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Lami Bayisa,1 Diriba Bayisa,2 Ebisa Turi,3 Diriba Mulisa,1 Tadesse Tolossa,3 Adugna Olani Akuma,1 Merga Chala Bokora,2 Dawit Tesfaye Rundasa1 1Department of Nursing, School of Nursing and Midwifery, Wollega University, Nekemte, Ethiopia; 2Department of Midwifery, School of Nursing and Midwifery, Wollega University, Nekemte, Ethiopia; 3Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, EthiopiaCorrespondence: Lami Bayisa, Department of Nursing, School of Nursing and Midwifery, Wollega University, P.O.Box: 395, Nekemte, Ethiopia, Tel +251 924318135, Email lamisabayisa@gmail.comBackground: The test-and-treat approach recommends early ART initiation (same day). Early ART start has double the benefits as treatment and as prevention. However, there is limited information regarding same-day ART initiation in Ethiopia. Hence, this study aimed to assess the magnitude and factors of same-day ART initiation among people living with HIV (PLHIV) on ART at Nekemte specialized hospital, in Western Ethiopia.Methods: A cross-sectional study was conducted among 483 PLHIV from January 10 to February 15, 2021. Data were collected using an investigator-administered questionnaire. Epi Data 3.1 and STATA 14.0 were used for data entry and analysis, respectively. Variables with P-value < 0.25 from bivariable analysis were included in the multivariable analysis. AOR with 95% CI and P-value < 0.05 were used to declare statistical significance.Results: A total of 483 study subjects participated and gave a 100% response rate. Two thirds (65%) of them started ART on the same day with a 95% CI [60.2– 68.8]. Urban dwellers (AOR = 3.93 (95% 1.96– 7.87)), with no OIs (AOR = 4.02 (95% CI: 1.54– 10.47)), not screened for TB (AOR = 6.02 (95% CI: 1.71– 21.15)), tested via VCT (AOR = 2.32 (95% CI: 1.37– 3.26)), who have not used CPT (AOR = 1.88 (95% CI: 1.10– 3.23)), who have not used IPT (AOR = 2.36 (95% CI: 1.0– 5.57)), who were tested in 2019/20 (AOR = 2.37 (95% CI: 1.08– 5.518)), and with BMI ≥ 25 kg/m2 (AOR = 2.18 (95% CI: 1.05– 4.52)) were significantly associated with same-day ART initiation.Conclusion: Two thirds of study subjects initiated ART on the same day as HIV diagnosis. Voluntary testing and immediate referral to HIV care, advocating test-and-treat, and intensive counseling should be strengthened and reinforced for newly diagnosed HIV-positive people. Given that, high attention should be paid to individuals from urban residence, not screened for TB, who have not used CPT and IPT prophylaxis.Keywords: antiretroviral therapy, ART initiation, same day

Lami Bayisa,1 Tesfaye Abera,1 Diriba Mulisa,1 Getu Mosisa,1 Alemnesh Mosisa,1 Tadesse Tolosa,2 Ebisa Turi,2 Bizuneh Wakuma,3 Eba Abdisa,1 Diriba Bayisa4 1Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 2Department of Public Health, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia; 3Department of Pediatric Nursing, Institutes of Health Sciences, Wollega University, Nekemte, Ethiopia; 4Department of Midwifery, Institutes of Health Sciences, Wollega University, Nekemte, EthiopiaCorrespondence: Lami BayisaDepartment of Nursing, Institutes of Health Sciences, Wollega University, P.O. Box: 395, Nekemte, EthiopiaTel +251 924318135Email lamisabayisa@gmail.comBackground: HIV continuum of care demands early ART initiation for all HIV-infected individuals. Early ART initiation reduces onward HIV transmission facilitating rapid viral suppression. Despite this, delayed ART use is a challenge among newly diagnosed HIV-positive individuals, and there is limited evidence on time to ART initiation among this group in Ethiopia. Thus, this study aimed to assess time to ART initiation and its predictors among newly diagnosed HIV-positive individuals in Nekemte town, Western Ethiopia.Methods: An institution-based retrospective follow-up study was conducted on 518 newly diagnosed HIV-positive people from September 5, 2016 to December 20, 2020 at Nekemte town, Western Ethiopia. Data were collected from ART intake forms, registration log books and patient charts. The collected data were entered into Epi Data version 3.1 and STATA version 14.0 was used for analysis. Survival probability was checked graphically by Kaplan–Meier curve and statistically by Log rank test. Both bivariable and multivariable Cox Proportional hazards regression models were conducted to identify the predictors of ART initiation. Hazard ratio with 95% CI and p-value of < 0.05 was used to declare a statistical significance.Results: By the end of the follow-up, 371 (71.6%) individuals had initiated ART with an overall incidence rate of 51.9 per 1000 [95% CI: 54.07– 66.32] person days; median time to ART initiation was 4 [IQR: 1– 9] days. Being female (AHR = 1.33, 95% CI: 1.06– 1.67), urban dwellers (AHR = 2.02, 95% CI: 1.37– 2.97), having baseline OIs (AHR = 1.62, 95% CI: 1.60– 4.30); being tested via VCT (AHR = 1.33, 95% CI: 1.02– 1.74); linked from OPD (AHR = 0.64, 95% CI: 0.47– 0.85); disclosing HIV sero-status (AHR = 2.07, 95% CI: 1.17– 3.68); and college and above education level (AHR = 1.43, 95% CI: 1.00– 2.0) were identified as significant predictors of early initiation of ART.Conclusion: The proportion and incidence of ART initiation was high; a short median time to ART initiation was revealed in this study. Strictly screening OIs, encouraging HIV sero-status disclosure and voluntary HIV testing are recommended to increase early ART initiation.Keywords: ART initiation, time to ART initiation, newly diagnosed HIV positive, Ethiopia

