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Ebsitu Abate,1 Maria Degef,1 Addisu Melkie,2 Natesan Gnanasekeran,1 Mohammed Mehdi,1 Yosef Tolcha,3 Dawit Chala3 1Department of Medical Biochemistry Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Diagnostic Laboratory, Ethiopian Public Health Institute, Addis Ababa, EthiopiaCorrespondence: Ebsitu Abate, Tel +251 912632054, Email ebsitu.abate@aau.edu.etIntroduction: Cardiovascular disease (CVD) is the foremost killer disease worldwide. ASCVD is one of the most common types of CVD. It is mainly associated with a condition called atherosclerosis. Its occurrence is linked to several risk factors. Hypertension, diabetes, dyslipidemia, smoking, genetic factors, and so on are examples. The presence of ASCVD, as well as its risk factors, causes a variety of disruptions in the body’s physiological and biological functions. The presence of abnormal physiological and biological functions, for example, tends to disrupt hematological parameters.Purpose: The study’s aim was to assess and compare the pattern of hematological parameters in people with established atherosclerotic cardiovascular disease (ASVD) versus people with ASCVD risks alone who attended TASH Addis Ababa, Ethiopia, as well as to correlate hematological parameters with the novel inflammatory marker hs-CRP.Methods: A prospective cross-sectional comparative study with 100 study participants was conducted during where October 2019-March 2020 proposal development, sample collection, and lab analysis period, and from March 2020-June to 2021 data entry, analysis, and writing period. A serum sample was collected from each study participant for the lipid and hsCRP analyses and whole blood for hematological parameter determination. The socio-demographic characteristics of the study participants were obtained through a well-structured questionnaire.Results: The ASCVD-risk group had significantly higher mean platelet volume (MPV), which was associated with the presence of the risk. Furthermore, hs-CRPs show a significant correlation with MPV in a correlation analysis of highly sensitive C-reactive protein (hs-CRP) with hematological parameters. Thus, using these affordable, routinely tested, and easily available tests may help to infer future ASCVD risk as well as the presence of ASCVD morbidity while hsCRP level in comparison group vs cases requires further study.Keywords: ASCVD, hematological parameters, hs-CRP, hypertension, diabetes

Hilina Mollalign,1,2 Dawit Chala,1 Dereje Beyene2 1TB/HIV Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 2Department of Microbial, Cellular, and Molecular Biology, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Hilina Mollalign, Email tersit21@gmail.comBackground: Coronavirus disease 19 (COVID-19) and Mycobacterium tuberculosis (MTB) are among the top ongoing health crises globally. Both cause respiratory diseases, and the clinical presentations are similar. There is no summarized information about cases of COVID-19 patients with concomitant TB infection from different settings. Therefore this review aimed to summerize the clinical features and treatment outcomes of coronavirus and tuberculosis co-infected patients.Methods: An electronic search of case reports published between 2020 and 2021 was conducted using Google Scholar, PubMed, Scopus, and ScienceDirect. From eligible reports, data were collected for the selected variables. We analyzed the collected information using SPSS version 27 software. Descriptive statistics were computed for the selected variables.Results: A total of 83 patient histories were collected from 47 case reports. The majority (80%) of the cases were reported for male patients. The mean age was 42.6 years (3 months to 84 years, SD=17.3). Fever was reported in 80% of cases, followed by cough (73.3%) and hypotension (37.1%). Blood cell parameters revealed lymphopenia (52%), lower hemoglobin (30%), elevated CRP (70%), elevated ferritin (28%), and increased D-dimer (23.4%). Treatment outcome is significantly associated with blood cell count results (p-0.044) and a rise in blood inflammatory cytokines(p-0.041). The mean days for viral clearance or negative PCR was 23 days (Range 5– 82 days) and the overall mean duration of hospitalization was 27 days. The total death rate was 22.4%. Recovery was reported for 76.6% of cases. Survival status (p-0.613) and disease severity (p-0.68) are not significantly associated with the gender of the participants.Conclusion: An alteration in blood cell parameters is associated with an unfavorable treatment outcome. There is a higher death rate in COVID-19/TB co-infection. The death is associated with older age, smoking or smoking history, drug abuse, and co-morbidity of non-communicable diseases. Conversely, there is a lower death rate in HIV patients.Keywords: coronavirus, SARSCOV-2, COVID-19, Mycobacterium tuberculosis, tuberculosis, TB, co-infection

Dinkenesh Chalchisa,1,2 Yohannes Belay,1 Endalkachew Befekadu,3 Melkitu Kassaw,4 Letebrhan G/Egzeabher,5 Gebremedhin Gebremicael,1 Boki Lengiso,1 Dawit Chala,1 Zewdineh Sahlemariam,6 Estifanos Kebede,6 Ebba Abate,4 Aster Tsegaye2 1National HIV Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 2Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Medical Laboratory, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia; 4Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 5Department of Medical Laboratory, Yekatit 12 Medical College Hospital, Addis Ababa, Ethiopia; 6Jimma University, Jimma, EthiopiaCorrespondence: Dinkenesh Chalchisa, National HIV Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, 1242, Ethiopia, Tel + 251-91-064-0900, Email dinkeneshc@gmail.comBackground: Reference intervals for clinical laboratory parameters differ based on several factors, including age, sex, genetic variation, and geographic location. This variation influences clinical decisions and treatment monitoring. Currently, Ethiopia has used adopted reference intervals from manufacturer values derived from non-Africans. Therefore, the aim this study was to determine reference intervals for absolute and percentage CD4+ T cells for an apparently healthy population in Addis Ababa, Ethiopia.Methods: A community-based cross-sectional study was conducted on 361 apparently healthy people in four subcities in Addis Ababa from January to June 2019. Sociodemographic and clinical data were collected using a structured questionnaire after informed consent had been obtained. Blood samples were collected and CD4+ T-lymphocyte enumeration performed using a BD FACSPresto near-patient CD4 counter. Data were entered and analyzed using SPSS 20. Reference intervals were determined by a nonparametric test estimating percentiles 2.5 (lower limit) and 97.5 (upper limit) with 95% CIs. P< 0.05 was considered statistically significant.Results: A total of 337 (183 female and 154 male) healthy participants of median age 28 (IQR 17– 35) years were included in the final analysis. Medians of absolute and percentage CD4+ T-cell counts (932.0 and 42.9, respectively) of female participants were significantly higher than male participants (802.5 and 38.7, respectively; P< 0.05). Reference intervals for absolute CD4+ T-cell count and percentages in males were 483.8– 1,310 cells/μL and 18.1– 57.3 and in females 447.8– 1,479.8 cells/μL and 25.6– 58.9, respectively.Conclusion: The CD4+ T-count reference intervals established in this study showed some inconsistency from the manufacturer’s provided values and other studies and also revealed sex differences, necessitating sex-specific locally established reference intervals.Keywords: reference interval, CD4 count, %CD4, Ethiopia

Abstract Background Respiratory tract infection (RTI) has been a predominant health problem worldwide, including Ethiopia. It is one of the major causes of under-five mortality in Ethiopia, accountable for 18% of total deaths. Nationwide studies on the incidence of respiratory infections and maternal risk factors are limited. Hence, this study was aimed to determine the incidence and predictors of respiratory infections among infants aged less than six months in Ethiopia, 2023. Methods This was a retrospective follow up study using data from Performance Monitoring for Action Ethiopia (PMA Ethiopia). A two-stage cluster sampling technique was used to select a total 2,246 eligible study participants from 206 enumeration areas. A Cox proportional hazards regression model was used to identify independent predictors of respiratory tract infection incidence. Hazard ratios with 95% confidence intervals and p value

Abstract Background Undernutrition remains a global challenge and public health concern, despite the presence of policies, programs and interventions. There is substantial evidence that the majority of the rural children under-5 years old have composite index of anthropometric failure than the urban counter parts. Hence, identifying the main contributors of these disparities will help health policy makers, program designers and implementers for the reduction of composite index of anthropometric failures in children under-5 years old in the study areas. Methods The most recent and nationally representative samples of demographic and health surveys of five East African countries data were used for the current study. To appreciate the residence-based differences of composite index of anthropometric failure in under-5 children, the Blinder-Oaxaca decomposition analysis and its extensions were employed to determine the effects of covariates and coefficients. The country specific survey data analysis was performed. Results The current study revealed that the burden of composite index of anthropometric failure (CIAF) in under-5 children were 40.69%, 22.04%, 34.06%, 31.99%, and 33.27% in Ethiopia, Kenya, Rwanda, Uganda, and Tanzania respectively. The residence-based differences in CIAF were 25.49%, 11.38%, 27%, 22.15%, and 20.55% in Ethiopia, Kenya, Rwanda, Uganda, and Tanzania respectively. Results of the Blinder-Oaxaca decomposition analysis and its extensions revealed that 100% of the rural–urban children under-5 composite index of anthropometric failure disparity was explained by endowment characteristics (covariate effect). Wealth index, mother’s education, age of child, type of birth, sex of child and birth interval inequality between rural and urban households explains most of the composite index of anthropometric failure disparity in children under-5 years old. Conclusions The residence-based CIAF differences were high in all study countries. The rural–urban CIAF gap is ascribed by household, maternal and child characteristics. This result implies that rural children under-5 is disproportionally disadvantaged with respect to characteristics than their consequences. Through identification of the underlying factors behind the rural–urban CIAF disparities, the result of this study is important in planning effective intervention measures aiming at reducing residence-based inequalities and the population health outcomes. Therefore, should be given for rural children to reduce CIAF by improving house hold wealth index, women education and attentions to older children, and female children.

