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Background: The genetic diversity of Plasmodium falciparum provides the parasite with many effective immune evasion and drug resistance mechanisms. This phenomenon is a major problem in eradicating malaria globally. This study aimed to assess merozoite surface protein 2 polymorphisms in P. falciparum isolates from Northwest Ethiopia. Method: A cross-sectional study was conducted to assess merozoite surface protein 2 polymorphisms in P. falciparum isolates from selected malarious areas in Northwest Ethiopia from April to June 2021. A convenience sampling technique was used to select 150 study participants. A finger prick blood sample was collected to prepare blood films and dried blood spots for molecular genotyping. The merozoite surface protein 2 allele frequency and multiplicity of infection were computed. Linear regression was employed to evaluate the associations between the multiplicity of infection, parasite density, and age by calculating Spearman's rank correlation coefficients. A P value < 0.05 was considered to indicate statistical significance. Result: Polymorphism analysis was performed on 126 P. falciparum isolates. There were 38 different merozoite surface protein 2 alleles, 20 of which corresponded to the IC/3D7 allelic family and 18 to the FC27 allelic family. Most patients contained multiple infections, and the mean multiplicity of infection was 3.46. There was no statistically significant difference in the multiplicity of infection in relation to the age of patients (P = 0.646). However, a statistically significant correlation was found between parasite density and the multiplicity of infection (P = 0.046). The heterozygosity index for merozoite surface protein 2 was 0.948. Conclusion: This study showed that P. falciparum isolates contain multiple genotypes with a high multiplicity of infections and mixed strain infection, suggesting extensive genetic diversity and a high level of malaria transmission. This genetic variability could complicate malaria treatment and control efforts, as it can facilitate the emergence and spread of drug-resistant strains. Consequently, the findings highlight the complex malaria epidemiology in the region and emphasize the need for intensified efforts to control malaria transmission and prevent the probable emergence of drug resistance alleles in the study area. [ABSTRACT FROM AUTHOR]

Introduction: Hypertensive retinopathy refers to changes in the retinal microvasculature resulting from elevated blood pressure, and the global burden ranges from 2 to 85%. However, there was no evidence on prevalence and associated factors of hypertensive retinopathy among adult hypertensive patients in the study area even in Ethiopia. Objective: The aim of this study was to investigate prevalence of hypertensive retinopathy and associated factors in adult hypertensive patients attending at Comprehensive Specialized Hospitals in Northwest Ethiopia in 2024. Methods: Multicenter hospital-based cross-sectional study was conducted in Northwest Ethiopia Comprehensive specialized hospitals from June, 07 to August, 07, 2024. A multistage sampling technique with an interval of 3 was applied to select 696 study participants. Data were collected through personal interviews, review of medical records and eye examinations. Data were entered into the Kobo Toolbox and then transferred to STATA version 17 for analysis. Bivariable and then multivariable binary logistic regression models were fitted to determine factors associated with hypertensive retinopathy. Variables with a P-value of less than 0.05 at multivariable analysis were considered statistically significant. Result: A total of 696 (95.34%) participants were included in the study. The prevalence of hypertensive retinopathy was 57.47%(95%CI: 53.75, 61.10). Age > 74 years (AOR = 4.24, 95%CI = 1.54,11.64), heart disease(AOR = 5.38, 95%CI = 1.86,15.58), duration of hypertension > 5years (AOR = 12.66, 95%CI = 3.88,41.29), dyslipidemia (AOR = 3.44,95%CI = 1.59–7.45), uncontrolled current levels of hypertension (AOR = 40.03, 95%CI = 17.19,93.18), poor adherence of hypertensive medications (AOR = 1.84, 95%CI = 1.12,3.03) and diabetes (AOR = 3.56, 95%CI = 1.49,5.99) were positively associated with hypertensive retinopathy. Conclusion: -The prevalence of hypertensive retinopathy is high among systemic hypertensive patients seen in Northwest Ethiopia comprehensive specialized hospitals and independently associated with older age, longer duration of hypertension, heart disease, diabetes, dyslipidemia, poor adherence of hypertension medications and uncontrolled hypertension. Early diagnosis and treatment of hypertension was recommended to prevent target organ complications. [ABSTRACT FROM AUTHOR]

Urban agriculture (UA) and green infrastructure (GI) enhance food security, improve air quality, reduce urban heat islands, and promote biodiversity, playing a crucial role in addressing rapid urbanization and the need for sustainable development in Bahir Dar City, Northwest Ethiopia. This study investigates the determinants of UA and GI integration in Bahir Dar City, emphasizing their critical role in urban development and sustainability. Data were collected through surveys and analyzed using binary and ordinal logistic regression models. The findings reveal that awareness and education are crucial, with a lack of awareness and lower education levels, such as no formal and primary education, significantly hindering the integration of UA and GI practices. Larger residential spaces and household sizes positively influence integration levels, with each additional household member increasing the score by 0.236 units for consumption needs, and each unit increase in residential site size raising the score by 0.004 units due to space availability. Conversely, smaller residential spaces present challenges to integration, which can be mitigated by adopting vertical and container farming practices with adaptable tree shading. The study underscores the need for policy measures and comprehensive strategies to support educational programs, technical assistance, and resource allocation from local governments, which are essential for promoting UA and GI integration, addressing challenges, and fostering sustainable urban development in Bahir Dar City. Article Highlights: Study Focus: Investigates factors influencing the integration of Urban Agriculture (UA) and Green Infrastructure (GI) in Bahir Dar City. Key Findings: Higher education levels, larger family sizes, and larger residential spaces positively influence UA and GI integration. Challenges: Lack of awareness and enabling institutional strategies hinder UA and GI integration practices Recommendations: Local governments should focus on educational programs and awareness campaigns to promote UA and GI. [ABSTRACT FROM AUTHOR]

Baground: Cataract is a major public health concern and the leading cause of blindness and low vision in Ethiopia. However, no studies have been conducted to assess the prevalence of cataract and associated factors among adult diabetic patients in the study area. Therefore, this study aimed to assess the prevalence of cataract and associated factors among adult diabetic patients in Northwest Ethiopia. Methods: A multicenter cross-sectional study was conducted in Northwest Ethiopia from May 8 to June 8, 2023. A systematic random sampling technique was used to select study subjects. Data were collected through an in-person interview and physical examination. The data were imported to Kobo Toolbox version 2022 4.4 and exported to Stata version 14. A binary logistic regression was carried out to identify factors associated with cataract, and the strength of association was determined by adjusted odds ratio. A variable with a P-value of < 0.05 at a 95% confidence interval was considered a significant factor for cataract. Results: The study included 1100 study subjects with a median age of 52 years. The prevalence of cataract was 42.2% (95%CI: 39.1-45.1%). Older age (AOR = 9.73, 95% CI: 5.53–17.13), ≥ 10 years duration of diabetic mellitus (AOR = 2.77, 95% CI: 1.96–3.90), poor glycemic control (AOR = 1.96, 95% CI: 1.40–2.74), and proliferative diabetic retinopathy (AOR = 4.14, 95% CI: 2.04–8.40), were factors significantly associated with cataract. Conclusions: This study revealed a high prevalence of cataract among adult diabetic patients. Older age, longer duration of diabetes mellitus, poor glycemic control, diabetic retinopathy, and proliferative diabetic retinopathy had statistically significant associations with cataract. Therefore better controlling blood sugar levels will reduce the development of cataract. Regular screening of their eye will be also recommended to reduce visual impairment and blindness due cataract. [ABSTRACT FROM AUTHOR]

