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The evolution of human behaviour is marked by key decision-making processes reflected in technological variability in the early archaeological record. As part of the technological system, differences in raw material quality directly affect the way that humans produce, design and use stone tools. The selection, procurement and use of various raw materials requires decision-making to evaluate multiple factors such as suitability to produce and design tools, but also the materials' efficiency and durability in performing a given task. Therefore, characterizing the physical properties of various lithic raw materials is crucial for exploring changes in human interactions with their natural environment through time and space and for understanding their technological behaviour. In this paper, we present the first step in an ongoing program designed to understand the decision-making criteria involved in the use of raw materials by the early Acheulian tool-makers at the Melka Wakena (MW) site-complex, located on the Ethiopian highlands. We present the results of the first experimental step, in which we identified and measured the engineering properties of raw materials in the lithic assemblages. These data serve as an objective, quantifiable baseline for natural experiments as well as archaeological inquiries into the technological decision-making processes of early Pleistocene hominins in Africa. [ABSTRACT FROM AUTHOR]

Background: Klebsiella bacterial strains harboring Extended-Spectrum Beta-Lactamase (ESBL) enzymes are the primary culprits behind neonatal sepsis globally. These strains significantly impact clinical outcomes due to their multi-drug resistance patterns in local healthcare settings. In response to this spiraling threat, we studied the prevalence and clinical implications of ESBL-encoding genes in neonates hospitalized with confirmed sepsis. Methods: A correlational study was conducted on 51 neonates diagnosed with sepsis caused by ESBL-positive Klebsiella pneumoniae at Jimma Medical Center spanning from May 2022 to July 2023. Antimicrobial resistance profiles of the bacterial isolates were determined using the Kirby-Bauer diffusion test, while multiplex polymerase chain reaction (mPCR) techniques were employed to identify resistance genes. The correlation between resistance genes and treatment outcomes was analyzed using the phi coefficient (φ) with a significance level below 0.05. The data management was executed through the utilization of WHONET and STATA software platforms. Results: The sample consisted of 26 (50.9%) male and the remaining 25 (49.1%) female neonates, with diverse clinical characteristics. All 51 Klebsiella pneumoniae isolates were 100% resistant to trimethoprim/sulfamethoxazole and ceftriaxone, but showed varying resistance profiles ranging from 30.8% to meropenem to 94.2% to ceftazidime. Notably, all isolates demonstrated multidrug resistance, with 23% of cases showing resistance to seven different antimicrobial classes. The most prevalent resistance genes identified were blaCTX−M (96.1%), blaTEM (94.1%), and blaSHV (88.2%). The majority of isolates (94.1%) carried at least two resistance genes, such as blaTEM and blaCTX (94.1%), blaTEM and blaSHV (86.2%), and blaCTX and blaSHV (86.2%). Notably, 84.3% of the bacteria harbored the trio of blaTEM, blaCTX, and blaSHV resistance genes, and only the presence of blaSHV in monogenic (φ = 0.4, P = 0.01) or the trio of blaTEM, blaCTX, and blaSHV genes (φ = 0.3, P = 0.02) showed positive correlation with neonatal mortality. Conclusion: We observed a significant prevalence of multidrug-resistant Klebsiella pneumoniae strains among neonates. Moreover, ESBL-resistance genes were widespread, with the blaSHV gene showing a correlation with increased neonatal mortality. These findings emphasize the urgent need for enhanced infection prevention measures, robust antimicrobial resistance surveillance, innovative treatment strategies, antibiotic stewardship initiatives, further research into resistance transfer mechanisms as well as hierarchical predictors of neonatal mortality. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is of critical concern in healthcare settings, leading to limited treatment options. In this study, we conducted a comprehensive meta-analysis to assess the prevalence of CRAB by examining temporal, geographic, and bias-related variations. Methods: We systematically searched prominent databases, including Scopus, PubMed, Web of Science, and EMBASE. Quality assessment was performed using the JBI checklist. Subgroup analyses were performed based on the COVID-19 timeframes, years, countries, continents, and bias levels, antimicrobial susceptivity test method and guidelines. Results: Our comprehensive meta-analysis, which included 795 studies across 80 countries from 1995 to 2023, revealed a surge in carbapenem resistance among A. baumannii, imipenem (76.1%), meropenem (73.5%), doripenem (73.0%), ertapenem (83.7%), and carbapenems (74.3%). Temporally, 2020–2023 witnessed significant peaks, particularly in carbapenems (81.0%) and meropenem (80.7%), as confirmed by meta-regression, indicating a steady upward trend. Conclusion: This meta-analysis revealed an alarmingly high resistance rate to CRAB as a global challenge, emphasizing the urgent need for tailored interventions. Transparency, standardized methodologies, and collaboration are crucial for the accurate assessment and maintenance of carbapenem efficacy. [ABSTRACT FROM AUTHOR]

Foodborne pathogens (FBPs) are transmitted principally through the consumption of contaminated food or drinking water and pose a remarkable public health risk, particularly in low-income countries. A cross-sectional study was conducted between November 2021 and January 2023 to estimate the prevalence, co-occurrence, and monthly patterns of FBPs in the physical exposures of children with diarrhea in Harar town and Kersa district, Ethiopia. Animal, food, and environmental samples were collected from direct or indirect contact sites of children with diarrhea. The isolation and identification of FBPs, including nontyphoidal Salmonella (NTS), diarrheagenic E. coli (DEC), and Shigella, was performed using selective and deferential culture media and a series of biochemical tests. Among the 438 analyzed samples, the overall prevalence of these pathogens was 18.3%, with 3.9% co-occurrence and 14.4% single pathogen occurrence rates. The highest prevalence was observed in wastewater (40.9%; AOR = 3.3; 95% CI: 1.1-10.1). The pathogen detection rate in food was 17.9% (AOR = 1.2; 95% CI: 0.4-3.6), with no significant difference between animal-sourced and other food categories. The occurrence rates of NTS, DEC, and Shigella in the meat samples were 13.9%, 5.4%, and 6.5%, respectively. Interestingly, DEC and Shigella were detected in cooked food. Moreover, Shigella was detected in drinking water (5%) and other water sources (10%). A significantly higher prevalence of FBPs was detected in poultry than in cattle and camel feces. This study revealed fluctuations in the monthly occurrence patterns of FBPs, with a peak of 37.1% during the dry season. In conclusion, the study revealed a high prevalence of FBPs, with no significant differences between rural and urban areas or food and water sources, highlighting the need for food safety measures in both settings. Further studies with larger sample sizes and advanced diagnostics are recommended to determine the relative contribution of each source. [ABSTRACT FROM AUTHOR]

