Search

The northern part of Ethiopia is endowed with local and exotic breeds of chicken; however, their morphometric characterization needs to be done to support future improvements and conservation. Hence, the study was conducted in three agro-ecologies (lowland, midland, and highland) of Northern Ethiopia to assess the morphometric traits of local and exotic (Naked-neck) chicken genotypes. The experiment was designed as 4×2 factorial with Chicken genotype (4 levels: local from each of lowland, midland and highland, and exotic from lowland) and Sex (2 levels: female and male) being the factors. ANOVA was conducted to determine the main and interaction effects of these factors on 21 morphometric traits. The results revealed significant interaction of Chicken genotype and Sex on all morphometric traits other than skull length, skull width, skull index and neck length highlighting the presence of vast sex specific differences among the genotypes. Apart from comb, earlobe and beak indices and wattle width, male Naked-neck (from lowland) have significantly higher values than the other seven combinations. The morphometric variations of chicken genotypes unveiled in this study are good indicators of genetic diversity of chicken population in Northern Ethiopia and calls for designing community based genetic improvement program to maximize desirable traits. [ABSTRACT FROM AUTHOR]

Background: Since 2005, Ethiopia has aggressively scaled up malaria prevention and case management. As a result, the number of malaria cases and deaths has significantly declined. In order to track progress towards the elimination of malaria in Amhara Region, coverage of malaria control tools and current malaria transmission need to be documented. Methods: A cross-sectional household survey oversampling children under 5 years of age was conducted during the dry season in 2013. A bivalent rapid diagnostic test (RDT) detecting both Plasmodium falciparum and Plasmodium vivax and serology assays using merozoite antigens from both these species were used to assess the prevalence of malaria infections and exposure to malaria parasites in 16 woredas (districts) in Amhara Region. Results: 7878 participants were included, with a mean age of 16.8 years (range 0.5--102.8 years) and 42.0% being children under 5 years of age. The age-adjusted RDT-positivity for P. falciparum and P. vivax infection was 1.5 and 0.4%, respectively, of which 0.05% presented as co-infections. Overall age-adjusted seroprevalence was 30.0% for P. falciparum, 21.8% for P. vivax, and seroprevalence for any malaria species was 39.4%. The prevalence of RDT-positive infections varied by woreda, ranging from 0.0 to 8.3% and by altitude with rates of 3.2, 0.7, and 0.4% at under 2000, 2000--2500 and>2500 m, respectively. Serological analysis showed heterogeneity in transmission intensity by area and altitude and evidence for a change in the force of infection in the mid-2000s. Conclusions: Current and historic malaria transmission across Amhara Region show substantial variation by age and altitude with some settings showing very low or near-zero transmission. Plasmodium vivax infections appear to be lower but relatively more stable across geography and altitude, while P. falciparum is the dominant infection in the higher transmission, low-altitude areas. Age-dependent seroprevalence analyses indicates a drop in transmission occurred in the mid-2000s, coinciding with malaria control scale-up efforts. As malaria parasitaemia rates get very low with elimination efforts, serological evaluation may help track progress to elimination. [ABSTRACT FROM AUTHOR]

Sugarcane primarily cultivated for sugar production and other multiple uses. A field experiment was conducted at Tana Beles sugar project, North western Ethiopia during 2021 and 2022 cropping season to determine the optimum rate of NPSB fertilizer on three sugarcane varieties. The treatments were laid out in factorial randomized complete block design arranged with three replications. The experiment was arranged with five of NPSB blended fertilizer (0, 200, 260, 320 and 380 kg ha-1) combined with three sugarcane varieties (NCO-334, N-14 and C86/56). Among the parameters of seed cane crop; germination percent stalk weight, stalk diameter, node length, inter node number, plant height, stalk population, and sett yield for growth and yield parameters and sett moisture content, sett nitrogen content, reducing sugar content and total sugar content for seed cane quality parameters were significantly affected by applied NPSB fertilizer, varieties and their interaction (p<0.05). Brix% and pol% were not significantly affected by different rates of NPSB fertilizer rates and varieties (p<0.05). The highest leaf area index, plant population, sett yield, average cane weight, seed cane moisture content and total nitrogen content was attained with 380 kg ha-1NPSB fertilizer applied on variety NCO-334 and N-14. Maximum population stand, average plant height, and sett yield of verity C86/56 were recorded at 320 kg ha-1 NPSB fertilizer rate. Sett yield, were positively correlated with germination percent, population stand count, inter node number, seed cane weight, seed cane diameter reducing sugar content, total sugar yield and sett moisture content. Therefore, it is advisable to recommend 380 kg NPSB ha1 for variety NCO-334 and N-14, and 320 kg NPSB ha1 for variety C86/56 with application of 160 kg ha-1 urea at the age of two month and half for effective seed cane production. It was aimed to fill the seed cane fertilizer rate problems of different sugarcane varieties., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Gebeyehu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Adolescents differ from adults not only in biological factors related to age but also in social and psychological characteristics, which may heighten their risk of adverse obstetrical outcomes. This study explores the relationship between maternal age and adverse obstetrical outcomes by comparing adolescent and adult mothers in North Wollo Zone public hospitals, by adjusting for potential confounders such as sociodemographic factors, healthcare access, antenatal care utilization, and pregnancy-related variables. A comparative cross-sectional study was conducted from November 20, 2022, to February 20, 2023, involving 488 mothers to assess adverse obstetrical outcomes among adolescent and adult mothers who gave birth at 28 or more weeks of gestation in North Wollo Zone Public Hospitals, Northern Ethiopia. Data were collected through interviews and clinical chart reviews, then entered into EPI DATA version 4.6.6.0 and analyzed using SPSS version 26. Descriptive statistics summarized the data, and logistic regression identified significant variables (p < 0.05). Adolescent mothers exhibited significantly higher rates of adverse obstetrical outcomes compared to adult mothers, including preterm labor (7.0% vs. 2.0%, p = 0.04), antepartum hemorrhage (11.9% vs. 4.9%, p = 0.014), anemia (19.3% vs. 10.2%, p = 0.006), pregnancy-induced hypertension (11.9% vs. 7.0%, p = 0.047), malpresentation (9.0% vs. 2.5%, p = 0.008), cephalopelvic disproportion (6.1% vs. 1.2%, p = 0.046), major perineal tears (8.6% vs. 3.3%, p = 0.016), and cesarean delivery (16.0% vs. 9.8%, p = 0.04). Adolescent pregnancy is strongly linked to a range of adverse obstetrical outcomes, including preterm labor, antepartum hemorrhage, malpresentation, oligohydramnios, anemia, major perineal tears, and an increased likelihood of cesarean delivery. To mitigate these risks, it is crucial to implement targeted community and health facility-based interventions that focus on preventing adolescent pregnancies and addressing contributing factors, ultimately improving maternal health outcomes among adolescents., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The study adhered to the Declaration of Helsinki and received approval from the Ethical Committee of Wollo University College of Medicine and Health Science (Ref. No. CMHS1354/13/15). Mothers who met the inclusion criteria and gave birth in the study area were invited to participate by consenting to interviews and allowing access to their medical records. Written informed consent was obtained from all participants. Adolescent participants aged 18 and above provided their own written informed consent. For those under 18, written informed consent was obtained from their legal guardians in line with ethical guidelines, while individuals without guardians were categorized as non-respondents. All collected data was treated with strict confidentiality., (© 2025. The Author(s).)