Lencho Megersa Marami,1 Getachew Mulatu Dilba,1 Dagmawit Atalel Babele,1 Edilu Jorga Sarba,2 Askale Gizaw,1 Wakuma Mitiku Bune,1 Morka Dandecha Bayu,1 Petros Admasu,2 Abraham Mekbeb,2 Miressa Tadesse,3 Kebede Abdisa,2 Dejene Bayisa4 1Ambo University, College of Agriculture and Veterinary Science, Department of Veterinary Laboratory Technology, Ambo, Oromia, Ethiopia; 2Ambo University, College of Agriculture and Veterinary Science, Department of Veterinary Science, Ambo, Oromia, Ethiopia; 3Ambo University, College of Computational and Natural Science, Department of Chemistry, Ambo, Oromia, Ethiopia; 4Jeldu Woreda, Livestock and Fishery Development Office, Gojo, Oromia, EthiopiaCorrespondence: Getachew Mulatu DilbaAmbo University, College of Agriculture and Veterinary Science, Department of Veterinary Laboratory Technology, P.O. Box 19, Ambo, Oromia, EthiopiaTel +251-912717217Email getachew.mulatu@ambou.edu.etBackground: Although traditional healers in Ethiopia have a long history of using medicinal plants to treat diseases in animals and humans, studies on the antibacterial activities and potential bioactive ingredients of most medicinal plants have been insufficient. Therefore, this study aimed to evaluate the in-vitro antibacterial activities and to screen phytochemical constituents of selected medicinal plants against reference bacterial strains.Methods: The fresh and healthy roots of Echinops amplexicaulis, fruits of Ruta chalepensis, and leaves of Salix subserrata were collected from West Shewa Zone, Ethiopia. Agar well diffusion and agar dilution methods were used to evaluate antibacterial activities and minimum inhibitory concentrations (MIC). All the crude plant extracts were tested against Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli and Pseudomonas aeruginosa at concentrations of 100, 50, and 25 mg/mL in each triplet (3x). MIC of crude extracts ranging from 1.5625 to 12.50 mg/mL was applied to all bacterial strains. The positive control was ciprofloxacin disk (5 μg) and the negative control was 5% dimethyl sulfoxide. The presence of secondary metabolites of each crude extract was screened. The group means comparisons were done using one-way ANOVA and results were presented as mean ± standard deviation.Results: Although all selected plant extracts had shown antibacterial activities, methanol extracts had a greater zone of inhibition against all reference bacterial strains when compared to petroleum ether extracts. The growth of P. aeruginosa was inhibited at a minimum concentration of both methanol and petroleum extracts (1.5625 mg/mL) when compared to the remaining bacterial strains. Phytochemical screening showed that saponins and alkaloids were found in all crude plant extracts, while phytosterol was meager.Conclusion: This study revealed that all tested plants had significant secondary metabolites and antibacterial activities against reference bacterial strains.Keywords: antibacterial activity, crude plant extract, ethnomedicine, methanol, petroleum ether

