Search

Abstract During and after recent La Niña events, the decline of the eastern East African (EA) March‐April‐May (MAM) rains has set the stage for life‐threatening sequential October‐November‐December (OND) and MAM droughts. The MAM 2022 drought was the driest on record, preceded by three poor rainy seasons, and followed by widespread starvation. Connecting these dry seasons is an interaction between La Niña and climate change. This interaction provides important opportunities for long‐lead prediction and proactive disaster risk management, but needs exploration. Here, for the first time, we use observations, reanalyses, and climate change simulations to show that post‐1997 OND La Niña events are robust precursors of: (a) strong MAM “Western V sea surface temperature Gradients” in the Pacific, which (b) help produce large increases in moisture convergence and atmospheric heating near Indonesia, which in turn produce (c) regional shifts in moisture transports and vertical velocities, which (d) help explain the increased frequency of dry EA MAM rainy seasons. We also show that, at 20‐year time scales, increases in atmospheric heating in the Indo‐Pacific Warm Pool region are attributable to warming Western V SST, which is in turn largely attributable to climate change. As energy builds up in the oceans and atmosphere, during and after La Niña events, we see stronger heating and heat convergence over warm tropical waters near Indonesia. The result of this causal chain is that increased Warm Pool atmospheric heating and moisture convergence sets the stage for dangerous sequential droughts in EA. These factors link EA drying to a stronger Walker Circulation and explain the predictable risks associated with recent La Niña events.

Kusse Otayto, Wanzahun Godana, Tesfaye Feleke, Sultan Hussen, Mathewos Alemu School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Kusse Otayto, Email kusseotayto0916@gmail.com; kusse.otayto@amu.edu.etBackground: Milk tooth extraction (MTE) is one of the most common harmful traditional practices performed by traditional healers without anesthesia and unsterile materials. The acute and chronic complications of this practice greatly affect the health of children. In order to develop effective preventive measures towards this harmful practice, the extent of the problem and factors contributing to the practice should be verified. The objective of this study was to assess the prevalence and associated factors of MTE among under five-years-old children in Alle special Woreda.Methods: A community-based cross-sectional survey was undertaken at Alle Special Woreda among 363 women using a multi-stage stratified sampling method. Data was collected using semi-structured questionnaires and data entry was done with Epi-data version 4.4.3.1, while data management and analysis were done with STATA version 14.0. Univariate and multivariate binary logistic regression models were used while model’s fitness was checked by Hosmer and Lemeshow test. Variables having a p-value of less than 0.05 were declared statistically significant in the final model.Result: Milk teeth extraction was practiced on 58.68% (95% CI:0.5,0.6) of children. Age of the child less than 12 months, AOR:1.27 (95% CI:1.02,1.6), maternal occupation (housewife) AOR:1.3 (95% CI:1.04,65), paternaleducational, level (illiterate) AOR:1.4 (95% CI:1.2,1.9), residence (rural) AOR:3.6 (95% CI:1.08,12.4), positive attitude AOR:1.65 (95% CI:1.01,2.8) and intentions AOR: 1.82 (95% CI:1.1,3.3) towards MTE practice showed statistically significant association with MTE practice.Conclusions and Recommendations: It was found that milk teeth extraction practice was the most common practice in the study area, with a prevalence of 58.68%. Age of the child, maternal occupation, paternal educational level, residence, having a positive attitude and intentions toward MTE practice all had a statistically significant (P value less than 0.05) association with MTE practice. Society’s barriers, such as knowledge, attitude, and practice (KAP) related, health facility related, and peer and social pressure-related factors, were identified. All stakeholders should put great emphasis on the elimination of this harmful practice.Keywords: harmful traditions, milk teeth extraction, children under five years old

Hayelom Berhe,1 Wanzahun Godana,2 Negussie Boti Sidamo,2,3 Gebremaryam Temesgen Birgoda,4 Lielt Gebresillasie,5 Sultan Hussen,2 Selamawit Gebeyehu2 1Department of Nursing, Hossana College of Health Science, Hossana, Ethiopia; 2School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia; 3Department of Public Health, PHARMA College, Wolaita Sodo Campus, Wolaita Sodo, Ethiopia; 4Departments of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 5Department of Nursing, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita, EthiopiaCorrespondence: Gebremaryam Temesgen Birgoda; Negussie Boti Sidamo, Email degnesh31@gmail.com; Hanehalid@gmail.comBackground: HIV/AIDS remains one of the world’s serious public health challenges. Patients with limited support from their family and community often experience social damage, poor adherence, compliance and are prone to additional psychosocial problems. This study aimed to assess the level of perceived social support and factors among adults living with HIV/AIDS.Methods: Facility-based mixed study (sequential explanatory) design was conducted among 423 adults living with HIV/AIDS attending chronic care follow-up at public hospitals in Gamo zone, southern Ethiopia. Respondents were selected by systematic sampling technique. The bivariable and multivariable ordinal logistic regression was used to determine associated factors. All assumptions applied to ordinal logistic regression including multicollinearity, proportional odds, model fitness and pseudo R2 were checked. Level of significance was declared at p-values < 0.05 and 95% CI.Results: Proportion of perceived social support of participants was 128 (30.7%), 197 (47.2%) and 92 (22.1%) with low, moderate and high levels of perceived social support, respectively. Females [(APOR = 2.42, 95% CI:(1.63– 3.58), P < 0.001)], no formal education [(AOR = 0.49, 95% CI: (0.30– 0.789), P = 0.004)], fair adherence [(APOR = 2.07, 95% CI: (1.17– 3.49), P = 0.006)], no comprehensive knowledge about HIV [(APOR = 0.40, 95% CI: (0.26– 0.62), P < 0.001)], and no disclosure status [(APOR = 0.64, 95% CI: (0.43– 0.95), P = 0.028] were significantly associated with perceived social support. Qualitative findings revealed that disclosure and adherences involving income generation activities are beneficial to perceived social support.Conclusion: This study showed that one from three of the participants had low perceived social support. Low perceived social support was associated with adherence, disclosure status of individual, educational status and knowledge about HIV/AIDS. Family, friends, health care providers and significant others should provide necessary support and inform people living with HIV/AIDS (PLWHA) about social support.Keywords: perceived social support, HIV/AIDS, adults, adherence

Negussie Boti Sidamo,1 Sultan Hussen,1 Tamiru Shibiru,2 Meseret Girma,1 Mulugeta Shegaze,1 Abera Mersha,3 Teshale Fikadu,1 Zeleke Gebru,1 Eshetu Andarge,1 Mustefa Glagn,1 Selamawit Gebeyehu,1 Bilcha Oumer,4 Gebremaryam Temesgen5 1School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 4Department of Midwifery, College of Health Sciences, Arba Minch, Ethiopia; 5Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Negussie Boti SidamoSchool of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaEmail Hanehalid@gmail.comBackground: Since the occurrence of the COVID-19 pandemic, different public health measures have been implemented to prevent and control the further spread of the disease. However, barriers that influence the effective implementation of public health measures were not explore in Ethiopia especially in study Area. Therefore, this study tried to fill this gap by exploring the barriers to effective implementation of public health measures for prevention and control of the COVID-19 pandemic in the Gamo Zone of southern Ethiopia.Methods: The study employed a qualitative study with a phenomenology approach among purposely selected 30 individuals in the community and selected institutions. Key informant interview was used to collect the data. The data were transcribed verbatim and translated into the English language. The transcribed data were read several times to clearly understand the content for further analysis. The analysis of the data was conducted based on the modified Tanahashi framework.Results: The study identified different barriers under five main themes: accessibility, acceptability, availability, contact and use, and effective implementation of public health measures related to barriers. The main barriers to effective implementation of public health measures were resistance to change, negligence, lack of community engagement, insufficient training for front line workers, poor supportive supervision, poor law enforcement, and lack of continuous community awareness creation. Beside, acceptability related barriers like cultural and religious norms and availability related barriers like shortage of personal protective equipment and shortage of skilled health professional have also lion share barriers for implementation of the public health measures.Conclusion: The study identified different personal, institutional, and societal level barriers for effective implementation of public health measures for the COVID-19 pandemic. Therefore, proper and targeted continuous community awareness creation with further mandatory law enforcement activities should be implemented by the concerned bodies to mitigate individual and societal level barriers. In addition, the government with relevant stakeholders should give due attention to equip and protect the frontline professionals by availing the necessary logistic and provision of continuous capacity-building activities.Keywords: COVID-19, effective implementation, public health measures, modified Tanahashi model, barriers, Gamo zone

