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Asrat Wolde,1 Yonas Tesfaye,2 Yimenu Yitayih2 1Department of Psychiatry, Colleague of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, Ethiopia; 2Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, EthiopiaCorrespondence: Asrat WoldeDepartment of Psychiatry, Colleague of Medicine and Health Sciences, Mizan Tepi University, Mizan Aman, EthiopiaTel +251916389179Email Asratwolde2017@gmail.comBackground: Psychopathy is an emerging health and behavioral problem worldwide. Psychopathy is linked to risk substance use, maltreatment, violence, crime, and reoffending, but little is known about psychopathy in low income countries like Ethiopia. Therefore, we assessed the prevalence and factors associated with psychopathy among newly-admitted prisoners in Bench Sheko and West Omo zone correctional center, Mizan Aman, Ethiopia.Methods: A cross-sectional study was conducted from April 20 to July 19, 2019, among 411 (N=422) newly-admitted Bench Sheko and West Omo zone correctional center prisoners by using a consecutive sampling technique. A semi-structured and interviewer administered psychopathy checklist revised tool was used for screening psychopathy. WHO, ASSIST tool was used for screening risk use of khat, tobacco, and alcohol. Trauma, maltreatment, and social support were assessed with a life event checklist, adverse life experience screening tool, and Oslo social support scale, respectively. In addition, Criminal and clinical history of the prisoner was also assessed. The data was entered into Epi-data 3.1 and exported to Statistical Package for Social Science (SPSS) Version 21 for statistical analysis. A logistic regression model was used. Variables with a p-value less than 0.05 in the final fitting model were declared as independent predictors of psychopathy.Results: The prevalence of psychopathy was 24.3%. Childhood maltreatment (AOR=6, 95% CI=2.2– 17.5), risky khat use (AOR=4.6, 95% CI=2.4– 8.7), poor social support (AOR=3.5, 95% CI=1.9– 6.6), family history of imprisonment (AOR=3, 95% CI=1.5– 6), history of trauma (AOR=2.3, 95% CI=1.1– 4.8), and reoffending (AOR=2, 95% CI=1.1– 3.8) were positively associated variables with psychopathy.Conclusion: Psychopathy is highly prevalent among newly-admitted prisoners. Integrated efforts involving relevant stakeholders are needed to design strategies for early screening of psychopathy to prevent reoffending, and management of risk substance use at admission is crucial.Keywords: psychopathy, prisoners, crime, khat use, Ethiopia

Background: Multidrug-resistant (MDR) bacteria have significantly affected the management and treatment of wound infections globally. Data on the prevalence of MDR bacterial profiles that cause wound infections in Ethiopia are scarce. Therefore, this study aimed to determine MDR as well as extended-spectrum beta-lactamase production profiles of Gram-negative rods that are difficult to treat with conventional antibiotics and that cause wound infections. Objective: The aim of the study was to determine the prevalence of extended-spectrum beta-lactamase producer Gram-negative rods and associated factors among patients with wound infection at University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia. Materials and Methods: This hospital-based cross-sectional study was conducted at University of Gondar Comprehensive Specialized Hospital between May and July 2022. Convenience sampling was used to recruit 228 participants. Swabs from different wound types were inoculated onto the MacConkey agar and blood agar plates and incubated overnight at 37°C for 24 h. Biochemical tests were performed on isolated colonies for the identification of bacterial species based on their biochemical reaction. Antimicrobial susceptibility tests were performed using the disk diffusion technique as per the standard Kirby-Bauer method by using Muller-Hinton agar, and the zone of inhibition was interpreted as resistant, intermediate, and sensitive as per the recommendation of Clinical Laboratory Standard Institute. Isolates were tested against ceftriaxone, cefotaxime, and ceftazidime for extended-spectrum beta-lactamase screening using the Kirby-Bauer disk diffusion method, and combined disk tests were applied for phenotypic confirmatory test of extended-spectrum beta-lactamase producing isolates. Result: Of 228 study participants, 162 (71.1%) were culture-positive. Among culture-positive patients, 165 Gram-negative bacteria were recovered. The most common Gram-negative isolates were Pseudomonas aeruginosa (47; 28.5%), followed by Escherichia coli (43; 26.1%) and Klebsiella pneumoniae (24; 14.5%). The susceptibility rates of the isolate for imipenem and tobramycin were 97.0% and 73.2%, respectively, and the overall multidrug resistance rate was 80.5%. Extended-spectrum beta-lactamase producer bacteria were also isolated. Besides, all (100%) of extended-spectrum beta-lactamase producer bacteria were MDR. Living in rural areas (AOR 5.8; 95% CI [2.01-16.7]), hospital admission (AOR 3.95; 95% CI [1.13-13.83]), antibiotic use (AOR 2.83; 95% CI [1.03-7.72]), and comorbidity (AOR 0.25; 95% CI [0.07-0.59]) were significantly associated with wound infection. Conclusions and Recommendations: There was a high prevalence of Gram-negative bacterial isolates in this study . Pseudomonas aeruginosa (28.5%) was the predominant isolate. In addition, high rates of multidrug resistance were observed. The high level of multidrug resistance in this study implies that definitive therapy should be based on culture and susceptibility analysis to promote the rational use of antibiotics and to reduce the emergence of bacterial resistance to antimicrobials., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Sara Tesfaye et al.)

Background : Globally, rotavirus (RV) A (RVA) is the most common cause of severe and sometimes fatal diarrhea in young children. It is also the major cause of acute gastroenteritis among children in Ethiopia. Currently, the WHO has prequalified four RVA vaccines for universal childhood immunization. Ethiopia introduced the monovalent Rotarix vaccine into its national immunization program in 2013. Since then, only a few studies on the burden and genotype distribution of RVA infection post-vaccine introduction have been conducted (mostly at sentinel surveillance sites). Therefore, this study aimed to assess RVA prevalence and genotype distribution among children under five years in Ethiopia (February 2021-December 2022). Methods : This multi-center hospital-based cross-sectional study involved 537 diarrheic children under-five years old. Rotavirus A detection was conducted using a one-step reverse-transcriptase polymerase chain reaction (RT-PCR). Genotyping was conducted by Sanger sequencing of the VP7 (complete) and VP4 (partial) genes. Descriptive analysis and Pearson's chi-squared test were carried out using SPSS version 29. Phylogenetic analysis with 1000 bootstrap replicates was performed using MEGA version 11 software. Statistical significance was set at p < 0.05 for all analyses. Results : The prevalence of RVA infection among diarrheic children was 17.5%. The most prevalent G-types identified were G3 (37%), the previously uncommon G12 (28%), and G1 (20%). The predominant P-types were P[8] (51%), P[6] (29%), and P[4] (14%). The three major G/P combinations observed were G3P[8] (32.8%), G12P[6] (28.4%), and G1P[8] (19.4%). Phylogenetic analysis revealed clustering of Ethiopian strains with the globally reported strains. Many strains exhibited amino acid differences in the VP4 (VP8* domain) and VP7 proteins compared to vaccine strains, potentially affecting virus neutralization. Conclusions : Despite the high RVA vaccination rate, the prevalence of RVA infection remains significant among diarrheic children in Ethiopia. There is an observable shift in circulating RVA genotypes from G1 to G3, alongside the emergence of unusual G/P genotype combinations such as G9P[4]. Many of these circulating RVA strains have shown amino acid substitutions that may allow for neutralization escape. Therefore, further studies are warranted to comprehend the emergence of these unusual RVA strains and the diverse factors influencing the vaccine's diminished effectiveness in developing countries.

Background: Cholera is an acute infectious disease caused by ingestion of contaminated food or water with Vibrio cholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. The aim of this study was to assess the prevalence and antimicrobial susceptibility pattern of V. cholerae from cholera outbreak sites in Ethiopia., Methods: Across-sectional study was conducted from May 2022 to October 2023 across different regions in Ethiopia: Oromia National Regional State, Amhara National Regional State and Addis Ababa City Administration. A total of 415 fecal samples were collected from the three regions. Two milliliter fecal samples were collected from each study participants. The collected samples were cultured on Blood Agar, MacConkey Agar and Thiosulfate Citrate Bile Salt Sucrose Agar. A series of biochemical tests Oxidase test, String test, Motility, Indole, Citrate, Gas production, H 2 S production, Urease test were used to identify V. cholerae species. Both polyvalent and monovalent antisera were used for agglutination tests to identify and differentiate V. cholerae serogroup and serotypes. In addition, Kirby-Bauer Disk diffusion antibiotic susceptibility test method was done. Data were registered in epi-enfo version 7 and analyzed by Statistical Package for Social Science version 25. Descriptive statistics were used to determine the prevalence of Vibrio cholerae. Logistic regression model was fitted and p-value < 0.05 was considered as statically significant., Results: The prevalence of V. cholerae in the fecal samples was 30.1%. Majority of the isolates were from Oromia National Regional State 43.2% (n = 54) followed by Amhara National Regional State 31.2% (n = 39) and Addis Ababa City Administration 25.6% (n = 32). Most of the V. cholerae isolates were O1 serogroups 90.4% (n = 113) and Ogawa serotypes 86.4% (n = 108). Majority of the isolates were susceptible to ciprofloxacin 100% (n = 125), tetracycline 72% (n = 90) and gentamycin 68% (n = 85). More than half of the isolates were resistant to trimethoprim-sulfamethoxazole 62.4% (n = 78) and ampicillin 56.8% (n = 71). In this study, participants unable to read and write were about four times more at risk for V. cholerae infection (AOR: 3.8, 95% CI: 1.07-13.33). In addition, consumption of river water were about three times more at risk for V. cholerae infection (AOR: 2.8, 95% CI: 1.08-7.08)., Conclusion: our study revealed a high prevalence of V. cholerae from fecal samples. The predominant serogroups and serotypes were O1 and Ogawa, respectively. Fortunately, the isolates showed susceptible to most tested antibiotics. Drinking water from river were the identified associated risk factor for V. cholerae infection. Protecting the community from drinking of river water and provision of safe and treated water could reduce cholera outbreaks in the study areas., (© 2024. The Author(s).)

