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Abstract Improving the dietary quality of adolescents is crucial in public health, especially in low-income countries like Ethiopia. Despite numerous nutritional interventions, those interventions targeting adolescents were inconsistent due to fragmented implementation. Thus, this study aimed to evaluate the effect of selected double-duty interventions on the dietary diversity scores (DDS) of adolescents in Debre Berhan Regiopolitan City, Central Ethiopia. A two-arm parallel cluster randomized controlled study involved 708 adolescents (356 for intervention group (IG) and 352 for control group (CG)) was conducted from October 13, 2022 to June 30, 2023. The study found a 30.4% reduction in the proportion of adolescents with low DDS in the IG along with an 18.4% increase in high DDS compared to the CG as measured by the minimum dietary diversity score indicator. The generalized estimating equation (GEE) model revealed that adolescents in the IG were nearly twice as likely to achieve a high DDS compared to the CG [AOR = 1.91, 95% CI (1.85, 1.97)]. This study highlights the effectiveness of double-duty interventions supported by behavioral models in enhancing dietary diversity and advocates for their integration into nutritional policies. Clinical Trials: The trial was prospectively registered at ClinicalTrials.gov (NCT05574842) and was first posted on October 12, 2022.

Abstract Pharmacy-based vaccination (PBV) programs have proven to be a promising strategy for improving vaccination coverage, particularly in resource-limited countries. These programs increase accessibility and convenience, increase vaccination rates, and benefit vulnerable populations. However, successful implementation requires addressing gaps in regulatory oversight, pharmacists training, inter-professional collaboration, and public awareness. With proper regulatory frameworks, advocacy, enhanced training programs, public education, and establishment of well-designed database, PBV can achieve outcomes comparable to high-resource settings. This commentary aims to inform stakeholders and offer practical recommendations to minimize risks while leveraging its benefits.

Sintayehu Asrat Beyene,1 Nahom Tadesse Bogale,1 Mahad Mohammed Abdinasir,1 Addisu Zegeye Desalegne,2 Megdelawit Ayalew Wossen3 1General Surgery Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 2Department of Radiology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 3School of Medicine and Health Sciences, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, EthiopiaCorrespondence: Sintayehu Asrat Beyene; Nahom Tadesse Bogale, Email sintayehubeyene54@gmail.com; Tadnahi2@gmail.comIntroduction: Ileosigmoid knotting is the wrapping of an active component of either the ileum or the sigmoid colon over each other. It is an unusual cause of intestinal obstruction, accounting for 1– 2% of cases of all mechanical obstruction in the majority published literatures. A viable knot is a unique phenomenon of this seldom cause of bowel obstruction.Case Presentation: A sixteen-year-old female patient presents with a complaint of central abdominal distension and obstipation of 12-hour duration. Later, she also developed abdominal cramps and vomiting of ingested matter. Her vital signs were all in the normal range, and the abdominal examination was positive for a grossly distended abdomen with mild upper and central abdominal tenderness. The ileosigmoid knotting was clearly visible on the computed tomography. Emergency exploratory laparotomy was performed, and a viable ileosigmoid knot was identified. Unknotting, derotation, and decompression of the sigmoid colon were performed. The postoperative course was uneventful.Discussion: Ileosigmoid knotting is a rare, life-threatening cause of intestinal obstruction with rapid progression to intestinal vascular compromise and gangrene. It is a hyperactive segment of ileum that winds around the pedicle of the redundant sigmoid colon, resulting in a closed-loop obstruction. There are different classification schemes of ileosigmoid knotting depending on the active component of the knot and based on the viability of the bowel and physiology of the patient. Preoperative diagnosis of this condition is often challenging and usually confirmed intraoperative.Conclusion: A high index of suspicion and prompt surgical exploration are crucial for the best outcome of the patient. Despite being a rare cause of intestinal obstruction, ileosigmoid knotting poses a significant morbidity and mortality to the patient. Management of a patient with viable ileosigmoid knotting is controversial, as some scholars suggest non-resective options and others recommend resective treatment as a recurrence preventive measure.Keywords: ileosigmoid knotting, intestinal obstruction, acute abdomen, volvulus, unknotting, operative decompression, viable

Abstract Education is a critical component in the advancement of global sustainable development. In recent years, there has been a notable increase in research output within higher education institutions dedicated to this pivotal area. This study aims to identify emerging trends in higher education research on sustainable development goals and examine the specific focus areas in which researchers are engaged. A comprehensive bibliometric analysis was conducted on scholarly articles on education for sustainable development (ESD), utilizing data from the Scopus database. 2221 documents were extracted from the database of scientific articles published between 1990 and 2023. After a thorough screening, 1013 articles met the eligibility criteria and were subsequently analyzed using the R-Studio software platform. The findings indicate a significant increase in scientific output in this area since 2018, peaking in 2022 and then declining in 2023. The most prominent journal in this field is Sustainability, published in Switzerland. Gericke is identified as the most prolific author, followed by notable contributions from Leal and Kopnina, who have the highest H-index impact. Regarding publication volumes, China, Spain, and Germany are the leading countries. Thematic analysis revealed a predominant emphasis on the environmental and economic dimensions of sustainable development, with a comparatively less focus on social sustainability. This imbalance has significant implications, as social sustainability is critical to achieving societal stability. The findings of this research highlight the necessity for a comprehensive approach to higher education research that considers social sustainability, intending to promote a more holistic and enduring sustainability in the future.

The Internet of Things (IoT) has rapidly expanded, providing significant benefits across various fields. However, the complexity of IoT networks, with their resource-constrained devices, presents substantial security challenges, particularly Distributed Denial of Service (DDoS) attacks. Integrating Software Defined Networking (SDN) with IoT has emerged as a promising solution to enhance security. Despite this, DDoS attacks through IoT botnets remain a significant threat. Existing studies on DDoS detection in SDN-IoT networks often suffer from inefficient detection accuracy due to poor algorithm design and latency issues arising from deploying models in the control plane. This study aims to improve DDoS detection accuracy by training a robust Machine Learning (ML) model using effective hyper-parameter tuning and Cross-Validation (CV) techniques. To mitigate latency issues, we deploy the model at the edge of the SDN-IoT network, enforcing mitigation rules through the SDN controller. We evaluated four popular classifiers (K-Nearest Neighbor (K-NN), Random Forest (RF), eXtreme Gradient Boosting (XGBoost), and FeedForward Neural Network (FFNN)) on benchmark datasets CICIDS2017 and Edge-IIoTset, conducting both binary and multi-class classifications. Our implementation using the Mininet-WiFi emulation tool revealed that XGBoost outperformed others in binary DDoS detection, achieving accuracy, precision, recall, and F1-score all above 99.997%, with a testing time of 3.559 seconds on the Edge-IIoTset dataset. Compared to recent studies, the proposed approach demonstrates XGBoost’s clear superiority. Consequently, XGBoost was deployed at the edge of the SDN-IoT for live traffic classification, showing improved performance by classifying live traffic within 3.946 ms and using only 8.80% of memory with a 0.5-second window size.

Abstract Background The issue of workplace violence (WPV) directed at nurses is a chronic and global public health concern. Numerous studies on workplace violence in Ethiopia have been conducted; however, the results have been inconsistent. The review aims to identify the pooled prevalence and associated factors of workplace violence against nurses. Methods A systematic and methodical literature search was conducted using electronic databases such as Google Scholar, EMBASE I, Scopus, PubMed, HINAR, the Web of Science, and the African Journal Online (AJOL). Each original study’s efficacy and quality were assessed using a modified Newcastle-Ottawa scale (NOS) technique designed for cross-sectional research. The Cochrane Q and I2 test statistics were used to verify the heterogeneity of the studies. Using a random effect model, the pooled estimate of workplace violence among nurses was calculated. Result The pooled estimate of workplace violence among nurses in Ethiopia was 39.43% (95% CI: 27.63, 51.23). Female nurse (POR = 2.25; 95% CI: 1.29, 3.92), short work experience (POR = 3.25; 95% CI: 2.37, 4.45), and living without a spouse (POR = 2.03; 95% CI: 1.03, 3.99) were identified factors associated with workplace violence. Conclusion This study found that about two-fifths of nurses encounter workplace violence. According to this study, there was a significant association between work place violence among Nurses and being female, having less job experience, and being single. To address this issue, the Federal Ministry of Health (FMOH), policymakers, and other stakeholders should prioritize interventions aimed at reducing workplace violence.

Abstract In this manuscript, we investigated the existence, uniqueness, and Ulam–Hyers stability results of solutions to implicit Caputo–Hadamard fractional differential equations with noninstantaneous impulses and δ − d e r i v a t i v e $\delta -derivative$ initial conditions. By employing Banach’s and Schaefer’s fixed-point theorems, we attain the required results. Finally, we provide examples that support the main findings we arrived at.