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Background: The emergence of ESBLs producing cephalosporin-resistant Escherichia coli isolates poses a threat to public health. This study aims to decipher the genetic landscape and gain insights into ESBL-producing E. coli strains belonging to the high-risk clone ST410 from pediatric patients. Methods: 29 E. coli ST410 isolates were collected from young children and subjected to antimicrobial susceptibility testing, Whole-genome sequencing (WGS), serotype analysis, MLST, ESBL genes, virulence genes, and plasmid profiling. Results: Antimicrobial susceptibility testing demonstrated a high level of resistance to cephalosporins followed by aminoglycoside, sulfonamide, carbapenem and penicillin group of antibiotics. However, n=20/29 shows MDR phenotype. Phylogenetic group B2 (n=15) dominated, followed by group D (n=7), group A (n=4), and group B1 (n=3). Serotyping analysis identified O1:H7 (n=8), O2:H1 (n=6), O8:H4 (n=5), O16:H5 (n=4), and O25:H4 (n=3). Other serotypes identified included O6:H1, O15:H5, and O18:H7 (n=1 each). The most commonly detected ESBL genes were blaCTX-M, (n=26), followed by blaTEM (n=23), and blaSHV (n=18). Additionally, blaOXA-1 (n=10), blaOXA-48 (n=5), blaKPC-2 (n=3), blaKPC-3 (n=2), blaNDM-1 (n=4), blaNDM-5 (n=1), blaGES-1 (n=2), blaGES-5 (n=1), and blaCYM-1 (n=3). Notable virulence genes identified within the ST410 isolates included fimH (n=29), papC (n=24), hlyA (n=22), and cnf1 (n=18), among others. Diverse plasmids were observed including IncFIS, IncX4, IncFIA, IncCol, IncI2 and IncFIC with transmission frequency ranges from 1.3X10-2 to 2.7X10-3. Conclusion: The ST410 clone exhibited a complex resistance profile, diverse serotypes, the presence of specific resistance genes (ESBL genes), virulence gene repertoire, and diverse plasmids. The blaCTX-M was the most prevalent ESBL gene detected. [ABSTRACT FROM AUTHOR]

Background: Even though the disease has spread throughout the world, with millions killed, global COVID-19 vaccination coverage remains low, particularly in developing countries. However, epidemiological data is lacking in the area. Hence, this study aimed to assess COVID-19 uptake, willingness for vaccination, and associated factors. Method: A hospital-based cross-sectional study was conducted from May 1 to June 30, 2022, among patients attending chronic follow-up clinics in the two comprehensive specialized hospitals in Bahir Dar. The total sample size was 423. Participants were selected by a systematic random sampling technique. Data was gathered using a pre-tested questionnaire and analyzed using SPSS version 23. A descriptive analysis was performed. A binary logistic regression analysis was done to assess the association between variables. Variables with a p-value < 0.05 in the multi-variable logistic regression with a 95% confidence interval were considered statistically significant. Results: The analysis included 400 out of 423 participants, representing a 95% response rate. The COVID-19 vaccination uptake was 46.8%, while the acceptance was 60.5%. About 56% and 68% of the respondents had good knowledge and a favorable attitude, respectively. Elderly people were 2.7 times more likely to be vaccinated. Similarly, urban residents were 3.94 times more vaccinated. The probability of being vaccinated among respondents with good knowledge and favorable attitudes was 70% and 79%, respectively. The willingness for vaccination increased among those individuals with favorable attitudes (AOR: 1.82). Urban people were less likely to accept vaccination (AOR: 0.46). Some participants misunderstood that vaccination may aggravate their disease condition. Conclusion: The overall COVID-19 vaccine uptake and acceptance for vaccination were low compared to what was estimated by the WHO. Age, residence, knowledge, and attitude were associated with COVID-19 vaccine uptake and acceptance of vaccination. Besides, there was a high level of rumor about the status of the vaccine and risk factors. Hence, special emphasis is warranted to deliver centrally trusted information. Moreover, further nationwide studies are warranted in the future. [ABSTRACT FROM AUTHOR]

Soil fertility depletion has significantly reduced the yields of various crops in Ethiopia, mainly the yield of malt barley in the district. To address this issue, integrated applications of vermicompost and mineral nitrogen (N) fertilizers were tested. Therefore, this study aimed to evaluate the effects of vermicompost and mineral nitrogen fertilizers application on malt barley yield (Hordeum distichum L.), soil properties, and economic benefits. The experiment was arranged in a randomized complete block design with three replications. The treatments were nine in various combinations of vermicompost (VC) and N fertilizer (N): (69 kg N; 0.79 t VC + 58.65 kg N; 1.59 t VC + 48.30 kg N; 2.39 t VC + 37.95 kg N; 3.19 t VC + 27.60 kg N; 3.98 t VC + 17.25 kg N; 4.78 t VC + 6.90 kg N; 5.31 t VC ha−1 and control). The highest soil pH was recorded by applying 5.31 t of vermicompost ha−1 alone. The highest total nitrogen (0.34%), available phosphorus (15.58 mg kg−1), grain yield (4950 kg ha−1), and net benefit (4255.74 USD) were recorded from the application of 2.39 t VC plus 37.95 kg N, while the highest soil organic carbon (3.38%) and cation exchange capacity (26.17 cmol (+) kg−1) were recorded from 3.19 t VC plus 27.60 kg N ha−1 compared to the control. This study concludes that applying 2.39 t VC and 37.95 kg N ha−1 in combination improves soil fertility, malt barley yield, and economic benefits for smallholder farmers in the study district and adopts this in similar soil types and agroecologies. Core Ideas: Effects of vermicompost and N fertilizer integration on soil properties, yield, and economic benefits were evaluated.Integrated application of 2.39 t VC and 37.95 kg N ha−1 increased total N, available P, soil organic carbon, and cation exchange capacity.Combined application of 2.39 t VC and 37.95 kg N ha−1 gave 30% yield advantage over 100% recommended nitrogen.Application of 2.39 t VC combined with 37.95 kg N ha−1 N fertilizer generates greater net benefits to farmers. [ABSTRACT FROM AUTHOR]

