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Yonas Angaw,1 Abera Kumie,2 Yifokire Tefera,2 Samson Wakuma,2 Ansha Nega,2 Hagos Degefa Hidru,1 Medhin Mehari,1 Embay Amare Alemseged,1 Abadi Hailay,1 Fre Gebremeskel,1 Haftom Mamo,3 Hailu Belay,3 Meresa Berwo Mengesha,4 Hirut Teame1 1College of Medicine and Health Science, Department of Public Health, Adigrat University, Adigrat, Ethiopia; 2College of Health Science, Department of Public Health, Addis Ababa University, Addis Ababa, Ethiopia; 3College of Medicine and Health Science, Department of Psychiatry, Adigrat University, Adigrat, Ethiopia; 4College of Medicine and Health Science, Department of Midwifery, Adigrat University, Adigrat, EthiopiaCorrespondence: Yonas Angaw Email yonasangaw27@gmail.comIntroduction: The development of modern automated machines in industries has considerably decreased the physical burden of workers in addition to increasing the productivity of the industries resulting in noise pollution. Noise exposure above the limit value of 90 dB (A) is known to cause temporary hearing loss among exposed workers.Materials and Methods: Institutional-based cross-sectional study design was employed for a total of 406 study participants using a simple random sampling technique from January 15 to April 30, 2019. The data collection methods were observational checklist and a self-administered questionnaire. The collected data were entered into EpiData software version 4.2 and exported to SPSS software version 21 for analysis. Bivariate and multivariable logistic analyses wwere used to identify the associated factors. Statistical significance was declared using a 95% confidence interval and a p-value of less than 0.05.Results: A total of 388 study participants were included in the study with a response rate of 95.6%, of which 254 (65.5%) were females. The overall temporary hearing loss among the textile factory workers was found to be 49% with COR=1.53; 95% CI (1.15– 2.03). The workers from the spinning department were 2.38 times more likely to develop temporary hearing loss after exiting from work than workers from the dyeing department (95% CI= (1.16– 4.90). Similarly, workers from the knitting department were 3.67 times more likely to develop temporary hearing loss after exiting from work than workers from the dyeing department (95% CI=1.42– 9.47).Conclusion: The present study demonstrated that the workforce in the spinning and knitting departments of the textile factory had a high prevalence of temporary hearing loss than the workers in dyeing and garment working sections. Therefore, the textile factory should provide hearing protection devices to the workers.Keywords: noise exposure, temporary hearing loss, Ayka Addis

Mekonnen Haftom,1 Pammla Petrucka,2 Kbrom Gemechu,1,3 Haftamu Mamo,3,4 Tesfay Tsegay,1,5 Embay Amare,4 Hayelom Kahsay,5 Alem Gebremariam4 1Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 2College of Nursing, University of Saskatchewan, Saskatchewan, Canada; 3Department of Psychiatric Nursing, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 4School of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 5School of Medicine, College of Medicine and Health Sciences, Adigrat University, Adigrat, EthiopiaCorrespondence: Mekonnen Haftom Email haftommekonnen@gmail.comBackground: With the onset of any novel condition, it is the “first” case identified that brings attention and sets into motion the machinery to respond – so it began with a first novel pneumonia case of unknown origin in Wuhan, China. Currently, the World Health Organization has declared SARS-CoV-2 (more commonly known as COVID-19) a public health emergency of international concern. It is projected that the path of COVID-19 could kill 50– 80 million people and impacts the world’s economy in its devastating global sweep. The surge is increasing on global and national levels, causing rapid loss of life, joblessness, deterioration of the healthcare systems, and both national and global economies. In Ethiopia, the first COVID-19 case was reported in March. Since then, the government has been taking different measures to prevent its spread. Locking down all schools, declared social distancing and hand hygiene, and restricting large gatherings were some of the Ethiopian government’s actions.Objective: To determine knowledge, attitudes, and practices towards COVID-19 pandemic among quarantined adults in Tigrai region, Ethiopia.Methods: A total of 331 participants selected using a systematic random sampling method were included in the study. We used an interviewer-administered questionnaire. After describing the variables using frequencies, means, and standard deviations, multivariable logistic regression determined factors associated with knowledge and chi-squared tests for attitudes and practices towards COVID-19.Results: The study participants were primarily males (70%) and mean age 30.5 (SD=11) years. The mean knowledge score was 8.73 (SD=2.64), with less than half 42.9% (95% CI: 37.5– 48%) of the study participants were knowledgeable. Regarding the attitude questions, three-fourths of the participants believed that Ethiopia will control and win the battle against the COVID-19 pandemic. Nearly one-third of the participants replied that the Ethiopian government is handling this pandemic health crisis well. About half of the study participants reported that they had gone to crowded places in recent days, did not wear face mask when leaving home, and practiced preventive measures given by local health authorities. Knowledge score was statistically significantly associated with gender, age, and educational status of the study participants, whereas attitude and practices were significantly associated with educational status and knowledge of participants.Keywords: knowledge, attitude, practice, quarantine, COVID-19, Ethiopia

