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Abstract Background Digital technologies, such as wearable devices and smartphone applications (apps), can enable the decentralisation of clinical trials by measuring endpoints in people’s chosen locations rather than in traditional clinical settings. Digital endpoints can allow high-frequency and sensitive measurements of health outcomes compared to visit-based endpoints which provide an episodic snapshot of a person’s health. However, there are underexplored challenges in this emerging space that require interdisciplinary and cross-sector collaboration. A multi-stakeholder Knowledge Exchange event was organised to facilitate conversations across silos within this research ecosystem. Methods A survey was sent to an initial list of stakeholders to identify potential discussion topics. Additional stakeholders were identified through iterative discussions on perspectives that needed representation. Co-design meetings with attendees were held to discuss the scope, format and ethos of the event. The event itself featured a cross-disciplinary selection of talks, a panel discussion, small-group discussions facilitated via a rolling seating plan and audience participation via Slido. A transcript was generated from the day, which, together with the output from Slido, provided a record of the day’s discussions. Finally, meetings were held following the event to identify the key challenges for digital endpoints which emerged and reflections and recommendations for dissemination. Results Several challenges for digital endpoints were identified in the following areas: patient adherence and acceptability; algorithms and software for devices; design, analysis and conduct of clinical trials with digital endpoints; the environmental impact of digital endpoints; and the need for ongoing ethical support. Learnings taken for next generation events include the need to include additional stakeholder perspectives, such as those of funders and regulators, and the need for additional resources and facilitation to allow patient and public contributors to engage meaningfully during the event. Conclusions The event emphasised the importance of consortium building and highlighted the critical role that collaborative, multi-disciplinary, and cross-sector efforts play in driving innovation in research design and strategic partnership building moving forward. This necessitates enhanced recognition by funders to support multi-stakeholder projects with patient involvement, standardised terminology, and the utilisation of open-source software.

Abstract Background People with rheumatic diseases experience troublesome fluctuations in fatigue. Debated causes include pain, mood and inflammation. To determine the relationships between these potential causes, serial assessments are required but are methodologically challenging. This mobile health (mHealth) study explored the viability of using a smartphone app to collect patient-reported symptoms with contemporaneous Dried Blood Spot Sampling (DBSS) for inflammation. Methods Over 30 days, thirty-eight participants (12 RA, 13 OA, and 13 FM) used uMotif, a smartphone app, to report fatigue, pain and mood, on 5-point ordinal scales, twice daily. Daily DBSS, from which C-reactive Protein (CRP) values were extracted, were completed on days 1–7, 14 and 30. Participant engagement was determined based on frequency of data entry and ability to calculate within- and between-day symptom changes. DBSS feasibility and engagement was determined based on the proportion of samples returned and usable for extraction, and the number of days between which between-day changes in CRP which could be calculated (days 1–7). Results Fatigue was reported at least once on 1085/1140 days (95.2%). Approximately 65% of within- and between-day fatigue changes could be calculated. Rates were similar for pain and mood. A total of 287/342 (83.9%) DBSS, were returned, and all samples were viable for CRP extraction. Fatigue, pain and mood varied considerably, but clinically meaningful (≥ 5 mg/L) CRP changes were uncommon. Conclusions Embedding DBSS in mHealth studies will enable researchers to obtain serial symptom assessments with matched biological samples. This provides exciting opportunities to address hitherto unanswerable questions, such as elucidating the mechanisms of fatigue fluctuations.

BackgroundThe past decade has seen an explosion of research in causal mediation analysis. However, most analytic tools developed so far rely on frequentist methods which may not be robust in the case of small sample sizes. In this paper, we propose a Bayesian approach for causal mediation analysis based on Bayesian g-formula, which will overcome the limitations of the frequentist methods.MethodsWe created BayesGmed, an R-package for fitting Bayesian mediation models in R. The application of the methodology (and software tool) is demonstrated by a secondary analysis of data collected as part of the MUSICIAN study, a randomised controlled trial of remotely delivered cognitive behavioural therapy (tCBT) for people with chronic pain. We tested the hypothesis that the effect of tCBT would be mediated by improvements in active coping, passive coping, fear of movement and sleep problems. We then demonstrate the use of informative priors to conduct probabilistic sensitivity analysis around violations of causal identification assumptions.ResultThe analysis of MUSICIAN data shows that tCBT has better-improved patients' self-perceived change in health status compared to treatment as usual (TAU). The adjusted log-odds of tCBT compared to TAU range from 1.491 (95% CI: 0.452-2.612) when adjusted for sleep problems to 2.264 (95% CI: 1.063-3.610) when adjusted for fear of movement. Higher scores of fear of movement (log-odds, -0.141 [95% CI: -0.245, -0.048]), passive coping (log-odds, -0.217 [95% CI: -0.351, -0.104]), and sleep problem (log-odds, -0.179 [95% CI: -0.291, -0.078]) leads to lower odds of a positive self-perceived change in health status. The result of BayesGmed, however, shows that none of the mediated effects are statistically significant. We compared BayesGmed with the mediation R- package, and the results were comparable. Finally, our sensitivity analysis using the BayesGmed tool shows that the direct and total effect of tCBT persists even for a large departure in the assumption of no unmeasured confounding.ConclusionThis paper comprehensively overviews causal mediation analysis and provides an open-source software package to fit Bayesian causal mediation models.