BackgroundLate initiation of antenatal care (ANC) is a major public health concern. If women initiate ANC late, they do not get adequate care, reducing the chances of early detection of pregnancy-related complications. However, there is a lack of data related to the initiation of antenatal care in the study area.ObjectivesTo assess the prevalence of late initiation of antenatal care and identify associated factors among pregnant women attending antenatal care at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia.MethodsAn institutional-based cross-sectional study design was conducted among 454 pregnant women. All eligible participants during the study period were included. Data were collected via face-to-face interviews, were entered into Epi Data version 4.3, and analyzed using SPSS version 22 software. The results are presented using texts and tables. Logistic regression with the 95% confidence interval (CI) was used to identify factors associated with the late initiation of antenatal care. Statistical significance was declared at P

One of the most promising solutions to the current energy crisis is an efficient catalytic transformation of abundant low-cost renewable raw biomass into high-quality biofuel. Herein, a highly effective catalyst was constructed systematically for the selective synthesis of 2,5-dimethylfuran (DMF) biofuel from biomass-derived 5-hydroxymethylfurfural (HMF) via green catalytic transfer hydrogenolysis (CTH) using a nitrogen-doped ordered mesoporous carbon (N-CMK-1) decorated ruthenium (Ru)-based catalyst in i-propanol as hydrogen source. The structures and properties of different catalysts were characterized by different characterization techniques such as FTIR, XRD, N2-sorption, CO2-sorption, TGA, TEM, ICP-AES, CHNO analysis, and acid-base back titration. A complete HMF conversion with a high DMF yield of 88% was achieved under optimized reaction conditions. Regarding substrate conversion and product yield, the influence of reaction temperature, time, and hydrogen donors was thoroughly investigated. The nitrogen-promoted carbon support enhanced the dispersion of Ru due to the formation of appropriate basic site density which could efficiently promote the activation of alcohol hydroxyl in i-propanol and subsequent release of active hydrogen species. In the meantime, highly dispersed surface Ru nanoparticles (NPs) were beneficial for hydrogen transfer and activation of both carbonyl and hydroxyl groups in HMF. Moreover, Arrhenius kinetic analysis was studied by identifying 5-methyl furfural (5-MF) and 2,5-bishydroxymethylfuran (BHMF) as two key intermediates that dominate a distinct reaction pathway during hydrogenolysis of HMF to DMF via CTH. Furthermore, high stability without obvious loss of activity after three consecutive cycles was observed in a fabricated N-CMK-1 decorated Ru-based catalyst as a result of superior metal-support interaction and the mesoporous framework nature of the catalyst. These findings would not only offer a robust catalyst synthetic approach but also open a new avenue for the exploitation of biomass to specialty chemicals and advanced biofuels.