Abstract Introduction Hypertensive retinopathy refers to changes in the retinal microvasculature resulting from elevated blood pressure, and the global burden ranges from 2 to 85%. However, there was no evidence on prevalence and associated factors of hypertensive retinopathy among adult hypertensive patients in the study area even in Ethiopia. Objective The aim of this study was to investigate prevalence of hypertensive retinopathy and associated factors in adult hypertensive patients attending at Comprehensive Specialized Hospitals in Northwest Ethiopia in 2024. Methods Multicenter hospital-based cross-sectional study was conducted in Northwest Ethiopia Comprehensive specialized hospitals from June, 07 to August, 07, 2024. A multistage sampling technique with an interval of 3 was applied to select 696 study participants. Data were collected through personal interviews, review of medical records and eye examinations. Data were entered into the Kobo Toolbox and then transferred to STATA version 17 for analysis. Bivariable and then multivariable binary logistic regression models were fitted to determine factors associated with hypertensive retinopathy. Variables with a P-value of less than 0.05 at multivariable analysis were considered statistically significant. Result A total of 696 (95.34%) participants were included in the study. The prevalence of hypertensive retinopathy was 57.47%(95%CI: 53.75, 61.10). Age > 74 years (AOR = 4.24, 95%CI = 1.54,11.64), heart disease(AOR = 5.38, 95%CI = 1.86,15.58), duration of hypertension > 5years (AOR = 12.66, 95%CI = 3.88,41.29), dyslipidemia (AOR = 3.44,95%CI = 1.59–7.45), uncontrolled current levels of hypertension (AOR = 40.03, 95%CI = 17.19,93.18), poor adherence of hypertensive medications (AOR = 1.84, 95%CI = 1.12,3.03) and diabetes (AOR = 3.56, 95%CI = 1.49,5.99) were positively associated with hypertensive retinopathy. Conclusion -The prevalence of hypertensive retinopathy is high among systemic hypertensive patients seen in Northwest Ethiopia comprehensive specialized hospitals and independently associated with older age, longer duration of hypertension, heart disease, diabetes, dyslipidemia, poor adherence of hypertension medications and uncontrolled hypertension. Early diagnosis and treatment of hypertension was recommended to prevent target organ complications.

Abstract While pharmacotherapy is the primary approach for treating patients with bipolar disorder, non-adherence is the most common barrier preventing these patients from achieving optimal medication effectiveness. This study aimed to assess medication non-adherence and its predictors among patients with bipolar disorder in Northwest Ethiopia. A hospital-based cross-sectional study was conducted among 404 patients with bipolar disorder in Northwest Ethiopia from January to March 2024. Study participants were enrolled using systematic random sampling. Medication non-adherence was measured using the Medication Adherence Rating Scale (MARS). Data were entered and analyzed using Epi-data version 4.6.0 and SPSS version 26, respectively. A multivariable logistic regression model was fitted to identify predictors of medication non-adherence. Variables with a P-value

Abstract Background Individuals can learn their HIV status through voluntary HIV counseling and testing (VCT), which also serves as a crucial access point for prevention, treatment, care, and support programs. VCT has grown in significance as a component of HIV prevention and care in Ethiopia because of its viability and convenience for the wider community, as well as its ability to provide access to care, treatment, and support for those in need. However, studies on this topic are limited, particularly because the fidelity of Ethiopia’s VCT program has not been evaluated or measured. Therefore, this study aimed to assess the current implementation status of VCT services and client satisfaction in public health facilities in Gondar City. Methods This cross-sectional study was conducted out from June to July 2022. This study involved 130 counselors and 423 VCT users. Information on physical facilities, client satisfaction, and counselor impressions of the services was gathered using a standardized and pre-tested questionnaire, observation checklists, and resource inventory checklists developed from Ethiopian national VCT guidelines, the World Health Organization, United Nations AIDS, and previous literature. In the bivariate and multiple logistic regression models, variables with p values ≤ 0.2 and

Abstract Background Leadership plays a critical role in the delivery of person centered, safe, efficient, and effective healthcare services globally. Poor healthcare leadership contributes to low staff motivation, patient dissatisfaction, and reduced healthcare-seeking behavior. However, there is limited evidence on healthcare leadership practice and associated factors among primary healthcare managers in the study area and at large in Ethiopia. Therefore, the findings of this study will contribute to improved healthcare leadership practices among primary healthcare managers. Method Facility-based cross-sectional study supplemented with qualitative inquiry was conducted in the East Gojam zone among 532 primary healthcare managers selected by a two-stage stratified random sampling technique. A pre-tested and structured self-administered questionnaire was used to collect the quantitative data. Data were entered into Epi-Data version 4.6 and exported into Stata version 14.0 for analysis. Multiple linear regression analysis was used to identify factors associated with healthcare leadership practice, and statistical significance was declared at a p-value

Introduction: The adoption of climate-smart agriculture practices (CSAPs) at the plot level is a promising yet underutilized strategy in Ethiopia, where subsistence farming predominates. This study investigates the factors influencing the intensity of CSAPs on homesteads and identifies key barriers to their broader adoption. Methods: Quantitative data were collected through household surveys. Multiple Linear Regression (MLR) analysis was employed to examine the relationship between the independent variables and farmers' decisions to intensify CSAPs. Results: The findings reveal that slope gradient, extension contacts, farming experience, dependency ratio-induced labor, and livestock diversity significantly impact farmers' decisions to enhance CSAPs. Major barriers include insecure land tenure, poor management of open grazing, labor-intensive practices, and limited access to agricultural inputs. Discussion: To promote the widespread implementation of CSAPs, it is imperative that these variables are prioritized in agricultural extension policies. Addressing these barriers is essential for enhancing the adoption of CSAPs, which will significantly contribute to sustainable agricultural development in Ethiopia. [ABSTRACT FROM AUTHOR]

Numerous studies found that the main factor contributing to the export of sediment from the Ethiopian highlands is soil erosion, which is related to the expansion of cultivated land at the expense of steep slopes of natural vegetation covers. Plantation practices on steep slopes of bare surfaces and utilizing effective water and soil conservation measures on cultivated lands, may, however, have an impact on the rate of soil loss and the sediment yield ratio. Thus, the main objective of the research was to determine how changes in land use and land cover introduced by soil conservation affected the spatiotemporal variability in soil loss and sediment delivery ratio. RUSLE, InVEST, and integrated GIS technology were used to quantify the study's results. The expansion of farmed land at the expense of natural forests, woodlands, shrubs, and grasslands between 1990 and 2000 resulted in a significant increase in soil loss and sediment yield. This was mostly seen where natural vegetation cover areas on steep slopes were turned into cultivable land. Watershed development interventions significantly decreased both the mean annual soil loss and sediment yields between 2003 and 2021. For instance, from 2010 to 2021, the mean annual soil loss in the watershed dropped by 23.5 t ha−1 and the sediment export declined by 6.13 t ha−1yr−1. To prevent soil loss and sediment export at the extensive level, it is therefore concluded that sustainable soil management on cultivated land and plantation techniques on community land should be expanded up to the adjacent watersheds. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the level of community pharmacy professionals' (CPPs) actual practices and contrasted it with their self-reported perceived involvement in diabetes management. Methods: A self-reported cross-sectional and simulated patient (SP)-based study were employed at community drug retail outlets (CDROs) in Northwest Ethiopia. SP-case scenarios were used to examine the actual practices of CPPs in diabetes management and were compared with self-reported perceived involvement. The data were managed and analysed using SPSS version 26. Results: About 184 participants in the self-reported and 100 CPPs' actual practices using three SP visits were included. The overall actual practice (17.8%) was found to be significantly different compared with the perceived level of involvement (73.5%) (p-value <0.05). About 94.3% of CPPs dispensed requested medications to the SP without a prescription. Despite most participants being perceived to be involved, more than 76% of CPPs did not counsel the SP for lifestyle modifications, avoiding risky behaviours, adherence to treatment, routine blood glucose checkups, diabetic foot care techniques, or consultation with physicians for further management. Conclusion: A significant discrepancy between actual practices and perceived CPPs' involvement in the management of diabetes was observed. The findings may suggest that exploring possible gaps may be crucial. [ABSTRACT FROM AUTHOR]

This study examines smallholder farmers' preferences and willingness to pay for an improved irrigation water supply program in northwest Ethiopia. We employed a discrete choice experiment with five attributes and three levels. Data were collected from randomly selected sample households of both irrigation users and non-users. A total of 379 respondents participated, and a mixed logit model was used to analyze the household-level survey data. The result indicates that to deviate from the business-as-usual scenario, smallholder farmers are willing to pay between 3,228 and 8,327 Ethiopian Birr per hectare of irrigated land. Furthermore, the results showed a strong public preference for access to produce cash crops, followed by irrigation water availability in the dry season, and adequate access to improved farm inputs. The results also provide useful information for policymakers and suggested possibilities for generating finance from farmers to cover the operation and maintenance costs of irrigation schemes. Also, this study result reveals that irrigation development and expansion must be integrated into a comprehensive support package that combines irrigation water with access to improved farm inputs and access to produce cash crops on farmers' farm plots. [ABSTRACT FROM AUTHOR]

