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Background: Ectoparasites are organisms which inhabit the skin or outgrowths of the skin of another organism (the host). Many ectoparasites are known to be vectors of pathogens, which the parasites typically transmit to hosts. Though, ectoparasites are common in the vulnerable groups and economically disadvantaged communities, there is limited evidence on its magnitude in Ethiopia. This community-based cross-sectional study was, therefore, conducted to assess the prevalence and associated factors of ectoparasites in the rural communities of northwest Ethiopia. Methods: A community-based cross-sectional study design with structured observation was conducted among 1191 randomly selected rural households in northwest Ethiopia in May 2016. Data were collected using structured interviewer administered interview questionnaire and structured observation checklist. Prevalence of human ectoparasites in the rural communities was defined as the presence of one or more lice, fleas, bed bugs, mites, and ticks and the presence of these ectoparasites were observed by trained environmental health experts. Multivariable binary logistic regression analysis was used to identify variables associated with prevalence of ectoparasites on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P values Results: Of a total of 1191 rural households, human or hair lice were observed in one or more of the family members in 186 (15.6%) rural households. Similarly, fleas were observed in more than half, 609 (51.1%) of rural households and bed bugs were observed in 441 (37%) rural households. Furthermore, mites and ticks were reported in 113 (9.5%) and 130 (10.9%) of the households respectively. Accordingly, one or more ectoparasites were observed in 865 of 1191 rural households. The presence of one or more ectoparasites was, therefore, found to be 72.6% (95% CI = 70%-75.1%). The prevalence of ectoparasites was statistically associated with educational status of the female head being not educated (AOR = 1.476, 95% CI = 1.001, 2.177) and absence close supervision by health extension workers (AOR = 2.151, 95% CI = 1.205, 3.843). Conclusion: The prevalence of one or more ectoparasites was high in the rural communities of northwest Ethiopia. The high prevalence was associated with education status of the female head and close supervision of households by health extension workers. Disseminating health information about intervention strategies of ectoparasites and closely supervising the rural households need to be considered.

Background Substance use related health and social problems are on the rise in sub-Saharan Africa. Currently, substance abuse is one of the most burning public health problems in Ethiopia. Although it has been known that this public health problem is an urgent issue, the real extent and magnitude of substance abuse is not yet properly explored. The purpose of this study was to assess substance use and associated factors among Gumuz people in Mandura Woreda, northwest Ethiopia. Methods A community based cross sectional study was conducted involving 1588 adults, recruited using multi stage stratified simple random sampling technique. The data were collected at the household level by using pre tested Standardized questionnaire of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Oslo social support scale and substance use questionnaire. The data was entered and cleaned using Epi Data version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 22 statistical package. Descriptive statistics and logistic regression were performed to examine the prevalence and predictors of substance use. An Adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. Result The overall life time substance use prevalence in the current study was 25.9% (95% CI = 23.7, 28.0). The three-month prevalence of Alcohol and tobacco use was 48.4 and 15.8% respectively. The three-month prevalence of hazardous alcohol and tobacco use were 25.8 and 7.8% respectively. Able to read and write (AOR = 3.79; 95%CI 2.34–6.15) in educational status and Strong social support (AOR = 0.39; 95%CI 0.27–0.58) were significantly associated with substance use. Conclusion High level of substance use was detected in the current study setting. This high prevalence (three-month) of substance use affects the productive age groups which influence on the family and cause the rise of major public health and socio economic problems. The finding informed the need to integrate services for hazardous substance use such as brief intervention at different levels of primary care services in the district. Public health interventions to reduce hazardous substance especially on alcohol and smoking use also need to be initiate.

