in HIV prevalence in the hotspot areas. Hotspot analysis findings indicated that, localized, context-specific intervention efforts tailored to at-risk populations, such as divorced or widowed women or uncircumcised men, could decrease HIV transmission and prevalence in urban Ethiopia., Competing Interests: The authors have declared that no competing interests exist.

Background: In Ethiopia, the proportion of older adults is steadily increasing. This rapidly growing older adult population may increase the burden of malnutrition. However, malnutrition among older adults, particularly those living in rural areas, is regularly underrecognized and/or ignored. There have been no studies among older adults in the Metu district that have used the Min nutritional assessment (MNA). As a result, the purpose of this study is to determine the prevalence of malnutrition and its associated factors among older adults in Metu district, Southwest Ethiopia., Methods: A community-based comparative cross-sectional study was conducted from May to June 2021 in Metu district. A multi-stage stratified sampling technique was employed. The nutritional status of the older adults was measured by MNA. Data from 616 older adults (308 from urban and 308 from rural residences) was collected through face-to-face interviews using a structured questionnaire. Bivariable and multivariable logistic regression analyses were done to identify factors associated with malnutrition., Results: According to this study, the overall prevalence of malnutrition in Metu district was 17.5% (95% CI: 14.4%-20.7%). The prevalence of malnutrition in urban and rural residences was 9.9% and 25.2%, respectively. In the overall study, insomnia (AOR: 2.0, 95%CI: 1.1-3.7), residence (AOR: 3.47, 95%CI: 1.8-6.5), and smoking (AOR: 3.7, 95%CI: 2.1-6.7) were associated with malnutrition. In urban residences, depression (AOR: 3.4, 95%CI: 1.2-9.5), dietary diversity score (DDS) (AOR: 3.5, 95%CI: 1.2-10.0), and eating problems (AOR: 2.8, 95%CI: 1.1-7.3) were associated with malnutrition. In rural residence, age (AOR:3.8; 95%CI: 1.2-11), sex (AOR:2.2,95%CI:1.0-4.8), DDS (AOR:5.4,95%CI:2.2-13.3), depression (AOR: 4.6,95%CI:2.2-9.2), and chronic disease (AOR: 3.8 95%CI: 1.8-8.2) were associated with malnutrition., Conclusions and Recommendations: Malnutrition was more prevalent among older adults living in rural areas than in urban areas. In the overall study, insomnia, residence, and smoking were significantly associated with malnutrition. DDS, depression, and eating difficulties were significantly associated with malnutrition among older adults living in urban areas, whereas sex, age, depression, chronic disease, and dietary diversity were factors influencing malnutrition in rural areas. Strengthening strategies aimed at addressing nutrition policy, as well as paying attention to the nutritional needs of the older adult population, can help to improve the health and quality of life of older adults., (© 2022. The Author(s).)

Introduction: iodine deficiency remains a foremost public health problem in developing countries. About 66 million populations were at risk from iodine deficiency, 28 million people suffer from goiter and more than 50,000 prenatal deaths are related to iodine deficiency each year in Ethiopia. Besides, studies from different parts of Ethiopia have shown that a low proportion of households use adequate iodine concentration and varied from one household to another. Despite increased coverage, the quality of available salt is poor. To ensure safe and effective levels of iodine consumption, monitoring the levels of iodine in salt and the iodine status of the population is critical. However, kinds of literature are scant in Ethiopia particularly; no study is conducted in the current study area. Thus, the study aimed to determine the iodine content of salt and associated factors at the household level in Bahir Dar Town, Northwest Ethiopia., Methods: a community based cross-sectional study design was carried out in Bahir Dar Town from September to October 2015. A multi-stage sampling technique was used to select 706 study participants. A pre-tested, structured questionnaire and laboratory were used to collect data. A laboratory test, gold standard iodometric titration method was used to measure individual availability of adequately iodized salt. Multivariable logistic regression analysis was fitted to identify factors associated with the content of iodine. Adjusted Odds Ratio (AOR) with corresponding 95% confidence interval was computed to show the strength of association. In multivariable analysis, a p-value of <0.05 was used to declare statistical significance., Results: a total, of 690 participants were included in the study. About 70.1% (95%CI: 63.41, 76.76) of the households were used adequate iodized salt (≥15 ppm). The result of the multivariate analysis revealed that respondents with secondary school (AOR=3.05; 95%CI: 1.51,6.18), age 30-44 years (AOR=1.99; 95%CI: 1.08,3.69), good knowledge (AOR=3.34; 95% CI: 2.09,5.32) and being in the highest wealth status (AOR=4.35,95% CI: 2.43,7.8) had higher odds of availability of adequately iodized salt at the household compared to the counterpart. Besides, using covered salt (AOR=6.10, 95% CI: 3.78, 9.87) and storing salt in a dry place (AOR=4.17; 95% CI: 2.21, 7.86) were positively associated with the availability of adequately iodized salt., Conclusion: the availability of adequately iodized salt in the household is still low. Further institutionalizing iodized salt regulation and awareness creation will require to improve safe iodine consumption through the community., Competing Interests: The authors declare no competing interest., (Copyright: Temesgen Mersha et al.)

