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Abstract Diarrhea claims >500,000 lives annually among children under five years of age in low- and middle-income countries. Mortality due to acute diarrhea (

Abstract 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, H2S 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

Abstract Background Even though childhood vaccination is a common and cost-effective public health intervention in preventing and reducing childhood disease and death, significant numbers of children do not complete vaccination within the first year of life. Studies indicated that user satisfaction influences service utilization and used as a key indicator of quality care. However, evidence on the level of mothers’ satisfaction with immunization service are limited in urban and accessible places and not well investigated among remote and pastoral communities. As such, this study aimed to address this gap and investigated mothers’ satisfaction towards child vaccination in a pastoralist and agrarian community of the South Omo zone in Southern region of Ethiopia. Methods An institution-based cross-sectional study was conducted among 1221 randomly selected mothers with children eligible for childhood vaccination using a structured, pretested, and interviewer-administered questionnaire. Maternal positive evaluations of the overall vaccination service were measured using 5-point Likert scale questions. Data were entered into Epi data version 3.5.1 and analyzed using IBM SPSS statistical package version 25. Exploratory factor analysis was used for Likert scale questions to extract factor scores which facilitate treatment of variables as continuous for further analysis. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with the outcome variable. A P-value

BackgroundFebrile illnesses are commonly reported as a primary reason for seeking healthcare in sub-Saharan Africa. Timely diagnosis and getting prompt treatment within 24 h of fever onset is crucial to avert the risk of developing severe complications and death. Understanding factors contributing to delayed health seeking is important for public health interventions. Hence, this study aimed to assess individual- and contextual-level factors associated with the delay in seeking prompt treatment for children with fever.MethodA community-based cross-sectional study was conducted from September 2022 to June 2023 in Gamo zone, southern Ethiopia. Three districts were chosen, and then, from each district, six clusters or kebeles were chosen by simple random sampling. A total of 820 caregivers were randomly selected. A two-level mixed-effects logistic regression model was employed to identify factors associated with the delay in seeking prompt treatment. The associations were measured by an adjusted odds ratio (AOR), and statistical significance was declared at a 5% level of significance.ResultThe prevalence of the delay in seeking prompt care was 47.8%. Factors contributing to the delay were caregivers who were aged 30 years and above [AOR 0.23, 95% confidence interval (CI): 0.10–0.52], caregivers who followed the Protestant religion (AOR 3.67, 95% CI: 2.08–6.48), caregivers unable to read and write (AOR 5.32, 95% CI: 6.80–11.70), merchant caregivers (AOR 6.63, 95% CI: 2.75–15.97), caregivers who were exposed to only one media source (AOR 9.3, 95% CI: 8.43–15.60), caregivers with the experience of child death (AOR 0.05, 95% CI: 0.01–0.22), and caregivers seeking permission from their partners to access healthcare (AOR 12.64, 95% CI: 6.98–22.89).Conclusion and recommendationsThere was a high level of delay in seeking healthcare. Targeted community education through mass media, healthcare facilities, and community-level awareness campaigns should be strengthened to improve early treatment seeking and lessen the consequences of delayed treatment seeking.

Abstract Metabolic syndrome (MetS) poses a significant public health challenge globally, including in Ethiopia, with risks for both mothers and children. Unfortunately, there is limited data on MetS in pregnant Ethiopian women. This study aims to evaluate the prevalence and factors associated with MetS in this population. A cross-sectional study was conducted using a systematic random sampling technique. Data were collected through face-to-face interviews using a structured questionnaire adapted from the World Health Organization Steps Survey Tool for Non-communicable Diseases. About five ml of fasting peripheral blood samples were collected from each participant. The Beckman Coulter DXC 700 AU clinical chemistry analyzer was employed for lipid profile and glucose analysis. Subsequently, data were inputted into Epi Data and later exported to SPSS Version 20 for further analysis. Bivariable and multivariable binary logistic regression analyses were carried out, with a predefined level of statistical significance at p

While computer animations have the potential to assist learners in understanding difficult concepts and eliminating misconceptions, studies supporting this claim are scarce. This study investigated how the 7E instructional model integrated with computer animations affected students' conceptual understanding and misconceptions about food making and plant growth. Experimental groups were taught the 7E learning cycle model [7E LCM], and 7E LCM with computer animation [CA] while the control group was taught the conventional instruction method. A two-tiered conceptual understanding multiple-choice test and semi-structured interviews were used to collect the data. ANOVA analysis revealed no significant differences between groups or genders in pre-food making and growth in plant conceptual understanding [pre-FMGPCU] and pre-misconceptions test scores [pre-MC]. There were, however, significant differences in post-FMGPCU and post-MC mean scores, with the 7E LCM with CA showing better results in improving conceptual understanding and minimizing misconceptions. MANOVA revealed no statistically significant difference between male and female students' post-FMGPCU and post-MC results. It was concluded that the 7E LCM with CA enhances students' conceptual understanding and minimizes misconceptions more effectively than other instructional approaches. It is recommended that similar designs be used in biology teaching.

Agroforestry is an emerging livelihood strategy for meeting the fundamental requirements of millions of rural households, yet quantifying its expansion and management practices in Ethiopia remains limited. This study investigated the trends, extents and drivers of agroforestry expansion and related management practices in the central highlands of Ethiopia. A two-stage sampling method was employed to select 160 rural households that engaged in home garden and woodlot agroforestry practices. The data were collected via semi-structured questionnaires, key informant interviews, and focus group discussions and analyzed using descriptive statistics, content analysis, the Kruskal-Wallis test, and the Mann‒Whitney U test. The results demonstrated that there was a significant difference in the mean size (in hectares) of home gardens and woodlot agroforestry practices (p < 0.05). There has been an increasing trend in the adoption and expansion of agroforestry practices, both in home gardens and woodlots. The rate of agroforestry expansion increased from 0.23 % before the 1980s to 3.95 % between 2011 and 2022. The expansion of agroforestry practices, particularly the increase in home garden size and woodlot establishment, was positively influenced by increased market demand, increased seedling availability, increased availability of labor, improved knowledge of agroforestry benefits, and increased proximity to homes and roads. Furthermore, the findings demonstrated that rural households implemented weeding, pruning, thinning, looping, pollarding, fertilizer application, watering, coppicing, fencing, and mulching to maintain and optimize the productivity of their agroforestry systems. Policymakers and stakeholders should consider developing targeted programs and incentives to further encourage the expansion of both home gardens and woodlot agroforestry practices.

BackgroundKey essential nutrition actions (ENA) messages are a comprehensive and evidence-based nutritional package designed to improve the nutritional status during the critical first 1,000 days of life. The poor practice of ENA contributes significantly to mortality and morbidity related to malnutrition in young children. However, there is a dearth of studies focusing on the practice of key ENA messages among mothers and the factors associated with their practice. Therefore, this study aimed to assess the practice of key ENA messages among mothers of children aged 6 months to 2 years in Karat town, Konso zone, South Ethiopia in 2024.MethodsA community-based cross-sectional study involving 421 mothers of children aged 6 months to 2 years was conducted in Karat town, Konso zone, South Ethiopia from January 15 to February 29, 2024. Respondents were chosen using computer-generated random numbers. A structured, pretested, and interviewer-administered questionnaire was used to collect data. Following coding and entry into EpiData 3.1, the data were exported to SPSS version 25 for analysis. Logistic regression (bivariate and multivariable) was employed to identify factors influencing mothers’ practice of key ENA messages, and statistical significance was set at p

Abstract Background Maternal delay in timely seeking health care, inadequate health care and the inability to access health facilities are the main causes of maternal mortality in low and middle income countries. The three-delay approach was used to pinpoint responsible factors for maternal death. There was little data on the delay in decision making to seek institutional delivery service in the study area. Therefore, the aim of this study was to assess the extent of the first maternal delay for institutional delivery and its associated factors among postpartum mothers in the Bale and east Bale zones. Methods An institutional-based cross-sectional study was conducted among 407 postpartum mothers from April 6 to May 6, 2022. A systematic sampling technique was used to select study participants. The data were collected electronically using an Open Data Kit and exported to SPSS window version 25 for cleaning and analysis. Both bivariate and multivariable analysis was done by using binary logistic regression model to identify factors associated with maternal delay for institutional delivery services. Statistical significance was declared at P-value

This study describes the goat production system and breeding practices in selected districts of North Wollo zone, Ethiopia. Data were collected from 180 respondents through a semi-structured questionnaire and group discussions. Descriptive and GLM procedures were employed for data analysis. A mixed crop-livestock production system was the main production system in the area. The mean number of goats per household is 9.66 and they are mainly kept for cash income and meat consumption. The flock structure of indigenous goats consisted of a large number of female goats. Natural pasture and crop residue were the major feed resources in the dry and wet seasons, with an overall mean of 37.53% and 54.26%, respectively. Feed shortage, diseases, and drought were the major constraints for goat production. Most goat owners (97.1%) practiced an uncontrolled mating system. Most farmers (88.93%) reported selecting breeding goats to be a parent for the next generation. Body conformation and coat colour were the preferred traits for the selection of goats. The current level of goat management and breeding methods would not significantly enhance goats’ productivity and profitability. Therefore, designing management and genetic improvement programmes would be vital to improving the productivity of indigenous goats.