Tigist Mechal,1 Siraj Hussen,2 Moges Desta2 1Department of Medical Laboratory Science, Hawassa College of Health Sciences, Hawassa, South Nations and Nationalities Peoples Region, Ethiopia; 2School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, EthiopiaCorrespondence: Moges DestaSchool of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, EthiopiaTel +251911744891Email moges22@gmail.comBackground: Urinary tract infection (UTI) is a common health problem occurring when infectious agents colonize, invade, and propagate the urinary tract including the urethra, bladder, renal pelvis, or renal parenchyma. The study aimed to determine the prevalence of symptomatic UTI, drug resistance pattern, and its associated factors among patients attending adult outpatient department (OPD) at Hawassa University Comprehensive Specialized Hospital (HUCSH).Methods: A cross-sectional study was conducted from October 2018 to February 2019 among adults ≥ 18 years old with symptoms of UTI. Processing of specimens for culture and identification was done. Antimicrobial susceptibility was done for positive urine cultures. Data entry and analysis were performed using SPSS version 23.0 software. Bivariate and multivariate logistic regression analysis test results were used.Results: The overall prevalence of symptomatic urinary tract infection was 32.8% (95% CI: 28.3– 37.6). The predominant isolated bacteria was E. coli 46 (36.2%) followed by S. aureus 21 (16.5%). Gram-negative bacteria were a high level of resistance to ampicillin (71.4%), and tetracycline (68.2%). Gram-positive bacteria were highly resistant to norfloxacin (77.7%). The overall prevalence of multi-drug resistant isolates was 102 (80.3%). Being female, no formal education, and self-medication history had more likely cause UTI.Conclusion: Urinary tract infection (UTI) among adults was prevalent in the study area. Being female, educational status and self-medication history had a significant association with UTI. Resistance to ampicillin, tetracycline, and norfloxacin was high. Therefore, culture and antibiotic susceptibility testing should be routinely used for the proper management of patients with UTI.Keywords: urinary tract infection, antimicrobial susceptibility, Hawassa, Southern Ethiopia

Negussie Boti,1 Sultan Hussen,1 Gistane Ayele,1 Abera Mersha,2 Selamawit Gebeyehu,1 Mekidm Kassa,1 Tesfaye Feleke,1 Gebremaryam Temesgen3 1School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 3Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Negussie Boti Tel +251-920-997-752Email Hanehalid@gmail.comBackground: Mental health disorders have identified as being one of the public health issues throughout the world. Recent evidence reveals that more than 21 million people diagnosed with schizophrenia. However, there is little information about community perception and attitude towards people with Schizophrenia in Ethiopia.Objective: The aim of this study was to assess the community perception and attitude towards people with Schizophrenia among residents of Arba Minch Zuria Districts, Southern Ethiopia.Methods: A community-based cross-sectional study was conducted among 617 randomly selected adults. Interviewer-administered standard tool was used to collect the data. Descriptive statistics like frequency, mean, and median computed. A binary logistic regression model used to identify factors affecting community perception and attitude towards people with schizophrenia.Results: Of the study population, 469 (76%) of respondents had good perception and 390 (63.2%) had positive attitudes towards people with schizophrenia. The study participants identified talkativeness and self-neglect behaviors as the most common manifestations of schizophrenia. Besides, this study identified substance misuse and head injury as the perceived cause and spiritual or traditional methods as a preferred treatment for people with schizophrenia. Moreover, the study participants preferred spiritual or traditional methods for the treatment of schizophrenia. Young age [AOR=2.03, 95% CI: 1.21, 3.40], females [AOR=2.32, 95% CI: 1.58, 3.41], good perception towards people with schizophrenia [AOR=4.95, 95% CI: 3.25, 7.54] and no formal educational status [AOR=2.75, 95% CI: 1.33, 5.70], and primary education [AOR=3.72, 95% CI: 1.87, 7.39] were significantly associated with the attitude towards people with schizophrenia.Conclusion: The findings of this study indicate that approximately one-third of the residents had unfavorable attitudes towards people with schizophrenia. Therefore, giving special attention to male, elders and those who were educated, and individuals who have poor perceptions of people with schizophrenia is crucial.Keywords: perception, attitude, schizophrenia, Arba Minch Zuria District, Southern Ethiopia

Seifu Wanaka,1 Sultan Hussen,2 Amsalu Alagaw,2 Kabtamu Tolosie,3 Negussie Boti2 1Gamo Zone Health Department, Arba Minch, Ethiopia; 2Arba Minch University, College of Medicine & Health Sciences, Department of Public Health, Arba Minch, Ethiopia; 3Arba Minch University, College of Natural Sciences, Department of Statistics, Arba Minch, EthiopiaCorrespondence: Negussie BotiDepartment of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaEmail Hanehalid@gmail.comBackground: Maternal health delays like delay in deciding to seek care, reaching a health facility, and receiving appropriate care were identified as the main contributing factors for maternal mortality and morbidity in many developing countries including Ethiopia. However, little is known about the magnitude and factors predisposing for maternal health delays in Ethiopia especially in a rural part of the country. Therefore, the aim of this study is to assess the magnitude of maternal delays for institutional delivery and associated factors among mothers attending post-natal service at public health facilities of the Gamo zone, Southern Ethiopia.Methods: A cross-sectional study was conducted in rural districts of Gamo zone. Eleven public health centers in the two districts were selected randomly. The Systematic random sampling method was used to select study participants from each public health centers. A total of 394 postnatal mothers were selected every secondly and interviewed in a separate room. Face to face interview methods were used to collect the data. Binary and multivariable logistic regression analyses were conducted to identify the associated factors for the three delays.Results: The magnitude of first, second and third maternal delays were 46.80%, 44.00%, and 31.70%, respectively. Unemployed women [AOR: 2.20, 95% CI (1.15, 4.16)], birth preparedness [AOR: 2.70, 95% CI (1.29, 5.71)], husband’s decisions making [AOR: 6.00, 95% CI (2.87, 12.42)] were found to be significantly associated with first delay. Distance to health facility [AOR: 7.00, 95% CI (3.58, 13.71)], and means of transportation [AOR: 3.30, 95% CI (1.13, 9.54)] were found to be significantly associated with the second delay. Availability of obstetric drugs [AOR: 8.40, 95% CI (3.76, 18.76)], and availability of skilled health provider [AOR: 10.40, 95% CI (4.24, 25.69)] were found to be significantly associated with the third delay for institutional delivery.Conclusion: The magnitude of first, second and third maternal delays were high which indicates that most mothers were not receiving institutional delivery services at the recommended time. Maternal socio-economic, obstetric factors and health-care system factors affected the three delays in this study. Therefore, improving women empowerment and resource availability at health facilities is vital.Keywords: maternal delays, institutional delivery service utilization, Ethiopia

Bilcha Oumer,1 Negussie Boti,2 Sultan Hussen,2 Teklemariam Gultie1 1Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; 2Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaCorrespondence: Negussie BotiDepartment of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, EthiopiaEmail hanehalid@gmail.comIntroduction: Access to antiretroviral drugs for all infected persons in need is a global health priority. The primary goals of initiating antiretroviral drugs are to suppress human immunodeficiency virus viral replication and to restore immune function. However, adequate nutrition is necessary to manage opportunistic infections and to maintain the immune system. Therefore, this study aimed to determine the recent prevalence of undernutrition and associated factors among HIV patients receiving first-line antiretroviral therapy in public health facilities of Arba Minch town, Gamo zone, Southern Ethiopia.Methods: Institution-based cross-sectional study was used among 333 adult patients receiving first-line antiretroviral therapy at public health facilities of Arba Minch town. A simple random sampling technique was used to select the study subjects. Data were collected through interviewer-administered questionnaires. Binary and multivariable logistic regression analyses were used to identify factors associated with undernutrition. A p-value