Introduction: Non-typhoidal Salmonella (NTS) bacteremia is common in sub-Saharan Africa. We examined the prevalence of antibiotic resistance to fluoroquinolones, third-generation cephalosporins, and multi-drug resistance (MDR) in NTS human isolates from sub-Saharan Africa. Methods: A systematic review was conducted using a search in Ovid Medline, Embase, and African Index Medicus of publications between 2000 and 2021. A random-effects model meta-analysis was performed using data from 66 studies that included 29,039 NTS blood and 1,065 stool isolates. Results: The pooled prevalence proportions of MDR were 0.685 (95% CI 0.574–0.778) and 0.214 (0.020–0.785) in blood vs. stool isolates. The corresponding estimates of fluoroquinolones resistance were 0.014 (0.008–0.025) vs. 0.021 (0.012–0.036) and third-generation cephalosporins resistance 0.019 (0.012–0.031) vs. 0.035 (0.006–0.185). Similar results were found for children and adults. Resistance prevalence to these antibiotics in blood isolates increased between 2000–2010 and 2011–2021. The guidelines employed to determine antimicrobial resistance and epidemiological characteristics (e.g. sample size, study duration) correlated with the resistance prevalence. Conclusions: The prevalence of MDR and resistance to fluoroquinolones and third-generation cephalosporins in NTS in sub-Saharan Africa is alarming. Expert opinion: Standardized surveillance of antimicrobial drug resistance in NTS in sub-Saharan Africa is warranted to guide healthcare policymaking and antibiotic stewardship programs. Plain Language Summary: Non-typhoidal Salmonella (NTS) usually causes diarrheal disease, but some patients might develop bloodstream infection. The occurrence and case fatality of bloodstream infections caused by NTS are high in sub-Saharan Africa. However, the information on antibiotic resistance of these bacteria in this region is scarce. We performed a systematic review and meta-analysis to examine the prevalence of multi-drug resistance (MDR) and resistance to antibiotics used to treat NTS bloodstream infection: fluoroquinolones and third-generation cephalosporins in NTS isolates from patients from sub-Saharan Africa. We used data from 66 studies. In NTS blood isolates, the combined prevalence was 1.4% for fluoroquinolones resistance, 1.9% for resistance to third-generation cephalosporins, and 68.5% for MDR. These estimates were 2.1%, 3.5%, and 21.4% in stool isolates. The prevalence of resistance to fluoroquinolones and third-generation cephalosporins in blood isolates has increased in the past 2 decades. The guidelines employed to determine antimicrobial resistance and the study epidemiological characteristics were related to the resistance prevalence. The high prevalence of MDR in NTS raises concerns, and the emergence of resistance to fluoroquinolones and third-generation cephalosporins is worrisome. Strengthening the monitoring of antimicrobial drug resistance in NTS is essential to guide patients' care and policymaking in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

The use of tracers, particularly isotope geochemistry tracers, is the most efficient method for understanding and providing fresh perspectives on hydrologic processes. The purpose of this study is to determine the stable isotope and geochemical characteristics of groundwater alluvial aquifers in eastern Ethiopia. Samples of water from rainfall, surface water, and groundwater sources were gathered and analyzed. The research discovered that EC, pH, and TDS fluctuated from 871 to 6090 μS/cm, 6 to 8.2, and 558 to 3898 mg/L, correspondingly. In both regions major cation and anion concentrations fall in the order of Ca2+ > Na+ > Mg2+ > K+ and SO42− > HCO3− > Cl− > NO3− respectively. The most common water types are mixed Na-Mg-Ca, Ca-Cl, Na-Cl, and Ca- HCO3−. Hydrogeochemical experiments revealed that carbonate and silicate weathering and ionic exchanges primarily govern the supply of important ions in the waters and the geochemical history. The stable isotopic compositions vary from − 2.772 to − 0.418 ‰ with a mean value of− 1.772 ‰, for oxygen and from− 10.37 to 1.01 ‰ with a mean value of− 4.306 ‰ for hydrogen. The results show precipitation has been found to have more enriched isotope compositions than groundwater. In other words, both the hydrogen and oxygen isotope of groundwater are depleted than the precipitation isotope composition. The findings contribute to our knowledge of the stable isotope and geochemistry and are useful in determining the primary compositions of groundwater, water type, and the hydrogeochemistry of semi-arid areas. Article Highlights: Provides information on stable isotope and geochemical modeling, as well as a comparison of two Ethiopian catchments. The key finding of the study is the stable isotope composition, water type, geochemical process, and various ion activity of groundwater. It is fundamental research for a data-scarce and understudied semi-arid climatic area. [ABSTRACT FROM AUTHOR]

Background: ESBL-producing Escherichia coli pose a growing health risk in community and healthcare settings. We investigated the resistome, virulome, mobilome, and genetic relatedness of multidrug-resistant (MDR) E. coli isolates from patients and their environment in a Ghanaian teaching hospital. Materials and methods: Twenty-three MDR ESBL-producing or carbapenem-resistant E. coli isolates from a collection of MDR Gram-negative bacteria (GNB) from patients and environments were selected for genomic analyses. Whole genome sequencing and bioinformatics tools were used to analyze genomic characteristics and phylogeny. Results: The prevalence and incidence of rectal carriage of ESBL E. coli among patients were 13.65% and 11.32% respectively. The β-lactamase genes, blaTEM−1B (10 isolates) and blaCTX−M−15 (12 isolates) were commonly associated with IncFIB plasmid replicons and co-occurred with aminoglycoside, macrolide, and sulfamethoxazole/trimethoprim resistance. Insertion sequences, transposons, and class I integrons were found with blaCTX−M−15. Carriage and environmental isolates carried multiple virulence genes, with terC being the most prevalent in 21 isolates. Seventeen sequence types (STs) were identified, including a novel ST (ST13846). Phylogenetic analysis grouped the isolates into four main clusters, with one outlier. High genetic relatedness was observed between two carriage isolates of ST940 and between a carriage isolate and an environmental isolate of ST648. Isolates with different STs, collected at different times and locations, also showed genetic similarities. Conclusion: We identified ESBL-producing E. coli with diverse genomic characteristics circulating in different hospital directorates. Clonal relatedness was observed among isolates from patients and the environment, as well as between different patients, suggesting transmission within and between sources. [ABSTRACT FROM AUTHOR]