IntroductionThe inappropriate disposal of unused medicines poses significant risks to public health and the environment. Gondar City, located in Northwest Ethiopia, is not exempt from this problem. However, little is known about the current disposal practices and the determinants influencing those practices in this specific context.ObjectivesThis study aimed to evaluate the disposal practices of unused medicines among the general public in Gondar City and to identify the factors that influence these practices.MethodsA cross-sectional study design was employed to collect data from the general public in Gondar City from July 30 to August 30, 2023. Data were collected through interviews using a structured questionnaire to gather information on disposal practices and determinants that could influence disposal practices.ResultsA total of 845 respondents were involved in this study with a response rate of 93%. 56.9% of the respondents had poor disposal practices. Lower educational status [AOR = 2.76 (CI: 1.59, 4.79)]; p

Abstract The early stages of childhood are a crucial period of life for health, with inadequate nutrition impacting physical growth, cognitive development, and the immune system. A considerable proportion of children are affected by micronutrient intake inadequacy and deficiency across the globe. Evidence on micronutrient intake among children aged 6–23 months is limited in Northwest Ethiopia, where there is a divergence between production and dietary consumption practices compared to other regions of the country. This study aimed to determine micronutrient inadequacy and associated factors among children aged 6–23 months. From February 1 to February 18, 2023, 435 children aged 6–23 months participated in a community-based cross-sectional study in the North Mecha District of the Amhara Region, Northwest Ethiopia. The study participants were selected using a multistage sampling technique. A multiphasic interactive 24-h dietary recall was used to collect dietary intake data via an interviewer-administered questionnaire. The interviews were conducted with the mothers of the selected children. Nutrient values for the selected 12 micronutrients were calculated using the NutriSurvey 2007 software and food composition tables from Ethiopia, Tanzania, and Kenya. SPSS version 25 was used for the remaining parts of the analysis. The Nutrient Adequacy Ratio and Mean Adequacy Ratio were calculated to evaluate the nutrient intakes. To identify the factors associated with overall micronutrient intake inadequacy, a binary logistic regression analysis was performed, with statistical significance determined at a p-value

Abstract Background Malaria is an intravascular parasitic-related blood disease that causes bleeding, coagulopathy, and thrombocytopenia. However, limited data shows the effect of Plasmodium species infection on basic coagulation parameters and platelet count. Thus, this study aimed to assess basic coagulation parameters and platelet count among malaria patients. Method A cross-sectional study was conducted among 240 study participants (120 cases and 120 controls) from June 1, 2021, to February 30, 2022. A convenient sampling technique was employed to select study participants. The blood sample was collected by a trained laboratory technologist for platelet counts, prothrombin time (PT), partial thromboplastin time (PTT), international normalization ratio (INR), blood film, and serological testing. The collected data were analyzed in SPSS version 23. Data were analyzed by the Mann-Whitney U test, Kruskal Wallis H, and Spearman’s rank-order correlation tests. Descriptive findings were presented through median, tables, and chart. In all cases, a P-value

Abstract Objective This study aimed to determine the proportion of poor visual outcome and associated factors among adult patients who underwent cataract surgery at Debre Markos and Felege Hiwot Comprehensive Specialized Hospitals in northwestern Ethiopia in 2023. Methods A hospital based cross-sectional study was conducted on 418 adult patients who had undergone cataract surgery from June 07 to August 07, 2023. Patients were recruited using systematic random sampling with an interval of 2. A pre-tested semi-structured questionnaire, medical record review, and ophthalmologic examination were used to collect data. The collected data was entered into Epi-info version 7 and exported to SPSS version 25 software for analysis. Binary logistic regression was used to determine the factors associated with poor visual outcomes of cataract surgery. Variables with a p-value of less than 0.05 in the multivariable binary logistic regression were considered statistically significant. Results A total of 408 study participants with a median age of 65 years and a response rate of 97.6% took part. The proportion of poor visual outcomes of cataract surgery from 4 weeks to one year was 25.7% (95%CI: 21.6%, 30.3%). Factors responsible for poor visual outcomes of cataract surgery were intraocular lens implantation without a posterior chamber (AOR = 2.91, 95%CI:1.46,5.80), per-existing central corneal opacity (AOR = 3.83, 95%CI:1.52,9.69), pseudoexfoliation (AOR = 3.91,95%CI:1.39,11.88), age-related macular degeneration(AOR = 3.75, 95%CI:1.22, 11.88), glaucoma (AOR = 3.11, 95%CI:1.06,9.17) and striate keratopathy(AOR = 3.4, 95%CI: 1.11, 10.88). Conclusion In this study, the proportion of poor visual outcomes of cataract surgery is higher than the World Health Organization recommendation. The study found that implantation of an intraocular lens without a posterior chamber, pre-existing central corneal opacity, pre-existing age-related macular degeneration, pre-existing glaucoma, pseudoexfoliation, and striate keratopathy were significantly associated with poor visual outcomes of cataract surgery. We recommend that ophthalmologists and cataract surgeons prioritize the reduction of surgical complications and pre-existing ocular co-morbidities to enhance post-operative visual acuity. Improving pre-operative assessment and refining surgical techniques like phacoemulsification will aid in achieving this goal.

Abstract Background Schizophrenia is a serious and debilitating psychiatric disorder that is linked to marked social and occupational impairment. Despite the vital relevance of medication, non-adherence with recommended pharmacological treatments has been identified as a worldwide problem and is perhaps the most difficult component of treating schizophrenia. There are limited studies conducted on magnitude and potential factors of medication non-adherence among peoples with schizophrenia in Ethiopia. Objectives This study aimed to assess medication non-adherence and associated factors among peoples with schizophrenia at comprehensive specialized hospitals in Northwest Ethiopia. Methods An institutional-based cross-sectional study was conducted among 387 peoples with schizophrenia at selected hospitals in the Northwest of Ethiopia from June to August 2022. Study participants were enrolled using systematic random sampling. Medication non-adherence was measured using Medication Adherence Rating Scale (MARS). Data entry and analysis were done using Epi-data version 4.6.0 and SPSS version 24, respectively. A multivariable logistic regression model was fitted to identify factors associated with medication non-adherence. Variables with a p-value of

In many parts of the world, degradation of grazing lands is one of the most important environmental issues. This study analyzed farmers’ perception of area closure and its associated factors of participation in degraded grazing land restoration in Sede-Muja Woreda, Northwest Ethiopia. A cross-sectional research design and a mixed research approach were applied in this study. The 384 sample respondents were randomly selected. Household surveys, interviews, focus groups, and field study techniques were used to acquire the data. A binary logistic regression model was used to identify the determinant elements that affect farmers' participation in the area closure of degraded grazing land restoration. All of the total respondent farmers (100%) have a positive attitude towards multi-functionality benefits of area closures for local farmers. The model results show that the grazing experience (AOR = 2.981,95% CI = (1.143-7.775), access to safety net program (AOR = 2.787,95% CI = (1.146-6.77), access to livestock forage (AOR = 4.493,95% CI = (1.149-14.028), access to extension service (AOR = 2.522,95% CI = (1.917-6.6397), livestock ownership (AOR = 0.026,95% CI = (0.008-0.087), improved cattle breeds (AOR = 4.955,95% CI = (1.944-12.630), access to training (AOR = 3.169,95% CI = (1.409-7.131), farmers’ perception (AOR = 0.085,95%CL = (0.023-0.310), and communities’ consensus (AOR = 4.230, 95% CI = (1.377-12.996) were determinant factors that affect farmers' participation in the area closure of degraded grazing land restoration. To address the current grazing land degradation issues, every one of the relevant authorities as well as communities needs to work together to create modern grazing land management mechanisms such as grazing land enclosures, reduce animal size through improved cattle breeds, implement zero-grazing systems, and ensure the sustainability of existing enclosures.