The performance of most crop genotypes is greatly influenced by the interactions between genotype and environment. Providing information on well-adapted and high-yielding potato genotypes in a given environment is paramount for small-holder farmers to enhance their productivity. The study aimed to understand GEI effect on tuber yield, and identify and select widely or specifically adapted high-yielding potato genotypes for production. Eleven genotypes were evaluated using a randomized complete block design with three replications. The results of the AMMI analysis of variance showed that tuber yield significantly (p ≤ 0.05) influenced genotype-environment interaction. This reveals that genotypes exhibit varying mean performance in tuber yield across different environments. The sum squared results showed that genotype (62.40 %) and environment (26.73 %) were the main contributors to tuber yield variation, while the genotype-environment interaction effect (10.87 %) contributed least to then tuber yield total variation. The AMMI, GGE biplot, and GSI analysis revealed Gudanie and Gorebella as superior genotypes in tuber yield, demonstrating high mean performance across tested environments. Thus, Gudanie and Gorebella have been chosen as the most broadly adaptable genotypes for production in all potato-growing agroecologies in the Dawuro zone. The GGE and AMMI biplot provided the genotype-by-environment interaction association among environments and genotypes.

Objectives To assess the yield and cost of implementing systematic screening for tuberculosis (TB) disease among people living with HIV (PLHIV) and initiation of TB preventive treatment (TPT) in Ghana.Design Prospective cohort study from August 2019 to December 2020.Setting One hospital from each of Ghana’s regions (10 total).Participants Any PLHIV already receiving or newly initiating antiretroviral treatment were eligible for inclusion.Interventions All participants received TB symptom screening and chest radiography. Those with symptoms and/or an abnormal chest X-ray provided a sputum sample for microbiological testing. All without TB disease were offered TPT.Primary and secondary outcome measures We estimated the proportion diagnosed with TB disease and proportion initiating TPT. We used logistic regression to identify factors associated with TB disease diagnosis. We used microcosting to estimate the health system cost per person screened (2020 US$).Results Of 12 916 PLHIV attending participating clinics, 2639 (20%) were enrolled in the study and screened for TB disease. Overall, 341/2639 (12.9%, 95% CI 11.7% to 14.3%) had TB symptoms and/or an abnormal chest X-ray; 50/2639 (1.9%; 95% CI 1.4% to 2.5%) were diagnosed with TB disease, 20% of which was subclinical. In multivariable analysis, only those newly initiating antiretroviral treatment were at increased odds of TB disease (adjusted OR 4.1, 95% CI 2.0 to 8.2). Among 2589 participants without TB, 2581/2589 (99.7%) initiated TPT. Overall, the average cost per person screened during the study was US$57.32.Conclusion In Ghana, systematic TB disease screening among PLHIV was of high yield and modest cost when combined with TPT. Our findings support WHO recommendations for routine TB disease screening among PLHIV.

The COVID-19 pandemic has caused an abrupt reduction in the use of in-person health care. Children and women of reproductive age groups might be disproportionately affected by the disruption of routine health services, particularly in low and middle-income countries (LMICs). The aim of this study was to see the potential effects of the COVID-19 pandemic on maternal and child health (MCH) care service utilization and strategies for effective service implementation. A phenomenological qualitative inquiry was used. For the collection of the data, an in-depth interview was employed among women and informants from all levels of the health system including the health development army in July and September 2020. The data were analyzed thematically using framework analysis. The study identified a range of COVID-19 impacts on maternal and child health service utilization in Ethiopia. Namely, reduction in accessibility and quality of routine health services, low maternal and child health service utilization, challenges in the commitment of health workers, shortage in the supply of routine resources for maternal and child health services; and enduring strategies designed for effective maternal and child health service implementation. The impact of the COVID-19 pandemic on maternal and child health service utilization was identified in a clear thematic area. The findings of this study provide evidence on bases at the local level; will help the policymakers and local administrators to develop strategies for early preparedness in the context of pandemics.

Demewoz Kefale,1 Mastewal Endalew,2 Worku Necho Asferie,3 Solomon Demis,3 Tigabu Munye,4 Yohannes Tesfahun,5 Amare Simegn,6 Mahilet Wondim,7 Amare Kassaw,1 Gashaw Kerebeh,1 Demeke Mesfin Belay,1 Binyam Minuye,3 Shegaw Zeleke4 1Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Maternal and Neonatal Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 4Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 5Department of Emergency and Critical Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 6Department of Reproductive Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 7Department of Midwifery, South Gondar Zone Health Office, Debre Tabor, EthiopiaCorrespondence: Demewoz Kefale, Tel +251920253332, Email demewozk@yahoo.comBackground: Childhood abuse and neglect is defined as any intentional harm or mistreatment of a child that results in actual or potential harm to the child’s health, survival and development. It has been linked to an increased risk of a wide range of serious short- and long-term medical and mental health problems. Although it is a complex societal issue, it receives limited research attention in the area.Objective: To assess lifetime prevalence of childhood abuse and neglect among high school students in Debre Tabor town, south Gondar Zone, Northwest Ethiopia, 2022.Methods: A cross-sectional study design was used to assess 423 high school students, chosen through a systematic sampling technique. Data were collected using a pre-tested, structured and self-administered international child abuse screening tool, child version (ICAST-C). The effect of independent variables on the outcome variable was explored using logistic regression analyses. The level of significances were determined using an odds ratio with a 95% confidence interval.Results: Of the 423 study participants, 84.4% had lifetime experience of childhood abuse and neglect. Being female (AOR=4.5, 95% CI: 2.38, 8.60), parental marital status (AOR=5.4, 95% CI: 1.07, 27.3), illiteracy of father (AOR=1.65, 95% CI: 4.5, 6.03), birth order (AOR=4.5, 95% CI: 1.57, 13.0), open family discussion of sexual matters (AOR=0.37, 95% CI:1.74, 7.86), and watching pornography (AOR=0.08, 95% CI: 0.02, 0.40) were significantly associated with lifetime experience of childhood abuse and neglect.Conclusion: Lifetime experience of childhood abuse and neglect was high as compared with previous studies. Being female, parental marital status, illiterate fathers, watching pornography, and open family discussion of sexual matters were predictors of childhood abuse and neglect. Dealing with this issue should be considered an integral component of high school students’ care, including parental education and respite care.Keywords: childhood abuse, neglect, high school students, ICAST-C

Abstract Background Mental health problems are the most common morbidities of women during the prenatal period. In LMICs mobile phones have been identified as a good vehicle for monitoring individuals with a high risk of mental health conditions. However, evidence is scarce and the purpose of this study was to assess the intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, Ethiopia 2022. Methods and materials An institutional-based cross-sectional study design was conducted from May 20th to June 20th, 2022. A total of 715 prenatal women were included and a systematic random sampling technique was employed. An interviewer-administered structured questionnaire was used. Collected data was exported to SPSS version 25 for the descriptive part, and AMOS 26 structural equation modeling was also used to describe and assess the degree and significance of relationships between variables. Results A total of 699 (97.8% response rate) responded to complete all the questionnaires. About 530 (77.3%) 95% CI (74%-80.3%) of women intended to use a mobile phone to receive mental health support. The perceived usefulness has a positive effect on attitude (β = 0.391, p

This study aimed to provide a better understanding of the type, function, and production potential of Central Highland goats. Morphometric measurements were collected from 510 heads of goats. About 17 biologically important structural indices were computed using morphological trait measurements. The data were analyzed using SAS’s general linear model, principal component analysis, and stepwise multiple regression techniques. Body index value indicate that the Central Highland goat’s shape is rectangular, which is good conformation for meat production. The dactyl thorax, transverse pelvic, longitudinal pelvic, relative depth of thorax, and width indices suggest their suitability for meat production. However, proportionality and length indices showed an aptitude for milk production. Besides, the body ratio and depth indices indicate less susceptibility of this goat breed to dust infestation and arthritis, good walking ability, good foraging capability, and move easily in sloppy areas. In conclusion, structural indices showed that Central Highland goats could be classified as having a dual purpose and better aptitude for meat production. The results of this study could be an input for designing genetic improvement and conservation programmes for the sustainable utilization of indigenous goats.

