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Muluneh Ademe,1 Friehiwot Girma2 1Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Muluneh Ademe P.O. Box: 9086, Addis Ababa, EthiopiaTel +251 912 63 4868Fax +251 1 551 30 99Email muluneh.ademe@aau.edu.etAbstract: Immunologically, chronic worm infections prevent themselves from strong immune responses by skewing the host response towards a T helper 2 (Th2) type. The regulatory response initiated by helminth infections is supposed to temper responses to non-helminth antigens including viral infections which will, in turn, alter the clinical outcomes of infections. In view of this, recent reports highlighted the possible negative associations of severe COVID-19 and helminth co-infections in helminth-endemic regions. As the pathology of COVID-19 is primarily mediated by an excessive immune response and subsequent cytokine storm, which contributes to the poor prognosis of COVID-19, helminth-driven immune modulation will hypothetically contribute to the less severe outcomes of COVID-19. Nevertheless, emerging reports also stated that COVID-19 and helminth co-infections may have more hidden outcomes than predictable ones. Herein, the current knowledge on the interaction of COVID-19 and helminth co-infections will be discussed.Keywords: SARS-CoV-2, worm co-infections, cytokine storm, Th2 response

Wondwossen Wale Tesega, 1 Solomon Genet, 2 Gnanasekeran Netasan, 2 Getahun Tarekegn, 2 Fitsum Girma, 3 Dinkinesh Chalchisa, 3 Yohannes Belay, 3 Zeleke Geto, 4 Tadesse Asmamaw Dejenie 5 1Department of Biomedical Sciences, School of Medicine, College of Health Sciences, Arbaminch University, Arba Minch, Ethiopia; 2Department of Medical Biochemistry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3National Reference Laboratory for Immunohematology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; 4Department of Biomedical Science, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia; 5Department of Biochemistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, EthiopiaCorrespondence: Tadesse Asmamaw Dejenie Tel +251 90-904-5760Email as24tadesse@gmail.comBackground: Metformin is the first-line drug in the treatment of type 2 diabetes mellitus. Monitoring vitamin B 12 deficiency associated with long-term and high-dose therapy is not a common practice in many clinical settings in Ethiopia.Objective: The study aimed to measure levels of serum vitamin B 12 and folate and to assess the macrocytic status of type 2 diabetes mellitus patients on metformin.Methods: A cross-sectional study was conducted on 80 type 2 diabetes mellitus patients who had been on metformin for 5 months or more at the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital. Serum vitamin B 12 and folate levels were quantified by chemiluminescent immunoassays. Mean corpuscular volume was determined by complete blood count. Differences in vitamin B 12 and folate levels and mean corpuscular volume between different groups were assessed using Kruskal–Wallis H and Mann–Whitney U tests.Results: Vitamin B 12 and folate deficiency were documented in 5% and 23.8% of participants, respectively, and 6.2% of patients were macrocytic. Levels of vitamin B 12 and folate in patients who had been on metformin > 1,500 mg/day ≥ 4 years were significantly lower those who had been on metformin 1,000– 1,500 mg/day and < 1,000 mg/day < 4 years, respectively.Conclusion: Low serum vitamin B 12 and folate levels and macrocytosis were found to be associated with prolonged metformin treatment.Keywords: macrocytosis, metformin, type 2 diabetes mellitus, vitamin B 12, folate

Muluneh Ademe,1 Friehiwot Girma2 1Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Muluneh AdemeDepartment of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, EthiopiaEmail muluneh.ademe@aau.edu.etAbstract: Candida auris is an emerging multidrug-resistant fungus that is rapidly spreading worldwide. Currently, C. auris cases have been reported globally from > 30 countries. Most reported infections involve critically ill patients in hospitals, mainly in intensive care unit settings. Infection with C. auris is associated with high mortality rates, and it is often resistant to multiple classes of antifungal drugs. Despite the rapid global spread, it is difficult to predict the actual burden of the infection as the standard laboratory methods fail to correctly identify the fungi. Longer stays in healthcare facilities, use of tracheostomies and percutaneous endoscopic gastrostomy tubes, ventilators in clinical care units and mobile equipment in healthcare settings are shown as major risk factors of C. auris infection. Due to its propensity to cause outbreaks and its antifungal resistance, C. auris poses a risk for patients in healthcare facilities. The emergence of pan-resistant C. auris strains in some areas is an alarming signal for the disease with limited treatment options, high mortality rates, and the ability of the pathogen to spread easily in healthcare settings. In this regard, susceptibility testing on clinical isolates, mainly for patients treated with echinocandins, is needed. Increasing awareness about C. auris infection and advancing the diagnostic methods are also essential for early detection and control of the deadly fungal infection.Keywords: Candida auris, multidrug resistance, pandrug resistance, risk factors, challenges

The use of optimum seeding rate for the genotype may enhance productivity and grain protein content of durum wheat. Therefore, an experiment was conducted at two locations in south-eastern Ethiopia during the main cropping season of 2008 with the objective of elucidating the effects of seeding rate and genotype on agronomic performance and grain protein content of the crop. The experiment consisted of factorial arrangements of four improved durum wheat genotypes and five seeding rates, which were laid out as a randomized complete block design with three replicates. Seeding rates significantly influenced agronomic performances including number of fertile spikes [m.sup.-2], plant height, number of seeds [spike.sup.-1], and grain yield. Number of fertile spikes [m.sup.-2] was increased proportionally with the seeding rate and the highest number (382 spikes [m.sup.-2]) was recorded in the highest seeding rate of 200 kg [ha.sup.-1]. Inversely, the highest number of kernels [spike.sup.-1] (29.8) was at the seeding rate of 100 kg [ha.sup.-1]. The highest grain yield (4341 kg [ha.sup.-1]) was obtained in response to seeding rate of 175 kg [ha.sup.-1], which was in statistical parity with the yield obtained at the seeding rate of 150 kg [ha.sup.-1]. However, grain protein content was not influenced by the seeding rates. There were significant (P [less than or equal to] 0.05) variations among the genotypes for all the agronomic traits measured. The largest number of fertile spikes [m.sup.-2] was recorded for the genotypes Oda (360 spikes [m.sup.-2]) and Bakalcha (345 spikes [m.sup.-2]). Genotype Illani produced the longest spike (6.9 cm). Oda and Illani produced the highest numbers of seeds [spike.sup.-1], 38.8 and 36.9, respectively. The number of fertile spikes [m.sup.-2], number of seeds [spike.sup.-2] and kernels weight significantly contributed grain yield. The genotypes had exhibited less variation for grain protein content. Except for grain yield and harvest index, seeding rate x genotype interaction had no significant effect on other agronomic traits. Highest grain yields of 4938 kg [ha.sup.-1] and 4774 kg [ha.sup.-1] were obtained from genotypes Ejersa and Bakalcha when sown at the seeding rate of 150 kg [ha.sup.-1] and 175 kg [ha.sup.-1], respectively. Grain protein response was significantly influenced by the interaction effect in which genotype Oda had the highest (12.9%) and lowest (10.5%) protein contents at the highest (200 kg [ha.sup.-1]) and lowest (100 kg [ha.sup.-1]) seeding rates, respectively. Key words: Genotype, seeding rate, protein, wheat, INTRODUCTION Wheat is one of the most important cereal crops of the world and is a staple food for about one third of the world's population [1]. In Ethiopia, it [...]