Abstract Background Extemporaneous compounding for dermatological use is an important therapeutic alternative for patients whose clinical needs are not met by approved drug products circulated in the market. Evaluating patients’ perceptions and levels of satisfaction towards such services is an important factor for the adherence of patients and maintaining the quality of healthcare services. The current study aimed to assess patients’ perception and level of satisfaction with the compounding service and extemporaneous preparations rendered at ALERT hospital. Methods An institution-based cross-sectional study was conducted among patients receiving compounding pharmacy services at ALERT hospital, Addis Ababa, Ethiopia from 10th April to 10th May 2023. A consecutive sampling technique was used to recruit the study participants. Data were collected using an interviewer-administered structured questionnaire, entered into the EPI info, exported and analyzed using SPSS. Multivariate linear regression analysis was performed to determine possible predictors of patient satisfaction and p-value

Purpose – The purpose of this study is to examine the crucial factors that impact the quality of pre-primary education in Gambella Regional State, Ethiopia. This study uses a convergent mixed-methods design, integrating both quantitative and qualitative methodologies, to investigate the complex relationship between teacher-related factors and the delivery of quality pre-primary education. This research aims to identify the challenges faced in pre-primary education and provide recommendations to improve the quality of service provision, ultimately fostering positive learning outcomes for children. Design/methodology/approach – This study uses a convergent mixed-methods design, combining quantitative and qualitative methodologies to examine the crucial factors of effective teacher-related elements in providing quality pre-primary education in Gambella Regional State, Ethiopia. Data were collected through surveys, observations, interviews and focus group discussions involving education experts, school principals, teachers and parent–teacher association leaders. Quantitative data was analyzed using inferential statistics, while qualitative data were analyzed thematically. This study integrated the findings from both methodologies to provide a comprehensive understanding of the relationship between teacher-related factors and quality service provision in pre-primary education. Findings – The findings of this study revealed a significant shortage of trained teachers with adequate experience and understanding of early childhood learning. In addition, inappropriate qualifications, insufficient play-based methods and communication shortage between teachers and parents were also identified as critical issues. This study found a strong, positive association between teacher-related factors and quality service provision (coefficient of 0.815 and p-value < 0.001), explaining 51.4% of the variance in service quality. These findings highlight the urgent need for policymakers and educators to prioritize teacher training and professional development in pre-primary education to enhance the quality of pre-primary education and improve learning outcomes for children. Research limitations/implications – This study has some limitations, including the use of a convenience sample and the reliance on self-reported data from teachers, which may be subject to social desirability bias. The findings may not be generalizable to other regions with different contexts, cultures and education systems. Despite these limitations, this study has important implications for policymakers and educators. The findings highlight the critical need for teacher training and professional development in pre-primary education. Practical implications – The findings of this study have important practical implications for policymakers, educators and stakeholders involved in pre-primary education in Gambella Regional State, Ethiopia. This study highlights the urgent need for policymakers to prioritize teacher training and professional development programs in pre-primary education. The findings suggest that improving teacher qualifications, addressing individual learning needs and enhancing play-based methods can positively impact pre-primary education quality. Additionally, this study emphasizes the importance of communication between teachers and parents, as well as effective time management, resource utilization and play-based methods. Social implications – The social implications of this study are significant, as pre-primary education is a critical foundation for a child’s future academic success and overall development. The findings of this study highlight the need for policymakers and educators to prioritize teacher training and professional development in pre-primary education. By addressing the shortage of trained teachers and improving teacher-related factors, pre-primary education quality can be significantly enhanced. This, in turn, can lead to improved cognitive, social and emotional development outcomes for children, setting them up for a lifetime of success and positive contributions to society. Originality/value – This study makes an original contribution to the literature on pre-primary education in Gambella Regional State, Ethiopia, by examining the crucial factors of effective teacher-related elements in providing quality services. The convergent mixed-methods design used in this study provides a comprehensive understanding of the complex interplay between teacher-related factors and the delivery of quality pre-primary education. The findings highlight the significant shortage of trained teachers, inadequate qualifications and deficiencies in addressing individual learning needs and using play-based methods, time management and communication between teachers and parents.

Abstract Background Placental malaria (PM) is characterized by Plasmodium parasite sequestration in the placenta. It is responsible for various adverse pregnancy outcomes, including maternal anaemia and low birth weight (LBW). This study aimed to assess prevalence and risk factors of PM, and gestational malaria (GM), together with the prevalence of congenital malaria (CM), maternal anaemia, and LBW among parturient women attending delivery ward of Metti Health Centre (Metti HC) in Majang Zone of Gambella Region, Southwest Ethiopia. Methods A cross-sectional study involving 180 parturient women attending delivery ward of Metti HC was conducted from November 2022-March 2023. Sociodemographic, obstetric, and anti-malarial intervention data were collected. Capillary, placental and cord blood, and placental biopsy were collected to diagnose malaria using rapid diagnostic test (RDT), microscopy, quantitative polymerase chain reaction (qPCR), and histopathology. Haemoglobin concentration and blood group of the mother and weight of the newborn were determined. Statistical analyses were done by SPSS Version 26.0. Multivariable logistic regression analysis and Chi-square test were done to identify risk factors. Results were presented in text, tables and graphs. Results The prevalence of GM, PM, CM, maternal anaemia, and LBW was 24.4% (95% CI 18.1–30.1), 34.4% (95% CI 27.4–41.4), 5.0% (95% CI 2.4–8.8), 41.7% (95% CI 34.6–49.0) and 27.8% (95% CI 21.6–34.6), respectively. Risk factors of GM were: presence of malaria history within the previous year (AOR: 5.10; 95% CI 1.64–15.83), lack of indoor residual spray (IRS) within the previous year (AOR: 2.98; 95% CI 1.05–8.45), and lack of antenatal care (ANC) contact during the index pregnancy (AOR: 3.96; 95% CI 1.44–10.87). Risk factors of PM were: presence of malaria history within the previous year (AOR: 2.98; 95% CI 1.05–8.45), and lack of ANC contact during the index pregnancy (AOR: 4.83; 95% CI 1.91–12.18). The risk of CM (p

Abstract 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 Background Bacteremia is prevalent in neonates, largely attributed to factors inherent in the neonatal period. However, the prevalence of proven bacteremia in Ethiopian neonates has not been previously synthesized. Accordingly, this systematic review and meta-analysis aimed to analyze the prevalence of bacteremia and pathogen profiles in neonates hospitalized for clinical sepsis in Ethiopia. Methods This systematic review and meta-analysis followed the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020. The literature search was conducted across five databases including PubMed, Google Scholar, Web of Science, Science Direct, and Research for Life spanning from January 2015 to July 2023. The search strategy used MeSH terms and involved screening titles and abstracts, reviewing full-text articles, and including only observational studies published in English within the specified timeframe. Data extraction and quality assessment were performed by three experienced reviewers using a validated data collection tool and the Joanna Briggs Institute quality assessment tool, respectively. The prevalence of neonatal bacteremia was determined through a random effects model, with heterogeneity among studies assessed using the Q statistic and the I2 statistic. Publication bias was evaluated using a funnel plot and Egger’s regression test, and STATA version 16.0 was used for all analysis at 95% confidence level. Results A meta-analysis of nine studies revealed a bacteremia prevalence of 40.0% (95% CI: 34.0–46.0%). Subgroup analysis indicated variations in prevalence based on regions and study designs, with Oromia at 44.0% (95% CI: 28.0, 61.0%) and Amhara at 39.0% (95% CI: 27.0, 51.0%). Longitudinal studies exhibited a higher prevalence (47.0%, 95% CI: 27.0–68.0%) compared to cross-sectional designs (38.0%, 95% CI: 32.0–44.0%). Gram-negative bacteria were identified as the predominant etiological agents, representing 59.5% (95% CI: 56.8–62.3%) of cases. Among the bacterial species, Staphylococcus aureus emerged as the most prevalent (20.0%, 95% CI: 18.0%, 22.0%), followed by coagulase-negative staphylococci and Klebsiella pneumoniae, each contributing to 17.0% (95% CI: 15.0%, 20.0%) of bacteremia cases. Conclusion The study revealed a significant high prevalence of bacteremia, with differences noted across regions and study designs. Key pathogens identified were Staphylococcus aureus, Klebsiella pneumoniae and coagulase-negative staphylococci. It is advisable to implement surveillance systems, targeted prevention strategies, diagnostic stewardship, and further research on regional variations and bacterial profiles to effectively enhance the ominous future.

Abstract Introduction Simulation is defined as "the processes by which we are trying to achieve results approximating clinical practice as closely as possible." It is a technique for replacing or completing real-life experiences with guided experiences. Objective To assess and explore clinical simulation practice and associated factors among nurse and midwife educators working at teaching institutions in Bahir Dar, Ethiopia. Method An institutional mixed-method study was conducted from May 9 to June 7, 2022, at six teaching institutions in Bahir Dar City. A sample size of 220 was taken into account for the quantitative study, and a self-administered questionnaire was used to gather data. In-depth interviews were used to acquire data for the qualitative study, which involved eight participants. The data was entered into EpiData and exported to SPSS version 26 for additional analysis after being reviewed for consistency and completeness. To evaluate the relationship between the dependent and independent variables, binary logistic regression analysis with both (bi-variant) and (multivariable) inputs was carried out. Result Among respondents, 104 (49.1%) were government employees. Most of the respondents in this study were male (65.6%). Statistically significant associations simulation practice experience (AOR = 0.21; 95% CI: 0.07–64), training (AOR = 0.52; 95% CI: 0.27–0.98), educational qualification (AOR = 0.37; 95% CI: 0.15–0.93) and cost (AOR = 0.37; 95% CI: 0.18–0.74). The study showed that only 121 (57%) of the respondents’ practices were classified as "good practice," while 91 (42.9%) were classified as "poor practice." Qualitative findings revealed that a lack of classroom space, inadequate training in the institution, and a consistent checklist hampered the implementation of clinical simulation practice. Conclusion and recommendation We determined that a shortage of classroom space, inadequate resources, high costs, and an absence of ongoing training were the key obstacles to the successful implementation of clinical simulation practice. Responsible governmental bodies should give attention for clinical simulation education.

Abstract Despite the increasing global burden of mental illness and the availability of effective evidence-based treatments, many individuals with mental illness do not seek professional help. Therefore, this study aimed to assess help-seeking intention for mental illness and associated factors among Dessie town residents, Northeast Ethiopia, 2021. A community-based cross-sectional study was conducted among 501 Dessie town residents. The data were collected by face-to-face interview. The General Help Seeking Questionnaire was used to assess help-seeking intention. Bivariable and multivariable logistic regression analysis techniques were used. Finally, a statistically significant level was declared at a p-value less than 0.05. Among 501 participants, 67.5% were likely to seek help from health professionals. Being female (AOR = 4.695, 95% CI = 1.63– 13.50), being single (AOR = 0.330, 95% CI = 0.12–0.89), and having good knowledge (AOR = 3.030, 95% CI = 1.25–7.35) were significantly associated with help-seeking intention. This study indicated that the participants’ help-seeking intention was inadequate. Sex, marital status, monthly income, and knowledge of mental illness were found to be associated with help-seeking intentions for mental illnesses. Therefore, community healthcare workers, healthcare administrators, and religious and community leaders should work to enhance the help-seeking intention of the community.