Abstract Background Chest x-ray is commonly used for pulmonary abnormality screening. However, since the image characteristics of x-rays highly depend on the machine specifications, an artificial intelligence (AI) model developed for specific equipment usually fails when clinically applied to various machines. To overcome this problem, we propose an image manipulation pipeline. Methods A total of 15,010 chest x-rays from systems with different generators/detectors were retrospectively collected from five institutions from May 2020 to February 2021. We developed an AI model to classify pulmonary abnormalities using x-rays from a single system. Then, we externally tested its performance on chest x-rays from various machine specifications. We compared the area under the receiver operating characteristics curve (AUC) of AI models developed using conventional image processing pipelines (histogram equalization [HE], contrast-limited histogram equalization [CLAHE], and unsharp masking [UM] with common data augmentations) with that of the proposed manipulation pipeline (XM-pipeline). Results The XM-pipeline model showed the highest performance for all the datasets of different machine specifications, such as chest x-rays acquired from a computed radiography system (n = 356, AUC 0.944 for XM-pipeline versus 0.917 for HE, 0.705 for CLAHE, 0.544 for UM, p $$\le$$ ≤ 0.001, for all) and from a mobile x-ray generator (n = 204, AUC 0.949 for XM-pipeline versus 0.933 for HE, p = 0.042, 0.932 for CLAHE (p = 0.009), 0.925 for UM (p = 0.001). Conclusions Applying the XM-pipeline to AI training increased the diagnostic performance of the AI model on the chest x-rays of different machine configurations. Relevance statement The proposed training pipeline would successfully promote a wide application of the AI model for abnormality screening when chest x-rays are acquired using various x-ray machines. Key points • AI models developed using x-rays of a specific machine suffer from generalization. • We proposed a new image processing pipeline to address the generalization problem. • AI models were tested using multicenter external x-ray datasets of various machines. • AI with our pipeline achieved the highest diagnostic performance than conventional methods. Graphical Abstract

Tirsit Ketsela Zeleke,1 Worku Birhane,1 Kale Gubae,1 Bekalu Kebede,1 Rahel Belete Abebe2 1Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Tirsit Ketsela Zeleke, Tel +251919187613, Email teryketsela2018@gmail.com; tirsit_ketsela@dmu.edu.etBackground: Psychotropic medications, consisting of antidepressants, mood stabilizers, antipsychotics, and anxiolytics, are the pillars of managing mental illnesses. Since there is impairment in judgment, attitude, and stability in patients with severe mental conditions, they are vulnerable to non-adherence, which compromises treatment outcome. Nevertheless, a lack of studies investigating medication non-adherence and its predictors in severe mental illnesses patients in Ethiopia has been noticed. The purpose of this study was to evaluate the extent of non-adherence to psychotropic medication and its predictors in patients with severe mental illnesses in Ethiopia.Patients and Methods: A cross-sectional study was carried out among severely ill mental patients attending outpatient psychiatry department at Debre Markos Comprehensive Specialized Hospital. Stratified sampling strategy was used to enroll patients with a variety of mental diseases. The determinants of non-adherence were identified using logistic regression analysis. Statistical significance was determined by a p-value of < 0.05 and a 95% confidence range.Results: The prevalence of non-adherence to psychotropic medication was 50.9%. Missing regular follow-up [AOR (95% CI): 2.36 (1.24– 4.47)], current substance use [AOR (95% CI): 2.48 (1.44– 4.27)], negative attitude towards treatment [AOR (95% CI); 3.87 (2.26– 6.62)], experience of side effects [AOR (95% CI); 4.84 (2.74– 8.54)], medication use for more than 3 years [AOR (95% CI); 7.16 (3.93– 13.06)], and no family support [AOR (95% CI); 2.07 (1.19– 3.58)] were predictors of psychotropic medication non-adherence.Conclusion: This study generalized that most of the patients were non-adherent to their medications. Missing regular follow-up, current substance use, negative attitude towards treatment, experience of side effects, Medication use for more than 3 years and absence of family support were found to influence medication adherence of the patients. In order to correct patients’, caregivers’, and societal misconceptions regarding the significance of treatment adherence, we recommend the need to implement psycho-educational programs.Keywords: severe mental illness, psychotropic medication, non-adherence, Ethiopia

Abstract Background Malaria and dengue fever are the leading causes of acute, undifferentiated febrile illness. In Africa, misdiagnosis of dengue fever as malaria is a common scenario. Through a systematic review of the published literature, this study seeks to estimate the prevalence of dengue and malaria coinfection among acute undifferentiated febrile diseases in Africa. Methods Relevant publications were systematically searched in the PubMed, Cochrane Library, and Google Scholar until May 19, 2023. A random-effects meta-analysis and meta-regression were used to summarize and examine the prevalence estimates. Results Twenty-two studies with 22,803 acute undifferentiated febrile patients from 10 countries in Africa were included. The meta-analysis findings revealed a pooled prevalence of malaria and dengue coinfection of 4.2%, with Central Africa having the highest rate (4.7%), followed by East Africa (2.7%) and West Africa (1.6%). Continent-wide, Plasmodium falciparum and acute dengue virus coinfection prevalence increased significantly from 0.9% during 2008–2013 to 3.8% during 2014–2017 and to 5.5% during 2018–2021 (p = 0.0414). Conclusion There was a high and increasing prevalence of malaria and acute dengue virus coinfection in Africa. Healthcare workers should bear in mind the possibility of dengue infection as a differential diagnosis for acute febrile illness, as well as the possibility of coexisting malaria and dengue in endemic areas. In addition, high-quality multicentre studies are required to verify the above conclusions. Protocol registration number: CRD42022311301.

This study aimed to retrospectively assess the cost-effectiveness of various COVID-19 vaccination strategies in Ethiopia. It involved healthcare workers (HCWs) and community participants; and was conducted through interviews and serological tests. Local SARS-CoV-2 variants and seroprevalence rates, as well as national COVID-19 reports and vaccination status were also analyzed. A cost-effectiveness analysis was performed to determine the most economical vaccination strategies in settings with limited vaccine access and high SARS-CoV-2 seroprevalence. Before the arrival of the vaccines, 65% of HCWs had antibodies against SARS-CoV-2, indicating prior exposure to the virus. Individuals with prior infection exhibited a greater antibody response to COVID-19 vaccines and experienced fewer new infections compared to those without prior infection, regardless of vaccination status (5% vs. 24%, p < 0.001 for vaccinated; 3% vs. 48%, p < 0.001 for unvaccinated). The cost-effectiveness analysis indicated that a single-dose vaccination strategy is optimal in settings with high underlying seroprevalence and limited vaccine availability. This study underscores the need for pragmatic vaccination strategies tailored to local contexts, particularly in high-seroprevalence regions, to maximize vaccine impact and minimize the spread of COVID-19. Implementing a targeted approach based on local seroprevalence information could have helped Ethiopia achieve higher vaccination rates and prevent subsequent outbreaks.