Background: Diarrheal disease remains the leading cause of morbidity and mortality among under-five children worldwide. It is one of the top leading causes of under-five morbidity & mortality in Ethiopia. Knowing the determinants of a disease enables us to design an effective intervention. The main objective of this study was to assess the prevalence and associated factors of acute diarrheal disease among under-five years of age.Methods: Community-based cross-sectional study was carried out. Five hundred thirty mothers/care takers with under-five children were selected by using systematic random sampling from selected kebeles in the district. Data were collected using structured and pre-tested questionnaires. Data was cleaned and analyzed using SPSS version 20. Bivariate and multivariate analysis was done to assess factors affecting diarrhea. Results: A total of 530 households with under- five children were involved in the study. The mean ages of the respondents and the index children were 33.30(+6.26SD) years and 22.75 (+12.79SD) months, respectively. Prevalence of diarrheal disease over a period of two weeks preceding the study was 21.3%. Water source [AOR: 4.476, 95% CI (1.962, 10.210)], distance to water source [AOR: 2.252, 95% (1.139, 4.451)], feces seen outside the pit hole of latrines [AOR: 2.943, 95% (1.347, 6.429)], mothers/care takers who feed adult food to the children [AOR: 6.985,95 %( 1.074, 45,433)] and bottle feeding [AOR: 8.269 ,95%(1.086, 62.975)] were significantly associated variables on multivariate analyses.Conclusions and recommendations: The magnitude of diarrhea among under -five children was relatively high. Improper use of latrines, source of water of for drinking, times to water source, types of food and methods of feeding were the factors associated with acute childhood diarrheal. The authors of the study recommend availing improved water sources for the community. The community is also advised to use latrine appropriately and use appropriate food and method of feeding to reduce the risk of diarrheal. Health education program should be given to the hygiene sanitation and behavioral practice of the households

Kala azar occurs among seasonal and migrant agricultural workers in northwest Ethiopia and accounts for almost 60% of the disease burden in the country. We conducted a quantitative study on the level of knowledge and practice of this vulnerable group in relation to kala azar transmission and acceptability of its vector control tools. A total of 403 workers were randomly selected from eight farms using a purposive sampling technique. Knowledge and practice scores were calculated based on 12 and 9 core questions, respectively. Binary logistic regression was used to identify factors associated with knowledge and practice. A large gap in knowledge of the disease and the vector was evident with 61.8%, 24.6%, and 13.6% of the workers having poor, moderate, and good levels of knowledge scores, respectively. Similarly, 95% of the seasonal workers reported poor level of use of protective measures against the bite of the sand fly vector. Good level of knowledge about kala azar and its sand fly vector was statistically associated with formal education (adjusted odds ratio [AOR] = 2.11; 95% CI = 1.17, 3.80; P < 0.05) and previous exposure to health education (AOR = 4.72; 95% CI = 1.99, 11.16; P < 0.001). Despite poor current knowledge and practice, a large proportion of the study participants showed interest in using vector control tools if made available, with 78% of the seasonal and migrant workers expressing some willingness to pay for different measures that can protect against sand fly bites. Therefore, we strongly recommend that comprehensive health education and vector control programs should be provided to these workers.

Background The World Health Organization estimates that globally only 43% of women have access to skilled care during deliveries and the rest are exposed to unskilled delivery service. A recent Ethiopian Demographic and Health Survey report stated that maternal death was 412 per 100,000 in 2016.This still indicates that maternal health remains a major public health problem in Ethiopia irrespective of the government’s measure to institutional delivery. Therefore, the aim of this study was to assess the magnitude of home delivery and associated factors among women of child bearing age in Sherkole district, Western Ethiopia. Methods A community based cross sectional study was conducted among women aged 15–49 years in Sherkole district, Benishangul Gumuz region from January to June 2018. A total of 451 randomly selected women were included in the study. Stratified sampling followed by simple random sampling technique was used to select the study participants. Data were collected using pretested and structured questionnaires. Bivariate and multivariate logistic regression models were fitted to identify factors associated with home delivery among women in the child bearing age. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance. Results The magnitude of home delivery was 353 (80%) and were assisted by non-skilled birth attendants. Mothers whose husband chooses the place of delivery [AOR: 5.6, 95% CI (2.1–15.2), Mothers’ occupation ([AOR: 0.21 95% C I (0.08–0.57), ANC visit [AOR: 95 CI: 5.1(1.6–15.8), decision making [AOR: 95 CI: 0.3(0.01–0.7)] and traditional remedies [AOR: 95%CI: 0.03 (0.01–0.09)] were significantly associated with home delivery. Conclusions Based on the findings of the survey, it was concluded that the overall magnitude of home delivery was found to be high. Therefore, it is recommended that the promotion of antenatal care follow-up with maternal and child health information particularly on delivery complications or danger signs needs due attention and remedial actions. In addition, it is indispensable introducing defaulter tracing mechanisms in ANC services, by learning from experiences of settings that have already adopted it.