Background: Seasonal migrant workers are at increased risk of malaria and can play a substantial role in transmitting the disease to receptive areas. Assessments conducted among these workers showed a high prevalence of malaria. This qualitative study aimed to explore the contributing factors and challenges to the high malaria prevalence among seasonal migrant workers in agricultural farm areas. The study also sought to identify potential solutions., Methods: A descriptive phenomenological approach was employed to investigate the perceived causes, challenges, and solutions related to malaria prevalence among seasonal migrant workers in the development corridors of southwest Ethiopia. This approach emphasizes describing experiences as they are, without researcher interpretation. Data were gathered from 24 individuals purposefully selected for their close involvement with seasonal migrant workers and their experience with malaria issues in agricultural farm areas. Open-ended questions were used, and interviews were conducted in safe, quiet settings. Data management was performed using Open Code software version 4.03, and thematic analysis was applied to the contents., Results: The study findings identified origin from highland areas, low health-seeking behaviour, working at night, and lack of use of long-lasting insecticidal nets (LLINs) as the perceived causes of high malaria prevalence among seasonal migrant workers by the study participants. Limited collaboration among stakeholders, a lack of migrant-friendly malaria prevention strategies, and inconsistent support for medical supplies were challenges highlighted by the key informants. Therefore, seasonal migrant workers were faced with high risk of malaria due to factors such as lack of immunity, delayed treatment, exposure to mosquitoes, and limited prevention efforts. Addressing these challenges is crucial for reducing malaria prevalence among this vulnerable population., Conclusion: The study findings highlighted the need for targeted interventions to address the specific factors contributing to high malaria prevalence among seasonal migrant workers and to overcome the challenges in implementing effective malaria prevention strategies in this vulnerable population. Further study should be conducted to include the views and positions of seasonal migrant workers, owners of the farm areas, host communities, and political leaders., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical clearance was obtained from the institutional review board of the University of Gondar. Then, the Ethical Committee of the Amhara Regional Health Bureau (ARHB) was approached to get further permission. Local administrations were also informed for permission and facilitation of the study. During data collection, informed consent was sought from all the study participants, and they were informed and assured that interviews and use of audio recorder were completely voluntary. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: Drinking contaminated water is a significant cause of mortality and morbidity in Sub-Saharan Africa, where access to safe drinking water is limited. Although numerous studies have investigated the bacteriological quality of drinking water in Ethiopia, their findings have been inconsistent and varied, hindering the implementation of effective water quality monitoring. Moreover, there is a lack of nationwide assessment of the bacteriological quality of drinking water in Ethiopia. Therefore, this systematic review and meta-analysis aimed to determine the bacteriological quality of drinking water and its associated factors in Ethiopia., Methods: An international electronic database, including PubMed, Science Direct, Global Health, CINAHL, African Journals Online, HINARI, and Google Scholar was employed to retrieve the relevant articles. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) guidelines. A random-effects model was used to estimate the pooled effect size, and the Egger regression model was employed using STATA 14 software to assess potential publication bias., Results: A total of 26 studies involving 7,962 water samples met the eligibility criteria for meta-analysis. The pooled prevalence of at least one bacteriological contamination of drinking water was 52.26% (95%CI: 39.09-65.43), with extreme heterogeneity (I2 = 99.7%; p-value < 0.001). The pooled prevalence of total and fecal coliform in drinking water was 49.55% (95% CI: 34.88-64.23) and 44.27% (95%CI: 34.36-54.19), respectively. 14.13% of the water source was at a very high sanitary risk level (unfit for drinking), with significant heterogeneity (I2 = 94.1%, p< 0.001). The absence of household-level water treatment (OR = 3.3; 95%CI: 1.28-5.32) and drawing water using dipping methods (OR = 4.52; 95%CI: 1.71-7.34) were determinant factors for bacteriological contamination of drinking water., Conclusion: We found that the bacteriological quality of drinking water did not comply with the World Health Organization and Ethiopia's standard guidelines for drinking water, which call for urgent intervention. One out of seven water sources was at a high sanitary risk level, which could increase the risk of infectious disease in the country. The absence of household-level water treatment and drawing water using dipping was a significant factor in the bacteriological quality of drinking water. Based on these findings, the water supply and sewerage authority should prioritize regular monitoring of the bacteriological quality of drinking water., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Daba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The loss of vaccination cards is a momentous public health challenge in the prevention of vaccine-preventable diseases in most developing countries. There is a paucity of studies on the magnitude of vaccination card losses and associated factors in Ethiopia. Therefore, the aim of the current study was to assess the level of vaccination card loss and associated factors in Ethiopia., Methods: Data were extracted from the 2019 Ethiopia Mini Demographic and Health Survey, a nationally representative household survey of women aged 15-49 years with children aged 0-35 months. Data from a total of 3208 mother-child pairs was extracted for the study. A multilevel logistic regression model with random effect analysis techniques was used to identify individual and regional-level determinants of vaccination card loss. We checked the model's fitness by using Akaike Information Criteria and Bayesian Information Criteria. Odds ratios with a 95% Confidence intervals were used to declare statistical significance., Results: A total of 3208 mother-child pairs from nine regions and two city administrations were included in the analysis. The result revealed that 1933 (60.26%) mother-child pairs did not have vaccination cards during home visits. illiterate mother 2.239 (95% CI: 1.297, 3.864), lowest wealth index category 2.089 (95% CI: 1.432, 3.048), ANC non-user 2.047 (95% CI: 1.605, 2.609), children living with their caretaker 6.749 (95% CI: 1.425, 13.654), having no access to television 1.384 (95% CI: 1.150, 1.664), longer birth interval 1.325 (95% CI: 1.027,1.710), giving birth at home and private health facilities 1.985 (95% CI: 1.579, 2.497), 1.696 (1.086, 2.648), contraceptive non-users 1.295 (95% CI: (1.042,1.609) and children aged 12-23 months and 24-35 months 1.577 (95% CI: 1.252, 1.985) and 2.282 (1.803, 2.889) were associated with vaccination card loss., Conclusions: Overall vaccination card loss among mothers of 0-35-month-old children is considerably high. To enhance maternal awareness regarding the significance of vaccination cards, promote antenatal care and public health facility delivery, and future researchers have to explore how to enhance vaccination card retention in Ethiopia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Edossa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Brucellosis is a neglected zoonotic disease often contracted through contact with animals and consumption of unpasteurized dairy products. Despite being the most common cause of non-malarial acute febrile illness brucellosis is often misdiagnosed in healthcare setups. The global incidence of Brucella infection is reported to be over 2 million cases annually. In Ethiopia, there are varying reports on the prevalence of brucellosis, and just a few researches have been undertaken on the prevalence among febrile patients. Therefore, this study aimed to determine sero-prevalence of human brucellosis and associated factors among febrile patients attending Moyale Primary Hospital in southern Ethiopia., Methods: Cross-sectional study was conducted on 293 febrile patients attending Moyale Primary Hospital. We used convenience sampling technique. Blood specimen was collected and screened for Brucella antibody using Rose-Bengal plate test and ELISA was used for confirmation of Brucella infection. We used a questionnaire to collect socio-demographic data and to assess associated factors (S1 Table). Bivariate and subsequent multivariable logistic regression was performed to explore associated factors with the prevalence of human brucellosis., Results: The sero-prevalence of human brucellosis in this study was 13% (95% CI: 9.5, 16.5). Majority of the study participants (58.7%) were rural dwellers; 54.6% were male and the age range was from 5 to 80 years (mean = 24.17, SD = ±15.9). Higher number of sero-prevalence was seen among rural residents (19.8%) and male participants (14.40%). Drinking unpasteurized camel milk (AOR = 11.62, 95% CI: 3.85, 17.13; P = 0.000) and rural residence (AOR = 7.21, 95% CI: 2.48, 15.90; P = 0.000) were significantly associated with brucellosis. Consumption of pasteurized milk was shown to have protective effect (AOR = 6.12, 95% CI: 1.26, 29.76; P = 0.025) against brucellosis., Conclusion: The current study showed 13% point prevalence of human brucellosis among febrile patients attending Moyale Primary Hospital. Consuming unpasteurized milk, particularly unpasteurized camel milk, and rural residence was significantly associated with Brucella infection. Awareness creation about the zoonotic nature of brucellosis and the role of unpasteurized milk in the transmission of the disease is important to control human brucellosis., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Sileshi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Schistosoma mansoni and soil-transmitted helminth (STH) infections are major public health problems in areas with poor sanitation and limited access to water. In Ethiopia, there is limited data available for monitoring the efficacy of interventions aimed at reducing helminth infections. Therefore, we assessed the prevalence of S. mansoni and STH infections, as well as factors associated with this prevalence, among schoolchildren and compared the findings with those of earlier studies. We also evaluated the diagnostic agreement between two parasitological methods., Methods: A cross-sectional study involving 363 schoolchildren from three rural primary schools located along the shore of Lake Hawassa, Sidama Regional State, southern Ethiopia, was conducted in October and November 2023. The schoolchildren were selected using a systematic random sampling technique. Socio-demographic data were collected using pre-structured questionnaires. A single stool sample was collected from each study participant and processed using direct wet mount (DM) microscopy and the formol-ether concentration technique (FECT) to detect helminth ova., Results: The overall prevalence of helminths was 59.8%, with 36.6% of participating children having a single infection and 23.1% having multiple infections. Schistosoma mansoni and STHs were present in 33.9% and 38.8% of children, respectively. The STHs included Ascaris lumbricoides (28.9% of children), Trichuris trichiura (10.7%), hookworms (5.2%) and Strongyloides stercoralis (2.8%). Diagnostic agreement between the DM microscopy method and FECT was substantial [kappa (κ) = 0.710] for the detection of Hymenolepis nana and almost perfect (κ = 0.827) for the dection of A. lumbricoides, but only fair for the detection of other detected helminths. Children at Finchawa primary school had a lower prevalence of S. mansoni infection [adjusted odds ratio (AOR) 0.31; 95% confidence interval (CI) 0.13-0.76] than those at St Paul's Tullo Catholic primary school. STH infections were more common among children who sometimes (vs. always) washed their hands before meals (AOR 1.89; 95% CI 1.01-3.54) and those who regularly played with soil (AOR 2.56; 95% CI 1.47-4.46)., Conclusions: This study showed a reduction in STH infections from a high prevalence in 2015 to a moderate prevalence at the present time, despite a similar moderate prevalence of S. mansoni infection. Thus, it is crucial to intensify deworming interventions to reduce the burden of helminths in the study area. Additionally, there is a need to enhance the capacity of clinical laboratories to perform FECT in Ethiopian clinical settings where DM is often employed to diagnose helminths., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval for the study was obtained from the Institutional Review Board of Hawassa University College of Medicine and Health Sciences (Ref. No: IRB/205/15). Participation was fully voluntary, with written informed consent obtained from the parents/guardians of the children enrolled. Assent  was obtained from students aged ≥ 12 years, following parent/guardian consent. Schoolchildren found to be positive for any pathogenic intestinal parasite were treated by public health professionals. All information obtained in the process of this study was kept confidential and used solely for research purposes. All methods were carried out in accordance with relevant guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests., (© 2024. The Author(s).)

Rotavirus A (RVA) is one of the major viral causes of acute gastroenteritis in calves globally. Bovine RVA can represent a public health concern as it is capable of zoonotic transmission. We assessed the burden, genotype distribution, and zoonotic potential of RVA among calves in Amhara National Regional State, Ethiopia. A multi-center cross-sectional study was conducted involving a total of 266 calves. Clinical data and fecal samples were collected by trained veterinarians. Total RNA was extracted using QIAamp viral RNA mini kit and RVA was detected by One-step qRT-PCR. Amplification and Sanger sequencing of VP7 and VP4 genes were performed to determine G-types and P-types of the circulating RVA, respectively. The prevalence of RVA among calves was 41/266 (15.4 %, 95 % CI = 11.3 %-19.5 %). The circulating G-types were G6, G8, and G10, while the circulating P-types were P[1], P[4], P[8], P[11], P[13] and P[14]. G10P[11] (37.5 %) followed by G6P[14] (18.8 %), and G6P[1] (12.5 %) were the dominant G/P combinations circulating among calves in the study area. The circulating bovine RVA strains including human-like bovine (GxP[4] and GxP[8]) and porcine-like bovine (G8P[13]) P-genotypes identified in calves were closely related to RVA strains globally reported from bovine, human, caprine, porcine, and other hosts. Our data reveal that the prevalence of RVA in calves is significant with diverse genotypes circulating in the study area with a potential for zoonosis and/or reverse zoonosis. Hence, continuous surveillance of the circulating RVA genotypes is crucial to curb the RVA-associated morbidity and mortality in cattle and human populations., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: Pesticide exposure is a major public health issue among farmers affecting make it their health, economic stability, and agricultural productivity. This study aimed to investigate the magnitude and determinants of farmers' knowledge of health risks, safety practices, and acute pesticide poisoning in the South Wollo Zone, Ethiopia., Methods: A community-based cross-sectional study was conducted in the South Wollo Zone's irrigation areas from July to August 2022. Using a multistage sampling technique, five out of ten irrigation districts were randomly selected, and three kebeles (the smallest administrative unit) from each district (15 total) were chosen based on intensive irrigation activities. A proportional sample size was allocated across the selected kebeles according to the number of farmers. Trained data collectors conducted face-to-face interviews using a pretested structured questionnaire. Crude and adjusted odds ratios with 95% confidence intervals at a p -value of 0.05 identified statistically significant factors., Result: The study found that 55.2% of farmers had below mean knowledge of health risks, 63.7% practiced below mean safety practices, and 47.9% experienced acute pesticide poisoning. Significant factors for below mean knowledge included no formal education (AOR = 2.32; 95% CI: 1.27-4.23) and lack of pesticide training (AOR = 2.07; 95% CI: 1.33-3.21). Below mean safety practices were associated with age > 47 years (AOR = 2.07; 95% CI: 1.06-4.04), below mean retailer actions (AOR = 1.97; 95% CI: 1.34-2.89), and below mean attitude (AOR = 1.79; 95% CI: 1.23-2.62). Acute pesticide poisoning was significantly associated with over 10 years of exposure (AOR = 4.34; 95% CI: 2.55-7.39), below mean knowledge (AOR = 2.17; 95% CI: 1.23-2.62), lack of training (AOR = 3.73; 95% CI: 2.33-5.98), and below mean safety practices (AOR = 4.40; 95% CI: 2.86-6.78)., Conclusion: Farmers' knowledge of health risks and safety practices was not satisfactory. Low educational status, lack of training, and minimal government involvement were associated with below mean knowledge. Below mean knowledge and below mean safety practices, low education, lack of training, and minimal government involvement were associated with acute pesticide poisoning. Young farmers, limited retailer involvement, and below mean attitudes contribute to unsafe practices., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Keleb, Ademas, Abebe, Berihun, Desye and Bezie.)

Background: The ability of an expert's item difficulty ratings to predict test-taker actual performance is an important aspect of licensure examinations. Expert judgment is used as a primary source of information for users to make prior decisions to determine the pass rate of test takers. The nature of raters involved in predicting item difficulty is central to set credible standards. Therefore, this study aimed to assess and compare raters' prediction and actual Multiple-Choice Questions' difficulty of the undergraduate medicine licensure examination (UGMLE) in Ethiopia., Method: 815 examinees' responses to 200 Multiple-Choice Questions (MCQs) were used in this study. The study also included experts' item difficulty ratings of seven physicians who participated in the standard settings of UGMLE. Then, analysis was conducted to understand experts' rating variation in predicting the actual difficulty levels of examinees. Descriptive statistics was used to profile the mean rater's and actual difficulty value for MCQs, and ANOVA was used to compare the mean differences between raters' prediction of item difficulty. Additionally, regression analysis was used to understand the interrater variations in item difficulty predictions compared to the actual difficulty. The proportion of variance of actual difficulty explained from rater prediction was computed using regression analysis., Results: In this study, the mean difference between raters' prediction and examinees' actual performance was inconsistent across the exam domains. The study revealed a statistically significant strong positive correlation between the actual and predicted item difficulty in exam domains eight and eleven. However, a non-statistically significant very weak positive correlation was reported in exam domains seven and twelve. The multiple comparison analysis showed significant differences in mean item difficulty ratings between raters. In the regression analysis, experts' item difficulty ratings of the UGMLE had 33% power in predicting the actual difficulty level. The regression model also showed a moderate positive correlation (R = 0.57) that was statistically significant at F (6, 193) = 15.58, P = 0.001., Conclusion: This study demonstrated the complex process for assessing the difficulty level of MCQs in the UGMLE and emphasized the benefits of using experts' ratings in advance. To ensure the exams maintain the necessary reliable and valid scores, raters' accuracy on the UGMLE must be improved. To achieve this, techniques that align with the evolving assessment methodologies must be developed., (© 2024. The Author(s).)