Background: Feeding the world's future population while still facing a variety of socioeconomic and climate change scenarios with uncertain outcomes is a key global societal concern that should be addressed in a science-based manner. Ethiopia boasts a great diversity of wild edible plant species (WEPS), but millions of its citizens still suffer from chronic hunger every year. In this context, we here document the use and conservation of WEPS in the Awi Agäw community, Northwestern Ethiopia., Methods: We performed a cross-sectional study from October 2021 to June 2022. Ethnobotanical and conservation status data were collected via semi-structured interviews, focus group discussions, field walks and market surveys. A total of 374 respondents from three districts (Guangua, Jawi and Ankasha) were purposely selected for the study. Descriptive statistics, including preference rankings, frequencies and direct matrix rankings, were employed for the data analysis., Results: We identified a total of 39 WEPS plant taxa distributed among 26 families and 32 genera. The Moraceae and Rosaceae had the greatest numbers of plants, with five and three species, respectively. The WEPS are regularly consumed in the study area to alleviate hunger. However, threats such as habitat loss, agricultural expansion, deforestation for firewood and other reasons, and pesticide use threaten WEPS availability., Conclusion: Therefore, community-based conservation interventions need to be encouraged to safeguard WEPS and associated traditional knowledge. Furthermore, nutritional quality analysis is recommended for the selection of promising WEPS candidates., (© 2024. The Author(s).)

Background: Traditional healers are in the front line to give the mental healthcare service in developing countries like Ethiopia. In Ethiopia, different studies were done focusing on the role of traditional medicine and perception of the community toward traditional medicine. However, there is paucity of studies, which shows the level of mental health literacy among traditional healers. Therefore, this study intended to mental health literacy level of traditional healers in Jimma town, Ethiopia., Method: A community-based cross-sectional study design was employed among 310 participants. To select the participants from Jimma town, a stratified random sampling method was utilized from August 1 to September 30, 2020. The Mental Health Literacy Questionnaire was used to assess mental health literacy for assessment of mental health literacy among traditional healers. The collected data were coded and entered into EpiData version 4.6 and exported to SPSS version 25.0 for analysis. Bivariate and multivariable linear regression was used for data analysis., Result: The finding of this study showed that the samples of traditional healers found in Jimma town scored a total mean of 95.91 ± 3.0025 for mental health literacy. Age [β = -0.052 (95% CI: -0.078, -0.026)], year of experience [β = 0.095 (95% CI: 0.067, 0.123)], family history of mental illness [β = 1.709 (95% CI: 0.543, 2.360)], history of professional help seeking on mental illness [β = 0.501 (95% CI: 0.715, 2.288)], history of getting information of mental illness on media [β = 0.941 (95% CI: 0.345, 1.538)], training on mental health [β = 2.213 (995% CI: 1.520, 2.906)], history of treating mental illness [β = 1.676 (95% CI: 0.808, 2.544)], and informal education [β = -1.664 (95% CI: -2.081, -1.247)] were factors significantly associated with MHL., Conclusion: The mental health literacy of traditional healers mean score is lower than the mean score of other studies. Age, year of experience, training on mental illness, family history, history of professional help seeking, history of treating mental illness, information on mental illness, and informal education are significantly associated with mental health literacy. Therefore, structured training is very important to improve their level of mental health literacy., 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. The reviewer CK declared a shared affiliation with the author YS to the handling editor at the time of review., (Copyright © 2024 Mideksa, Tesfaye, Yitayih, Sime, Aliye and Gizaw.)

Rotavirus is the leading cause of morbidity and mortality due to acute gastroenteritis among children under five years globally. Early diagnosis of rotavirus infection minimizes its spread and helps to determine the appropriate management of diarrhea. The aim of this study was to evaluate the performance of EpiTuub® Fecal Rotavirus Antigen Rapid Test Kit for the diagnosis of rotavirus infection among diarrheic children under five years in Ethiopian healthcare settings. A total of 537 children with diarrhea were enrolled from three referral hospitals in Amhara National Regional State, Ethiopia. The samples were tested using one-step RT-PCR and EpiTuub® Fecal Rotavirus Antigen Rapid Test Kit (KTR-917, Epitope Diagnostics, San Diego USA) in parallel. Diagnostic performance of the rapid test kit was evaluated using the one-step RT-PCR as a gold standard. The sensitivity, specificity, and predictive values of the rapid test kit were determined. Moreover, the agreement of the rapid test kit with one step RT-PCR was determined by kappa statistics and receiver operators' curve (ROC) analysis was done to assess the overall diagnostic accuracy of the rapid test kit. Fecal Rotavirus Antigen Rapid Test Kit has shown a sensitivity of 75.5% and specificity of 98.2%. The kit was also found to have 89.9% and 95.0% positive and negative predictive values, respectively. The Fecal Rotavirus Antigen Rapid Test Kit has shown a substantial agreement (78.7%, p = 0.0001) with one-step RT-PCR. The overall accuracy of the Fecal Rotavirus Antigen Rapid Test Kit was excellent with the area under the ROC curve of 86.9% (95% CI = 81.6, 92.1%) (p = .0001). Thus, Fecal Rotavirus Antigen Rapid Test is a sensitive, specific, user-friendly, rapid, and equipment-free option to be used at points of care in Ethiopian health care settings where resource is limited precluding the use of one step RT-PCR. Furthermore, the kit could be used in the evaluation and monitoring of rotavirus vaccine effectiveness in the aforementioned settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Introduction: Data on colorectal cancer (CRC) patients' thorough management practices and medication-related harms (MRH) are scarce. This study's aim was to investigate the MRHs in patients receiving CRC chemotherapy at the comprehensive specialized hospital of the University of Gondar (UoGCSH)., Methods: A registry-based retrospective cohort study was conducted on CRC patients at the UoGCSH during 2017-2021. From February to May 2022, medical records were reviewed using a pretested data collection tool to collect socio-demographic and disease-related characteristics, MRHs, and medication regimens. MRHs occurrence and adverse drug reactions (ADRs) severity were assessed using standard guidelines and protocols. Version 16/MP of STATA for Windows was used for the analysis. Independent predictors of MRHs were investigated using logistic regression analysis. A p-value ≤0.05 was used to determine an independent variable's statistical significance., Results: One hundred forty three CRC patients were included, with a mean age of 49.9 ± 14.5 years. About 32.9% and 33.6% had stage II and III cancer, respectively. Significant patients had co-morbidities (15.4%) and complications (13.3%). Fluorouracil (5-FU)-based regimens were given to more than half (56%) of the patients. MRHs were found in 53.1% of the patients, with a mean of 2.45 ± 1.37 MRHs. The most common MRHs were the need for additional drug therapy, sub-therapeutic dose, DDIs, and ADRs. Being on stage IV (AOR = 27.7, 95% CI = 3.85-199.38, p = 0.001), having co-morbidity (AOR = 7.42, 95% CI = 1.80-30.59, p = 0.018) and having complication (AOR = 11.04, 95% CI = 1.72-70.95, p = 0.011) and treated with five or more drugs (AOR = 2.54, 95% CI = 1.07-6.07, p = 0.035) were independent predictors of MRHs., Conclusion: A fluorouracil-based treatment regimen was most frequently used. MRHs were found in nearly half of CRC patients. Furthermore, MRHs were significantly associated with cancer stage, comorbidity and complication status, and the number of medications used. Because MRHs are common, improving clinical pharmacy services is critical for optimizing drug therapy in CRC patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kefale, Engidaw, Tesfa, Molla, Kefale and Tafere.)

Background: Dry evergreen montane forests of Ethiopia provide economic and ecological services for the community but it is under several threats of natural and anthropogenic disturbances. The study aimed to investigate the floristic composition, species diversity, and plant community distribution of Guard forest along environmental gradients., Methods: A systematic sampling technique was used to collect vegetation and environmental data. Fifty eight plots each with 400 m 2 (20 m X 20 m) were established for trees and shrubs and 2 m x2m (4 m 2 ) for herbs along eleven transect lines. Shannon Weiner diversity index and evenness were used to assess the species diversity and richness. The similarities among plant communities were computed using Sorenson's similarity index. The plant community types and vegetation-environment relationships were analyzed using hierarchical cluster analysis and Canonical correspondence analysis (CCA) in R software, respectively., Results: A total of 137 plant species belonging to 111 genera and 55 families were identified. The most dominant families in the study area were Fabaceae and Asteraceae. Among the total plant species documented in the forest, 42(30.65%) were trees, 36 (26.28%) were shrubs, 48(35.04%) were herbs, and 11 (8.03%) were climbers. Of the total species, 14(10.22%) species are endemic to Ethiopia and Eritrea. Three plant community types were identified by cluster analysis. The Shannon-Weiner Diversity Index was 3.39 and evenness was 0.87 for the forest. The pattern of plant species distribution was significantly influenced by altitude, pH, BD, slope, and charcoal (P < 0.05)., Conclusion: Guard forest has good species diversity and richness, and supports different endemic plant species that show the potential of the area to support useful but some of the characteristics species are not found in the forest and others are rare in their existence due to the presence of disturbances and need immediate conservation to ensure sustainable use and management of the forest., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Chewing khat during pregnancy adversely affects maternal and fetal health, but available studies are scarce and inconsistent, and it is difficult to conclude the relationship between khat consumption and perinatal outcomes. We aimed to investigate the available studies on the effect of khat use during pregnancy on perinatal and maternal outcomes. For this meta-analysis, we conducted a thorough search of articles published in PubMed, Embase, Scopus, and Web of Science up to the date this search was undertaken (03.01.2022). We used random effect model with the Mantel-Haenszel method to calculate the pooled odds ratio and mean difference. We found that khat use during pregnancy was significantly associated with increased odds of low birth weight (OR:2.51; 95% CI: 1.60 to 3.94), congenital anomalies (OR:3.17; 95% CI: 1.30 to 7.73), premature rupture of membrane (OR: 1.99; 95% CI: 1.59 to 2.50), perinatal mortality (OR: 1.95; 95% CI: 1.26 to 3.03), and lower APGAR scores at the fifth minute (MD: -1.7; 95% CI: -2.32 to -1.07). Also, increased odds for developing maternal psychological stress and anemia were reported in women using khat during pregnancy. There were no statistically significant differences in stillbirth and preterm birth between women using khat during pregnancy and their counterparts. Since prenatal khat use is associated with adverse perinatal and maternal outcomes, we strongly recommend equitable and easily accessible health services through the implementation of integrated addiction treatment with maternity services to address khat use during pregnancy and encourage the practice of healthy behavior of women., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Competing Interests: The authors report no conflicts of interest in this communication.