Background: Malaria is an intravascular parasitic-related blood disease that causes bleeding, coagulopathy, and thrombocytopenia. However, limited data shows the effect of Plasmodium species infection on basic coagulation parameters and platelet count. Thus, this study aimed to assess basic coagulation parameters and platelet count among malaria patients. Method: A cross-sectional study was conducted among 240 study participants (120 cases and 120 controls) from June 1, 2021, to February 30, 2022. A convenient sampling technique was employed to select study participants. The blood sample was collected by a trained laboratory technologist for platelet counts, prothrombin time (PT), partial thromboplastin time (PTT), international normalization ratio (INR), blood film, and serological testing. The collected data were analyzed in SPSS version 23. Data were analyzed by the Mann-Whitney U test, Kruskal Wallis H, and Spearman's rank-order correlation tests. Descriptive findings were presented through median, tables, and chart. In all cases, a P-value < 0.05 was considered statistically significant. Results: The percentage of mild, moderate, and high malaria parasitemia levels per microliter of blood was 21.7%, 20%, and 58.3%, respectively. The overall median malaria parasitemia was 10,304 per microliter of blood. Among malaria patients, 77.5%, 61.7%, and 51.7% had prolonged PT, INR, and APTT, respectively as compared to control. Moreover, 26.7% of Plasmodium-infected participants had mild thrombocytopenia as compared to the control group (P < 0.001). Conclusion: The value of PT, APTT, and INR were significantly elevated, whereas the level of platelet count was inversely reduced when the malaria parasitemia level increased as compared to controls (p < 0.001). [ABSTRACT FROM AUTHOR]

Objectives To assess the implementation of proficiency testing in the northwest Ethiopian government comprehensive specialized hospital laboratories, with a focus on identifying and understanding the challenges encountered during their participation in the external quality assessment scheme. Methods A cross-sectional study was conducted among 3 comprehensive specialized hospitals in northwest Ethiopia, analyzing 41 documented laboratory test parameters from 2020 to 2022. In addition, face-to-face, in-depth interviews were carried out to identify the major challenges the participating institutions faced. Results The study covered a total of 41 tests across 9 cycles. Overall, proper implementation of proficiency testing was observed in 59.3% of the tests, with 61.8% maintaining consistent implementation status over 3 consecutive years. In addition, the overall performance of the laboratory was 54.3%, with a 68.7% participation rate. The predominantly identified challenges included the lack of participation, insufficient reagents and supplies, inadequacy of suitable proficiency testing materials, equipment malfunction and downtime, lack of management support, insufficient budget, and inadequate training and awareness. Conclusions The results of this study highlight the ineffective implementation of proficiency testing. Contributing factors include personnel issues, equipment and supplies challenges, managerial shortcomings, difficulties with proficiency testing providers, budgetary constraints, and a lack of training and motivation. [ABSTRACT FROM AUTHOR]

Background: The incidence of hypermucoviscous Klebsiella pneumoniae (hmvKp), which complicates communityacquired pneumonia, has been increasing recently. This study aimed to detect hypermucoviscous K. pneumoniae and determine its antimicrobial susceptibility pattern in adult patients with community-acquired pneumonia in Northwest Ethiopia. Methods: This cross-sectional study included 39 K. pneumoniae isolates identified by using Gram stain, culture, and biochemical tests from 312 adult patients with community-acquired pneumonia at the University of Gondar Comprehensive Specialized Referral Hospital from April to June 2021. The hypermucoviscous strains were identified by using the string test. Antimicrobial susceptibility testing was performed by using the Kirby-Bauer disk diffusion method. Data were entered by using EPI data version 4.6 and were analyzed by using SPSS version 20. A pvalue ≤ 0.05 at a 95% confidence interval was considered statistically significant. Results: Overall, 35.9% (n = 14) of the 39 K. pneumoniae isolates were hypermucoviscous phenotype. The mean age of the hmvKp group was lower than of the cKp group (36.93 ± 12.573 vs. 53.52 ± 19.556 years, p = 0.007). All hmvKp isolates were resistant to amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole. Azithromycin resistance in the hmvKp strains was significantly higher than in the cKp group (p = 0.012). Conclusions: This study demonstrates that the hmvKp phenotype causes community-acquired pneumonia and a full resistance to amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole. Antimicrobial resistance was higher in the hmvKp strain than in the classic strains. Further detection of resistance genes, capsular serotypes, hypermucoviscosity-related genes, and virulence genes is necessary. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the proportion of poor visual outcome and associated factors among adult patients who underwent cataract surgery at Debre Markos and Felege Hiwot Comprehensive Specialized Hospitals in northwestern Ethiopia in 2023. Methods: A hospital based cross-sectional study was conducted on 418 adult patients who had undergone cataract surgery from June 07 to August 07, 2023. Patients were recruited using systematic random sampling with an interval of 2. A pre-tested semi-structured questionnaire, medical record review, and ophthalmologic examination were used to collect data. The collected data was entered into Epi-info version 7 and exported to SPSS version 25 software for analysis. Binary logistic regression was used to determine the factors associated with poor visual outcomes of cataract surgery. Variables with a p-value of less than 0.05 in the multivariable binary logistic regression were considered statistically significant. Results: A total of 408 study participants with a median age of 65 years and a response rate of 97.6% took part. The proportion of poor visual outcomes of cataract surgery from 4 weeks to one year was 25.7% (95%CI: 21.6%, 30.3%). Factors responsible for poor visual outcomes of cataract surgery were intraocular lens implantation without a posterior chamber (AOR = 2.91, 95%CI:1.46,5.80), per-existing central corneal opacity (AOR = 3.83, 95%CI:1.52,9.69), pseudoexfoliation (AOR = 3.91,95%CI:1.39,11.88), age-related macular degeneration(AOR = 3.75, 95%CI:1.22, 11.88), glaucoma (AOR = 3.11, 95%CI:1.06,9.17) and striate keratopathy(AOR = 3.4, 95%CI: 1.11, 10.88). Conclusion: In this study, the proportion of poor visual outcomes of cataract surgery is higher than the World Health Organization recommendation. The study found that implantation of an intraocular lens without a posterior chamber, pre-existing central corneal opacity, pre-existing age-related macular degeneration, pre-existing glaucoma, pseudoexfoliation, and striate keratopathy were significantly associated with poor visual outcomes of cataract surgery. We recommend that ophthalmologists and cataract surgeons prioritize the reduction of surgical complications and pre-existing ocular co-morbidities to enhance post-operative visual acuity. Improving pre-operative assessment and refining surgical techniques like phacoemulsification will aid in achieving this goal. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a serious and debilitating psychiatric disorder that is linked to marked social and occupational impairment. Despite the vital relevance of medication, non-adherence with recommended pharmacological treatments has been identified as a worldwide problem and is perhaps the most difficult component of treating schizophrenia. There are limited studies conducted on magnitude and potential factors of medication non-adherence among peoples with schizophrenia in Ethiopia. Objectives: This study aimed to assess medication non-adherence and associated factors among peoples with schizophrenia at comprehensive specialized hospitals in Northwest Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 387 peoples with schizophrenia at selected hospitals in the Northwest of Ethiopia from June to August 2022. Study participants were enrolled using systematic random sampling. Medication non-adherence was measured using Medication Adherence Rating Scale (MARS). Data entry and analysis were done using Epi-data version 4.6.0 and SPSS version 24, respectively. A multivariable logistic regression model was fitted to identify factors associated with medication non-adherence. Variables with a p-value of < 0.05 at a 95% confidence interval were considered statistically significant. Results: The prevalence of medication non-adherence was 51.2% (95% CI: 46.3, 56.3). Duration of treatment for more than ten years (AOR = 3.76, 95% CI: 1.43, 9.89), substance use (AOR = 1.92, 95% CI: 1.17, 3.13), antipsychotic polypharmacy, (AOR = 2.01, 95% CI: 1.11, 3.63) and extra-pyramidal side effect (AOR = 2.48, 95% CI: 1.24, 4.94) were significantly associated with medication non-adherence. Conclusion: In this study, half of the participants were found to be medication non-adherent. Respondents with a longer duration of treatment, substance users, those on antipsychotic polypharmacy, and those who develop extra-pyramidal side effect need prompt screening and critical follow-up to improve medication adherence. [ABSTRACT FROM AUTHOR]