Abstract The environment and human existence are inextricably intertwined. Consequently, alterations in the environment’s natural characteristics can lead to severe resource shortages. This affects the institutions that have been crucial in shaping and guiding human lives and preserving the environment’s richness, as well as the endeavours of communities to sustain their livelihoods. This article examines the impact of environmental change on the indigenous belief system of the Bayso community of Gidicho Island, southern Ethiopia. Ethnographic data were collected through interviews, focus group discussions, observation, and photographs. The results showed that environmental change on Gidicho Island and its environs has disrupted the socio-economic and cultural life of the Bayso, essentially their religious rituals. Thus, we advise the federal government to amend the country’s development policies that exacerbate environmental degradation and intervene to reduce the effects of poverty on the resource-use behaviours of its people.

AbstractThis article investigates the Sebat Bête Gurage’s perceptions and engagement experiences with their cultural landscapes. Using phenomenology and landscape multifunctionality approaches, it examines the relationships between social groups and everyday landscapes as sites of dwelling, well-being, and interaction. The study utilised ethnographic in-depth interviews, focus group discussions and observations. The data was analysed qualitatively by generating themes and meanings from various data sources. Social groups such as children, youth, elderly, women, men, the disadvantaged, crafts, non-local residents and local government agents perceive and engage with landscapes based on their socio-economic and well-being associations. Non-Gurage local residents have positive perceptions and well-being associations, despite their socio-cultural backgrounds. Local government actors viewed village landscapes as public reserves for infrastructure and service expansions, despite the costs of prior landscape identities and provisions. Shared perceptions and engagement experiences exist in public landscapes, regardless of the socio-economic differences of social groups. Social groups viewed landscapes as ancestors’ gifts that stored values of man-environment interactions, memories, identities, and well-being associations. However, landscape dynamics due to intrusions, encroachments, and generation gaps regarding landscape values challenge social groups’ perceptions and landscape associations, leading to a decrease in landscape appreciation and well-being associations and a shift in perceptions. Henceforth, decision-making and interventions in village landscapes necessitate consultation of diverse interests, social demands, prior landscape provision, and long-standing landscape values as part of policy decisions in the case of micro-landscapes. An understanding of landscape dynamics among social groups is also needed to inform policy for micro-landscape decisions to balance conflicts of interests, diverse demands and ensuring landscape sustainability and multifunctionality.

Cultural landscapes are living evidence of human-environment interactions and patterns of living. This research explores Gurage landscapes' multifunctional and dynamic aspects, mainly Jefore. The study employed an ethnographic research design, and data were generated from multiple sites and sources. Research sites were purposefully selected based on prior knowledge and socio-ecological parameters. Landscape multifunctionality and phenomenological approaches were used to understand landscape's human-environment interactions. According to the findings, Jefore is a well-structured, managed indigenous road network serving public and private roles with a width of 24–84 m and a length of ½ up to 20 km beyond the road network. Jefore remains evidence of human-environment interaction frameworks for living and socio-cultural and ecosystem services as well as phenomenological experiences and associations. As a public landscape, Jefore promotes and maintains village social networks, cultural practices, livelihoods, well-being, and socio-ecological resources integration. It regulates agroforestry practices, optimises resource utilisation, and allows home garden productivity. However, Jefore's socio-ecological landscape identity, landscape multifunctionality, and phenomenological associations are affected by land use and land cover changes, unplanned physical infrastructures expansion, and socio-ecological values crackdown. Largely, Jefore dynamics affected prior landscape designations, socio-cultural and ecological provisions, and long-established sustainable human-environment interactions. Thus, to maintain Jefore's landscape identities and sustainability, micro and macro landscape interventions need to respect and recognize its socio-ecological essence and multifunctionality.