Background: Clinicians rely on local antimicrobial resistance pattern data to guide empiric treatment for seriously ill patients when culture and antimicrobial susceptibility testing results are not immediately available. Objective: This study aimed to analyse 5-year trends in antimicrobial resistance profiles of Escherichia coli and Klebsiella pneumoniae isolates. Methods: Bacteriology reports from 2017 to 2021 at the Ethiopian Public Health Institute were analysed retrospectively. Isolates were identified using either the VITEK 2 Compact system, the BD Phoenix M50 instrument, or conventional biochemical tests. Antimicrobial susceptibility testing was conducted using either the Kirby-Bauer disk diffusion method or the VITEK 2 Compact system and BD Phoenix M50 systems available at the time of testing. The Cochran Armitage trend test was employed to test the significance of antimicrobial resistance trends over time. P-values less than 0.05 were considered statistically significant. Results: Of the 5382 bacteriology reports examined, 458 (9%) were on E. coli and 266 (5%) were on K. pneumoniae. Both K. pneumoniae (88%) and E. coli (65%) demonstrated high resistance to extended-spectrum cephalosporins. However, both K. pneumoniae (14%) and E. coli (5%) showed lower rates of resistance to carbapenems compared to other antimicrobials. In K. pneumoniae, resistance to carbapenems (from 0% to 38%; p 0.001) and ciprofloxacin (from 41% to 90%; p 0.001) increased significantly between 2017 and 2021. Conclusion: Both organisms showed very high resistance to broad-spectrum antibiotics. Additionally, K. pneumoniae demonstrated a statistically significant rise in ciprofloxacin and carbapenem resistance. What this study adds: This study emphasises the significance of regular reporting of local antimicrobial resistance patterns as this information can guide appropriate empiric therapy and efforts to address antimicrobial resistance issues.

Objectives Lockdowns and border closures impacted medicine availability during the COVID-19 pandemic. This study aimed to assess the availability of essential, generic medicines for chronic diseases at public pharmaceutical supply agencies in Ethiopia.Design Comparative cross-sectional study.Setting The availability of essential, generic medicines for chronic diseases was assessed at two public pharmaceutical supply agency hubs.Participants The current study included public supply agency hub managers, warehouse managers and forecasting officers at the study setting.Outcomes The assessment encompassed the availability of chronic medicines on the day of data collection, as well as records spanning 8 months before the outbreak and 1 year during the pandemic. A total of 22 medicines were selected based on their inclusion in the national essential drug list for public health facilities, including 17 medicines for cardiovascular disease and 5 for diabetes mellitus.Results The results of the study indicate that the mean availability of the selected basket medicines was 43.3% (95% CI: 37.1 to 49.5) during COVID-19, which was significantly lower than the availability of 67.4% (95% CI: 62.2 to 72.6) before the outbreak (p

Objectives This systematic review and meta-analysis aimed to assess the magnitude and determinants of diabetic ketoacidosis (DKA) among patients with diabetes mellitus (DM) in Ethiopia.Design Systematic review and meta-analysis.Participants Age 15 and above all patients with diabetes with the diagnosis of DKA in EthiopiaData source PubMed/MEDLINE, Cochrane Library, Science Direct, HINARI, Google Scholar and grey literatures were accessed to find relevant articles. Studies that have been conducted and reported in English language, articles with an available full-text, and observational studies were included. The task of searching sources was carried out from all stated electronic databases performed during 15 April–29 April 2023.Primary and secondary outcome measures Eligible studies were critically appraised by three independent reviewers for methodological quality in the review using standardised critical appraisal instruments from Joanna Briggs Institute (JBI) for observational studies. After the finally extracted studies were exported, systematic review and meta-analysis were conducted using Unified Management, Assessment and Review of Information (JBI SUMARI) (JBI, Adelaide, Australia) and STATA V.17 software. Sensitivity tests were done, and funnel plot inspections with Egger’s test were used to check for publication bias.Result From a total of 19 studies with 6498 study participants, the pooled prevalence of DKA among patients with DM in Ethiopia was 30.92% (95% CI 29.96 to 31.89) with a significant statistical heterogeneity (I2=99.2, p=

The effect of scandium doping on the structural, electronic, optical, and thermodynamic properties of scandium-doped zirconia (Zr0.875Sc0.125 O1.9375) was investigated by first-principles calculations. The results of electronic property calculation show that the incorporation of scandium (Sc3+) in ZrO2 has reduced its bandgap due to the formation of scandium 3d states in the conduction band. The analysis of optical properties shows that scandium doping in ZrO2 improves the real ε1 and imaginary dielectric functions ε2, extinction coefficient (k), refractive index (n), reflectivity (R), and absorption coefficient (α) properties thereby enhancing its photocatalytic and optical activities. The heat capacities of ZrO2 and Sc-ZrO2 calculated at temperature of 800 K are 74.27 and 77.98 J/K/Nmol, respectively. The result of thermodynamic properties calculations show that doping scandium in zirconia enhances its entropy and specific heat capacity thereby allowing it to be thermodynamically stable for a wide range of electronic applications.

BackgroundA significant proportion of women in Ethiopia suffer from violence by their intimate partner during pregnancy, which has adverse maternal and newborn outcomes. Couple-focused interventions are effective in reducing and/or controlling violence between women and their intimate partners. However, interventions addressing intimate partners of the victims are not well studied, particularly in the Ethiopian setting. This study aims to assess the effect of couple-based violence prevention education on intimate partner violence during pregnancy.MethodsWe will use a cluster randomized controlled trial to evaluate the effectiveness of couple-based violence prevention education compared to routine care in reducing intimate partner violence during pregnancy. Sixteen kebeles will be randomly assigned to 8 interventions and 8 control groups. In the trial, 432 couples whose wife is pregnant will participate. Health extension workers (HEWs) will provide health education. Data will be collected at baseline and endline. All the collected data will be analyzed using Stata version 16.0 or SPSS version 25.0. We will use the McNemar test to assess the differences in outcomes of interest in both intervention and control groups before and after the intervention for categorical data. A paired t-test will be used to compare continuous outcome of interest in the intervention and the control groups after and before the intervention. The GEE (Generalized Estimating Equation), will be used to test the independent effect of the intervention on the outcome of the interest. Data analysis will be performed with an intention-to-treat analysis approach. During the analysis, the effect size, confidence interval, and p-value will be calculated. All tests will be two-sided, and statistical significance will be declared at p < 0.05.DiscussionWe expect that the study will generate findings that can illuminate violence prevention strategies and practices in Ethiopia.Trial registrationIt has been registered on ClinicalTrials.gov as NCT05856214 on May 4, 2023.

Ethiopian schools were closed for nearly 40 weeks as a measure to control the COVID-19 pandemic. The objective of the study was to evaluate the role of COVID-19 pandemic's restrictive measures on cognition and behavioral difficulties of schoolchildren in Arba Minch Health and Demographic Surveillance Site. Two cross-sectional surveys were conducted in November 2019 (pre-COVID-19-lockdown) and November 2020 (post-COVID-19 lockdown). Data were collected both at the school and homes of the children. Cognitive development of the children was assessed using digit span, Raven's coloured progressive matrices (RCPM) and Visual search using cancellation task. Behavioral difficulties score of the children was assessed using Strengths and Difficulties Questionnaire. Analysis of covariance (ANCOVA) was used to compare between the cognition outcomes and behavioral difficulties score pre- and post-COVID-19-lockdown. In a sub-group of children who provided data in both surveys, the difference in cognitive and behavioral outcomes was tested using a mixed effect model. Compared to the pre-COVID-19-lockdown, schoolchildren post-COVID-19-lockdown scored lower in the standardized performance index for the visual search task, which measures attention (0.27 SD, 95% confidence intervals (95%CI): -0.40, -0.13). However, they scored higher by 0.26 SD (95%CI: 0.13, 0.40) and 0.36 SD (95%CI: 0.22, 0.49) in digit span and RCPM, respectively, measuring working memory and non-verbal intelligence. There was no significant difference in total difficulties score between pre- and post-COVID-19-lockdown (0.01 SD, 95%CI: -0.12, 0.15). The subgroup analysis showed a significant increase in digit span among children post-COVID-19-lockdown while the other domains did not show a significant change. Factors contributing to the improvement of children's cognitive domains while away from the school environment should be explored and utilized to enhance child development. This study was registered at clinicaltrials.gov as NCT04137354 on October 14, 2019.