During and after recent La Niña events, the decline of the eastern East African (EA) March‐April‐May (MAM) rains has set the stage for life‐threatening sequential October‐November‐December (OND) and MAM droughts. The MAM 2022 drought was the driest on record, preceded by three poor rainy seasons, and followed by widespread starvation. Connecting these dry seasons is an interaction between La Niña and climate change. This interaction provides important opportunities for long‐lead prediction and proactive disaster risk management, but needs exploration. Here, for the first time, we use observations, reanalyses, and climate change simulations to show that post‐1997 OND La Niña events are robust precursors of: (a) strong MAM "Western V sea surface temperature Gradients" in the Pacific, which (b) help produce large increases in moisture convergence and atmospheric heating near Indonesia, which in turn produce (c) regional shifts in moisture transports and vertical velocities, which (d) help explain the increased frequency of dry EA MAM rainy seasons. We also show that, at 20‐year time scales, increases in atmospheric heating in the Indo‐Pacific Warm Pool region are attributable to warming Western V SST, which is in turn largely attributable to climate change. As energy builds up in the oceans and atmosphere, during and after La Niña events, we see stronger heating and heat convergence over warm tropical waters near Indonesia. The result of this causal chain is that increased Warm Pool atmospheric heating and moisture convergence sets the stage for dangerous sequential droughts in EA. These factors link EA drying to a stronger Walker Circulation and explain the predictable risks associated with recent La Niña events. Plain Language Summary: In 2022, an unprecedented sequence of five sequential failed rainy seasons, exacerbated by high global food and fuel prices, drove an exceptional food security crisis in Ethiopia, Somalia, and Kenya, pushing more than 20 million people into extreme hunger. The potential for famine loomed in some areas. Beginning in late 2020, this was the longest and most severe drought recorded in the Horn of Africa in at least 70 years, resulting in multiple failed harvests and large‐scale livestock deaths that decimated the food and income sources of rural communities. It placed increasing pressure on the cost of food among urban communities and led to rising levels of destitution and displacement. These droughts occurred against the backdrop of the "East Africa Climate Paradox", which centers on the discrepancy between climate change model projections of increased East African March–April–May rains, and many observational studies pointing toward declines. Before the western Pacific Ocean warmed dramatically in 1998, the link between La Niña events and dry March‐April‐May (MAM) rains was weak. Since 1998, the link has been very strong. This set the stage for dangerous sequential droughts in October‐November‐December and MAM, such as in 2010/11, 2016/17, 2020/21, and 2021/22. Here, we link the decline to an important question: Why are so many recent La Niña events associated with dry March–April–May rains? La Niña events tend to reach their maximum intensity in the boreal fall and winter, often producing East African droughts during the October‐November‐December "short rains". We explain the link between La Niña and dry MAM seasons using observations, reanalyses, and the latest (Phase 6) climate change simulations. While climate change models do not recreate the observed East African drying, they recreate the observed west Pacific warming very well. Climate change, not natural decadal variability associated with the Pacific Decadal Oscillation, has increased west Pacific sea surface temperatures. This, in turn, is increasing the "Western V Gradient", a measure of the east‐west differences in Pacific Ocean temperatures. When this gradient is negative, there are frequent East African droughts, and this happens in a predictable way during or after recent La Niña events. This allows us to predict many dry rainy seasons approximately 8 months in advance. Such predictive capacity is important, because the frequency of strong Pacific temperature gradients is increasing. We show that climate change simulations recreate this tendency for stronger Pacific SST gradients, and project that it will continue over the coming decades. What connects East African droughts to Pacific temperature gradients? We answer this question by examining observed atmospheric heating, moisture transports, and moisture convergence patterns. In general, eastern East Africa is dry because it resides along the western edge of the Indian Ocean branch of the Indo‐Pacific "Walker Circulation". Across eastern East Africa and the western Indian Ocean, and over the central and eastern Pacific, rainfall and moisture levels are low. In the area around Indonesia (the eastern Indian and western Pacific Oceans), winds drive moisture convergence and heavy rains. Here, building on many years of research by scientists working for the Famine Early Warning Systems Network, we show for the first time that the strength of the Walker Circulation can be quantified using atmospheric heating and moisture convergence. Since 1998, when there has been a La Niña in October–November–December, there has almost always been strong March‐April‐May heating and moisture convergence around Indonesia, and suppressed rainfall in eastern East Africa. Climate change‐enhanced La Niñas amplify the Pacific trade winds which produce strong March–April–May sea surface temperature gradients. These gradients amplify the Walker Circulation, and reduce moisture convergence and ascending atmospheric motions over the eastern Horn of Africa. We conclude with a look toward the future evolution of the Walker Circulation by relating the observed strength of the Walker Circulation to 20‐year averages of western and eastern Pacific sea surface temperatures. Both play a significant role, and together explain 96% of the observed variability. The observed Walker Circulation intensification is primarily driven by the west Pacific, which in turn is strongly related to climate change. CMIP6 projections of Pacific sea surface temperatures, combined with the observed empirical relationships, imply further strong increases in Walker Circulation intensities. Hence, additional rainfall declines appear likely, especially during or directly following La Niña events. More optimistically, the process‐based analyses presented here suggest that many of the dry seasons may be predictable at long lead times, based on Pacific sea surface temperature gradients. Key Points: Human‐induced warming in the Western V region of the Pacific, combined with La Niña, has produced frequent, predictable March‐April‐May droughtsThermodynamic analyses link these droughts to a stronger Walker Circulation driven by predictable warming in the Western V regionProjected CMIP6 SST increases imply a tendency for continued Walker Circulation intensification and associated drought risks in eastern East Africa [ABSTRACT FROM AUTHOR]

Timing of the rainy season is essential for a number of climate sensitive sectors over Eastern Africa. This is particularly true for the agricultural sector, where most activities depend on both the spatial and temporal distribution of rainfall throughout the season. Using a combination of observational and reanalysis datasets, the present study investigates the atmospheric and oceanic conditions associated with early and late onset for Eastern Africa short rains season (October–December). Our results indicate enhanced rainfall in October and November during years with early onset and rainfall deficit in years with late onset for the same months. Early onset years are found to be associated with warmer sea surface temperatures (SSTs) in the western Indian Ocean, and an enhanced moisture flux and anomalous low‐level flow into Eastern Africa from as early as the first dekad of September. The late onset years are characterized by cooler SSTs in the western Indian Ocean, anomalous westerly moisture flux and zonal flow limiting moisture supply to the region. The variability in onset date is separated into the interannual and decadal components, and the links with SSTs and low‐level circulation over the Indian Ocean basin are examined separately for both timescales. Significant correlations are found between the interannual variability of the onset and the Indian Ocean dipole mode index. On decadal timescales the onset is shown to be partly driven by the variability of the SSTs over the Indian Ocean. Understanding the influence of these potentially predictable SST and moisture patterns on onset variability has huge potential to improve forecasts of the East African short rains. Improved prediction of the variability of the rainy season onset has huge implications for improving key strategic decisions and preparedness action in many sectors, including agriculture. [ABSTRACT FROM AUTHOR]

The Greater Horn of Africa is prone to extreme climatic conditions, thus, making climate services increasingly important in supporting decision-making processes across a range of climate sensitive sectors. This study aims to provide a comprehensive review of the recent advances, gaps and challenges in the provision of climate services over the region, for each of the components of the Global Framework for Climate Services. The study explores various milestones that have been achieved toward climate service delivery. The achievements include improvement of station network coverage, and enhancing the capacity of member states to utilize various tools in data analysis and generate routine climate products. The advancement in science, and availability of High-Performance Computing has made it possible for forecast information to be provided from nowcasting to seasonal timescales. Moreover, operationalizing of the objective forecasting method for monthly and seasonal forecasts has made it possible to translate tercile forecasts for applications models. Additionally, innovative approaches to user engagement through co-production, communication channels, user-friendly interfaces, and dissemination of climate information have also been developed. Despite the significant progress that has been made in the provision of climate services, there are still many challenges and gaps that need to be overcome in order to ensure that these services are effectively meeting the needs of users. The research of the science underpinning climate variability, capacity building and stakeholder engagement, as well as improved data management and quality control processes are some of the gaps that exist over the region. Additionally, communication and dissemination of climate information, including timely warnings and risk communication, require improvement to reach diverse user groups effectively. Addressing these challenges will require strengthened partnerships, increased investment in capacity building, enhanced collaboration between the climate information producers and stakeholders, and the development of user-friendly climate products. Bridging these gaps will foster greater resilience to climate-related hazards and disasters in the Greater Horn of Africa and support sustainable development in the region.

Poor agronomic practices, such as inadequate plant density, can result in suboptimal carrot (Daucus carota L.) yield and quality in some regions. In 2020, a field experiment was conducted under irrigation conditions in Gerado, South Wollo administrative zone, Ethiopia, using the Nantes variety as a test crop, to investigate the impact of inter-row and intra-row spacing on carrot yield. The treatments involved three inter-row (row) spacing levels (10, 15, and 20 cm) and three intra-row (plant) spacing levels (5, 10, and 15 cm) in a randomized complete block design with three replications. Row and plant spacing significantly affected (P

In recent years, there has been a notable surge in research interest in vehicular ad-hoc networks (VANETs) due to advancements in wireless communication technology and the vehicle sector. Vehicles to vehicles (V2V) and vehicles to infrastructure comprise a vehicular network. The potential machine learning (ML) method can offer practical solutions for various application fields. Machine learning is a technique where a system uses data that has already been processed to learn from and improve itself automatically. Vehicular networks are a significant application domain where ML-based techniques are highly helpful in solving various issues. Vehicular nodes and infrastructure communicating wirelessly are susceptible to many kinds of assaults. Intelligent transportation systems (ITS) rely heavily on vehicle ad hoc networks (VANETs). These methods enable effective supervised and unsupervised learning of the acquired data, hence accomplishing the goal of VANETs. Because of identifying security concerns in-vehicle networks from source to destination, this evaluation attempts to apply it. We outlined the problems with traffic, safety, and communication in VANET systems, discussed whether or not they could be implemented, and investigated the potential solutions provided by machine learning techniques.

Abstract This commentary discusses new advances in the predictability of east African rains and highlights the potential for improved early warning systems (EWS), humanitarian relief efforts, and agricultural decision‐making. Following an unprecedented sequence of five droughts, 23 million east Africans faced starvation in 2022, requiring >$2 billion in aid. Here, we update climate attribution studies showing that these droughts resulted from an interaction of climate change and La Niña. Then we describe, for the first time, how attribution‐based insights can be combined with the latest dynamical models to predict droughts at 8‐month lead‐times. We then discuss behavioral and social barriers to forecast use, and review literature examining how EWS might (or might not) enhance agro‐pastoral advisories and humanitarian interventions. Finally, in reference to the new World Meteorological Organization “Early Warning for All” Executive Action Plan, we conclude with a set of recommendations supporting actionable and authoritative climate services. Trust, urgency, and accuracy can help overcome barriers created by limited funding, uncertain tradeoffs, and inertia. Understanding how climate change is producing predictable climate extremes now, investing in African‐led EWS, and building better links between EWS and agricultural development efforts can support long‐term adaptation, reducing chronic needs for billions of dollars in reactive assistance. In Africa and beyond, climate change brings increasingly extreme sea surface temperature (SST) gradients. Using climate models, we can often see these extremes coming. Prediction, therefore, offers opportunities for proactive risk management and improved advisory services, if we can create effective societal linkages via cross‐silo collaborations.