Northwest Ethiopia (east Gojjam) has envisioned developing its Climate Resilient Green Economy strategy through the use of renewable energy sources. However, harvesting wind, solar, and geothermal energy is below the satisfactory level. Therefore, this paper aims to model and assess the potential of renewable energy to improve energy accessibility in the rural areas of northwest Ethiopia. Wind, cloud cover, temperature, and radiation data were obtained from the European Centre of Medium Range Weather Forecast (ECMWF) model. Logarithmic power-law interpolation, radiation flux, and irradiance power modeling are applied to this work. The study area model results indicated that the annual wind potential is limited for implementation. A minimum and maximum value of solar energy is found at 5.30 kWm−2 during summer and 9.75 kWm−2 during spring, respectively. The average value of the total energy flux for geothermal energy exploration is found 1500.00 Wm−2. Generally, the south and southwest parts of northwest Ethiopia have the potential to implement geothermal energy. Solar energy plantation is encouraged in the whole parts of the study area excluding Choke Mountain. Hence, a renewable energy implementation plan for energy resource management through a stakeholder engagement platform is required to convert this research into a project. [ABSTRACT FROM AUTHOR]

Studies in Ethiopia have shown how climate-induced impacts are experienced differently by male and female farmers, with women being generally more vulnerable. Yet, less is known about how vulnerability to climate-induced risks differs between men and women of different marital statuses Therefore, we applied an intersectionality framework to examine how the level of intrinsic vulnerability is mediated through gender and marital status. Categorical Principal Component Analysis (CAPCA) was used to construct a household heads' intrinsic vulnerability index. Drawing on a systematic random sample of 1602 respondents and based on logistic regression analysis, the study shows that, while a man's marital status is a less important factor in determining his level of vulnerability to climate change, it is a key factor in the case of women. Compared to other women, female divorcees and widows are highly likely to be vulnerable to climate change in northwestern parts of Ethiopia. Integrating information about marital relationships, especially the neglected widows and divorcees into the design of interventions may help to better target potential beneficiaries among smallholder farming communities. Our study makes a unique contribution to the intersectionality literature in understanding the diversified experiences of vulnerable rural communities which are susceptible to climate-induced shocks. [ABSTRACT FROM AUTHOR]

In many parts of the world, degradation of grazing lands is one of the most serious environmental issues. This study analyzed farmers' perception of area closure and its associated factors of participation in degraded grazing land restoration in Sede-Muja Woreda, Northwest Ethiopia. A cross-sectional research design and a mixed research approach were applied in this study. The 384 sample respondents were randomly selected. Household surveys, interviews, focus groups, and field study techniques were used to acquire the data. A binary logistic regression model was used to identify the determinant elements that affect farmers' participation in the area closure of degraded grazing land restoration. All of the total respondent farmers (100%) have a positive attitude towards multi-functionality benefits of area closures for local farmers. The model results show that the grazing experience (AOR = 2.981, 95% CI = (1.143-7.775), access to safety net program (AOR = 2.787, 95% CI = (1.146-6.77), access to livestock forage (AOR = 4.493, 95% CI = (1.149-14.028), access to extension service (AOR = 2.522, 95% CI = (1.917-6.6397), livestock ownership (AOR = 0.026, 95% CI = (0.008-0.087), improved cattle breeds (AOR = 4.955, 95% CI = (1.944-12.630), access to training (AOR = 3.169, 95% CI = (1.409-7.131), farmers' perception (AOR = 0.085, 95% CI = (0.023-0.310), and communities' consensus (AOR = 4.230, 95% CI = (1.377-12.996) were determinant factors that affect farmers' participation in the area closure of degraded grazing land restoration. To address the current grazing land degradation issues, every one of the relevant authorities as well as communities needs to work together to create modern grazing land management mechanisms such as grazing land enclosures, reduce animal size through improved cattle breeds, implement zero-grazing systems, and ensure the sustainability of existing enclosures. [ABSTRACT FROM AUTHOR]

IntroductionThe adoption of climate-smart agriculture practices (CSAPs) at the plot level is a promising yet underutilized strategy in Ethiopia, where subsistence farming predominates. This study investigates the factors influencing the intensity of CSAPs on homesteads and identifies key barriers to their broader adoption.MethodsQuantitative data were collected through household surveys. Multiple Linear Regression (MLR) analysis was employed to examine the relationship between the independent variables and farmers' decisions to intensify CSAPs.ResultsThe findings reveal that slope gradient, extension contacts, farming experience, dependency ratio-induced labor, and livestock diversity significantly impact farmers' decisions to enhance CSAPs. Major barriers include insecure land tenure, poor management of open grazing, labor-intensive practices, and limited access to agricultural inputs.DiscussionTo promote the widespread implementation of CSAPs, it is imperative that these variables are prioritized in agricultural extension policies. Addressing these barriers is essential for enhancing the adoption of CSAPs, which will significantly contribute to sustainable agricultural development in Ethiopia.

Introduction: Engaging in risky sexual behaviors can lead to HIV infection, sexually transmitted infections, and unintended pregnancy among youths. University students had greater sexual risks for many reasons. Therefore, this study aimed to assess the magnitude and associated factors of risky sexual behaviors among regular undergraduate students at Injibara University, Northwest Ethiopia. Methods: A cross-sectional study was conducted at Injibara University from 20 January to 30 2020. Multistage sampling was employed to select 770 students. Data were collected using a semistructured self-administered questionnaire. A binary logistic regression model was used to identify factors associated with risky sexual behavior. Adjusted odds ratios with 95% CIs were determined, and variables with P-values <0.05 were considered significant. Result: A total of 770 students participated in the study, providing a response rate of 100%. In this study, 294 (38%, 95% CI: 35%, 42%) students engaged in risky sexual behaviors. Risky sexual behavior was significantly associated with not tested for HIV (AOR = 1.62, 95% CI: 1.15--2.31), peer pressure (AOR = 1.90, CI: 1.37--2.64), basic HIV knowledge (AOR = 2.16, CI: 1.65--2.89), substance use (AOR = 3.56, CI: 2.11--6.06), watching pornography videos (AOR = 1.58, CI: 1.11--2.23), and HIV risk perception (AOR = 1.37, CI: 1.02--1.91). Conclusion and recommendation: A substantial proportion of university students in this study engaged in unsafe sexual behavior. Risky sexual behaviors are more likely to occur when students are under peer pressure, use substances, have no perceived HIV risk, watch pornography, and have inadequate basic HIV knowledge. Therefore, tailored strategic interventions such as life skill training should be designed to bring about positive behavioral changes among university students. [ABSTRACT FROM AUTHOR]

Background: In Ethiopia, domestic animals and their feces are not properly contained. However, the risk of exposure to zoonotic pathogens is not well documented. This study was conducted to assess animal handling practices and the risk of childhood diarrhea among rural households in northwest Ethiopia. Methods: This study was done among 403 randomly selected households. Information on animal handling was collected using a questionnaire and spot-check observation. The occurrence of childhood diarrhea in 14 days prior to the survey was assessed based on the reports of female head of households. Multivariable binary logistic regression analysis was performed to identify the association between animal handling practices and childhood diarrhea. Results: All the female head of households had contact with animal feces when preparing fuel disks and plastering the house components with animal dung. Domestic animals shared a corral within the living space of the humans in 20% of the households. Animals entered the human living quarters and accessed foods in 32% of the households. Moreover, 24% of the children aged 24 to 59 months had diarrhea in a 2-week period prior to the survey. Childhood diarrhea was associated with domestic animals sharing the same house as humans (AOR: 3.3, 95% CI: 1.3, 8.6), presence of animal excreta in child playing areas (AOR: 2.4, 95% CI: 1.2, 4.6), contact of domestic animals with stored foods (AOR: 3.5, 95% CI: 2.0, 5.9), trapped dirt under fingernails of female heads (AOR: 3.7, 95% CI: 1.9, 7.5), open defecation (AOR: 3.24, 95% CI: 1.8, 5.9), and unprotected sources (AOR: 4.2, 95% CI: 1.1, 15.3). Conclusion: Domestic animals and their excreta are not hygienically contained in the area. Animal handling practices including their excreta and the hygiene behavior of female head of households (eg, handwashing and food handling practices) should be improved to prevent childhood diarrhea. [ABSTRACT FROM AUTHOR]