Background. The social and economic changes taking place in developing countries are influencing the pace at which hypertension and its risk factors are expanding. As opposed to the already established inverse association in developed nations, the association between socioeconomic status and hypertension in developing countries is poor and inconsistent. This study aims to determine the association between socioeconomic status and hypertension among teachers and bankers in Addis Ababa, Ethiopia. Methods. This study is based on a cross-sectional study conducted to assess the prevalence of NCDs in Addis Ababa, Ethiopia. The study was undertaken among workers of the Commercial Bank of Ethiopia and teachers of public schools in 2010. Results. Majority of participants were teachers (70.3%). Most of the respondents (54.1%) earn an annual income between 15,000 ETB and 48,000 ETB, and 51.9% of them have educational status of first degree and above. Among the socioeconomic factors income was strongly associated with the odds of having hypertension (AOR: 2.17 with 95% CI: 1.58–2.98). Conclusions. Higher burden of hypertension is observed among teachers and bankers in Addis Ababa, Ethiopia. Promotion of healthy behaviors and interventions that target higher income groups needs to be put in place.

Introduction: Attention Deficit Hyperactivity Disorder (ADHD), a prevalent neurodevelopmental disorder affecting a significant portion of the population, is commonly managed with stimulant medications. These medications, while effective, have been associated with thermoregulatory dysfunction and an increased risk of heat-related adverse events. The current study sought to compare the incidence of such events in ADHD patients receiving stimulant medications with those not on these treatments., Methods: A retrospective cohort study was conducted utilizing de-identified electronic medical records from a Global Research Network. The study population comprised ADHD patients on stimulant medication aged 6-24 years, with a comparison group of ADHD patients not receiving stimulant medications. Patients were followed from the date of first cohort inclusion (index event) for one year to track heat-related illnesses, including dehydration, hyperthermia, heat stroke, and other heat-related conditions. Propensity score matching was employed to balance baseline characteristics (age, gender) between cohorts. Risk ratios, odds ratios, and hazard ratios were calculated to assess the incidence of heat-related illnesses between groups. Statistical analysis was performed on the TriNetX platform, with survival analysis conducted via Kaplan-Meier estimates., Results: Analysis revealed a decreased risk of heat-related illnesses in the stimulant medication group, with a risk ratio of 0.559(95% CI: 0.485, 0.644). The mean number of events was also lower in the stimulants medication group (p=0.028). Additionally, Kaplan-Meier survival analysis indicated a higher probability of remaining free from heat-related illnesses in the stimulant group over a one-year period, with a statistically significant difference (log-rank test, χ² = 93.035, p < 0.0001)., Discussion: These results suggest that stimulant medications may be associated with a reduced risk of heat-related illnesses in ADHD patients, potentially contributing to better overall outcomes in this population. Further research is warranted to explore the underlying mechanisms and to confirm these findings across larger and more varied patient populations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zinabu, Gasmelseed, Wheaton, Girma, Wong, Tabraiz, Mubasher, Mack, Lexima, Qazi, Mohammed, Sood and Michael.)

Background: Poor food hygiene practices in developing nations like Ethiopia pose a significant public health threat by increasing the likelihood of food-borne infections. In the study area, there is a lack of comprensive information regarding the hygienic standards and associated factors influcncing the food hygienic practices of street food vendors. Therefore, this study aims to assess food hygienic practices and related variables among street food vendors in Bishoftu town, central Ethiopia., Method: A cross-sectional study was conducted from June 16, 2023 to August 16, 2023, involving 210 street food vendors selected through a simple random sampling technique. Data were collected through face-to-face interviews and analysed using Statistical Package for the Social Sciences (SPSS) version 21. Descriptive statistics like mean, frequency, and percentages were used. Logistic regression analysis was performed to determine the significance of the relationship between each independent and dependent variables. The strength of the association was calculated using adjusted odds ratio (AOR) and the 95 % CI and a p-value of 0.05 was considered statistically significant., Results: The finding of this study revealed that about 64.8 % and 35.2 % of the street food vendors had good and poor food hygiene practices, respectively. Variables such as being female [AOR = 0.191, 95 % CI (0.043, 0.840)], having rich experience in food vending [AOR = 5.793, 95%CI (1.419, 23.649)], maintaining a clean environment [AOR = 2.860, 95%CI (1.484, 5.512)], and possessing knowledge of food hygiene [AOR = 2.726, 95 % CI (1.317, 5.643)] were significantly associated with the food hygiene practices of street vendors., Conclusion: The level of food hygiene practice observed among street food vendors in the study area was lower compared to other study findings conducted in different regions of Ethiopia. Significant factors influencing these hygiene practices were sex, food vending experience, environment, and knowledge. Therefore, current national regulations must be revised to address the existing gaps and enhance food safety procedures for street food vendors nationwide., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors.)