المقدّمة: يعتبر الداء السكري مرض العصر وله اختلاطات عديدة منها زيادة الأهبة للانتانات بشكل عام والانتانات البولية بشكل خاص لذا تناولنا في دراستنا موضوع دراسة العلاقة بين درجة ضبط السكر لدى مرضى الداء السكري نمط2 وتأثيره الملموس على منع تكرار الانتانات البولية. الطرق: شملت دراستنا 92مريض مصابين بالداء لسكري نمط 2 ولديهم انتان بولي مثبت بالفحص والزرع، كانوا مقبولين سواء بالقسم أو مراجعين لعيادة الغدد الصم اوالكلية. هذا وتمت متابعتهم من ناحية ضبط السكر بواسطة مشعرات الضبط المعروفة وإعادة تقييم الناحية الانتانية لديهم بواسطة فحص البول بعد 3 أشهر كما تم تقصي عن تواتر الانتان لديهم خلال السنة الماضية النتائج: قيم الخضاب السكري الأولية تراوحت بين 6.5% و12.9% وبقيمة وسطى (8.28 ± 1.43%) ومدة تشخيص الإصابة بالداء السكري تراوحت بين 3 أشهر و30 سنة وسطياً (13.3 ± 7.9 سنة) والعلاج الدوائي المتبع عند المرضى: الخافضات الفموية مستخدمة عند 58 مريض (63%) والانسولين عند 34 مريض (37%) موقع الانتان: علوي عند 49 مريضاً (53.3%) وسفلي عند 43 مريضاً (46.7%) وجدنا أنّ كلاً العمر المتقدم p

A significant proportion of the population in Sub-Saharan Africa are vulnerable to extreme climatic conditions, hence there is a high demand for climate information. In response to this need, the Global Challenges Research Fund African Science for Weather Information and Forecasting Techniques has been undertaking a two-year testbed to co-produce tailored forecasts for different sectors using the sub-seasonal to seasonal forecast datasets from the sub-seasonal to seasonal Real Time Pilot Initiative project. Sub-seasonal forecasts are essential for early warning and informed decision-making in the agriculture and food security sector. This study summarises the co-production process of climate services between the Intergovernmental Authority on Development (IGAD) Climate Prediction and Applications Centre and the Food Security and Nutrition Working Group for Eastern and Central Africa, highlighting the importance of efficient communication as well as the lessons learnt and challenges faced in the co-production process. A case study approach is utilised to evaluate the model performance. Two contrasting case studies, one for an extreme rainfall event in week three in April and another for the evolution of tropical cyclone Gati were conducted for the year 2020. Skillful and timely climate information and services co-produced has the potential to increase the uptake, ownership, and appropriate use of sub-seasonal forecasts for resilience building in Eastern Africa.Practical Implication.In the past decades Eastern Africa has been plagued by numerous climate related disasters including flooding and drought. Eastern Africa has a relatively dry tropical climate with a high percentage of the region being arid or semi-arid. To properly plan for these events there is need for provision of weather and climate forecasts. Traditionally forecasts have been mostly issued out at short range and seasonal timescales. Creating a glaring gap in the provision of forecasts between the short-range and seasonal forecasts, thus raising the need for sub-seasonal forecasts. Sub-seasonal forecasts bridge the gap between the short-range and long-range forecasts and are critical for informed decision making in the agricultural and disaster risk reduction sectors over Eastern Africa.Here we propose utilisation of a co-production process to increase sub-seasonal forecast uptake over Eastern Africa. The co-production is implemented through a two-year testbed under the Global Challenges Research Fund African Science for Weather Information and Forecasting Techniques. The IGAD Climate Prediction and Applications Centre collaborated with the Food Security Nutrition Working Group (FSNWG) for Eastern and Central Africa in the co-production process. The FSNWG coordinates regional food security, and nutrition updates to planners and decision-makers (e.g in disaster and risk reduction, agriculture, livestock sectors). In the region the main drivers of food insecurity include climate, conflict and macro-economic drivers. The European Centre for Medium Range Weather Forecasts (ECMWF) model outputs are utilized to derive the forecast information. The co-produced products include weekly total rainfall, rainfall anomalies, probability of exceedance, soil moisture anomalies, maximum and minimum temperature anomalies and also the maximum wet and dry spells. The forecast information is disseminated through bulletins and also during the monthly FSNWG plenary sessions. Sharing of the sub-seasonal forecasts in the monthly meetings allows for further direct interaction between the climate information users and producers. The forecasts are mostly used for crop choice, planting timing, drought risk, flood risk, disease outbreaks, early assistance appeals, disaster relief preparation, and early warning with drought and flood risk tied on top decisions made.One major challenge that is often faced by climate producers and users is the communication of the forecasts. In this study the challenge is addressed by incorporating a communication and user service team based at ICPAC. The communication and user service team is composed of social scientists, climate information experts and journalists. Improved communication is fundamental in increasing the uptake of the sub-seasonal forecasts and appropriate use of these climate products by climate information users. In consequence the communication and user services team at ICPAC simplifies the language that is utilized in the forecast bulletins and also improves on the layout of the bulletins. This improves the readability and usage of the forecast outputs. For example, initially forecast bulletins were written in paragraph format, which potentially makes the readability of the document harder. Hence, it was suggested that the forecast bulletins be produced in bullet point form.To evaluate the model a case study approach is utilized for two extreme events that occurred in 2020. One case focused on an extreme rainfall event in week 3 in April and another for the evolution of tropical cyclone Gati. Tropical cyclones that make landfall over Somalia are rare during the October-December season. Results showed that the model is able to capture the wet anomalies for both case studies, hence giving an indication to stakeholders of potential flood risk. However, the model underestimates the rainfall intensity over the region thus use of anomalies might provide more information on the risk of flooding or extended dry spells in comparison to the total rainfall.In conclusion this study has shown that the S2S forecast information have a potential to provide early warning systems and hence, increase the Eastern Africa community resilience. However, to ensure long term viability of the co-production process there is need for continued support in access to the real time S2S forecast datasets.

Beshir Legas Muhammed, Mohammed Hussen Seid, Adere Tarekegne Habte Department of Chemistry, Woldia University, Woldia, EthiopiaCorrespondence: Beshir Legas Muhammed Email legasbeshir@yahoo.comBackground: Coffee is a well-known beverage that is widely used around the world. Despite the wide use of coffee in Ethiopia, there is a lack of extensive studies addressing the issues related to the caffeine content and hydrogen peroxide antioxidant activity of varieties of coffee types, particularly in Habru woreda, Ethiopia.Objective: This study aimed to determine the caffeine content and hydrogen peroxide antioxidant activity of raw and roasted coffee beans collected directly from Habru woreda, North Wollo zone of Ethiopia.Methods: The study was conducted in Bohoro, Girana, and Wurgisa kebeles of Habru woreda, Ethiopia, by collecting 500 g of green beans of Arabica coffee without considering their variety. Then, the collected beans were divided into raw and roasted coffee to perform aqueous and dichloromethane extraction of their caffeine content and hydrogen peroxide antioxidant activity using UV-Vis spectrophotometry.Results: The amounts of caffeine in aqueous and dichloromethane extraction were in the range of 124.01− 191.27 ppm and 145.15− 200.09 ppm in raw and roasted coffees, respectively. Using the IC50 value, the hydrogen peroxide scavenging activity of the aqueous phase coffee bean extracts in Bohoro raw, Bohoro roasted, Wurgisa raw, Wurgisa roasted, Girana raw, and Girana roasted coffee were 32.17 ppm, 11.69 ppm, 26.14 ppm, 3.12 ppm, 24.83 ppm, and 11.06 ppm, respectively, while that of ascorbic acid was 6.91 ppm.Conclusion: The study showed that the highest amount of caffeine in both aqueous and dichloromethane solvent extraction was found in Bohoro’s raw and roasted coffee beans. Also, the amounts of caffeine in all coffee bean samples were safe and the antioxidant activity was excellent. In most of the samples, significant variations in the concentration of caffeine in raw and roasted coffee bean samples were observed in the two extraction solvents.Keywords: caffeine, coffee, hydrogen peroxide scavenging, UV-Vis spectroscopy

Forecasts on sub-seasonal to seasonal (S2S) timescales have huge potential to aid preparedness and disaster risk reduction planning decisions in a variety of sectors. However, realising this potential depends on the provision of reliable information that can be appropriately applied in the decision-making context of users. This study describes the African SWIFT (Science for Weather Information and Forecasting Techniques) forecasting testbed which brings together researchers, forecast producers and users from a range of African and UK institutions. The forecasting testbed is piloting the provision of real-time, bespoke S2S forecast products to decision-makers in Africa. Drawing on data from the kick-off workshop and initial case study examples, this study critically reflects on the co-production process. Specifically, having direct access to real-time data has allowed user-guided iterations to the spatial scale, timing, visualisation and communication of forecast products to make them more actionable for users. Some key lessons for effective co-production are emerging. First, it is critical to ensure there is sufficient resource to support co-production, especially in the early co-exploration of needs. Second, all the groups in the co-production process require capacity building to effectively work in new knowledge systems. Third, evaluation should be ongoing and combine meteorological verification with decision-makers feedback. Ensuring the sustainability of project-initiated services within the testbed hinges on integrating the knowledge-exchanges between individuals in the co-production process into shaping sustainable pathways for improved operational S2S forecasting within African institutions.