Solid organ transplant (SOT) recipients are particularly susceptible to infections caused by multidrug-resistant organisms (MDRO) and are often the first to be affected by an emerging resistant pathogen. Unfortunately, their prevalence and impact on morbidity and mortality according to the type of graft is not systematically reported from high-as well as from low and middle-income countries (HIC and LMIC). Thus, epidemiology on MDRO in SOT recipients could be subjected to reporting bias. In addition, screening practices and diagnostic resources may vary between countries, as well as the availability of new drugs. In this review, we aimed to depict the burden of main Gram-negative MDRO in SOT patients across HIC and LMIC and to provide an overview of current diagnostic and therapeutic resources. [ABSTRACT FROM AUTHOR]

Background: COVID-19 and its prevention measures have had a significant impact on patients with non-communicable diseases (NCDs) by disrupting routine healthcare service and increasing risk factors. These challenges were expected to be more severe in sub-Saharan Africa due to the lack of physical infrastructure and inadequate resources. The quantity of studies conducted was limited, and there was a lack of published systematic reviews in the specified region. This systematic review aimed to assess the indirect impacts of the COVID-19 pandemic and associated lockdown measures on individuals with non-communicable diseases (NCDs) in sub-Saharan African countries. Method: This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and is registered with PROSPERO (ID CRD42023387755). Extensive searches were conducted in MEDLINE, EMBASE, and CINAHL databases in December 2023, supplemented by a manual search of references, grey literature, and the WHO COVID-19 database. Inclusion criteria encompassed studies that reported on the impact of COVID-19 on NCD patients in sub-Saharan African countries, focusing on access to care, health outcomes, and factors related to NCDs. Critical appraisal of study quality was performed using the Joanna Briggs Institute (JBI) analytical cross-sectional studies critical appraisal tool. Data were extracted and synthesized, highlighting the main findings and relevant limitations. Findings: This review included 30 primary studies with a cumulative sample size of 25634 participants, conducted in seven sub-Saharan African countries. These studies demonstrated that the COVID-19 pandemic significantly disrupted regular NCD patient care provision, with regional variations. The studies also identified a reduction in patient health-seeking behavior and reduced medication adherence, leading to poor treatment outcome. Furthermore, the pandemic and related lockdowns have been implicated in the increased prevalence of substance use, decreased physical exercise, and increased mental health problems. Conclusion: This systematic review identified the complex challenges faced by NCD patients in sub-Saharan Africa during the COVID-19 pandemic. It also underlines the need to consider the indirect impact on vulnerable populations while developing pandemic prevention and control strategies for the future. The current NCD management strategies should prioritize the restoration of access to essential healthcare services while considering the multifaceted risks posed by decreased physical activity, poor dietary practices, and increased substance use. The main limitation of this review was the study design and setting. All of the studies included in this review employed a cross-sectional design, which may result in a low quality of evidence. This study identified research conducted in only seven countries among the 46 UN-classified sub-Saharan nations, which may impair the generalizability of the result. [ABSTRACT FROM AUTHOR]

Fodder crops are generally cultivated using the blanket recommended fertilizer rate in Ethiopia. However, use of optimum and economically feasible fertilizer rate based on the requirement of species and factors of climate, soil, and management conditions is very important to improve the grain yield performance of oat varieties. Thus, the study aimed to evaluate the effect of fertilizer levels on the performances of agro-morphological traits, nutrient uptake and use efficiency, and relative profitability of oat (Avena sativa L.) varieties at Holetta, Ethiopia. The experiment was laid out in a randomized complete block design in a factorial arrangement with three replications. The study consists of twenty-four treatment combinations comprised of three oat varieties (CI-8251, SRCPX80Ab2291, and Sorataf) and eight fertilizer levels (0, 25, 50, 75, 100, 125, 150, and 175%). The results revealed that fertilizer level, variety, and year had significant effect on grain yield (GY), grain nutrient uptake (GNU), partial factor productivity (PFP), and agronomic efficiency (AE). The highest GY (6.5 t/ha) and GNU (141.7 kg/ha) were recorded for 150% fertilizer level while unfertilized treatment produced the least. Among oat varieties, Sorataf produced the highest GY (5.7 t/ha) and GNU (129.3 kg/ha). On the other hand, the highest PFP (346.6 kg/kg) and AE (164.8 kg/kg) were observed for 25% fertilizer level while the lowest PFP (59.4 kg/kg) and AE (33.4 kg/kg) were recorded for 175% fertilizer level. Sorataf variety exhibited the highest PFP (143.3 kg/kg) and AE (74.9 kg/kg). Moreover, the 2021 cropping season had 5.8, 10.4, 12.0, and 17.3% advantages over the 2020 cropping season in GY, GNU, PFP, and AE, respectively. The Pearson correlation analysis indicated that the nutrient concentration and uptake had positive association with fertilizer level and GY while nutrient harvest index and nutrient use efficiency had inverse correlation with fertilizer level and GY. The combined partial budget analysis for oat varieties showed that application of 150% fertilizer produced the highest net benefit. Therefore, the blanket recommended fertilizer dose of 150% (61.5 kg N + 30 kg P/ha) could increase the grain yield performance of oat varieties and farm profitability in the study area. [ABSTRACT FROM AUTHOR]