Background: Sexually transmitted infections (STIs) are a public health problem worldwide. Hepatitis B virus infection (HBV), hepatitis C virus infection (HCV), and syphilis are among the STIs. Female sex workers (FSWs) continue to be a high-risk group for STIs due to a variety of factors, including exposure to unsafe sexual practices. Therefore, this study determines the seroprevalence of HBV, HCV, Treponema palladium , and associated factors among FSWs in Gondar town, Northwest Ethiopia., Methods: A cross-sectional study was conducted on 194 FSWs from March to June 2021 in Gondar town. Socio-demographic and behavioral data were collected using a questionnaire. Five milliliters (5mL) of venous blood was collected and tested for hepatitis B surface antigens, anti-hepatitis C antibodies, and anti-syphilis antibodies using an enzyme-linked immunosorbent assay. Logistic regression, univariate, and multivariate analyses were carried out. A p-value of < 0.05 at a 95% confidence interval was considered statistically significant., Results: A total of 194 FSWs were included in the study. The seroprevalence rates of HBV infection, HCV infection, and syphilis were 23 (11.9%), 13 (6.7%), and 22 (11.3%), respectively. All three infections were statistically associated with inconsistent condom use (AOR = 1.72, 95% CI: 1.95-5.07, p = 0.03); (AOR = 10.51, 95% CI: 1.62-68.26, p = 0.014); and (AOR = 17.3, 95% CI: 4.55-65.6, p = 0.001). Whereas sex stimulant drug use (AOR = 9.4, 95% CI: 1.002-88.14), intravenous drug use (AOR = 15.53, 95% CI: 1.9-127.99, p=0.011), and sex while having a vaginal ulcer (AOR = 5.72, 95% CI: 1.13-28.9, p=0.035) were all statistically associated with HCV infection., Conclusion: The prevalence of HBV infection, HCV infection, and syphilis was comparatively higher. Regular screening, health education, and other preventative strategies are advised to lower the STI burden among FSWs., Competing Interests: The authors declare that they have no conflicts of interest in this work., (© 2022 Wondmagegn et al.)

Objective: The objective of this study is to investigate the effect of food insecurity on the mental health of patients with tuberculosis (TB) in Ethiopia., Design: A prospective cohort study., Setting: Health centres and hospitals located in Jimma zone, Southwest Ethiopia., Participants: Patients with TB who had recently been diagnosed with TB and started directly observed treatment in the selected 26 health institutions from October 2017 to October 2018. A total of 268 patients were followed for 6 months and data were collected at recruitment and two follow-up visits (at 2 and 6 months). Patients with multidrug-resistant TB were not included in the study., Main Outcome Measures: Mental distress was measured by the Self-Reporting Questionnaire-20 while food insecurity was assessed by using the Household Food Insecurity Access Scale., Results: A total of 268 patients were recruited and there was no lost to follow-up. The prevalence of food insecurity at baseline, first and second follow-up was 49.3%, 45.9% and 39.6%, respectively. Of these, 28.0% of them reported severe food insecurity at baseline which declined to 23.5% at the end of the sixth month. Likewise, the prevalence of mental distress at baseline was 61.2% but declined to 22.0% at the second follow-up. At baseline, 77.3% of patients with mental distress reported severe food insecurity but declined to 46.0% at second follow-up. In the final model, severe food insecurity (OR 4.7, 95% CI 2.4 to 9.4) and being a government employee (adjusted odds ratio (aOR) 0.3, 95% CI 0.1 to 0.9) were associated with mental distress., Conclusion: In this study, food insecurity was associated with mental distress over the course of follow-up. Likewise, there is a high prevalence of food insecurity and mental distress among patients with TB on treatment. Therefore, early assessment and interventions for food insecurity may improve the mental health of patients with TB on treatment., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Khat ( Catha edulis ) is a traditionally used substance in African and Arab countries that contains the amphetamine-like alkaloid cathinone. Khat use among Ethiopian students is a growing concern. This study aims to describe khat use, psychological problems, and motivation to change and to determine associated factors of khat use among students from Jimma University seeking psychological assistance. Methods: In a cross-sectional study, a sample of 717 students from Jimma University, southwestern Ethiopia, who seek assistance to reduce khat use were recruited. The study used Amharic and Afaan Oromoo language versions of common psychological instruments and employed them as part of a comprehensive tablet computer-delivered self-report assessment battery, comprising the SRQ-20, the PCL-5, the LEC-5, the AUDIT, and the SOCRATES-khat. In addition, socio-demographic, economic variables, and functioning problems due to severe mental disorders were assessed. The analysis relied on the data of the 575 included participants and used clinical cut-off values to describe this treatment-seeking sample and hierarchical regression models to determine variables associated with khat use. Results: The sample showed high khat use in the past month ( M = 31.55 bundles, SD = 28.53, on M = 15.11 days, SD = 8.54); 17.0% showed highly problematic use. The sample was extremely burdened with comorbid psychiatric problems: 21.6% reported functioning problems due to past mental disorders, 60.2% scored above the cut-off for current common mental disorders, 37.9% screened positive for PTSD, and 47.1% reported hazardous alcohol use. Small to medium intercorrelations between variables were detected, and in hierarchical regression models, higher motivation to change khat use was associated with higher use of the substance. Conclusions: This study clearly shows the need to develop research instruments, screening methods, and assistance services for khat-using students at Jimma University. Study participants' high mental health burden shows the need for targeted intervention programs that go beyond brief interventions for khat use. Furthermore, the study highlights challenges for implementing such services: the barriers to utilization for females and khat users without comorbid mental health problems., 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. The reviewer AA declared a shared affiliation, with one of the authors with two of the authors to the handling editor at the time of the review., (Copyright © 2021 Hassen, Soboka, Widmann, Keller, Zeller, Büchele, Barnewitz, Yitayih, Schiller, Senger, Adorjan and Odenwald.)

Objectives: In Ethiopia, little is known about the association between substance use disorders and adherence to antituberculosis (anti-TB) medications. Therefore, the objective of this study was to assess the effect of substance use disorders on adherence to anti-TB medications in Southwest Ethiopia., Design: Prospective cohort study., Settings: Patients were recruited from 22 health centres and four hospitals in Southwest Ethiopia., Participants: This study was conducted among 268 patients with TB, aged 18-80 in Southwest Ethiopia between October 2017 and October 2018. At baseline, patients who were exposed substance use disorders (134 patients) and unexposed to substance use disorders (134 patients) were recruited. Patients were followed for 6 months, and data were collected on three occasions., Main Outcome Measure: Adherence to anti-TB medications., Results: Patients with substance use disorders had consistently higher prevalence of non-adherence than those without, 16.4% versus 3.0% at baseline, 41.7% versus 14.4% at 2-month follow-up and 45.7% versus 10.8% at 6-month follow-up assessments. Patients with khat use disorder were 3.8 times more likely to be non-adherent to anti-TB medications than patients without khat use disorder (Adjusted odds ratio (aOR)=3.8, 95% CI 1.8 to 8.0). Patients who had alcohol use disorder (AUD) were also 3.2 times likely to have poor adherence compared with their counterparts (aOR=3.2, 95% CI 1.6 to 6.6). In addition, being educated (aOR=4.4, 95% CI 1.7 to 11.3), and being merchant (aOR=6.1, 95% CI 1.2 to 30.8) were associated with non-adherence to anti-TB medications., Conclusion: Khat and AUDs predict greater likelihood of non-adherence to anti-TB medication. This implies the need to integrate the management for substance use disorders into the existing TB treatment services., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Effective risk communication is one of the critical strategies in the response to COVID-19. This study examined risk perceptions and attitudinal responses to COVID-19 among the educated section of the society in Ethiopia., Methods: An internet-based survey was conducted from April 22 to May 04, 2020, in Ethiopia. A questionnaire addressing the perception of health threat-combination of perceived vulnerability (PV) and perceived seriousness (PS), and perceived efficacy-combinations of perceived response efficacy (PRE), perceived self-efficacy (PSE), and perceived collective efficacy (PCE). The data were analyzed using SPSS 21.0. Descriptive statistics were computed after the standardization of the scores. The scores for overall efficacy and threat were split by median value and response classifications were generated through threat by efficacy interactions. For statistical significance, 95% CI and p-value < 0.05 were used., Results: A total of 929 respondents submitted their responses. Eight hundred and twenty-eight (89.1%) of the respondents were male and 753 (81.1%) were Christian. The perceived threat to COVID-19 was generally low (median = 58.3). The median score for overall efficacy, PRE, and PSE were 79.8, 87.5, and 80.0, respectively. However, the median value (66.7) for PCE was relatively low. Perceived threat significantly varied by age, education, occupation, and place of residence (p < 0.05). Perceived efficacy significantly differed by gender, residence, and use of some sources of information (p < 0.05). In terms of response to COVID-19, 290 (31.2%), 239 (25.7%), 175 (18.8%) and 225 (24.2%) of the respondents were in the responsive, pro-active, avoidant, and indifferent attitudinal categories, respectively. The avoidant and indifferent groups constituted a fear control response (mal-adaptive motivation towards COVID-19 protective behavior) whereas responsive and pro-active categories formed a danger control response (self-protective motivation). These responses varied significantly by residence, region, religion, and sources of information (p < 0.05)., Conclusions: Understanding people's perceived health threat and efficacy is a critical step toward creating risk communication campaigns. Hence, this study provided an insight that has the potential to inform the COVID-19 risk communication campaigns targeting the educated section of the society, by ensuring a balanced combination of threat appeals and efficacy messages for improved self-protective responses.