The present study investigated the impact of selection for body weight (BW) on productive performance, predicted BW and genetic improvement of related traits in Japanese quail. Base population, selected parent and F1 progeny were tested. Pens and cages were used for rearing and breeding. A total of 240 birds in two successive generations, 27 sires and 54 dams (as selected parents) were used. Body weight from multiple regression equation, covariance analysis and combining models were estimated, response to selection, realized heritability and genetic correlation were computed for BW, weight gain (WG), feed intake (FI) and feed conversion ratio (FCR). The results showed that the response to selection for BW, WG, FI and FCR were 11.48 g, 27.04 g, 37 g and -0.2, respectively. The estimated heritabilities for the same traits were 0.78, 0.67, 0.52 and 0.77, respectively. Predicted equation (DUHOK equation) for BW as dependent variable on the initial body weight and sex ratio was derived. The final response for the body weight was determined as 5.84 % of live BW. [ABSTRACT FROM AUTHOR]

This study examines the effects of 1.5 °C and 2 °C global warming levels (GWLs) on intra-seasonal rainfall characteristics over the Greater Horn of Africa. The impacts are analysed based on the outputs of a 25-member regional multi-model ensemble from the Coordinated Regional Climate Downscaling Experiment project. The regional climate models were driven by Coupled Model Intercomparison Project Phase 5 Global Climate Models for historical and future (RCP8.5) periods. We analyse the three major seasons over the region, namely March–May, June–September, and October–December. Results indicate widespread robust changes in the mean intra-seasonal rainfall characteristics at 1.5 °C and 2 °C GWLs especially for the June–September and October–December seasons. The March–May season is projected to shift for both GWL scenarios with the season starting and ending early. During the June–September season, there is a robust indication of delayed onset, reduction in consecutive wet days and shortening of the length of rainy season over parts of the northern sector under 2 °C GWL. During the October–December season, the region is projected to have late-onset, delayed cessation, reduced consecutive wet days and a longer season over most of the equatorial region under the 2 °C GWL. These results indicate that it is crucial to limit the GWL to below 1.5 °C as the differences between the 1.5 °C and 2 °C GWLs in some cases exacerbates changes in the intra-seasonal rainfall characteristics over the Greater Horn of Africa.

We analyze the potential effect of global warming levels (GWLs) of 1.5 °C and 2 °C above pre-industrial levels (1861−1890) on mean temperature and precipitation as well as intra-seasonal precipitation extremes over the Greater Horn of Africa. We used a large, 25-member regional climate model ensemble from the Coordinated Regional Downscaling Experiment and show that, compared to the control period of 1971−2000, annual mean near-surface temperature is projected to increase by more than 1 °C and 1.5 °C over most parts of the Greater Horn of Africa, under GWLs of 1.5 °C and 2 °C respectively. The highest temperature increases are projected in the northern region, covering most parts of Sudan and northern parts of Ethiopia, and the lowest temperature increases are projected over the coastal belt of Tanzania. However, the projected mean surface temperature difference between 2 °C and 1. 5 °C GWLs is higher than 0.5 °C over nearly all land points, reaching 0.8 °C over Sudan and northern Ethiopia. This implies that the Greater Horn of Africa will warm faster than the global mean. While projected changes in precipitation are mostly uncertain across the Greater Horn of Africa, there is a substantial decrease over the central and northern parts of Ethiopia. Additionally, the length of dry and wet spells is projected to increase and decrease respectively. The combined effect of a reduction in rainfall and the changes in the wet and dry spells will likely impact negatively on the livelihoods of people within the coastal cities, lake regions, highlands as well as arid and semi-arid lands of Kenya, Tanzania, Somalia, Ethiopia and Sudan. The probable impacts of these changes on key sectors such as agriculture, water, energy and health sectors, will likely call for formulation of actionable policies geared towards adaptation and mitigation of the impacts of 1.5 °C and 2 °C warming.

The impact of changes in 1993 of the old 1987 WHO/CDC AIDS case definition was studied in a cohort of 153 HIV-infected injection drug users (IDUs) and 502 HIV-infected homosexual men in Amsterdam. It appeared that the extension in Europe of the old AIDS definition to also include recurrent pneumonia, pulmonary tuberculosis and invasive cervical neoplasia, strongly increases the number of persons diagnosed with AIDS among IDUs, but will hardly influence the AIDS incidence among homosexual men. As recurrent pneumonia and pulmonary tuberculosis are present among drug users with high CD4 cell counts, the incidence of these diseases may partly be determined by environmental factors. The extension of the old 1987 AIDS definition in the USA with CD4 count <200 cells/mm In addition to the 3 above-mentioned diseases, will also have a larger impact on drug users than on homosexual men. [ABSTRACT FROM PUBLISHER]

The demand for organic agriculture has been growing due to concerns about the environmental and health impacts of chemical-intensive farming. The study aimed to investigate the effects organic fertilizers on carrot (Nantes) growth and yield in Tehuledere district. The experiment was conducted at two sites (Gobeya and Libannos) using four fertilizer types (vermicompost, conventional compost, mixture of the two, and inorganic fertilizer) and a control. The experiment was laid out in randomized complete block design with three replications, and data were analyzed using R-software. The study analyzed various growth (emergence percentage, plant height, leaf number, fresh weight, and dry weight of leaves), and yield (root length, root diameter, fresh weight of roots, marketable root yield, unmarketable root yield, and total root yield) parameters. Generally, fertilizer application improved (p < 0.001) growth and yield compared to the control. Vermicompost and inorganic fertilizer (NPSB) showed similar results (p > 0.001) but the highest values (p < 0.001) for most of the parameters (marketable yield was 41.7 t/ha±0.76 for vermicompost and 42.5 t/ha±1.14 for NPSB). However, NPSB could pose negative environmental impact that could not result in sustainability if used in excess and inappropriate (method and time) in particular. Therefore, carrot production using vermicompost is recommended for farmers of Tehuledere district and similar agroecological areas to enhance productivity while contributing to sustainable agriculture. The results have implications for policy makers, researchers, and farmers interested in promoting environmentally friendly and sustainable carrot production., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Tewodros Alemu reports financial support was provided by 10.13039/100009131Swiss Agency for Development and Cooperation in collaboration with Biovision Africa Trust through Institute for Sustainable Development (ISD) to implement the project 'Ecological Organic Agriculture Initiative (EOAI)' of pillar-I phase-II. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Wollo University.)