Clustered, regularly interspaced short palindromic repeats (CRISPRs) and their related genes (Cas) are prevalent in the genomes of several bacteria and serve as a defense mechanism against external attackers, such as plasmids and viruses. This study aimed to examine the frequency of the CRISPR/Cas system in naturally occurring strains of Klebsiella pneumoniae sub spp pneumoniae confirmed by Vitek 2 biochemical test, in the hospital setting and determine its correlation with antibiotic resistance both phenotypically and genetically (antibiotic-resistant genes, namely blaTEM and AcrA efflux pump gene). The research was conducted at Medical College/Mosul University 23 multi-drug resistant K. pneumoniae sub spp. pneumoniae that were obtained from 230 clinical samples from infected patients with different types of infections attending Al-Salam and Al-Jumhoree Teaching hospitals. PCR was used to detect blaTEM, AcrA genes, and CRISPR/Cas system genes (CAS1A and CAS1B) among the clinical isolates. The correlation between the CRISPR/Cas system and antibiotic-resistance was determined. All the isolates were multiple drug-resistant strains, and the blaTEM gene was detected in all clinical isolates, whereas AcrA gene was detected in 94% of the isolates. The frequency of CAS1A and CAS1B was 21.73% and 86.95% respectively. There was an inverse correlation between the CAS1A gene and phenotypic antibiotic resistance Disc diffusion test results, so isolates carrying CAS1A gene were less resistant to different antibiotics studied in this research. In contrast, there was no significant correlation between CRISPR / Cas genes, blaTEM, and AcrA genes at the genetic level. [ABSTRACT FROM AUTHOR]

Background: Placenta praevia (PP) is a significant obstetric complication associated with antepartum haemorrhage (APH) and adverse maternal and fetal outcomes. Identifying risk factors for APH in women with PP is important for guiding management decisions., Aims: This study aimed to identify risk factors associated with APH amongst women admitted to a single tertiary hospital with PP., Materials and Methods: A retrospective cohort study was undertaken, utilising data from the hospital's maternity dataset (2007-2021) and included publicly funded women with PP after 24 weeks gestation. Exclusions comprised multiple pregnancies, fetal abnormalities, intra-uterine fetal death and deliveries at other hospitals. Baseline characteristics, outcomes and potential risk factors for APH were analysed through bivariate and stepwise logistic regression., Results: Of the 430 cases with PP, 112 (26%) were admitted with APH. Of these, 45 had two or more admissions with APH, constituting 40% of the APH cohort. Those requiring admission were more likely to deliver at an early gestation, and their baby required nursery admission. Factors independently associated with APH included a higher number of previous caesarean sections, parity, Caucasian ethnicity and major PP., Conclusions: Most women with PP will not require an admission with APH. In considering inpatient versus outpatient management, multiparous Caucasian women with a major PP appear more likely to be at risk of APH admission and premature delivery. These findings underscore the importance of tailoring clinical decision-making., (© 2025 Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

Klebsiella pneumoniae (K. pneumoniae) cultures from a hospital-wide outbreak in the UK, which lasted for over 12 months, were sequenced. We sought to sequence and genetically characterise the outbreak strain. Antibiotic Susceptibility Testing (AST) was performed on 65 K. pneumoniae isolates saved from the outbreak. All isolates were sequenced using the Oxford Nanopore Technologies (ONT) MinION flowcell: 10 isolates, including the isolate with the earliest collection date in 2017, were additionally sequenced on the NovaSeq 6000 platform to build high-accuracy nanopore-illumina assemblies. Among the sequenced strains, 60 were typed as ST628. 96.6% (n = 58/60) ST628 strains harboured a large ~247-kb FIB(K) plasmid carrying up to 11 antimicrobial resistance genes, including the extended-spectrum beta-lactamase (ESBL) gene, blaCTX-M-15. Clonality between the outbreak isolates was confirmed using single nucleotide polymorphism (SNP) typing. The outbreak strains were phylogenetically related to clinical ST628 strains identified in 2012, 6 years prior to the outbreak. A rare ESBL K. pneumoniae K2 ST628 strain harbouring a multi-drug resistant (MDR) plasmid encoding the ESBL gene blaCTX-M-15 was detected across multiple independent wards during the protracted nosocomial outbreak. Surveillance of this strain is recommended to prevent future nosocomial outbreaks. [ABSTRACT FROM AUTHOR]

Introduction: Antimicrobial resistance (AMR) is a pressing global health concern, particularly pronounced in low-resource settings. In Ethiopia, the escalating prevalence of carbapenem-resistant Pseudomonas aeruginosa (P. aeruginosa) poses a substantial threat to public health. Methods: A comprehensive search of databases, including PubMed, Scopus, Embase, Hinari, and Google Scholar, identified relevant studies. Inclusion criteria encompassed observational studies reporting the prevalence of meropenem-resistant P. aeruginosa in Ethiopia. Quality assessment utilized JBI checklists. A random-effects meta-analysis pooled data on study characteristics and prevalence estimates, with subsequent subgroup and sensitivity analyses. Publication bias was assessed graphically and statistically. Results: Out of 433 studies, nineteen, comprising a total sample of 11,131, met inclusion criteria. The pooled prevalence of meropenem-resistant P. aeruginosa was 15% (95% CI: 10–21%). Significant heterogeneity (I2 = 83.6%) was observed, with the number of P. aeruginosa isolates identified as the primary source of heterogeneity (p = 0.127). Subgroup analysis by infection source revealed a higher prevalence in hospital-acquired infections (28%, 95% CI: 10, 46) compared to community settings (6%, 95% CI: 2, 11). Geographic based subgroup analysis indicated the highest prevalence in the Amhara region (23%, 95% CI: 8, 38), followed by Addis Ababa (21%, 95% CI: 11, 32), and lower prevalence in the Oromia region (7%, 95% CI: 4, 19). Wound samples exhibited the highest resistance (25%, 95% CI: 25, 78), while sputum samples showed the lowest prevalence. Publication bias, identified through funnel plot examination and Egger's regression test (p < 0.001), execution of trim and fill analysis resulted in an adjusted pooled prevalence of (3.7%, 95% CI: 2.3, 9.6). Conclusion: The noteworthy prevalence of meropenem resistance among P. aeruginosa isolates in Ethiopia, particularly in healthcare settings, underscores the urgency of implementing strict infection control practices and antibiotic stewardship. Further research is imperative to address and mitigate the challenges posed by antimicrobial resistance in the country. [ABSTRACT FROM AUTHOR]