BackgroundDisordered eating attitudes are characterized by abnormal beliefs, thoughts, and feelings regarding food and weight control. Dieting, intentional weight loss, and weight control affect 41–62% of girls worldwide. However, there is limited information related to disordered eating attitudes and associated factors among late adolescent girls in Ethiopia, including in the study area. Thus, the study aimed to assess disordered eating attitudes and associated factors among late adolescent girls in Gondar city, northwest Ethiopia.MethodsFor this community-based cross-sectional study, which was conducted from 26 June to 26 July 2022, in Gondar city, Ethiopia, 1,188 adolescent girls were included. Multistage stratified sampling followed by a systematic random sampling technique was applied to recruit participants for the study. Data were collected using an interviewer-administered questionnaire containing the Eating Attitudes Test-26 (EAT-26). Anthropometric measurements were also taken. Bivariable and multivariable logistic regressions were employed to identify factors associated with disordered eating attitudes. In the final model, variables with a p-value of < 0.05 were considered statistically significant.ResultsA total of 1,158 late adolescent girls (a response rate of 97.5%) participated in the study. The prevalence of disordered eating attitudes among late adolescent girls was 9.7% [95% confidence interval (CI): 7.96, 11.4%]. Having a mother who was unable to read and write [adjusted odds ratio (AOR): 3.88 (95% CI: 1.07, 14.11)], having a mother who could read and write [AOR: 4.31: (95% CI: 1.14, 16.24)], having a father who only attended primary school [AOR: 3.78 (95% CI: 1.33, 10.78)], having severe anxiety [AOR: 3.26 (95% CI: 1.42, 7.49)], and severe usage of social media [AOR: 2.80 (95% CI: 1.22, 6.46)] were factors significantly associated with disordered eating attitudes among late adolescent girls.ConclusionThis study revealed that disordered eating attitudes among late adolescent girls were relatively high. The educational status of parents, anxiety, and severe usage of social media were positively associated with disordered eating attitudes. Therefore, nutritional education for parents of adolescents who are vulnerable to unhealthy behavior is imperative. The finding also implied the importance of an inclusive strategy to mitigate the emerging problem of targeting vulnerable groups.

BackgroundChemotherapy-induced anemia (CIA) is a hematologic complication that frequently affects patients with cancer undergoing chemotherapy. It is associated with worse treatment outcomes, higher rates of morbidity and mortality, worse quality of life, and higher healthcare costs. The incidence and predictors of CIA in Ethiopia, particularly in Northwest Ethiopian oncology centers, are poorly understood. This study was conducted at Northwest Ethiopian oncology centers to evaluate the incidence and determinants of chemotherapy-induced anemia in adult patients with cancer undergoing chemotherapy.MethodsThis 3-year hospital-based retrospective follow-up study included adult patients with cancer receiving chemotherapy between 2019 and 2021 at two oncology centers in Northwest Ethiopia. Data were collected from October to December 2021. A binary logistic regression model was used to select variables and determine the Crude Odds Ratio (COR). Variables with P-value < 0.2 were entered into the multivariable logistic regression and Adjusted odds ratio (AOR) with 95% Confidence intervals (CI) for variables with P-value < 0.05 were estimated to show determinants of chemotherapy-induced anemia among cancer patients who received chemotherapy.ResultsA total of 402 patients were included in the final analysis. The overall incidence of CIA was 75.4% (95% CI 70.7, 79.8). Older age [AOR = 1.8, 95% CI (1.4–3.5); P = 0.043], hematologic cancer [AOR = 3.7, 95% CI (3.2–5.7), P = 0.021], obesity [AOR = 3.4, 95% CI (2.3–6.9); P = 0.028], ≥6 chemotherapy cycles [AOR = 3.8, 95% CI (3.2–5.1), P = 0.019], cancer metastasis to bone [AOR = 2.9, 95% CI (1.2–4.7), P = 0.025] were statistically significant predictors of chemotherapy-induced anemia.ConclusionChemotherapy-induced anemia persisted in a significant percentage of cancer patients. Chemotherapy-induced anemia developed in three-quarters of patients undergoing chemotherapy. Chemotherapy-induced anemia was significantly associated with older age, hematologic malignancy, obesity, a greater number of chemotherapy cycles, and cancer metastasis to bone. To lower the risk of morbidity related to anemia, patients with chemotherapy-induced anemia should be regularly evaluated and treated with appropriate treatment.

BackgroundThe diminished quality of life among healthcare providers (HCPs) could impact both their personal well-being and their ability to effectively fulfill healthcare needs and provide necessary facilities to the public. Furthermore, this decline in quality of life may also significantly influence the overall health of HCPs, regardless of their professional training and duties.ObjectivesThe aim of this study was to assess the health-related quality of life (HRQoL) and associated factors among healthcare providers at comprehensive specialized hospitals in the Northwest Ethiopia.MethodA cross-sectional study was conducted among 412 healthcare providers at comprehensive specialized hospitals in Northwest Ethiopia from June to July 2023. Study participants were enrolled using simple random sampling. Health-related quality of life (HRQoL) was measured using the World Health Organization Quality of Life Scale–Bref Version. Data entry and analysis were performed using Epi-data version 4.6.1 and SPSS version 24, respectively. Binary logistic regression was employed to assess the association between quality of life and independent variables. Variables with a p-value

Acacia decurrens (hereafter Acacia) agroforestry system has been expanding rapidly in the northwestern highlands of Ethiopia. The agroforestry system provides multiple eco-environmental services; however, there is inadequate quantitative evidence on its livelihood benefits. This study, therefore, investigated the livelihood benefits and challenges of Acacia-based agroforestry system in the Awi area, Northwest Ethiopia. Data was collected through household survey quetionnaires (296 randomly selected Acacia growers), focused-group discussions, interviews, and observations. A combination of quantitative and qualitative methods was used for the data analysis. The findings showed that crop production, charcoal making, animal rearing, and fuelwood selling were the major sources of livelihood. Notwithstanding the complex challenges (Acacia pests/diseases, traditional charcoal-making, limited road access and market opportunities, negative human-health impacts, and high production cost), Acacia-based agroforestry positively affected farmers livelihoods. Comparatively, the natural, physical, financial, human and social capital indices of farmers were higher by 0.25, 0.24, 0.43, 0.25, and 0.06, respectively, in the post-than pre-Acacia periods. The overall livelihood index of farmers increased from 0.47 (pre-Acacia) to 0.71 in the post-Acacia period. The study concluded that this agroforestry practice has immense livelihood benefits, although diverse challenges question its sustainability. Therefore, short and long-term strategies should be designed to strengthen the opportunities and address the challenges. [ABSTRACT FROM AUTHOR]

Yeshimebet Tamir Tsehay,1 Helen Lamesgin Endalew,2 Alemwork Dessalegn Bogale,1 Tarkie Abebe Walle2 1Department of Surgical Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia; 2Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaCorrespondence: Yeshimebet Tamir Tsehay, Department of Surgical Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, PO Box 79, Bahir Dar, Ethiopia, Tel +251943526569, Email tamirtsehay@gmail.comBackground: Ankle-foot pain is a serious public health concern among nurses and has a significant impact on the quality of the health care service delivery system. However, little is known about the prevalence and factors associated with ankle-foot pain among nurses working in surgical units in Ethiopia.Purpose: The study aimed to assess the prevalence and associated factors of ankle-foot pain among nurses working in surgical units of comprehensive specialized hospitals in Amhara regional state, Northwest Ethiopia, 2022.Participants and Methods: An institution-based cross-sectional study was conducted among 409 nurses working in surgical units of comprehensive specialized hospitals, from May 15 to June 7, 2022. A simple random sampling technique was employed. Data were collected by five BSc nurses using a structured self-administered questionnaire. The collected data were entered into Epi-data version 4.6 and exported to SPSS version 23 for analysis. The descriptive statistics and bivariable and multivariable logistic regression analyses were computed. Finally, variables were declared as statistically significant at P < 0.05 using the odds ratio and 95% CI.Results: The prevalence of ankle-foot pain among nurses working in surgical units was 51.8% (95% CI = 46.9– 57.5). More than 10 years of working experience [AOR = 3.48, 95% CI = 1.35– 8.92], working 48 or more hours per week [AOR = 2.69, 95% CI = 1.27– 6.00], prolonged standing [AOR = 5.72, 95% CI = 3.20– 10.25], high physical job demand [AOR = 2.41, 95% CI = 1.53– 3.80], and low job control [AOR = 2.34, 95% CI = 1.47– 3.71] had statistically significant association with ankle-foot pain.Conclusion: This study found that ankle-foot pain was common among nurses working in surgical units. Having more years of work experience, working more hours per week, prolonged standing, high physical job demand, and low job control were statistically associated with ankle-foot pain.Keywords: ankle-foot discomfort, ankle-foot pain, Northwest Ethiopia, nurses