Background: The COVID-19 pandemic led individuals to suffer from different levels of mental health problems such as psychological distress, anxiety, depression, denial, panic, and fear. This study aimed at determining the prevalence of psychological distress and associated factors among the Ethiopian population during the COVID-19 pandemic., Methods: A cross-sectional study was performed through an online survey using different online platforms. The questionnaire was created through Google Form and the survey link was administered by e-mail, LinkedIn, Telegram, and Facebook. Educated Ethiopian population who have access to the internet were invited to participate through an online survey and addressed to 929 respondents. The study participants completed the survey anonymously without any personal identifier. The psychological distress was assessed using the Kessler 10-item tool to measure psychological distress. Data were analyzed using SPSS and logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. A generalized additive model was also employed to identify additional predictors using R., Results: The prevalence of high psychological distress among the study population was 236 (25.5%). Of all respondents, 421 (45.1%) had low psychological distress, 274 (29.4%) had moderate psychological distress, 164 (17.6%) had high psychological distress, and 72 (7.3%) had very high psychological distress. Psychological distress increased with being at young and middle-aged adults, getting information from social media, and not correctly practicing infection prevention and control measures to prevent COVID-19 infection. Respondents with high perceived severity had increased psychological distress. On the contrary, those with the highest score of perceived response efficacy had low distress., Conclusion: Prevalence of psychological distress was substantial. The need for intervention of psychological distress inline with the prevention of COVID-19 is critically essential. The intervention target groups are those whose information sources are from social media, young and middle-aged adults, and those who do not correctly practice infection prevention and control measures against COVID-19 infection.

Background: Human-monkey conflict exists in different forms all over the world and is experienced more in developing countries. The conflict between human and grivet monkey (Chlorocebus aethiops) ranks among the main threats to biodiversity conservation and has become frequent and severe in different parts of Africa. A study on population size and human-grivet monkey conflict in Zegie Peninsula was carried out from August 2019 to March 2020; the study comprised both the wet and dry seasons. The line transect method was used to collect data on the population size of grivet monkeys. Questionnaires and focus group discussions were used to study the human-grivet monkey conflict and its conservation status., Results: The estimated population of grivets in the study area was 5046. Population structure of grivets indicated that there were 637 adult males, 1246 adult females, 1839 juveniles, and 1324 infants. The number of grivets in different habitat was; 1925 grivets in agricultural area, 1568 in lakeshore, 988 in forest and 565 grivets in shrub. Grivet population estimate between the wet and dry seasons did not show significant differences (χ 2  = 0.941, df = 1, p > 0.05). But there was a significant difference in the population estimate of grivets among the different habitats (χ 2  = 239.135, df = 3, p < 0.05 and among their age/sex (χ 2  = 504.102, df = 3, p < 0.05. Based on the questionnaire result the most problematic crop pests in the area were grivet monkeys (96.4%), bush pigs (52.3%), porcupine (46.3%) and squirrels cover (33.2%). The result of discussions held with focus groups and questionnaires in the study area showed that grivet monkeys damage crops (98.4%), chicken depredation (49.5%), steal and snatch human food (32%), disturbing communities (11.3%) in the area. Most (62%) of the respondents noted that guava is the most vulnerable crop followed by papaya, mango, avocado to be damaged by grivet monkeys., Conclusion: The total number of grivet monkey in the study area is 5046. The number of grivet monkeys varies based on their sex/age and their habitat type. There is no significant difference in their number according to season since the movement of grivets is restricted to the area (there is no migration in the area). The increasing population number leads the occurrence of human grivet monkey conflict in the area and this inversely affects grivet monkeys. There was a human-grivet monkey conflict in the Peninsula and grivets damaged crops, not only crops but also predating poultry, stealing eggs, and human food. Consequently, grivets were killed in response to the damage they caused to crops. Grivet's habitat in the Peninsula is highly disturbed because the local people cut trees for sale to support their livelihood. Awareness creation of the residents about wildlife and their habitat is necessary, and people should understand the impact of deforestation, illegal hunting, and the role of grivets in the ecosystem at large. Hence there is a need to protect the forest in order to ensure sustainable conservation of biodiversity in general and grivet monkeys in particular., (© 2021. The Author(s).)

Background: In Ethiopia and other countries in eastern Africa, khat abuse is an increasing public health problem. Levels of use appear to be increasing in women, who are more vulnerable to khat-related problems. However, population-based data are lacking as studies have been small and related to specific settings. This study aimed to contribute to current knowledge on the prevalence of chewing khat and associated factors among women in Ethiopia, using data from the 2016 Ethiopian national demographic and health survey., Methods: The 2016 EDHS used a two-stage stratified sampling design to select households. A total of 645 enumeration areas (202 urban and 443 rural) were selected, based on the 2007 Ethiopia Population and Housing Census. In these, 18,008 households were considered, from which 15,683 women were included from individual households. The women were interviewed by trained lay interviewers. Data were tabulated and logistic regression was used to examine mutually adjusted associations, expressed as adjusted odds ratios., Results: The lifetime prevalence of chewing khat among women was 9.9%. Current khat use was 8.4%, with a mean of 14.2 days of use in the last month. Khat use increased with increasing age, remaining constant after age 35 years, having one child, lower educational level, being Muslim by religion and not pertaining to the lowest wealth index category. Not being in a marital relationship with the most recent sex partner and Protestant religion were protective factors., Conclusion: Lifetime prevalence of chewing khat among women in Ethiopia is substantial and associated with specific sociodemographic risks. These can be used in targeted public health efforts to control the use of khat and reduce the associated health and economic burden.

Background: Chikungunya virus (CHIKV) infection has similar clinical presentations to malaria. Hence, febrile illnesses are often misdiagnosed as malaria. Therefore, this study aimed to generate baseline data on CHIKV infection in northwest Ethiopia where malaria is endemic., Methods: A hospital-based cross-sectional study was conducted among febrile patients presenting at the Metema and Humera Kahsay Abera hospitals from March 2016 to May 2017. Data on socio-demographic, clinical presentations, and possible risk factors were collected using a structured questionnaire. Serum samples were screened for immunoglobulin-M (IgM) and IgG antibodies to CHIKV infections using enzyme-linked immunosorbent assay. Logistic regression analysis was used to determine the strength of association., Results: Of 586 samples screened, the overall seroprevalence of CHIKV infection was 23%. Of the total study participants, 22.5% had CHIKV-specific IgM, indicating recent CHIKV infection. During monsoon and post-monsoon periods, increased prevalence of anti-CHIKV IgM seropositivity was found. The most common clinical presentation observed was fever, followed by headache and joint pain. Men had twice the likelihood of CHIKV infection. The presence of stagnant water near the residence almost doubled the risk for CHIKV infection., Conclusions: Most of the study participants had recent infection with CHIKV, suggesting the need to design disease prevention and intervention strategies., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: COVID-19 has posed several medical, psychosocial and economic impacts among the majority of the society. The ambiguity of its transmission, the intense desire of self-protection, family, and friends, the unknown impact of catching the disease itself, unstoppable spread, the panic and outright misinformation lead to acute stress reaction syndrome. However, reliable data related to this contagion lack the prevalence of acute stress reaction syndrome and associated factors among Jimma University Medical Centre hospital visitors in Southwestern Ethiopia., Aims: The main objective of the study was to assess the prevalence and factors associated with acute stress reaction syndrome during the COVID-19 outbreak among Jimma University Medical Centre Hospital visitors, Ethiopia., Methods: An interviewer-administered cross-sectional study was conducted among 247 visitors of the Jimma University Medical Centre in Ethiopia. The study was conducted within 2 weeks of the first COVID-19 cases detected on 13 March 2020 in Ethiopia. Data on demographic and socioeconomic status were collected during the interview using structured questionnaires. The psychological impact was assessed using the Impact of Event Scale-Revised, and symptoms of insomnia were measured using the Insomnia Severity Index. Social support was evaluated using Oslo three-item Social Support Scale. Logistic regression was employed to determine the associations between dependent and independent variables. Besides, psychosocial stress score was generated using principal component analysis. A paired permutation test was also performed to determine the variability of psychosocial stress between groups., Results: The mean age of participants was 30.47 years, and 76.5% of the participants were male. Acute stress reaction syndrome was detected in 44.1% of hospital visitors. Of the participants, 38.5%, 17.4%, 8.5% and 35.6% had a minimal, mild, moderate and severe psychological impact, respectively. Factors positively associated with acute stress reaction syndrome were individuals who perceived that COVID-19 leads to stigma (adjusted OR (AOR): 3.24, 95% CI 1.11 to 9.45), mild insomnia (AOR: 14.74, 95% CI 6.14 to 35.40), moderate to severe insomnia (AOR: 35.1, 95% CI 10.76 to 114.66), low social support (AOR: 4.08, 95% CI 1.31 to 12.67) and governmental employees (AOR: 8.09, 95% CI 1.38 to 47.18)., Conclusion: The study revealed the existence of a high prevalence of acute stress reaction syndrome during the COVID-19 outbreak among different groups of the community. Therefore, our results will contribute to the global awareness of the psychological impact of the COVID-19 outbreak., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The coronavirus (COVID-19) pandemic causes healthcare professionals to suffer mental health problems such as psychological distress, anxiety, depression, denial and fear. However, studies are lacking related to Ethiopia and to Africa in general., Aims: To study the mental health of healthcare professionals during the COVID-19 pandemic in Ethiopia., Method: A hospital-based cross-sectional study was conducted at Jimma University Medical Center among 249 healthcare professionals. The data were collected using self-administered questionnaires between 22 and 28 March 2020. The psychological impact was assessed using the Impact of Event Scale - Revised (IES-R) and symptoms of insomnia were measured using the Insomnia Severity Index (ISI). Social support was evaluated using the three-item Oslo Social Support Scale. Data were analysed using logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. The psychosocial status of the healthcare professionals was predicted using a classification tree model supported by the genetic search method., Results: The prevalence of psychological distress among healthcare professionals was 78.3%. The mean IES-R score was 34.2 (s.d. = 19.4). The ISI score indicated that the prevalence of insomnia was 50.2%. Higher psychological distress was associated with younger age, having insomnia, not having a daily update on COVID-19, and feeling stigmatised and rejected in the neighbourhood because of hospital work., Conclusions: This study indicates that, in Ethiopia, the prevalence of psychological distress among healthcare professionals is high and associated with specific sociodemographic risks.