Abstract Rational use of steroids is essential in the long term for improving patient safety. Systemic steroids are important in clinical treatment, but if they are misused, they might have negative effects. This study assessed systemic steroid use and its determinants at Debre Berhan University Hakim Gizawu Teaching Hospital (DBUHGTH), Ethiopia. A cross-sectional study was conducted among 210 admitted patients at the Medical ward of DBUHGTH. A simple random sampling method was used to recruit study participants. The data was collected from patient medical records and patient interviews using a structured data abstraction and patient interview format. Binary logistic regression was employed to identify the potential predictors of systemic steroid use. Finally, the results were interpreted and presented by tables, charts, and graphs. Most study participants were 142 (67.62%) male. The mean age of the participants was 44.94 (SD, 19.2) years. Prednisolone was mostly utilized drug 130 (42.07%), followed by hydrocortisone 81 (26.21%), beclomethasone 58 (18.77%), and dexamethasone 40 (12.94%). Respiratory disorders 112 (53.34%), meningitis 25 (11.91%), and rheumatoid arthritis 19 (9.05%) were the top three disease conditions in which steroids were used with the highest frequency. Most systemic steroids were administered orally, 130 (42.07%). Short-acting (hydrocortisone, beclomethasone) 139 (44.98%) were mostly used, followed by intermediate-acting steroids (prednisolone) 130 (42.07%). Study participants in the 18–40 age range were approximately 2.5 times more likely than those in the 65 + age group to be using systemic steroids (AOR = 2.5, 95% CI 2.86–6.07). Prednisolone was mostly utilized, followed by hydrocortisone, beclometasone, and dexamethasone drugs in the medical ward of DBUHGTH.

Abstract Access to health care is a fundamental human right. However, nearly one-third of the global population have no access to it. This magnitude is even much worse in low- and middle-income countries. A cross-sectional study was conducted from April 12 to June 5, 2024 to determine availability, price and affordability of essential medicines for managing cardiovascular diseases using WHO/HAI methodology in Addis Ababa, Ethiopia. Data on the availability and price of the lowest priced generic medicines were collected from five public, ten private and eight other sectors in Addis Ababa, Ethiopia. The availability was assessed as the percentage of health facilities that stocked the listed medicines. The prices of these medicines were evaluated across all sectors. Price variations were calculated to identify differences among these settings. Additionally, medicine prices were compared against the management sciences for health (MSH) International Reference Prices to calculate the Median Price Ratio (MPR), providing a standardized measure of price affordability and accessibility. The data was analyzed using WHO/HAI work book Excel sheet V 15. The overall availability of generic drugs in all sectors was found to be 34.52%. The availability was 33.73, 40.58, 29.8 and 33.99% in Public, Private, Kenema and Red Cross pharmacies, respectively. The median price ratios for the medications used to treat cardiovascular disease were 3.49, 7.24, 2.84 and 5.2 at Public, Private, Kenema, and Red Cross Pharmacies, respectively. Majority of the medicines were found to be unaffordable, costing up to 352.44 days’ wage of the lowest paid government employee to cover a one-month standard treatment. In conclusion, the study underscores significant challenges in the availability, pricing, and affordability of LPG medications to treat CVDs in Ethiopia.

Genotype evaluation for stability and high yielding in maize is an important factor for boosting productivity and sustainability of maize production. A total of 25 maize genotypes were evaluated over six environments namely Bako (BK), Asosa (AS), Hawasa (HW), Pawe (PW), Jimma (JM) and Arsi-Negele (AN) using randomized complete block design with three replications during 2022 for the objective to identify superior and stable maize genotypes through stability analysis. Combined ANOVA revealed highly significant (p

Educators (Higher education teachers) play a significant role in equipping future professionals and contributing to societal progress. They are responsible for preparing competent citizens who serve various societal roles. Hence, examining educators' perceptions regarding professional development and technological proficiency is crucial. This study examines educators' perceptions of professional development and technological proficiency in Ethiopian higher education institutions, focusing on curriculum content, interdisciplinary integration, and aligning theory with practice. The impetus for this study is the growing necessity for educators to possess technological proficiency to meet global educational standards and the demand for innovative teacher education programs. It addresses Educators' perceptions of (1) Their technological proficiency, (2) The relevance and interdisciplinary integration of teacher education curricula, (3) The alignment of theoretical and practical curriculum components, and (4) The integration of technological training in teacher development programs. A structured questionnaire was utilized to collect data from instructors across various university categories. The analysis employed descriptive statistics, ANOVA, and post hoc tests. The findings indicate that educators perceive their technological proficiency as moderate (M = 3.0, SD = 0.66) and regard curriculum relevance and interdisciplinary integration as slightly above average (M = 3.1, SD = 0.64). Research universities demonstrate consistently higher scores across all variables, including technological training and curriculum alignment, than comprehensive and applied universities. Technological training integration and the alignment of theoretical and practical elements were identified as areas requiring improvement (M=2.8, SD=0.58; M=2.9, SD=0.67). Significant differences in perceptions were observed based on university type, qualifications, and experience, with research universities exhibiting the highest levels of perceived innovation and technological adoption. The study highlights gaps in technological training and curriculum alignment in Ethiopian higher education, urging strategic policies and resources to improve teacher education programs. By Emphasizing the importance of integrating theory and practice and fostering technological proficiency, the study calls for collaborative efforts to tackle the educational challenges of the 21st century.

Abstract Background The World Health Organization recommends a cesarean delivery rate of 5–15%, which is thought to be within the range that can reduce infant morbidity and mortality. Various investigations have shown that those poor newborn outcomes are influenced by a variety of maternal and fetal factors and are more prevalent in emergencies than planned cesarean deliveries. Ethiopia is one of the five nations that account for 50% of all neonatal fatalities worldwide. Sub-Saharan African countries account for 38% of all infant deaths worldwide. Aim To know the determinants of adverse early neonatal outcomes after emergency cesarean delivery. Method and material A multicenter case-control study design would be carried out between November 2022 and January 2023. Using the consecutive method, a sample of 318 mother-newborn pairs was studied. Direct observation and face-to-face interviews were undertaken to gather the data using a semi-structured questionnaire. For both data input and analysis, Epi Data version 4.6 and Stata version 14 software were used. Both the crude and adjusted odds ratios were computed. The measure of significance was based on the adjusted odds ratio with a 95% confidence interval and a p-value of less than 0.05. Results Maternal age over 35, the presence of danger signs during pregnancy, and non-reassuring fetal heart rate were significantly associated with increased risk of adverse fetal outcomes following emergency cesarean section. Women aged over 35 were 3.6 times more likely to experience adverse fetal outcomes compared to younger women (AOR: 3.6, 95% CI: 1.1, 9.7). Women with danger signs during pregnancy were 3.5 times more likely to have adverse fetal outcomes compared to those without (AOR = 3.5, 95% CI: 2.4, 36). Similarly, cases with non-reassuring fetal heart rate were associated with a 5.2 times higher risk of adverse newborn outcomes (AOR = 5.2, 95% CI: 1.1, 26). Conclusion This study identified advanced maternal age (over 35 years old), pregnancy complications, and non-reassuring fetal heart rate as significant risk factors for adverse neonatal outcomes following emergency cesarean section.

Abstract Background Schistosoma mansoni and soil-transmitted helminth (STH) infections are major public health problems in areas with poor sanitation and limited access to water. In Ethiopia, there is limited data available for monitoring the efficacy of interventions aimed at reducing helminth infections. Therefore, we assessed the prevalence of S. mansoni and STH infections, as well as factors associated with this prevalence, among schoolchildren and compared the findings with those of earlier studies. We also evaluated the diagnostic agreement between two parasitological methods. Methods A cross-sectional study involving 363 schoolchildren from three rural primary schools located along the shore of Lake Hawassa, Sidama Regional State, southern Ethiopia, was conducted in October and November 2023. The schoolchildren were selected using a systematic random sampling technique. Socio-demographic data were collected using pre-structured questionnaires. A single stool sample was collected from each study participant and processed using direct wet mount (DM) microscopy and the formol-ether concentration technique (FECT) to detect helminth ova. Results The overall prevalence of helminths was 59.8%, with 36.6% of participating children having a single infection and 23.1% having multiple infections. Schistosoma mansoni and STHs were present in 33.9% and 38.8% of children, respectively. The STHs included Ascaris lumbricoides (28.9% of children), Trichuris trichiura (10.7%), hookworms (5.2%) and Strongyloides stercoralis (2.8%). Diagnostic agreement between the DM microscopy method and FECT was substantial [kappa (κ) = 0.710] for the detection of Hymenolepis nana and almost perfect (κ = 0.827) for the dection of A. lumbricoides, but only fair for the detection of other detected helminths. Children at Finchawa primary school had a lower prevalence of S. mansoni infection [adjusted odds ratio (AOR) 0.31; 95% confidence interval (CI) 0.13–0.76] than those at St Paul’s Tullo Catholic primary school. STH infections were more common among children who sometimes (vs. always) washed their hands before meals (AOR 1.89; 95% CI 1.01–3.54) and those who regularly played with soil (AOR 2.56; 95% CI 1.47–4.46). Conclusions This study showed a reduction in STH infections from a high prevalence in 2015 to a moderate prevalence at the present time, despite a similar moderate prevalence of S. mansoni infection. Thus, it is crucial to intensify deworming interventions to reduce the burden of helminths in the study area. Additionally, there is a need to enhance the capacity of clinical laboratories to perform FECT in Ethiopian clinical settings where DM is often employed to diagnose helminths. Graphical Abstract

Abstract Lead (Pb) exposure negatively impacts fertility in both males and females, pregnancy outcomes, and child brain development. We investigated the reproductive and neurological effects of Pb exposure on male and female mice via Pb-contaminated soil for 4 weeks. Breeding was conducted after completion of exposure, in four groups; group 1 consisted of exposed dams and unexposed sires, group 2 consisted of exposed sires and unexposed dams, group 3 consisted of exposed sires and exposed dams and group 4 was the control. Generally, Pb exposure reduced observed conception rates, with a cumulative decrement observed when both males and females are exposed. Gene expression of the testes revealed oxidative stress as the cause of reduced conception rates. Neurological tests: Morris water maze and rotarod were conducted on F1 generation offspring. Maternally and paternally exposed F1 mice performed poorly in the Morris water maze when compared to the control. The severity of the neurological effects was also parent-dependent and sex-dependent. Paternal Pb exposure effects were more pronounced in female offspring. A comparison of gene expression changes of the hippocampus and prefrontal cortex showed paternal Pb-exposure resulted in more prefrontal cortex changes than in the hippocampus, a trend also recorded in the exposed sires. The pronounced effects in female offspring of paternal Pb exposure may suggest that Pb neurological effects may be X-chromosome-linked.