Streptococcus pneumoniae, a medically important opportunistic bacterial pathogen of the upper respiratory tract, is a major public health concern, causing a wide range of pneumococcal illnesses, both invasive and noninvasive. It is associated with significant global morbidity and mortality, including pneumonia, meningitis, sepsis, and acute otitis media. The major purpose of this study was to determine the molecular epidemiology of Streptococcus pneumoniae strains that cause invasive and noninvasive infections in Ethiopia. A prospective study was undertaken in two regional hospitals between January 2018 and December 2019. Whole-genome sequencing was used to analyze all isolates. Serotypes and multilocus sequence types (MLST) were derived from genomic data. The E-test was used for antimicrobial susceptibility testing. Patient samples obtained 54 Streptococcus pneumoniae isolates, 33 from invasive and 21 from noninvasive specimens. Our findings identified 32 serotypes expressed by 25 Global Pneumococcal Sequence Clusters (GPSCs) and 42 sequence types (STs), including 21 new STs. The most common sequence types among the invasive isolates were ST3500, ST5368, ST11162, ST15425, ST15555, ST15559, and ST15561 (2/33, 6% each). These sequence types were linked to serotypes 8, 7 C, 15B/C, 16 F, 10 A, 15B, and 6 A, respectively. Among the noninvasive isolates, only ST15432, associated with serotype 23 A, had numerous isolates (4/21, 19%). Serotype 14 was revealed as the most resistant strain to penicillin G, whereas isolates from serotypes 3, 8, 7 C, and 10 A were resistant to erythromycin. Notably, all serotype 6 A isolates were resistant to both erythromycin and penicillin G. Our findings revealed an abnormally significant number of novel STs, as well as extremely diversified serotypes and sequence types, implying that Ethiopia may serve as a breeding ground for novel STs. Recombination can produce novel STs that cause capsular switching. This has the potential to influence how immunization campaigns affect the burden of invasive pneumococcal illness. The findings highlight the importance of continuous genetic surveillance of the pneumococcal population as a vital step toward enhancing future vaccine design., (© 2024. The Author(s).)

Background: Poor surgical outcomes remain a problem in trachoma-endemic countries working to reach elimination thresholds. Methods to improve outcomes could positively impact programmatic success., Methods: This parallel, three-armed clinical trial conducted in Ethiopia randomized individuals with previously unoperated trachomatous trichiasis (TT) to receive surgery utilizing one of three approaches: bilamellar tarsal rotation with a 3 mm incision height (BLTR-3), BLTR with 5 mm incision height (BLTR-5) and posterior lamellar tarsal rotation (PLTR). We followed participants for one year. The primary outcome was post-operative trichiasis (PTT). Secondary outcomes were eyelid contour abnormalities (ECA) and pyogenic granulomata., Findings: We randomized and operated on 4,914 individuals with previously unoperated TT (6,940 eyes). Primary analyses include 6,815 eyes with follow-up. Overall, 1,149 (16.9%) eyes developed PTT. The risk difference for PTT was minimal comparing BLTR-3 and PLTR (adjusted risk difference [aRD] 1.8% (98.3%CI: -0.5-4.2%)), but significantly higher for BLTR-5 surgeries compared to BLTR-3 (aRD: 6.7% (3.9-9.4%)) and PLTR (aRD: 8.6% (5.9-11.3%)). BLTR-5 had the lowest ECA (6.1% versus 9.6% BLTR-3, 11.2% PLTR) and granuloma rates (5.2% versus 6.5% BLTR-3 and 7.5% PLTR). One eyelid operated with PLTR experienced an eyelid margin division; four BLTR-3 and eight BLTR-5 eyelids experienced excessive bleeding., Interpretation: We do not recommend modifying the BLTR incision height of 3 mm. Overall, we did not find a significant difference in PTT between BLTR-3 and PLTR in terms of PTT or ECA., Trial Registration: Registration number: NCT03100747; ClinicalTrials.gov Full study protocol available at (https://doi.org/10.15139/S3/QHZXWD)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gower et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Indigenous institutions play a vital role in fighting HIV stigma by leveraging their cultural knowledge, leadership, and community connections. Understanding HIV/AIDS attitudes, information gaps, and stigma among members of indigenous institutions is critical for devising culturally relevant and successful interventions and preventative strategies. This study was conducted with the objective of assessing the levels of knowledge about HIV/AIDS and the various HIV/AIDS discriminatory attitudes and practices among members of the Awi Equestrian Association, an indigenous association in Awi Zone, Northwest Ethiopia, that plays major roles in the social, cultural, political, and economic activities of the community. The study is a cross-sectional study conducted from June through July 2022. Eight hundred and forty-six people in the study area were interviewed using a pilot-tested questionnaire. Multiple linear regression analysis was used to identify factors associated with the score level of HIV-related stigma. Forty-five percent of study participants did not have adequate knowledge of HIV/AIDS, and 67.4% had moderate to high discriminatory attitudes towards people living with HIV. HIV-stigmatizing practices were high, with 36% admitting to speaking badly about people living with HIV and 23% wanting their relative with HIV to seek treatment in another zone. In our study, low level of knowledge about HIV/AIDS ( p < 0.001), older age ( p < 0.05), and male sex ( p < 0.05) were factors associated with higher levels of stigmatizing practices. In conclusion, HIV-related stigma is common in Awi Zone. The Awi Equestrian Association has become a unique potential partner for HIV control in the area in an effort to achieve United Nation AIDS target of 95-95-95.

Background: Reports showed that Amhara Region is accounting for 31% of Ethiopia`s malaria burden. Reports also depicted that despite the existing malaria vector control tools implemented by the regional government, currently there is an increment in malaria prevalence in the region. This might be due to lack of entomological monitoring and comprehensive information on the prevailing species composition, infection rate and feeding presences of An. mosquito species in the study areas. Therefore, this study aimed to address this information., Methods: A community-based cross-sectional study was conducted from 18 February to 30 March 2023 at three districts of the west Amhara Region. For this, six CDC light traps (three indoor and three outdoor) were used to collect adult female An. mosquito species. In this study, 261 An. mosquito species comprising seven species were collected. Their morphological identification and abdominal status determination were carried out using standard morphological identification keys under a dissection microscope. While their infection rates and blood meal sources were determined, using circumsporozoite protein-ELISA and blood meal-ELISA based on the standard protocol. Data were entered to SPSS versions 20 for analysis and p- value < 0.05 was considered as statistically significant., Results: In our study, total of 261 An. mosquito species were identified. An. demeilloni was the most abundant species accounted for 112(42.9%) of all captures. It was also the most predominant species at Ayehu-Guagusa followed by Jabitehnan districts. An. demeilloni and An. cinereus altogether accounting for infection rate of 3(1.1%) for P. vivax parasite. Furthermore, our study showed that more than 50% of An. mosquito species collected fed on cattle blood showing shifting of feeding behaviors., Conclusions: Our study depicted that An. demeilloni and An. cinereus were the most abundant species and infected with P. vivax parasite. Therefore, further comprehensive study should be done in the future., Competing Interests: he authors have declared that no competing interests exist., (Copyright: © 2024 Yimer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Patient satisfaction is a critical measure of the quality of healthcare services provided by healthcare facilities. However, very few studies, particularly in Ethiopia, which includes the study area, have specifically examined these discrepancies among people who use outpatient care. In this study, satisfaction levels and associated factors were compared between insured and uninsured patients receiving outpatient services at public health institutions in Hadiya Zone, southern Ethiopia., Methods: A facility-based comparative cross-sectional study design was employed on 630 patients using multistage and systematic random sampling. Data were collected using a pretested and structured interviewer-administered questionnaire. Results of the analysis were presented in text, tables, and graphs as appropriate. Multivariable logistic regression was used to predict associations between predictors and the outcome variable. Statistical significance was declared at p-value < 0.05., Results: Overall, 344(55.48%) patients were satisfied with the service they received, of which 206(65.8%) out of 313 with a 95% CI [60.7-71.2%] were insured and 138(44.95%) out of 307 with a 95% CI [39.4-5.1%] were uninsured. Among insured patients, factors associated with higher satisfaction included having a family size less than five members [AOR = 3.3, 95% CI; 1.5, 7.4], perceived fair waiting time to be seen[AOR = 2.35, 95% CI; 1.02, 5.5], perceived short waiting time to be seen[AOR = 8.12, 95% CI; 1.6, 41.3], having all ordered laboratory tests available within the facility[AOR = 7.89, 95% CI; 3.5, 17.5], having some ordered laboratory tests within the facility[AOR = 2.97, 95% CI; 1.25, 7.01] having all prescribed medications available within the facility[AOR = 16.11, 95% CI; 6.25, 41.5], having some prescribed medications available within the facility[AOR = 13.11, 95% CI; 4.7, 36.4]. Among non-insured patients, factors associated with higher satisfaction included urban residency, a fair and short perceived time to be seen, having ordered laboratory tests within the facility, and having prescribed drugs within the facility., Conclusion: This study identified lower overall satisfaction, particularly among uninsured patients. Enrollment in the CBHI program significantly impacted satisfaction, with both groups reporting lower levels compared to enrollment periods. Access to essential services, wait times, and socio-demographic factors identified as associated factors with patient satisfaction regardless of insurance status., (© 2024. The Author(s).)

Background: Children with under-five year age disproportionally affected with foodborne illness. Campylobacteriosis is the most common foodborne disease next to Norovirus infection. Macrolides are commonly prescribed as the first line of treatment for Campylobacter gastroenteritis, with fluoroquinolone and tetracycline as secondary options. However, resistance to these alternatives has been reported in various regions worldwide., Objective: To determine the prevalence, associated risk-factors and antimicrobial resistance of Campylobacter jejuni and C. coli among under-five children with diarrhea., Methods: Institution-based cross-sectional study was conducted from November, 2022 to April 2023. The study sites were selected using a random sampling technique, while the study subjects were included using a convenient sampling technique. The data were collected using a structured questionnaire. Stool samples were inoculated onto modified charcoal cefoperazone deoxycholate agar and incubated for 48 hours. The suspected colonies were analyzed using matrix-assisted laser desorption ionization-time of flight mass spectrometry to confirm the species. Antimicrobial susceptibility testing was performed using a disc diffusion technique. All potential covariates (independent variables) were analyzed one by one using bivariate logistic regression model to identify candidate variables with P value < 0.25. Multivariable logistic analysis was used to identify potential associated factors using the candidate variables. A p value ≤ 0.05 at a 95% confidence interval was statistically significant., Result: Among the 428 samples, 7.0% (CI: 4.5-9.3) were confirmed Campylobacter species. The prevalence of C. jejuni and C. coli among under-five children was 5.1% (CI: 3.0-7.0) and 1.9% (CI: 0.7-3.3), respectively. C. jejuni (73.3%) was dominant over C. coli (26.7%). The resident, contact with domestic animals, and parents/guardians education level were significantly associated with campylobacteriosis among under-five children. One-third of the Campylobacter isolates (33.3%, 10/30) were resistant to ciprofloxacin and tetracycline whereas 10.0% (3/30) were resistant to erythromycin. Furthermore, 3.3% (1/30) of the Campylobacter were found to be multidrug-resistant., Conclusion: The prevalence of Campylobacter species was 7.0%. The resistance rate of Campylobacter species of ciprofloxacin and tetracycline-resistance strains was 33.3%. Peri-urban residence, contact with domestic animals, and low parental educational statuses were significantly associated factors with increased risk of Campylobacter infection. Continuous surveillance on antimicrobial resistance and health education of personal and environmental hygiene should be implemented in the community., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Worku et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: The public health concern of tobacco smoking is more prevalent in low- and middle-income countries including Ethiopia. Various studies have investigated tobacco smoking in various parts of Ethiopia. However, the findings have been inconsistent and characterized by significant variability. Besides, there is no nationally representative data on the subject, which could deter the design of effective intervention strategies to reduce tobacco-related problems. Therefore, this study aimed to estimate the pooled prevalence of tobacco smoking and associated factors among adults in Ethiopia., Methods: The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Guideline. A detailed search was conducted from international databases including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google Scholar. The extracted data was analyzed using STATA 14 software. A random-effects model was used to estimate the effect size. The Egger regression test and I 2 statistics were used to determine potential publication bias and heterogeneity among the reviewed articles, respectively., Results: A total of 32 studies with 69,897 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime tobacco smoking among adults in Ethiopia was 16.0% (95% confidence Interval (CI): 13.6-18.39) and there was significant heterogeneity among the included studies (I 2  = 99.1%, p  < 0.001). Male adults were three times more likely to smoke tobacco as compared with females [OR = 3.22 (95% CI: 2.06-5.03)]. Being an alcohol user [OR = 3.78 (95%CI: 1.27-11.24)] and having tobacco-smoking friends [OR = 7.21 (95%CI: 5.56-9.35)] are potential determinant factors for tobacco smoking., Conclusion: The pooled prevalence of lifetime and current tobacco smoking among adults in Ethiopia was high, which calls for urgent intervention. Therefore, prioritization of tobacco control strategies, such as creating awareness about the public health importance of tobacco smoking, can help prevent and mitigate the effects of tobacco smoking. Alcohol control law enforcement should also be strengthened., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Daba, Atamo, Debela, Dagne, Desye and Gebrehiwot.)