Background: The endeavor to tackle the spread of COVID-19 effectively remains futile without the right grasp of perceptions and beliefs presiding in the community. Therefore, this study aimed to assess myths, beliefs, perceptions, and information gaps about COVID-19 in Ethiopia., Methods: An internet-based survey was conducted in Ethiopia from April 22 to May 04, 2020. The survey link was promoted through emails, social media, and the Jimma University website. Perceptions about COVID-19 have considered the World Health Organization (WHO) resources and local beliefs. The data were analyzed using Statistical Package for Social Science (SPSS) software version 20.0. Classifications and lists of factors for each thematic perception of facilitators, inhibitors, and information needs were generated. Explanatory factor analysis (EFA) was executed to assist categorizations. Standardized mean scores of the categories were compared using analysis of variance (ANOVA) and t-tests. A significant difference was claimed at p-value <0.05., Results: A total of 929 responses were gathered during the study period. The EFA generated two main categories of perceived facilitators of COVID-19 spread: behavioral non-adherence (55.9%) and lack of enablers (86.5%). Behavioral non-adherence was illustrated by fear of stigma (62.9%), not seeking care (59.3%), and hugging and shaking (44.8%). Perceived lack of enablers of precautionary measures includes staying home impossible due to economic challenges (92.4%), overcrowding (87.6%), and inaccessible face masks (81.6%) and hand sanitizers (79.1%). Perceived inhibitors were categorized into three factors: two misperceived, myths (31.6%) and false assurances (32.9%), and one correctly identified; engagement in standard precautions (17.1%). Myths about protection from the virus involve perceived religiosity and effectiveness of selected food items, hot weather, traditional medicine, and alcohol drinking, ranging from 15.1% to 54.7%. False assurances include people's perception that they were living far away from areas where COVID-19 was rampant (36.9%), and no locally reported cases were present (29.5%). There were tremendous information needs reported about COVID-19 concerning protection methods (62.6%), illness behavior and treatment (59.5%), and quality information, including responses to key unanswered questions such as the origin of the virus (2.4%). Health workers were perceived as the most at-risk group (83.3%). The children, adolescents, youths were marked at low to moderate (45.1%-62.2%) risk of COVID-19. Regional, township, and access to communication showed significant variations in myths, false assurances, and information needs (p <0.05)., Conclusions: Considering young population as being at low risk of COVID-19 would be challenging to the control efforts, and needs special attention. Risk communication and community engagement efforts should consider regional and township variations of myths and false assurances. It should also need to satisfy information needs, design local initiatives that enhance community ownership of the control of the virus, and thereby support engagement in standard precautionary measures. All forms of media should be properly used and regulated to disseminate credible information while filtering out myths and falsehoods., Competing Interests: The authors have declared that no competing interests exist.

Objective: Surgical site infection (SSI) is one of the leading causes of hospital-acquired infection among hospitalized patients. It causes significant health problems and results in an extended length of hospital stay, increased cost, and increased patient morbidity and mortality. To prevent the development of SSI, surgical antibiotic prophylaxis (SAP) administration before surgery is an evidence-based practice. Therefore, this study aimed to assess the prevalence of SSIs and surgical antibiotic prophylaxis practice, and identifying the gap in practicing prophylactic surgical antibiotic use., Methods: A retrospective cross-sectional study design was conducted on randomly selected 281 participants who fulfilled the inclusion criteria. Appropriateness of surgical antibiotic prophylaxis was assessed by clinical pharmacists based on the standard treatment guideline. Descriptive and multivariate logistic regression analyses were performed in SPSS version 25. Statistical significance was set at p <0.05., Results: The overall prevalence of SSI was 19.6% (95% CI: 19-20.2). Majority of surgical patients (88.6%) got surgical antibiotic prophylaxis. Ceftriaxone and metronidazole (45.4%), and ceftriaxone (33.3%) were the most frequently used prophylactic antibiotics. Presence of comorbidity (AOR=9.18, 95% CI: 5.17-17.9, p<0.001), contaminated (AOR=6.01, 95% CI: 1.77-16.8, p=0.019) and dirty (AOR=7.20, 95% CI: 1.23-12.1, p=0.029) wound classes, devoid of prophylactic antibiotics (AOR=6.63, 95% CI: 0.89-19.3, p=0.006), the timing of prophylactic antibiotic administration between 1 hour and 2 hours before incision (AOR=8.2, 95% CI: 4.34-18.1, p=0.001), and 48 hours duration of surgical antimicrobial prophylaxis (AOR=7.20, 95% CI: 1.23-28.17, p=0.027) were significantly associated with the development of SSIs., Conclusion: The prevalence of SSI was relatively high despite most surgical patients were given prophylactic antibiotics. The presence of comorbidity, contaminated and dirty wound classes, devoid of prophylactic antibiotics, administering prophylactic antibiotics between 1 hour and 2 hours before incision, and 48 hours duration of surgical antibiotic prophylaxis were significantly associated with SSIs., Competing Interests: The authors declare that they have no competing interests., (© 2020 Kefale et al.)

Introduction: Type 2 diabetes mellitus patients with hypertension are at high risk of drug therapy problems since they are subject to receive multiple drug therapies due to comorbidities., Objectives: To determine the magnitude of drug therapy problems and its determinants among Type 2 diabetes mellitus patients with hypertension., Methods: A cross-sectional study was employed among 423 randomly selected participants based on the inclusion criteria. A structured questionnaire and review of patients' medical record were employed in the data collection. The classification system used by Cipolle was used to classify and evaluate drug therapy problems. Data were analyzed using Statistical Package for the social sciences version 25.0 software. Multivariate logistic regression analysis was used to identify determinants of drug therapy problems with a statistical significance of p  ⩽ 0.05., Results: A total of 491 drug therapy problems with a mean of 1.86 ± 0.53 drug therapy problems per patient were identified, and 62.4% (264) of them experienced at least one drug therapy problem. Non-compliance (197, 40.1%), needs of additional drug therapy (119, 24.2%), and dosage too low (91, 18.5%) were the most frequently observed drug therapy problems in the study setting. Anti-diabetic medications (88.4%), statins (44.5%), and aspirin (33.5%) were the most commonly involved drugs in drug therapy problems. The determinants of drug therapy problems were very low family income (adjusted odds ratio = 4.64, p   =  0.010), age (45-65 years old) (adjusted odds ratio = 2.55, p  = 0.008), presence of comorbidity (adjusted odds ratio = 9.19, p  < 0.001), and taking ⩾5 medications (adjusted odds ratio = 2.84, p  = 0.001)., Conclusion: Approximately three out of five patients had one or more drug therapy problems encountered. In this study, the most common types of drug therapy problems were non-compliance, needs additional drug therapy, and dosage too low. Family monthly income, age, comorbidities, and number of medications were the significant determinants of drug therapy problems. Therefore, patient education regarding medication adherence, routine medication review, and strengthening clinical pharmacy services should be promoted., 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) 2020.)

Introduction: Tuberculosis (TB) is a leading cause of morbidity and mortality in low and middle-income countries. Substance use negatively affects TB treatment outcomes. Our recent study has found that khat use predicted poorer adherence to anti-TB medications. However, there is scarce longitudinal study on predictors of khat use among outpatients with TB, and this study aimed at addressing this research gap., Methods: From October 2017 to October 2018, 268 outpatients with tuberculosis on DOTs were enrolled in a longitudinal study from 26 health institutions in Southwest Ethiopia. Structured questionnaires translated into local languages (Afaan Oromoo and Amharic) were used to assess khat use. Patients were followed for six months, and data were collected on three occasions during the follow-up. A generalized linear mixed model was used to identify the relation between khat use and predictors. Model fitness was checked using the Bayesian Information Criterion (BIC). Odds ratio (OR) and 95% CI were used to describe the strength of association between the outcome variable and predictors., Results: The overall prevalence of khat use at baseline and first follow up was 39.2% while it was 37.3% at second follow up. Of this, 77.1% and 96.2% of them believed that khat use reduces the side effects of anti-TB medications and symptoms of tuberculosis respectively. In the final model, being male (aOR = 7.0, p-value = 0.001), being government employee (aOR = 0.03, p-value≤0.001) and presence of alcohol use disorders (AUD) (aOR = 2.0, p-value≤0.001) predicted khat use among outpatients with tuberculosis., Conclusion: A considerable proportion of patients with TB used khat throughout DOTs and wrongly perceived that it had health benefits. The finding implies that all patients diagnosed with TB should be screened for khat use, and a particular emphasis should be given to males and individuals with a history of alcohol use. Moreover, further studies are needed to assess patients' beliefs regarding the benefits of khat use so that interventions can be developed., Competing Interests: The authors have declared that no competing interests exist.

Background: Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome. It is underresearched and virtually forgotten but still a frequent neuropsychiatric phenotype in both developed and low-income countries. Catatonia is associated with a number of medical complications like pulmonary embolism, dehydration, or pneumonia if it is not treated and managed adequately. In Ethiopia, however, almost no studies are available to describe the symptoms and the response to treatment in patients with catatonia. The aim of this retrospective study was therefore to describe the symptom profile of catatonia and to evaluate the treatment and outcome of catatonia in patients admitted to the psychiatric inpatient unit at Jimma University, Ethiopia., Method: Detailed treatment records of all inpatients were reviewed for the period from May 2018 to April 2019. All patients with catatonia at the inpatient unit of Jimma University Medical Center were assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), and all comorbid psychiatric diagnoses were made according to the criteria of the Diagnostic Statistical Manual V. The presence and severity of catatonia were assessed by using the BFCRS at baseline and at discharge from the hospital., Result: In the course of one year, a total of 18 patients with the diagnosis of catatonia were admitted. The mean age of the participants was 22.8 years (SD 5.0; range: 15 to 34 years). The most common diagnosis associated with catatonia was schizophrenia ( n = 12; 66.7%), followed by severe depressive disorders ( n = 4; 22.2%). Mutism, posture, and withdrawal were registered in all patients ( n = 18, 100%). All patients received an injection of diazepam and had improved at discharge., Conclusion: Our study provides further evidence that catatonia is most commonly associated with schizophrenia, followed by major depressive disorder, and that mutism, posturing, and withdrawal are the most common signs and symptoms of catatonia., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Yimenu Yitayih et al.)