Abstract In our present work, we study a coupled system of Caputo–Hadamard fractional differential equations supplemented with a novel set of initial value conditions involving the η = ( t d d t ) $\eta =(t\frac{d}{dt})$ derivatives. We provided sufficient criteria for the existence and stability of the solutions for a coupled system of fractional differential equations by applying the Hyers–Ulam stability theory, the fixed point theorems of Banach, Krasnoselskii, and the Leray–Schauder nonlinear alternative. When computing priori bounds in Leray–Schauder nonlinear alternative and stability of the solutions, a novel Gronwall type inequality related to Hadamard integral is employed. This study investigates the properties of a solution, such as existence, uniqueness, and stability, to a given problem without attempting to solve the exact solution, and its theoretical applications are illustrated by providing an example.

Abstract The deep connection between Indigenous communities and nature plays a pivotal role in biodiversity conservation. Ethiopia, one of Africa's priority countries for bird conservation, harbours 821 bird species and 83 ethnic groups of Indigenous people. However, cultural and spiritual ties between Indigenous peoples and bird species remain largely unexplored. This is particularly true for remote Indigenous communities such as the Nuer. Relying on preexisting bird survey data, we conducted focussed group discussions and semi‐structured interviews with Indigenous Nuer in western Ethiopia to explore human–bird interactions and documented associated traditional ecological knowledge and considered their conservation implications. We found that Nuers have strong ties with birds. In Nuer community, birds are collectively known by three interchangeable terms: ‘gaatkuoth’ to mean sacred children of god, ‘kuoth’ meaning bearers of spirit and ‘diit’ symbols of human twins (since birds nurture multiple offspring, they associate the incidence of twins in human with birds). We identified 71 culturally important bird species that were used in seven different use categories. Among these species, 10 were used as bushmeat, five for traditional medicine, eight as fish indicators, seven as omens (believed to indicate upcoming misfortunes), three as amulets (believed to protect against danger when bird's body parts are used as necklaces and bracelets), three as season indicators and 45 for their scenic beauty. An informant consensus factor for species in all use categories was >90%, except for the scenic value, indicating a high homogeneity of knowledge about species uses. Bird species with multiple uses have significant cultural values among locals, emphasizing the need to understand these values in conservation efforts. Nuer traditional systems regulate the direct use of birds including for bushmeat. Hunting is permitted only by impoverished households during severe food shortages and is prohibited for those with a history of twins in their ancestry. The Nuer people exhibit a profound cultural connection to birds, viewing them as sacred and spiritually valuable beings. This deep‐seated reverence and traditional knowledge highlight the importance of integrating Indigenous perspectives into bird conservation strategies to enhance their effectiveness and respect cultural values. Read the free Plain Language Summary for this article on the Journal blog.

Irrigation remains important to meet the needs of the people by increasing agricultural productivity. However, its water productivity in developing countries is low due to inefficient irrigation water management. The main objective of this study was to evaluate soil water, crop growth and nutrient dynamics under different irrigation techniques. Hydrus-1D model was used to simulate soil water content (SWC), actual evapotranspiration (ETa) and soil leachates. The model performance was evaluated by comparing the measured and simulated treatment variables. The Hydrus-1D performance showed good agreement between the observed and simulated SWC (R2 = 0.55–0.81; NRMSE = 0.01-0.09; d-index = 0.95-0.99) and with a very good agreement for nitrate-nitrogen (NO3–N) leaching (R2 = 0.97, d index = 0.99 and NRMSE = 0.02). Similarly, performance in simulating PO4-P were acceptable (R2 = 0.88; d index = 0.99; NRMSE = 0.04). The value of SWC (cm3 cm−3) ranged from 0.30 to 0.38 at 10 cm and from 0.27 to 0.37 at 20 cm soil depths. The seasonal drainage water was reduced to 86%, 87%, and 54 %, respectively for AFI, FFI, and OHI treatments compared with CFI treatment. The NO3–N leaching was reduced by 41%, 71%, and 83% under AFI, FFI, and OHI compared with CFI while phosphate – P (PO4-P) leaching was 60%, 66%, and 79.6%, respectively, lower in AFI, FFI, and OHI than CFI. The highest seasonal ETa (421.95 mm) was found in CFI while the lowest (335.22 mm) was found in AFI treatment. Besides, the highest IWP (9.11 kg/m3) was obtained from AFI technique indicating that that AFI was the most efficient irrigation technique in saving both nutrient and water under onion production. Hydrus-1D could be a successful tool for predicting water and nutrient transport management decisions to improve water and nutrient management.

Abstract Background Understanding antimicrobial prescribing (AMP) practices and their prudent use in livestock can support the implementation of stewardship programs in veterinary medicine. Empiric therapy using antimicrobials is widely practiced in resource-poor settings, including Ethiopia. This could significantly contribute to the global burden of antimicrobial resistance (AMR) and the potential accumulation of residues in food. This study assessed AMP practices in Ethiopian veterinary clinics located in different agroecological zones (AEZs) as well as adherence to antimicrobial stewardship principles (ASPs). Methods Data were collected from case book records from four district veterinary clinics located in different AEZs in Ethiopia from 2015 to 2019. To identify factors associated with non-prudent AMP practices (i.e., the use of antimicrobials without therapeutic effects or benefits to the animal), data from registered clinical veterinary cases were selected using a systematic random sampling method. This led to the inclusion of approximately one-third of all records, including animal characteristics, disease symptoms and diagnosis, and details about the prescribed drugs. Descriptive statistics were used to report the proportions of drugs prescribed and adherence to the ASPs. The Chi-square test was used to establish an association between the drugs prescribed and the disease diagnoses and the districts. The factors associated with cases receiving antimicrobials and non-prudent AMP practices were also assessed using a multivariable logistic regression analysis. Results In total, 12,438 clinical case records were considered. Approximately 97% of these cases received treatment without laboratory confirmation, and 15,243 drugs were prescribed. Among these prescriptions, 75% were for antimicrobials, with oxytetracycline (29%) and a combined formulation of penicillin-dihydrostreptomycin (19%) being the most often prescribed drugs. Overall, 19% of the cases were treated non-prudently with antimicrobials, with high incidences at Holeta (32%) and Sekoru (19%) (p

Hydatid disease is a common parasitic illness. The paravertebral region is rarely involved. After presenting with chronic posterior upper neck swelling, a 28-year-old male patient underwent successful surgical treatment for a primary hydatid disease of the cervical paravertebral compartment after he presented with chronic posterior neck pain. Magnetic resonance imaging was very helpful in identifying a single, well-encapsulated lesion located in the suboccipital paravertebral region. The lesions contained classic daughter cysts that were isointense to the cerebrospinal fluid on all sequences. He had no abdominal or chest hydatid diseases. Primary hydatid disease is extremely rare in this area, and to our knowledge, only 1 previous case similar to ours exists.

Sintayehu Asrat Beyene,1 Nahom Tadesse Bogale,1 Binyam Mohammedbirhan Berhe,2 Demis Degu Teshome3 1General Surgery Unit, Department of Surgery, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 2Department of Pathology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia; 3Department of Obstetrics and Gynecology, Jigjiga University Sheik Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, EthiopiaCorrespondence: Sintayehu Asrat Beyene; Nahom Tadesse Bogale, Email sintayehubeyene54@gmail.com; Tadnahi2@gmail.comIntroduction: Endometriosis is a disease condition characterized by the presence of endometrial glands and stroma outside the uterine cavity and musculature. It affects 7– 10% of women of reproductive age and usually involves pelvic organs. The common symptoms include dysmenorrhea, menorrhagia, pelvic pain, dyspareunia, and infertility. Umbilical endometriosis is the rarest form of extra-pelvic endometriosis.Case Presentation: A 32-year-old Para II mother presented with umbilical swelling and pain that worsened during the menses of 2 months. She had two caesarean scars, both transverse Pfannenstein incisions. There was a dark blue, firm to hard 2× 3 cm umbilical mass on physical examination. Laboratory results are normal. Ultrasound of the abdomen showed umbilical mass with homogeneous echotexture measuring 2 cm × 3 cm with an irregular border and hypoechoic texture. An excisional biopsy was performed and a biopsy showed umbilical endometriosis.Discussion: Primary umbilical endometriosis is a disorder first described by Villar in 1886, and among all cases of extra-genital involvement of endometriosis, primary umbilical endometriosis accounts for 0.5– 1%. The usual presentation of primary umbilical endometriosis is typically the presence of a discrete bluish-purple mass in the umbilicus, which becomes swollen, painful, and bleeds concomitantly with the menstrual cycle. Ultrasound and other imaging techniques help in making diagnoses, and the diagnosis is confirmed by cytological examination. The management of umbilical endometriosis involves surgical excision and reconstruction of the umbilicus.Conclusion: Umbilical endometriosis is an uncommon form of extra-pelvic endometriosis. There is a wide differential diagnosis for swellings of the abdominal wall; however, it should be suspected in any female patient of reproductive age with an umbilical lesion that becomes more painful and swollen during her menstrual period. Appropriate clinical examination and workup are helpful to make a diagnosis and do a surgical excision.Keywords: endometriosis, umbilical nodules, umbilical hernia, abdominal wall scar, caesareans section

Abstract Background Enterobacterales infections in immunocompromised individuals are associated with considerable morbidity, mortality, and health care costs. This study aimed to assess the faecal carriage of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Enterobacterales (CPE) among HIV-infected patients at Jimma Medical Center. A total of 344 stool samples were collected and inoculated on Mac-Conkey and Eosin-Methylene Blue agar and incubated at 35–37 °C aerobically. ESBL and carbapenemase production were detected using D68C ESBL/AmpC and D73C CARBA plus (Mast Group, UK). Results A total of 376 Enterobacterales were isolated. The prevalence of ESBL-PE and CPE carriage rate was 13.3% (50/376) and 4.3% (16/376) respectively. The highest proportion of ESBL producing isolates were found in K. pneumoniae 29.0% (9/31) followed by E. coli 13.4% (39/292). Similarly, K. pneumoniae 12.9% (4/31) was the most common carbapenem-resistant isolate followed by E. coli 3.8% (11/292). Multi-drug resistance was observed in 66.5% (250/376) of the isolates. Prior cephalosporin use (AOR = 7.9; 2.31–27.29), CD4 count (≤ 350 cells/µL) (AOR = 3.8; 1.12–12.9), and comorbidities (AOR = 2.3; 1.24–4.32) were significantly associated with ESBL production. Additionally, cephalosporin use (AOR = 6.34; 1.27–31.66) was significantly associated with the presence of CRE. Conclusions This study revealed a high prevalence of ESBL-PE and CPE among HIV patients, with K. pneumoniae and E. coli being the dominant isolates. MDR was common, with key risk factors being prior cephalosporin use, low CD4 counts, and comorbidities. These findings emphasize the need for enhanced infection prevention and control, regular screening, and improved antibiotic stewardship to curb the spread of resistant bacteria in immunocompromised individuals.