Background: Most children with developmental disabilities (DD) live in low- and middle-income countries, but access to services is limited, impacting their ability to thrive. Pilot study findings of the World Health Organization's Caregiver Skills Training (WHO CST) intervention, which equips caregivers with strategies to facilitate learning and adaptive behaviours in children with DD, are promising but evidence from an appropriately powered trial delivered by non-specialist facilitators is lacking. This study will investigate the effectiveness and the resource impacts and costs and consequences of the WHO CST intervention in four sites in rural and urban Kenya and Ethiopia., Methods: This is a 2-arm multi-site hybrid type-1 effectiveness implementation cluster randomised controlled superiority trial. After baseline assessments (T0) are completed by participants in clusters comprising 7 to 10 caregiver-child dyads, the clusters will be randomised to either the WHO CST intervention arm or a waitlist enhanced care as usual control arm. Further assessments will be completed at endpoint (T1, 18 ± 2 weeks after randomisation) and follow-up (T2, 44 ± 2 weeks after randomisation). The intervention comprises three individualised home visits and nine group sessions with trained non-specialist facilitators. Participants in the control arm will receive the intervention after completing follow-up assessments. We aim to recruit 544 child-caregiver dyads, evenly distributed across the two arms and countries. The co-primary outcomes are the child-focused Child Behavior Checklist (assessing emotional and behavioural problems) and the caregiver-focused Pediatric Quality of Life Inventory (assessing caregiver quality of life), both assessed at endpoint. Secondary outcome measures comprise the two co-primary outcomes at follow-up and ten additional outcome measures at endpoint, assessing stigma-based experiences, depressive symptoms, household food insecurity, child disciplinary strategies and beliefs, CST knowledge and skill competencies, caregiver and child quality of life, social support, and children's communication modes and functions. After quantitative follow-up assessments are completed, a mixed-methods evaluation approach will be used to investigate implementation processes and acceptability, feasibility, and potential sustainability of the intervention., Discussion: The study's findings will provide evidence of the effectiveness and resource impacts and costs and consequences of a non-specialist-delivered intervention in under-resourced contexts in one low-income and one middle-income country in East Africa. Findings will inform future research, intervention, and policy efforts to support children with DD and their families in under-resourced majority world contexts., Trial Registration: Pan African Clinical Trial Registry PACTR202310908063134. Registered on October 16, 2023., (© 2024. The Author(s).)

Children with developmental disabilities (DD) including intellectual disability and autism, experience exclusion from social life and education in Ethiopia. Including children with DD in mainstream inclusive classes has potential to expand access to education and uphold their right to learn alongside typically developing peers. However, inadequate support in inclusive settings can hinder their participation and educational achievement. This study explores the perspectives of stakeholders on the ways in which inclusive education can support the needs or exacerbate the challenges of children with DD in Addis Ababa, Ethiopia, and on recommendations to address the challenges. Thirty-nine participants with expertise or experience relevant to children with DD, including caregivers, educators, clinicians and other experts, took part in semi-structured interviews. Their responses were analysed using thematic template analysis. The themes developed identify four aspects which are most relevant to the potential positive and negative consequences of inclusive education for children with DD: learning and development, peer relationships, safety in school and inclusion in society. The themes encompass sub-themes of positive and negative consequences, and suggested improvements to facilitate positive effects. Identified priorities for action include enhanced teacher training, awareness-raising initiatives, tailoring infrastructure and manpower to safeguard children with DD and promoting government focus on successful inclusion. These recommendations can be implemented to facilitate well-structured inclusive education, where children with DD are supported to participate alongside typically developing peers, as well as to safeguard against the potential negative consequences of inclusion, paying sufficient attention to the distinctive needs of children with DD., (© 2024. The Author(s).)

A large gap in provision of services for children with developmental disabilities (DD) has been identified in Ethiopia, especially in the education system. Including children with disabilities in mainstream schools is encouraged by policies, but progress in this direction has been limited. This study aimed to explore stakeholders' perspectives on contextual factors relevant for inclusive education for children with DD in mainstream schools in Ethiopia, with a focus on Adis Ababa. Data were collected through semi-structured interviews with 39 local stakeholders, comprising caregivers of children with DD, school teachers and principals/managers, non-governmental organisation representatives, government officials, clinicians and academics/consultants. We used template analysis to code the data and map them onto domains of the Context and Setting dimensions of the Context and Implementation of Complex Interventions framework. Stakeholders discussed frameworks in the Legal and Ethical context endorsing the right of all children to education. However, they reported multiple reasons why children with DD in Ethiopia have limited access to education, either in special or mainstream schools. First, individual features, such as gender and support needs, discussed in the Epidemiological context, may affect the likelihood of a child with DD to be accepted in school. Transportation challenges are a key barrier in the Geographical context. Socio-economic and Socio-cultural contexts present barriers at the levels of the nation, school and family, mostly related to limited services and material and financial resources and limited awareness of DD. Stakeholders believe the currently limited but growing commitment in the Political context can support progress towards the removal of these barriers. Our findings can form the basis for development of an implementation plan that addresses such barriers and capitalises on existing facilitators., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Genovesi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: Raising a child with a developmental disability or physical health condition can have a major impact on the lives of their families, especially in low-income countries. We explored the impact on such families in Ethiopia., Study Design: A total of 241 child-caregiver dyads were recruited from two public hospitals in Addis Ababa, Ethiopia. Of these, 139 children were diagnosed with a developmental disability (e.g. autism, intellectual disability) and 102 children with a physical health condition (e.g. malnutrition, severe HIV infection). The family quality of life was assessed using caregiver reports on the Pediatric Quality of Life Inventory™ (PedsQL-FIM™). The disability weight score, which is a Global Burden of Disease measure to quantify health loss, was estimated for each child., Results: Families with a child with a developmental disability reported lower quality of life than families caring for a child with a physical health condition (p < .001). Mean disability weight scores in children with a developmental disability were higher than in children with a physical health condition (p < .001), indicating more severe health loss. Disability weight scores were negatively associated with the family quality of life in the whole group (B=-16.8, SE=7.5, p = .026), but not in the stratified analyses., Conclusions: Caring for a child with a developmental disability in Ethiopia is associated with a substantial reduction in the family quality of life. Scaling up support for these children in resource-limited contexts should be prioritized., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Lay Abstract: Children with developmental disabilities including autism who live in low- and middle-income countries have very limited access to care and intervention. The World Health Organization initiated the caregiver skills training programme to support families with children with developmental disabilities. In Ethiopia, contextual factors such as poverty, low literacy and stigma may affect the success of the programme. In this study, we aimed to find out if the caregiver skills training programme is feasible to deliver in rural Ethiopia and acceptable to caregivers and programme facilitators. We trained non-specialist providers to facilitate the programme. Caregivers and non-specialist facilitators were asked about their experiences in interviews and group discussions. Caregivers found the programme relevant to their lives and reported benefits of participation. Facilitators highlighted the skills they had acquired but also emphasised the importance of support from supervisors during the programme. They described that some caregiver skills training programme topics were difficult to teach caregivers. In particular, the idea of play between caregiver and child was unfamiliar to many caregivers. Lack of available toys made it difficult to practise some of the caregiver skills training programme exercises. Participants indicated that the home visits and group training programme components of the caregiver skills training were acceptable and feasible, but there were some practical barriers, such as transportation issues and lack of time for homework practice. These findings may have importance to non-specialist delivery of the caregiver skills training programme in other low-income countries., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Changes in land use and land cover (LULC) reached a point where we must reconcile. Thus, this study was conducted to assess the LULC changes, deriving forces, and the local community perceptions in Derashe, Southern Ethiopia. Landsat Series sensors' 4, 5, and 8 imagery was used to analyze the LULC over the year. Focus group discussions (FGDs) and key informant interviews (KIIs) were used to assess the deriving force and perceptions. Maximum likelihood of the supervised digital image classification technique was employed. Postclassification was used to detect and quantify changes. Deriving force and perception data were analyzed through descriptive statistics and narration. Five major LULC classes were identified. A major increase was observed in settlement and agricultural land by displacing forest and bush lands. However, the water body was fluctuated. According to the local community, the agricultural land expansion and growing population pressure are the major proximate and underlying deriving forces, respectively. Therefore, proper design for efficient use is necessary., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Agegnehu Taye et al.)