Introduction: Musculoskeletal disorders are the leading cause of illness, disability, and poor quality of life. Lack of access to potable water in the backyard forces women to take water from off-plot sources every day, which may expose them to various health risks. However, there has been little investigation on the musculoskeletal disorders' health effects on water-carrying women., Objective: This study aimed to assess musculoskeletal disorders symptoms and associated factors among water-carrying women in the Legambo district, Northeastern Ethiopia., Materials and Methods: A community-based cross-sectional study was done with 618 water-carrying women chosen using simple random and systematic random sampling techniques. The data were collected using face-to-face interviews with the standard Nordic Musculoskeletal Questionnaire. Data entry were carried out using Epi-data version 4.6 and exported to SPSS version 25.0 for analysis. A binary logistic regression was used to determine the factors associated with self-reported musculoskeletal disorder symptoms at a 95% confidence interval (CI). In the multivariate model, variables with a p -value ≤0.05 and a 95% CI were declared as factors of self-reported musculoskeletal disorder symptoms. The model's fitness was assessed using Hosmer and Lemeshow, and it was found to be fit., Results: The prevalence of self-reported MSD symptoms was 72.5% during the previous 12 months. MSD symptoms were significantly elevated among women who carried water from a distance of 501-1,000 m [adjusted odds ratio (AOR) = 5.39, 95% CI = 3.64-9.69] and >1,000 m (5.93, 2.84-12.40), carried a water load of >15 kg during pregnancy (8.29, 2.97-23.09), and carried a water load of >15 kg when not pregnant (1.59, 1.44-2.68)., Conclusion: Three-fourths of the participants had self-reported musculoskeletal disorder symptoms in the past 12 months. Distance of water sources from their house, carrying the same amount of water during pregnancy, and weight of the water load carrying were factors associated with the self-reported musculoskeletal disorder symptoms. Hence, health professionals should raise awareness of the association between carrying high water loads and the development of MSDs, especially during pregnancy. Improvement in water supply infrastructure and enhancing behavioral intervention should be done. Furthermore, Future researchers should assess MSDs using objective measurements and cohort studies should be implemented., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Berihun, Gasheya, Abebaw, Abebe, Gizeyiatu, Berhanu, Dagne, Desye, Walle, Zewdu and Wondim.)

Introduction: Cigarette smoking is a persistent public health problem as it is a risk factor for many diseases. Previous studies on the role of illegal drug use in cigarette smoking have yielded disparate and inconclusive results, hindering the development of effective intervention strategies to address this issue. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of cigarette smoking and its associated factors, with a specific focus on the influence of illegal drug use among students in Ethiopia., Methods: We conducted a comprehensive search of international databases, including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google and Google Scholar. Grey literature was also identified from various university digital libraries. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. Due to the high heterogeneity among the included studies (I2 = 98.6%; p-value <0.001), we employed a random-effects model with a 95% confidence interval (CI) to estimate the pooled effect using STATA 14 software. The publication bias was assessed using a statistical Egger regression test., Results: A total of 22 studies involving 18,144 students met the eligibility criteria for this systematic review and meta-analysis. The pooled prevalence of lifetime and current cigarette smoking among students in Ethiopia was 13.8% (95% CI: 9.90-17.82) and 9.61% (95% CI: 7.19-12.03), respectively. Students who used illegal drugs were twenty-three times more likely to smoke cigarettes compared to their counterparts (OR = 23.57, 95% CI: 10.87-51.1). Living in urban settings (OR = 2.9; 95% CI: 1.15-7.28) and the habit of alcohol consumption (OR = 4.79; 95% CI: 1.57-14.64) were also identified as factors associated with cigarette smoking., Conclusions: We found that more than one in eight students in Ethiopia have engaged in lifetime cigarette smoking. Notably, students who used illegal drugs exhibited a significantly higher likelihood of cigarette smoking. In light of these findings, it is imperative to implement comprehensive public health interventions that target illegal drug use, cigarette smoking, and alcohol consumption, with a particular emphasis on urban residents., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Daba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Millions of working equids provide socio-economic support for many low-income communities worldwide. With the prevalence of harness-related wounds reported as higher than 60%, this study aims to describe the equipment used by working equids in three locations of the Ethiopian national regional state of Oromia (Fiche, Bishoftu and Shashamene), and the attitudes and practices of equid owners, users and harness makers regarding work equipment. This mixed-methods study consists of cross-sectional surveying of working equids used for taxi or transport of goods or water, as well as cart-driver questionnaires and focus groups (FG) with working equid stakeholders. Activities conducted with FG included participatory ranking of equipment attributes and equipment drawing exercises. Indicators of equipment design and assembly, as well as cart-driver attitudes and practices were described quantitatively. Associations between equipment characteristics and species, work-type and cart-driver indicators were investigated through univariable logistic regression models, whereas focus group discussions were transcribed and analysed thematically., Results: In total, 368 working equid surveys and cart-driver questionnaires were completed and 87 participants took part in nine FG. Equipment composition and characteristics differed considerably from ideal animal draught and harnessing principles described in the literature, with none of the observed harnesses adhering to all principles and thus not considered fully adequate. Various harness compositions were used, with only saddles and breast collars present in all. Donkey equipment had fewer components than that of horses, such as swingle trees (OR 0.02; 95% CI 0.01-0.06; p < 0.001) or girths (OR 0.09; 95%CI 0.02-0.4; p = 0.002). Horse equipment was more likely to have functional elements such as breeching (OR 7.8; 95% CI 2.9-20.9; p < 0.001). Of all equipment attributes, FG participants ranked cost, design and impact on animal wellbeing as having the highest importance. Thematic analysis identified motivations and priorities regarding equipment; awareness and knowledge of design and function; barriers to using ideal equipment; and consequences of equipment design and practices as key themes., Conclusions: Various weaknesses of design, assembly and use of equid work equipment were identified. Promoting behavioural change through awareness and training could lead to a sustainable improvement of work equipment quality, access, and prevention of equipment-related problems., (© 2024. The Author(s).)

Background: Although there have been consistent improvements in maternal mortality, it remains high in developing countries due to unequal access to healthcare services during pregnancy and childbirth. Thus, this study aimed to further analyze the variations in the number of antenatal care utilizations and associated factors among pregnant women in urban and rural Ethiopia., Methods: A total of 3962 pregnant women were included in the analysis of 2019 Ethiopian Demographic and Health Survey data. A negative binomial Poisson regression statistical model was used to analyze the data using STATA version 14.0. An incident rate ratio with a 95% confidence interval was used to show the significantly associated variables., Results: Of the 3962 (weighted 3916.67) pregnant women, about 155 (15.21%) lived in urban and 848 (29.29%) rural residences and did not use antenatal care services in 2019. Women age group 20-24 (IRR = 1.30, 95%CI:1.05-1.61), 25-29 (IRR = 1.56, 95%CI:1.27-1.92), 30-34 (IRR = 1.65, 95%CI:1.33-2.05), and 35-39 years old (IRR = 1.55, 95%CI:1.18-2.03), attending primary, secondary, and higher education (IRR = 1.18, 95%CI:1.07-1.30), (IRR = 1.26, 95%CI:1.13-1.42) and (IRR = 1.25, 95%CI:1.11-1.41) respectively, reside in middle household wealth (IRR = 1.31, 95%CI:1.13-1.52), richer (IRR = 1.45, 95%CI:1.26-1.66) and richest (IRR = 1.68, 95%CI:1.46-1.93) increases the number of antenatal care utilization among urban residences. While attending primary (IRR = 1.34, 95%CI:1.24-1.45), secondary (IRR = 1.54, 95%CI:1.34-1.76) and higher education (IRR = 1.58, 95%CI:1.28-1.95), following Protestant (IRR = 0.76, 95%CI:0.69-0.83), Muslim (IRR = 0.79, 95%CI:0.73-0.85) and Others (IRR = 0.56, 95%CI:0.43-0.71) religions, reside in poorer, middle, richer, and richest household wealth (IRR = 1.51, 95%CI:1.37-1.67), (IRR = 1.66, 95%CI:1.50-1.83), (IRR = 1.71, 95%CI:1.55-1.91) and (IRR = 1.89, 95%CI:1.72-2.09) respectively, being married and widowed/separated (IRR = 1.85, 95%CI:1.19-2.86), and (IRR = 1.95, 95%CI:1.24-3.07) respectively were significantly associated with the number of antenatal care utilization among rural residences., Conclusion: The utilization of antenatal care is low among rural residents than among urban residents. To increase the frequency of antenatal care utilization, health extension workers and supporting actors should give special attention to pregnant women with low socioeconomic and educational levels through a safety-net lens., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Endale et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Twenty-one morphometric traits were measured on 770 extensively managed indigenous chickens in the western zone of Tigray, comprising 412 hens and 358 cocks in three agro-ecologies. The quantitative traits for male and female chicken ecotypes were separately analyzed using multivariate analysis with SAS 2008. Four and seven principal components accounted for about 74.26% and 69.77% of the total variability in morphometric traits for males and females, respectively. Earlobe length, wingspan, skull length, and shank length werethe most important traits for discriminating among female chicken ecotypes, while wingspan, neck length, earlobe length, spur length, body length, and shank length were the most important discriminatory traits among male chicken ecotypes. The discriminant analysis accurately classified 97.3% of female and 100% of male chicken ecotypes. Cluster analysis revealed the genetic heterogeneity of indigenous chicken populations in both sexes. This finding suggests the presence of morphological variations among the indigenous chicken populations in the different agro-ecological zones, classified as distinct indigenous chicken ecotypes (Lowland, Midland, and Highland). Further DNA-based studies are needed to confirm and complement these morphological variations for effective conservation and the development of sustainable genetic improvement strategies for indigenous chicken populations in the region., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Markos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Charcoal production stemming from small-scale Eucalyptus camaldulensis plantations has brought about significant socio-economic benefits and improved livelihoods in Ethiopia. Nevertheless, the current practice involves the use of traditional earth mound kilns, leading to inefficiencies, reduced charcoal income, and environmental pollution. This research aims to assess charcoal conversion efficiency, perform a cost-benefit analysis, and measure gas emissions from improved charcoal-making kilns sourced from Eucalyptus camaldulensis small-scale plantations in comparison to traditional earth mound kilns in northwestern Ethiopia. A one-way analysis of variance (ANOVA) was executed, with a significance level set at 0.05. The study results indicate a significant (P < 0.001) disparity in charcoal conversion efficiency across the various tested kilns, with the ranking as follows: Green mad retort kiln (33.7%) > Casamance kiln (32.09%) > MRV steel kiln (28.25%) > traditional earth mound kilns (23.55%). The improved charcoal-making kilns enhanced wood-to-charcoal conversion efficiency by 20-43% compared to traditional earth mound kilns. In terms of financial viability, Casamance improved kilns generated the highest equivalent annual charcoal income (117,126.9 ETB/year), followed by Green Mad Retort (82,893.8 ETB/year) and MRV steel kilns (58,495.9 ETB/year). As anticipated, traditional earth mound kilns yielded the lowest net present value (47,304.3 ETB/year). Traditional earth mound kilns also exhibited significantly longer carbonization times (P < 0.001), taking 3.6 times longer than the Mark V kiln and 2 times longer than the Casamance kiln. Furthermore, the statistical analysis demonstrated that improved charcoal-making technology reduced carbon dioxide (CO2) emissions by 36.1-50.7%, carbon monoxide (CO) emissions by 39.2-54.3%, and methane (CH4) emissions by 29.6-47%. In conclusion, the use of improved charcoal-making kilns has demonstrated significant enhancements in charcoal conversion efficiency, charcoal income, and environmental sustainability. Given these positive outcomes, we strongly recommend a decisive transition from traditional to cleaner, sustainable, and less emissions-intensive charcoal making kilns., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: The use of swimming pool water for recreation, rehabilitation, and athletics is widespread around the world, especially in large Cities and Towns. However, poorly managed swimming pool water can facilitate the spread of illnesses connected to recreational water. Despite this, there is no evidence on quality of swimming pools water in Kombolcha Town. Therefore, this study was aimed to evaluate the physicochemical and bacteriological quality of swimming pools water in Kombolcha Town., Methods: A laboratory-based cross-sectional study was conducted from February to April, 2021 in Kombolcha Town. A total of 90 water samples were collected from the three outdoor swimming pools. The collected data of both physicochemical and bacteriological parameters were entered into Microsoft Excel 2010 and analyzed using SPSS version 25.0. One-way ANOVA was used to test whether there were statistically significant differences between different swimming pools. The level of significance was declared at a p -value of <0.05., Results: In this study, out of all the pool water samples that were examined, 37.8% had pH values between 7.2 and 7.8, 36.7% had temperatures between 21°C and 32°C, and 26.7% had turbidity values that were within the WHO standard. Furthermore, only 16.7% of the pool water samples showed residual chlorine levels of 2-3 mg/L. In addition, only 27.8, 35.6, and 32.2% of the samples, respectively, met the WHO criterion for total coliform, fecal coliform, and heterotrophic plate count., Conclusion: The result indicates that most pool water samples did not fulfill both the physicochemical and bacteriological quality of the WHO standard limit for swimming pools. Thus, it is crucial to clean and regularly check the pool water, apply pool safety requirements, and raise pool user's awareness about the danger of pool water pollution through training., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Natnael, Hassen, Desye and Woretaw.)