Sacred landscapes are texts of sustainable human-ecological relationships with strong senses of spirituality. This article explores the sacred and dynamic aspects of the Sebat Bête Gurage landscapes using ethnographic research design. Furthermore, to grasp elements of sacred environments and their dynamics, a spiritual ecology perspective was used. The data was based on ethnographic sources, with original data gathered through in-depth interviews, focus group discussions, observations, and an inventory of sacred sites. And data from sacred forest facts and people’s experiences were examined using ethnographic data analysis approaches such as thematization and meaning constructions generated from primary data sources through data triangulation. The study examines indigenous religious aspects and sacredness; the characteristics and spiritual dimensions of sacred forests; the nature of engagements and benefits obtained from sacred forests; governance practices and dynamics aspects of sacred forests; and the implications of dynamics on human-ecology interaction sustainability among the Gurage. The study’s findings also revealed the multi-functionalities of sacred forests for forest-surrounding communities, as well as the importance of managing sustainable nature-culture interactions in the quest for spiritual ecology and sustainable living. The research also portrays the effects of human intrusions on the state of sacred forests and their provisions. The article concludes with a call for concern for multifunctional sacred landscape governance.

The road traffic is one of the main sources of noise pollution in the urban area. The main purpose of this study was to measure the ambient noise fluctuation levels in five selected sites of Dire Dawa city. The study reports traffic noise fluctuations during the day and night since the city is an industrial corridor and it is used as a dry port for the country. The noise level was measured after the standard measure followed by standard calibrated devices. The variations of the equivalent noise levels were represented in figures and the total annoyance of the noise levels was calculated and shown in Table 1. The results revealed that the highest annoyance and the equivalent noise levels at Delchora hospitals were 83.15 dB and 85.20 dB respectively in the morning. However, the noise pollution level (LNP) at Delchora Hospital during the morning is greater than in the afternoon. The minimum noise levels were measured in the residence of MA hotel 24.77 dB with the standard deviation of 0.10 in the morning time interval. [ABSTRACT FROM AUTHOR]

Noise pollution consists of any unwanted sound from various sources with numerous effects. Urban noise pollution is one of the challenges of those people that live in the urban area and which causes health and social problems. The aim of this study was to evaluate the people perception on major noise source and its impact on health at Dire Dawa city, Ethiopia. Cross-sectional study method and purposive random sampling were applied as well as structured pre-tested questionnaire was developed. The result of this study revealed that the major sources of noise in the city were vehicles, such as three wheel vehicles, automobiles, and trucks. One of the major findings of this study was that people perceptions of noise pollution do not depend on the intensity level of sound, but merely on the people's interest for that sound. For instance, the noise source from the religious institute was not considered as a noise for the follower of that religion, but it was considered as a noise pollution for others. Moreover, the noise source from recreation centers was not considered as noise pollution for most respondents. Another important finding of this study was the sensory adaptation to the noise of the people. For the people who have lived for a long time around one type of noise source, that noise was not considered as noise pollution, but it was considered as noise pollution for the newcomers. These two important findings of this study disagree with the World Health Organization (WHO) Guidelines for Community Noise and health risks associated with noise pollution [26]. [ABSTRACT FROM AUTHOR]

Regional cerebral blood flow (rCBF) was studied by the intravenous 133Xe method in 38 patients with systemic lupus erythematosus (SLE); 21 patients had neuropsychiatric manifestations (N+) and 17 did not (N-). Twelve of the N+ patients had had neuropsychiatric episodes less than one year before measurement of CBF ("recent" N+), while seven patients in this group had had episodes over a year before measurement ("old" N+). The results were compared with those obtained from a group of 27 age-matched normal healthy subjects. It was found that, in most of the N+ and N- patients, rCBF was evenly distributed bilaterally, but there was a "patchwork" of high/normal and low flow areas. This disturbance of rCBF distribution was significantly greater in "recent" N+ patients than in "old" N- patients, but was not a function of the potential evolution of systemic lupus erythematosus. It was also found that there was a reduction in the physiological high frontal rCBF in the "old" N+ patients. No correlation could be found between rCBF, the topography of the neuropsychological lesions, other neurological investigations or the glucocorticoid dosage and treatment schedules. [ABSTRACT FROM AUTHOR]

Regional cerebral blood flow (rCBF) was recorded in 32 young otherwise healthy alcoholics (less than 40 years old) by the Xenon 133 method. The duration of the intoxication was less than 10 years in all patients. A psychometric evaluation was also performed (Weschler Adult Intelligence Scale, Benton's visual retention test and Binois Pichot Vocabulary test). A hypofrontal flow distribution was found in all except two subjects. A significant heterogeneity of flow distribution was also found, rCBF was reduced by 20% to 47.1 (right) and 47.4 (left), compared to 57.7 and 60.3 in the control group. There were considerable abnormalities of cognitive functions in alcoholics, but only weak correlation was found between frontal blood flow and Benton's visual retention test. [ABSTRACT FROM AUTHOR]