Abstract Bovine viral diarrhea (BVD) is a highly infectious disease affecting cattle, leading to significant economic losses in many countries engaged in cattle production. From February 2022 to October 2022, a study was conducted to determine the seroprevalence and associated risk factors of Bovine Viral Diarrhea Virus (BVDV) in the Sebeta subcity area of Sheger city, Ethiopia. The study utilized a semi-structured questionnaire to gather information on herd management practices from dairy farm owners. Serum samples from 170 individual cattle across 34 herds were collected and tested for BVDV antibodies using the indirect enzyme-linked immunosorbent assay (ELISA). The prevalence of BVD antibodies at both the animal and herd levels was analyzed, and potential risk factors were identified using Chi-square analysis and logistic regression. The study found that 19.41% of individual cattle (33 out of 170) and 44.12% of herds were positive for BVDV antibodies. Multiple logistic regression analysis identified several significant risk factors associated with BVDV infection. Multiparous dairy cows were found to be 2.3 times more likely to be seropositive compared to primiparous and nulliparous cows. Crossbreed dairy cattle had double the odds of being seropositive compared to pure breeds. Additionally, cattle from larger herds were 5.01 times more likely to be seropositive than those from smaller herds. Farms that introduced new animals had triple the odds of seropositivity compared to those that did not. The study indicates a high exposure rate of cattle to BVDV infection in and around Sebeta sub-city. Further research is recommended to explore the molecular epidemiology of BVDV in the region.

Abstract Background Equity in COVID-19 vaccine uptake is the heart of managing the ongoing pandemic of COVID-19 disease. However, the evidence of inequality in COVID-19 vaccination in Ethiopia is limited. Therefore, this study investigated the trends of socioeconomic and geographic inequality of COVID-19 vaccine uptake in Ethiopia. Method This study used the Global COVID-19 trends and impact survey as part of the WHO Health Equity Assessment Toolkit software 2021 version. The trends of socioeconomic and geographic inequalities in COVID-19 vaccine uptake between surveys were calculated with a 95% confidence interval (CI). A 95% CI was calculated along with measures of inequality in COVID-19 vaccine uptake and statistical significance was declared if the 95% CI of absolute and relative measures of inequalities does not include 0 and 1 respectively. Result The COVID-19 vaccine uptake in the 45–65 age group significantly increased from 40.04%, 95% CI (32.49, 48.1) to 72.7%, 95%CI (63.7, 80.2) in 05/2021 to 03/2022 respectively. The absolute inequality of COVID-19 vaccine uptake among male vs female respondents was 3.6%, 95% CI (3.9, 11.2) in 08/2021 which was obtained by subtraction of the respecting proportion of vaccines uptakes 32.9% for males minus 29.28% for females and there was a significant more prevalence of vaccine uptake in males than in females. The absolute inequality in COVID-19 vaccine uptake among health workers vs non-health workers was 28.5%, 95% CI (17.8, 37.2), 03/2022 and there was a significantly higher prevalence of vaccine uptake in health workers than non-health workers in each survey. The relative measures of inequality in the ratios of COVID-19 vaccine uptake among urban vs rural was 0.85, 95%CI (0.7, 0.994) in 08/2021 which was obtained by dividing the respecting proportion of vaccine uptakes of urban by rural residents. Conclusion The study showed that the proportion of COVID-19 vaccine uptake in Ethiopia significantly increased from 2021 to 2022 with distinct inequality. The study indicated there is significant absolute and relative inequality in COVID-19 vaccine uptake between health workers and non-health workers, male and female, and urban and rural residents in Ethiopia. Therefore, the effort should be geared towards reducing health workers vs non-health workers, urban vs rural, and gender inequalities in COVID-19 vaccine uptake through health literacy and recommend geographic and equity-oriented policies, to ensure effective pandemic management of COVID-19.

Abstract Introduction The utilization of maternal health services is vital to prevent maternal and child health problems. However, there is limited evidence as to why rural women have lower utilization and educational inequality in maternal health services utilization in Ethiopia. Identifying the causes is the first step to achieving maternal and child health initiatives. Objective The objective of this study was to decompose the urban-rural disparities and educational inequalities in maternal health care utilization in Ethiopia. Methods The study used the 2019 Ethiopian Demography Health Survey. Blinder-Oaxaca decomposition and multivariate decomposition analyses were done on a weighted 3,926.7 women to see the urban-rural differences in maternal health service utilization by using Stata 17.0. For the educational inequality of maternal health service utilization, concentration curve and concentration index were used by using conindex. P value

Abstract Background The increasing use of pesticides has become a global public health concern. The problem is more devastating in developing countries, which deters the implementation of effective intervention strategies. Moreover, the existing evidences are inconsistent and not comprehensive. Therefore, this study aimed to determine the pooled pesticide safe use practices and acute health symptoms, and identify factors among farmers in developing countries. Methods A comprehensive search using databases such as PubMed, HINARI, Google Scholar, and Epistemonikos, as well as grey literature, was searched up to June 30, 2023. The updated preferred reporting items for systematic reviews and meta-analysis guidelines were used. Data were extracted using Microsoft Excel, and it was exported to STATA 14/SE software for analysis. The Joanna Briggs Institute’s quality appraisal tool was used to assure the quality of the included articles. A random-effects model was used during analysis. The funnel plot and Egger’s regression test were used to assess the publication bias, and sensitivity analysis was conducted to assess the effect of a single study. Results The pooled pesticide safe use practice was 43.1% (95% CI: 31.01–55.2), and the prevalence of acute health symptoms was 30.36% (95% CI: 19.61–41.1). Farmers with good knowledge (OR = 3.83, 95% CI: 2.36–5.29), good attitudes (OR = 2.16, 95% CI: 1.46–2.86), being educated (OR = 5.11, 95% CI: 2.96–7.26), and having more than five years of experience (OR = 6.13, 95% CI: 2.56–9.71) were found to be the identified factors associated with pesticide safe use practice. Conclusions This study highlighted a significant gap in pesticide safe use practices and a high prevalence of acute health symptoms among farmers. Therefore, comprehensive intervention measures such as providing educational and safety training programs are required for pesticide users among farmers.

IntroductionStress is an increasing public health issue among the student population worldwide. This stress can significantly affect their academic performance, mental health, and overall well-being. As a result, we conducted a systematic review and meta-analysis to determine the pooled prevalence and associated factors of stress among students in Ethiopia.MethodsAn extensive search of electronic databases such as PubMed, Google Scholar, Semantic Scholar, HINARI, and Science Direct, cross-referencing, and Google manual search was conducted to identify cross-sectional studies published from 1998 to 2024. The preferred PRISMA guideline was used to report items for this systematic review and meta-analysis. To extract data, Microsoft Excel 16 and to analyze STATA 17 software were used. The JBI quality assessment tool was used for the included studies with medium to high-quality scores. To estimate the pooled prevalence of stress and its associated factors, a random effects model was used. The funnel plot and Egger’s regression test were used to assess publication bias, and I2 test statistics were used to determine heterogeneity of the included studies. The protocol for this review has been registered with PROSPERO (ID: CRD42024578490).ResultsA total of 23 studies with 8,946 study participants met the inclusion criteria. The pooled prevalence of stress among students in Ethiopia was 37.64% (95% CI: 29.61–45.66; I2 = 98.8%). Female gender (OR = 1.82, 95% CI: 1.57–2.12), rural resident (OR = 1.51, 95% CI: 1.22–1.87), living outside university dormitory (OR = 2.02, 95% CI: 1.34–3.05), the habit of alcohol consumption (OR = 1.46, 95% CI: 1.12–1.91), being a cigarette smoker (OR = 2.36, 95% CI: 1.49–3.74), being a khat chewer (OR = 1.35, 95% CI: 1.02–1.80), working in an unfavorable environment (OR = 1.80, 95% CI: 1.20–2.71), and having poor social support (OR = 1.93, 95% CI: 1.39–2.68), were significantly associated with an increased risk of stress.ConclusionThe findings of this systematic review and meta-analysis indicated high prevalence of stress among students in Ethiopia. The study identified female gender, being rural residence, living outside university dormitory, khat chewing, and having the habit of alcohol consumption, working in an unfavorable environment, poor social support and cigarette smoking as significant risk factors for stress. To develop coping skills and resilience, integrating mental health education into the curriculum could help students to prevent stress. Furthermore, strategies such as academic support programs, substance use reduction programs, counseling services, and stress management workshops could be beneficial.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024578490, CRD42024578490.