Background: Shiga toxin-producing Escherichia coli O157:H7 (STEC O157:H7) is a zoonotic pathogen that causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome worldwide. This study aimed to determine the prevalence, antibiotic susceptibility, and associated risk factors of STEC O157:H7 among diarrheic patients and their cattle., Methods: A cross-sectional study was conducted among diarrheic patients and their cattle in Amhara National Regional State, Ethiopia from December- 2020 to June- 2022. A total of 1,149 diarrheic patients and 229 cattle were included in the study. STEC O157:H7 detection was done using culture, latex agglutination test, and polymerase chain reaction on diarrheic stool samples and recto-anal mucosal swabs of cattle. Antibiotic susceptibility tests were performed using disk diffusion techniques. Risk factors association were identified using binary and multivariable logistic regression analysis., Results: The overall prevalence of STEC O157:H7 in diarrheic patients and their cattle was 11.1% (128/1149) and 14.4% (33/229) respectively. High percentage of the study subjects were found in under-five children (34.5%). Age less than 5 (AOR: 4.02, 95%CI:1.608-10.058,P = 0.003), and greater than 64 years old (AOR:3.36, 95% CI:1.254-8.986, P = 0.016), presence of diarrheic patient in the house (AOR:2.11, 95%CI:1.309-3.390, P = 0.002), availability of cattle in the house (AOR:2.52, 95%CI:1.261-5.049, P = 0.009), and habit of consuming raw foods (AOR:4.35, 95%CI:2.645-7.148, P = 0.000) were risk factors. Antibiotic resistance was shown in 109(85.2%), and 31(93.9%) isolates from diarrheic patients and their cattle respectively. The highest levels of antibiotic resistance were found to tetracycline (54.7%, 69.7%) in diarrheic patients and their cattle respectively. Multiple drug resistance was also observed among 56(43.8%) and 11(33.3%) isolates in diarrheic patients and their cattle respectively., Conclusion: Our study showed high prevalence of STEC O157:H7 in diarrheic patients and their cattle. Therefore, health education should be given to the community on how to care for animals, proper sanitation, and the impact of raw food consumption., Competing Interests: The authors have declared that no competing interest exist, (Copyright: © 2023 Engda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The aim of this study is to investigate how climate change influences the distribution of economically and environmentally important species of P. abyssinica and H. citrispinum in Ethiopia. The species distribution modeling intends to forecast species' ecological niche ranges and habitat suitability by employing a variety of environmental parameters as predictors, which is vital for conservation planning and restoration success. Six representative concentration pathways (RCP 2.6, 4.5, and 8.5 for the years 2050 and 2070) with the same resolution of 2.5 min that shows the emission scenarios were used for the prediction. To predict the current and future distributions of H. citrispinum and P. abyssinica 56 and 45 occurrence records from National Herbarium, Addis Ababa University, GBIF, and available literatures were used respectively., Results: The MaxEnt model predicted habitat suitability for H. citrispinum species with an Area Under Curve (AUC) value of 0.961 ± 0.027, and 0.809 ± 0.045 for P. abyssinica, indicating excellent discriminatory ability or accuracy under the current climate scenario. The Future distribution of suitable habitat for both H. citrispinum and P. abyssinica plant species was accurately predicted with AUC values of 0.960 ± 0.017 and 0.780 ± 0.35, respectively under future climatic scenarios. The jackknife test result indicates that environmental variables such as topographic position index (92.5%), precipitation of the driest quarter (3%) and precipitation in the coldest quarter (1.8%) are associated with the distributions of H. citrispinum, while topographic position index (36.6%), precipitation of driest quarter (21.4%), precipitation of warmest quarter (16.2%) and precipitation seasonality (13.9%) were found to be limiting environmental variables for P. abyssinica under current and future climatic conditions in Ethiopia. The prediction map and interception calculation for both present and projected (in the 2050s and again in the 2070s) climate change scenarios indicate significant habitat loss, decreased, and fragmentation under all RCPs (2.6, 4.5, and 8.5) scenarios for P. abyssinica while habitat gain, and increasing for H. citrispinum in Ethiopia., Conclusions: Topographic position index (TPI) is the most impactful predictor variable on the distribution of the two species. Consequently, potentially habitable areas (with diverse aspects and slopes) are increasing for H. citrispinum while decreasing for P. abyssinica., (© 2023. The Author(s).)

Rotavirus is the leading cause of morbidity and mortality due to acute gastroenteritis among children under five years globally. Early diagnosis of rotavirus infection minimizes its spread and helps to determine the appropriate management of diarrhea. The aim of this study was to evaluate the performance of EpiTuub® Fecal Rotavirus Antigen Rapid Test Kit for the diagnosis of rotavirus infection among diarrheic children under five years in Ethiopian healthcare settings. A total of 537 children with diarrhea were enrolled from three referral hospitals in Amhara National Regional State, Ethiopia. The samples were tested using one-step RT-PCR and EpiTuub® Fecal Rotavirus Antigen Rapid Test Kit (KTR-917, Epitope Diagnostics, San Diego USA) in parallel. Diagnostic performance of the rapid test kit was evaluated using the one-step RT-PCR as a gold standard. The sensitivity, specificity, and predictive values of the rapid test kit were determined. Moreover, the agreement of the rapid test kit with one step RT-PCR was determined by kappa statistics and receiver operators' curve (ROC) analysis was done to assess the overall diagnostic accuracy of the rapid test kit. Fecal Rotavirus Antigen Rapid Test Kit has shown a sensitivity of 75.5% and specificity of 98.2%. The kit was also found to have 89.9% and 95.0% positive and negative predictive values, respectively. The Fecal Rotavirus Antigen Rapid Test Kit has shown a substantial agreement (78.7%, p = 0.0001) with one-step RT-PCR. The overall accuracy of the Fecal Rotavirus Antigen Rapid Test Kit was excellent with the area under the ROC curve of 86.9% (95% CI = 81.6, 92.1%) (p = .0001). Thus, Fecal Rotavirus Antigen Rapid Test is a sensitive, specific, user-friendly, rapid, and equipment-free option to be used at points of care in Ethiopian health care settings where resource is limited precluding the use of one step RT-PCR. Furthermore, the kit could be used in the evaluation and monitoring of rotavirus vaccine effectiveness in the aforementioned settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Background: Trachoma control programs use multiple approaches to identify individuals with trachomatous trichiasis (TT). Evidence is limited regarding which approaches are most effective and cost-efficient., Methods: We evaluated the effectiveness of two TT case-identification approaches in Ethiopia: community mobilization to encourage self-referral for centralized screening and house-to-house screenings conducted by case finders. We compared the number of true cases found per 1000 population and costs associated with case identification under each approach, stratified by villages that received one or multiple screening visits., Results: We conducted screenings in 396 villages. In villages receiving one house-to-house visit, case finders identified 14,229 suspected cases, of whom 10,513 (73.9%) presented for TT confirmation. A median of 17.2% (interquartile range [IQR]: 9.1%-27.8%) of those presenting truly had TT (positive predictive value). In single-visit villages, the community mobilization approach yielded higher rates of confirmed cases than the house-to-house approach (1.5 [IQR: 1.1, 2.6] vs. 1.1 [IQR: 0.5, 1.9] cases per 1000 population), and the median cost of identifying a TT case was less ($5.59 vs. $31.18) using community mobilization than house-to-house. In multiple-visit villages, additional screening visits increased the median rate of confirmed cases to 2.5 per 1000 population in community mobilization villages, but the rate remained unchanged in house-to-house villages., Conclusions: Community mobilization-based TT case finding had a higher yield than house-to-house, at a substantially lower cost. Future research should examine whether additional tools to aid case finders in their diagnosis increases case-finding efficiency and accuracy and whether TT prevalence and surgical program duration impact case-finding success., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Functional Gastrointestinal Disorders (FGIDs) and their risk factors vary from region to region. Therefore, this study aimed to determine the prevalence of abdominal pain of FGIDs in different dietary diversity score (DDS) and its determinant factors among adults in Jimma City, Southwest Ethiopia., Methods: A community-based cross-sectional study was conducted from July 17 to October 27, 2019. The study included systematically selected healthy adults aged ≥ 18years. Data were collected on gastrointestinal symptoms (Rome III), and DDS (24-dietary recall)., Results: Of 865 healthy adults, the prevalence of abdominal pain symptoms co-occurrence was 168(19.4%), dyspepsia, 152(17.6%) and IBS, 133(15.4). Similarly, the co-occurrence was distributed as 81(9.4%) in middle, 64(7.4%) in high and 23(2.6%) in low DDS groups. Although this distribution was different in the DDS groups, it is not significantly associated. With potential confounders adjusted, the behavioral factors associated with the co-occurrence with an AOR (95% CI) were khat chewing: 7.37 (1.76 - 30.87), drinking alcohol: 3.24 (1.15 - 9.18), sedentary life: 12.28 (3.19 - 48.40) and less physical activity: 4.44 (1.43-13.75). Moreover, elevated TAG: 5.44 (2.78 - 8.10), elevated LDL: 4.26 (1.61-11.29), central obesity: 2.78 (1.08 -7), low HDL 5.89 (2.22-15.60), positive H.pylori stool test: 2.7 (1.86 -7.72), being diabetic: 2.7 (1.79 -7.79) and hypertensive: 2.79 (1.08 - 7.14) were associated with the co-occurrence., Conclusion: Abdominal pain and FGIDs had significant distribution among adults in Jimma City. Therefore, early screening and managing FGIDs in the community is recommendable., (© 2023 Zawdie, et al.)