Purpose – The purpose of this study is to identify the most vulnerable households and districts in Northwest Ethiopia and help decision-makers in developing and prioritising effective adaptive strategies and actions. Design/methodology/approach – A multi-scale analytical tool and hazard-generic socio-economic indicators were developed to identify and prioritise the most vulnerable households and districts in Northwest Ethiopia. Categorical principal component analysis with 36 indicators was used to develop weights for different indicators and construct a household intrinsic vulnerability index. Data were collected through key information interviews, focus group discussions and a household survey with 1,602 randomly selected households in three districts of Northwest Ethiopia. Findings – Drawing on intrinsic vulnerability index computation, this study highlights that low levels of education, low access to climate information and credit services, long distance travelled to fetch water and frequent food shortages are the dominant factors contributing to high levels of intrinsic vulnerability at district level, while lack of livelihood support and income diversification are the key drivers of vulnerability at household level. The findings of this study further show that the majority of households (78.01%) falls within the very high to moderately high vulnerable category. Disaggregating the data according to agro-climatic zones highlights that the prevalence of high intrinsic vulnerability is most widespread in the lowland agro-climatic zone (82.64%), followed by the highland (81.97%) and midland zones (69.40%). Practical implications – From a policy intervention vantage point, addressing the drivers of vulnerability provides a reliable approach to reduce the current vulnerability level and manage potential climate change-induced risks of a system. Specifically, reliable information on inherent vulnerability will assist policymakers in developing policies and prioritising actions aimed at reducing vulnerability and assisting in the rational distribution of resources among households at a local level. Originality/value – This study contributes to the existing vulnerability literature by showing how hazard-generic socio-economic indicators in the vulnerability assessment adopted by the IPCC (2014) are important to identify drives of vulnerability which ultimately may feed into a more fundamental treatment of vulnerability.

BackgroundLactating mothers are frequently at risk for nutritional deficiencies due to the physiological requirements of lactation. Throughout the world, a significant number of lactating mothers have micronutrient intake inadequacy. Evidence on micronutrient intake during lactation is limited in rural Ethiopia. Therefore, this study aimed to determine micronutrient intake inadequacy and associated factors among lactating mothers.Methods and materialsA community-based cross-sectional study was conducted from February 1 to 18, 2023, among lactating mothers in rural areas of the North Mecha District of Amhara Region, Northwest Ethiopia. A multistage sampling technique was used to select 449 study participants. An interviewer-administered questionnaire was employed to collect dietary intake data by using a single multiphasic interactive 24-h dietary recall. The NutriSurvey 2007 software and Ethiopia, Tanzania and Kenya food composition tables were used to calculate nutrient values for the selected 12 micronutrients. For the remainder of the analysis, SPSS version 25 was employed. The Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR) were calculated by dividing all NAR values by the number of micronutrients computed to evaluate the nutrient intakes. A logistic regression analysis was conducted to determine the factors contributing to the overall micronutrient intake inadequacy, and statistical significance was determined at a p value

IntroductionEngaging in risky sexual behaviors can lead to HIV infection, sexually transmitted infections, and unintended pregnancy among youths. University students had greater sexual risks for many reasons. Therefore, this study aimed to assess the magnitude and associated factors of risky sexual behaviors among regular undergraduate students at Injibara University, Northwest Ethiopia.MethodsA cross-sectional study was conducted at Injibara University from 20 January to 30 2020. Multistage sampling was employed to select 770 students. Data were collected using a semistructured self-administered questionnaire. A binary logistic regression model was used to identify factors associated with risky sexual behavior. Adjusted odds ratios with 95% CIs were determined, and variables with P-values

This study was conducted to identify farmers' breeding objectives and trait preferences for indigenous cattle in north-west Ethiopia. Multistage purposive and random sampling techniques were used to select study districts, and smallholder farmers. The required data were collected through structured questionnaires from 320 households, personal observations, and focus group discussions. The chisquare (Χ2) test, least squares mean, and ranking index were statistical methods used for data analysis. The least squares mean analysis showed a difference (p < 0.001) and the mean herd size was 10.9 heads. Based on ranking index results, milk production (0.35) and draught power (0.25) were the main cattle production purpose/objectives of farmers. The chi-square (Χ2) test results of mating practices showed a significant difference (p < 0.001) and 63.8% of farmers used controlled mating. According to the ranking index result, large body size (0.35), colour (0.26), and good traction (0.18) were considered the most important traits in selecting a breeding bull. High milk yield (0.4), colour (0.19), large body size (0.16), and calf growth (0.13) were the preferred traits/criterias for cow selection. Prioritizing farmer trait preference and breeding objectives in this study was critical for the design and implementation of breeding programmes. [ABSTRACT FROM AUTHOR]

Background and Aims: Neonatal period is the most vulnerable time in which children face the greatest risk of death. Worldwide, each year, millions of newborns died in the first month of life. Sub‐Saharan Africa, Ethiopia, in particular, is largely affected. However, there is a dearth of information regarding the survival status of neonates and determinants of their mortality in the study area. Therefore, this study was aimed at investigating neonatal mortality and its predictors in Jabitehnan district, Northwest Ethiopia. Method: A single‐arm community‐based retrospective cohort study was conducted in March 2021 among 952 neonates born between August 2020 and February 2021. Data were collected by a semi‐structured questionnaire, and a multistage stratified sampling technique was employed to select one urban and 10 rural kebeles from the district. Then, the total sample size was proportionally allocated to these selected kebeles. Neonatal death was ascertained by community diagnosis. Kaplan–Meier curve was used to estimate survival time. Cox regression was used to identify factors, the hazard ratio was estimated, and a p‐value < 0.05 was considered statistically significant. Results: The neonatal mortality rate was 44 (95% confidence interval [CI]: 33–60) per 1000 live births; and the incidence rate was 1.64 (95% CI: 1.21–2.23) per 1000 neonate days. Three‐quarters of deaths occurred in the first week of life. Medium household wealth index (adjusted hazard ratio [AHR] = 3.54; 95 CI: 1.21–10.35), increased number of pregnancies (AHR = 1.22; 95%CI: 1.01–1.47), being male (AHR = 2.45, 95% CI: 1.12–5.35) and not starting breastfeeding in the first hour of life (AHR = 4.00; 95% CI: 1.52–11.10) were found to be predictors of neonatal mortality. Conclusion: Neonatal mortality was high compared to the national target. Wealth, number of pregnancies, sex of the neonate, and breastfeeding initiation were factors associated with neonatal death. Hence, strengthening interventions such as providing sexual education in the population, considering households with a medium wealth index in the exemption service, and counseling mothers about early breastfeeding initiation would improve neonatal survival. [ABSTRACT FROM AUTHOR]