Maternal mortality occurs in developing nations as a result of inadequate health care, delayed medical attention and the inability to access medical facilities. The three-delay model was employed to determine the causes of maternal death. There was limited data on maternal delay in reaching health facilities for emergency obstetric care services in the study area. Therefore, the aim of this study was to assess the prevalence of delay in reaching health facilities for emergency obstetric care and associated factors among postpartum mothers at Bale and east Bale zones. An institutional-based cross-sectional study was conducted among 407 postnatal women from April 6 to May 6, 2022. A systematic sampling technique was used to select study participants. The data were collected electronically using an Open Data Kit and exported to SPSS window version 25 for cleaning and analysis. Both bivariable and multivariable analysis was done by using a binary logistic regression model to identify factors associated with delay in traveling for emergency obstetric care services. Statistical significance was declared at P-value < 0.05. In this study, the prevalence of delay in reaching health facilities during emergency obstetric care was 38.1% (95%CI: 33.3, 43). The following factors showed significant association with delay in reaching health facilities during emergency obstetric care: Average monthly income (AOR = 1.87; 95% CI: 1.12, 3.14), distance (AOR = 4.35; 95% CI: 2.65, 7.14), a referral from other health facilities (AOR = 1.77; 95% CI: 1.01, 3.11) and delay one (AOR = 2.9; 95% CI: 1.7, 4.93). This study showed that the prevalence of delay in reaching health facilities for emergency obstetric care services in the study area was high. Promoting road accessibility and transport mechanisms and strengthening referral mechanisms shall be emphasized.

In this study, the structural, electronic, optical, elastic, and thermodynamic properties of Ytterbium chalcogenides YbX (X = S, Se and Te) were computed within the first principles using generalized gradient approximation (GGA) as implemented in the pseudopotential plane wave approach. The equilibrium total energy for YbX (X = S, Se, and Te) was calculated as a function of the energy cutoff, k-point grid, and lattice parameter. An optimized lattice parameter of 5.6, 5.66, and 6.136 Å were calculated for YbS, YbSe, and YbTe, respectively. The energy band gaps of YbS, YbSe, and YbTe computed are 1.14, 1.32, and 1.48 eV, respectively. In addition, the low band gap (less than 3 eV) for ytterbium chalcogenides indicated that they may have potential applications in photovoltaic cells and laser diodes. Moreover, the negative dielectric function value for a certain frequency range indicates that these compounds are suitable for specific optical and microwave circuit applications. The result of elastic and thermodynamic property computation reveals that ytterbium chalcogenides are mechanically and thermodynamically stable, which can be useful in a variety of electronic device applications.

Objective: This study aimed to determine the diagnostic accuracy of the antigen rapid diagnostic test (Ag-RDT) as a screening tool for SARS-CoV-2 infection compared to Quantitative reverse transcription polymerase chain reaction (qRT-PCR). Methods: This study was conducted at six referral hospitals in Oromia Region, Ethiopia. One thousand seven hundred twenty-one patients who visited the hospitals for various medical conditions were tested with qRT-PCR and/or Ag-RDTs. Qualitative detection of SARS-CoV-2 antigen was performed using the Panbio™ COVID-19 Ag rapid test device. Results: Compared with qRT-PCR, Ag-RDTs had a sensitivity of 33.3 % (95%CI: 30.9%–35.9 %) and a specificity of 99.3 % (95%CI: 98.8%–99.7 %) to detect active SARS-CoV-2 infection. The area under the receiver operator curve was 0.67 (95%CI: 0.63–0.69). The sensitivity of Ag-RDTs appeared high in patients with shortness of breath (73.3 %) and those presenting with all three symptoms – fever, cough, and dyspnea (71.4 %). In all instances, specificity was more than 98 %. The Ag-RDT positivity rate also correlated well with viral load: 51.7 % in cases with cycle threshold (Ct) 25 (low viral load). Conclusion: Although Ag-RDT for diagnosing SARS-CoV-2 is a good option as a point-of-care screening tool, it has a low sensitivity to detect active infections. Using Panbio™ COVID-19 Ag Rapid test for diagnostic and treatment decisions may lead to a false negative, resulting in patient misdiagnosis, ultimately contributing to disease spread and poor patient outcome.

Tirsit Ketsela Zeleke,1 Zegaye Agmassie Bazezew,2 Rahel Belete Abebe3 1Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 2Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 3Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Tirsit Ketsela Zeleke, Tel +251 919187613, Email teryketsela2018@gmail.com; tirsit_ketsela@dmu.edu.etBackground: Pathophysiological alterations in liver cirrhosis affect how medications are metabolized and eliminated. Therefore, when prescribing medicines for patients with cirrhosis, appropriate prescription of medication is an accepted standard of practice. Since patients with cirrhosis require a complex therapy plan, it necessitates regular reviews of medication utilization. However, no research was conducted in Ethiopia. The aim of this study was to figure out the predictors of inappropriate prescriptions and the pattern of prescription in patients with cirrhosis.Patients and methods: A cross-sectional study design was carried out at Felege-Hiwot, a specialized and comprehensive referral hospital, from June 30, 2022, to November 30, 2022, in 123 hospitalized patients with cirrhosis. Patients were recruited using a simple random sampling procedure, and data were collected using an interviewer-administered questionnaire. For the purpose of identifying determinants of inappropriate prescription, logistic regression analyses have been carried out and statistical significance was defined by a p-value of less than 0.05 and a 95% confidence range.Results: The burden of inappropriate prescriptions among patients with cirrhosis was 35.8%. An increased number of medications prescribed (AOR = 4.88 (1.05– 22.68)), prescription by a general practitioner (AOR = 3.57 (95% CI 1.07– 11.44)), increased level of bilirubin (AOR = 3.54 (95% CI 1.95– 6.45)), and decreased level of albumin (AOR = 0.18 (95% CI 0.04– 0.72)) were predictors for an inappropriate prescription.Conclusion: It has been found that there were inappropriate prescriptions among patients with liver cirrhosis. Prescribers should pay close attention to patients who have prescribed with higher number of medications, increased level of bilirubin and decreased level of albumin. Moreover, educational level of prescribers needs to be upgraded in order to adopt evidence-based medication prescriptions and adhere to recommended practices.Keywords: inappropriate prescription, cirrhosis, Ethiopia

Hana Gebreselassie,1 Henok Zeleke,2 Daniel Ashebir2 1Department of Surgery, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2Department of Surgery, Addis Ababa University, College of Health Sciences, Addis Ababa, EthiopiaCorrespondence: Hana Gebreselassie, Department of Surgery, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, Email hanaabebe23@gmail.comBackground: Alvarado score is the most widely used scoring system for diagnosing acute appendicitis, globally. There have been concerns regarding the diagnostic accuracy of this score as it was shown to have lower sensitivity in certain populations like Blacks and Asians. Despite its wide clinical use in the Ethiopian set up, the diagnostic accuracy of this score remained largely unexamined in this population.Methodology: A prospective cross-sectional study was conducted and all adult patients who presented with right lower quadrant abdominal pain and evaluated with a clinical impression of acute appendicitis were enrolled in the study. Data was collected by trained surgical residents over a period of six months (August 2019– January 2020) and analysed using SPSS version 25.Results: A total of 235 patients were enrolled in this study among whom two thirds were males. The majority of the study participants (61.7%) had an Alvarado score of ≥ 7 while almost a quarter of them had a score of < 4. The mean Alvarado score in this study was 7 ± 1.8 whereas the median and the mode were 7 and 9 respectively. The overall sensitivity, specificity, positive predictive value and negative predictive value of Alvarado score were 99.1%, 55.6%, 98.2% and 62.5% respectively. The sensitivity and specificity of this score was superior in males compared to females (99.3% vs 97.6% and 80% vs 25%). A score of ≥ 5 was found to have a sensitivity of 98.4%.Conclusion: Alvarado score was found to have good sensitivity and positive predictive value in this study. A score of ≥ 5 can be used to “rule in” the diagnosis of acute appendicitis. Hence, the use of Alvarado score’s in the Ethiopian setup is to be encouraged.Keywords: Alvarado score, acute appendicitis, sensitivity, specificity