IntroductionDrinking 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.MethodsAn 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.ResultsA 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.ConclusionWe 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.

BackgroundAlcohol consumption continues to be a public health problem in Ethiopia. Previous investigations have been conducted on alcohol consumption in Ethiopia; however, these investigations were limited to specific localities, which could not represent the existing alcohol consumption in different parts of Ethiopia. Besides, the spatial variation of alcohol consumption was not well investigated in the previous studies, which could hinder the implementation of effective intervention towards alcohol consumption. Hence, this study aimed to determine the spatial distribution and determinant factors of alcohol consumption in Ethiopia.MethodsSecondary data from the 2016 Ethiopian demographic health survey was used in this study. A total of 44,023 weight samples were included using a stratified two-stage cluster sampling technique. The spatial variation of alcohol consumption was analyzed using ArcGIS version 10.7.1. The statistical significance of alcohol consumption clusters were identified using Kuldorff's SaTScan version 10.2. A multi-level analysis was also conducted to identify factors associated with alcohol consumption using STATA version 14.ResultsIn this study, 33.15% (95%CI: 32.5-33.8) of the study participants consumed alcohol with statistically significant spatial variation across regions of the country. Traditional religion (AOR = 13.7; 95%CI: 2.68-70.3), Regional variations (Amhara region-AOR = 3.56; 95%CI: 1.85-6.8, living in a low proportion of community literacy (AOR = 1.84; 95%CI: 1.1-3.18), cigarette smoking habit (AOR = 15.82; 95%CI: 4.31-58.1), and chewing Khat (AOR = 2.98; 95%CI: 1.22-7.27) were positively linked with alcohol consumption. Hot spot areas of alcohol consumption were found in Tigray, Amhara, and some parts of Oromia regions. The statistical significance of the primary clusters was also observed in Tigray and Amhara regions.ConclusionsWe found that one-third of Ethiopia's population is consuming alcohol. Having a cigarette smoking habit, chewing khat, high proportion of community literacy, and traditional religion were associated factors for alcohol consumption. Therefore, the federal government of Ethiopia, and ministry of health, and other concerned bodies should work in collaboration to decrease the proportion of people consuming alcohol.

IntroductionAntimicrobial resistance is a major global public health concern, especially in low-resource settings. In low- and middle-income countries, the existing evidence about antimicrobial resistance in drinking water is inconsistence and not comprehensive. Therefore, this study aimed to estimate the pooled prevalence of antimicrobial resistance profiles of Escherichia coli from drinking water in low- and middle-income countries.MethodsThis study was conducted using comprehensive literature searches using various databases such as PubMed, Scientific Direct, HINARI, and Google Scholar. Data extraction was performed using Microsoft Excel and exported to STATA 14/SE software for analysis. We used the Joanna Briggs Institute’s quality appraisal tool to ensure the quality of the included studies. A random effects model was employed to estimate the pooled prevalence. Publication bias was evaluated using funnel plots and Egger’s regression test. Subgroup and sensitivity analysis were also conducted in this study.ResultsThe study found that the pooled prevalence of Escherichia coli isolates in drinking water was 37.94% (95% CI: 26.73–49.13). The prevalence of multidrug resistance was 43.65% (95% CI: 31.15–56.15). Regarding specific antimicrobials, the pooled resistance levels of Escherichia coli were 54.65% (95% CI: 41.35–67.96) against contrimoxazole, followed by 48.64% (95% CI: −3.6–101) against amoxicillin and 48% (95% CI: −18.1–114.2) against cefuroxime.ConclusionThe findings indicated a significant prevalence of antimicrobial resistance of Escherichia coli isolated from drinking water and its multidrug resistance. To address this issue, it recommends focusing on improving basic hygiene and sanitation practices and enhancing water and wastewater treatment systems.Systematic review registrationIdentifier CRD42024533592.

BackgroundAntenatal care (ANC) is an important component of maternal and child healthcare. The World Health Organization (WHO) recommends that pregnant women book their ANC contact at or before 12 weeks of gestational age. However, in East Africa, evidence on whether the WHO recommendations have been followed is limited. Therefore, this study aimed to determine the time to ANC booking and its predictors among pregnant women in East Africa.MethodThis study was conducted among 86,662 pregnant women in East Africa. The time to ANC booking was estimated using the Kaplan–Meier (K–M) survival estimate. A Weibull gamma shared frailty model was used to determine the predictors of time to the first ANC visit. An adjusted hazard ratio (AHR) with a 95% confidence interval (CI) was reported.ResultThe median time to ANC booking among pregnant women in East Africa was 4 ± 2 months. Maternal education at the primary (AHR = 1.01, 95% CI: 1.02–1.25), secondary (AHR = 1.03, 95% CI: 1.02–1.05), and higher level (AHR = 1.40, 95% CI: 1.30–1.50); husband's education level at the primary (AHR = 1.08, 95% CI: 1.06–1.09), secondary (AHR = 1.12, 95% CI: 1.10–1.13), and higher (AHR = 1.08, 95% CI: 1.07–1.10) levels as compared to with no education; a middle-class wealth status (AHR = 1.66, 95% CI: 1.60–1.70), being rich (AHR: 1.60, 95% CI: 1.56–1.73), high community-level maternal literacy (AHR = 1.05, 95% CI: 1.04–1.06), high community-level poverty (AHR = 0.99, 95% CI: 0.98–0.99), previous Cesarean section (CS) (AHR = 1.35, 95% CI: 1.33–1.39), and unwanted pregnancy (AHR = 0.74, 95% CI: 0.72–0.77) were predictors of the time to ANC booking.ConclusionThe median time to ANC booking among pregnant women in East Africa is longer than the new WHO recommendation. Maternal and husband education, high community-level maternal literacy, a better household, community-level wealth index, and previous CS increase the likelihood of an early ANC booking. However, unwanted pregnancy lowers the likelihood of an early ANC booking. Therefore, strengthening systematic efforts to improve women’s and their husbands' educational status, encouraging women's education in the community, providing economic support for women with low wealth status and poor communities, encouraging wanted pregnancy, and providing accessible counseling services for women with unwanted pregnancies will help to encourage early ANC booking among pregnant women in East Africa.

IntroductionVisceral Leishmaniasis, also known as kala-azar, is a potentially fatal, neglected tropical disease caused by the protozoan parasite Leishmania and transmitted through infected sandflies. It is one of the major global public health problems and contributors to economic crisis among people. Though different studies investigated human visceral leishmaniasis in Eastern Africa, the findings were inconsistent and inconclusive enough, and there is no representative data on this devastating public health concern. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence and risk factors associated with human visceral leishmaniasis in Eastern Africa.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) guidelines were followed for this study. Databases such as PubMed/MEDLINE, CINAHL, LIVIVO, African Journals Online, African Index Medicus (AIM), HINARI, Science Direct, Web of Science, Cochrane Library, Google Scholar, Semantic Scholar, and Google were used to retrieve all the relevant articles. The search was carried out from 23 May 2024 to 17 July 2024. Data were analyzed using STATA 17 software to determine the pooled prevalence of human visceral leishmaniasis with a 95% confidence interval using a random-effects model.ResultIn this meta-analysis, thirty-nine articles with 40,367 study participants were included. The overall pooled prevalence of human visceral leishmaniasis in Eastern Africa was 26.16% [95%; CI: 19.96, 32.36%; I2 = 99.67%; p = 0.00]. Gender, age, family size, presence of termite hill/mound, presence of cattle/domestic animals, outdoor sleeping, presence of VL infected family member/s, and presence of water source/pathway near home were the risk factors significantly associated with human visceral leishmaniasis.ConclusionThe recorded pooled prevalence of human visceral leishmaniasis in Eastern Africa underscores the urgent need for comprehensive intervention strategies. This includes rigorous health education for residents, covering the disease’s cause, transmission, vector breeding sites, and prevention mechanisms.