Introduction: Curriculum-based sexual and reproductive health education (CBSRHE) is one of the preventive strategies targeting youth in higher institutions to protect them from sexual and reproductive health problems, despite never assessing the effect in Ethiopia. Therefore, this study aimed to assess the effect of CBSRHE on knowledge and attitude about SRH services to have safer sexual behaviors among first-year students of Arba Minch University., Method: We conducted a quasi-experimental study among purposively selected campuses. The campuses were allocated to (i) an intervention arm consisting of curriculum-based sexual and reproductive health, or (ii) a control arm for those who were free from intervention. Data was collected, at baseline and immediately after the intervention ended by using a structured self-administered questionnaire. To compare differences in the change from baseline to post-intervention between the two arms we use the chi-square test and independent-samples t-test. To see the effect of the CBSRHE by controlling the effect confounding inverse probability-weighted analysis was conducted., Result: A total of 832 and 820 students participated in a baseline and post-test respectively. The proportion of youth who practice receptive penetrative sex decreases from 40.9% to 28.3% in the intervention arm compared to 37.6% to 37.3% in the non-intervention arm between baseline and end line, with statistically significant differences between groups. However, there are statistically significant differences between the intervention and control groups in terms of changes in contraception utilization (X2 = 1.21; P>0.05). Furthermore, there were significant improvements in knowledge and attitude among the intervention arm a comprehensive knowledge of HIV/AIDS (ATE = 0.22,95% CI, 0.14 to 0.29; p < 0.01), an average change of attitude toward HIV/AIDS(ATE = 1.32, 95% CI, 1.18 to 1.47; p < 0.01), comprehensive condom knowledge score (ATE = 0.23, 95% CI, 0.13 to 0.33; p < 0.01) and the average change of attitude toward condom score (ATE = 1.83, 95% CI, 1.19 to 2.77; p < 0.01)., Conclusion and Recommendation: It was found that there was a significant difference in knowledge and attitude toward a disk sexual behaviors among r one student. This implies that the educational authority o the country can gain through the adoption of courses to all universities across the country, besides doing further comparative studies to determine the long-term effect of the course supported with models and/or theories like the theory of change., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Boti Sidamo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: There is an urgent need to increase diversity among scientific investigators in the HIV research field to be more reflective of communities highly affected by the HIV epidemic. Thus, it is critical to promote the inclusion and advancement of early-stage scholars from racial and ethnic groups underrepresented in HIV science and medicine., Methods: To widen the HIV research career pathway for early-stage scholars from underrepresented minority groups, the National Institutes of Health supported the development of the Centers for AIDS Research (CFAR) Diversity, Equity, and Inclusion Pathway Initiative (CDEIPI). This program was created through partnerships between CFARs and Historically Black Colleges and Universities and other Minority Serving Institutions throughout the United States., Results: Seventeen CFARs and more than 20 Historically Black Colleges and Universities and Minority Serving Institutions have participated in this initiative to date. Programs were designed for the high school (8), undergraduate (13), post baccalaureate (2), graduate (12), and postdoctoral (4) levels. Various pedagogical approaches were used including didactic seminar series, intensive multiday workshops, summer residential programs, and mentored research internship opportunities. During the first 18 months of the initiative, 257 student scholars participated in CDEIPI programs including 150 high school, 73 undergraduate, 3 post baccalaureate, 27 graduate, and 4 postdoctoral students., Conclusion: Numerous student scholars from a wide range of educational levels, geographic backgrounds, and racial and ethnic minority groups have engaged in CDEIPI programs. Timely and comprehensive program evaluation data will be critical to support a long-term commitment to this unique training initiative., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: COVID-19 has been causing significant mental health problems and other health-related issues. Despite the fact that COVID-19 has a significant impact on chronic disease patients, there is scant research on insomnia, common mental health disorders (CMD), and their associated factors among chronic disease patients., Objective: The purpose of this study was to assess the prevalence of insomnia and common mental disorders (CMD) and their associated factors among patients with pre-existing chronic NCDs in Sidama, southern Ethiopia., Methods: A multicenter cross-sectional study was undertaken between June 1 and September 1, 2021. The study included 633 participants. CMD and insomnia were assessed using a 20-item Self-Reported Questionnaire (SRQ-20) and a 7-item Insomnia Severity Index (ISI) scale, respectively. To describe the various variables, descriptive statistics were used. We performed multivariable logistic regression analysis to identify independent factors associated with CMD and insomnia. A value of p < 0.05 was considered statistically significant at a 95% confidence interval., Results: The prevalence of insomnia and CMD was found to be 39.3% and 46.8%, respectively. Being merchant (AOR = 0.33; 95% CI = 0.13, 0.82), having a diagnosis of diabetes mellitus (AOR = 1.89; 95% CI = 1.04, 3.46), comorbid diagnosis (AOR = 3.96; 95% CI = 2.27, 6.89), low social support (poor (AOR = 3.37; 95% CI = 1.51, 7.57) and moderate (AOR = 3.13; 95% CI = 1.46, 6.69)), symptoms of insomnia (AOR = 12.08; 95% CI = 7.41, 19.72) and poor quality of life (QOL) (AOR = 1.67; 95% CI = 1.04, 2.72) were independent predictors of CMD. We also found out that, having cardiovascular disorders (CVDs) (AOR = 2.48; 95% CI = 1.18, 5.19), CMD (AOR = 12.09; 95% CI = 7.46, 19.61), and poor QOL (AOR = 2.04; 95% CI = 1.27, 3.26) were significantly associated with insomnia symptoms., Conclusion: Our study suggests that substantially high prevalence of CMD and insomnia. Significant association between CMD and occupation, diagnosis, comorbidity, social support, insomnia, and QOL were found. We also revealed that having CVDs, CMD, and poor QOL were significantly associated with insomnia symptoms. Therefore, dealing with the mental health problems of patients with chronic NCDs is an essential component of public health intervention during the COVID-19 pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ayalew, Deribe, Hussen, Defar, Tesfaye and Gedefaw.)

South Africa has the highest burden of adolescents living with HIV (ALHIV) in the world. The transition from pediatric to adult centered HIV care is a vulnerable period during which many clinical outcomes of ALHIV suffer. Transition readiness assessments may help ALHIV transition from pediatric to adult care to improve their health outcomes. Here, we evaluated the perceived acceptability and feasibility of a mobile health (mHealth) application, eHARTS, to determine transition readiness for ALHIV in South Africa. We conducted in-depth interviews with adolescents (n = 15) and healthcare providers (n = 15) at three government-supported hospitals in KwaZulu-Natal, South Africa. We used a semi-structured interview guide comprising of open-ended questions based on the unified theory of acceptance and use of technology. We did a thematic analysis of the data using an iterative, team-based coding approach to develop themes that were representative of the participants' perspectives on the acceptability and feasibility of eHARTS. We found that most participants found eHARTS to be acceptable because of its simplicity and lack of stigma. Participants believed eHARTS was feasible as it could easily be administered within a hospital setting and integrated into regular clinic activity without disrupting patient care. Additionally, eHARTS was found to have great utility for adolescents and healthcare providers. Clinicians saw it as a valuable tool to engage adolescents and prepare them for transition. Despite concerns that eHARTS may give adolescents a wrong impression about immediate transition, participants suggested that eHARTS be framed in an empowering way as they prepare for transition to adult care. Our data showed that eHARTS is a simple, mobile transition assessment tool with perceived acceptability and feasibility for use in HIV clinics in South Africa for ALHIV. It is particularly useful for ALHIV and transitioning to adult care as it can help identify gaps in readiness for transition., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Fomo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Rubella virus infection during pregnancy has several effects on the developing fetus. However, little is known about the epidemiology of the infection in Ethiopia. A cross-sectional study was conducted to assess the seroprevalence of rubella virus infection on consecutive 299 pregnant women attending antenatal care clinics in public health facilities in Halaba Town, Southern Ethiopia. Structured questionnaires were used to collect information on socio-demographic and reproductive characteristics. Venous blood samples were collected, and sera were tested for anti-rubella IgM and IgG using the enzyme-linked immunosorbent assay. Anti-rubella IgG and IgM were detected in 265 (88.6%) and 15 (5.0%) of 299 participants, respectively. Pregnant women in their first trimester [crude odds ratio (cOR) = 4.26; 95% CI (1.47, 12.4)] were at increased risk of having anti-rubella IgM compared to those in their second and third trimesters. Urban residents [cOR = 4.06; 95% CI (1.94, 8.47)] were with a higher percentage of IgG positivity compared to rural residents. Anti-rubella IgG positivity was higher in housewives [cOR = 2.94; 95% CI (1.07, 8.04)] compared to self-employed women. Our findings showed a high prevalence of rubella virus exposure, and considerable percentages of recent infection and susceptible women to contracting the infection, emphasizing the importance of congenital rubella syndrome in the research area., (© 2023. The Author(s).)

Atrial flutter (AFL) is a common arrhythmia with two significant mechanisms, namely, focal (FAFL) and macroreentry (MAFL). Discrimination of the AFL mechanism through noninvasive techniques can improve radiofrequency ablation efficacy. This study aims to differentiate the AFL mechanism using a 12-lead surface electrocardiogram. P-P interval series variability is hypothesized to be different in FAFL and MAFL and may be useful for discrimination. 12-lead ECG signals were collected from 46 patients with known AFL mechanisms. Features for a proposed classifier are extracted through descriptive statistics of the interval series. On the other hand, the class ratio of MAFL and FAFL was 41 : 5, respectively, which was highly imbalanced. To resolve this, different data augmentation techniques (SMOTE, modified-SMOTE, and smoothed-bootstrap) have been applied on the interval series to generate synthetic interval series and minimize imbalance. Modification is introduced in the classic SMOTE technique (modified-SMOTE) to properly produce data samples from the original distribution. The characteristics of modified-SMOTE are found closer to the original dataset than the other two techniques based on the four validation criteria. The performance of the proposed model has been evaluated by three linear classifiers, namely, linear discriminant analysis (LDA), logistic regression (LOG), and support vector machine (SVM). Filter and wrapper methods have been used for selecting relevant features. The best average performance was achieved at 400% augmentation of the FAFL interval series (90.24% sensitivity, 49.50% specificity, and 76.88% accuracy) in the LOG classifier. The variation of consecutive P-wave intervals has been shown as an effective concept that differentiates FAFL from MAFL through the 12-lead surface ECG., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Muhammad Usman Gul et al.)