Soil erosion poses a global threat to soil loss, agricultural land deterioration, and crop yield decreases. This paper accounts for the establishment of sustainable land planning, and methods for evaluating soil erosion rates. The study was conducted based on the system complex analysis to prioritize soil erosion in Ribb watershed to improve soil and water conservation planning. Several geographical-environmental factors affecting soil erosion (land use, soil, slope, SPI, TWI, river Proximity, curvature, aspect) considered to assess potential soil erosion risk. The information levels were focused on expert experience, and the dynamic decision-making process built in a network framework. The weights for each layer were computed by R Studio fuzzy AHP package. The map of soil erosion susceptibility was developed by combining layers in a platform based on their weights and means of erosion-related incidents in regional surveys. Hence, the soil erosion map's overall results showed very high, high, moderate, low, and very low vulnerability to erosion with areal coverage of 13.4 %, 27.93 %, 32.74 %, 17.42 %, and 8.5 %, respectively. The susceptibility map demonstrates that high soil erosion sensitive areas with Fuzzy and AHP respectively cover 11.05 % and 15.75 %. The study indicates that priority should be given to high and very high erosion-prone areas in Rib watershed to adapt to climate change and control sedimentation problems in the Rib reservoir and Lake Tana.

The study aimed to evaluate the SWAT and HBV model’s responses to estimate streamflow in three typical selected watersheds in the upper Blue Nile Basin, Ethiopia. The evaluation was carried out through simulation of runoff in three watersheds, namely: Gilgel Abay, Anger, and Maybar located in the upper Blue Nile Basin, Ethiopia. The same calibration and validation period were applied for each watershed model with their respective historical records. The objective function indicates the optimized range of model parameters during the calibration and validation procedure, and it gives a good model response result, which is determined by the recommended performance indicators and hydrograph plots. The HBV and SWAT model’s calibration responds with (NSE = 0.81, NSE = 0.48 and NSE = 0.46) and (NSE = 0.81, NSE = 0.63, NSE = 0.61), respectively for Gilgel Abay, Anger, and Maybar watersheds. The optimized parameters were applied to validate the model using independent historical data. The SWAT and HBV model responses for NSE during the validation period were 0.8, 0.55, and 0.54 and 0.63, 0.45, and 0.34, respectively, for Gilgel Abay, Anger, and Maybe watersheds. An alternative was observed to over and under estimate runoff during stimulation periods in extreme wet and dry periods. Generally, the calibrated and validated hydrograph output result indicates that the model’s responses to too wet and dry conditions were not satisfactory. Therefore, further model refinements for extreme events, including season-based model evaluations that could improve the process representation of rainfall-runoff events, are recommended.

Detailed knowledge of the characteristics of COVID-19 patients helps with public health planning. Here, the authors use routinely-collected data from seven databases in three countries to describe the characteristics of >30,000 patients admitted with COVID-19 and compare them with those admitted for influenza in previous years.