IntroductionInadequate ventilation and improper use of personal protective equipment are often observed in many occupational settings with a high risk of dust and other fine particle exposure. Workers who are exposed to dust at work may suffer from respiratory difficulties. Previous systematic reviews on organic dust exposure and its association with respiratory health outcomes did not provide a comprehensive assessment. Therefore, the objective of this systematic review and meta-analysis was to summarize the reported effects of organic dust exposure on lung function parameters among African industrial workers.MethodsA compressive literature search was conducted in PubMed, MEDLINE, Google Scholar, Embase, the Web of Science, African Journals Online, and ScienceDirect databases to identify relevant studies for the review. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included studies. The lung function indices including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), the FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were obtained from primary studies and analyzed using STATA version 17. The I2 test was used to assess the heterogeneity of studies. We used a random-effects model to estimate the pooled standard mean difference in lung function indices between organic dust-exposed and non-exposed industrial workers. To analyze publication bias, funnel plots and Egger’s test were applied.ResultsIn this systematic review and meta-analysis, 32 studies involving 7,085 participants were included from 13,529 identified studies. The estimated mean differences with 95% confidence intervals were as follows: −0.53 [−0.83 to −0.36] L for FVC, −0.60 [−0.77 to −0.43] L for FEV1, −0.43 [−0.57, −0.29] L for FEV1/FVC, and −0.69 [−0.88 to −0.50] L/min for PEFR.ConclusionThis systematic review and meta-analysis revealed that the lung function indices, such as FVC, FEV1, FEV1/FVC, and PEFR, were statistically significantly lower among organic dust-exposed industrial workers compared to non-exposed industrial workers. Therefore, effective dust control measures should be implemented to protect workers from exposure to organic dust.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024527139.

IntroductionAir pollution is a significant global public health concern. However, there is a lack of updated and comprehensive evidence regarding the association between exposure to ambient air pollution and adverse birth outcomes (preterm birth, low birth weight, and stillbirth). Furthermore, the existing evidence is highly inconsistent. Therefore, this study aims to estimate the overall association between ambient air pollution and adverse birth outcomes.MethodsIn this study, initially a total of 79,356 articles were identified. Finally, a total of 49 articles were included. We conducted compressive literature searches using various databases, including PubMed, Scientific Direct, HINARI, and Google Scholar. Data extraction was performed using Microsoft Excel, and the data were exported to STATA 17 software for analysis. We used the Joanna Briggs Institute’s quality appraisal tool to ensure the quality of the included studies. A random effects model was employed to estimate the pooled prevalence. Publication bias was assessed using funnel plots and Egger’s regression test.ResultsIn this study, the pooled prevalence of at least one adverse birth outcome was 7.69% (95% CI: 6.70–8.69), with high heterogeneity (I2 = 100%, p-value 10 μg/m3) during the entire pregnancy, and O3 (≤10 μg/m3) during the entire pregnancy increased the risk of preterm birth by 4% (OR = 1.04, 95% CI: 1.03–1.05), 5% (OR = 1.05, 95% CI: 1.01–1.09), 49% (OR = 1.49, 95% CI: 1.41–1.56), and 5% (OR = 1.05, 95% CI: 1.04–1.07), respectively. For low birth weight, exposure to PM2.5 (≤10 μg/m3) and PM2.5 (>10 μg/m3) throughout the entire pregnancy was associated with an increased risk of 13% (OR = 1.13, 95% CI: 1.05–1.21) and 28% (OR = 1.28, 95% CI: 1.23–1.33), respectively.ConclusionThis study highlighted a significant association between ambient air pollution and adverse birth outcomes. Therefore, it is crucial to implement a compressive public health intervention.Systematic review registrationThe review protocol was registered with the record ID of CRD42024578630.

IntroductionDisparities in access to basic sanitation services between rural and urban households pose significant challenges to public health and human development. Understanding the determinants contributing to this gap is vital for advancing the Sustainable Development Goals (SDGs) and improving environmental and public health through evidence-based interventions.ObjectiveThis study aims to analyze and understand the disparities in access to basic sanitation services between rural and urban households in Ethiopia.MethodsThis study analyzed a sample of 8,663 weighted households, collected using stratified sampling techniques, utilizing the data from the 2019 Ethiopian Demographic and Health Survey (EDHS). The primary outcome was basic sanitation access, defined as access to flush or pour-flush systems, septic tanks, pit latrines, or composting toilets. A multivariable decomposition analysis was conducted to identify factors contributing to rural–urban disparities. Statistically significant variables were determined at a p-value of

Introduction Unintended pregnancy is defined as a pregnancy that is either mistimed (wanted at a later time) or unwanted (not wanted at all). It has been a concerning issue for reproductive health and public health, with significant negative effects on the mother, child, and the public at large. It is a worldwide public health issue that can have a major impact on the health of pregnant women and newborns. Methods The study was conducted using secondary data from IPUMS Multiple Indicator Cluster Surveys round 6. The analysis was based on a data merged from six sub-Saharan Africa countries such as Gambia, Ghana, Lesotho, Malawi, Nigeria, and Sierra Leone. A total weighted sample of 28,027married/in-union reproductive-age women was included in the study. Seven machine learning algorithms were trained and their performance compared in predicting unintended pregnancy. Finally, Shapley Additive exPlanations model explanation technique was used to identify the predictors of unintended pregnancy. Results XGBoost was the top-performing model, achieved the highest area under receiver operating characteristic curve (0.62) and accuracy (65.92%), surpassing all other models. SHAP global feature importance identified top predictors of unintended pregnancy, with women from Malawi, Ghana, and Lesotho, women having primary education and secondary education, with parity of more than three, have higher likelihood of unintended pregnancy. In the other hand, women from Nigeria and Sierra Leone, whose husband/partner has more wives or partners (polygamy relation), and women who owns mobile phone had lower risk of unintended pregnancy. Conclusion These findings highlight the importance of considering contextual factors, such as country-specific sociocultural norms and individual characteristics, in understanding and addressing unintended pregnancies. By strategically addressing the identified predictors, policymakers, and healthcare providers can develop impactful programs that address the root causes of unintended pregnancies, ultimately contributing to improved reproductive health outcomes worldwide.

Abstract Increasing soybean [Glycine max L. (Merrill)] productivity relies heavily on optimizing crop geometry, encompassing both inter‐ and intra‐row spacing. This crucial agronomic practice directly impacts the productivity of soybean crops, making it vital for farmers to consider soybean maturity group when determining optimal crop geometry. Hence, the study was conducted to determine the effect of inter‐ and intra‐row spacing on yield and yield components of soybean varieties and to determine appropriate plant spacing for each maturity group of soybean varieties to achieve a high yield of soybean in the study area. Two soybean varieties from each maturity group, four inter‐row spacing (30, 40, 50, and 60 cm), and two intra‐row spacing (5 and 10 cm) were arranged in factorial combinations in randomized complete block design with three replications. The results showed that days to flowering, days to maturity, plant height, number of seeds/pod, number of pods/plant, and 100‐seed weight were significantly influenced by the main effect of varieties, inter‐ and intra‐row spacing for each maturity group of soybean varieties. The highest grain yield was recorded from narrow inter‐row spacing for early and medium maturity groups regardless of intra‐row spacing while the highest grain yield was obtained from 50‐cm inter‐row spacing for late maturing groups. Thus, it can be concluded that 40‐cm inter‐row spacing is recommended for early and medium soybean varieties, while 50‐cm inter‐row spacing is recommended for late‐maturing soybean varieties for western parts of Oromia and similar agroecologies.

Background The HIV epidemic continues to be a major public health challenge worldwide, particularly in sub-Saharan African countries such as Ethiopia. Community-based antiretroviral refill groups are emerging as a patient-centered approach, but there is limited evidence. Therefore, this study aimed to assess attrition and predictors in community antiretroviral refill groups among ART users in Eastern Ethiopia. Methods Institutional-based retrospective cohort study was conducted. Systematic random sampling techniques were used. Data were collected via Kobo Collect and exported to Stata. Statistically significant effects were assumed for a P-value