Background: Youth born outside of the US with perinatally acquired HIV infection (YBoUS-PHIV) account for most children living with HIV in the US, but there are few data characterizing their care outcomes., Methods: We conducted a retrospective study of YBoUS-PHIV receiving care across 3 HIV clinics in the Southeastern US between October 2018 and 2019. Primary outcomes were retention in care and viral suppression defined as (1) proportion of suppressed viral loads (VLs) and (2) having all VLs suppressed (definition 1 presented in the abstract). Primary predictors were age, adoption and disclosure status (full, partial and none/unknown). Multivariable logistic regression and χ 2 tests were used to test for associations with care outcomes. Analysis of disclosure status was restricted to youth greater than or equal to 12 years., Results: The cohort included 111 YBoUS-PHIV. Median age was 14 years (interquartile range, 12-18), 59% were female, and 79% were international adoptees. Overall, 84% of patients were retained in care, and 88% were virally suppressed at each VL measurement. Adopted youth were more likely to be virally suppressed than nonadopted youth [odds ratio (OR), 7.08; P < 0.01] although the association was not statistically significant in adjusted analysis (adjusted OR, 4.26; P = 0.07). Neither age nor adoption status was significantly associated with retention. Among 89 patients greater than or equal to 12 years, 74% were fully disclosed of their HIV status, 12% were partially disclosed, and 13% had not started the disclosure process. There was no significant difference in retention or viral suppression by disclosure status., Conclusions: YBoUS-PHIV achieved high rates of retention and viral suppression. Adopted youth may be more likely to achieve viral suppression which may reflect the need for tailored interventions for nonadopted youth., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The COVID-19 outbreak became a continuing global health agenda. It has a significant impact on individuals' quality of life (QOL). Patients with preexisting medical conditions may have severely reduced QOL. The aim of this study was to assess QOL and its associated factors among patients with chronic non-communicable diseases (NCDs) during COVID-19 pandemic at Sidama Regional State, southern Ethiopia., Methods: We conducted a multicenter, cross-sectional study from 1 June to 1 September 2021. A total of 633 participants took part in the study, using an interviewer-administered structured questionnaire. The QOL was measured using the World Health Organization Quality of Life (WHOQOL-BREF) Scale, which has 12 items. To describe different variables, descriptive statistics were employed. To find independent factors associated with QOL, we used multivariable linear regression analysis. P -value of < 0.05 was declared statistically significant at 95% confidence interval (CI)., Results: The majority (56.4%) of participants were male and about half (53.1%) had a diagnosis of diabetes mellitus. The multivariable linear regression model showed statistically significant negative association between different independent variables such as age (β = -0.188, 95% CI = -0.238 to -0.139), being female (β = -1.942, 95% CI = -3.237 to -0.647), duration of illness ≤ 5 years (β = -4.222, 95% CI = -6.358 to -2.087), alcohol use in the past 3 months (β = -4.574, 95% CI = -6.905 to -2.243), common mental disorder (CMD) (β = -1.512, 95% CI = -2.924 to -0.100), insomnia (β = -0.274, 95% CI = -0.380 to -0.168), and QOL. Also, there is a statistically significant positive association between QOL and being illiterate (β = 3.919, 95% CI = 1.998-5.841) and living in the rural area (β = 2.616, 95% CI = 1.242-3.990)., Conclusion: In general, the findings confirmed that the COVID-19 pandemic had a negative impact on patients with chronic NCDs QOL. The QOL was significantly influenced by age, gender, educational status, residence area, duration of illness, alcohol use, CMD, and insomnia during COVID-19 pandemic. Thus, this study suggests that addressing insomnia, co-morbidities of mental disorders, and alcohol use has the potential effect to improve the QOL of patients with chronic medical illnesses., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ayalew, Deribe, Hussen, Defar and Gedefaw.)

Background: Campylobacteriosis, is a zoonotic bacterial disease observed with a rising worldwide. It is becoming the most commonly recognized cause of bacterial gastroenteritis in under-five mortality in recent years. This study was done to determine the prevalence and determinants of Campylobacter infection among under-fives with acute watery diarrhea., Methods: This institutional-based cross-sectional study was conducted at governmental and private health institutions in Hawassa city. All outpatient under-five children who met the inclusion criteria from April 2021 to August 2021 were enrolled in this study. Demographic and clinical data were obtained using a standardized data collection tool. Stool samples were collected from each participant with a sterile container and inoculated on a campylobacter agar media. The isolates were identified by using biochemical tests and a disc diffusion technique was performed to determine the antimicrobial sensitivity patterns of the isolates. Data were entered and analyzed using SPSS version 21. Descriptive and Logistic regression analysis was applied to determine the determinants of Campylobacter infection. P-value < 0.05 was considered statistically significant., Results: A total of 235 under-five children were enrolled in this study with a 100% response rate. Of these 130 (55.3%) and 105(44.7%) were males and females respectively with the age range of 2 months to 60 months with the mean age of 25 months. The majority of the 150 (63.2%) were rural residents. Of 235 under-fives with acute watery diarrhea, 16 (6.8%) patients were found to have Campylobacter infection with (95% CI, 3.8-10.2%). Consumption of pasteurized milk (AOR: 0.12; 95% CI 0.02-0.75, P<0.05), presence of domestic animals like cats, hens, and cows (AOR: 0.09: 95% CI 0.01-0.67, P<0.05), absence of handwashing practice before food preparation (AOR: 3.63, 95% CI 1.15-11.46, P<0.05) showed significant association with campylobacter infection. The antimicrobial susceptibility patterns of the isolated bacteria were 100% sensitivity to Azithromycin, Chloramphenicol, and Gentamicin, however; it was 100% resistant to Cephalothin. The associations of socio-demographic, environmental, and behavioral factors were compared and consumption of unpasteurized milk, the presence of domestic animal like the cat was significantly associated., Conclusion: Campylobacter infection showed a comparatively low prevalence in under-fives with acute watery diarrhea. In this study contact with cats, consumption of unpasteurized milk were associated with Campylobacter infection. The treatment approach of Campylobacter infection must consider the sensitivity profile of antibiotics as indicated in the study. We, therefore, recommend further studies to determine the species responsible for Campylobacter infection with other co-morbidities and the susceptibility pattern for each species to indicate appropriate antibiotic therapy., Competing Interests: The authors have declared that no competing interests exist.

In multiagent systems, social dilemmas often arise whenever there is a competition over the limited resources. The major challenge is to establish cooperation among intelligent virtual agents for solving the situations of social dilemmas. In humans, personality and emotions are the primary factors that lead them toward a cooperative environment. To make agents cooperate, they have to become more like humans, that is, believable. Therefore, we hypothesize that emotions according to the personality give birth to believability, and if believability is introduced into agents through emotions, it improves their survival rate in social dilemma situations. The existing researches have introduced different computational models to introduce emotions in virtual agents, but they lack emotions through neurotransmitters. We have proposed a neurotransmitters-based deep Q-learning computational model in multiagents that is a suitable choice for emotion modeling and, hence, believability. The proposed model regulates the agents' emotions by controlling the virtual neurotransmitters (dopamine and oxytocin) according to the agent's personality. The personality of the agent is introduced using OCEAN model. To evaluate the proposed system, we simulated a survival scenario with limited food resources in different experiments. These experiments vary the number of selfish agents (higher neuroticism personality trait) and the selfless agents (higher agreeableness personality trait). Experimental results show that by adding the selfless agents in the scenario, the agents develop cooperation, and their collective survival time increases. Thus, to resolve the social dilemma problems in virtual agents, we can make agents believable through the proposed neurotransmitter-based emotional model. This proposed work may help in developing nonplayer characters (NPCs) in games., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Awais Hassan et al.)

Background: Water, sanitation and hygiene (WASH) interventions should support infant growth but trial results are inconsistent. Frequently, interventions do not consider behaviours or transmission pathways specific to age. A household playspace (HPS) is one intervention component which may block faecal-oral transmission. This study was a two-armed, parallel-group, randomised, controlled feasibility trial of a HPS in rural Ethiopia. It aimed to recommend proceeding to a definitive trial. Secondary outcomes included effects on infant health, injury prevention and women's time., Methods: November 2019-January 2020 106 households were identified and assessed for eligibility. Recruited households (N = 100) were randomised (blinded prior to the trial start) to intervention or control (both n = 50). Outcomes included recruitment, attrition, adherence, and acceptability. Data were collected at baseline, two and four weeks., Findings: Recruitment met a priori criteria (≥80%). There was no loss to follow-up, and no non-use, meeting adherence criteria (both ≤10%). Further, 48.0% (95% CI 33.7-62.6; n = 24) of households appropriately used and 56.0% (41.3-70.0; n = 28) cleaned the HPS over four weeks, partly meeting adherence criteria (≥50%). For acceptability, 41.0% (31.3-51.3; n = 41) of infants were in the HPS during random visits, failing criteria (≥50%). Further, the proportion of HPS use decreased during some activities, failing criteria (no decrease in use). A modified Barrier Analysis described good acceptability and multiple secondary benefits, including on women's time burden and infant injury prevention., Interpretation: Despite failing some a priori criteria, the trial demonstrated mixed adherence and good acceptability among intervention households. A definitive trial to determine efficacy is warranted if recommended adjustments are made., Funding: People In Need; Czech Development Agency., Trial Registration: RIDIE-ID-5de0b6938afb8., Competing Interests: The authors have declared that no competing interests exist.