Background: Unsafe abortion is a serious reproductive health problem in developing countries including Ethiopia. The attitude of healthcare providers toward abortion is one of contributing factors to unsafe abortion. This study aimed to determine the pooled effect of healthcare workers' attitudes toward safe abortion care and its determinants factors in Ethiopia. Methods: Search engines such as Scopus, CINAHL, EMBASE, PubMed, Web of Science, and CAB Abstracts were used to find published studies where as Google and Google Scholar were used to find unpublished research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. The analysis was performed using STATA 14 and the random-effects model was used to calculate the odds ratios of medical professionals' attitudes regarding safe abortion services. Study heterogeneity was assessed by using I 2 and P -values. To evaluate the stability of pooled values to outliers and publication bias, respectively, sensitivity analysis and funnel plot were also performed. Results: A total of 15 published and unpublished articles with a sample size of 4060 were incorporated in this Review. The overall pooled prevalence of this study was 56% (95% CI: 45-67). Sex of participants (AOR: 2.37; 95% CI: 1.57, 3.58), having training (AOR: 2.86; 95% CI: 1.58, 5.17), Professional type (AOR: 1.55; 95% CI: 1.04, 4.46), and knowledge of abortion law (AOR:2.26; 95% CI: 1.14, 4.46) were the determinants factors that significantly associated with health care workers' attitude toward safe abortion care. Sensitivity analysis shows that the pooled odds ratios were consistently stable throughout all meta-analyses, and the funnel plot shows no evidence of publication bias. Conclusion: Half of health care providers sampled among the pooled studies have favorable attitudes toward abortion services in Ethiopia; which could hamper women's access to safe abortion care. Sex, training, type of profession, and knowing abortion law were determinants of health care workers' attitudes toward safe abortion services. Stakeholders should emphasize improving the attitude of healthcare workers toward safe abortion care which has a vital role in reducing maternal mortality. Moreover, working on modifiable factors like training, assigning personnel whose professions align with the service, and updating care providers about abortion law is also the essential key point to improve their intentions to deliver the services. [ABSTRACT FROM AUTHOR]

The hospital environment is increasingly becoming an important reservoir for multi-drug-resistant (MDR) Gram-negative bacteria, posing serious challenges to efforts to combat antimicrobial resistance (AMR). This study aimed to investigate the role of hospital waste as a potential source of MDR ESBL-producing bacteria. Samples were collected from multiple sources within a hospital and its vicinity, including surface swabs, houseflies, and sewage samples. The samples were subsequently processed in a microbiology laboratory to identify potential pathogenic bacteria and confirmed using MALDI-TOF MS. Bacteria were isolated from 87% of samples, with the predominant isolates being E. coli (30.5%), Klebsiella spp. (12.4%), Providencia spp. (12.4%), and Proteus spp. (11.9%). According to the double disc synergy test (DDST) analysis, nearly half (49.2%) of the bacteria were identified as ESBL producers. However, despite exhibiting complete resistance to beta-lactam antibiotics, 11.8% of them did not test positive for ESBL production. The characterization of E. coli revealed that 30.6% and 5.6% of them carried blaCTX-M group 1 type-15 and blaNDM genes, respectively. This finding emphasizes the importance of proper hospital sanitation and waste management practices to mitigate the spread of AMR within the healthcare setting and safeguard the health of both patients and the wider community. [ABSTRACT FROM AUTHOR]

Introduction and aim. The fear of contracting COVID-19, which affects human health biopsychosocially, is expected to affect the self-care management of patients with heart failure (HF). This study was conducted to investigate the relationship between perceived fear of COVID-19 and self-care management in HF patients. Material and methods. The study was conducted with 115 HF patients. "Sociodemographic characteristics form", "Fear of COVID-19 tool" and "Nine-item European Heart Failure Self-care Behavior Scale (EHFScB Scale-9)" were used to collect data. Results. 51.3% of the participants in the study are in the 40-60 age range, 53.7% are male, 92.2% live with their family, 64.3% have a diagnosis of HF for less than 5 years. Levels of COVID-19 fear, and self-care management were found to be high in the participants who are 40 years old or younger, has higher education level, diagnosed within 1 to 3 years, received psychological support during the pandemic process, received training from doctor or nurse about COVID-19. Fear level and self-care levels were moderately positively correlated. Conclusion. During the COVID-19 pandemic, it is necessary to develop effective care strategies to identify individuals with diseases such as HF who should have high self-care management skills. [ABSTRACT FROM AUTHOR]

Simple Summary: Consuming unsafe food globally results in millions of illnesses and deaths. The safety of our food, from farm (pre-harvest) to table (postharvest), is paramount. In low- and middle-income countries (LMICs), ensuring food safety is challenging. This review explores current insights into pre-harvest critical issues related to food safety. At the farm level, critical food safety issues include animal health, antimicrobial resistance, and farmers' knowledge, attitudes, and practices. Globally, several pre-harvest interventions aim to mitigate risks from animal-origin food. Despite effectiveness at a small scale, these interventions often lack scalability. Many countries have established laws and regulations to shield consumers from unsafe food consumption. However, food safety regulations in several LMICs are weak, inconsistent, and inadequately enforced. Preventing foodborne diseases requires a One Health approach, uniting experts in animal, human, and environmental health. Despite its importance, the application of this approach to address food safety issues is limited in low- and middle-income countries. Food safety remains a significant global public health concern, with the risk of unsafe food varying worldwide. The economies of several low- and middle-income countries (LMICs) heavily rely on livestock, posing a challenge to ensuring the production of safe food. This review discusses our understanding of pre-harvest critical issues related to food safety in LMICs, specifically focusing on animal-derived food. In LMICs, food safety regulations are weak and inadequately enforced, primarily concentrating on the formal market despite a substantial portion of the food sector being dominated by informal markets. Key critical issues at the farm level include animal health, a low level of good agriculture practices, and the misuse of antimicrobials. Effectively addressing foodborne diseases requires a comprehensive One Health framework. Unfortunately, the application of the One Health approach to tackle food safety issues is notably limited in LMICs. In conclusion, considering that most animal-source foods from LMICs are marketed through informal channels, food safety legislation and policies need to account for this context. Interventions aimed at reducing foodborne bacterial pathogens at the farm level should be scalable, and there should be strong advocacy for the proper implementation of pre-harvest interventions through a One Health approach. [ABSTRACT FROM AUTHOR]