Background: Duffy Binding Protein (PvDBP) binding to the Duffy antigen receptor for chemokine (DARC) is essential for Plasmodium vivax invasion of human reticulocytes. PvDBP copy number variation (CNV) might increase parasite invasion and thus parasitemia. We examined the spatial distribution of PvDBP CNVs and DARC genotypes and their association with parasitemia in P. vivax endemic settings in Ethiopia., Methodology/principal Findings: P. vivax isolates (n = 435) collected from five P. vivax endemic settings in Ethiopia were genotyped by amplifying the GATA1 transcription factor-binding site of the Duffy blood group and the CNV of PvDBP was quantified. Parasitemia was determined using 18S-based qPCR. The majority of participants were Duffy positive (96.8%, 421/435). Of the few Duffy negative individuals, most (n = 8) were detected from one site (Gondar). Multiple copies of PvDBP were detected in 83% (363/435) isolates with significant differences between sites (range 60%-94%). Both heterozygous (p = 0.005) and homozygous (p = 0.006) patients were more likely to have been infected by parasites with multiple PvDBP copies than Duffy negatives. Parasitemia was higher among the Duffy positives (median 17,218 parasites/µL; interquartile range [IQR] 2,895-104,489) than Duffy negatives (170; 78-24,132, p = 0.004) as well as in infections with 2 to 3 PvDBP copies (20,468; 3,649-110,632, p = 0.001) and more than 3 PvDBP copies (17,139; 2,831-95,946, p = 0.004) than single copy (5,673; 249-76,605)., Conclusions/significance: A high proportion of P. vivax infection was observed in Duffy positives in this study, yet few Duffy negatives were found infected with P. vivax. The significant prevalence of multi-copy PvDBP observed among Ethiopian P. vivax isolates explains the high prevalence and parasitemia observed in clinical cases. This suggests that vivax malaria is a public health concern in the country where the Duffy positive population predominates. Investigating the relative contribution to the maintenance of the infectious reservoir of infections with different genotyping backgrounds (both host and parasite) might be required., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Nasir 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.)

This study aimed to comprehensively examine the prevalence of L. monocytogenes and Listeria spp. in dairy products including raw milk, pasteurized milk, and cottage cheese, and identify potential risk factors for contamination throughout the dairy value chain in major milk sheds in Ethiopia. We collected 912 samples, comprising 736 milk samples (368 raw and 368 pasteurized) and 176 cottage cheese samples, from the Oromia, SNNP, and Amhara regions. The isolation of L. monocytogenes and Listeria spp. followed the EN ISO 11290-1: 2017 standards, with confirmation via PCR targeting the lmo2234 and iap genes. The overall prevalence rates were 12.2 % for Listeria spp. and 4.7 % for L. monocytogenes. Notably, the prevalence of Listeria spp. (P = 0.024) and L. monocytogenes (P < 0.001) varied significantly across regions. Raw milk showed the highest prevalence of Listeria spp. at 15.2 %, followed by pasteurized milk at 12.2 %, and cottage cheese at 5.7 %, with these differences being statistically significant (P = 0.006). The prevalence of Listeria spp. differed significantly (P = 0.001) among the value chain stages (producers, collectors, processors, and retailers) and was 12.5 %, 17.9 %, 17.4 %, and 7.1 %, respectively. Furthermore, the prevalence rates in cottage cheese from producers and retailers were significantly different at 6.8 % and 4.5 % (P = 0.001). The prevalence of L. monocytogenes among milk producers, collectors, and processors was also significantly different, at 4.4 %, 5.4 %, and 12.0 % respectively (P < 0.001). Filtration of milk and cooling for preservation of milk were significantly associated with Listeria spp. or L. monocytogenes contamination at milk collectors' level (P < 0.05). These findings underscore the need for targeted interventions focused on the risk factors identified here to mitigate Listeria contamination in the dairy sector., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier B.V.)