Shegaw Zeleke,1 Solomon Demis,2 Yeshiambaw Eshetie,1 Demewoz Kefale,3 Yohannes Tesfahun,4 Tigabu Munye,1 Amare Kassaw3 1Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Maternity and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 4Department of Emergency and Critical Care Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Shegaw Zeleke, Email shegawzn@gmail.comBackground: Approximately 38.4 million adult people worldwide live with HIV, of which the majority live in Africa. In Ethiopia increasing the quality of life to HIV patients and preventing HIV transmission are challenging. Even though test-and-treat strategy is applied for early enrollment to ART, poor retention and loss to follow-up are hindering the care.Objective: This study examined the incidence and predictors of loss to follow-up among adult HIV patients on ART in South Gondar governmental hospitals, September 11, 2017–September 10, 2022.Methods: A multi-facility-based retrospective follow-up study was conducted. Study subjects were assigned using simple random sampling methods by their medical record numbers. The data were entered into EPI data version 3.0.2 and exported to STATA version 17 for analysis. The Kaplan–Meier failure function was employed to determine the overall failure estimates. Cox proportional hazard model was tailored for both bi-variable and multivariable. Variables at p-value < 0.05 with 95% CI were significantly associated with loss to follow-up.Results: In this study, about 559 adult HIV survivors were included, and the response rate was 98%. The mean age and standard deviation (±SD) of study subjects were 36.6± 9.3 years. The incidence rate of loss to follow-up was 6.7 per 100 person-years (95% CI: 5.6, 8.1). Educational status [AHR: 1.68 (95% CI: 1.04, 2.72)], substance use [AHR: 2.38 (95% CI: 1.50, 3.75)], and ART adherence [AHR: 3.33 (95% CI: 1.38, 8.08)] were significant determinants to loss to follow-up.Conclusion: In conclusion, the study finding reported that the incidence of loss to follow-up was low. HIV patients who did not have formal education, substance users, and poor ART adherence were at greater hazard of being lost to follow-up. In order to mitigate the rate of loss to follow-up, it is recommended to strengthen the available intervention modalities.Keywords: HIV/AIDS, ART, lost follow-up, predictors, adults, Ethiopia

Mastewal Zeleke,1 Almaz Badanie,2 Elsah Tegene Asefa,3 Wondu Reta Demissie,2 Getahun Chala,1 Husen Aman,4 Teka Obsa Feyisa,5 Mezgebu Legesse Habte5 1Department of Medical Physiology, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2Department of Biomedical Sciences, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia; 3Department of Medicine, College of Medicine and Health Sciences, Jimma University, Jimma, Ethiopia; 4Department of Human Anatomy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5Department of Medical Biochemistry, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Mastewal Zeleke, Department of Medical Physiology, College of Health and Medical Sciences, Haramaya University, P.O.Box:235, Harar, Harari Regional State, Ethiopia, Tel +251911142917, Email mastewalzeleke2015@gmail.comBackground: Thyroid dysfunction (TD) is a metabolic manifestation related to either excessive or inadequate production of thyroid hormones. It has been widely proven to have comorbidities like cardiovascular disease. An electrocardiograph is a simple investigative instrument used to assess cardiac status to prevent complications in the later stages of the disease.Objective: To assess electrocardiogram (ECG) changes and associated factors among TD patients.Methods: An institution-based cross-sectional study was conducted among 273 TD patients attending Jimma Medical Center from October 11 to December 11, 2021. An ECG tool with 12 leads was used to assess the cardiac status, and a semi-structured questionnaire was used to assess sociodemographic, behavioral, and comorbidity variables. Bodyweight, height, waist circumference (WC), hip circumference (HC), and blood pressure variables were recorded, and body mass index (BMI) and waist-to-hip ratio (WHR) were calculated.Results: Out of a total of 273 analyzed and interpreted ECG results by the cardiologists, 185 (67.8%) had ECG alterations. The most common types of ECG changes were arrhythmia 153 (56%), followed by myocardial infarction 74 (27.1%), ventricular hypertrophy [left 20 (7.3%) and right 15 (5.5%)], left atrial enlargement 3 (1%), axis deviation, and other abnormalities 24 (8.8%) and 18 (6.6%), respectively. The identified predictor variables for the ECG changes were the age group of 41 to 60 years old [AOR = 2.5, 95% CI: 1.25, 5.05], being female [AOR = 2.7, 95% CI: 1.28, 5.59], having diabetes mellitus [AOR = 4.25, 95% CI: 1.6, 11.2], and not starting the treatment [AOR = 8.6, 95% CI: 3.45, 21.6].Conclusion: This study revealed that the prevalence of ECG changes was high among TD patients. The most common type of ECG change observed was arrhythmia followed by myocardial infarction. The age range of 41– 60 years old, being female, having diabetes mellitus, and not starting the treatment were significantly associated with the ECG changes. Implementing an efficient noninvasive screening of cardiac status can detect unrecognized and asymptomatic cardiac impairment in TD patients.Keywords: cardiovascular disease, electrocardiogram, Ethiopia, thyroid dysfunction

Abstract Background COVID-19 pandemic posed a major impact on the availability and affordability of essential medicines. This study aimed to assess the knock-on effects of the COVID-19 pandemic on the supply availability of non-communicable chronic disease (NCD) medicines and paracetamol products in Ethiopia. Methods A mixed methods study was conducted to assess the supply and availability of twenty-four NCD drugs and four paracetamol products listed on the national essential medicines list for hospitals. Data were collected from twenty-six hospitals located in seven zones of Oromia region in the southwestern part of Ethiopia. We extracted data on drug availability, cost and stock out for these drugs between May 2019 and December 2020. The quantitative data were entered into Microsoft Excel and exported to statistical package software for social science (SPSS) version 22 (IBM Corporation, Armonk, NY, USA) software for analysis. Results The overall mean availability of selected basket medicines was 63.4% (range 16.7% to 80.3%) during the pre-COVID-19 time. It was 46.3% (range 2.8% to 88.7) during the pandemic. There was a relative increase in the availability of two paracetamol products [paracetamol 500 mg tablet (67.5% versus 88.7%) and suppository (74.5% versus 88%)] during the pandemic. The average monthly orders fill rates for the selected products range from 43 to 85%. Pre-COVID-19, the average order fill rate was greater or equal to 70%. However, immediately after the COVID-19 case notification, the percentage of order(s) filled correctly in items and quantities began decreasing. Political instability, shortage of trained human resources, currency inflation, and limited drug financing were considered as the major challenges to medicine supply. Conclusion The overall stock out situation in the study area has worsened during COVID-19 compared to pre-COVID-19 time. None of the surveyed chronic disease basket medicines met the ideal availability benchmark of 80% in health facilities. However, availability of paracetamol 500 mg tablet surprisingly improved during the pandemic. A range of policy frameworks and options targeting inevitable outbreaks should exist to enable governments to ensure that medicines for chronic diseases are consistently available and affordable.

Abstract Background Tuberculosis (TB) remains a major public health threat in Ghana. The impact of COVID-19 resulted in a 15% decline of TB case notification in 2020 compared to 2019. To mitigate the impact on TB services, the Ghana National Tuberculosis Programme (NTP) introduced the bidirectional screening and testing for TB and COVID-19 in 2021. Objective To evaluate the yield of bidirectional screening and testing for TB and COVID-19 among facility attendees in the Greater Accra region. Method We used secondary data obtained from the initial implementation stage of the bidirectional testing for TB and COVID-19 among COVID-19 and/or TB presumed cases in five health facilities in the Greater Accra Region from January to March 2021. To mitigate the impact of COVID-19 on TB services and accelerate TB case detection, the NTP of Ghana introduced bidirectional screening and testing for TB and COVID-19 in Greater Accra Region before scaling up at national level. Results A total of 208 presumed TB or COVID-19 cases were identified: 113 were tested for COVID-19 only, and 94 were tested for both TB and COVID-19, 1 was tested for TB only. Among presumed cases tested for COVID-19, 9.7% (95% CI, 5.6-13.7%) were tested positive. Whilst among the total presumed tested for TB, 13.7% (95% CI, 6.8-20.6%) were confirmed to have TB. Among the total 94 presumed cases tested for both TB and COVID-19, 11.7% (95% CI, 5.2-18.2%) were confirmed to have TB and 13.8% (95% CI, 6.9-20.8%) participants were COVID-19 positive and one participant (1.1%) had both COVID-19 and TB. Conclusion Bidirectional screening and testing for TB and COVID-19 shows significant potential for improving overall case detection for the two diseases. The bidirectional screening and testing could be applicable to address a similar respiratory epidemic in the future that might have a masking effect on the response to TB disease.