Abstract The world’s energy consumption is being replaced by renewable energies in large part because of the depletion of fossil fuels and the acceleration of environmental change. This study reports the amount of inward solar radiation in the date range from January 2018 to December 2022 in the Gregorian Calendar for certain areas in Bahir Dar, Ethiopia: 37°E and 11.6°N. On the horizontal surface of the case area, the month with the highest global radiation (monthly average daily) is March, at approximately 42.56 MJ/m2. day; June has the lowest diffuse radiation, at 16.2 MJ/m2.day. Furthermore, April had the most global radiation (monthly average hourly) on the horizontal surface, measuring 9.09 MJ/m2.hour, while June had the lowest diffuse radiation, measuring 2.3 MJ/m2.hour. In addition, this study predicts the beam, diffuse, and total radiation on the tilted collector using the total available horizontal radiation on a monthly and hourly basis. According to the research, the output of the radiation on the tilted surface towards the equator in the northern hemisphere, azimuth angle, γ = 0°, shows that the highest possible total radiation (monthly average daily) is 48.3 MJ/m2. day (January) and the highest possible total radiation (monthly average hourly) in February, 9.14 MJ/m2.hour at 1:00 p.m.

Abstract Background Globally, 64–74 million individuals around the world are estimated to sustain traumatic brain injury every year. Moderate and severe traumatic brain injury can lead to a lifetime physical, cognitive, emotional, and behavioral changes. There were limited studies conducted in Ethiopia regarding to traumatic brain injury mortality. Methods An institutional based retrospective cohort study was conducted on 429 randomly selected traumatic brain injury patients aged 18 to 64 years who were admitted to East Amhara Comprehensive Specialized Hospitals from January 1, 2016 to December 31, 2021. Kobo toolbox was applied for data collection and exported to Stata version 17 for data processing and analysis. To estimate death free time, a Kaplan Meier failure curve was used. The Cox proportional hazards regression model was used at the 5% level of significance to determine effect of predictor variables on time to death. Result A total of 429 traumatic brain injury patients aged 18 to 64 years were included with response rate of 91.3% and 145(33.8%) were dead. Open injuries (AHR = 0.25; 95% CI: 0.18–0.36), co-existing injuries (AHR = 0.40; 95% CI: 0.24–0.66), ICU admission (AHR = 0.42; 95% CI: 0.29–0.60), arrival within 4–24 h (AHR = 3.48; 95% CI: 2.01–6.03), arrival after 24 h (AHR = 6.69; 95% CI: 3.49–12.28), subdural hematoma (AHR = 2.72; 95% CI: 1.77–4.19), serum albumin 24 h), subdural hematoma, serum albumin

Abstract Background and objective Urolithiasis, the presence of stones in the urinary tract, has been linked to various clinical features and reported as a worldwide health concern. Its prevalence varies across different regions as well as populations. Several primary studies have been conducted in Sub-Saharan Africa on the situation. However, their reports are inconsistent. Hence, this review aimed to assess the pooled magnitude of urolithiasis and its clinical patterns among hospital-visiting patients in sub-Saharan Africa. Methods Online databases such as PubMed, Hinari, the African Journals online database, and Google Scholar were used to comprehensively search articles published until June 28, 2023, about the prevalence and clinical patterns of urolithiasis in Sub-Saharan Africa. All the included studies were conducted at hospital setting. The retrieved data was exported to STATA version 16 for final analysis. A random-effect meta-analysis model was computed to estimate the pooled results. The heterogeneity of the studies was assessed using I 2 and Cochran’s Q. Publication bias was examined by observation using funnel plots and statistically by Egger’s tests. Subgroup analysis was performed based on the country where the studies have been conducted. Result A total of 26 articles (11 reported both prevalence and clinical pattern, 5 reported only prevalence, and 10 reported only clinical patterns of urolithiasis) were included in the final systematic review and meta-analysis. The pooled prevalence of urolithiasis among hospital-visiting patients was 9.4% (95% CL = 4.9–14%), with significant heterogeneity. Most of the urolithiasis was located in the kidney, with an estimated pooled proportion of 4.6% (95% CI = 2.7, 6.5), followed by bladder stone-2.0% (95% CI = 0.7, 3.4), ureteral stone-1.8% (95% CI = 0.7, 2.9), and urethral stone-0.2% (95% CI = 0.00, 0.05). The subgroup analysis showed the highest prevalence of urolithiasis was found in Mauritian, 28.1% (95%CI 24.5, 31.7), followed by Ethiopia 18.1%, and the lowest was in Eritrea, 1.0%. A sensitivity analysis using the random-effects model found no influential study on the pooled prevalence of urolithiasis. Evidence of significant publication bias was observed and trim-fill analysis was conducted for adjustment. Accordingly, two missing studies were identified, and after adjustment, the combined prevalence of urolithiasis was estimated to be 10.7%. The study also found that urolithiasis prevalence per gender was 6.3% in males and 2.9% in females. The most common clinical presentation of urolithiasis was flank pain at 58.4% (95% CL=, 45.9, 70.8), followed by low back pain at 45.9% (95% CL=, 23.1, 68.8), and nausea/vomiting at 29.9% (95% CI: 1 1.1, 48.8). Conclusion The prevalence of urolithiasis in Sub-Sahara African Countries is increasing even though a remarkable regional variation was observed, with higher predominance in males than females. Common clinical presentations of urolithiasis were flank pain, low back pain, and nausea/vomiting.

Abstract Bismuth oxyhalide (BiOX) represents a class of layered materials distinguished by unique physicochemical and optical characteristics. This study delivers an extensive investigation into the properties of BiOX crystals, employing first-principles calculations to analyze the electronic band structure, projected density of states (PDOS), Raman and infrared (IR) spectra, dielectric functions, alongside phonon and thermodynamic properties. The computed electronic band gaps BiOI, BiOBr, BiOCl, and BiOF crystals were determined to be 2.19 eV, 3.05 eV, 3.29 eV, and 3.43 eV, respectively. Furthermore, an analysis of the PDOS for each BiOX type indicates that the valence band maximum (VBM) primarily comprises dominant O 2p and halide X np states, while the conduction band minimum (CBM) predominantly features Bi 6p states. In addition, significant absorption edges for BiOI, BiOBr, BiOCl, and BiOF crystals, oriented along the [100] axis, were observed at wavelengths of 540 nm, 449 nm, 367 nm, and 320 nm, respectively. The Raman spectral analysis revealed a noticeable shift correlating with the increasing number of halogen atoms, with intensity enhancements observed at elevated temperatures. Phonon dispersion studies corroborated the geometric stability of the optimized structures of BiOX crystals. Thermodynamic evaluations suggested that BiOX materials exhibit qualities characteristic of hard materials at higher temperatures while displaying softer material attributes at lower temperatures. In summary, this research substantially enriches the current understanding of bismuth oxyhalides by detailing their structural, electronic, optical, phonon, and thermodynamic properties. The findings presented in this study provide a foundational basis for future advancements in photocatalytic applications and material development.

Abstract Background Uterine rupture is a rare but severe obstetric complication that poses significant risks to maternal and fetal health. Understanding the lived experiences of individuals who have undergone uterine rupture is crucial for improving care and support for those affected by this condition. This qualitative phenomenological study aimed to explore the experiences of individuals who have experienced uterine rupture. Method The study employed a qualitative phenomenological approach, conducting 12 in-depth interviews and four key informant interviews with individuals who had experienced uterine rupture. Data analysis was conducted thematically using Atlas ti software to identify patterns and themes within the participants’ narratives. Results The analysis of the interviews highlighted six key themes: experience during diagnosis and initial symptoms, perceived predisposing factors of uterine rupture, challenges faced by individuals with uterine rupture, impacts on their lives, and coping and resilience strategies. The findings revealed that women often failed to recognise the initial symptoms of uterine rupture due to a lack of preparation, a preference for home deliveries, husband refusal, and a general lack of awareness. This delay in seeking care resulted in severe consequences, including the loss of their babies, infertility, fistula, psychological trauma, and disruptions to daily life and relationships. To cope, many women resorted to accepting their situation, isolating themselves, and using traditional healing techniques. Conclusions This study’s findings provide valuable insights into the complex and multifaceted nature of uterine rupture, shedding light on the experiences of those affected by this condition. To address the challenges, it is essential to enhance awareness and education through community education programs and comprehensive antenatal classes. Additionally, improving access to healthcare by strengthening health infrastructure and deploying mobile health clinics can ensure better prenatal care. Furthermore, encouraging hospital deliveries through incentives and the support of community health workers can reduce risks. Providing psychological counselling and establishing support groups can help affected women cope with the consequences. Moreover, engaging men in maternal health through educational programs and involving them in antenatal care can foster better support. Finally, promoting safe traditional practices by integrating traditional healers and respecting cultural sensitivities can increase acceptance and adherence.