Background : Schistosomiasis continues to be a major public health concern in Ethiopia. Eliminating the intermediate host snails is an effective and cost-efficient strategy for preventing and controlling schistosomiasis transmission. However, chemical molluscicides have limitations due to their toxicity to nontarget aquatic organisms, environmental concerns, and the development of resistance. Plant-based molluscicides are biodegradable, less toxic, safe, and cost-effective. Objective : This study is aimed at evaluating the molluscicidal activity of Hagenia abyssinica flowers, Rosa abyssinica fruits, and Cucumis ficifolius roots against Biomphalaria and Bulinus species. Methods : Adult Biomphalaria and Bulinus species were subjected to varying concentrations of aqueous and 70% ethanol extracts and solvent partitions from H. abyssinica , R. abyssinica , and C. ficifolius for 24, 48, and 72 h. The investigation involved conducting a phytochemical analysis using standard screening methods. Female mice were subjected to an acute oral toxicity test using a 70% ethanol extract of H. abyssinica , R. abyssinica , and C. ficifolius . The mortality data were then determined using GraphPad Prism 9 software. Results : Aqueous and 70% ethanol extracts of R. abyssinica and C. ficifolius did not exhibit molluscicidal activities against Biomphalaria and Bulinus species. However, aqueous, 70% ethanol, and chloroform extracts of H. abyssinica showed significant molluscicidal activities against Biomphalaria species with 24-h LC 50 values of 39.05, 11.93, and 5.52 mg/L, respectively. Similarly, the LC 50 values of the same extracts against Bulinus species after 24 h of exposure were 40.08, 12.23, and 6.13 mg/L, respectively. The plant extract's LD 50 for acute toxicity against mice was found to be over 2000 mg/kg of body weight. Conclusion : H. abyssinica demonstrated potent molluscicidal activity, making it a potential candidate for application. Further isolation of active ingredients and field trials are necessary to determine the optimal conditions for its use in snail control., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Hirut Basha et al.)

Background: The spread of multidrug-resistant tuberculosis (MDR-TB) poses a significant challenge to TB control efforts. This study evaluated the treatment outcomes and associated factors among patients receiving treatment for MDR-TB in southern Ethiopia., Methods: A retrospective follow-up study covering ten years, from 2014 to 2023, analyzed the records of confirmed cases of pulmonary TB admitted to Yirgalem General Hospital, an MDR-TB treatment initiation center in the Sidama Region. To compare the successful treatment outcomes across the years, a chi-square test of independence was conducted. Bivariate and multivariable logistic regression models were used to identify factors associated with treatment outcomes for MDR-TB., Results: Out of 276 confirmed MDR-TB cases, 4(1.4%) were diagnosed with resistance to second-line drugs (SLDs). Overall, 138 patients achieved favourable treatment outcomes, resulting in a treatment success rate of 50.0% [95% CI 44.1-55.9%]. Among these 138 patients, 105(76.1%, 95 CI 68.7-83.5%) were cured, while 33(23.9%, 95 CI 16.5-31.3%) completed their treatment. The successful treatment outcomes varied significantly across the years, ranging from 3.6% in 2020 to 90% in 2021. The analysis indicated a statistically significant difference in treatment outcomes when considering data from 2014 to 2023 (χ 2  = 44.539, p = 0.001). The proportion of patients with deaths, lost-to-follow-up (LTFU), treatment failures and not evaluated were 7.9% [95% CI 4.8-11.2%], 10.9% [95% CI 7.2-14.6%), 2.2% [95% CI 1.1-3.3%), and 28.9% [95% CI 23.7-34.2%] respectively. Individuals with a positive HIV status had significantly lower odds of a favorable treatment outcome [AOR = 0.628, 95% CI (0.479-0.824), p = 0.018]. Similarly, patients with a BMI of less than 18 are more likely to have unfavorable treatment outcomes compared to those with a BMI of 18 or higher [AOR = 2.353, 95% CI 1.404-3.942, p < 0.001]., Conclusion: The study revealed a concerning 1.4% prevalence of additional resistance to SLDs. The 50% rate of unfavorable treatment among MDR-TB cases exceeds the target set by the WHO. A significant number of patients (10.9%) were LTFU, and the 28.9% categorized as 'not evaluated' is also concerning. Enhanced strategic interventions are needed to reduce such cases, and factors associated with poor treatment outcomes should receive greater attention. Future prospective studies can further explore the factors influencing improved treatment success., (© 2024. The Author(s).)