Ephrem Mannekulih Habtewold,1 Godana Arero Dassie,1 Shileshi Garoma Abaya,1 Endashaw Abebe Debela,2 Bekana Lemessa Bayissa,3 Worku Dugassa Girsha,1 Alem Deksisa Abebe,1 Hunde Lemi Sori,1 Meyrema Abdo Komicha,1 Birhanu Kenate Sori,4 Gemechu Shumi Bajiga,4 Melese Lemi Heyi,4 Dabesa Gobena Iticha,4 Tesfaye Kebebew Jiru,4 Mengistu Bekele Hurissa,4 Dereje Abdena Bayisa,4 Lemesa Tadese Amante,4 Yadeta Ayana Sima,4 Dejene Gemachu Dhaba4 1Department of Public Health, Adama Comprehensive Specialized Hospital Medical College, Adama, Ethiopia; 2Department of Internal Medicine, Adama Comprehensive Specialized Hospital Medical College, Adama, Ethiopia; 3Department of Surgery, Adama Comprehensive Specialized Hospital Medical College, Adama, Ethiopia; 4Oromia Regional Health Bureau, Addis Ababa, EthiopiaCorrespondence: Ephrem Mannekulih Habtewold, Correspondence: Tel +251-91-336-5954, Email ephrem4emt@gmail.comPurpose: To assess survival patterns and predictors of mortality among patients admitted with COVID-19 to treatment centers in the Oromia region of Ethiopia from April 1 to August 31, 2021.Methods: A prospective cohort study design was employed, taking a sample of 854 patients selected from eight treatment centers in the region. The follow-up duration was the time interval from admission to the treatment center until the final disposition of patients at discharge (death, recovery, or failed to recover). Data were collected by computer tablet with an interviewer-administered questionnaire and checklist designed using CSPro 7.5 and exported to Stata 13 for analysis. Descriptive analysis was used to explore the characteristics of patients. The mortality rate was estimated by number of deaths per 1,000 person-days of observation. The survival duration was estimated by medians with IQR. The Kaplan–Meier method was used to compare the survival experiences of patients. To identify the predictors of time to death after hospitalization, a Cox proportional-hazard model was used. The magnitude of association was estimated using HRs with 95% CIs, and statistical significance was set at P< 0.05.Results: The mortality rate among hospitalized patients was 9.9 per 1,000 person-days of observation and the median survival time after admission was 9 (IQR 9– 10) days. Higher hazard of death was observed among patients who drank alcohol (AHR 2.0, 95% CI 1.2– 3.3), required anticoagulants (AHR 10, 95% CI 1.2– 91.5), glucocorticoids (AHR 1.7, 95% CI 1.1– 2.8), and oxygen (AHR 4.7, 95% CI 1.1– 22.0), those with acute respiratory distress syndrome (AHR 2.9, 95% CI 1.7– 5.1), and critical patients admitted to intensive care units (AHR 3.4, 95% CI 2.0– 5.9).Conclusion: The hazard of death is significantly predicted by alcohol use, requiring anticoagulants, glucocorticoids, or oxygen medication, acute respiratory distress syndrome complication, and being critical when admitted to intensive care units.Keywords: COVID-19, Ethiopia, mortality, Oromia, survival

The textile industry is one of the biggest water consumption production areas and its waste is essential to cause ecological contamination as they deliver questionable color, weighty metal, and degradable natural and inorganic results whenever arranged without treatment. The natural treatment strategy is not broadly drilled because of its intricate method. In the adsorption method, for example, actuated carbon was limited by prudence of its significant expense and low adsorption limit. This study has completed the combination and portrayal of bagasse cellulose-based hydrogel for the expulsion of methylene blue color from textile industry wastewater. The study furnishes a major critical contributing option for biodegradable adsorption material by supplanting the conventional color evacuation method with a nonconventional one that showsthe attainability of horticultural waste for a union of the hydrogel as opposed to noninexhaustible petrochemical based and show the capability of involving hydrogel for the expulsion of harmful contamination from the textile industry. The hydrogel was combined utilizing free extreme polymerization that can utilize acrylic corrosive (AA) and citrus extract as cross-connecting specialists and monomers individually. FTIR, XRD, and conduct metric titration are the primary hardware utilized for the portrayal of the hydrogel. The cycle boundaries that can influence the color evacuation proficiency of hydrogel, for example, pH, contact time, and temperature have been examined. A focal composite plan by rotatable component is the technique used to browse reaction surface strategies to control the tests with the communication of cycle boundaries.

Dawit Wolde Daka,1 Mirkuzie Woldie,1,2 Meskerem Seboka Ergiba,1 Birhanu Kenate Sori,3 Dereje Abdena Bayisa,3 Asfaw Benti Amente,3 Firew Tekle Bobo4,5 1Faculty of Public Health, Department of Health Policy and Management, Jimma University, Jimma, Ethiopia; 2Fenot Project, Harvard T.H. Chan School of Public Health, Addis Ababa, Ethiopia; 3Policy, Planning, Monitoring and Evaluation Directorate, Oromia Region Health Bureau, Addis Ababa, Ethiopia; 4Institute of Health Science, Department of Public Health, Wollega University, Nekemte, Ethiopia; 5School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, AustraliaCorrespondence: Dawit Wolde DakaJimma University, P.O. Box=378, Jimma, EthiopiaTel +251-966763913Email dave86520@gmail.comBackground: Despite improvement in the coverage of most maternal, newborn, and child health services, inequality in the uptake of services still remains the challenge of health systems in most developing countries. This study was conducted to examine the degree of inequities and potential predictors of inequity in reproductive and maternal health services utilization in the Oromia region, Ethiopia.Methods: The 2016 Ethiopian demographic and health survey data set was used. Utilization rate of four maternal health service categories (family planning, antenatal care, facility based delivery and postnatal care) was considered in the analysis. Equity in each of these indicators was assessed by residence (urban/rural), wealth index, and educational status. Inequality in service utilization was estimated using rate ratios, concentration curve, and concentration indices.Results: Overall data of 5701 women were used in this analysis. The concentration index to all of the maternal health service utilization indicators showed significance. The concentration index of family planning, antenatal care, facility based delivery, and postnatal care was 0.136 (95% CI=0.099– 0.173), 0.106 (95% CI=0.035– 0.177), 0.348 (95% CI=0.279– 0.418), and 0.348 (95% CI=0.279– 0.418), respectively. Maternal age and all of the three socio-demographic factors (residence, education, and wealth) showed inequitable distribution of maternal health service utilization in the Oromia region. The majority of women who were in the favored groups utilized the key reproductive and maternal health services.Conclusion: The utilization of maternal health services in the study area is grossly skewed to those who are well off, educated, and live in urban areas. Any action intended to improve utilization of maternal and child health services should aim to reduce the unnecessary and avoidable disparity demonstrated in our analysis. This of course demands multisectoral intervention to impact on the determinants.Keywords: inequity, reproductive health, maternal health, utilization, Oromia, Ethiopia