Background: Novel-coronavirus disease-2019 (COVID-19) is currently a pandemic and public health emergency of international concern, as avowed by the World Health Organization (WHO). Ethiopia has become one of the affected countries as of March 15, 2020., Objective: This study aimed to assess the knowledge, perceptions, and practices among the Jimma University medical center (JUMC) visitors in Jimma town., Methods: A cross-sectional study was conducted on 247 sampled visitors, from 20-24 March 2020. Consecutive sampling was used to recruit the participants. The study tools were adapted from WHO resources. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics were used to describe the status of knowledge, perception, and practices. Logistic regression was executed to assess the predictors of dominant preventive practices., Results: Of the 247 respondents, 205 (83.0%) knew the main clinical symptoms of COVID-19. 72.0% knew that older people who have chronic illnesses are at high risk of developing a severe form of COVID-19. About 95.1% knew that the COVID-19 virus spreads via respiratory droplets of infected people, while 77 (31.2%) of the respondents knew about the possibility of asymptomatic transmission. Only 15 (6.1%) knew that children and young adults had to involve preventive measures. Overall, 41.3% of the visitors had high knowledge. The majority, 170(68.8%), felt self-efficacious to controlling COVID-19. 207(83.3%) believed that COVID-19 is a stigmatized disease. Frequent hand washing (77.3%) and avoidance of shaking hands (53.8%) were the dominant practices. Knowledge status and self-efficacy (positively), older age, and unemployment (negatively) predicted hand washing and avoidance of handshaking., Conclusions: The status of knowledge and desirable practices were not sufficient enough to combat this rapidly spreading virus. COVID-19 risk communication and public education efforts should focus on building an appropriate level of knowledge while enhancing the adoption of recommended self-care practices with special emphasis on high-risk audience segments., Competing Interests: The authors have declared that no competing interests exist.

Objective: The objective of this review is to evaluate the effectiveness of a symptom-triggered regimen versus a fixed-dosage regimen of benzodiazepine treatment for alcohol detoxification., Introduction: Patients with alcohol use disorder who suddenly decrease their alcohol consumption or abstain completely may experience alcohol withdrawal syndrome. Adequate treatment of detoxification can relieve the patient's distress, prevent the development of more serious symptoms and forestall collective effects that might worsen future withdrawals., Inclusion Criteria: The review will consider studies that include people with alcohol withdrawal syndrome who are taking benzodiazepine treatment in an inpatient setting. Studies of people with alcohol withdrawal syndrome who are under the age of 18 will be excluded. This review will exclude studies of people with alcohol withdrawal syndrome who are non-verbal (e.g. stupor due to head injury) or have a history of seizure. Studies published in English will be included., Methods: An initial limited search of MEDLINE and CINAHL was undertaken to identify articles. The text words contained in the titles and abstracts, and index terms were used to develop a full search strategy. The search strategy, including all identified keywords and index terms, will be adapted for each included information source. Studies will be pooled for statistical meta-analysis. Effect sizes will be expressed as odds ratios (for categorical data) or weighted mean differences (for continuous data), and their 95% confidence intervals will be calculated for analysis. The heterogeneity will be assessed using the I test and chi-squared test., Systematic Review Registration Number: PROSPERO CRD42018115777.

Background: Khat (Catha edulis) is a fresh green leave commonly chewed for recreational purpose and its euphoric effect as a result of dopamine activities stimulation effect of Khat. Women may use Khat during their pregnancy to tolerate their pregnancy related distress. Khat has biological, social or psychological complications; adverse pregnancy outcomes and negatively affects the health of the mother and the fetus. However, magnitude, pattern and associated factors of Khat use are not well addressed among pregnant women in Ethiopia. The aim of this study was to address this gap by assessing the magnitude and associated factors of Khat use among women attending antenatal care service at Gedeo zone rural health centers., Methods: This was a facility based cross-sectional study conducted at rural health centers in Gedeo zone from June 1 st  to August 1 st , 2017. The data were collected through structured interview using an interview guide developed from different literatures. A total of 718 pregnant women attending antenatal care service participated in the study using multi stage sampling technique. Bivariable and multivariable analysis were used to identify associated factors of Khat use among women during their current pregnancy period. In the multivariable analysis, variables with P-Values of less than 0.05 were considered as statistically significant correlates of Khat use. The strength of the association was also measured with adjusted odds ratio at a corresponding 95% confidence interval., Results: The lifetime and current prevalence of khat use among pregnant women were 11.0% (95%CI: 8.8-13.2) and 9.9% (95% CI: 7.7-12), respectively. The odds of being khat user was higher among those who had khat user partner [AOR = 3.450, 95% C.I (1.907-6.244)], respondents with alcohol use behavior [AOR = 3.235, 95% C.I (1.573-6.659)] and mental distress [AOR = 3.575, 95% C.I (2.067-6.189)]., Conclusion: Significant proportions of pregnant women were experiencing khat chewing during pregnancy. Having khat user partner, alcohol use behavior and metal distress were significantly associated with khat use of pregnant women. This demonstrates a need to integrate the prevention, early identification and intervention of Khat use as a component of treatment modality for pregnant women during their antenatal visit.

Background: Khat abuse and psychopathy are both strongly related to criminal activity. Higher rates of substance use in people with psychopathy are hypothesized to be related to psychopathic personality traits, which include high sensation seeking, low conscientiousness and neuroticism, impulsivity, and irresponsibility. Little is known, however, about the association between psychopathy and khat abuse among prisoners in Ethiopia. Therefore, we evaluated the presence of these two factors in prisoners in the correctional institution in Jimma, Southwest Ethiopia., Materials and Methods: We used a cross-sectional study design to collect data from 336 prisoners from June 5 to July 5, 2017. Study participants were selected by a systematic random sampling technique. Khat abuse was assessed with the Drug Abuse Screening Tool and psychopathy with the Psychopathy Checklist: Screening Version. We also assessed nicotine dependence with the Fagerstrom Test for Nicotine Dependence; alcohol use disorder, with the alcohol use disorder identification test; adverse traumatic life events, with the Life Events Checklist; and social support, with the Oslo 3-Item Social Support Scale. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models. Variables with a P value < 0.05 in the final fitted model were declared to be significantly associated with the outcome variable., Results: The overall prevalence of lifetime khat use was 59.9%, and the prevalence of khat abuse in prisoners with psychopathy was 78.0%. Prisoners with psychopathy had a three times higher odds ratio of abusing khat than those without psychopathy (AOR = 3.00 [1.17-7.67]). Among the confounders, a family history of substance use (AOR = 2.50 [1.45-4.31]), poor support (AOR = 2.28 [1.11-4.67]), alcohol use disorder (AOR = 7.78 [4.16-14.53]), and suicidal ideation and suicide attempts (AOR = 2.26 [1.45-4.31]) were also positively associated with khat abuse., Conclusions: The prevalence of khat abuse was higher in prisoners with possible or probable psychopathy., Competing Interests: The authors have declared that no competing interests exist.

Objective: Trauma exposure and alcohol use are closely related, and large proportion of trauma-exposed individuals use alcohol. The data presented in this paper were obtained as part of a study on substance use disorder and associated factors among prisoners in the correctional institution in Jimma, Southwest Ethiopia. Therefore, in this study we examined comorbidity of traumatic life experiences and alcohol use disorder in inmates of correctional institution in Jimma, Southwest Ethiopia., Results: The overall prevalence of lifetime alcohol use disorder was 40.1%, and the prevalence of alcohol use disorder among prisoners with lifetime trauma exposure was 44.0%. Participants with multiple trauma exposures had 2.5-fold higher odds of association for alcohol use disorder than their counterparts (AOR = 2.47 [1.23-4.94]). Living in urban areas (AOR = 4.86 [2.38-9.94]), presence of psychopathy (AOR = 3.33 [1.25-8.86]), khat abuse (AOR = 7.39 [3.99-13.68]), and nicotine dependence (AOR = 2.49 [1.16-5.34]) were also positively associated with alcohol use disorder. The prevalence of alcohol use disorder was higher among prisoners with lifetime trauma exposure. Also, this study indicates that prisoners with multiple trauma exposures had higher odds of association for alcohol use disorder than those with no trauma exposure. A public health intervention targeting survivors of traumatic experiences needs to be designed and implemented.

Objective: Intestinal parasites are present throughout the world in varying degrees of prevalence due to many factors. The aim of this study was to determine the 5-year trend prevalence of intestinal prevalence among patients who had been suspected for intestinal parasite infections. A retrospective study was conducted from 2009 to 2013 at Poly Health Center Gondar, Northwest Ethiopia. Samples were examined using direct saline wet mount methods. Statistical analysis was done using SPSS version 20 software and a P-value of < 0.05 was considered statistically significant. The results were presented in tables and graphs., Results: During the study period, a total of 13,329 stool samples were requested for intestinal parasite diagnose and 5510 (41.3%) laboratory-confirmed cases were reported with a fluctuating trend. Ten different parasites were reported in each year with Entamoeba histolytica/dispar (16.8%) being the predominant parasite followed by Giardia lamblia (11.4%) and Ascaris lumbricoides (6.7%). Both males (49%) and females (51%) were equally affected (P = 0.14). The intestinal parasite was reported in all age groups in the area but the highest and the lowest prevalence were reported in age groups of 20-29 years and 40-49 years, respectively (26.5% vs 6.4%) (P < 0.001).

Background: Dengue is one of the most common arboviral diseases with increased outbreaks annually in tropical and subtropical areas. In Ethiopia, there are no data regarding clinical, hematological and biochemical parameters which are very important in the clinical management of dengue patients. Hence this study was carried out to provide the first baseline data of clinical, hematological and biochemical profiles of patients infected with dengue virus., Methods: A cross-sectional study was carried out among febrile patients in northwest Ethiopia from March 2016 to May 2017. Blood samples were collected from dengue presumed cases and tested against dengue specific IgM antibody by enzyme-linked immunosorbent assay (ELISA). Those study participants who fulfilled the inclusion criteria were enrolled in the study. Clinical examination findings were recorded, hematological and biochemical parameters tests were done., Results: During the study period, a total of 102 dengue cases were included in the study. Of these, there were 16 (15.7%) children and 86 (84.3%) adults between 1 and 76 year age. The most common clinical presentations followed by fever (100%) were a headache 89 (87.3%), myalgia 82 (80.4%), nausea/vomiting 71 (69.6%). The common hematological findings were thrombocytopenia 61 (59.8%), followed by anemia 45 (44.1%) and leucopenia 27 (26.5%) and the elevated levels of biochemical parameters were AST 46 (45.1%) and ALT in 18 (17.6%)., Conclusions: This study highlights the most common clinical and laboratory profiles of dengue viral infections that could alert physicians to the likelihood of dengue virus infections in the study area.