Background: The world continues to be challenged by the Coronavirus disease 2019 (COVID-19) and preventive measures like maintaining social distancing and lockdowns challenge patients to attend regular follow-ups and get a refill for medication that causes adherence problems. Hence, this study attempts to assess the impact of COVID-19 on treatment follow-up and medication adherence among patients with epilepsy. Method: A total of 276 patients with epilepsy were enrolled in the study. Data collection was carried out through medical record reviews and patient interviews. Patients who visited Zewditu Memorial Hospital from August to September 2021 and those who had follow-up at least for two years before the outbreak of the pandemic were included. The data was analyzed using SPSS v.24. Result: About 69.6% of patients were adherent to their treatment and 83.3% of the patients had a seizure-free period of less than 1 year. Ninety (32.6%) of the participants missed their treatment follow-up during the pandemic, mainly due to fear of being infected with COVID-19. Sixty-eight (24.6%) patients have experienced increased seizure episodes during the pandemic as compared to the previous times. Moreover, 56 (20.3%) participants were not taking their antiseizure medications (ASMs) during the pandemic because of the unavailability of medications and they discontinued hospital visits for their medication refills. Among those who missed their treatment follow-up, 20% had seizure-related physical injuries. Only educational level has a significant association with visiting health facilities during the pandemic. Thus, participants who completed college and above (OR = 2.58, 95% CI (1.32–6.38)) were more likely to attend their follow-up during the pandemics as compared to participants who can't read and write. Conclusion: The present study revealed that COVID-19 might have impacts on treatment follow-up and medication adherence due to fear of infection, travel restrictions and the indirect impact on the availability and affordability of medications. These might lead to poor treatment outcomes like increased seizure frequency and seizure-related physical injuries. [ABSTRACT FROM AUTHOR]

Background: In resource-constrained settings, limited antibiotic options make treating carbapenem-resistant bacterial infections difficult for healthcare providers. This study aimed to assess carbapenemase expression in Gramnegative bacteria isolated from clinical samples in Jimma, Ethiopia. Methods: A cross-sectional study was conducted to assess carbapenemase expression in Gram-negative bacteria isolated from patients attending Jimma Medical Center. Totally, 846 Gram-negative bacteria were isolated and identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Phenotypic antibiotic resistance patterns were determined using the Kirby-Bauer disk diffusion method and Etest strips. Extended-spectrum β-lactamase phenotype was determined using MAST disks, and carbapenemases were characterized using multiplex polymerase chain reactions (PCR). Results: Among the isolates, 19% (157/846) showed phenotypic resistance to carbapenem antibiotics. PCR analysis revealed that at least one carbapenemase gene was detected in 69% (107/155) of these strains. The most frequently detected acquired genes were blaNDM in 35% (37/107), blaVIM in 24% (26/107), and blaKPC42 in 13% (14/107) of the isolates. Coexistence of two or more acquired genes was observed in 31% (33/107) of the isolates. The most common coexisting acquired genes were blaNDM + blaOXA-23, detected in 24% (8/33) of these isolates. No carbapenemase-encoding genes could be detected in 31% (48/155) of carbapenem-resistant isolates, with P. aeruginosa accounting for 85% (41/48) thereof. Conclusion: This study revealed high and incremental rates of carbapenemresistant bacteria in clinical samples with various carbapenemase-encoding genes. This imposes a severe challenge to effective patient care in the context of already limited treatment options against Gram-negative bacterial infections in resource-constrained settings. [ABSTRACT FROM AUTHOR]

Simple Summary: Numerous diseases, such as liver abscesses, bacteremias, pneumonia, and urinary tract infections, are caused by Klebsiella pneumonia (K. pneumonia). Historically, immunocompromised patients have been the main target of serious infections induced by K. pneumoniae. However, with the recent appearance and dissemination of hypervirulent strains, healthy individuals have also become susceptible to infection. Moreover, treating K. pneumoniae infections is extremely difficult due to the strains' increased antibiotic resistance. This review summarizes the various virulence factors of this bacterium, especially metallophores. The bacteriology, pathology, and epidemiology of K. pneumonia are also included in this review. The opportunistic pathogen Klebsiella pneumoniae (K. pneumoniae) can colonize mucosal surfaces and spread from mucosae to other tissues, causing fatal infections. Medical equipment and the healthcare setting can become colonized by Klebsiella species, which are widely distributed in nature and can be found in water, soil, and animals. Moreover, a substantial number of community-acquired illnesses are also caused by this organism worldwide. These infections are characterized by a high rate of morbidity and mortality as well as the capacity to spread metastatically. Hypervirulent Klebsiella strains are thought to be connected to these infections. Four components are critical to this bacterium's pathogenicity—the capsule, lipopolysaccharide, fimbriae, and siderophores. Siderophores are secondary metabolites that allow iron to sequester from the surrounding medium and transport it to the intracellular compartment of the bacteria. A number of variables may lead to K. pneumoniae colonization in a specific area. Risk factors for infection include local healthcare practices, antibiotic use and misuse, infection control procedures, nutrition, gender, and age. [ABSTRACT FROM AUTHOR]