The high cost of chemical coagulants for water treatment makes most people in rural community to resort to readily available surface water which are usually of low quality exposing them to different water-borne diseases. It is in this light, this research was conducted to assess the effectiveness of Papaya seed extract for the removal of turbidity and total coliform in raw water sampled from Tulte River which serves as potable water for the society. Jar test experiment was carried out via locally available Papaya seed as coagulant for treatment of high (392.7NTU) & medium (94.2NTU) turbidity level to obtained optimum operation condition of dose, pH and mixing time plus suitable extraction method. Those optimized parameters were then applied in household level of water treatment through manual coagulation (coagulation by hand) in order to qualify its effectiveness. The three extraction method used for coagulation/flocculation were Aqueous crude extract, salt crude extract and defatted salt extract which were gave best result at dosage of 20 ml,acidic condition of 6.0 and 60 min of agitation time. Coagulation test revealed that, superior total coliform removal of 96.32% was achieved through Defatted salt extract and gave residual turbidity of 4.25NTU which is acceptable based on WHO standard of drinking water. Its removal efficiency was good for all pH range especially at neutral and slightly basic pH condition. Overall, finding of this research suggest the potential of using Papaya seed as bio-coagulant for raw water treatment.

Several methods have been used to reduce the negative contribution of heavy metal contaminants effluents in the environment. The method studied in this research was the use of activated carbon derived from Ethiopian lignite for hexavalent chromium adsorption from aqueous solution. The adsorption study was evaluated as the function of initial Cr (VI) concentration, adsorbent dosage and pH. All the batches' tests were conducted by using synthetic wastewater in this study. General Factorial Design (GFD) of Response surface methodology (RSM) was used in this batch test for analysis of experimental. The effects of independent variables on various initial Cr (VI) concentrations between 20 ppm and 100 ppm were evaluated. According to ANOVA analysis, each and combined term is statistically significant. A Cr (VI) removal efficiency of 98 % was achieved at pH 1 with 3.5 g of LAC in 200 ml of solution at 4 h of contact time using initial Cr (VI) concentration of 20 ppm. Removal increased up to 96.54% when Cr (VI) concentration decreased to 20.5 ppm, and adsorbent dose increased to 3.01 g at pH 1. 49.94% chrome removal was achieved at Cr (VI) concentration of 100 ppm and pH 5 with an adsorbent dose of 3.5 g for the combined effect of initial Cr (VI) concentration and pH, which was decreased with increased both initial Cr (VI) concentrations and pH value. With the combined effect of pH and adsorbent dosage the maximum percentage removal of Cr (VI) ion was obtained at lower pH and higher adsorbent dosage (96.5%). The adsorption of Cr (VI) was evaluated using batch adsorption equilibrium isotherms (Langmuir and Frendlich) and kinetics reaction rate (first and second order). The Frendlich isotherm model was the best one for the description of adsorption of Cr (VI) onto LAC heterogeneous surface energy. The adsorption kinetics of Cr (VI) onto LAC followed the second order kinetic model, suggesting that the adsorption reaction rate depends on two parameters, which might be the Cr (VI) concentration and adsorbent dosage. These results support similar conclusions mentioned by several authors in the literature.