Land degradation is one of the contemporary environmental challenges affecting regions inhabited by over one-third of the global population. In response to land degradation, restoration of degraded landscapes through area closure has been implemented through government and bilateral organizations for the last three decades in Ethiopia. Objectives of this study were to: i) explore the effects of landscape restoration on vegetation cover; ii) identify the perceived benefits to local communities; and 3) synthesize the lessons learnt on communities' willingness to sustain the restored landscapes. The study was conducted in project-supported restoration areas including the Dimitu and Kelisa watersheds representing the central rift valley dry lands and the Gola Gagura watershed representing the eastern dry land areas around Dire Dawa. The temporal changes in land use and land cover due to area closure integrated with physical and biological soil and water conservation measures were detected using GIS/Remote sensing techniques. Moreover, eighty-eight rural households were interviewed. The results of the study revealed that landscape restoration activities such as area closure integrated with physical soil and water conservation, and planting of trees and shrubs contributed to the significant changes in land covers of the watersheds in 3-5 years. Hence, barren lands were reduced by 35-100% while there were significant increases in forest lands (15%), woody grasslands (247-785%), and bushlands (78-140%). More than 90% of the respondents in the Dimitu and Gola Gagura watersheds verified that the landscape restoration activities improved vegetation cover and ecosystem services, reduced erosion, and increased incomes. A great majority of farm households (63-100%) expressed their willingness to contribute to different forms of landscape restoration interventions. Encroachment of livestock to closed area, shortage of finance, and the growing number of wild animals in closed area were the perceived challenges. Proper planning and implementation of integrated interventions, creating local watershed user associations, ensuring appropriate benefit-sharing and implementing innovative pathways to reconcile the tradeoffs could be considered to scale up interventions and address potential conflicts of interest., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Common bean is the most important pulse crops worldwide and in Ethiopia for its multipurpose uses. However, common bean production and productivity is mainly constrained by common bacterial blight (CBB) and angular leaf spot (ALS) diseases. Identifying and using resistant common bean genotypes is the best option to reduce the impact of such bacterial and fungal diseases. Field experiments were carried out to evaluate the genetic resistance of 25 common bean genotypes as treatments to CBB and ALS diseases, and agronomic performances at Haramaya and Melkassa, Ethiopia, during the 2019 and 2020 main cropping seasons. The treatments were arranged in a 5 × 5 triple lattice design with three replications. Data on disease intensity, growth, grain yield and yield components were recorded. Analysis of variance indicated significant (p < 0.0001) variations existed among the genotypes for diseases intensity, grain yield and yield components. Eight genotypes, namely DAB-388, DAB-478, DRKDDRB-70, DRKDDRB-81, NUA-225, NUA-517, NUA-536 and NUA-577 attained relatively low disease severity, AUDPC and disease progress rate next to the checks Zoasho (DAB-96) and Gorossa (Biofort large seed-5) to both common bean diseases regardless of locations and seasons. The genotype DAB-525 showed a moderately resistant reaction to both CBB and ALS, and the other genotypes demonstrated variable disease resistance reactions at both locations and in the two cropping years. Similarly, genotypes DAB-388, NUA-225, NUA-517, and NUA-577 relatively executed well for grain yield and yield components at both experimental fields in the 2019 and 2020 main cropping seasons. Disease severity and grain yield variably and negatively associated with reaction groups of genotypes evaluated for reaction CBB and ALS diseases. In the study, resistance to CBB and ALS diseases and good agronomic performing common bean genotypes were identified which could be important for smallholder and commercial bean production in the study area and other similar agro-ecologies in Ethiopia. It is suggested that a large number of common bean accessions should be evaluated in CBB and ALS hot spot agro-ecologies of Ethiopia for more sources of resistance and better agronomic advantages., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Lay Abstract: Although most children with autism and other neurodevelopmental disorders live in low- and middle-income countries, reliable tools to assess these conditions are often not available in these settings. In this study, we adapted two questionnaires developed in Western high-income contexts for use in Ethiopia - the Autism Treatment Evaluation Checklist and the Pediatric Quality of Life Inventory™ Family Impact Module. Both measures are completed by a child's caregiver and both are relatively short and easy to complete. The Autism Treatment Evaluation Checklist is used to monitor the developmental issues of the child, while the Pediatric Quality of Life Inventory™ Family Impact Module measures the impact of the child's condition on the caregiver. We translated both tools into the Ethiopian language Amharic, and adapted them to the local cultural context. Three hundred caregivers, half of whom were parents of children with neurodevelopmental disorders, and half were parents of children with physical health problems, completed the questionnaires through a face-to face interview, so that non-literate caregivers could also take part. Both tools performed adequately, measured what we aimed to measure and were reliable. Both the Autism Treatment Evaluation Checklist and Pediatric Quality of Life Inventory™ are suitable tools to assess children with developmental and other health problems in Ethiopia and their caregivers. We believe that more similar tools should be developed or adapted for use in low-income countries like Ethiopia, to gain a better understanding of developmental problems in those settings, and allowing clinicians and service providers to use these tools in their practice. Moreover, these tools can be used in future studies to evaluate interventions to improve support for families.