Ethiopia has a plan to eliminate malaria in selected low-transmission districts by 2025. However, complex factors such as seasonality, focal heterogeneity, and coendemicity of Plasmodium vivax and Plasmodium falciparum, and asymptomatic cases, along with other factors, pose challenges. This longitudinal study assessed these dynamics and associated factors in three elimination-targeted settings in southern Ethiopia. The study included rural districts (Wonago and Yirgacheffe) and an urban setting (Dilla town) with 504 participants from 168 households per season. The study covered the peak and minor malaria transmission seasons and the dry season. Finger-prick blood was collected for microscopy, rapid diagnostic tests, and 18S-rRNA-based quantitative polymerase chain reaction (qPCR). During the dry season, P. vivax accounted for most infections (64.5%, 71/110) and symptomatic malaria (50.9%, 29/57), whereas P. falciparum dominated during the peak transmission season (45.7%, 42/92 infections and 58.1%, 25/43 of symptomatic cases). Treatment-seeking behavior was low, with 65.3% (143/219) of symptomatic individuals not seeking treatment. Dilla town had significantly higher infection prevalence (29.6%, 149/504, P <0.001) in all seasons compared with the rural sites. The incidence rate was 12/1,000 person-seasons by qPCR and 5/1,000 person-seasons by microscopy. Urban residents, those with low hemoglobin levels, nonuse of mosquito nets, and proximity to stagnant water had a significantly higher risk of infection (P <0.001). Tailored approaches are needed in elimination-targeted areas, focusing on urban settings, Plasmodium species, and strengthening community-level interventions for behavioral change and active case detection.

Background: Malaria remains a major global health problem although there was a remarkable achievement between 2000 and 2015. Malaria drug resistance, along with several other factors, presents a significant challenge to malaria control and elimination efforts. Numerous countries in sub-Saharan Africa have documented the presence of confirmed or potential markers of partial resistance against artemisinin, the drug of choice for the treatment of uncomplicated Plasmodium falciparum malaria. The World Health Organization (WHO) recommends regular surveillance of artemisinin therapeutic efficacy to inform policy decisions., Methods: This study aimed to evaluate the therapeutic efficacy of artemether-lumefantrine (AL), which is the first-line treatment for uncomplicated P. falciparum malaria in Ethiopia since 2004. Using a single-arm prospective evaluation design, the study assessed the clinical and parasitological responses of patients with uncomplicated P. falciparum malaria in Metehara Health Centre, central-east Ethiopia. Out of 2332 malaria suspects (1187 males, 1145 females) screened, 80 (50 males, 30 females) were enrolled, followed up for 28 days, and 73 (44 males, 29 females) completed the follow up. The study was conducted and data was analysed by employing the per-protocol and Kaplan-Meier analyses following the WHO Malaria Therapeutic Efficacy Evaluation Guidelines 2009., Results: The results indicated rapid parasite clearance and resolution of clinical symptoms, with all patients achieving complete recovery from asexual parasitaemia and fever by day (D) 3. The prevalence of gametocytes decreased from 6.3% on D0 to 2.5% on D2, D3, D7, and ultimately achieving complete clearance afterward., Conclusion: The overall cure rate for AL treatment was 100%, demonstrating its high efficacy in effectively eliminating malaria parasites in patients. No serious adverse events related to AL treatment were reported during the study, suggesting its safety and tolerability among the participants. These findings confirm that AL remains a highly efficacious treatment for uncomplicated P. falciparum malaria in the study site after 20 years of its introduction in Ethiopia., (© 2024. The Author(s).)