Demeke Shumu,1 Balew Zeleke,2 Addisu Simachew3 1Department of Pediatrics and Child Health Nursing, Debre Markos University, College of Medicine and Health Science, Debre Markos, Ethiopia; 2Department of Pediatrics and Child Health Nursing, Bahir Dar University, College of Medicine and Health Science, Bahir Dar, Ethiopia; 3Department of Nursing, Dima Technology College, Debre Markos, EthiopiaCorrespondence: Demeke Shumu, Tel +251920218042, Email demekeshumu21@gmail.comIntroduction: Female genital mutilation is the removal of a woman’s external genitalia in whole or in part for a non-obvious medical reason. Female genital mutilation causes short- and long-term complications like bleeding, pain, infection and exposes girls to sexually transmitted diseases. The determinants of female genital mutilation among children under the age of five have received less attention. As a result, the purpose of this study was to determine the factors that influence female genital mutilation in children under the age of five.Methods: A community-based unmatched case control study design was used. The study participants were chosen using computer-generated simple random sampling technique. With a ratio of 1:4 between cases and controls, 323 participants were recruited. Data were collected using an interviewer-administered questionnaire. The association between each independent variable and the dependent variable was determined using binary logistic regression. In a multivariable analysis, variables were considered statistically significant if they had a P-value of less than 0.05 at a 95% confidence interval.Results: In this study, mothers’ circumcision status (AOR = 4.6; 95% CI: 2.29– 9.25), mothers who had an unfavorable attitude (AOR = 4.15; 95% CI: 1.96– 8.82), households in the poorest wealth quintile (AOR = 3.65; 95% CI: 1.2– 11.54), mothers who had inadequate knowledge (AOR = 3.31; 95% CI: 1.51– 7.25) and antenatal care visit of mothers (AOR = 2.46; 95% CI: 1.03– 5.83) were found to be determinant factors of female genital mutilation.Conclusion and Recommendation: Mothers’ circumcision status, mother’s attitude, wealth quintile, knowledge of mothers, and number of antenatal care visits were factors associated with female genital mutilation. Regular awareness-building on the impacts of the practice and special attention to the mother’s attitude are important to eliminate female genital mutilation.Keywords: female genital mutilation, determinants, under-five children, Motta town

Tesfaye Yimer Tadesse,1 Mulugeta Molla Zeleke,1 Samuel Berihun Dagnew,2 Getu Tesfaw Addis3 1Pharmacology and Toxicology Unit, Department of Pharmacy, Health Science College, Debre Tabor University, Debre Tabor, Ethiopia; 2Clinical Pharmacy Unit, Department of Pharmacy, Health Science College, Debre Tabor University, Debre Tabor, Ethiopia; 3Social and Administrative Pharmacy Unit, Department of Pharmacy, Health Science College, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Tesfaye Yimer Tadesse, Pharmacology and Toxicology Unit, Department of Pharmacy, Health Science College, Debre Tabor University, Debre Tabor, Amhara, 272, Ethiopia, Tel +251921313476, Email yimertesfaye00@gmail.comAbstract: The Urticaceae family contains 54 genera and more than 2000 species that can be found in tropical, subtropical, and temperate climates all over the world. This family includes the largest genus in the world, Urtica, which is also known as stinging nettle. Stinging hairs are present on the lower surface of the leaves and beneath the stems of Urtica simensis, also known as the stinging nettle, herbal nettle that is dioecious, upright, and unbranched. For the treatment of conditions like gastritis, heart disease, diabetes, gonorrhea, and malaria, people employ various portions of Urtica simensis in a variety of ways in traditional medicine. The Urtica simensis leaves are rich in variety of active secondary phytochemical constituents including terpenoids, saponins, tannins, flavonoids, steroids, alkaloids, polyphenols, sterols, oxalate, and ascorbic acid (vitamin C). According to different reports, it possesses a variety of pharmacological properties, including antioxidant, antiproliferative, antidiabetic, cardioprotective, antiulcer, antibacterial, and antifungal actions. The current review summarizes published and unpublished information about the ethnobotanical, phytochemical, ethnopharmacological, and toxicological reports of Urtica simensis and summarizes all the research work carried out on this plant to provide updated information for future work.Keywords: Urtica simensis, ethnobotanical uses, phytochemical studies, ethnopharmacological studies, Ethiopia

AbstractThe present study aimed to assess whether a training-based intervention using an explicit rime-based phonics method improves the phonological awareness outcomes of EFL children in Ethiopia. The participants were two sections of 3rd grade children (N = 70) from two public primary schools in Hawassa, Ethiopia. A quasi-experimental research design was used in which a section of the children (N = 35) were randomly assigned to the experimental group and the other section of the children (N = 35) to the control group. The experimental group was explicitly exposed to a training-based beginning reading intervention using an explicit rime-based phonics method. The control group stayed in their regular classroom with their regular beginning reading lessons with the conventional way. The phonological awareness test (PAT) was used to measure phonological awareness outcomes in the two groups before and after the intervention. The findings showed that the experimental group achieved significant improvement on the phonological awareness at post- test and that the magnitude of the intervention’s effect was very large for all sub-subtests and the total phonological awareness. The findings also indicated that brief and direct beginning reading instruction with an explicit rime-based phonics method helps children in a non-English language context with a first language (L1) significantly different from English to rapidly improve their phonological awareness performances. The findings further suggested that just knowledge of letters alone is not a sufficient condition for phonological awareness to develop.

Background: Diaper dermatitis is one of infants and toddlers' most common skin diseases; it accounts for 10–20 % of all skin diseases and 25 % of pediatric dermatology visits. Diaper dermatitis also increases parents' mental health problems and compromises the quality of life. Despite its ill outcome, diaper dermatitis's burden and risk factors are poorly studied in Ethiopia. Therefore, this study aimed to assess the magnitude of diaper dermatitis and associated factors among 1–24 months children visiting public health facilities in Arba Minch town, southern Ethiopia. Methods: A facility-based cross-sectional study was conducted among 671 mother-child pairs from May 15 to June 15, 2022. A structured and pretested interviewer-administered questionnaire and observational checklist were used to collect the information. The data was collected using an open data kit tools and analyzed using Stata version 17.0. Bivariable and multivariable analyses were carried out to identify factors associated with diaper dermatitis. P-value