Introduction: Neurotropic pathogens such as Toxoplasma gondii (T. gondii) which result in chronic infections in the brain are associated with mental illnesses. In view of this, a growing body of literature has revealed the possible interaction of schizophrenia and T. gondii infection., Method: A case-control study was conducted from February 2018 to January 2019 among 47 Schizophrenia patients and 47 age and sex-matched controls. Data was collected using a structured questionnaire. Serum was used for serological analysis of anti-T. gondii IgG and IgM antibodies through chemiluminescent immunoassay. Proportions and mean with standard deviations (SD) were used as descriptive measures and variables with p-values <0.05 were considered as statistically significant and independently associated with schizophrenia., Result: The mean ages of schizophrenia patients and controls were 29.64 ± 5.8 yrs and 30.98 ± 7.3 yrs, respectively. We found that 81.9% (77/94) of the study subjects had a positive anti-T. gondii IgG antibody. While the difference is statistically insignificant, schizophrenic patients have a marginally higher seroprevalence of toxoplasmosis than controls (87.2% vs 80.9%; p = 0.398). Schizophrenia cases who live in homes with soil floors have a significantly higher T. gondii infection as compared to those who live in homes with cement/ceramic floors (90.9% vs 33.3%; p = 0.004). Furthermore, there was a significantly lower T. gondii infection among schizophrenic cases who were taking antipsychotic medication for more than three yrs (79.3% vs 100.0%, p = 0.039). On the other hand, among all study subjects who have T. gondii infection, subjects who are addicted to khat and alcohol were about seven times more likely to develop schizophrenia (71.4% vs 47.7%, OR = 7.13, p = 0.024)., Conclusion: Our data is not sufficient to show a significant positive correlation between T. gondii infection and schizophrenia. For study subjects with T. gondii infection, addiction to khat and alcohol is one of the risk factors for schizophrenia., Competing Interests: The authors have declared that no competing interests exist.

Background: The inconsistent use of antiretroviral therapy can lead to the risk of cross-resistance between drugs. This reduces subsequent antiretroviral drug options. The burden of initial antiretroviral therapy ranges from 11.3% in South Africa to 71.8% in Malaysia. There is evidence that it is important to maintain children's initial antiretroviral therapy regimens. However, the incidence and predictive factors of initial antiretroviral therapy regimen changes in the research context are still unknown in the study setting. So, the study was aimed to assess incidence and predictors of initial antiretroviral therapy regimen changes among children in public health facilities of Bahir Dar city., Methods: A retrospective follow-up study was conducted in 485 children who received antiretroviral therapy between January 1, 2011 and December 30, 2020. These children were selected using simple random sampling techniques. The data were entered by Epi data 3.1 and the analysis was completed by STATA 14.0. The missing data was treated with multiple imputation method. The data were also summarized by median or mean, interquartile range or standard deviation, proportion and frequency. The survival time was determined using the Kaplan Meier curve. The Cox Proportional Hazard model was fitted to identify predictors of initial antiretroviral therapy regimen change. The global and Shoenfeld graphical proportional hazard tests were checked. Any statistical test was considered significant at P-value < 0.05. Finally, the data were presented in the form of tables, graphics and text., Result: Among the 459 study participants, 315 of them underwent initial regimen changes during the study accumulation period. The shortest and longest follow up time of the study were 1 month and 118 months, respectively. The overall incidence rate of initial regimen change was 1.85, 95% CI (1.66-2.07) per 100 person-month observation and the median follow up time of 49 (IQR 45, 53) months. The independent predictors of initial regimen changes were poor adherence (AHR = 1.49, 95%CI [1.16, 1.92]), NVP based regimen (AHR = 1.45, 95%CI [1.15, 1.84]) comparing to EFV based regimen, LPVr based regimen (AHR = 0.22, 95%CI: (0.07, 0.70)) comparing to EFV based regimen, history of tuberculosis (AHR = 1.59, 95%CI [1.14, 2.23]) and being male (AHR = 1.28, 95%CI [1.02, 1.60])., Conclusions and Recommendations: In this study, the incidence of initial regimen change was high. The risk of initial regimen change would be increased by being male, poor adherence, having history of tuberculosis and NVP based initial regimen. Therefore, strengthening the health care providers' adherence counseling capability, strengthening tuberculosis screening and prevention strategies and care of initial regimen type choice needs attention in the HIV/AIDS care and treatment programs., (© 2022. The Author(s).)

Background: Neurodevelopmental disorders (NDDs) are conditions affecting a child's cognitive, behavioural, and emotional development. Appropriate and validated outcome measures for use in children with NDDs in sub-Saharan Africa are scarce. The aim of this study was to validate the Communication Profile Adapted (CP-A), a measure developed in East Africa to assess caregivers' perception of communication among children with NDDs., Methods: We adapted the CP-A for use in Ethiopia, focusing on the communicative mode (CP-A-mode) and function (CP-A-function) scales. The CP-A was administered to a representative sample of caregivers of children with NDDs and clinical controls. We performed an exploratory factor analysis and determined the internal consistency, test-retest reliability, within-scale, known-group, and convergent validity of the identified factors., Results: Our analysis included N = 300 participants ( N = 139 cases, N = 139 clinical controls, N = 22 who did not meet criteria for either cases or controls). Within the CP-A-mode, we identified two factors (i.e. verbal and physical communication ); the CP-A-function scale was unidimensional. Combining both scales into one summary variable (the CP-A-total) resulted in a scale with excellent internal consistency and test-retest reliability (Cronbach's alpha = 0.97; Kappa = 0.60-0.95, p < 0.001; ICC = 0.97, p < 0.001). Testing known-group validity, the CP-A-total scores were significantly higher for controls than cases (Δ mean = 33.93, p < 0.001). Convergent validity assessment indicated that scores were negatively and moderately correlated with clinical severity ( ρ = -0.25, p = 0.04)., Conclusion: The CP-A is a valid tool for the assessment of communication among children with NDDs in Ethiopia. It holds promise as a brief, quantitative, and culturally appropriate outcome measure for use in sub-Saharan Africa., Competing Interests: Conflicts of Interest: None., (© The Author(s) 2021.)