Introduction Tuberculosis (TB) continues to be one of the deadliest infectious diseases over the centuries, killing more people worldwide than any other single infectious disease. There is an urgent need for additional strategies which can expedite efforts to combat TB including a preventive vaccine. In this endeavour, we have developed a protocol for a multisite, double-blind, placebo-controlled clinical trial in India that aims to evaluate the efficacy and safety of two TB vaccines; namely, VPM1002 and Immuvac (M.w) (Mycobacterium Indicus Pranii) (MIP) among healthy household contacts (HHCs) of sputum smear-positive pulmonary TB (PTB) patients.Methods and analysis In the three-arm randomised double-blind placebo-controlled trial study protocol, a total of 12 000 HHCs (aged 6−99 years) of sputum smear-positive PTB patients will be randomised to receive either of the two vaccine candidates VPM1002 and MIP or placebo. The primary efficacy endpoint is the prevention of microbiologically confirmed TB. Secondary endpoints will include (1) prevention against Latent TB infection, (2) incidence of adverse events and serious adverse events in study participants, (3) efficacy of vaccine in prevention of PTB/extra PTB in different age groups (6–18 years, 19–35 years, 36–60 years and above 60 years) and (4) immunogenicity of VPM1002 and MIP at month 2 and month 6 after first vaccination in terms of flow cytometric analysis of M.Tb specific CD4+ and CD8+ T cells secreting cytokines and Luminex assays for the presence of different cytokines in the sera and supernatants of peripheral blood mononuclear cells cultures stimulated with whole cell lysates of M.Tb and subsequently similar analysis for the cases who develop TB postvaccination during the follow-up period.Ethics and dissemination Ethics committees’ approvals have been granted by the Institutional Human Ethics Committees of all participating centres in this study and the names of the ethics committees and approvals are as follows: (1) National Institute for Research in Tuberculosis (NIRT)-Chennai (including subsites): ECR/135/Inst/TN/2013/RR-19, Approval No. 390/NIRT-Institutional Ethics Committee (IEC)/2018 dated 5 December 2018 (NIRT-Madurai-ECR/1365/Inst/TN/2020; approval dated 8 June 2020; NIRT, Vellore: ECR/1215/Inst/TN/2019; approval dated 26 September 2020); (2) All India Institute of Medical Sciences (AIIMS), Delhi (including subsites)-Institute Ethics Committee, ECR/547/Inst/DL/2014/RR-17 ECR/538/Inst/DL/2014/RR-20; approval No.IEC-385/06-07-2018, approval OP-28/05.04.2019 and SFH- ECR/593/Inst/DL/2014/RR-20 IEC/VMMC/SJH/project/2019-05/25 ; 23 May 2019; (3) National Institute of Tuberculosis and Respiratory Diseases (NITRD), Delhi: ECR/315/Inst/DL/2013/RR-19; approval IEC-No-NITRD/EC/2019/9004; 8 January 2019; (4) Pune-National AIDS Research Institute (NARI) and subsite-ECR/23/Inst/MH/2013/RR-19; IEC-NARI/EC/approval/2018/196; 29 May 2018; (5) Regional Medical Research Centre-Bhubaneshwar-ECR/911/Inst/OR-2017/RR-21; approval, dated 25 April 2018; Subsites- AIIMS, Bhubaneshwar ECR/534/Inst/OD/2014/RR-17 and 20 approval No. T/EMF/Pulm. Med/19/01 dated 13 May 2019; SCB, Cuttack No. No.ECR/84/Inst/OR/2013/RR-20; approval no.186 dated 7 February 2020; (6) NTI-Bengaluru: Ethics Committee-No-ECR/1819/Inst/KA/2019; approval No NTI-IEC/1.2019/principal investigator, dated 31 January 2019; (7) BMMRC, Hyderabad- ECR/450/Inst/AP/2013/RR-16 approval No. 779/BMMRC/2018/IEC, dated 11 June 2018 (Subsite Share India- Mediciti Ethics Committee-ECR/283/Inst/AP/2013/RR-20; Approval no. EC/11/VII/2K20(1) dated 11 July 2020) and (8) SJMC-Bengaluru: ECR/238/Inst/KA/2013/RR-19; approval IEC/1/491/2020; 7 August 2020.The trial findings will be published in accordance with the Consolidated Standards of Reporting Trials guidance. The results of this clinical trial will be presented at scientific conferences and disseminated through publications in peer-reviewed journals, conference presentations and shared with Ministry of Health and Family Welfare, policy-makers and other stakeholders.Trial registration number CTRI/2019/01/017026.

IntroductionThe 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.MethodsThe 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 I2 statistics were used to determine potential publication bias and heterogeneity among the reviewed articles, respectively.ResultsA 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 (I2 = 99.1%, p

IntroductionThe achievement of the minimum acceptable diet intake (MAD) stands at 14% among urban and 10% among rural under-five children in Ethiopia. Consequently, identifying the determinants of the urban–rural gap is vital for advancing Sustainable Development Goals (SDGs), fostering healthier communities, and developing evidence-driven approaches to enhance health outcomes and address disparities.ObjectiveThe objective of the study was to decompose the urban–rural disparities in minimum acceptable diet intake in Ethiopia using the Ethiopian Mini-Demographic and Health Survey 2019 data.MethodThe study was conducted using the Ethiopian Demographic and Health Survey 2019 report. A total of 1,496 weighted children aged 6–23 months were included using stratified sampling techniques. The main outcome variable minimum acceptable diet was calculated as a combined proportion of minimum dietary diversity and minimum meal frequency. A decomposition analysis was used to analyze the factors associated with the urban–rural discrepancy of minimum acceptable diet intake, and the results were presented using tables and figures.ResultThe magnitude of minimum acceptable diet among children aged 6–23 months in Ethiopia was 11.0%. There has been a significant disparity in the intake of minimum acceptable diet between urban and rural under-five children with 14 and 10%, respectively. Endowment factors were responsible for 70.2% of the discrepancy, followed by 45.1% with behavioral coefficients. Educational status of college and above was responsible for narrowing the gap between urban and rural residents by 23.9% (β = 0.1313, 95% CI: 0.0332–0.245). The number of children in the household and the age of the child between 18 and 23 months were responsible for widening the gap in minimum acceptable diet intake discrepancy between urban and rural residents by 30.7% and 3.36%, respectively (β = −0.002, 95% CI: −0.003 to −0.0011 and β = −30.7, 95% CI: −0.025 – −0.0085). From the effect coefficients, the effect of institutional delivery was responsible for 1.99% of the widening of the gap between urban and rural residents in minimum acceptable diet intake (β = −0.0862, 95% CI: −0.1711 – −0.0012).ConclusionThere is a significant variation between urban and rural residents in minimum acceptable diet. The larger portion of the discrepancy was explained by the endowment effect. Educational status of mothers with college and above, parity, age of child, and place of delivery were the significant factors contributing to the discrepancy of minimum acceptable diet intake between urban and rural residents.

Environmental sustainability is a growing concern for businesses and organizations due to climate change trends. This study aims to examine the direct impact of institutional pressures, green procurement (GP), and reverse logistics (RL) on environmental performance (EVP). The mediating influences of RL and GP on institutional pressure and EVP are also examined. The study uses a quantitative method where data is gathered from the CEO, operations, human resources, logistics, and procurement managers of 165 industrial park firms using customized questionnaires. The data is analyzed using the PLS-SEM software (SmartPLS 4). The results suggest that the adoption of institutional pressures has a significant effect on GP and RL, and the findings show that GP does not improve EVP. However, the implementation of RL mediates the relationship between institutional pressure and EVP. The study develops a comprehensive empirical model that tests the joint influence of institutional pressure- GP-RL-EVP model was developed and validated. The findings indicate that institutional pressure and RL help firms advance EVP.

BackgroundComputer vision syndrome (CVS) is the most pressing public health concern that affects vision and reduces quality of life and productivity, particularly in developing countries. Most of the previous studies conducted in Ethiopia focus on the knowledge and personal risk factors of bank workers. Moreover, ergonomic workstation design was not objectively assessed, which could hinder the implementation of effective intervention strategies. Therefore, this study aimed to determine CVS and ergonomic factors among commercial bank workers in Addis Ababa, Ethiopia.MethodsAn institutional-based cross-sectional study was carried out among 466 study participants from May 26 to July 24, 2022. A multistage sampling technique was applied to select the study participants. Data were collected via a standardized tool of CVS (CVS-Q). Besides, workstation ergonomics were pertinently assessed. The collected data was entered into EpiData version 3.1 and exported to SPSS version 26 for data analysis and cleaning. Multivariable logistics regression analysis was performed to identify factors associated with CVS. The variables with a p-value < 0.05 were considered statistically significant factors.ResultsPrevalence of CVS was 75.3% (95% CI: 71.2–79.2%). Blurred vision, eye redness, and headache, 59.8%, 53.7%, and 50.7%, respectively, were frequently reported symptoms. Glare (AOR = 4.45: 95% CI: 2.45–8.08), 20–20–20 principle (AOR = 1.98, 95% CI: 1.06–3.67), wearing non-prescription eyeglasses (AOR = 4.17; 95% CI: 1.92–9.06), and poor workstation (AOR = 7.39; 95% CI: 4.05–13.49) was significantly associated with CVS.ConclusionThe prevalence of CVS was found to be high. Glare at work, ignoring the 20–20–20 principle, wearing non-prescription eyeglasses, and poor workstation ergonomic design were independent predictors of CVS. Therefore, comprehensive interventional activities like adhering to the 20–20–20 principle, avoiding the use of non-prescription glasses, minimizing glare, and improving workstation ergonomic setup are essential to prevent CVS.