Background: Rubella virus infection in early pregnancy lead to serious multi-organ birth defects known as congenital rubella syndrome (CRS). The incidence of CRS varies in different populations and the highest burden is found in developing countries in which rubella vaccination is not included in their national immunization programs. In Ethiopia, there is scarcity of data about congenital rubella syndrome. Therefore, the aim of this study was to determine the burden of CRS-related birth defects and its incidence in the pre-vaccine era in Amhara Regional State, Ethiopia., Materials and Methods: A cross sectional study was conducted in Dessie, Felege-Hiwot and University of Gondar Referral Hospitals, from December 2015 to August 2017. After getting informed assent from each parent/guardian, blood was collected from infants < 1 year of age for laboratory determination of anti-rubella virus antibodies. Their socio-demographic data and clinical information compatible with congenital rubella syndrome were collected using WHO guideline., Results: During the study period, a total of 50 infants suspected for congenital rubella syndrome were included in the study. All infants suspected for CRS were tested against rubella specific IgM and IgG [for infants ≥ 6 months of age] antibodies using ELISA method. Of these, 9/50 (18%) and 4/14 (28.6%) of them were laboratory confirmed and potential CRS cases, respectively. In the present study, the most common laboratory confirmed defect was ocular manifestations 6 (66.7%) followed by heart related problems 5 (55.6%). In the present study, most of the laboratory confirmed cases (66.7%) were reported among 1-5 months of age infants. In addition, 5 (55.6%) of the infants with laboratory confirmed CRS cases were male and 6 (66.7%) of them were from urban settings. In this study, the incidence of CRS was 0.4 per 1000 live births., Conclusion: In this study, nearly one fifth of the infants had laboratory confirmed congenital rubella syndrome and most of them had multiple rubella associated congenital defects at a time. Most of these congenital anomalies were reported among infants ≥ 1 month of age. Based on our result, the incidence of the CRS was line with the global incidence of the CRS in the pre-vaccine era. Therefore, establishing strong rubella/CRS surveillance system as well as introducing the rubella containing vaccine in the national immunization program might be important to reduce the burden of rubella and CRS in the country., Competing Interests: The authors have declared that no conflicts of interest with respect to the authorship and/or publication of this research paper.

Introduction: Cancer is alarmingly increased in developing countries like Ethiopia, where multidrug resistant bacterial infection is rampant. The aim of this study was to determine the bacterial profile, antimicrobial resistance pattern, and associated factors among cancer patients attending University of Gondar Hospital., Methods: A consecutive 216 cancer patients were recruited from February to April, 2017. Socio-demographic and clinical data were collected using a structured questionnaire. Culture and antibiotic resistance were done following standard microbiological procedures., Result: The overall prevalence of bacterial infection was 19.4%. The predominant bacterial isolates were Staphylococcus aureus (28.6%), followed by coagulase negative staphylococci (26.2%) and Escherichia coli (21.4%). Multidrug resistance was detected in 46.5% bacterial isolates. Methicillin resistance was detected in 25% of S. aureus and in 45.5% of coagulase negative staphylococci. Fluoroquinolone resistance was detected in 33.3% of E. coli isolates. Cancer patients with solid tumor, started cancer therapy, and being symptomatic had higher odds of culture positivity., Conclusion: The overall burden of bacterial infection among cancer patients is considerably high. The findings of this study inform baseline information for policymakers and call for additional studies with large isolates in different cancer treatment centers in the region and in the country to better understand the bacterial isolate and resistance pattern., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: Rubella and its associated congenital anomalies have been greatly reduced in most developed countries through use of the rubella vaccine. However, the magnitude of the problem is underestimated and there are no well-established rubella/congenital rubella syndrome prevention and control strategies in many developing countries, including Ethiopia. The aim of this study was to determine the prevalence of rubella virus infections among pregnant women and their immune status before the introduction of rubella vaccine in Amhara Regional State, Ethiopia., Methods: A prospective cross-sectional study was conducted among pregnant women in Dessie, Felege-Hiwot, and University of Gondar referral hospitals, from December 2015 to February 2017. After obtaining written informed consent, socio-demographic data, reproductive history, clinical manifestations, and the possible risk factors for rubella virus infections were collected using a structured questionnaire. The laboratory analysis of rubella-specific antibodies was done using an enzyme-linked immunoassay method on venous blood samples. Data were entered and analyzed using IBM SPSS Statistics version 20. Binary logistic regression was used to determine the strength of association between the dependent variables and covariates., Results: A total of 600 pregnant women were included in the study. Their mean age was 26.4±5years (range 16-40 years). The overall seroprevalence of rubella infection was 89%. Of the total study participants, 9.5% were positive for rubella-specific IgM antibody, which indicates acute/recent rubella virus infection. In contrast, 79.5% of them had protective levels of rubella-specific IgG antibody and were immune as a result of previous wild-type rubella infection. However, 11% of the pregnant women were negative for both rubella-specific antibodies; these women represent the susceptible group., Conclusions: A large number of pregnant women had acute/recent rubella virus infections at the time of data collection, indicating that the virus is endemic in the study area. More than a tenth of pregnant women were found to be susceptible to acquiring the infection in future pregnancies, with the possible risk of rubella-associated congenital anomalies. Hence screening of all women of child-bearing age before conception and during pregnancy might reduce the devastating effects of the virus on the developing fetus., (Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Substance use disorder is an important public health problem and one of the major causes of disability worldwide. Substance use and criminal behavior are closely related and there is a significant association between substance misuse and crime, but little is known about substance use disorder among prisoners, in particular in low-income countries. Therefore, we investigated substance use disorder and associated factors in inmates of a correctional institution in Jimma, Southwest Ethiopia., Methods: We used a cross-sectional study design to collect data from 336 prisoners from June 5 to July 5, 2017. Study participants were selected from the total of 1460 prisoners eligible for the study by a systematic random sampling technique, i.e., one participant was randomly selected from every four consecutive admissions in the registration book. Alcohol use disorder, nicotine dependence, khat abuse, cannabis use disorder, psychopathy, adverse traumatic life events, and social support were assessed. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models with the Statistical Package for Social Science version 21. Variables with a P value < 0.05 in the final fitting model were declared to be associated with the outcome variable., Results: The overall prevalence of substance use disorder was 55.9%. The prevalence of khat abuse was 41.9%; alcohol use disorder, 36.2%; nicotine dependence, 19.8%; and cannabis use disorder, 3.6%. Poor social support, living in urban areas, psychopathy, and a family history of substance use were positively associated with substance use disorder., Conclusions: Substance use disorder is prevalent among prisoners. The increased morbidity and unpleasant psychosocial consequences associated with substance use disorder, together with our finding that 66.3% of prisoners with substance use disorder were interested in obtaining treatment, suggest a need to establish prison-based treatment in this correctional institution in Jimma.

Objective: Malaria and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) are the major medical challenges of priority faced by the sub-Saharan African countries in general and Ethiopia in particular. Thus, the aim of this study was to determine the prevalence and associated risk factors of HIV and malaria infections among febrile illness patients., Methods: A cross-sectional study was conducted from November 1, 2014 to May 30, 2015 at Kolla-Diba Health Center, Northwest Ethiopia. After obtaining informed consent, blood samples were collected from each febrile patient for the laboratory determination of HIV and malaria infections. Sociodemographic data and other associated factors for HIV and malaria infections were collected using a structured questionnaire., Results: Of the total of 384 febrile illness patients, 23.7% (91/384) were positive for Plasmodium species. Of these, the most prevalent was P. falciparum, 56.0% (51/91), followed by Plasmodium vivax infection, 38.5% (35/91). In this study, 13.8% (53/384) of the participants were positive for HIV. Furthermore, 3.13% (12/91) of the participants were coinfected with HIV and malaria. According to the findings of the present study, genital ulcer patients and those who do not use bed net were significantly associated with HIV and malaria infections, respectively., Conclusion: Malaria and HIV are still common challenges independently occurring in the study area. The coexistence of the two diseases cannot be underestimated. Hence, health professionals should strengthen the provider initiative counseling and testing (PICT) program as a means of HIV/AIDS prevention and control strategy. Furthermore, approaching the febrile illness patients for both malaria and HIV diagnoses may help in having a joint HIV and malaria prevention and control strategy.

Background: Dengue is one of the most serious and rapidly spreading arboviral diseases in the world. Despite many acute febrile illnesses in Ethiopia, the burden of illness due to dengue in the country is largely unknown. Thus, the present study aimed to provide the first baseline data on seroprevalence and associated risk factors of dengue virus (DENV) infection in the country., Methods: A cross-sectional study of febrile patients who were visiting Metema and Humera hospitals in Northwest Ethiopia from March 2016 to May 2017 was conducted. Blood samples were collected from each participant and serum samples were separated and tested for IgM and IgG antibodies against DENV infection by enzyme-linked immunosorbent assay (ELISA). Risk factors associated with the prevalence of anti-DENV antibodies were tested using logistic regression analysis., Results: Of the 600 samples tested, the overall seroprevalence against DENV infection was 33.3%, while the seroprevalence by the study area was 40% in Metema and 27.5% in Humera. The overall prevalence of IgM and IgG antibodies against DENV infection was 19% and 21% respectively. Of these, 6.7% were positive for both IgM and IgG antibodies. Residence and occupational status were significantly associated with the prevalence of anti-DENV IgM seropositivity and anti-DENV IgM-/G+serostatus. The seasonal variation was significantly associated with the prevalence of anti-DENV IgM but not with anti-DENV IgM-/G+serostatus. The prevalence of anti-DENV IgM-/G+serostatus was significantly higher in Metema than Humera. High prevalence of anti-DENV IgM seropositivity was found in the summer and spring, with a peak in the month of August. The presence of uncovered water either indoor or outdoor and lack of mosquito net use was identified as risk factors for DENV infection., Conclusions: These findings provide the preliminary data on seroprevalence and associated risk factors of DENV infection in the country. The presence of antibodies against DENV infection indicates dengue as one of the causes of undifferentiated febrile illnesses in the study areas. This suggests that prevention and control measures should be designed considering the risk factors identified by this study. Furthermore, we recommend a large-scale study to include DENV infection in the differential diagnosis of all febrile illnesses in Ethiopia., Competing Interests: The authors have declared that no competing interests exist.