Abstract. Introduction:. Previous studies on the association between weather and pain severity among patients with chronic pain have produced mixed results. In part, this inconsistency may be due to differences in individual pain responses to the weather. Methods:. To test the hypothesis that there might be subgroups of participants with different pain responses to different weather conditions, we examined data from a longitudinal smartphone-based study, Cloudy with a Chance of Pain, conducted between January 2016 and April 2017. The study recruited more than 13,000 participants and recorded daily pain severity on a 5-point scale (range: no pain to very severe pain) along with hourly local weather data for up to 15 months. We used a Bayesian multilevel model to examine the weather–pain association. Results:. We found 1 in 10 patients with chronic pain were sensitive to the temperature, 1 in 25 to relative humidity, 1 in 50 to pressure, and 3 in 100 to wind speed, after adjusting for age, sex, belief in the weather–pain association, mood, and activity level. The direction of the weather–pain association differed between people. Although participants seem to be differentially sensitive to weather conditions, there is no definite indication that participants' underlying pain conditions play a role in weather sensitivity. Conclusion:. This study demonstrated that weather sensitivity among patients with chronic pain is more apparent in some subgroups of participants. In addition, among those sensitive to the weather, the direction of the weather–pain association can differ.

Soil erosion is a major environmental problem that degrades topsoil and agricultural land productivity in mountainous areas such as Ethiopia. Soil erosion estimation is critical for the planning of erosion control plans in an agriculture-dependent economy. The current study used the Revised Universal Soil Loss Equation (RUSLE) model to evaluate the spatial distribution of annual soil loss and sediment yield in the Rib watershed. The main factors affecting soil erosion and sediment yield include vegetation cover, topography, soil, and climate. Soil erosion and sediment yield maps should be produced with these elements in account to describe locations with high soil erosion and sediment yield risks and to ensure improved erosion mitigation strategies in watersheds. The five input parameters were rainfall erosivity (R), soil erodibility (K), slope length-steepness (LS), cover-management factor (C), and support practice (P). The RUSLE model, when combined with remote sensing technology, has the ability to provide accurate and low-cost erosion and sediment yield risk maps in the Rib watershed. The estimated average annual soil loss was 25.53 t ha−1 yr−1. The soil loss rate was higher in the steeper and topographically dissected part of the watershed. Sediment delivery ratio ranges between 0 and 0.82. The outcome undoubtedly aids in the identification of priority locations for the adoption of sustainable land management and soil erosion mitigation conservation strategies.

BackgroundSmartphone location data can be used for observational health studies (to determine participant exposure or behavior) or to deliver a location-based health intervention. However, missing location data are more common when using smartphones compared to when using research-grade location trackers. Missing location data can affect study validity and intervention safety. ObjectiveThe objective of this study was to investigate the distribution of missing location data and its predictors to inform design, analysis, and interpretation of future smartphone (observational and interventional) studies. MethodsWe analyzed hourly smartphone location data collected from 9665 research participants on 488,400 participant days in a national smartphone study investigating the association between weather conditions and chronic pain in the United Kingdom. We used a generalized mixed-effects linear model with logistic regression to identify whether a successfully recorded geolocation was associated with the time of day, participants’ time in study, operating system, time since previous survey completion, participant age, sex, and weather sensitivity. ResultsFor most participants, the app collected a median of 2 out of a maximum of 24 locations (1760/9665, 18.2% of participants), no location data (1664/9665, 17.2%), or complete location data (1575/9665, 16.3%). The median locations per day differed by the operating system: participants with an Android phone most often had complete data (a median of 24/24 locations) whereas iPhone users most often had a median of 2 out of 24 locations. The odds of a successfully recorded location for Android phones were 22.91 times higher than those for iPhones (95% CI 19.53-26.87). The odds of a successfully recorded location were lower during weekends (odds ratio [OR] 0.94, 95% CI 0.94-0.95) and nights (OR 0.37, 95% CI 0.37-0.38), if time in study was longer (OR 0.99 per additional day in study, 95% CI 0.99-1.00), and if a participant had not used the app recently (OR 0.96 per additional day since last survey entry, 95% CI 0.96-0.96). Participant age and sex did not predict missing location data. ConclusionsThe predictors of missing location data reported in our study could inform app settings and user instructions for future smartphone (observational and interventional) studies. These predictors have implications for analysis methods to deal with missing location data, such as imputation of missing values or case-only analysis. Health studies using smartphones for data collection should assess context-specific consequences of high missing data, especially among iPhone users, during the night and for disengaged participants.

Abstract 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.