IntroductionExposure to indoor air pollution such as biomass fuel and particulate matter is a significant cause of adverse pregnancy outcomes. However, there is limited information about the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries. Therefore, this meta-analysis aimed to determine the association between indoor air pollution exposure and adverse pregnancy outcomes in low and middle-income countries.MethodsInternational electronic databases such as PubMed, Science Direct, Global Health, African Journals Online, HINARI, Semantic Scholar, and Google and Google Scholar were used to search for relevant articles. The study was conducted according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A random effect model at a 95% confidence interval was used to determine the association between indoor air pollution exposure and adverse pregnancy outcomes using STATA version 14. Funnel plot and Higgs I2 statistics were used to determine the publication bias and heterogeneity of the included studies, respectively.ResultsA total of 30 articles with 2,120,228 study participants were included in this meta-analysis. The pooled association between indoor air pollution exposure and at least one adverse pregnancy outcome was 15.5% (95%CI: 12.6–18.5), with significant heterogeneity (I2 = 100%; p < 0.001). Exposure to indoor air pollution increased the risk of small for gestational age by 23.7% (95%CI: 8.2–39.3) followed by low birth weight (17.7%; 95%CI: 12.9–22.5). Exposure to biomass fuel (OR = 1.16; 95%CI: 1.12–1.2), particulate matter (OR = 1.28; 95%CI: 1.25–1.31), and kerosene (OR = 1.38; 95%CI: 1.09–1.66) were factors associated with developing at least one adverse pregnancy outcomes.ConclusionsWe found that more than one in seven pregnant women exposed to indoor air pollution had at least one adverse pregnancy outcome. Specifically, exposure to particulate matter, biomass fuel, and kerosene were determinant factors for developing at least one adverse pregnancy outcome. Therefore, urgent comprehensive health intervention should be implemented in the area to reduce adverse pregnancy outcomes.

BackgroundExposure to pesticides is a global public health problem, especially for children. Its association with chronic respiratory disease among children has attracted considerable attention, but the existing evidence remains inconclusive and cannot be certain. Therefore, this systematic review and meta-analysis aim to determine the global pooled effect size of association with pesticide exposure and asthma, wheezing, and respiratory tract infections among children.MethodsA comprehensive search was conducted for relevant literature from electronic databases, including PubMed, Google Scholar, Hinari, Semantic Scholar, and Science Direct. Studies that provided effect size on the association between pesticide exposure and childhood asthma, wheezing, and respiratory tract infections in children were included. The articles were screened, data was extracted, and the quality of each study was assessed with four independent reviewers. Random effects models for significant heterogeneity and fixed effect models for homogeneous studies were conducted to estimate pooled effect sizes with 95% confidence intervals using Comprehensive Meta-Analysis version 3.3.070 and MetaXL version 2. Funnel plot and Higgins I2 statistics were used to determine the heterogeneity of the included studies. Subgroup analyses were computed based on the types of pesticide exposure, study design, sample size category, and outcome assessment technique.ResultA total of 38 articles with 118,303 children less than 18 years of age were included in this meta-analysis. Pesticide exposure among children increased the risk of asthma by 24%; (OR = 1.24, 95% CI: 1.14–1.35) with extreme heterogeneity (I2 = 81%, p

Introduction: Diarrheal diseases are significant causes of under-five children mortality and morbidity in developing countries. This is particularly alarming among the community living in conflict zones where less attention is given for basic services including water, food, and health. However, there are no detailed investigations on acute diarrhea among under-five children in conflict-affected areas, which impedes intervention approaches. Therefore, this study was designed to assess the prevalence of acute diarrhea and associated factors among under-five children in conflict-affected setting of Raya Kobo, Northeast Ethiopia. Methods: A community-based cross-sectional study was employed among 463 under-five children in Raya Kobo district, from February to March 2021. The study participants were selected from ten rural kebeles. Pre-tested questionnaire and observational checklist were used to collect the data. Bivariate and multivariable logistic regression analyses were computed to identify factors associated with the prevalence of acute diarrhea. Results: The prevalence of acute diarrhea among under-five children was 21% (95% confidence interval (CI): 18.50–23.91%). Unimproved drinking water source (Adjusted odds ratio (AOR) = 2.89; 95%CI: 1.38–6.06), disposal of garbage in open field (AOR = 3.33; 95%CI:1.66–6.67), having low monthly income (AOR = 5.73; 95%CI: 3.07–10.59), absence of latrine facility (AOR = 3.18; 95%CI: 1.09–8.78), poor hand washing practice at critical times (AOR = 2.52; 95%CI:1.28–4.05), not regularly cleaning food utensil before child feeding (AOR = 2.54; 95%CI:1.31–4.94), and not received Rota vaccine (AOR = 4.28; 95%CI: 1.82–10.11) were the determinant factors. Conclusions: To reduce the burden of acute diarrheal diseases, post-war intervention approaches should emphasize on advocating for Rota virus vaccination, regularly cleaning food utensils before feeding, improving hand washing practice at critical times, provision of improved drinking water source, and use of proper solid and domestic sewage discharge/disposal methods.

IntroductionNon-compliance with smoke-free law is one of the determinants of untimely mortality and morbidity globally. Various studies have been conducted on non-compliance with smoke-free law in public places in different parts of the world; however, the findings are inconclusive and significantly dispersed. Moreover, there is a lack of internationally representative data, which hinders the evaluation of ongoing international activities towards smoke-free law. Therefore, this meta-analysis aimed to assess the pooled prevalence of non-compliance with smoke-free law in public places.MethodsInternational electronic databases, such as PubMed/MEDLINE, Science Direct, Cochrane Library, CINAHL, African Journals Online, HINARI, Semantic Scholar, google and Google Scholar were used to retrieve the relevant articles. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. The Higgs I2 statistics were used to determine the heterogeneity of the reviewed articles. The random-effects model with a 95% confidence interval was carried out to estimate the pooled prevalence of non-compliance.ResultsA total of 23 articles with 25,573,329 study participants were included in this meta-analysis. The overall pooled prevalence of non-compliance with smoke-free law was 48.02% (95% CI: 33.87–62.17). Extreme heterogeneity was observed among the included studies (I2 = 100%; p

Abstract Background Newcastle disease (ND) is one of the most important respiratory viral diseases. The disease is endemic in many parts of Ethiopia. However, there is no clear record about the introduction of the virus to the country (Ethiopia). Hence, detail about the ND is very important in its (ND) control and prevention. Despite these facts, there is no available research work done on ND in the current research area that would help either as references for researchers or that could help in the control and prevention of the disease. Therefore, the objective of this study was to detect the ND virus (NDV), using serological methods in from December 2018 to November 2019. Methodology A cross‐sectional type of study was conducted to detect the NDV. The convenience sampling method was used for sample data collection. Before data collection, chicken with previous history of vaccination against the NDV was excluded from the sampling animals. Then, a total of 348 blood samples of 2 mL were collected from the brachial vein in 3 mL disposable syringes. The serum was collected in labeled 2 mL cryovial tubes. Indirect enzyme‐linked immunosorbent assay (ELISA) tests were performed to detect antibodies against NDV and to determine its antibody titer. The test was performed using (ID.vet innovative version 2) procedure. Result In the indirect ELISA test, 37.64% (131/348) were positive and antibody titer mean value of (1761.9088) was scored. The standard deviation of 2592.42160 and a percentage coefficient of variation of 147% was scored. Conclusion From the finding, we conclude that indirect ELISA test detected the presence of the NDV in the study area and the heterogeneousity of antibody titer in the study area. Therefore, further molecular characterization and epidemiological investigation should be carried and vaccination of animals is critical in the study area.

Introduction: Milk is a high-risk food and has been implicated in many foodborne illnesses. Thus, the pastoral communities in rural Ethiopia used a traditional practice of milk container fumigation to maintain the quality and safety of milk. Objective: to assess the indigenous knowledge on milk container fumigation practice and its effect on the microbial safety of milk among pastoral communities in the west Guji zone, southern Ethiopia. Methods: A cross-sectional study design was conducted in six randomly selected kebeles of the pastoral districts in the west Guji zone, Southern Ethiopia from December to June/2022. The preservative plants and raw milk samples were collected and transported to the laboratory, to analyze the efficacy of plants on the microbial safety throughout milk storage. A variance analysis was used to compare the means of microbiological growth and pH measure among the treatments and control; while thematic analysis was for qualitative data. Result: Four species of plants, namely: Olea africana, Clerodendrum myricoides (Hochst) vatke, Rhamnus staddo, and Rhus natalensis were identified from the study area; as they were used for fumigating milk storage containers to prevent a contamination of milk. According to respondents, the fumigation of milk containers was practiced by holding the container upside down over the smoke from a burning chip of each plant species. Accordingly, it was demonstrated that the R. staddo has relatively better efficacy in inhibiting microbial growth in milk than O. africana and C. myricoides (Hochst) vatke; while R. natalensis has no significant impact on microbial growth in milk over the storage period. Conclusion: Pastoralists in the West Guji zone were fumigated the milk storage container by using smoke of O. africana, R. staddo, C. myricoides (Hochst) vatke, and R. natalensis plants. As such, it was identified that R. staddo has relatively better efficacy in inhibiting microbial growth in milk than O. africana and C. myricoides (Hochst) vatke; and it is a better plant to be recommended for the preservation of cow milk.