Objective: This study aimed to investigate the prevalence and associated factors of poor sleep quality among Bole Lemi Industrial Park workers in Addis Ababa, the capital of Ethiopia., Design: An institution-based cross-sectional study was conducted from July to August 2022. The data were collected using a validated and standardised Pittsburgh Sleep Quality Index Questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable binary logistic regression analysis was conducted to identify factors associated with poor sleep quality. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05., Setting: The study was conducted in Bole Lemi Industrial Park in Addis Ababa., Participants: A total of 370 workers participated in this study., Outcome Measures: The primary outcome of the study was the prevalence of poor sleep quality., Results: The total response rate was 87.7%. The majority (260, 70.3%) of the participants were female. The mean (±SD) age of the participants was 30.5 (±10.6) years. The prevalence of poor sleep quality during the last months was found to be 75.4% (n=279) (95% CI: 70.7% to 79.7%). Undiversified dietary intake (AOR: 1.63; 95% CI (1.09 to 2.78)), caffeine consumption more than 250 mg per day (AOR: 2.57; 95% CI (1.12 to 6.05)) and night shift work (AOR: 2.36; 95% CI (1.27 to 4.41)) were risk factors for poor sleep quality among sampled workers., Conclusion: This study detected that poor sleep quality is highly prevalent among garment and textile industry workers, indicating that it is a significant public health issue that requires immediate attention. Therefore, modifications of the work environment involving night shift work and the improvement of workers' personal lifestyles involving dietary diversification and caffeine consumption are needed to minimise the burden of poor sleep quality among workers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Additive genetic and non-additive parameters for reproductive traits of Boer x Central Highland goats were estimated. Pedigree and performance records comprised of Central Highland and their crosses with Boer goats were collected from 2009 to 2018 in the Sirinka Agricultural Research Center sheep and goat breeding station. Least-squares means for genotypes were obtained using a general linear model procedure in SAS. To estimate crossbreeding parameters, breed additive, heterotic, and recombination effects were fitted as fixed covariates instead of genotypes. Variance, heritability, and repeatability estimates were estimated through the AI-REML algorithm using WOMBAT software. Genotype did not significantly (P>0.05) influence most of the reproductive traits studied except for gestation length. The additive effect for litter size at birth (LSB), total litter birth weight (LBW), total litter weaning weight (LWW), litter size at weaning (LSW), and gestation length (GL) was estimated to be -0.004 kid, 0.08 kg, -3.18 kg, -0.54 kid, and 3.69 days, respectively. The contribution of heterosis to LSB, LWW, and GL of crossbred goats was negative, while the estimates for LBW and LSW were positive. However, Boer goats' heterosis effect and direct additive contribution to reproductive traits were insignificant (P>0.05) except for LSW. The recombination effect was negligible and not significant (P>0.05) for all traits examined. The direct heritability estimate for LSB, LWB, LWW, LSW, and GL were 0.050, 0.098, 0.086, 0.018, and 0.00, respectively. The repeatability estimates for LSB, LWB, LWW, LSW, and GL were 0.149, 0.116, 0.099, 0.086, and 0.061, respectively. The result indicates that improvement in reproductive traits would not be expected by crossing Boer with Central Highland goats. In addition, heritability estimates indicate that the improvement of reproductive traits through selection will be small, and the repeatability estimates indicate that multiple records have to be used to make a decision of culling or selection., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Tesema et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: This study aimed to investigate the prevalence and factors associated with work-related musculoskeletal disorders among cashiers in small-scale businesses in Northwestern Ethiopia., Design: A multicentre cross-sectional study was conducted from July to September 2022. The data were collected using a validated and standardised Nordic Musculoskeletal Questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was used to ascertain the significance of associations at p<0.05 and the adjusted OR (AOR) with a 95% CI., Setting: The study was conducted in small-scale businesses in the North Gondar Zone., Participants: A total of 618 cashiers participated in this study., Outcome Measures: The primary outcome of the study is the prevalence of work-related musculoskeletal disorders, which was measured using the Nordic Musculoskeletal Questionnaire., Results: The response rate was 97.5% (N=618). The majority (373; 60.4%) of the study participants were female. The mean (±SD) age of the participants was 30 (±8.3) years. The prevalence of work-related musculoskeletal disorders during the last 12 months was found to be 75.4% (n=466) (95% CI 71.8%, 78.8%). Marital status (married) (AOR=2.12; 95% CI 1.26, 3.56), lack of physical exercise (AOR=2.07; 95% CI 1.32, 3.23), alcohol consumption (AOR=3.55; 95% CI 2.18, 5.78) and awkward work posture (AOR=2.40; 95% CI 1.43, 4.0) were significant factors associated with work-related musculoskeletal disorders among sampled cashiers., Conclusion: This study concluded that the overall prevalence of work-related musculoskeletal disorders was high among cashiers in small-scale businesses. Being married, a lack of physical exercise, alcohol consumption and awkward work posture were significant factors of work-related musculoskeletal disorders. To reduce work-related musculoskeletal disorders, it is recommended taking part in physical activity, avoiding alcohol consumption and avoiding awkward work posture., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Drug resistant Mycobacterium tuberculosis prevention and care is a major challenge in Ethiopia. The World health organization has designated Ethiopia as one of the 30 high burden multi-drug resistant tuberculosis (MDR-TB) countries. There is limited information regarding genetic diversity and transmission dynamics of MDR-TB in Ethiopia., Objective: To investigate the molecular epidemiology and transmission dynamics of MDR-TB strains using whole genome sequence (WGS) in the Amhara region., Methods: Forty-five MDR-TB clinical isolates from Amhara region were collected between 2016 and 2018, and characterized using WGS and 24-loci Mycobacterium Interspersed Repetitive Units Variable Number of Tandem Repeats (MIRU-VNTR) typing. Clusters were defined based on the maximum distance of 12 single nucleotide polymorphisms (SNPs) or alleles as the upper threshold of genomic relatedness. Five or less SNPs or alleles distance or identical 24-loci VNTR typing is denoted as surrogate marker for recent transmission., Results: Forty-one of the 45 isolates were analyzed by WGS and 44% (18/41) of the isolates were distributed into 4 clusters. Of the 41 MDR-TB isolates, 58.5% were classified as lineage 4, 36.5% lineage 3 and 5% lineage 1. Overall, TUR genotype (54%) was the predominant in MDR-TB strains. 41% (17/41) of the isolates were clustered into four WGS groups and the remaining isolates were unique strains. The predominant cluster (Cluster 1) was composed of nine isolates belonging to lineage 4 and of these, four isolates were in the recent transmission links., Conclusions: Majority of MDR-TB strain cluster and predominance of TUR lineage in the Amhara region give rise to concerns for possible ongoing transmission. Efforts to strengthen TB laboratory to advance diagnosis, intensified active case finding, and expanded contact tracing activities are needed in order to improve rapid diagnosis and initiate early treatment. This would lead to the interruption of the transmission chain and stop the spread of MDR-TB in the Amhara region., (© 2023. The Author(s).)

Background: Occupational respiratory diseases are major global public health problems, particularly for industry workers. Several studies have investigated occupational respiratory symptoms in various parts of Ethiopia. The findings have been inconsistent and inconclusive, and there is no nationally representative data on the subject. Therefore, this study aimed to estimate the pooled prevalence and factors associated with occupational respiratory symptoms among industry workers in Ethiopia (2010-2022)., Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework Guidelines, search was conducted on several international databases including PubMed, CINAHL, African Journals Online, Hinari, Global Health, and Google scholar. The extracted data was analyzed using STATA 14. Random effect model was used to estimate the effect size. Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity, respectively among the reviewed articles., Results: The meta-analysis included a total of 15 studies with 5,135 participants, revealing a pooled prevalence of 51.6% (95% CI: 43.6-59.6) for occupational respiratory symptoms among industry workers in Ethiopia. The absence of personal protective equipment (OR = 1.97, 95% CI: [1.17-3.32]), lack of occupational health and safety training (OR = 3.04, 95% CI: [2.36-3.93]), previous dust exposure (OR = 3.17, 95% CI: [2.3-4.37]), poor working environment (OR = 2.4, 95% CI: [1.7-3.2]), work experience greater than five years (OR = 4.04, 95% CI: [1.61-10.16]), smoking (OR = 6.91, 95% CI: [2.94-16.2]), and previous respiratory illness (OR = 4.25, 95% CI: [2.44-7.42]) were found to associate with the symptoms., Conclusions: The high prevalence of occupational respiratory symptoms among industry workers in Ethiopia underscores the urgent need for effective interventions. The provision of personal protective equipment and improvement of working environments by the government, industry owners, and other stakeholders are crucial in reducing occupational respiratory symptoms. Additionally, prioritizing occupational health and safety training for industry workers can help prevent and mitigate the impact of occupational respiratory diseases., Registration: This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42022383745., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Daba et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Access to safe food is considered a basic human right, but food-borne disease presents a significant public health concern globally. The problem is exacerbated in low- and middle-income countries. Due to the rise in urbanization and the popularity of street food in low- and middle-income countries, understanding the Knowledge, Attitude, and Practice (KAP) of street food vendors is crucial to ensuring food safety. Therefore, this review was aimed to estimate the pooled proportion of KAP of street food vendors toward food safety and its associated factors in low- and middle-income countries. A comprehensive search of published studies before January 30, 2023, was identified using databases like PubMed/MEDLINE, Cochrane Library, HINARI, Science Direct, and African Journals Online, as well as other sources. The preferred reporting items for systematic reviews and meta-analysis guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. The quality of the included studies was assessed using the Joanna Briggs Institute's quality appraisal tool. A random-effects model was used to estimate the pooled proportion of KAP of street food vendors toward food safety and associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics were used to assess heterogeneity. Furthermore, sensitivity analysis and subgroup analysis was also conducted. In this study, fourteen eligible studies with a total of 2,989 study populations were included. The pooled proportions of good knowledge 62% (95% CI: 51-73), positive attitude 66% (95% CI: 47-86), and good practice 51% (95% CI: 36-65) toward food safety were found among street food vendors. Being of secondary school education (OR = 5.95, 95% CI: 4.05-7.85), having training in food safety (OR = 4.64, 95% CI: 2.62-6.67), having a higher monthly income (OR = 2.98, 95% CI: 1.06-4.9), and having good knowledge of food handling (OR = 2.26, 95% CI: 1.17-3.16) were found to be associated factors in the food safety practice of street food vendors. Based on the findings of this study, there was a significant gap in the KAP of street food vendors toward food safety. Therefore, the provision of training and strengthening health education about food safety are invaluable strategies for improving food safety., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Desye et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: This study was designed to determine the prevalence and factors associated with occupational respiratory morbidity among hairdressers in Northwestern Ethiopia., Design: A cross-sectional study was conducted from 6 July 2022 to 17 August 2022. The data were collected using a standardised American Thoracic Society questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was conducted to identify factors associated with occupational respiratory morbidity. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05., Setting: The study was conducted in Gondar city, Northwestern Ethiopia., Participants: A total of 403 hairdressers participated in this study., Outcome Measures: The primary outcome is the prevalence of occupational respiratory morbidity., Results: The total response rate was 95.5%. The majority, 250 (62%) of the respondents were women. The mean age (±SD) of the respondents was 27 (±6.0) years. The overall prevalence of occupational respiratory morbidity during the past 12 months was found to be 134 (33.3%) (95% CI (28.7% to 38.1%)). Female hairdressers (18.6%) showed greater respiratory morbidity than male hairdressers (14.7%). Working experience 3-5 years (AOR: 3.05; 95% CI (1.76 to 5.30)) and working experience >5 years (AOR: 6.22; 95% CI (2.73 to 14.16)), overweight (body mass index (BMI)) (AOR: 3.01; 95% CI (1.19 to 7.58)) and working near roadsides (AOR: 2.15; 95% CI (1.33 to 3.37)) were risk factors of occupational respiratory morbidity among hairdressers., Conclusions: This study concluded that one-third of hairdressers experienced occupational respiratory morbidity. Longer work experience, higher BMI and working near roadsides were identified as significant risk factors for respiratory morbidity in hairdressers. Dietary calorie restrictions for overweight individuals and the development and implementation of air pollution mitigation measures targeted at roadside workers are advised to curb the problem., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: More than half of the 700 million people worldwide who lack access to a safe water supply live in sub-Saharan Africa, including Ethiopia. Globally, approximately 2 billion people use drinking water sources that are contaminated with fecal matter. However, little is known about the relationship between fecal coliforms and determinants in drinking water. Therefore, the objective of this study was to investigate the potential for contamination of drinking water and its associated factors in households with children under 5 years of age in Dessie Zuria district in northeastern Ethiopia., Methods: The water laboratory was conducted based on the American Public Health Association guidelines for water and wastewater assessment using a membrane filtration technique. A structured and pre-tested questionnaire was used to identify factors associated with the potential for contamination of drinking water in 412 selected households. A binary logistic regression analysis was performed to determine the factors associated with the presence or absence of fecal coliforms in drinking water, with a 95% confidence interval (CI) and a value of p  ≤ 0.05. The overall goodness of the model was tested using the Hosmer-Lemeshow test, and the model was fit., Results: A total of 241 (58.5%) households relied on unimproved water supply sources. In addition, approximately two-thirds 272 (66.0%) of the household water samples were positive for fecal coliform bacteria. Water storage duration ≥3 days (AOR = 4.632; 95% CI: 1.529-14.034), dipping method of water withdrawal from a water storage tank (AOR = 4.377; 95% CI: 1.382-7.171), uncovered water storage tank at control (AOR = 5.700; 95% CI: 2.017-31.189), lack of home-based water treatment (AOR = 4.822; 95% CI: 1.730-13.442), and unsafe household liquid waste disposal methods (AOR = 3.066; 95% CI: 1.706-8.735) were factors significantly associated with the presence of fecal contamination in drinking water., Conclusion: Fecal contamination of water was high. The duration of water storage, the method of water withdrawal from the storage container, covering of the water storage container, the presence of home-based water treatment, and the method of liquid waste disposal were factors for fecal contamination in drinking water. Therefore, health professionals should continuously educate the public on proper water use and water quality assessment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Berihun, Abebe, Hassen, Gizeyatu, Berhanu, Teshome, Walle, Desye, Sewunet and Keleb.)