Natnael Yeneneh Belie,1 Fisseha Admassu Ayele,2 Belayneh Mengist,3 Abiy Maru Alemayehu,1 Abel Sinshaw Assem,1 Sofonias Addis Fekadu,1 Betelhem Temesgen Yibekal1 1Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, EthiopiaCorrespondence: Betelhem Temesgen Yibekal, Email betelhemtemesgen28@gmail.comBackground: Glaucoma is one of the leading cause of global irreversible blindness if left untreated. Satisfaction is a multifaceted outcome based on sufficient information and encouragement from the practitioner and based on the medications’ nature. Determining patients’ satisfaction is essential to increase their courage in their long-time follow-up of medical care.Objective: To assess Patients’ satisfaction with topical anti-glaucoma medications and associated factors among glaucoma patients at Gondar University Tertiary Eye Care and Training Center, Northwest Ethiopia.Methods: Hospital-based cross-sectional study was conducted from June 30 to August 27, 2021, among 395 glaucoma patients at Gondar University Tertiary Eye Care and Training Center. Data was entered into Epi info version 7 and exported to SPSS version 26 software for analysis. A Binary logistic regression model was used to determine factors associated with satisfaction with topical anti-glaucoma medications. Statistical significance was considered when p-value < 0.05.Results: A total of 395 study subjects participated in the study with a response rate of 93.38%. The overall satisfaction with topical anti-glaucoma medication was 62.5% with 95% CI: (57.5– 67.8%). The absence of ocular side effects (AOR=5.39, 95% CI: 2.35– 12.37) and the absence of ocular surface diseases (AOR=4.12, 95% CI: 1.69– 10.09) were significantly associated with patient satisfaction.Conclusion: More than half of the study participants were satisfied with topical anti-glaucoma medications. The absence of ocular side effects and absence of Ocular surface diseases were significantly associated with patient satisfaction with anti-glaucoma medication.Keywords: satisfaction, anti-glaucoma medication, Gondar, Northwest Ethiopia

Abstract Background Discrete choice experiments (DCEs) are used to assess the strength of preferences and value of interventions. However, researchers using this approach have been criticized for not conducting or publishing rigorous studies to select the required attributes and levels. Proper specification of attributes and their levels determines the validity of DCE. Hence, our study aimed to identify and define attributes and levels for the design of a DCE to elicit patients’ and providers’ preferences for ART service in Northwest Ethiopia. Methods Four stages were followed to derive the final list of attributes and levels: (1) a literature review to derive conceptual attributes; (2) key informant interviews of 17 providers and in-depth interviews of 15 adult stable patients to identify context-specific attributes and attribute levels; (3) ranking survey among 31 HIV/AIDS program implementers and rating survey among 35 adult stable patients and 42 health workers providing antiretroviral therapy (ART) service to indicate participants’ preference of attributes; and (4) an expert opinion to reduce the list of attributes and levels. Results First, a literature review identified 23 candidate attributes. Second, individual-level analysis of the qualitative transcripts confirmed 15 of these 23 attributes. Third, the ranking and rating surveys put the importance of the 23 ART service attributes in order of preference. Fourth, through discussions with eight experts, 17 attributes were discarded based on multiple criteria. The six retained attributes were: the location of ART refills, the frequency of receiving ART refills, the person providing ART refills, the participants/others seen at the same ART refill visit, medication refill pick-up/delivery times, and the total cost of the visit during antiretroviral (ARV) medication refill. Finally, levels were assigned to these 6 attributes based on data from the literature, transcripts, and knowledge of the Ethiopian context. Conclusions This detailed description illuminates the attribute development process and provides the reader with a basis for evaluating the rigor of this phase of DCE construction. This paper contributes empirical evidence to the limited methodological literature on attributes and levels of development for DCE, thereby providing further empirical guidance on ART service preference, specifically among patients of low- and middle-income countries.

Abstract Background Adolescent depression is a serious mental disorder that makes family problems, learning challenges, drug addiction, and increases absenteeism from school. It also has a major impact on a person’s ability to manage his or her daily tasks. In the end, the condition may result in self-destruction. Research is scarce among high schools in the study setting. Therefore, this study aimed to assess the prevalence and its associated factors of depression among high school adolescent students in Bahirdar City, Northwest Ethiopia in 2022. Methods An institutional-based cross-sectional study was done from June 18 to July 16, 2022, among public and private high school adolescent students in Bahir Dar City, Amhara region, Ethiopia. A two-stage sampling technique was utilized. First, stratification by school type was made and schools were selected 30–40% by using a simple random sampling technique. Finally, an updated sampling frame was taken from each school director to select a sample of 584 study participants after proportional allocation by simple random sampling from six high schools. Patient Health Questionnaires were used to assess depression in high school students. The independent variables, like substance-related factors, were assessed by yes-or-no questions, and the academic stressor by academic stress in secondary education, was assessed by structured questionnaires. Binary and multivariate logistic regressions were used to identify factors associated with depression. Statistical significance was declared at a 95% confidence interval when the value of p was less than or equal to 0.05. Results The response rate of the participants was 96.9%. The overall magnitude of adolescent depression was found to be 22.1% (95%CI 18.7, 25.7%). Being female (AOR: 3.43; 95%CI 2.11, 5.56), small family size (AOR: 3.01; 95%CI 1.47, 6.15); ever alcohol use (AOR: 2.40; 95%CI 1.51, 3.81); attending a public school (AOR: 3.01; 95%CI 1.68, 5.40), and having a history of abuse (AOR: 1.92; 95%CI 2.2, 3.08) were associated with depression. Conclusion In this study, the magnitude of depression among high school students in Bahir Dar City was higher than the national threshold. There was a significant association between sex, family size of parents, ever alcohol use, public schools, and having a history of abuse with depression among adolescents. Hence, it is better for schools to screen and provide intervention for depression in public high school students and offer therapies, especially in females and those with a history of abuse, small family size, or alcohol use.

Abstract Introduction Bipolar disorder is a severe and chronic mental illness that could continue for a lifetime. Although it is a leading cause of disability and impairments for significant numbers of patients, the levels of functional outcomes have not been studied in Ethiopia. Therefore, this study aimed to assess the functional outcome levels and associated factors among bipolar disorder patients in Northwest Ethiopia. Method Hospital-based cross-sectional study was employed among bipolar disorder patients attending psychiatric clinics, in Northwest Ethiopia, from April to June 2021. Systematic random sampling was used to get respondents. Descriptive and inferential statistics were done. Data were entered into EpiData version 4.6.02 and exported to SPSS Version 22 for analysis. Bivariable and multivariable binary logistic regression analysis was used to identify the factors associated with functional outcome levels, and p value

Abstract Background Gender-based violence (GBV) is a common human right violence in conflict-affected communities. Women with GBV are prone to experience mental health problems such as post-traumatic stress disorder, depression, and anxiety. However, there is a paucity of evidence as to what extent the problem is affecting internally displaced women (IDW) in Ethiopia. This study aimed to assess the prevalence of GBV and its associated factors among IDW in Northwest Ethiopia. Methods A cross-sectional study was conducted among IDW residing at three humanitarian sites from May to June 2022 in Northwest Ethiopia. Study participants were selected using a stratified simple random sampling technique from the three sites. GBV was assessed using a 6-item Assessment Screen to Identify Survivors Toolkit questionnaire for Gender-based violence (ASIST-GBV). Data were analyzed using binary logistic regression. All variables with a p-value of ≤ 0.05 in the multivariable analysis were defined to have a statistically significant association with GBV at a 95% confidence interval (CI). Results Of 424 approached candidates, 412 (97.2%) of them participated in the study. A one-year prevalence of GBV was 37.9% (95%CI = 33.2–42.6) among IDW in Northwest Ethiopia. The mean age of the participants was 31.3 (± 7.6) years. Young women, 18–24 years old (AOR = 3.52, 95%CI = 2.15–5.34, p ≤ 0.001) and 25–29 years old (AOR = 2.41, 95%CI = 1.57–3.24, p ≤ 0.001) had a statistically significant association with GBV. Moreover, having no social protection (AOR = 3.18, 95%CI = 2.65–6.22, p ≤ 0.001), being current alcohol user (AOR = 2.54, 95%CI = 1.22–4.78, p ≤ 0.001) and being single in marital status (AOR = 1.69, 95%CI = 1.18–2.87, p

Abstract Background Pregnant mothers are a risky population group for COVID-19 and pregnant mothers with COVID-19 are at increased risk of hospitalization, intensive-care unit admission, invasive ventilation support, and maternal mortality. Vaccination is an essential tool in stopping the effect of the pandemic on maternal and child health. However, there are only limited studies in Ethiopia on the intention to take the COVID-19 vaccine among pregnant women. Thus, this study aimed to assess intention to take the COVID-19 vaccine and associated factors among pregnant women in Bahir Dar city, Northwest Ethiopia. Methods Facility based cross-sectional study was conducted among 590 pregnant women from 23 May to 07 July 2022. The study participants were selected using a systematic sampling technique. Interviewer administrative questionnaire with epicollect5 application was used to collect the data. Both bi-variable and multivariable binary logistic regression analysis was performed. Statistical significance was defined at a 95% CI with a p-value