Comorbid conditions appear to be common among individuals hospitalised with coronavirus disease 2019 (COVID-19) but estimates of prevalence vary and little is known about the prior medication use of patients. Here, we describe the characteristics of adults hospitalised with COVID-19 and compare them with influenza patients. We include 34,128 (US: 8362, South Korea: 7341, Spain: 18,425) COVID-19 patients, summarising between 4811 and 11,643 unique aggregate characteristics. COVID-19 patients have been majority male in the US and Spain, but predominantly female in South Korea. Age profiles vary across data sources. Compared to 84,585 individuals hospitalised with influenza in 2014-19, COVID-19 patients have more typically been male, younger, and with fewer comorbidities and lower medication use. While protecting groups vulnerable to influenza is likely a useful starting point in the response to COVID-19, strategies will likely need to be broadened to reflect the particular characteristics of individuals being hospitalised with COVID-19.

Abstract 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. Graphical Abstract

Abstract Expansive soils pose significant challenges to road construction globally due to their tendency to expand and contract with changes in moisture content, leading to pavement failure. In the construction industry, finding an economical and cost-effective alternative to conventional road construction materials is crucial. The use of a natural cinder ash and hydrated lime mixture as reinforcement has proven to be effective in addressing this issue. Cinder ash, a readily available waste material in countries like Ethiopia, is adaptable and water-resistant, making it an ideal choice for reinforcing expansive soil. This article investigates the strength performance of a cinder ash and hydrated lime mixture as a reinforcement material for expansive soil. The study involves mixing 0%, 20%, 25%, 30%, and 35% of cinder ash with soil stabilized with 2–5% hydrated lime. Expansive soil samples are prepared according to the ASSHTO & ASTM method and tested for compressive strength, California bearing ratio, bulk density, and water absorption. The findings reveal a 448.62%, and 374% increase in compressive strength and California Bearing Ratio respectively for the specimen containing 5% hydrated lime and 35% cinder ash, cured for 28 days. The water absorption is minimized at 15.23% for the 5% hydrated lime and 35% cinder ash mixture; while the maximum density of the soil is observed at 1.774 kg/m3 for the optimal combination of 5% hydrated lime and 35% cinder ash mix. The study suggests that using 5% hydrated lime and 35% cinder ash content for the stabilization of expansive soil significantly enhances the strength characteristics of compressed stabilized soil.

Abstract Background Adolescence is commonly perceived as a distinct and typically healthy stage of life. However, in regions with a high prevalence of HIV, like Ethiopia, numerous adolescents are contracting the virus. Upon testing and diagnosis, they encounter care-related issues, particularly barriers and facilitators of the healthcare transition from adolescent to adult clinics. Hence, the study aimed to investigate the barriers and facilitators influencing the transition of adolescents living with HIV (ALWHs) in the resource-limited settings of Southern Ethiopia. Methods The research employed a phenomenological study design with a qualitative methodology. Purposive sampling was used to gather data through in-depth interviews (IDIs) and focus group discussions (FDGs) involving ALWHs and their parents. The data analysis followed Van Manen’s principles. Results Following Van Manen’s guidelines, the data analysis revealed a conceptual framework with two major themes: “Barriers” and “Facilitators”. The theme barrier was derived from three sub-themes including behavioral barriers, social barriers, and system barriers in the transition. The theme facilitator was derived from four sub-themes including self-acceptance as an adult, a desire to experience new things, a supportive family, and friendly healthcare services. The study identified three levels of factors influencing the transition into adult clinics: individual, family/peer, and healthcare-related factors. The barriers to transition included lack of knowledge, being in a romantic relationship, psychosocial struggles, perceiving us as immature, stigma, negative peer pressure, lack of timely disclosure, absence of transition guidelines, disrespectful treatment, and absence of separate clinics. On the other hand, facilitators such as self-acceptance as an adult, desire for new experiences, family support, informed support and promising outcomes, flexible appointment scheduling, and psycho-social support groups were found to improve the transition process and enhance the overall well-being of adolescents living with HIV. Conclusion The study highlights the complex transition process for ALWHs into adult healthcare. Barriers such as lack of knowledge, stigma, and disrespectful treatment pose challenges during this critical period. Conversely, facilitators like self-acceptance, family support, and youth-friendly healthcare services can enhance the transition experience and well-being of ALWHs. Collaborative efforts among ALWHs, families, and healthcare providers are crucial for successful transitions and improved health outcomes. Separated clinics catering to the unique needs of ALWHs are recommended to address privacy concerns.