Objective: A 15-month longitudinal study was conducted to determine the duration and infectivity of asymptomatic qPCR-detected Plasmodium falciparum and Plasmodium vivax infections in Ethiopia., Method: Total parasite and gametocyte kinetics were determined by molecular methods; infectivity to Anopheles arabiensis mosquitoes by repeated membrane feeding assays. Infectivity results were contrasted with passively recruited symptomatic malaria cases., Results: For P. falciparum and P. vivax infections detected at enrolment, median durations of infection were 37 days (95% confidence interval [CI], 15-93) and 60 days (95% CI, 18-213), respectively. P. falciparum and P. vivax parasite densities declined over the course of infections. From 47 feeding assays on 22 asymptomatic P. falciparum infections, 6.4% (3/47) were infectious and these infected 1.8% (29/1579) of mosquitoes. No transmission was observed in feeding assays on asymptomatic P. vivax mono-infections (0/56); one mixed-species infection was highly infectious. Among the symptomatic cases, 4.3% (2/47) of P. falciparum and 73.3% (53/86) of P. vivax patients were infectious to mosquitoes., Conclusion: The majority of asymptomatic infections were of short duration and low parasite density. Only a minority of asymptomatic individuals were infectious to mosquitoes. This contrasts with earlier findings and is plausibly due to the low parasite densities in this population., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Listeriosis caused by Listeria monocytogenes often poses a significant threat to vulnerable populations. Dairy products have been implicated in outbreaks of listeriosis worldwide. In Ethiopia, studies have identified Listeria spp. and L. monocytogenes in various dairy products, but the genetic diversity and phylogenetic relationships of these bacteria remain largely unknown in the low- and middle-income countries. Therefore, we conducted whole-genome sequencing on 15 L. monocytogenes and 55 L. innocua isolates obtained from different levels of the dairy supply chains across three regions in Ethiopia. Genomes were assembled and used for MLST genotyping and single nucleotide polymorphism (SNP) analysis to infer phylogenetic relationships. We identified a total of 3 L. monocytogenes (i.e., 2, 145, and 18) and 12 L. innocua (i.e., 1489, 1619, 603, 537, 1010, 3186, 492, 3007, 1087, 474, 1008, and 637) MLST sequence types among the studied isolates. Some of these sequence types showed region-specific occurrence, while others were broadly distributed across regions. Through high-quality SNP analysis, we found that among 13 L. monocytogenes identified as ST 2, 11 of them were highly similar with low genetic variation, differing by only 1 to 10 SNPs, suggesting potential selection in the dairy food supply chain. The L. innocua isolates also exhibited low intra-ST genetic variation with only 0-10 SNP differences, except for the ST 1619, which displayed a greater diversity., (© 2024. The Author(s).)

Background: Diabetes-related distress lowers the motivation for self-care, often leading to lowered physical and emotional well-being, poor diabetes control, poor medication adherence and increased mortality among individuals with diabetes., Objective: To assess factors associated with diabetes-related distress among people living with type 2 diabetes in Southeast Ethiopia., Design: Institution-based cross-sectional study was conducted., Setting: Six diabetic follow-up care units at public hospitals in Southeast Ethiopia., Participants: All adult people living with type 2 diabetes from the diabetic follow-up clinic., The Main Outcome Measures: Diabetes Distress Scale-17 questionnaire was used to assess diabetes-related distress., Results: Out of the total 871 study participants intended, 856 participated in the study with a response rate of 98.3%. The findings showed that about 53.9% (95% CI 50.4% to 57.2%) of the patients have diabetes-related distress. Physical activity (adjusted OR, AOR 2.22; 95% CI 1.36 to 3.63), social support (AOR 4.41; 95% CI 1.62 to 12.03), glycaemic control (AOR 2.36; 95% CI 1.35 to 4.12) and other comorbidities (AOR 3.94; 95% CI 2.01 to 7.73) were factors that significantly associated with diabetes-related distress at p<0.05., Conclusion: This study demonstrated that more than half of the participants had diabetes-related distress. Therefore, the identified factors of diabetes-related distress need to be a concern for health institutions and clinicians in the management of people living with type 2 diabetes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Plasmodium falciparum genetic diversity can add information on transmission intensity and can be used to track control and elimination interventions., Methods: Dried blood spots (DBS) were collected from patients who were recruited for a P. falciparum malaria therapeutic efficacy trial in three malaria endemic sites in Ethiopia from October to December 2015, and November to December 2019. qPCR-confirmed infections were subject to amplicon sequencing of polymorphic markers ama1-D3, csp, cpp, cpmp, msp7. Genetic diversity, the proportion of multiclonal infections, multiplicity of infection, and population structure were analysed., Results: Among 198 samples selected for sequencing, data was obtained for 181 samples. Mean MOI was 1.38 (95% CI 1.24-1.53) and 17% (31/181) of infections were polyclonal. Mean H e across all markers was 0.730. Population structure was moderate; populations from Metema and Metehara 2015 were very similar to each other, but distinct from Wondogent 2015 and Metehara 2019., Conclusion: The high level of parasite genetic diversity and moderate population structure in this study suggests frequent gene flow of parasites among sites. The results obtained can be used as a baseline for additional parasite genetic diversity and structure studies, aiding in the formulation of appropriate control strategies in Ethiopia., (© 2023. The Author(s).)