Yeshiwas Guadie Zeleke,1 Seyfe Asrade Atnafie,2 Tezera Jemere Aragaw2 1College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia; 2Department of Pharmacology, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Tezera Jemere Aragaw, Tel +251918773670, Fax +2510581141240, Email tezeraadis1982@gmail.comBackground: Heteromorpha arborescens has been used to treat diabetes traditionally. There was no in vivo study to support the claim. This study aimed to confirm anti-diabetic activity of 80% methanol in water extract and solvent fractions of H. arborescens leaves in mice.Methods: H. arborescens leaves were macerated and extracted in 80% methanol in water. Hydro-methanol extract of H. arborescens leaves were tested in mice models. Overnight fasted mice were randomly divided into five groups for normoglycemic and glucose-loaded models as a negative control, positive control, and three tested groups, whereas, in streptozotocin-induced diabetic models, the mice were grouped into six groups each comprised six mice: diabetic negative control and normal negative control groups treated with 10 mL/kg distilled water, diabetic positive control group treated with Glibenclamide 5 mg/kg and three diabetic tested groups treated with extract at 100, 200, and 400 mg/kg doses. A one-way ANOVA was performed to analyze the data, and the post hoc Tukey’s test was utilized for multiple comparisons. The P-value < 0.05 was considered statistically significant.Results: Hydro-methanol extract of H. arborescens leaves at 400 mg/kg in normoglycemic mice significantly lowered blood glucose levels (BGLs) (P< 0.01). Mice with oral glucose-loaded test lowered BGLs at dosages of 200 mg/kg (P < 0.05) and 400 mg/kg (P < 0.01) respectively. Single-dose of ethyl acetate, n-hexane fractions and hydro-methanol extract at 100 mg/kg, 400 mg/kg and 200 mg/kg reduced BGLs (P < 0.05, P < 0.001, and P < 0.01) respectively. BGL drops in diabetic mice given daily repeated doses of 200 mg/kg of hydro-methanol extract and 400 mg/kg of ethyl acetate fraction (P < 0.001). Diabetic mice gained weight at a 400 mg/kg hydro-methanol extract and ethyl acetate fraction (P < 0.05 and P < 0.01) respectively. Hydro-methanol extract and ethyl acetate fraction and at 200 mg/kg decreased total cholesterol, triglycerides, and low-density lipoprotein and increased high-density lipoprotein (P < 0.001).Conclusion: 80% methanol in water extract and solvent fractions of H. arborescens leaves showed anti-diabetic effects and significantly reduced hyperlipidemia in diabetics, this study supported the traditional usage of H. arborescens for treating diabetes; however, species variation could also limit such a straightforward extrapolation of the findings of this study in humans.Keywords: antidiabetic, Heteromorpha arborescens, in vivo

Abstract Background Prevention of mother-to-child transmission service is a comprehensive package of services planned to reduce the risk of mother-to-child transmission of HIV. It is very crucial to determine the level of quality of PMTCT services in this study area since other studies in our country omitted several variables in each category of the Donobedian model. Therefore, this study aimed to determine the level of quality of option B + PMTCT of HIV services. Methods An institution-based cross-sectional study design with both quantitative and qualitative data collection method was employed. Donabedian’s model was used to assess the level of quality of PMTCT service. A total of 422 pregnant women were used to assess the level of satisfaction of clients. An inventory of resources and direct observation was done to assess the quality of the input and output component of the Donobedian model respectively. In addition to satisfaction items, 12 output-related items were also used to assess quality in the output dimension. Finally, those hospitals that scored above 90% in each component of the Donovedian model were categorized as having good quality. Finally, twelve in-depth interviews were conducted to explore barriers to the quality of option B + PMTCT services. The qualitative data were analyzed using the thematic analysis method and finally, it was presented with the quantitative result through triangulation. Results No hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. Only one hospital out of the four hospitals met the requirements for good quality of PMTCT service in the input dimension. Regarding the process and output dimension's quality of PMTCT services, two of the hospitals met the criteria for good quality. One hospital out of the total exhibited poor performance in all three dimensions of service quality for option B + PMTCT services. Conclusion According to this study no hospitals simultaneously met the requirements for good quality in all three dimensions of option B + PMTCT service quality. PMTCT unit performance must be continuously monitored, reviewed, and supervised. To obtain the minimum required resources primary hospitals must be supported.

Abstract Background In many low- and middle-income countries, the 2019 novel coronavirus (COVID-19) has challenged efforts to ensure access to and availability of quality maternal, newborn, and child health (MCH) services and essential MCH commodities. Objectives This study evaluated the impact of COVID-19 pandemic on the availability of maternal and child health products and childhood vaccines at selected health facilities in Ethiopia. Methods We have prospectively assessed 28 maternal–child health products and 14 childhood vaccines and accessories, which are listed in the Ethiopian national essential medicines list. Data were collected from 5 hospitals located in the Jimma zone of Oromia regional state in the southwestern part of Ethiopia. We extracted data on drug availability, and order fill rates for these pharmaceutical products between May 2019 and August 2020. Results The overall mean availability of selected maternal and child health products was 43.2%. It was 52.9% (range 21.0–63.6%) prior COVID-19 and 42.6% (range 19–56.4) during COVID-19 time. The average monthly orders fill rates of hospitals for the selected products ranged from 39 to 79%. Before COVID-19 the average order fill rate was near 70% of total orders placed by the hospitals. However, immediately after the COVID-19 case notification in Ethiopia, the percentage of order filled correctly in items and quantities began decreasing. Conclusion This study illustrates that the availability of key essential medicines for maternal and child health in the study area was low. The overall stock-out situation of MCH products has worsened during COVID-19 compared to pre-COVID-19 pandemic. None of the surveyed MCH products met the ideal availability benchmark of 80% in the public hospitals. To allow governments to guarantee these products are constantly available and affordable, a variety of policy frameworks and choices addressing inevitable epidemics should exist.

Abstract Ethiopia is the leading wheat producer in Sub‐Saharan Africa, and the productivity has increased in the last few years. There is also a potential for irrigated wheat production in the lowlands, even though its cultivation is at infant stage. The experiment was conducted in the Oromia region at nine locations in 2021 with irrigation. The study aimed to select high yielding and stable bread wheat variety/ies for lowland areas. Twelve released bread wheat varieties were tested using randomized complete block design with two replications. Environment had the largest effect, 76.5% of total variability, while genotypes 5.0% and GE interaction 18.5% explained total sum of squares. The average grain yield of varieties across locations ranged from the lowest 1.40 t ha−1 at Girja to the highest 6.55 t ha−1 at Daro Labu, with a grand mean of 3.14 t ha−1. The result showed that varieties released for irrigated areas, Fentale 1, Ardi, and Fentale 2, were ranked the top three based on overall environment mean grain yield. The first and second principal component account 45.5% and 24.7% of the genotype by environment interaction (G × E), respectively, explained 70.2% of the total variation. Daro Lebu and Bedeno were the most productive environment, while Girja was the least productive of irrigated bread wheat for lowlands of the Oromia region. Genotype Selection Index (GSI) showed that varieties Fentale 2, Fentale 1, Pavon 76, and ETBW9578 are stable and high yielding. Based on AMMI and GGE biplot analysis, Girja indicated the most discriminating area and Sewena as representative environment for selecting wide adaptable irrigated lowland varieties. The results of the present study indicated that Fentale 2 and Fentale 1 showed better yield stability across all test environments, therefore, these bread wheat varieties are recommended for wide cultivation in irrigated areas of the Oromia region.

Objective This analysis is to present the burden and trends of morbidity and mortality due to lower respiratory infections (LRIs), their contributing risk factors, and the disparity across administrative regions and cities from 1990 to 2019.Design This analysis used Global Burden of Disease 2019 framework to estimate morbidity and mortality outcomes of LRI and its contributing risk factors. The Global Burden of Disease study uses all available data sources and Cause of Death Ensemble model to estimate deaths from LRI and a meta-regression disease modelling technique to estimate LRI non-fatal outcomes with 95% uncertainty intervals (UI).Study setting The study includes nine region states and two chartered cities of Ethiopia.Outcome measures We calculated incidence, death and years of life lost (YLLs) due to LRIs and contributing risk factors using all accessible data sources. We calculated 95% UIs for the point estimates.Results In 2019, LRIs incidence, death and YLLs among all age groups were 8313.7 (95% UI 7757.6–8918), 59.4 (95% UI 49.8–71.4) and 2404.5 (95% UI 2059.4–2833.3) per 100 000 people, respectively. From 1990, the corresponding decline rates were 39%, 61% and 76%, respectively. Children under the age of 5 years account for 20% of episodes, 42% of mortalities and 70% of the YLL of the total burden of LRIs in 2019. The mortality rate was significantly higher in predominantly pastoralist regions—Benishangul-Gumuz 101.8 (95% UI 84.0–121.7) and Afar 103.7 (95% UI 86.6–122.6). The Somali region showed the least decline in mortality rates. More than three-fourths of under-5 child deaths due to LRIs were attributed to malnutrition. Household air pollution from solid fuel attributed to nearly half of the risk factors for all age mortalities due to LRIs in the country.Conclusion In Ethiopia, LRIs have reduced significantly across the regions over the years (except in elders), however, are still the third-leading cause of mortality, disproportionately affecting children younger than 5 years old and predominantly pastoralist regions. Interventions need to consider leading risk factors, targeted age groups and pastoralist and cross-border communities.