The provision of potable water is crucial to ensuring the health and dignity of individuals. In many developing countries, including Ethiopia, waterborne disease has become a major public health problem. There is a significant gap in accessing comprehensive national-wide evidence on Household Water Treatment (HWT) practices and associated factors in Ethiopia. Therefore, this study aims to assess the pooled HWT practice and associated factors in Ethiopia. A comprehensive search of published studies before October 15, 2022, was identified using databases and other sources. Data were extracted using Microsoft Excel, and analysis was performed using STATA 14/SE software. A random-effects model was used to estimate the pooled proportion of HWT practices and the odds ratio of associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. Duval and Tweedie's "trim and fill" method was performed to adjust the pooled estimate. A subgroup analysis was also conducted to identify the sources of heterogeneity. In this study, a total of 708 articles were retrieved, and 16 eligible studies were included. The pooled proportion of HWT practice in Ethiopia was found to be 21% (95% CI: 17-24). Having a formal education (OR: 2.42, 95% CI (2.11-2.74)), being male (OR: 1.32, 95% CI (1.13-1.51)), owning radio (OR: 1.33, 95% CI (1.18-1.47)), having a higher income (OR: 1.73, 95% CI (1.41-2.04)), unimproved water source (OR: 1.71, 95% CI (1.41-2.01)), fetching water at more frequently (OR: 3.31, 95% CI (1.99-4.64)), dipping methods of water drawing (OR: 2.08, 95% CI (1.66-2.51)), and taken training of water treatment (OR: 2.15, 95% CI (1.55-2.75)) were all found to be associated with HWT practice. Based on the findings of this study, the pooled proportion of HWT practice in Ethiopia was found to be one-fifth, which indicated that it was significantly low. Therefore, the authors recommend that households could better receive adequate information about HWT practices through strengthened health education and intensive training on HWT., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Desye et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Rapid Ethical Assessment (REA) is a rapid qualitative study anticipated to understand the ethical sphere of the research setting prior to recruiting study subjects. This study assessed the communities' knowledge about tuberculosis (TB) and research, understand the social arrangements advisable for recruiting research participant and appraised the information provision and consent process., Methods: The study was conducted in Amhara region, Ethiopia from 5 th -30 th January 2021. Google-based survey, face-to-face in-depth interview and focus group discussion were carried out to collect the data from researchers, data collectors, health professionals, TB program officers. A structured questionnaire was administered to assess the knowledge of TB patients and healthy controls about TB, research, gene, (co)evolution and consent process., Results: Over 71% of researchers were not satisfied with the current consent process, and 82.7% of researchers agreed that the best interest of the research participants was not adequately addressed in the current research practices in ANRS. TB patients and healthy controls misunderstood research and its goals. Participants advised the researchers to approach the community with the assistance of health extension workers (HEW) or religious/local leaders. Combined use of verbal and written based information provision at individual participant level is the preferred way for information provision., Conclusions: The adherence of researchers to standard information provision and consent process was very low. Healthy controls and TB patients have low level of knowledge and awareness about research, ethics and genomic research-related common terms. Hence, public education is required to strengthen the research ethics in the region., (© 2023 Mekonnen D., et al.)

Background: Post-traumatic stress disorder (PTSD) is a common mental disorder after traumatic exposure that can have long-lasting physical and mental health consequences. In 2021, Ethiopia saw the highest number of internally displaced people (IDP) due to conflict and war with the scope of the internal displacement being very high in the study area and less attention has been given to mental health., Objective: To determine the prevalence and associated factors of PTSD among internally displaced people in camps at Debre Berhan, Ethiopia., Methods: A cross-sectional study was conducted from December 1-30, 2021 among 406 IDPs, who were selected by random systematic sampling from the registration and proportionally allocated to three IDP camps in Debre Berhan. Post-traumatic stress disorder was measured by the PTSD checklist (DSM-5). Data were collected through an interviewer-administered pre-tested questionnaire, entered into EpiData version 3.1, and analyzed by Statistical Package for Social Sciences version 25. Bivariate binary logistic regression was used to select candidate variables with p < 0.25. Multicollinearity was checked by using the variance inflation factor and it was less than 10. Model adequacy was checked by Hosmer & Lemeshow goodness of test (p > 0.05). In the multivariable binary logistic regression, the association between outcome and independent variables was declared at p < 0.05 with its adjusted odds ratio (AOR) at a 95% confidence level., Results: The prevalence of PTSD among the respondents was 67.5% (95% CI: 63-72). Being a merchant (AOR = 0.41 [95% CI: 0.02-0.85]), witnessing the destruction of property (AOR = 1.67 [95% CI: 1.01-2.74]), facing trauma during displacement (AOR = 6.00 [95% CI: 2.75-13.10]), frequency of displacement (AOR = 0.31 [95% CI: 0.11-0.85]), being distressed (AOR = 5.42 [95% CI: 3.25-9.05]), and unemployment (AOR = 2.09 [95% CI: 1.24-3.54]) were factors significantly associated with PTSD., Conclusion: This study provides evidence of the high prevalence of PTSD among internally displaced people. Therefore, mental health and psychosocial support are urgently required to address the identified factors and help the displaced people against long-term avoidable suffering., (© 2023. The Author(s).)

Background: Globally, TB is the leading cause of infectious disease morbidity and mortality with many diagnostic uncertainties. Access to affordable and rapid diagnostics remained a major challenge for many developing countries which bear the greatest burden of TB delaying the initiation time to treatment., Objective: This study aimed to assess the GeneXpert MTBRIF assay probe utility for the detection of pulmonary TB and Rifampicin-resistant TB cases in Addis Ababa, Ethiopia., Materials and Methods: A cross-sectional study was performed from October 2019 to July 2020 in Saint Peter TB Specialized Hospital in Addis Ababa metropolitan area, Ethiopia. This study enrolled 216 clinically suspected new presumptive pulmonary TB cases confirmed by GeneXpert MTB/RIF Assay. Sociodemographic and clinical characteristics were captured using a structured tool. Data were entered in Microsoft Excel 2019, checked for inconsistency, cleaned promptly, and exported to IBM SPSS Statistics for Windows, Version 26.0. Armonk, N.Y: IBM Corp, the USA for analysis. Descriptive analysis and binary and multivariate logistics regression were performed and all statistical significance was determined at a 95% confidence level., Results: The majority of the study participants, 55.1% [119/216] were males aged 6-80 years. The prevalence of RR MTB was 11.11% [24/216]. A higher proportion of RR TB was found in female patients [54.2%, 13/24], in patients in the age group of 30-50 years [45.8%, 11/24], in married individuals [62.5%, 15/24], in persons whose residence is urban [79.2%, 19/24], in persons who had a previous history of TB symptoms [100%, 24/24], in persons who had a history of contact with active and LTBI [33.3%, 8/24], and in persons who had a history of HIV and IDUs [41.7%, 10/24]. Occupation (AOR 22.868, 95% CI 1.655-316.022, p = 0.019), history of previous PTB+ (AOR 4.222, 95% CI 1.020-17.47, p = 0.047), and history of HIV and IDUs (AOR 4.733, 95% CI 1.416-15.819, p = 0.012) were independent predictors associated with RR-TB emergence. The commonest mutation 62.5% [15/24] was found in probe E (codons 529-533) region. There was no mutation associated with probe A (codons 507-511), probe B (codons 511-518), and probe C (codons 518-523) regions, as well as no combination of missed probes, was revealed. However, 12.5% [3/24] of RR TB patients were found without unidentified missed probe types detected outside of the RRDR. The delta Ct max was >4.0 and the highest proportion of 35.6% [77/216] RR TB was detected in samples of medium DNA load., Conclusion: The proportion of RR-TB we observed in this study was high. Similarly, a higher proportion of RR TB was detected outside of the RRDR. Moreover, a significant number of the GeneXpert MTB/RIF Assay probes were identified as unhybridized and this critical observation would mean that most of the probes had no or minimal utility in this geographical region. This calls for further studies to uncover mutation in the rpoB gene conferring RR and reshape TB triage and definite diagnostic algorithm in Ethiopia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2022 Akalu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Dietary diversity score has long been recognized as a key component of diets quality balances for healthy life status. However, diets with more variety of food items might increase calorie intake and body weight, which, in turn leads to central obesity (waist circumference).Therefore, this study aims to determine the prevalence of metabolic syndrome among dietary diversity score groups, and its associated factors among adults in the urban community of Jimma, Southwest Ethiopia., Methods: A total of 915 adults aged ≥ 18 years were randomly recruited in this cross-sectional study.The study was undertaken from June 17, 2019, up to July 27, 2019. To this end, the collected data were entered to Epi Data 3.1 and analysed using and SPSS 25 version. What's more, a multivariable logistic regression was used to assess associated factors of the unrecognized metabolic syndrome; adjusted odds ratio (AOR) with its corresponding 95% CI, at P-value ≤ 0.05., Results: The occurrence of metabolic syndrome was 14.4%, and it is more prevalent in females, 11.15% than males, and 3.25%. The most prevalent components of the metabolic syndrome were low level of high-density lipoprotein, elevated level of triacylglycerol, and waist circumferences. Even though metabolic syndrome is not significantly associated with any of the dietary diversity score groups, its prevalence distribution varies among the groups (6.6% in middle, 5.8% in high and 1.9% in low dietary diversity groups). With potential confounders adjusted, by 75% female was significantly associated with the occurrence of metabolic syndrome than male (102 vs. 29, AOR = 0.25 at 95%CI: 0.15-0.40, P = 0.001). Whereas, age ≥ 35 years old (104 vs. 27, AOR = 2.91 at 95%CI:1.78-4.86,P = 0.001), large family size > 5 (65 vs. 10,AOR = 2.43 95% CI: 1.10-5.36, P = 0.03), overweight and obesity (121 vs. 10, AOR = 6.97, 95% CI: 4.50 -10.83, P = 0.005), elevated total cholesterol (103 vs. 28,AOR = 2.46, 95% CI: 1.47-4.11, P = 0.001), and consuming ( spices, condemns and beverages) ≥ 4 days per week (79 vs. 52, AOR = 0.52, 95% CI:0.33 -0.82, P = 0.005) were positively associated with the prevalence of metabolic syndrome as compared to their counterparts., Conclusion: Unrecognized metabolic syndrome was relatively high in the study community. The prevalence of metabolic syndrome varied among dietary diversity groups. But any of the dietary diversity scoring categories was not significantly associated with the occurrence of metabolic syndrome. Thus, awareness needs to be made to practice healthy diet and regular physical activity to maintaining normal body weight. Moreover, early screening of metabolic syndrome should be promoted., (© 2022. The Author(s).)