Carbon-fiber microelectrodes (CFMEs) are primarily used to detect neurotransmitters in vivo with fast-scan cyclic voltammetry (FSCV) but other carbon nanomaterial electrodes are being developed. CFME sensitivity to dopamine is improved by applying a constant 1.5 V vs. Ag/AgCl for 3 minutes while dipped in 1 M KOH, which etches the surface and adds oxygen functional groups. However, KOH etching of other carbon nanomaterials and applications to other neurochemicals have not been investigated. Here, we explored KOH etching of CFMEs and carbon nanotube yarn microelectrodes (CNTYMEs) to characterize sensitivity to dopamine, epinephrine, norepinephrine, serotonin, and 3,4-dihydroxyphenylacetic acid (DOPAC). With CNTYMEs, the potential was applied in KOH for 1 minute because the electrode surface cracked with the longer time. KOH treatment increased electrode sensitivity to each cationic neurotransmitter roughly 2-fold for CFMEs, and 2- to 4-fold for CNTYMEs. KOH treatment decreased the background current of the CFMEs by etching the surface carbon; however, KOH-treatment increased the CNTYME background current because the potential separates individual nanotubes. For DOPAC, the current increase was smaller at CNTYMEs because it is anionic and was repelled by the negative holding potential and did not access the crevices. XPS and Raman spectroscopy showed that KOH treatment changed the CNTYME surface chemistry by increasing defect sites and adding oxide functional groups. KOH-treated CNTYMEs had less fouling to serotonin than normal CNTYMEs. Therefore, KOH treatment activates both CFMEs and CNTYMEs and could be used in biological measurements to increase the sensitivity and decrease fouling for neurochemical measurements. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance of Escherichia coli is a growing problem in both developed and developing countries. This study aimed to investigate the phenotypic antimicrobial resistance of E. coli isolates (n = 260) isolated from the stool specimen of patients attending public health facilities in Addis Ababa and Hossana. This study also aimed to characterize phenotypically confirmed extended-spectrum beta-lactamase (ESBL)-producing E. coli isolates (n = 22) using whole-genome sequencing. Resistance to 18 different antimicrobials was assessed using the disc diffusion method according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The highest resistance rate among the E. coli isolates was found for ampicillin (52.7%), followed by trimethoprim-sulfamethoxazole (29.6%). Of all isolates, 50 (19.2%) were multidrug-resistant and 22 (8.5%) were ESBL producers. ESBL genes were detected in 94.7% of the sequenced E. coli isolates, and multiple β-lactamase genes were detected in 57.9% of the isolates. The predominant ESBL gene identified was blaCTX-M-15 (78.9%). The blaTEM-1B gene was detected in combination with other ESBL genes in 57.9% of the isolates, while only one of the sequenced isolates contained the blaTEM-1B gene alone. The blaCTX-M-3 gene was detected in three isolates. The genes blaCTX-M-15 and blaTEM-1B as well as blaCTX-M-15 and blaTEM-169 were confirmed to coexist in 52.6% and 10.5% of the sequenced E. coli isolates, respectively. In addition, blaOXA-1 was identified together with blaCTX-M-15 and blaTEM-1B in one isolate, and in one isolate, blaTEM-169 together with blaCTX-M-15 and blaTEM-1B was found. The results obtained show that measures need to be taken to reduce the spread of drug resistance and ensure the long-term use of available antimicrobials. [ABSTRACT FROM AUTHOR]

The global spread of cefotaxime-hydrolysing β-lactamase (CTX-M)-producing Escherichia coli (E. coli) and its associated impact on paediatric diarrhoeal treatment and management has become a public health concern. This review assessed surveillance studies on CTX-M-producing E. coli associated with diarrhoea in children published between 2012 and 2022 globally. A total of thirty-eight studies were included for data analysis, categorised into continental regions, and tabulated. The majority (68%) of studies were conducted in Asian countries while few studies were conducted in Europe (11%) and Africa (18%), respectively. On the African continent, the majority (11%) of studies were conducted in Northern Africa while no studies were reported in East Africa. On the American continent, 3% of the studies were reported from South America. The studies included were classified into diarrheagenic E. coli (74%; 28/38) and faecal carriage (26%; 10/38). Of all the E. coli pathotypes associated with CTX-M production, EPEC was frequently reported. The prevalence of CTX-M-producing E. coli including the CTX-M-15-producing variants ranged between 1% and 94%. About 37% of the studies generalised the report as blaCTX-M-positive E. coli. The use of sequencing in characterising the CTX-M-producing E. coli was reported in only 32% of all the studies. This review provides information on the epidemiology of CTX-M-15-producing E. coli in paediatric diarrhoea and the extent to which surveillance is being performed. This is relevant in informing clinical practice for the management of diarrhoea as well as the design of future surveillance studies. [ABSTRACT FROM AUTHOR]

Adherence to the treatment of type 2 diabetes (T2D), which includes the use of prescribed drugs, following a healthy diet, and adopting a physically active lifestyle, is important to control the disease and improve the patients' quality of life. The present study aimed to explain the determinants of adherence to treatment in patients with T2D based on Pender's Health Promotion Model (HPM). The present research used a qualitative content analysis and was based on Pender's HPM. The data were collected through in-depth semi-structured interviews with 20 T2D patients using a purposive sampling in Bandar Abbas, southern Iran. Maximum variation was considered in terms of gender, age, history of diabetes, type of drug used, education, and occupation. The data collection continued until data saturation. At the same time, the collected data were analyzed using the directed content analysis. MAXQDA 10 was used to manage codes and facilitate data analysis. The data analysis led to the extraction of 10 categories and 19 subcategories as the determinants of adherence to the treatment of T2D patients. The participants shared their experiences about personal characteristics and their ecological environment, specific cognition and emotions, and the behavioral results and experience as the determinants of adherence to T2D treatment. The categories extracted from this study in the form of HPM constructs provided a framework to explain treatment adherence. This information can help policy makers and planners in designing future programs. [ABSTRACT FROM AUTHOR]

The performance of most crop genotypes varies significantly depending on their genotype–environment interactions. Providing information on high-yielding and well-adapted common bean genotypes in a given environment is crucial for small-holder farmers to boost their productivity. A field trial was conducted at the Gendo and Wara locations over two consecutive seasons to understand genotype–environment interactions on grain yield and to identify and select common bean genotypes that were better adapted and had high yield potential for production. Ten genotypes were evaluated for their performance using a randomized complete block design with three replications. The AMMI and GGE models were used to identify superior genotypes regarding their mean grain yield performance. The AMMI analysis of variance results showed that grain yield was significantly (p ≤ 0.05) influenced by genotype–environment interactions. This shows that genotypes varied in grain yield mean performance across environments, indicating the possibility of selecting suitable genotypes with specific and broad adaptability. The sum of squares factor indicated that grain yield variation was contributed by the genotype (61.0%), followed by the environment (29.80%) and the genotype–environment interaction effect (9.20%) of the total variation. The AMMI and GGE biplot analysis results showed that SER-119 and SER-125 were identified as the best genotypes regarding their mean grain yield performance. Additionally, the genotype selection index analysis result indicated that SER-119 and SER-125 were stable and consistently exhibited high mean performance in all evaluated settings. Therefore, SER-119 and SER-125 are prime candidates for production in various agroecologies suitable for common bean cultivation in Dawuro zones. The use of tools like GGE biplots and AMMI analysis helped visualize the genotype–environment interactions, aiding in the selection of appropriate genotypes for both specific and wide adaptability. [ABSTRACT FROM AUTHOR]