Abstract Maternal morbidity and mortality have long been among the world’s most challenging health issues. Uterine rupture is one of the peripartum complications that kills almost one in every thirteen mothers. However, there is limited evidence on uterine rupture trends, proportions, and determinants. Thus, this study assessed the trend, prevalence, and associated factors of uterine rupture at Nekemte Specialized Hospital, Oromia Regional State, Western Ethiopia. An institution-based cross-sectional study was conducted among 2661 clients selected using a systematic random selection technique among the data collected for the project between January 2014 and December 2022 at Nekemte Specialized Hospital. Data were collected through an interview-administered questionnaire and card review from March 2023 to August 2023. The collected data were checked, coded, and entered into Epi info version 7.2 and then exported to SPSS Version 27 for analysis. Logistic regression models were fitted to identify the factors of uterine rupture. Adjusted odds ratio with 95% Confidence Interval was estimated to measure the strength of the association, and statistical significance was declared at a p-value less than 0.05. The trend of uterine rupture declined from 1.54% in 2014 to 0.93% in 2022. The overall prevalence was 3.53% (95%CI: 2.7%, 4.3%). Low household income (Adjusted OR = 3.75, 95%CI: 1.97, 7.13), grandmultiparity (Adjusted OR = 7.78, 95%CI: 4.70, 12.88), having a history of obstetrics complications such as prolonged labor (Adjusted OR = 3.78, 95%CI:2.11, 6.75), a history of cesarean section (Adjusted OR = 2.49, 95%CI:1.42, 4.35), and history of uterine repair (Adjusted OR = 18.01, 95%CI: 6.81, 47.64) were significantly associated with uterine rupture. This finding showed that the trend is declining, and the proportion of uterine rupture is still higher. A more vigilant approach to increase access to lower-income mothers, prevent prolonged and obstructed labor, and maintain antenatal care with complete packages and a referral system are issues to be addressed to minimize the chance of uterine rupture among women.

Abstract Background Male partner involvement in antenatal care is a key factor that cannot be ignored in the quest for improvement in maternal health and is recommended as an essential intervention to improve maternal and neonatal health outcomes. However, little attention has been given to male partners’ involvement in maternity care, particularly in developing countries. Objective This study aimed to assess male partners’ involvement in antenatal care and its associated factors among male partners whose wives gave birth within the last one-year in Bichena town, Westcentral, Ethiopia, 2019. Methods A community-based cross-sectional study design was conducted from October 1/2018 to June 15/2019, in Bichena town, among 406 male partners. The data was collected by a simple random sampling technique and analyzed using the Statistical Package of the Social Science 23.0 version. Bivariate and multivariable logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P-value of

Background: Antibiotic use has been rising in both humans and animals. The growing concern over antimicrobial drug resistance and the promotion of regional drug use have led to a rising in the interest medicinal applications of herbs combined with biosynthesized nanoparticles. Aim: To evaluate the antimicrobial and acaricidal effects of Syzygium cumini leaves crude extract (Sc-CE) and biosynthesized S. cumini silver nanoparticles (Sc-AgNPs) on dog skin pathogens and determined the optimal concentration and time for in vitro application. Methods: S. cumini leaves (Sc) were prepared as Sc-CE and Sc-AgNPs. The biosynthesized silver nanoparticles were characterized employing various techniques, including dynamic light scattering (DLS), scanning electron microscopy (SEM), and energy-dispersive X-ray analysis (EDAX). Phytochemical analyses were conducted using liquid chromatography coupled with quadrupole time-of-flight mass spectrometry screening (LC/QTOF-MS). Antimicrobial activity was examined against gram-positive bacteria, including Staphylococcus aureus and Staphylococcus pseudintermedius, gram-negative bacteria such as Pseudomonas aeruginosa, yeast strains including Malassezia pachydermatis and Candida albicans, and ectoparasite. Cytotoxicity was evaluated on canine primary dermal fibroblast (CPDF) using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results: The Sc-AgNPs exhibited nanoparticle sizes ranging from 100 to 350 nm with aggregated spherical shape and contained Ag element in this nanoparticle. Myricetin and Phloretin were among the extracted compounds, contributing to the reduction of pathogenic organisms. Sc-AgNPs showed high efficacy against skin pathogens compared to Sc-CE, with lower cytotoxicity effect on CPDF. Conclusion: The Sc-AgNPs demonstrated superior efficiency against pathogens in dog skin diseases as both concentration- and time-dependent and were deemed safe to CPDF within 24h. [Open Vet J 2024; 14(10.000): 2662-2677]

Introduction: Focused cardiac ultrasound (FoCUS) has emerged as a valuable tool in emergency and critical care medicine, allowing for rapid assessment of cardiac function and structure at the bedside. This rapid diagnostic technique holds particular promise in resource-limited settings like Ethiopia, where access to standard echocardiography may be limited and delayed. However, the accuracy of FoCUS interpretation is highly dependent on the operator's skills and expertise. To inform the design of effective interventions, the study aimed to assess the accuracy of FoCUS interpretation and associated factors among senior Emergency Medicine residents at two large referral teaching hospitals in Ethiopia. Methods: A cross-sectional study was conducted from October to December 2023 among 80 residents at Tikur Anbessa Specialized Hospital and St. Paul's Hospital Millennium Medical College. To assess diagnostic accuracy, 15 pre-selected cardiac ultrasound videos (normal and pathological cases) were selected from American College of Emergency Physicians website and the PoCUS Atlas, and accurate interpretation was defined as correctly answering at least 12 out of 15 readings. A binary logistic regression model was fitted to identify significant factors at the 5% level of significance, where significant results were interpreted using adjusted odds ratio (AOR) with 95% confidence interval (CI). Result: The overall accuracy in interpreting FoCUS findings was 47.5% (95% CI: 38.8–60.0%), with highest for collapsing Inferior Vena Cava (91.3%) and standstill (90.0%), and lowest for Regional Wall Motion Abnormality of Left Ventricle (46.3%). Residents who received training (AOR=4.14, 95%CI:1.32–13.04, p = 0.015), perceived themselves as skilled (AOR=4.81, 95%CI=1.06–21.82, p = 0.042), and felt confident in acquiring and interpretation (AOR=3.16, 95%CI=1.01–9.82, p = 0.047) demonstrated significantly higher accuracy. Conclusion: The study identified a low overall accuracy in FoCUS interpretation, with accuracy improving with training and better perceived skill and confidence. Training programs with simulation, continuous education, and mentorship are crucial to enhance these critical skills.

Abstract Skipping breakfast during pregnancy presents several challenges and potential health risks for both the mother and her baby. Breakfast plays a crucial role in providing essential nutrients and energy after an overnight fast. Skipping breakfast during pregnancy creates an unhealthy environment for the fetus. Thus, this study aimed to identify the determinants of breakfast skipping among pregnant women. An unmatched, community-based case-control study was conducted among 116 randomly selected cases (breakfast skippers) and 232 neighboring controls (regular breakfast consumers). Data was collected using pre-tested interviewer-administered structured questionnaire. Binary logistic regression analysis was employed to determine predictors of breakfast skipping using STATA version 16. The odds of non-formal education (AOR = 3.92; 95% CI: 1.75, 8.78), low socioeconomic status (AOR = 2.93; 95% CI: 1.12, 7.68), poor dietary knowledge (AOR = 2.89; 95% CI: 1.29, 6.47), and experiencing morning sickness (AOR = 2.57; 95% CI: 1.13, 5.84) were higher among cases than controls. The odds of breakfast skipping were higher for every increase in family size (AOR = 1.65; 95% CI: 1.25, 2.18), but decrease with every unit increase in mid-upper arm circumference (AOR = 0.58; 95% CI: 0.46, 0.72) and weekly frequency of drinking coffee leaf tea beverage (AOR = 0.84; 95% CI: 0.78, 0.89). Findings of this study showed that poor economic status, lack of formal education, poor dietary knowledge, having morning sickness, having large family size, maternal nutritional status, and frequent consumption of coffee leaf tea beverage were significantly associated with breakfast skipping among pregnant women. Thus, efforts should focus on improving dietary awareness during pregnancy, strengthening dietary counseling during antenatal care, enhancing access to contraceptive services, and ensuring timely management of morning sickness.

Abstract Background Loss to follow-up (LTFU) among under-five children from HIV care profoundly affects the treatment outcomes of this vulnerable population. It is a major factor that negatively affects the benefits of antiretroviral therapy (ART). Current information about LTFU among HIV-positive under-five children on ART is essential for effective treatments. To far, nevertheless, limited research has been done in Ethiopia to address this issue. Thus, this study aimed to assess the incidence and predictors of LTFU among HIV-infected under-five children receiving ART in West Amhara Comprehensive Specialized Referral Hospitals. Methods A multicenter institution-based retrospective follow-up study was conducted among 435 HIV-infected under-five children on ART selected by simple random sampling from January 1, 2010 to December 31, 2019, and data were collected between December 1, 2021, and January 31, 2022. A standardized data extraction tool adapted from the ART entry and follow-up forms was used. The event of interest for this study was LTFU, whereas the absence of LTFU was censored. Before being transferred to STATA version 14 for analysis, the data were entered into Epi-Data version 3.1. The Kaplan‒Meier curve was used to estimate an individual's survival-free probability at each specific point in time. The Cox proportional hazards model was used to identify predictors of LTFU. Results Among the 420 records included in the final analysis, 30 (7.14%) of the individuals were LTFUs. The incidence rate of LTFU was 3.4 per 1000 person-months of observation (95% CI: 2.43–4.87). The survival probabilities of children after 12, 24, 36, and 48 months were 0.97, 0.92, 0.88, and 0.77, respectively. The independent predictors of LTFU were HIV infection in under-five children who lived in rural areas (AHR = 3.64; 95% CI: 1.41, 9.37), poor adherence to ART (AHR = 4.37; 95% CI: 1.59, 12.02), not receiving cotrimoxazole preventive therapy (AHR = 3.75; 95% CI: 1.39, 10.08), not receiving isoniazid prophylaxis (AHR = 3.4; 95% CI: 1.29, 9.01), and having a severe WHO clinical stage (AHR = 5.43; 95% CI: 1.38, 11.43). Conclusion and recommendation The incidence of loss to follow-up was high, especially in the first two years after ART initiation. The risk of LTFU was greater for those who were rural residents, had poor adherence, lacked cotrimoxazole preventive therapy, not given isoniazid prophylaxis, and presented with WHO clinical stages III and IV. Therefore, clinicians should emphasize for cotrimoxazole preventive therapy and isoniazid prophylaxis, for those living in rural areas, who present with poor adherence and WHO clinical stages III and IV.