Background: Distinguishing a recent from long-standing HIV infection is a critical step to reduce new infections in 2030. Therefore, this analysis determines the proportion of recent HIV infections among newly diagnosed cases and associated factors in the Amhara regional state between 2019 and 2021., Methods: We got the HIV case-based surveillance dataset (July 2019 up to August 12/2021) from the Amhara Public Health Institute. Recent infection is an infection gained within the last 12 months as identified by Asante recency test kits. Logistic regression was carried out to identify factors associated with recent infection. Adjusted odd with 95% CI and a p -value of < 0.05 was considered to declare significant associations., Results: Out of 5,689 eligible cases, 3,129 (55%) recency tests had been performed. The proportion of recent HIV infection is 443 (14.2%, 95% CI: 13, 15.4%). High proportion of recent infections is reported from Bahir Dar city (23.3%), Central Gondar (17.7%), West Gojjam (16.5%), North Shewa (16.5%) and South Gondar zones (15.7%). Besides, the proportion of recent infection is high among clients aged ≥ 51 years (32.4%), illicit drug users (30.6 %), homelessness (28.5%), current commercial sex workers (27.9%), prisoners (21.1%), and among clients with invasive medical procedures (22.2%). Recent infection is significantly associated with females (AOR: 1.9, 95% CI: 1.2-3.1), secondary and above education (AOR: 2.1, 95% CI: 1.3-3.4), commercial sex workers (AOR: 1.8, 95% CI: 1.2-2.7), having contact with index case (AOR: 0.5, 95% CI: 0.3-0.8) and illicit drug utilization (AOR: 3.6, 95% CI: 1.1-12.4)., Conclusion: In the Amhara region, the proportion of recent HIV infection is high with marked variation across sociodemographic characteristics. We identified the risk or preventive factors associated with a recent infection. Therefore, all HIV responders should target their prevention efforts toward hot spot areas and sub-populations to stop further transmission., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Alemu, Ayalew, Haile, Amsalu, Ayal, Wale, Belay, Desta, Taddege, Lankir and Bezabih.)

Background: Data on the magnitude of road traffic accidents (RTAs) were mostly obtained through police records and hospital registration data. However, insufficient data reporting masked the gravity of the problem, and little attention was paid to the magnitude and correlation of road traffic accidents from the driver's perspective. Therefore, this study aimed to assess the prevalence of RTA and related factors among drivers., Methods: A community-based cross-sectional study involving 316 drivers was conducted in Southern Ethiopia. The participants were chosen using a systematic random sample technique, and the data were obtained using an interview-administered structured questionnaire. To analyze the data, SPSS software (version 20) was employed. In addition to descriptive statistics, binary logistic regression analysis was also employed to find factors connected to traffic accidents. RTA factors were considered statistically significant if they had a P -value of 0.05 or below in the multivariate analysis., Result: The RTA among drivers was 126 (39.9%) (95% confidence interval (CI): 34.2-45.6%) in the previous year. The following factors were associated with RTA: vehicle maintenance (AOR = 0.11, 95% CI: 0.09, 0.96), media utilization (AOR = 0.38, 95% CI: 0.18, 0.65), participation in driving-related training (AOR = 0.73, 95% CI: 0.28, 0.91), punishment for prior traffic violations (AOR = 0.56, 95% CI: 0.47, 0.83), and risky driving behavior (AOR = 7.89, 95% CI: 3.22, 12.38)., Conclusion: Two-fifths of the drivers were involved in a traffic accident. Risky driving behaviors, vehicle maintenance, media usage, attending driving-related training in the previous 2 years, and prior experience with traffic police punishment or warning were all strongly linked to road traffic accidents. In light of these statistics, the Federal Ministry of Transport of Ethiopia and other stakeholders should support making it mandatory for drivers to check their vehicles' safety, provide them with safety training, raise awareness about vehicle maintenance and risky driving behaviors, and enforce strict penalties for traffic violations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer CK declared a shared affiliation with the author(s) to the handling editor at the time of review., (Copyright © 2022 Hareru, Negassa, Kassa Abebe, Ashenafi, Zenebe, Debela, Ashuro and Eshete Soboksa.)

Objective: This study aimed to assess factors associated with poor medication adherence during the COVID-19 pandemic among hypertensive patients visiting public hospitals in Eastern Ethiopia., Setting: Hospital-based cross-sectional study was conducted in Harari regional state and Dire Dawa Administration from 1 January to 30 February 2022. Both settings are found in Eastern Ethiopia., Participants: A total of 402 adult hypertensive patients who visited the chronic diseases clinic for follow-up were included in the study., Main Outcome Measures: The main outcome measure was poor medication adherence during the COVID-19 pandemic., Results: The level of poor antihypetensive medication adherence was 63% (95% CI 48.1 to 67.9). Patients who had no formal education (adjusted OR (AOR)=1.56, 95% CI 1.03 to 4.30), existing comorbid conditions (AOR=1.98, 95% CI 1.35 to 4.35), self-funded for medication cost (AOR=2.05, 95% CI 1.34 to 4.73), poor knowledge about hypertension (HTN) and its treatment (AOR=2.67, 95% CI 1.45 to 3.99), poor patient-physician relationship (AOR=1.22, 95% CI 1.02 to 4.34) and unavailability of medication (AOR=5.05, 95% CI 2.78 to 12.04) showed significant association with poor medication adherence during the pandemic of COVID-19., Conclusion: The level of poor antihypertensive medication adherence was high in this study. No formal education, comorbidity, self-funded medication cost, poor knowledge about HTN and its treatment, poor patient-physician relationship, and unavailability of medication during the COVID-19 pandemic were factors significantly associated with poor adherence to antihypertensive medication. All stakeholders should take into account and create strategies to reduce the impact of the COVID-19 pandemic on medication adherence of chronic diseases., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Backgrounds: Micronutrient deficits in women of reproductive age have been linked to poor pregnancy outcomes. The most common micronutrient deficits in women are iron and folate. The World Health Organization recommends daily oral iron and folic acid supplementation (IFAS) as part of routine antenatal care to lower the risk of maternal anemia and adverse pregnancy outcomes. However, the effectiveness of the supplementation relies on client's strict adherence. The aim of this study was to determine time- to- non-adherence to IFAS and associated factors among pregnant women in Hosanna Town, South Ethiopia., Methods: A community based cross sectional study design was employed from May 15-June11, 2021. Data were entered into Epi-Data version 3.1 and exported to SPSS version 23 for analysis. The Cox regression hazard model was applied. The threshold of statistical significance was declared at a p-value <0.05 and adjusted hazard ratios (AHRs) with corresponding 95% confidence intervals were used to report., Result: The median time-to-non-adherence was 74 days (95 percent CI: 65.33-82.67). After adjusting for the confounders, age (AHR = 1.05, 95% CI: 1.01-1.09), education status (AHR = 2.43 95%CI 1.34-4.40, AHR 3.00, 95% CI: 2.09-4.31, AHR 1.91, 95% CI: 1.32-2.77), household's wealth index (AHR = 1.73, 95% CI: 1.19-2.51, AHR = 1.64, 95% CI:1.15-2.35), and counseling at service delivery (AHR = 2.53, 95% CI: 1.88-3.41) were independent predictors of time to non-adherence to IFAS among pregnant women., Conclusion: The median time to non-adherence was short and women became non-adherent before the recommended duration. Improving women's education and counseling pregnant women on IFAS during pregnancy would make a change., Competing Interests: The authors have declared that no competing interests exist

Background: In October 2020, about 79,041 ethnically Amhara/Agew people had been internally displaced (IDPs) from Metekel zone of Benishangul-Gumuz region and lived in Ranch collective site, Chagni town, Ethiopia. Onsite PHEOC met the health and nutrition needs of the IDPs as per international humanitarian response standards., Methods: On January 11/2021, the Amhara Public Health Institute (APHI) established an onsite Public Health Emergency Operation Center (PHEOC) at Ranch collective site. Health workers and vehicles were deployed. A temporary clinic having nine outlets was built. Drugs and medical supplies were mobilized from different sources. The overall response period lasted about 8 months, from December 2020 up to June 2021., Results: A total of 33,410 IDPs had received free essential health services. Mental health and psychosocial support services had been given for 1,803 cases. Specialized medical services such as trachomatous trichiasis (30), cataract surgery (8) and sputum samples for mycobacterium tuberculosis (120) have been done. Moreover, 454 women received antenatal care services and 137 women gave birth at health facilities. About 837 children have got measles supplementary dose and 1,280 adults took a COVID-19 vaccination. A total of 1,448 children under five, 454 pregnant and 402 lactating women had been screened on monthly basis. Of which, severe and moderate malnutrition rate was 46 (3.2%) and 75 (5.2%), respectively. A total of 194 trench latrine seats, 74 shower rooms and 50 hand washing facilities had been constructed. There were no human feces present nor solid wastes accumulated around the shelters or settlements. Both active and passive surveillance activities were carried out throughout the camp life. We also conducted regularly Risk Communication and Community Engagement activities on priority health issues., Conclusion: We adequately met the health and nutrition needs of the IDPs as stated in the Sphere humanitarian handbook. We sought to have a strong Incident Management System and coordination platforms like PHEOC, a resilient health system, a training curriculum called Leading in Emergencies, and a multipurpose collective center with infrastructures, humanitarian response guidelines, training materials, and risk/vulnerability-based preparedness plan., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Alemu, Bezabih, Amsalu, Hassen, Haile and Abite.)

Background: Even if modern medicine is becoming more widely available, a considerable portion of the world's population continues to rely on complementary and alternative medicine. Complementary and alternative medicine is used by 80% of the population in developing countries for their health care. The study was conducted to assess Knowledge, Attitude and practice towards complementary and alternative medicine and associated factors among health care professionals in public health facilities of Hadiya Zone, South Ethiopia., Methods: The study was conducted in Hadiya Zone from October 10 to October 30, 2019. A facility-based cross-sectional study design was employed using simple random sampling methods. Three hundred sixty six health care professionals were selected using a simple random sample method. The data were collected using a standardized self-administered and pre-tested questionnaire that was adapted from different literatures. We used descriptive statistics, as well as bivariate and multivariate logistic regression analysis. An association was determined using P-values less than 0.05 and 95 percent confidence intervals. The results of the study were presented using texts and tables., Results: Three hundred and fifty-five respondents were interviewed, with a 97 percent respondent rate. Two hundred thirty-two (65.4%) of the study participants have good knowledge towards complementary and alternative medicine, 216 (60.8%) have a favorable attitude toward complementary and alternative medicine, and 182 (51.3%) have utilized it in the previous two years. Some of the factors associated with knowledge, attitude, and practice towards complementary and alternative medicine were health care professionals who have contact with patients who seek complementary and alternative medicine [AOR = 1.89(95% CI; 1.18, 3.03), female health care professionals [AOR = 2.43(95% CI; 2.68, 9.74), and more than six years work experience [AOR = 1.68(95% CI; 1.04, 2.71)., Conclusion: The knowledge, attitude, and practice of complementary and alternative medicine among health care professionals were low. Creating communication lines with patients and facilitating the integration of complementary and alternative medicine with modern medicine., Competing Interests: The authors have declared that no competing interests exist.