Community based newborn care is a means of bringing life-saving care to mothers and newborns at the community level. However, the practice is challenging within the Ethiopian health system. The aim of this study was to assess prevalence of community based newborn care practices and associated factors among women who gave birth at home in Amaro Woreda, southern Ethiopia, 2019. Across-sectional study design and simple random sampling technique was employed to select study participants. Data was collected through face-to-face interview; EpiData version 3.1 and SPSS version 20 software were used for analysis. Bi-variable and multivariable logistic regression was employed to analyze the associated factors. In this study 29% practiced community based essential newborn care. Educational status of father (AOR = 2.28; 95% CI: 1.07-4.84), last delivery assisted by relative (AOR = 3.58; 95% CI: 1.66-7.73), having awareness about community based newborn care (AOR = 3.49; 95% CI: 2.11-5.77), awareness about newborn danger sign (AOR = 2.18; 95% CI: 1.29-3.68) were some of identified factors associated with community based newborn care practice. In conclusion, community based newborn care practice was low. Therefore, promotion of information at community level, women empowerment, and strengthening health extension program were recommending., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Background:  Intestinal parasitic infections (IPIs) are common problems during pregnancy, with adverse outcomes including low birth weight and prenatal mortality. The burden of parasitic infections and its impacts are high among pregnant women in developing countries like Ethiopia. Therefore, this study aimed to assess the burden and associated factors of parasitic infections. Methods:  A facility-based cross-sectional study was conducted among 365 randomly selected women attending antenatal clinic at five selected health facilities. Data was collected by a pre-tested questionnaire and stool specimens were collected in clean plastic containers. A combination of direct microscopy and the formol-ether concentration technique was used as soon as the specimen collected. Data entry and analysed for descriptive and logistic regression models by SPSS v.23. The result declared as statistically significant at p < 0.05.   Results: The overall prevalence of IPI was 161 (45.9%). The most frequently identified parasites were Ascaris lumbricoides (27.9%), Schistosoma species (13.7%), Trichuris trichiura (5.1%), Hookworm (4.8%), and Taenia species. (1.4%). The IPIs were associated with women having no formal education [AOR=2.19, 95% CI: 1.05-4.57] or elementary school education [AOR=1.90, 95% CI: 1.11-3.27], as compared with high school educated and above. Monthly income of less than 1920 Ethiopian birr [AOR=2.06, 95% CI: 1.28-3.31], sharing a latrine with neighbours [AOR=1.83, 95% CI: 1.14-2.93], using lake water for washing clothes [AOR=2.24, 95% CI: 1.34-3.74], habit of eating raw vegetables [AOR=2.26, 95% CI: 1.30-3.92] were associated with IPI as compared to their counterparts. Conclusions:  Nearly half of the pregnant women were infected with IPs. The health facilities and clinicians need to focus on prevention of IPIs by early diagnosis, treating lake water before use, promote proper latrine utilization and provision of pertinent health education as part of ante-natal care service. It is important to minimize the impact of IPIs on pregnant women and their child., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Wachamo D et al.)

Background: Schistosomiasis is a common helminthic infection in the tropics and subtropics, particularly in sub-Saharan African countries including Ethiopia. In these counties, Schistosoma mansoni infection is a significant public health problem due to the risk of reinfection and recurrent disease despite implementing several rounds preventive chemotherapy. This systematic review and meta-analysis aimed at assessing the pooled prevalence of schistosomiasis in Ethiopia., Methods: The PRISMA guidelines were followed to perform the systematic review and meta-analysis. Published studies from January 1999 to June 2020 were searched in Medline, PubMed, Google Scholar, EMBASE, HINARI, and Cochrane Library using key words including: "prevalence", "incidence", "schistosomiasis" "Bilharziasis", "Bilharzia", "S. mansoni ", "Ethiopia". Heterogeneity of included studies was assessed using Cochran's Q test and I 2 test statistics while publication bias was assessed using Egger's test., Results: Ninety-four studies were included in the systematic review and meta-analysis. The pooled prevalence of S. mansoni in Ethiopia was 18.0% (95%CI: 14.0-23.0). The southern region of Ethiopia had a higher S. mansoni prevalence of 25.9% (995% CI, 14.9-41.1) than the national prevalence. The burden of S. mansoni infection was also higher than the national average in rural areas and among men with pooled prevalence of 20.2% (95% CI, 13.2-28.5) and 28.5% (95%CI, 22.7,35.1), respectively. The trend analysis showed that the prevalence of S. mansoni infection in Ethiopia decreased over the past 15 years, potentially because of the repeated preventive chemotherapy., Conclusion: The review unveiled a moderate prevalence of S. mansoni infection in Ethiopia. Targeted treatment of at-risk population groups ad high burden areas coupled with implementation of integrated vector control strategies are critical to address the burden of Schistosomiasis.

Background : Streptococcus pneumonia causes high morbidity and mortality, particularly in children under five. Nasopharyngeal (NP) carriage predisposes individuals to pneumococcal infection and horizontal spread within the community. Overuse of antibiotics has been linked to increased risk of antimicrobial resistance to S. pneumonia . We investigated NP carriage rate and resistance to commonly prescribed antibiotics in under-five children visiting a public referral center in southern Ethiopia. Methods : In total, 413 under 5 children who visited the outpatient department for a health check-up, immunization or acute mild illnesses underwent NP sampling. Parent/caregiver surveys were administered at the clinic. Sterile plastic applicator rayon tipped swabs were used for NP sampling. Antimicrobial susceptibility testing was performed using modified the disk diffusion method. Results : S. pneumonia NP carriage was observed in 39% [95% confidence interval (CI): 34.4-43.8]. Living with one or more sibling (AOR (adjusted odds ratio) 1.95: 95% CI: 1.01, 3.76), age group of 3-23 months (AOR 2.31: 95% CI: 1.07, 4.98), co-sleeping with family (AOR 2.09, 95% CI: 1.16, 3.79), attendance at kindergarten/day-care (AOR 1.84: 95% CI: 1.09, 3.11) and malnutrition independently increased S. pneumonia carriage at the individual level. S. pneumonia was highly resistant to Oxacillin (38.5%), Tetracycline (37.3%), and Trimethoprim-sulfamethoxazole (34.2%). Multi-drug resistance was observed in 42.2% of isolates. Conclusions : A high streptococcal NP carriage rate was observed in under-five children. The high level of resistance to commonly used antibiotics calls for enhancing national surveillance of resistance patterns and enforce antibiotic stewardship efforts., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Hussen S et al.)

Background : Rubella continues to be a leading cause of vaccine-preventable congenital birth defects and permanent organ damage, especially in developing countries. For women who are infected with the rubella virus (RV) before conception or during the first trimester of pregnancy, the unborn child has up to a 90% probability of developing congenital rubella syndrome. There are limited data on the seroprevalence of the rubella virus among pregnant women in Sub-Saharan Africa. Therefore, the aim of this study was done to determine the pooled seroprevalence of rubella among pregnant women in Sub-Saharan Africa. Methods : The PRISMA guidelines protocol was followed to write the systematic review and meta-analysis. Published studies were searched in Medline, PubMed, Google scholar, advance google and Cochrane Library. The search terms on the databases are: "rubella"OR "rubeo*", "rubella"AND"seroepidemiology", "seroprevalen *" OR "prevalen*", "seroprevalen *" OR "seroimmun*", "rubella antibod*"AND "pregnan*", "seroprevalen *" AND "sub-Saharan Africa".The heterogeneity of studies was weighed using Cochran's Q test and I 2 test statistics. Publication bias was assessed by using Egger's and Begg's test. Results : Twenty-eight studies were included in this meta-analysis. The pooled seroprevalence of anti-RV IgG among pregnant women in Sub-Saharan African was 89.0% (95%CI: 84.6-92.3), and the pooled prevalence of anti-RV IgM among pregnant women in Sub-Saharan Africa was 5.1% (95%CI: 2.6-9.9). Conclusion : This meta-analysis showed that seronegativity and acute infection with RV among pregnant women in sub-Saharan Africa is high compared to other studies and the WHO threshold among women of child-bearing age. This finding calls for primary health care providers to make the community aware of this rubella-susceptible group and its healthcare burden, with the desired outcome that sub-Saharan Africa countries would introduce an implementation strategy for rubella vaccination of pregnant women and women of child-bearing age.

Objective: Neisseria gonorrhoeae infection is a global, major public health problem. It is the second leading bacterial sexually transmitted infection (STI) in sub-Saharan Africa and worldwide. As study findings on the topic are inconsistent, we conducted a systematic review and meta-analysis to determine the pooled prevalence of N. gonorrhoeae infection in sub-Saharan Africa among reproductive-aged women., Methods: Published studies were systematically retrieved from PubMed, Embase, CINHAL and Science Direct. Their quality was measured using the Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data, and the score of each included study had to meet at least 4.5 out of 9 indicators of quality., Results: The meta-analysis of 35 studies showed that the pooled prevalence of N. gonorrhoeae infection among reproductive-aged women in sub-Saharan Africa was 3.28% (95% confidence interval 2.61%, 3.94%)., Conclusion: The prevalence of N. gonorrhoeae infection was higher than that found in other studies carried out in the region. The results suggest that greater attention should be paid to the primary prevention of N. gonorrhoeae. We recommend the implementation of STI education for reproductive-aged women and the use of specific and rapid diagnostic testing for N. gonorrhoeae infection in STI clinics. N. gonorrhoeae screening and treatment should be integrated into in- and outpatient clinics to reduce infection among reproductive-aged women.