Abstract Background The nutritional status of the mothers before pregnancy and the weights gained during pregnancy are very crucial factors affecting the pregnancy outcomes and health of the infants. This study aimed to assess early pregnancy weight, determine the magnitude of gestational weight gain, and investigate the factors affecting gestational weight gain among pregnant women in the Gurage zone, 2022. Methods A prospective cohort study was conducted among pregnant women who started antenatal care follow-up before the 16th week of gestation in the selected hospitals and health centers of the Gurage zone, Ethiopia. The gestational weight gain was obtained by subtracting the early pregnancy weight from the last pregnancy weight and categorizing based on the Institute of Medicine (IOM) recommendation. Results The early pregnancy weight status of the women at enrollment indicates that 10% of them were underweight and 83% of them had normal weight. On average, the study participants gained 13.3 kgs of weight with [95% CI: 13.0, 13.6]. More than half (56%) of them gained adequate weight, a quarter (26%) of them gained inadequate weight, and 18% of them gained excess weight during pregnancy compared to the IOM recommendation. Maternal age, occupational status, and early pregnancy weight status were found to have a statistically significant association with the gestational weight gained. Conclusion Almost half (44%) of the pregnant women gained either inadequate or excess weight during pregnancy. Promoting gestational weight gain within recommended guidelines should be emphasized for younger, employed women and those who are either underweight or overweight.

BackgroundAtrial fibrillation (AF) poses significant thromboembolism and bleeding risks, especially in older adults. Warfarin continues to be a primary treatment option, and maintaining the Time in Therapeutic Range (TTR) is critical for ensuring its effectiveness. However, suboptimal TTR is associated with increased risks of stroke, bleeding, and mortality. Despite its importance, there is limited data on warfarin management in Ethiopian older adults with AF. Therefore, this study aimed to determine the TTR, bleeding events, and their determinants, in older patients with AF in Ethiopia receiving warfarin therapy.MethodIn this study, older patients with AF who were treated with warfarin and had follow-up visits between May 2021 and May 2024, and met the inclusion criteria, were included. Patients were categorized based on TTR into two groups: poor anticoagulation (TTR < 65%) and good anticoagulation quality (TTR ≥ 65%). Bivariate and Multivariate Logistic regression was performed to predict determinants of a TTR < 65% and bleeding events. Odds ratios with 95% confidence intervals (CIs) were calculated, and statistical significance was set at P < 0.05.ResultsIn this study, 384 patients with AF were included. Of this 53.4% were female. Of these 71% of patients had a TTR below 65%, 29% achieved ≥65%, with a median TTR of 45%. Bleeding events were reported by 13.5% of patients. Poor TTR was significantly associated with age (AOR = 1.199, 95% CI: 1.109–1.297), chronic kidney disease (AOR = 27.809, 95% CI: 7.57–101.76), and infrequent INR monitoring at 31–90-day intervals (AOR = 0.15, 95% CI: 0.004–0.051). Regarding determinants of bleeding events, Patients with diabetes mellitus had a 2.6-fold higher bleeding risk (AOR = 2.585, 95% CI: 1.069–6.250), and a CHA2DS2-VASc score ≥3 significantly increased bleeding risk compared to scores ≤2 (AOR = 7.562, 95% CI: 2.770–20.640).ConclusionThis study highlights suboptimal warfarin therapy among older Ethiopian patients with AF. Poor anticoagulation was associated with advanced age, chronic kidney disease, and infrequent INR monitoring, while diabetes mellitus and high CHA₂DS₂-VASc scores increased bleeding risks. Close monitoring and frequent INR checks are essential to improving outcomes.

BackgroundPregnancy loss is a significant public health issue globally, particularly in Sub-Saharan Africa (SSA), where maternal health outcomes continue to be a major concern. Despite notable progress in improving maternal health, pregnancy-related complications, including s due to miscarriages, stillbirths, and induced abortions, continue to impact women's health, social wellbeing, and economic stability in the region. This study aims to identify the key predictors of pregnancy loss and develop effective predictive models for pregnancy loss among reproductive-aged women in SSA.MethodsWe derived the data for this cross-sectional study from the most recent Demographic and Health Survey of Sub-Saharan African countries. Python software was used to process the data, and machine learning techniques such as Random Forest, Decision Tree, Logistic Regression, Extreme Gradient Boosting, and Gaussian were applied. The performance of the predictive models was evaluated using several standard metrics, including the ROC curve, accuracy score, precision, recall, and F-measure.ResultThe final experimental results indicated that the Random Forest model performed the best in predicting pregnancy loss, achieving an accuracy of 98%, precision of 98%, F-measure of 83%, ROC curve of 94%, and recall of 77%. The Gaussian model had the lowest classification accuracy, with an accuracy of 92.64% compared to the others. Based on SHPY values, unmarried women may be more likely to experience pregnancy loss, particularly in contexts where premarital pregnancies are stigmatized. The use of antenatal care and family planning services can significantly impact the risk of pregnancy loss. Women from lower-income backgrounds may face challenges in accessing prenatal care or safe reproductive health services, leading to higher risks of loss. Additionally, higher levels of education are often correlated with increased awareness of family planning methods and better access to healthcare, which can reduce the likelihood of unintended pregnancy loss.ConclusionThe Random Forest machine learning model demonstrates greater predictive power in estimating pregnancy loss risk factors. Machine learning can help facilitate early prediction and intervention for women at high risk of pregnancy loss. Based on these findings, we recommend policy measures aimed at reducing pregnancy loss Sub-Saharan African countries.

BackgroundUnmet need for family planning (FP) refers to the proportion of women who are fecund, sexually active, and wish to delay or limit childbearing but are not using any effective contraceptive method. Unmet need for FP remains a significant public health concern, particularly among young women aged 15–24 years. This study explores the determinants of unmet need for FP among young women.Method and materialThis study used data from the 2022 Kenyan Demography and Health Survey to investigate the relationship between various factors and a binary outcome variable of unmet need for family planning among adolescent young age group. A multilevel binary logistic regression model was used to analyze the data, accounting for the clustering effects of the survey data. The statistical significance of the relationships was assessed using adjusted odds ratios with 95% confidence intervals. The model with the lowest deviance was considered the best fit for the data.ResultMagnitude of unmet need family planning among adolescent young age in Kenya is 25% (95% CI: 24.5%–26%). Determinants of Unmet need for family planning are age 15–19 (AOR: 3.4, 95%CI (1.3–11), undecided desire number of children (AOR: 2.3, 95%CI: 1.4–2.1), age at first sex 15–29 (AOR: 2.7, 95%CI: 1.2–6.2), rural residency (AOR: 3.9, 95%CI: 1.1–14), high community level poverty (AOR: 2.1, 95%CI: 1.1–4.5).ConclusionThe study finds that 25% of young women in Kenya lack access to family planning. Factors like age, desired family size, early sex, rural life, and poverty contribute to this. These factors create barriers that hinder women's ability to plan their pregnancies and access necessary resources. Younger women, those in rural areas, and those living in poverty are particularly affected. Addressing this issue requires a comprehensive approach that considers the specific circumstances of these vulnerable populations.

Contamination of milk is a serious public health risk, particularly in developing countries such as Ethiopia. Training is a tool for improving the quality and safety of milk. However, its effect on the microbial quality and safety of milk has not been well documented. This study assessed the impact of training interventions on the microbial quality and safety of milk, with a specific focus on smallholder dairy farms. The study was conducted from January to June 2022 in four locations in Central Ethiopia. Milk samples were collected from 120 dairy farmers one week before and four to six weeks after the training and analyzed for total coliforms, thermotolerant coliforms, Escherichia coli, Shiga toxin-producing E. coli (STEC), Salmonella enterica, and Campylobacter jejuni. Total and thermotolerant coliforms were determined by the Most Probable Number (MPN) method; categorized as high (≥1,001 MPN/ml), medium (101 103 MPN/ml), low (21–102 MPN/ml), and very low (≤20 MPN/ml); and analyzed using generalized linear mixed models. Prevalence of E. coli, STEC, S. enterica, and C. jejuni in raw milk samples were 67, 12, 3, and 4% pretraining and 45, 4, 3, and 2% posttraining, respectively. The prevalence of E. coli (p = 0.0389) and STEC (p = 0.0005) was significantly lower posttraining compared to pretraining. Most samples had total coliform counts exceeding 103 MPN/ml pretraining (71%); this proportion decreased to 62% posttraining. The estimated cumulative probability of being in the high category was marginally significantly higher (p = 0.0581) pretraining (76%) compared to posttraining (64%). In conclusion, reductions in the detection of some milk quality and safety parameters were observed. However, a considerable proportion of the milk samples were highly contaminated even after the training. Hence, comprehensive and continued risk mitigation strategies are needed to ensure milk safety for consumers.

This study examined the level of rural households’ vulnerability to food insecurity, and its determinants in North Shewa zone of Ethiopia using cross-sectional data collected from 382 sample households. The vulnerability of households to food insecurity was estimated using vulnerability as expected poverty approach. The factors which influenced vulnerability to food insecurity were analyzed using binary logistic regression model. Accordingly, based on the intensity of their vulnerability, households were grouped as chronic food insecure (43.72%), transient food insecure (12.57%), highly vulnerable-food secure (16.23%), and low vulnerable-food secure (27.49%). Overall, about 75.51% of households were categorized as vulnerable to food insecurity. These included households who were food insecure at the time of the survey (56.28%) and those who were categorized as transient food secure group (16.23%). In addition, logistic regression model results revealed that extension service, early warning information, agricultural technology, and crop diversity were the major factors affecting (negatively) households’ vulnerability to food insecurity. On the other hand, sex, rainfall variability, and drought have increased the probability of being vulnerable to food insecurity. The findings imply that design and implementation of food insecurity policies and strategies need to focus not only on households that are currently food insecure but also on those categorized as transient food insecure.