IntroductionEthiopia is experiencing high prevalence of occupational morbidity and disability. One of the main contributing reasons is a low utilization of personal protective equipment (PPE). Previous studies on PPE utilization and association with educational status among industry workers were largely inconsistent. Therefore, this meta-analysis is aimed to pool the magnitude of PPE utilization and its association with educational status among industry workers in Ethiopia.MethodA compressive search of international databases and libraries including Scopus, PubMed, MedNar, Embase, MEDLINE, the web of science, Google Scholar, the JBI Library, African Journals Online, and Science direct will be carried out to locate published reports. Two independent reviewers will screen the records for inclusion using standardized JBI tools. Before extracting and synthesizing data, the selected studies will undergo a rigorous critical appraisal. If appropriate, a meta-analysis will be conducted. Cochrane Q-test and I2-test statistics will be used to assess the heterogeneity between studies. If necessary, meta-regression and subgroup analyses will be conducted to explore potential reasons for any inconsistency and heterogeneity. Sensitivity analysis will be performed to assess the effect of a single study on the pooled magnitude estimates. Funnel plots, along with Egger's and Begg's tests, will be used to assess the presence of publication bias. PROSPERO registration number: PROSPERO, CRD42022364562.

IntroductionCigarette 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.MethodsWe 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 ResultsA 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.ConclusionsWe 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.

BackgroundLack of sunlight exposure is the primary reason for the worldwide epidemic of vitamin D deficiency. There was a meta-analysis conducted under the title of Knowledge and Practice of Mothers towards sunshine exposure of their children in Ethiopia. However, studies conducted on factors associated with sunlight exposure practice among infants showed non-conclusive and inconsistent findings. Hence, this systematic review and meta-analysis were conducted to estimate the pooled prevalence of good sunlight exposure practice and its associated factors among infants in Ethiopia.MethodsAll articles were systematically searched by PubMed, Hinari, Global Health and CINAHL, Epistemonikos, African Journal of Online (AJOL), Google Scholar and Google. All studies, until the end of May 30, 2023, were included in this review. Pure qualitative studies and studies in which the outcome was not reported were excluded from the review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was used. Meta-analysis was conducted by using STATA 17 software. Forest plots were used to present the pooled prevalence of good sunlight exposure practices. A random effect model was used to compute the pooled prevalence, while subgroup analysis was performed to identify the possible source of heterogeneity. Publication bias was assessed by begg's and Egger's tests. We use Trim and fill analysis was used to treat the publication bias.ResultsThis review involved 14 studies and 6,121 participants. The pooled prevalence of good sunlight exposure practice among infants in Ethiopia was 53.46% (95%CI: 45.98, 60.95). Mothers had PNC follow-up [OR = 2.22 (95% CI: 1.31, 3.47)], mothers with secondary and above educational status [OR = 4.17, (95% CI: 1.73, 10.06)], employed mothers [OR = 3.72, (95% CI: 2.71, 5.11)], urban residence [OR = 2.67, (95% CI: 1.17, 6.08)] and not fear of sunlight exposure [OR = 4.08, (95% CI: 1.44, 16.00)] were positively associated with good sunlight exposure practice.ConclusionsThe pooled prevalence of good sunlight exposure practices among infants in Ethiopia is low. Had postnatal care follow-up, being urban residents, mother's employment status, mother's educational status and not fear of sunlight exposure were independent factors of good sunlight exposure practice among infants. Therefore, health professionals create awareness for mothers to increase postnatal follow-up, and the importance of health education especially for rural residents.

Objective Non-compliance with COVID-19 infection prevention and control (IPC) is one of the global public health problems particularly among those frontline healthcare workers. However, there are no detailed investigations on COVID-19 IPC compliance among healthcare workers in conflict-affected settings. The objective of this research was to assess compliance with COVID-19 IPC measures and determine the factors associated with it among healthcare providers in Ethiopian governmental hospitals affected by conflict.Design A cross-sectional study was carried out within institutional settings.Study setting and period The study was conducted in three public hospitals located in northeastern Ethiopia during the period of March to April 2022.Participants Simple random sampling technique was used to select 325 healthcare workers after proportional allocation was made to each public hospital.Primary outcome measures The primary outcome was non-compliance with COVID-19 IPC. A multivariable logistic regression analysis was employed to identify factors associated with the lack of adherence to the COVID-19 IPC protocol.Results Nearly half (150, 46.2%) of the healthcare workers had non-compliance with COVID-19 IPC protocol. Absence of hand washing soap (adjusted OR (AOR)=2.99; 95% CI 2.46 to 5.76), workload (AOR=2.25; 95% CI 1.33 to 3.84), disruption in the supply of piped water (AOR=1.82; 95% CI 1.11 to 2.99), did not undergo training in COVID-19 IPC (AOR=2.85; 95% CI 1.85 to 4.84), absence of COVID-19 IPC guidelines (AOR=2.14; 95% CI 1.11 to 4.13) and chewing khat (AOR=2.3; 95% CI 1.32 to 3.72) were determinant factors for non-compliance.Conclusions The magnitude of non-compliance with COVID-19 IPC was high. Hospital managers and federal ministry of health should provide regular training on COVID-19 IPC, continuous piped water and personal protective facilities for healthcare workers. Ultimately, improving the security situation in the area would help improve COVID-19 IPC compliance among healthcare workers in these and other similar conflict-affected settings.

Abstract Maize monoculture is one of the major restrictions limiting maize productivity in Western Ethiopia. Although the inclusion of legumes in cropping systems is an essential approach for the sustainable management of farming systems and for reducing the nitrogen (N) fertilizer requirement for maize production in the long term, the effects of soybean on the sustainability of maize productivity and soil fertility are unclear in Ethiopia. Continuous cropping of maize has led to extensive degradation of soil and a decrease in crop productivity in Western Ethiopia. Thus, the study was conducted to compare the long‐term impact of soybean on the sustainability of the production system in soybean–maize rotation and to monitor soil fertility dynamics in soybean–maize rotational systems. Nine different soybean–maize rotation treatments were laid out in Randomized Complete Block Design (RCBD) with three replications. The study results showed that soybean–maize rotation gave a relatively steady yield compared to the maize mono‐cropping system. Soybean–maize rotation improves the productivity of component crops in cropping systems. The highest maize grain yield was recorded from soybean–maize rotation with fertilizer application for the two components (RS + M+) and soybean–maize rotation without fertilizer application for the soybean component (RS‐M+), respectively. Soybean grain yield was significantly correlated with OC (%), OM (%), and TN (%), whereas maize yield was adversely correlated with soil parameters, except soil pH. Overall, the knowledge we can contribute to the readers from this study is that soybean–maize rotation plays an important role in achieving sustainable agriculture by increasing soil fertility and achieving stable soybean and maize yields and soybean should be inoculated with Rhizobium strain year after year continuously. Thus, it can be concluded that soybean–maize rotation with fertilizer applications (RS + M+) for two components can be used in maize belt areas of Western Ethiopia.

Stroke is the second most common cause of death worldwide, and it greatly impacts the quality of life for survivors by causing impairments in their upper limbs. Due to the difficulties in accessing rehabilitation services, immersive virtual reality (IVR) is an interesting approach to improve the availability of rehabilitation services. This systematic review evaluates the technological characteristics of IVR systems used in the rehabilitation of upper limb stroke patients. Twenty-five publications were included. Various technical aspects such as game engines, programming languages, headsets, platforms, game genres, and technical evaluation were extracted from these papers. Unity 3D and C# are the primary tools for creating IVR apps, while the Oculus Quest (Meta Platforms Technologies, Menlo Park, CA, USA) is the most often used headset. The majority of systems are created specifically for rehabilitation purposes rather than being readily available for purchase (i.e., commercial games). The analysis also highlights key areas for future research, such as game assessment, the combination of hardware and software, and the potential integration incorporation of biofeedback sensors. The study highlights the significance of technological progress in improving the effectiveness and user-friendliness of IVR. It calls for additional research to fully exploit IVR’s potential in enhancing stroke rehabilitation results.