Background: Globally, the Tuberculosis treatment success rate was worse for HIV-positive TB patients compared with HIV- negative TB patients. This study aimed at determining the impact of HIV-AIDS and factors associated with TB treatment outcomes., Methods: This study was a retrospective cohort study of five years of tuberculosis data from four public health facilities in Hosanna Town. A total of 604 study participants were included using a systematic random sampling technique. Descriptive analysis of ratios, rates, and proportions was done and binary logistic regression, bivariable and multivariable, analysis was also done., Result: A total of 604 TB patients were enrolled in this study. 302 (50%) were HIV co-infected. The overall treatment success rate was 90.1% (544/604). Treatment success rates are 86.4% (261/302) for TB-HIV co-infected patients and 93.7% (283/302) for non-co-infected patients. TB-HIV co-infected patients had a higher risk of an unsuccessful treatment outcome (Adjusted Relative Risk [ARR]: 2.7; 95% Confidence Interval [CI]: 1.4 - 5.2). The risk of unsuccessful treatment outcome is also higher among rural residents (ARR: 3.3; CI: 1.4 - 5.0), patients on the re-treatment category (ARR: 2.7; CI: 1.4 - 5.1), and with chronic disease (ARR: 3.3; CI: 1.3 - 8.1)., Conclusion: TB treatment success rate is good as compared to the WHO minimum requirement. Successful treatment outcome is lower among patients with HIV infection, rural residents, patients on re-treatment, and patients with chronic disease. Therefore, due emphasis should be given to these high-risk groups., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Background: C-reactive protein (CRP) is an important inflammatory marker associated with different disease conditions, and its concentration differs among ethnicity. This study aimed to determine the distribution and determinants of serum high-sensitive method CRP (hsCRP) that can measure the typically low concentrations, among the Ethiopian population, for which there is no data., Methods: A cross-sectional community-based study was conducted in April-June 2015. A total of 5162 individuals aged 15-69 were included. Behavioral, physical, and biochemical measurements were taken using the WHO STEPS non-communicable diseases (NCDs) risk factors assessment tool. Serum hsCRP was determined using Cobas Integra 400 Plus (Roche). Factors associated with hsCRP levels were also considered., Results: median hsCRP was 0.80 mg/L (Interquartile range, 0.19-2.12) (males: 0.91 mg/L, females: 0.74 mg/L). More than 18% of the study participants had hsCRP greater than 3 mg/L according to the American Heart Association and Centers for Diseases Control and Preventions cut off value. Higher BMI, living in Somali and in Dire Dawa region, and not consuming of fruit or vegetables were independent risk factors for high hsCRP levels., Conclusion: Serum hsCRP levels distribution is comparable to other studies. Until now, no data have been reported in the literature about the Ethiopian population., (Copyright © 2021. Published by Elsevier B.V.)

Background: Metformin is the first-line drug in the treatment of type 2 diabetes mellitus. Monitoring vitamin B 12 deficiency associated with long-term and high-dose therapy is not a common practice in many clinical settings in Ethiopia., Objective: The study aimed to measure levels of serum vitamin B 12 and folate and to assess the macrocytic status of type 2 diabetes mellitus patients on metformin., Methods: A cross-sectional study was conducted on 80 type 2 diabetes mellitus patients who had been on metformin for 5 months or more at the diabetic clinic of Tikur Anbessa Specialized Teaching Hospital. Serum vitamin B 12 and folate levels were quantified by chemiluminescent immunoassays. Mean corpuscular volume was determined by complete blood count. Differences in vitamin B 12 and folate levels and mean corpuscular volume between different groups were assessed using Kruskal-Wallis H and Mann-Whitney U tests., Results: Vitamin B 12 and folate deficiency were documented in 5% and 23.8% of participants, respectively, and 6.2% of patients were macrocytic. Levels of vitamin B 12 and folate in patients who had been on metformin >1,500 mg/day ≥4 years were significantly lower those who had been on metformin 1,000-1,500 mg/day and <1,000 mg/day <4 years, respectively., Conclusion: Low serum vitamin B 12 and folate levels and macrocytosis were found to be associated with prolonged metformin treatment., Competing Interests: The authors declare that they have no conflicts of interest for this work., (© 2021 Wale Tesega et al.)

Background: Physical activity (PA) preserves mobility, but few practices screen older adults for mobility impairment or counsel on PA., Design: "Promoting Active Aging" (PAA) was a mixed-methods randomized-controlled pilot, to test the feasibility and acceptability of a video-based PA counseling tool and implementation into practice of two mobility assessment tools., Setting: Three primary care practices affiliated with Wake Forest Baptist Health., Participants: Adults aged 65 years and older who presented for primary care follow-up and were willing and able to answer self-report questions and walk 4 meters (n = 59)., Intervention: Video-based PA counseling intervention versus control video, "Healthy Eating.", Measurements: Potential participants completed mobility assessments: self-report (Mobility Assessment Tool-short form (MAT-sf)) and performance based (4-meter walk test). We assessed PAA's implementation-feasibility, acceptability, and value-via interviews and surveys. Effectiveness was measured via participant attendance at a PA information session., Results: Of 92 patients approached, 89 (96.7%) agreed to mobility assessment. Eighty-nine completed MAT-sf, and 97.8% (87/89) completed 4-meter walk test. Sixty-seven (75%) met eligibility criteria, and 59 (88%) consented to be randomized either to the PA counseling intervention (Video-PA) or to active control (Video-C). Most participants viewed the walk test positively (51/59; 86.4%). Staff reported that completion of patient surveys, MAT-sf, and videos required significant staff time and support (median = 26 minutes for all), resulting in low acceptability of MAT-sf and the videos. Attendance at a PA information session did not differ by randomization group (Video-PA = 11/29 (37.9%); Video-C = 12/30 (40%); 95% confidence interval for difference in proportion = -0.29 to 0.25)., Conclusions: Mobility assessment, particularly a 4-meter walk test, was feasible in primary care. Tablet-based assessment (MAT-sf) and video counseling tools, selected to reduce staff effort, instead required significant time to implement. Future work to promote PA should identify effective ways to facilitate adoption of PA in sedentary older adults that do not burden staff., (© 2020 The American Geriatrics Society.)