Teff (Eragrostis tef, Zucc) is the smallest grain commonly cultivated in Ethiopia and Eritrea and is used mainly to prepare pancake-like staple food called flatbread (Injera). It has substantial national and global recognition due to its nutraceutical benefits and its gluten-free nature. Flatbread, a functional food for health promotion, can be enhanced with less mineral-rich crops like Amaranthus, which are often underutilized, to increase its nutritional and mineral content. Thus, the study is aimed at studying the nutritional, sensory, and storage period of flatbread by incorporating amaranth leaves and grain powders into teff flour. Experiments were designed (using Minitab software, v.19.1), and flatbread was prepared by altering the proportions (grams) of Amaranthus leaf and grain flour incorporated with teff flour in ratios of 2:98, 4:96, 6:94, 8:92, and 10:90 (w/w), teff being the significant component in each blend. The results revealed that most of the nutritive components (except carbohydrates and chromium (Cr)) improved significantly due to the incorporation of both (Amaranthus leaf and grains). Minerals such as sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), iron (Fe), and zinc (Zn) increased noticeably (in percent), ranging from 10% to 12.2%, 0.02%–0.41%, 3%–4.4%, 0.33%–2.2%, 5.7%–10%, and 4.9%–28.7%, respectively. Furthermore, lower proportions of Amaranthus grain flour (2, 4, and 6 g blending) and leaf flour (2–10 g blending) significantly extended the storage period of blended flatbread up to 6–7 days, where higher proportions of Amaranthus grain (8 and 10 g blending) are expected to preserve the flatbread Injera up to 9–10 days, surpassing the 3–4 days of the control (100 g teff flour). Therefore, novel teff–Amaranthus blended food can be produced by means of a cost-effective and easy-to-produce new integrated teff–Amaranthus blended food that can enhance the nutritional value and shelf life of the existing teff Injera.

IntroductionThe traffic air pollution caused by transportation is a growing global problem that contributes to millions of deaths each year. Despite its importance, information on pollutant concentration is limited in many developing cities, especially in Ethiopia. This study aimed to determine the concentration levels and spatial and temporal variations of traffic air pollutants in Hawassa and to investigate the influence of metrological parameters on the concentration of traffic air pollutants.MethodsA real-time monitoring system of Aero-Qual Series 300/500 was used to monitor pollutants, and 24 monitoring sites were included on both heavy and low-traffic volume roads. The study monitored morning and afternoon times over 24 days to comprehensively characterize the temporal variations.ResultsThe results showed that the mean PM2.5 concentration on heavy- and low-traffic volume roads was 161.6 ± 26.1 μg/m3 and 95 ± 14.2 μg/m3, respectively, whereas the PM10 concentration was 178.7 ± 20.3 μg/ m3 and 102.3 ± 17.6 μg/m3, respectively. Similarly, the mean NO2 concentrations on roads with heavy and low traffic volumes were 86.4 ± 14.4 μg/m3 and 61.7 ± 14.2 μg/m3, respectively. Significantly higher, concentrations were recorded on traffic light roads, followed by main asphalt roads, for both types of traffic air pollutants. The ratio of PM2.5/PM10 was higher (0.924), in which the pollution sources attributed to anthropogenic sources. Kendall’s tau-b correlation analysis suggested that Meteorological parameters (temperature and relative humidity) were positively correlated with traffic air pollutants. Likewise, stepwise multiple linear regression analysis confirms that the concentrations of traffic air pollutants had a positive relationship with metrological parameters.ImplicationsThe findings of this study therefore showed the need for regular air quality monitoring of the urban areas to copping out the adverse public health impacts. And, it highlighted an urgent need for long-term monitoring of traffic air pollution and the development of emission control programs that can be readily implemented to decrease the emissions from anthropogenic sources. Also, it brings a sense of collaboration among stakeholders to tackle the effects of air pollution by providing an inclusive and sustainable development agenda for Hawassa.

BackgroundRespectful maternity care is care organized for and provided to all women in a manner that maintains their dignity, privacy, and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth. However, in many healthcare settings in Ethiopia, the standard practice of respectful obstetric care is not the norm, and a significant proportion of health professionals view patients merely as cases and do not show compassion.ObjectivesTo assess respectful maternity care and associated factors among mothers who gave birth at public health institutions in Debre Tabor town, Northwest Ethiopia from December 1, 2023, to January 30, 2024.MethodsAn institution-based cross-sectional study was conducted using qualitative and quantitative data collection methods. Three hundred seventy participants were selected for quantitative analysis using systematic random sampling, while eight were chosen for the qualitative study through purposive sampling. The quantitative data were coded and entered into Epi Data version 4.6, then exported to the Statistical Package for the Social Sciences (SPSS) version 25 for analysis. A multivariable logistic regression analysis was performed to identify factors associated with the outcome variable. Adjusted odds ratios with 95% confidence intervals were computed to determine the significance level. Thematic analysis was used for the qualitative data.ResultsThe proportion of respectful maternity care was 34.1% (95%CI: 29.4, 39.2) cesarean delivery [AOR = 3.45, 95%CI: 1.60, 7.42]. Daytime delivery [AOR = 3.14, 95%CI: (1.59, 6.18)] and less than or equal to 1 day stay in a healthcare facility [AOR = 3.03, 95%CI: (1.51, 6.08)] were positively associated with respectful maternity care. Inadequate equipment and supplies, shortage of staffing, and lack of accountability were barriers to providing respectful maternity care.ConclusionsThe proportion of respectful maternity care was low. Therefore, health institutions and other stakeholders should support and strengthen monitoring and evaluation mechanisms for maternal and neonatal healthcare providers and enhance education and constant support for women during their pregnancy and childbirth. Additionally, adequate access to basic equipment and supplies should be given due attention to ensure respectful maternity care.

BackgroundThe full pentavalent (DPT-HepB-Hib) vaccination is the main strategy to prevent five communicable diseases in early childhood, especially in countries with huge communicable disease burdens like Ethiopia. Exploring spatial distributions and determinants of full pentavalent vaccination status in minor ecological areas in Ethiopia is crucial for creating targeted immunization campaigns and monitoring the advancement of accomplishing sustainable development goals. This study aimed to investigate the spatial disparities and determinants of full pentavalent vaccination among 12-23-month-old children in Ethiopia.MethodThe data on pentavalent vaccine uptake was found in the Ethiopian Health and Demographic Survey (EDHS, 2019). A two-stage cluster sampling method was applied to collect the EDHS data. The enumeration area was the primary sample unit while the household served as the secondary sampling unit. The geographical variations of full pentavalent vaccine uptake were explored using Quantum Geographic Information System (QGIS) software. The significant predictors of full pentavalent vaccination were identified using a simple logistic regression model through R version 4.1 software.ResultThe national full pentavalent vaccine uptake was 59.2%. The spatial distribution of full pentavalent vaccine uptake was not uniform in Ethiopia. Spatial cluster analysis revealed that most of low coverage regions for full pentavalent vaccine uptake were Afar, Somali, and Harari. The regions with the highest and lowest rates of vaccine uptake were Tigray and Harari region, respectively. Maternal age of 35-49 years (AOR = 3.42; 95% CI: 1.99, 5.87), and 25-34 years (AOR = 1.55; 95% CI: 1.17, 2.19), primary education attended (AOR = 1.51; 95%CI: 1.07, 2.11), richness wealth index (AOR = 1.96; 95% CI: 1.40, 2.75), birth order of 1-3 (AOR = 1.88; 95% CI: 1.19, 2.96), and delivery in the health facility (AOR = 3.41: 95% CI: 2.52, 4.61) were the determinants of full pentavalent vaccine uptake in Ethiopia.ConclusionEthiopia's full pentavalent vaccine uptake was far lower than the global target. Older maternal age, maternal education, wealth index, birth order, and giving birth in a health facility were the determinants of full pentavalent vaccine uptake. Special attention should be given to Afar, Somali, and Harari regions, to strengthen the vaccine uptake. Moreover, improved socioeconomic status and getting maternal health services during delivery are necessary to enhance vaccine uptake.

BackgroundAdolescents who have the human immunodeficiency virus face difficulties in their lives not just from the physical consequences of the illness but also from social stigma and discrimination. The quantitative side of this issue was the focus of earlier Ethiopian research. However, there hasn't been any prior research done extensively in Ethiopia on the real-life experiences of teenagers infected with HIV. Therefore, in order to address the real issues that these teenagers encounter, it is imperative that we investigate their lived experiences as HIV-positive adolescents.ObjectiveThe goal is to investigate the experiences that adolescents at Felege Hiwot Comprehensive Specialized Hospital who are infected with HIV have on a daily basis.MethodA phenomenological approach was conducted among thirteen purposively selected adolescents at Felege Hiwot Comprehensive Specialized Hospital, Bahir-Dar, northwest Ethiopia, from March 25 to April 30, 2023. Information saturation was used to estimate the sample size. Data was gathered through semi-structured open-ended interview guides and in-depth interview techniques. The talk was recorded using an audio recorder. The data was transcribed verbatim. The conceptual translation approach was used to translate the transcribed data from Amharic to English. For additional analysis, the translated data was entered into the Atlas.ti.8 program. To demonstrate findings, the inductive thematic analysis technique was applied using illustrative quotes. Colleague feedback, member checks, and a debriefing were used to guarantee the quality of the data.ResultEleven subthemes, including main theme of "lived with burdens of immunodeficiency virus," "disclosure," "ART adherence," and "future aspiration," were used to describe the findings. The participants discussed how difficult it has been for them to deal with social, emotional, and psychological difficulties in addition to living with the HIV infection. They kept their illness a secret from others out of fear of prejudice and stigma. In conclusion, adolescents infected with the human immunodeficiency virus faced a variety of difficulties related to their mental health, relationships, emotions, and compliance. It is advised that the community get ongoing, comprehensive health education in order to prevent stigmatization and discrimination against young people who have the virus.