Background There is wide variation in the utilization of institutional delivery service in Ethiopia. Various socioeconomic and cultural factors affect the decision where to give birth. Although there has been a growing interest in the assessment of institutional delivery service utilization and its predictors, nationally representative evidence is scarce. This study was aimed to estimate the pooled national prevalence of institutional delivery service utilization and associated factors in Ethiopia. Methods Studies were accessed through PubMed, Cochrane library, Web of Science, and Google Scholar. The funnel plot and Egger’s regression test were used to see publication bias, and I-squared statistic was applied to check heterogeneity of studies. A weighted Dersimonian laired random effect model was applied to estimate the pooled national prevalence and the effect size of institutional delivery service utilization and associated factors. Result Twenty four studies were included in this review. The pooled prevalence of institutional delivery service utilization was 31% (95% Confidence interval (CI): 30, 31.2%; I2 = 0.00%). Attitude towards institutional delivery (Adjusted Odd Ratio (AOR) = 2.83; 95% CI 1.35,5.92) in 3 studies, maternal age at first pregnancy (AOR = 3.59; 95% CI 2.27,5.69) in 4 studies, residence setting (AOR = 3.84; 95% CI 1.31, 11.25) in 7 studies, educational status (AOR = 2.91;95% 1.88,4.52) in 5 studies, availability of information source (AOR = 1.80;95% CI 1.16,2.78) in 6 studies, ANC follow-up (AOR = 2.57 95% CI 1.46,4.54) in 13 studies, frequency of ANC follow up (AOR = 4.04;95% CI 1.21,13.46) in 4 studies, knowledge on danger signs during pregnancy and benefits of institutional delivery (AOR = 3.04;95% CI 1.76,5.24) in 11 studies and place of birth of the elder child (AOR = 8.44;95% CI 5.75,12.39) in 4 studies were the significant predictors of institutional delivery service utilization. Conclusion This review found that there are several modifiable factors such as empowering women through education; promoting antenatal care to prevent home delivery; increasing awareness of women through mass media and making services more accessible would likely increase utilization of institutional delivery.

Background. Human resource is the most crucial resources for the survival of an organization. Intention to leave is an employee’s plan to leave their current job in the near future and is used as a proxy indicator for measuring turnover in cross-sectional surveys. In developing countries human resource shortages are not only due to production of health professionals but also because of employee turnover and instability at health facilities. Objective. This study aimed to assess the magnitude of intention to leave and associated factors among health workers working at primary hospitals of North Gondar Zone, Northwest Ethiopia. Methods. Institution based cross-sectional mixed methods’ (both quantitative and qualitative) study design was conducted among health workers working at primary hospitals of North Gondar zone. Self-administered standardized structured questionnaires for quantitative and interview guide for qualitative were used for data collection. Variables having p-value less than 0.2 during bivariable analysis were entered into multivariable logistic regression model. Thematic analysis was done for qualitative data analysis. Results. A total of 382 health workers were participated in the study with a response rate of 93.6%. Overall, 67.8% of them were intended to leave their current organization. Age of participants, 20-29 years (AOR=3.96; 95%CI: 1.04, 15.07), living out of family (AOR= 1.73; 95% CI: 1.23, 3.02), opportunity of other job (AOR= 2.04; 95% CI: 1.21, 3.45), performance appraisal system (AOR= 2.97; 95%CI: 1.64, 5.36), and affective commitment (AOR= 3.12; 95% CI: 1.64, 5.92) were the factors affecting health workers intention to leave current organization. Conclusion. overall, magnitude of health workers intention to leave their current organization was high. Therefore, healthcare managers, supervisors, and policymakers need to develop and implement retention strategies that aim to improve the retaining of healthcare workers at their working organization such as unifying healthcare providers who are living separately with their families, use evidence-based performance evaluation mechanism, and make efforts to develop a sense of ownership in the health workers, which will reduce health professional’s intention to leave their organization.