Background: Despite a high prevalence of antenatal depression in low- and middle-income countries, there is very little evidence for contextually adapted psychological interventions delivered in rural African settings. The aims of this study are (1) to examine the feasibility of procedures for a future fully powered efficacy trial of contextually adapted brief problem solving therapy (PST) for antenatal depression in rural Ethiopia, and (2) to investigate the acceptability, fidelity and feasibility of delivery of PST in routine antenatal care., Methods: Design: A randomised, controlled, feasibility trial and mixed method process evaluation., Participants: Consecutive women attending antenatal clinics in two primary care facilities in rural Ethiopian districts. Eligibility criteria: (1) disabling levels of depressive symptoms (Patient Health Questionnaire (PHQ-9) score of five or more and positive for the 10 th disability item); (2) gestational age 12-34 weeks; (3) aged 16 years and above; (4) planning to live in the study area for at least 6 months; (5) no severe medical or psychiatric conditions., Intervention: Four sessions of adapted PST delivered by trained and supervised antenatal care staff over a maximum period of eight weeks., Control: enhanced usual care (EUC)., Sample Size: n = 50. Randomisation: individual randomisation stratified by intimate partner violence (IPV). Allocation: central phone allocation. Outcome assessors and statistician masked to allocation status. Primary feasibility trial outcome: dropout rate. Primary future efficacy trial outcome: change in PHQ-9 score, assessed 9 weeks after recruitment., Secondary Outcomes: anxiety symptoms, trauma symptoms, intimate partner violence, disability, healthcare costs at 9 weeks; postnatal outcomes (perinatal and neonatal complications, onset of breast feeding, child health) assessed 4-6 weeks postnatal. Other trial feasibility indicators: recruitment, number and duration of sessions attended. Audio-recording of randomly selected sessions and in-depth interviews with purposively selected participants, healthcare providers and supervisors will be analysed thematically to explore the acceptability and feasibility of the trial procedures and fidelity of the delivery of PST., Discussion: The findings of the study will be used to inform the design of a fully powered efficacy trial of brief PST for antenatal depression in routine care in rural Ethiopia., Trial Registration: The protocol was registered in the Pan-African clinical trials registry, (PACTR): registration number: PACTR202008712234907 on 18/08/2020; URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9578 .

Although stigma related to developmental disorders (DD) has been associated with poor mental health among caregivers, an in-depth understanding of factors that influence internalisation of stigma by caregivers is missing. The aim of our study was to explore perceptions and experiences of stigma among parents of children with DD in Ethiopia and examine the contributing and protective factors for internalised stigma based on the perspectives of the parents themselves. We conducted in-depth interviews with eighteen parents (fourteen mothers, four fathers) in Addis Ababa (between December 25, 2017 and January 8, 2018) and the rural town of Butajira (between August 08, 2018 and August 16, 2018). We analysed the data using thematic analysis. Parents perceived and experienced different forms of stigma that were directed towards their child (public stigma) and themselves (courtesy stigma). Some parents also described how they isolated themselves and their child from social life (affiliate stigma). Parents perceived the negative consequence of stigma on the lives of their child with DD, siblings and themselves. Most parents also described examples of positive reactions and support from their own family and the community. Participants' accounts suggested supportive contributions and positive responses from the general public came primarily from those who had better awareness of DD. Not all parents in our study internalised the stigma that was directed at them. Whilst perceived family support and acceptance and increased awareness about DD appeared to help some parents not to internalise stigma, the perceived lack of social support and acceptance made some parents vulnerable to internalised stigma. These findings can inform anti-stigma intervention priorities. Awareness-raising activities targeting the community as a whole as well as interventions targeting parents themselves are likely to be beneficial. Interventions should consider the wellbeing of the whole family unit rather than focus on individuals alone., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Following publication of the original article [1], we have been notified that the name of one author was spelled incorrectly as Kidanemariam Berhe, when the correct spelling is Kidanemaryam Berhe.

Background: Booming industrial development in Ethiopia, including a growing steel industry, may result in increased prevalence of pulmonary conditions. In this study, we evaluated steel workers' exposure to dust as well as its potential impact on lung function., Methods: Cross-sectional study of 75 steel workers in Ethiopia, interviewed from April to June 2015. We obtained information on respiratory symptoms and personal protective equipment use via interview and conducted spirometry testing to assess lung function. Dust samples were collected from different factory sections. Correlation analyses were used to assess associations between variables., Results: Maximum dust levels were recorded in the induction furnace, where both galvanized and non-galvanized metals are melted. Steel factory workers with higher levels of particulate matter exposure had increased rate of respiratory symptoms (r = 0.96). Forced vital capacity values showed a strong negative correlation with numbers of years at work (r = -0.86, p = 0.03) and responders age (-0.85, p = 0.49) and weak negative correlation with level of particular matter (PM) (r = -0.02, p = 0.07). Similarly, forced expiratory volume in 1 second was strongly negatively correlated with the number of years of exposure (r = -0.82, p = 0.05) and workers age (r = -0.85, p = 0.08) and weakly negatively correlated with PM level (r = 0.25, p = 0.67)., Conclusions: Occupational exposure continues to be a major problem among steel factory workers in Ethiopia and is associated with lung function abnormalities. Ensuring the availability of proper personal protective equipment, regular factory inspections, and training may help mitigate the impact of occupational exposures among these workers., Competing Interests: The authors have no competing interests to declare., (© 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.)

Following publication of the original article [1], the author reported that his name was misspelled. The original article has been corrected.Incorrect name: Gidiom GebrehetCorrect name: Gdiom Gebreheat.

Background: The incidence of premature rupture of membranes ranges from about 5% to 10% of all deliveries. A woman with premature rupture of membranes is at risk of intra-amniotic infection, postpartum infection, endometritis, and death. A neonate born from premature rupture of membranes mother is at high risk of respiratory distress syndrome, sepsis, intraventricular hemorrhage and death. Little is known regarding the risk factors in Ethiopia. Therefore, this study was conducted to identify risk factors of premature rupture of membranes among pregnant women admitted to public hospitals in Mekelle city, Tigray, Ethiopia., Methods: Hospital based unmatched case control study design was implemented on 240 samples (160 controls and 80 cases) from pregnant mothers admitted to public hospitals in Mekelle city from February - April/2016. Data was collected by interviewer administered Structured questionnaire and checklist. Binary logistic regression model was used to see the association between dependent and independent variables and multivariable logistic regression was used to identify the independent predictors of premature rupture of membranes., Results: A total of 160 controls and 80 cases were enrolled in the study. Multivariable logistic regression showed that history of abortion [AOR 3.06 (CI: 1.39, 6.71)], history of PROM [AOR 4.45 (CI: 1.87, 10.6)], history of caesarean section [AOR 3.15(CI: 1.05, 9.46)] and abnormal vaginal discharge in the index pregnancy [AOR 3.31(CI: 1.67, 6.56)] were positively associated with premature rupture of membranes., Conclusions: Past obstetric history and risks in the index pregnancy have an association with premature rupture of membranes. The finding of the study suggests early identification and treatment of genitourinary infection.