BackgroundThe full pentavalent (DPT-HepB-Hib) vaccination is the main strategy to prevent five communicable diseases in early childhood, especially in countries with huge communicable disease burdens like Ethiopia. Exploring spatial distributions and determinants of full pentavalent vaccination status in minor ecological areas in Ethiopia is crucial for creating targeted immunization campaigns and monitoring the advancement of accomplishing sustainable development goals. This study aimed to investigate the spatial disparities and determinants of full pentavalent vaccination among 12-23-month-old children in Ethiopia.MethodThe data on pentavalent vaccine uptake was found in the Ethiopian Health and Demographic Survey (EDHS, 2019). A two-stage cluster sampling method was applied to collect the EDHS data. The enumeration area was the primary sample unit while the household served as the secondary sampling unit. The geographical variations of full pentavalent vaccine uptake were explored using Quantum Geographic Information System (QGIS) software. The significant predictors of full pentavalent vaccination were identified using a simple logistic regression model through R version 4.1 software.ResultThe national full pentavalent vaccine uptake was 59.2%. The spatial distribution of full pentavalent vaccine uptake was not uniform in Ethiopia. Spatial cluster analysis revealed that most of low coverage regions for full pentavalent vaccine uptake were Afar, Somali, and Harari. The regions with the highest and lowest rates of vaccine uptake were Tigray and Harari region, respectively. Maternal age of 35-49 years (AOR = 3.42; 95% CI: 1.99, 5.87), and 25-34 years (AOR = 1.55; 95% CI: 1.17, 2.19), primary education attended (AOR = 1.51; 95%CI: 1.07, 2.11), richness wealth index (AOR = 1.96; 95% CI: 1.40, 2.75), birth order of 1-3 (AOR = 1.88; 95% CI: 1.19, 2.96), and delivery in the health facility (AOR = 3.41: 95% CI: 2.52, 4.61) were the determinants of full pentavalent vaccine uptake in Ethiopia.ConclusionEthiopia's full pentavalent vaccine uptake was far lower than the global target. Older maternal age, maternal education, wealth index, birth order, and giving birth in a health facility were the determinants of full pentavalent vaccine uptake. Special attention should be given to Afar, Somali, and Harari regions, to strengthen the vaccine uptake. Moreover, improved socioeconomic status and getting maternal health services during delivery are necessary to enhance vaccine uptake.

The globally increasing concern over industrial byproducts highlights the need for sustainable waste management solutions. Repurposing such byproducts offers a promising approach to sustaining development. This study focuses on the extraction of silica from filter cake waste (FCW). Amorphous silica was successfully synthesized through sol–gel method using acetic acid as the precipitation agent. XRD and SEM analyses were used to confirm the crystal structure of silica to be amorphous, while FTIR studies identified characteristic Si−O−Si bonds, indicating high purity of the extract. The silica purity was further validated by EDS analysis to be about 98.98%. Optimization of the extraction process was carried through variation of parameters such as NaOH concentration, temperature, and stirring time, resulting in a maximum yield of 54%.

Ethiopia is currently emphasizing the construction of micro dams to enhance agricultural productivity and assure food security. The Upper Guder Dam, situated in the West Shoa Zone, Central Ethiopia, is one such project. However, the dam faces challenges due to complex geological and structural conditions, including leakage and slope instability. Hence, this study focuses on addressing the abutment slope stability and watertightness condition of this dam. Accordingly, the study employed discontinuity surveying, Seismic Refraction Tomography (SRT), Rock Quality Designation (RQD), and Lugeon testing to assess the water tightness. Additionally, kinematic analysis and the Limit Equilibrium Method (LEM) were used to evaluate abutment slope stability. Results from surface geological mapping and core drilling showed that the dam site is constituted by quaternary soil, tuff, and basalt. The Lugeon test results indicate that the left abutment of the dam is susceptible to leakage down to a depth of 40 m, which suggests that the permeable zone extends deeper than the results revealed by the SRT. Furthermore, this test demonstrated that the dam's right and central foundations are susceptible to leakage to the drilled depths. The SRT revealed that the central foundation, right, and left abutments of the dam are susceptible to leakage to the depth of 35 m, 30 m, and 34 m, respectively. Moreover, the kinematic analysis revealed that a section of the left abutment of the dam is susceptible to wedge mode of failure due to the intersection of JS1 and JS2. The LEM modeling of the right abutment of the dam also depicted that this section of the dam is unstable under saturated conditions which illustrates the importance of precipitation as the major slope destabilizing factor in the study area. Based on the study findings, this study recommended the use of curtain grouting to address the water tightness issue and slope angle reduction to mitigate the slope instability problem.