Abstract Background Leishmania infantum infection can result in serious vector‐borne zoonotic disease such as visceral leishmaniasis. The objectives of the study were to estimate the seroprevalence and associated risk factors in Weliso, Ambo, and Ejaji towns in the Southwest and West Shewa zones, Oromia, Ethiopia. Methods A cross‐sectional study was conducted from October 2019 to September 2020. A total of 368 canines were sampled for the study using a basic random sampling procedure. An Indirect ELISA kit was used to test the presence of rK39 antigen eliciting specific antibodies in a serum sample. The association between L. infantum seropositivity and possible risk factors was assessed using Pearson's Chi‐square and logistic regression tests. Results The overall seroprevalence of L. infantum in dogs was found to be 84.24% (95% confidence interval [CI]: 80%–88%) with seroprevalences ranging from 76.11% (95% CI: 67%–84%) in Ambo to 79.82% (95% CI: 71%–87%) in Weliso, and higher seroprevalence, in Ejaji 93.84% (95% CI: 89%–97%). In a univariable logistic regression analysis, town (p = 0.001), season (p = 0.001), mixed living (indoor/outdoor) environment (p = 0.003), and kebele (p ≤ 0.05) were all found to be significantly linked with L. infantum seropositivity. In the multivariable analysis, wet season (p = 0.001) and mixed living environments (p = 0.025) were found to be independent predictors of L. infantum seropositivity. Conclusions This is the first comprehensive report of L. infantum infection in Ethiopian dogs. The very high seroprevalence suggests that dogs may play an important role in maintaining and spreading the infection to humans. Improvement of the living environment and health care facilities for dogs and humans as well health education for people awareness is suggested.

Over the years, the chemical market has shown significant growth, but the hazardous impact of chemical use and disposal on the environment and human health is a growing concern. Persistent organic pollutants (POPs) are among the most dangerous chemicals with widespread effects on the environment and living organisms, including humans. This study aimed to assess the current status of POP management and regulatory infrastructure in Ethiopia by collecting information from stakeholders responsible for recording the import, export, use, management, and regulation of POPs both in government and private sectors. Additionally, a comprehensive literature review was conducted using Boolean operators from international databases and libraries. The results indicated that Ethiopia banned the import of pesticides listed under Annex A (i.e., those to be eliminated), except endosulfan, which was imported at a quantity of 199,767 kg lt-1 from 2011 to 2015. There are 2,435 PCB-containing transformers in Ethiopia, of which 2,242 (92%) are currently in use. These transformers and capacitors contain 1,031,661 kg and 1,255 kg of dielectric fluids, respectively. As for Annex B POPs (i.e., those to be restricted), there are between 928,509 kg and 1,383,095 kg of active and obsolete dichlorodiphenyltrichloroethane found in different stores across the country. Ethiopia imported approximately 337,000 kg of products containing perfluorooctane sulfonic acid from 2000 to 2020, with an annual average of 16,850 kg of photographic film, paper, and plates. POPs were also detected in different environmental matrices (soil, waterbodies, sediments, food items, and air) as well as human blood. Despite these findings, regulation and management of POP waste and stockpiles are largely inadequate in Ethiopia. Therefore, it is crucial to improve the monitoring, management, and regulation of POPs in the country. This could be achieved by strengthening the collaboration among different regulatory bodies, harmonizing the fragmented laws on POP management and control, and building institutional capacity.

BackgroundCurrently, different COVID-19 vaccines are being developed and distributed worldwide to increase the proportion of the vaccinated people and as a result to halt the pandemic. However, the vaccination progress is different from place to place even among health care workers due to variation in vaccine acceptance. Therefore, this study aimed to assess the acceptance of COVID-19 vaccine and determinant factors among healthcare workers in west Guji zone, southern Ethiopia.Method and materialsAn institutional-based cross-sectional study design was employed to assess COVID-19 vaccine acceptance and associated factors among health care workers from July to August 2021. A simple random sampling technique was used to choose 421 representative healthcare workers from three hospitals in the west Guji Zone. The self-administrated questionnaire was used to collect data. Bivariate and multivariable logistic regression analyses were computed to identify factors associated with the acceptance of the COVID-19 vaccine. P < 0.05 was considered for significantly associated factors.ResultFrom the representative health workers, 57, 47.02, and 57.9% of healthcare workers had good practice of COVID-19 prevention, adequate knowledge, and a positive attitude toward the COVID-19 vaccine consecutively. 38.1% of healthcare workers said they had a willingness to accept the COVI-19 vaccine. Profession (AOR-6, CI: 2.92–8.22), previous history of vaccine side effects (AOR: 3.67, CI: 2.75–11.41), positive attitude toward vaccine acceptance (AOR: 1.38, CI: 1.18–3.29), adequate knowledge toward COVID-19 vaccine (AOR: 3.33, CI: 1.36–8.12), and adequate practice of COVID-19 prevention measure (AOR: 3.45, CI: 1.39–8.61) were significant associated with COVID-19 vaccine acceptance.ConclusionThe proportion of COVID-19 vaccine acceptance among health workers was found to be low. From the study variables, profession, previous history of vaccine side effects, positive attitude toward vaccine acceptance, adequate knowledge to ward off COVID-19 vaccine, and adequate practice of COVID-19 prevention measures were significantly associated with COVID-19 vaccine acceptance.

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.

Abstract Background Occupational blood exposure is one of the major public health problems that healthcare workers (HCWs) are encountering. Most previous occupational blood exposure studies are delimited to needle stick injury, which could underestimate the real level of blood exposure. On the other hand, others deal with crude blood and body-fluids exposure, which possibly overestimate the magnitude of blood exposure. Therefore, this study aimed at determining the prevalence of occupational blood exposure and identifying associated factors among HCWs in the Southern Tigrai zone governmental hospitals of Northern Ethiopia considering all the potential means of blood exposure (needle stick injury, sharp medical equipment injury, and blood splash) while excluding blood-free body-fluids. Methods A hospital based cross-sectional study design was employed to gather data from randomly selected HCWs in three governmental hospitals from February to March, 2020. A multivariable logistic regression model was used to identify the independent factors associated with the outcome variable. Results From the total of 318 HCWs, 148 (46.5 %) were exposed to blood at least once in their lifetime. Working for more than 40 h per week (AOR= 9.4; 95 % CI: 7.61, 11.41), lack of adequate personal protective equipment (PPE) (AOR=3.88; 95 % CI: 1.64, 5.42), Hepatitis B virus vaccination (AOR=0.54; 95 % CI: 0.12,0.78), recapping used needle sticks (AOR=3.18; 95 % CI: 1.28, 8.83), and lack of infection prevention and patient safety (IPPS) training (AOR=13.5; 95 % CI: 8.12,19.11) were detected to significantly increase the likelihood of occupational blood exposure. Conclusions As nearly half of the HCWs were exposed to blood, reducing work load below 40 h per week by employing additional staff members, supplying adequate PPE, avoiding recapping of used needle sticks, and providing IPPS training for the HCWs should be practiced.

BackgroundAs the COVID-19 pandemic continues to ravage the world, the most pretentious sector besides the economy is the education system. Ethiopia is not equipped with the infrastructure and facilities to provide online classes for students at all levels. Hence, all institutions were re-opened with mandatory infection prevention and control (IPC) protocols such as the use of face masks, physical distancing, shifts in classes, and routine hand washing practices with soap and water to restrict the spread of the virus. Nevertheless, there has been no monitoring and follow- up and there is no data on IPC compliance among school children in the country. The purpose of this study was to examine the COVID-19 preventive practices and their associated factors among high and preparatory school students in Dessie City, Ethiopia.MethodsA cross-sectional study was carried out by using a pre-tested face-to-face applied structured questionnaire and direct observations from March 8 to March 20, 2021, in five high and preparatory schools in Dessie City. The sample size was proportionally allocated in each school based on the students' total number registered in the first academic semester, then stratified by grade level, and proportionally allocated to each grade and section. Finally, a simple random sampling method was used to select study participants. Variables with p-values < 0.25 in the bivariate logistic regression analysis were entered into the multivariate logistic regression model.ResultsThis study involved 422 students with a response rate of 98.8%. The level of good preventive practices was 43.7%. After adjusting for covariates, female, positive attitudes, received IPC training and clear accessible sharing of information and feedback with parents, students and teachers were identified as predictors of good precaution practices.ConclusionThe prevalence of good prevention practices for COVID-19 among students was relatively very low. Therefore, the Department of Health and Education of Dessie City and each school should implement environmental health programs and promote prevention practices in high schools and preparatory schools.