Introduction: In 2014, the Joint United Nations Programme on HIV/AIDS set an 'ambitious' 90-90-90 target for 2020. By 2016, there were disparities observed among countries in their progress towards the targets and some believed the targets were not achievable. In this report, we present the results of data from the Ethiopia Population-based HIV Impact Assessment survey analyzed to assess progress with the targets and associated factors., Methods: We conducted a nationally representative survey in urban areas of Ethiopia. Socio-demographic and behavioural data were collected from consenting participants using a structured interview. HIV testing was done following the national HIV rapid testing algorithm and seropositivity confirmed using a supplemental laboratory assay. HIV viral suppression was considered if the viral load was <1,000 RNA copies/ml. Screening antiretroviral drugs was done for efavirenz, lopinavir, and tenofovir, which were in use during the survey period. In this analysis, we generated weighted descriptive statistics and used bivariate and logistic regression analysis to examine for associations. The 95% confidence interval was used to measure the precision of estimates and the significance level set at p<0.05., Results: Of 19,136 eligible participants aged 15-64 years, 614 (3% [95% CI: 0.8-3.3]) were HIV-positive, of which 79.0% (95% CI: 4.7-82.7) were aware of their HIV status, and 97.1% (95% CI: 95.0-98.3 were on antiretroviral therapy, of which 87.6% (95% CI: 83.9-90.5) achieved viral load suppression. Awareness about HIV-positive status was significantly higher among females (aOR = 2.8 [95% CI: 1.38-5.51]), significantly increased with age, the odds being highest for those aged 55-64 years (aOR = 11.4 [95% CI: 2.52-51.79]) compared to those 15-24 years, and was significantly higher among those who used condom at last sex in the past 12 months (aOR = 5.1 [95% CI: 1.68-15.25]). Individuals with secondary education and above were more likely to have achieved viral suppression (aOR = 8.2 [95% CI: 1.82-37.07]) compared with those with no education., Conclusion: Ethiopia made encouraging progress towards the UNAIDS 90-90-90 targets. The country needs to intensify its efforts to achieve the targets. A particular focus is required to fill the gaps in knowledge of HIV-positive status to increase case identification among population groups such as males, the youth, and those with low education., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests. None of the authors have any conflict on interest.

Background: TB (tuberculosis) is an infectious disease affecting millions of people worldwide; globally, an estimated 10 million people developed TB disease in the past two years; and there were an estimated 1.4 million TB deaths. In Ethiopia, the burden of TB is ranked third and seventh in Africa and the world, respectively. Hence, studies are limited to solving many of the problems related to undernutrition. Therefore this study aimed to assess the prevalence and associated factors of undernutrition among adult TB patients attending Amhara National Regional State hospitals, Northwest Ethiopia., Methods: A cross-sectional study was conducted in the TB clinics of Amhara Regional State Referral hospitals from March to April 2020. A total of 405 TB patients participated in the study. Proportional allocation and Systematic random sampling were employed to get representative study participants. The outcome variable, undernutrition, was determined by using Body Mass Index (BMI). Interviewer administered structured questionnaire, anthropometric measurements and patients' document review were done. Bivariable and multivariable logistic regressions were done to identify factors associated with undernutrition. Crude odds ratios (COR) and adjusted odds ratios (AOR) with 95% confidence intervals and P-values < 0.05 were employed to declare the significance and strength of association., Results: The prevalence of under nutrition was 42.2% [95%CI: 32.8, 51.6]. The mean (±SD) BMI was 19.30(±2.83). The odds of undernutrition was higher among TB patients with poor wealth status [AOR = 2.39, 95%CI; 1.19, 4.79], alcohol consumption [AOR = 1.57; 95%CI, 1.01, 2.47], bedridden [AOR = 3.02, 95%CI; 1.21, 7.50] and ambulatory patient [AOR = 2.11, 95%CI; 1.36, 3.26]. Furthermore, being farmer [AOR = 2.59;95%CI,1.08,6.20], housewife [AOR = 2.72;95%CI,1.22,6.06] and unemployed [AOR = 2.46;95%CI,1.18,5.13] were significantly associated with undernutrition., Conclusion and Recommendations: This study illustrated that a considerably high proportion of TB patients were undernourished in Amhara regionals state referral hospitals. Behavioral and socio-economic characteristics were significantly associated with undernutrition. Therefore, nutritional and social support activities are essential for TB patients, particularly those who are socio-economically disadvantaged. Regular nutritional screening and management, as well as behavioral interventions, should be strengthened., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Published by Elsevier Ltd.)