Background: The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa., Methods: Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I 2 statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity., Results: Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women., Conclusion: The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications., (© 2023. The Author(s).)

Background: Women's HIV-positive disclosure plays a pivotal role to achieve the goal of preventing mother-to-child transmission (PMTCT) among pregnant women in particular. Although several primary studies were conducted in the different countries of East Africa, no study concluded the prevalence of women's HIV status disclosure and associated factors in East Africa. Therefore, the current study aimed to assess the pooled prevalence of disclosure status and associated factors among women in East Africa., Objectives: To assess the pooled prevalence of HIV sero-status disclosure and associated factors among women in East Africa., Methods: HINARI, PubMed, and Cochrane Library databases were searched. The data were extracted using a Microsoft Excel spreadsheet and STATA v 14.1 was used for the analysis. The Funnel plots and Egger's statistical test was used to check publication bias. Heterogeneity was assessed by conducting sensitivity and subgroup analyses., Result: The pooled prevalence of sero-status disclosure among women in East Africa was 73.77% (95%CI 67.76, 79.77). Knowing partner's sero-status (OR = 10.04(95%CI 3.36, 31.84), married (OR = 2.46 (95%CI 1.23, 4.89), smooth relationship (OR = 3.30 (95%CI 1.39, 7.84), and discussion on HIV before the test (OR = 6.96 (95%CI 3.21, 15.05) were identified determinants of HIV sero-status disclosure., Conclusion: The current systematic and meta-analysis revealed that nearly one-fourth of women had not disclosed HIV sero-status to at least one individual. Knowing the partner's HIV sero-status, being married, having a smooth relationship, and discussing on HIV before the test were determinants of disclosure status. Therefore, disclosure of HIV-positive sero-status among women living with HIV needs to 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. The reviewer ET declared a shared affiliation with the authors to the handling editor at time of review., (Copyright © 2022 Mosisa, Mulisa, Oluma, Bayisa, Merdassa, Bayisa, Tamiru, Tolossa, Chala Diriba, Fetensa and Wakuma.)

Background: Exercise during pregnancy is among the cost-effective options that can significantly reduce the burden of chronic metabolic diseases leading to an adverse birth outcome. Despite the negative consequences of sedentary life among pregnant women, little is known about the pregnant mothers' knowledge, attitude, and associated factors toward exercise during pregnancy in Ethiopia, particularly in the study area., Objective: To assess knowledge, attitude, and associated factors toward exercise during pregnancy among women attending antenatal care at Bahir Dar city, Northwest Ethiopia, 2020., Methodology: A health facility-based cross-sectional study design was employed among 475 pregnant women from March 12 to May 12, 2020. A systematic random sampling technique was used to select the study participants. Interviewer-administered questionnaire was used to collect the data from pregnant women attending the antenatal care unit. Data were coded and entered using Epidata version 3.1 and analyzed by Statistical Package for Social Science (SPSS) version 25. Binary and multivariable logistic regressions were used to identify possible determinants and an odds ratio was used to measure the strength of associations at a p -value of <0.05., Result: The study showed that 55.8% (95% CI: 48.45-59.12) of pregnant women were knowledgeable about benefits and contraindication of exercise during pregnancy; 53.3% (95% CI: 49.05-57.62) of them had positive attitudes toward exercise during pregnancy. Educational status adjusted odd ratio (AOR) = 3.95 (95% CI: 1.712-9.108), practicing physical exercise before becoming pregnant AOR = 3.64 (95% CI: 1.091-12.118), and women who heard about exercise during pregnancy AOR = 4.74 (95% CI: 2.563-8.756) were found to have statistically significant association with knowledge of women about exercise during pregnancy. Women who were knowledgeable about exercise during pregnancy AOR = 4.45 (95% CI: 2.39-8.29) and women who heard about exercise during pregnancy AOR = 4.2 (95% CI: 2.19-8.08) were more likely to have a positive attitude toward benefits of exercise during pregnancy., Conclusion: The level of mothers' knowledge and attitude toward exercise during pregnancy in the study area was low. Educational status, physical exercise before pregnancy, ever heard about exercise during pregnancy were independent determinants of women's knowledge, while ever heard and knowledgeable about exercise during pregnancy were determinants of favorable attitude toward exercise during pregnancy. Empowering women through health education about physical exercise during pregnancy should get due attention., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)