Objectives: The Aedes mosquito is a vector for transmitting many arboviruses. Knowledge of the breeding habitat of this vector is vital for implementing appropriate interventions. Thus, this study was conducted to determine the breeding habitats and presence of Aedes mosquito species in the study areas., Methods: A house-to-house cross-sectional survey of Aedes mosquito breeding habitats was carried out in Metema and Humera, Ethiopia, in August 2017. All available water-holding containers present in and around houses were inspected for the presence of immature stages of Aedes mosquitoes, and they were collected and reared to the adult stage for species identification. In the larval survey, the house index, container index, and Breteau index were computed as risk indices., Results: Of the 384 houses surveyed for the presence of Aedes mosquito larval breeding, 98 were found to be positive for larvae. During the survey, a total of 566 containers were inspected, of which 186 were found to be infested with Aedes mosquito larvae, with a container index of 32.9, a house index of 25.5, and a Breteau index of 48.4. The most common Aedes mosquito breeding habitats were discarded tires (57.5%), followed by mud pots (30.0%). Of the 1,077 larvae and pupae collected and reared, Aedes aegypti (49.3%), Ae. vittatus (6.5%), and Culex species (44.2%) were identified., Conclusions: Discarded tires were the most preferred breeding habitats for Aedes mosquitoes. Moreover, Ae. aegypti , the main vector of dengue and other arboviruses, was identified for the first time in this region, suggesting a high potential for arbovirus transmission in the study areas.

Background: Despite high prevalence of visceral leishmaniasis and malaria in the study area, their coinfection remains unknown. Therefore, this study was aimed to document VL-malaria coinfections and their associated factors., Methods: A cross-sectional study was conducted among clinical suspected VL patients attending Metema hospital, Northwest Ethiopia, from January 2014 to June 2014. Blood sample was tested by rk39 antigen-based DiaMed IT-Leish dipstick and Giemsa stain microscopic examination of thick and thin blood smears for malaria detection was performed., Result: A total of 384 VL suspected patients were included in the study. Out of these, the prevalence of VL was 83 (21.6%) while the prevalence of malaria was 45 (11.7%). Of malaria cases, 40 (89%) were positive for P. falciparum and 5 (11%) positive for P. vivax . The overall prevalence of VL-malaria coinfection was 16 (4.2%). One-hundred eighty (46.9%) study participants have history of travel. Of these, 10 (5.6%) have VL-malaria coinfections. Age less than 5 years was associated with VL-malaria coinfection., Conclusion: This study highlights the importance of performing malaria screening amongst VL patients living in malaria-endemic areas, particularly in patients under five years.

Background. The World Health Organization estimates that about 80% of the world's population uses herbal medicine to treat various illnesses as means of primary healthcare. However, during preparation, herbal plants may be exposed to contamination by potential pathogens, and this may lead to infections. The aim of this study was to determine bacterial contamination of herbal medicinal products and to assess the antibiotic susceptibility pattern of the isolated bacteria. Methods. A cross-sectional study was conducted from January 1 to May 25, 2013, at Gondar Town. A total of 55 samples used as oral, local, and intranasal routes of administration were collected from the herbalists. Results. In the present study the total aerobic bacterial count ranges from zero to 2.41 × 10(9) CFU/g with mean count of 1.99 × 10(8) CFU/g or mL while the total coliform count showed an average of 1.05 × 10(8) CFU/g or mL with a range of zero to 2.1 × 10(9) CFU/g. The most common bacteria isolated were Bacillus spp. followed by Enterobacter spp., Shigella dysenteriae, and Salmonella spp. Multiple drug resistance was not uncommon and it was found that 125 (83.4%) of the isolates were resistant to two or more antibiotics. Conclusion. Herbal medicinal preparations were highly contaminated with pathogenic microorganisms with high microbial load. Most of the isolates have multiple drug resistance. Using those contaminated herbal medicines may lead to infection of other health related risks. Therefore, this warrants urgent training of herbalists and management scale-up for quality and safety of medicinal plants.

Background: In Ethiopia, where malaria and schistosomiasis are co-endemic, co-infections are expected to be high. However, data about the prevalence of malaria-schistosomiasis co-infection and their clinical correlation is lacking. Therefore, the aim of this study was to assess prevalence of Schistosoma mansoni co-infection and associated clinical correlates in malaria patients., Methods: A cross-sectional study was conducted in 2013 at Chwahit Health Center, in northwest Ethiopia. Blood film positive malaria patients (N = 205) were recruited for the study. Clinical, parasitological, hematological, and biochemical parameters were assessed from every study participant. Stool samples were also collected and processed with Kato-Katz technique to diagnose and classify intensity of Schistosoma mansoni., Results: The prevalence of Schistosoma mansoni and malaria co-infection was 19.5%. The age group of 16-20 years old was significantly associated with co-infection. Co-infected patients with a moderate-heavy egg burden of Schistosoma mansoni had significantly high mean Plasmodium parasitemia. On the other hand, age group of 6-10 years old and moderate-heavy Schistosoma mansoni co-infection were significantly associated with severe malaria., Conclusions: Prevalence of malaria and Schistosoma mansoni co-infection in the study area was considerably high. Severity of malaria and parasitemia of Plasmodium were associated with certain age groups and intensity of concurrent Schistosoma mansoni. Further study is needed to explore the underlying mechanisms of interaction between malaria and Schistosoma mansoni.

Background: In spite of advances in control of infections, wound infections have not completely controlled due to many reasons. The widespread uses of antibiotics, together with the length of time over which they have been available have led to major problems of resistant organisms contributing to morbidity and mortality. This study was aimed to assess bacterial isolates and their drug susceptibility patterns from patients with pus and/or wound discharge., Methods: A retrospective study was conducted at Gondar University Hospital from all individuals who provide pus and/or wound discharge sample from September, 2009 to August, 2012. Socio-demographic and laboratory results were collected from the University Hospital Microbiology Laboratory unit registration books by using a standard data collection format. Data were analyzed using SPSS version 20 software. P-value ≤ 0.05 was considered statistically significant., Result: A total of 628 study subjects were included in the study with bacterial isolation rate of 441 (70.2%). Of all, 344 (54.8%) were males. Two hundred eighty two (63.9%) of the isolates were gram positive and 159 (36.1%) were gram negative. About 331/ 441 (75.0%) of the total isolates were Staphylococcus aureus (32.9%), Coagulase Negative staphylococci (14.7%), Streptococcus spp. (11.6%), Escherichia coli (9.5%), Klebsiella spp. (6.3%). The result showed that 66.2% of the isolates were resistant to tetracycline, followed 59.8% for ampicillin, 59.1% for cotrimoxazole, 51.7% for penicillin; least resistant being 6.3% for gentamycin., Conclusion: High prevalence of bacterial isolates were found; S. aureus being the dominant. Most of the isolates were resistant to many of the antibiotics tested where all isolates of Pseudomonas spp. being resistant to two or more antibiotics. Antibiotic susceptibility test is necessary for effective control of wound infections.

Background: The type and pattern of organisms that cause ocular infection changes over time. Moreover, the causative organisms have developed increased drug resistance. Therefore, the aim of this study was to determine the prevalent bacterial agents of eye discharge and their drug susceptibility patterns to commonly used antimicrobial agents., Methods: A retrospective study was conducted at Gondar University Hospital, Northwest Ethiopia from September, 2009 to August, 2012. Culture and drug susceptibility test results of patients who had eye infections were taken for analysis. Eye discharge samples were cultured on MacConkey agar, blood agar and chocolate agar plates. A standard biochemical procedure was used for full identification of bacterial isolates. Antimicrobial susceptibility tests were done on Mueller-Hinton agar by using disk diffusion method. Data was entered and analyzed by using SPSS version 16 software., Result: A total of 102 eye discharges were submitted for microbiological evaluation, of which (60.8%) had bacterial growth. The most frequently isolated bacterial isolates were gram-positive bacteria (74.2%). The predominant bacterial species isolated was Coagulase-negative staphylococci (27.4%) followed by S. aureus (21%). Within the age group of 1 day-2 years old, (66.1%) of bacteria were isolated. Most of the bacterial isolates were resistance to ampicilin (71%), amoxicilin (62.9%), erythromycin (43.5%), gentamicin (45.2%), penicillin (71%), trimethoprim-sulphamethoxazole (58.1%), and tetracycline (64.6%) while Ceftriaxon and Ciprofloxacin showed (75.8%) and (80%) susceptibility respectively. From the total bacterial isolates, (87.1%) were showed multi drug resistance (MDR) to two or more drugs., Conclusion: The prevalence of bacterial isolates in eye discharge was high in the study area and majority of isolates were gram-positive bacteria. Most of the bacterial isolates were resistant to frequently used antimicrobials. Therefore, drug susceptibility test is necessary before prescribing any antimicrobials.

Background: Many women die from complications related to pregnancy and childbirth. In developing countries particularly in sub-Saharan Africa and Asia, where access to emergency obstetrical care is often limited, obstetric fistula usually occurs as a result of prolonged obstructed labour. Obstetric fistula patients have many social and health related problems like urinary tract infections (UTIs). Despite this reality there was limited data on prevalence UTIs on those patients in Ethiopia. Therefore, the aim of this study was to determine the prevalence, drug susceptibility pattern and associated risk factors of UTI among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia., Methods: A cross sectional study was conducted from January to May, 2013 at Gondar University Hospital. From each post repair obstetric fistula patients, socio-demographic and UTIs associated risk factors were collected by using a structured questionnaire. After the removal of their catheters, the mid-stream urine was collected and cultured on CLED. After overnight incubation, significant bacteriuria was sub-cultured on Blood Agar Plate (BAP) and MacConkey (MAC). The bacterial species were identified by series of biochemical tests. Antibiotic susceptibility test was done by disc diffusion method. Data was entered and analyzed by using SPSS version 20., Results: A total of 53 post repair obstetric fistula patients were included for the determination of bacterial isolate and 28 (52.8%) of them had significant bacteriuria. Majority of the bacterial isolates, 26 (92.9%), were gram negative bacteria and the predominant ones were Citrobacter 13 (24.5%) and E. coli 6 (11.3%). Enterobacter, E.coli and Proteus mirabilis were 100% resistant to tetracycline. Enterobacter, Proteus mirabilis, Klebsella pneumonia, Klebsella ozenae and Staphylococcus aureus were also 100% resistant to ceftriaxone., Conclusion: The prevalence of bacterial isolates in obstetric fistula patients was high and majority of the isolates were gram negative bacteria. Even thought the predominant bacterial isolates were Citrobacter and E. coli, all of the bacterial isolates had multiple antibiotic resistance patterns which alert health profession to look better treatment for these patients.