Background: Human illnesses caused by parasites, viruses, and bacteria that are transmitted by vectors are called vector-borne diseases. Vector-borne diseases usually affect the poorest populations, particularly where there is a lack of access to adequate housing, safe drinking water, and sanitation. This community-based cross-sectional study was, conducted to assess the prevalence of self-reported vector-borne diseases and associated factors in the rural communities of northwest Ethiopia. Methods: A community-based cross-sectional study design with structured observation was conducted among 1191 randomly selected rural households in northwest Ethiopia from April to June 2017. Data were collected by using a structured questionnaire; and observation checklist. Multivariable binary logistic regression analysis was used to identify variables associated with the prevalence of self-reported vector-borne diseases on the basis of adjusted odds ratio (AOR) with 95% confidence interval (CI) and P-values Results: In the current study, 216 (18.1%) of the rural households reported one or more vector-borne diseases. Scabies (9.5%) were the most reported vector-borne disease followed by Malaria (6.9%). The prevalence of self-reported vector-borne diseases was statistically associated with the head of the family (mother) (AOR = 0.13, 95% CI = 0.02-0.72), regular cleaning of the living environment (AOR = 0.51, 95% CI = 0.36-0.74), poor cleanness of the living rooms (AOR = 1.77, 95% CI = 1.03-3.03), and moderate cleanness of the floor (AOR = 1.64, 95% CI = 1.06-2.52). Conclusion: The prevalence of self-reported vector-borne diseases was high in the rural communities of northwest Ethiopia. The low prevalence was associated with family head; regular cleaning of living environment and cleanness of the floor. Designing and strengthening an intervention strategy for environmental sanitation, regular cleaning of living house, and keeping personal hygiene shall be considered.

Background Trachoma is the leading infectious cause of blindness worldwide. Though trachoma can be treated with antibiotic it is still endemic in most part of Ethiopia. Methods A community based cross-sectional study was conducted among 618 children 1–9 years of age from December 2013 to June 2014. A multistage systematic sampling technique was applied. Data were collected using pretested and structured questionnaire and also observation by using binocular loupe to differentiate active trachoma cases. The World Health Organization’s simplified classification scheme for assessing trachoma in community based surveys was used for the purpose. Bivariate and multivariate logistic regression model was fitted to identify factors associated with trachoma among children aged 1–9 years. An adjusted odds ratio with 95 % confidence interval was computed to determine the level of significance. Results The overall prevalence of active trachoma among children aged 1–9 years were 23.1 % (Trachomatous inflammation—Follicular, in 22.5 % (95 % CI: 22.3–22.69 %); Trachomatous inflammation—Intense, in 0.6 % (95 % CI: 0.4–0.79 %). Family size (>5) (AOR = 14.32, 95 % CI = 6.108–33.601), number of children under 10 years of age within household (AOR = 25.53, 95 % CI = 9.774–66.686), latrine utilizations (AOR = 10.274, 95 % CI = 4.274–24.968), route of waste disposal (AOR = 3.717, 95 % CI = 1.538 to −8.981), household literacy (AOR = 2.892, 95 % CI = 1.447–5.780), cattle housing practice (AOR = 4.75, 95 % CI = 1.815–12.431), time to collect water (AOR = 25.530, 95 % CI = 8.995–72.461), frequency of face washing practice (AOR = 6.384, 95 % CI = 2.860–14.251) and source of water (AOR = 2.353, 95 % CI = 1.134–4.882) were found to be associated with the presence of active trachoma in this study population. Conclusion The prevalence of active trachoma among rural communities of children aged 1–9 years was found to be high in reference to WHO recommended thresholds to initiate trachoma control recommendation (>10 % prevalence), which indicates that active trachoma is still a major public health concern in the study area. Therefore, it is recommended that coordinated work on implementing the WHO endorsed SAFE strategy in particular and enhancing the overall living conditions of the community is crucial.