Diagnosis and treatment of Plasmodium falciparum infections are required for effective malaria control and are pre-requisites for malaria elimination efforts; hence we need to monitor emergence, evolution and spread of drug- and diagnostics-resistant parasites. We deep sequenced key drug-resistance mutations and 1,832 SNPs in the parasite genomes of 609 malaria cases collected during a diagnostic-resistance surveillance study in Ethiopia. We found that 8.0% (95% CI 7.0-9.0) of malaria cases were caused by P. falciparum carrying the candidate artemisinin partial-resistance kelch13 (K13) 622I mutation, which was less common in diagnostic-resistant parasites mediated by histidine-rich proteins 2 and 3 (pfhrp2/3) deletions than in wild-type parasites (P = 0.03). Identity-by-descent analyses showed that K13 622I parasites were significantly more related to each other than to wild type (P < 0.001), consistent with recent expansion and spread of this mutation. Pfhrp2/3-deleted parasites were also highly related, with evidence of clonal transmissions at the district level. Of concern, 8.2% of K13 622I parasites also carried the pfhrp2/3 deletions. Close monitoring of the spread of combined drug- and diagnostic-resistant parasites is needed., (© 2023. The Author(s).)

Background: Mother-To-Child-Transmission (MTCT) of Human Immunodeficiency Virus (HIV) occurs during pregnancy, delivery and breastfeeding, and cause infection among several new-borns. However, there is limited recent evidence on the burden of MTCT of HIV in Ethiopia from a large-scale data. Thus, this study aimed to determine the positivity rate, trend and associated risk factors of MTCT among HIV-exposed infants., Methodology: A cross-sectional study was conducted among 5,679 infants whose specimen referred to Ethiopian Public Health Institute HIV referral laboratory for Early Infant Diagnosis (EID) from January 01, 2016, to December 31, 2020. Data were extracted from the national EID database. Frequencies and percentages were used to summarize the data on characteristics of infants. Logistic regression analysis was employed to identify factors associated with positivity rate of MTCT of HIV. Level of significance was set at 5%., Results: The mean age of the infants was 12.6 (± 14.6) weeks with an age range of 4 to 72 weeks. Half of the infants (51.4%) were female. The positivity rate of MTCT decreased from 2.9% in 2016 to 0.9% in 2020 with five-year average positivity rate of 2.6%. HIV test after six weeks (Adjusted odds ratio (AOR) = 2.7; 95% confidence interval (CI): (1.8-4.0,)); p < 0.001), absence of prevention of mother-to-child-transmission (PMTCT) service (AOR = 4.6; 95% CI: (2.9-7.4)); p = 0.001), nevirapine prophylaxis not received (AOR = 2.0; 95% CI: (1.3-3.2)); p < 0.001), and unknown ART status of the mother at delivery (AOR = 11; 95% CI: (5.5-22.1)); p < 0.001) were significantly associated with MTCT of HIV., Conclusion: The positivity rate of MTCT of HIV was showing declining tendency gradually in the study period. Strengthening PMTCT service, early HIV screening and starting ART for pregnant women, and early infant diagnosis are required to reduce the burden of HIV infection among infants exposed to HIV., (© 2023. The Author(s).)

CTX-Ms are encoded by bla CTX-M genes and are widely distributed extended-spectrum β-lactamases (ESBLs). They are the most important antimicrobial resistance (AMR) mechanism to β-lactam antibiotics in the Enterobacteriaceae. However, the role of transmissible AMR plasmids in the dissemination of bla CTX-M genes has scarcely been studied in Africa where the burden of AMR is high and rapidly spreading. In this study, AMR plasmid transmissibility, replicon types and addiction systems were analysed in CTX-M-producing Escherichia coli clinical isolates in Ethiopia with a goal to provide molecular insight into mechanisms underlying such high prevalence and rapid dissemination. Of 100 CTX-Ms-producing isolates obtained from urine (84), pus (10) and blood (6) from four geographically distinct healthcare settings, 75% carried transmissible plasmids encoding for CTX-Ms, with CTX-M-15 being predominant (n = 51). Single IncF plasmids with the combination of F-FIA-FIB (n = 17) carried the bulk of bla CTX-M-15 genes. In addition, IncF plasmids were associated with multiple addiction systems, ISEcp1 and various resistance phenotypes for non-cephalosporin antibiotics. Moreover, IncF plasmid carriage is associated with the international pandemic E. coli ST131 lineage. Furthermore, several CTX-M encoding plasmids were associated with serum survival of the strains, but less so with biofilm formation. Hence, both horizontal gene transfer and clonal expansion may contribute to the rapid and widespread distribution of bla CTX-M genes among E. coli populations in Ethiopian clinical settings. This information is relevant for local epidemiology and surveillance, but also for global understanding of the successful dissemination of AMR gene carrying plasmids., (© 2023. The Author(s).)