Our current understanding of autism and other developmental disorders is primarily based on research conducted in high-income countries, predominantly in North America and Europe. Even within high-income countries, White participants are overrepresented in autism research. There is now increased recognition that a more global and diverse research representation is warranted. This paper argues that in order for global and diverse research efforts to be effective, it is essential to collaborate and engage with local experts and stakeholders, including local researchers, clinicians and representatives from governmental and non-governmental organisations. Such collaborations ensure that studies use culturally appropriate methods and materials, and that research findings are interpreted taking local context into account. Ultimately, these collaborations build local capacity and foster the development of culturally and contextually appropriate interventions that address locally perceived needs. The adage 'nothing about us without us' is vital to global autism research.

Introduction: In Ethiopia, CD4+ T-cell counting is still required for all patients at baseline before antiretroviral therapy (ART) and to determine eligibility and follow-up of opportunistic infection prophylaxis. However, access to CD4+ T cell count in rural health facilities remains a major challenge in Ethiopia like other resource-limited settings., Methodology: Both capillary and venous blood was drawn from each of 325 study participant recruited in Addis Ababa and surroundings. The CD4+ T-cell count, CD4%, and hemoglobin (Hgb) were tested at one of the four study health facilities using capillary blood and BD FACSPresto™ device. These tests were also done at the national HIV reference laboratory, using venous blood with BD FACSCalibur™, Sysmex XT-1800i™, and BD FACSPresto™., Results: BD FACSPresto™ had an absolute mean bias of -13.3 cells/ul (-2.99%) and 28.3 cells/μl (6.4%) using venous and capillary blood, respectively, compared with BD FACSCalibur™. The absolute CD4 assay on the BD FACSPresto™ had a regression coefficient (R2) of 0.87 and 0.92 using capillary blood and venous blood samples, respectively, compared with BD FACSCalibur™. The percentage similarity of the BD FACSPresto™ using capillary and venous blood was 105.2% and 99.3%, respectively. The sensitivity of the FACSPresto™ using threshold of 500 cells/μl for ART eligibility using capillary and venous blood was 87.9 and 94.3%, while the specificity was 91.4 and 83.8%, respectively. Furthermore, the BD FACSPresto™ had an absolute mean bias of -0.2 dl/μl (0.0%) (95% LOA: -1.7, 1.3) and -0.59 dl/μl (0.1%) (95% LOA: -1.49, 0.31) for Hgb using capillary and venous blood compared with the Sysmex XT-1800i™, respectively., Conclusion: Our results showed acceptable agreement between the BD FACSPresto™ and BD FACSCalibur™ for CD4+ T-cell counting and CD4%; and between the BD FACSPresto™ and Sysmex XT-1800i™for measuring Hgb concentration.

Background: Providing quality of care for infectious pulmonary tuberculosis patients is crucial in prevention and control of the disease. However, little is known about the existing quality of care in such services. The objective of the study was to assess the quality of care delivered for infectious pulmonary tuberculosis patient in Jimma Zone, South West Ethiopia., Methods: Facility based cross- sectional study was conducted from January- February 2008 in 10 public health facilities in Jimma Zone. Facility audit was carried out to assess structural quality. Twenty providers were interviewed and records of 299 smear positive patients registered for 1 year was reviewed. Data were entered and analyzed using SPSS 11.0 for windows statistical software and findings at 95% CI and p value of 0.05 were reported as statistically significant., Results: The results of the study showed that all the three quality dimensions were graded as poor in all the study health facilities and overall 66.0% of TB patients receive poor quality care. Four variables were identified that significantly predicted treatment success, i.e. conformity to the recommended schedule of sputum smear microscopy, conformity to DOTS drug regimen during both intensive and continuation phase of therapy and quality of registration of patients' medical records., Conclusion: This study revealed that most of the problems could be managed at local level, while a few needs further discussion with other management bodies. Success of anti tuberculosis therapy could be ensured through strict adherence to all the elements of DOTS strategy, with special emphasis on the 4 variables that significantly predicted treatment success in the present study.

Background: In Ethiopia, utilization of health services remains low and unevenly distributed. To ensure appropriate health care use, we need to understand factors affecting health care use, and the reasons for low levels of utilization among our community. The objective of the study was to assess utilization of health services and associated factors in Jimma zone, south west Ethiopia., Methods: A cross sectional data was collected from January 15 to February 08, 2007 in Jimma zone. First, four districts were selected by lottery method. Then 2 'kebeles' from each district were selected randomly and households were selected by systematic sampling. A total of 836 households were studied. The data were cleaned, coded and entered into computer and analyzed using SPSS for windows version 12.0. Bivariate analysis and logistic regression were conducted and a significance level of 5% was considered for interpretation., Results: The health services utilization rate was found to be 45.6%. After controlling confounders using logistic regression; sex (OR=0.23), marital status (OR=8.1), household income (OR=0.70), socioeconomic status (OR=3.5), presence of disabling health problem (OR=3.3), presence of an illness episode (OR=28.3), perceived transport cost (OR=3.6), perceived treatment cost (OR=0.15) and distance to the nearest health center or hospital (OR=2.9) were found to be predictors of utilization of health care., Conclusion: It has been shown that utilization level was not satisfactory. Thus, we recommend that the level of health service utilization should be improved by improving predictors of health care use like physical accessibility.

Osmotic adjustment, defined as a lowering of osmotic potential (psi(pi)) due to net solute accumulation in response to water stress, has been considered to be a beneficial drought tolerance mechanism in some crop species. The objective of this experiment was to determine the relative contribution of passive versus active mechanisms involved in diurnal psi(pi) changes in sorghum (Sorghum bicolor L. Moench) leaf tissue in response to water stress. A single sorghum hybrid (cv ATx623 x RTx430) was grown in the field under variable water supplies. Water potential, psi(pi), and relative water content were measured diurnally on expanding and the uppermost fully expanded leaves before flowering and on fully expanded leaves during the grain-filling period. Diurnal changes in total osmotic potential (Deltapsi(pi)) in response to water stress was 1.1 megapascals before flowering and 1.4 megapascals during grain filling in comparison with 0.53 megapascal under well-watered conditions. Under water-stressed conditions, passive concentration of solutes associated with dehydration accounted for 50% (0.55 megapascal) of the diurnal Deltapsi(pi) before flowering and 47% (0.66 megapascal) of the change during grain filling. Net solute accumulation accounted for 42% (0.46 megapascal) of the diurnal Deltapsi(pi) before flowering and 45% (0.63 megapascal) of the change during grain filling in water-stressed leaves. The relative contribution of changes in nonosmotic volume (decreased turgid weight/dry weight) to diurnal Deltapsi(pi) was less than 8% at either growth stages. Water stress did not affect leaf tissue elasticity or partitioning of water between the symplasm and apoplasm.