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Uterine fibroids are benign tumors, arising from uterine smooth muscle cells. They are one of the most common benign tumors of the female genital tract among childbearing women, occurring in 20%–50% of women of reproductive age. The association of uterine myomas with pregnancy is high. This occurrence is constantly increased, linked to the onset of pregnancies, leading to the incidence of myomas gradually rising with age, hence the emergence of ultrasound reveals during routine ultrasound examinations of pregnancies, that were previously asymptomatic. Myomectomy during the second trimester was done and pregnancy continued safely to the third trimester. After successfully repairing it, the pregnant woman followed her antenatal care at Wollega University Referral Hospital, Western Oromia, Ethiopia. We presented the 20-year-old primigravida lady with a complaint of lower abdominal pain and a slight fever. We found a non-pedunculated, attached to the uterus via a broad base) myoma measuring 4 × 4 cm on 2D pelvic ultrasound. We admitted the client and gave her conservative management after we put her on antibiotics. Despite antibiotics, the pain persists we decided to manage it through an operation after we counseled the client about the potential complications. Then we removed the myoma without manipulating the uterus and it was a successful myomectomy without complicating the fetomaternal conditions. Currently, fetomaternal conditions are safe, and the woman is following her antenatal care at Wollega University’s Referral Hospital. In the majority of cases of women with fibroids, pregnancy comes with complications, according to literature data, The coexistence of the myoma with pregnancy: increased frequency of spontaneous abortions and premature births, increased risk of bearing ablation, higher incidence of maternal-fetal incommunicability, incorrect position of the fetus, more often performed cesarean surgery, higher probability of postpartum hemorrhage. Prenatal myomectomy can be safely performed in the first and second trimesters of pregnancy; however, it is recommended to deliver the baby via cesarean section, due to fear of intrauterine rupture of the uterus.

Abstract Background Antibiotics are commonly used drugs in farm animals for therapeutic, prophylactic and diagnosis purposes. As a result of the use of antibiotics in livestock, residues of antibiotics may be present in animal‐derived foods, especially in meat. This study aimed at determining the antibiotic residues in cattle slaughtered at Nekemte municipal abattoir and assessing the knowledge, attitude and practice (KAP) level of the community about antibiotic residue in food of cattle origin. Materials and methods A cross‐sectional study was conducted on randomly selected kidney and muscle samples slaughtered at Nekemte municipal abattoir. The samples were collected aseptically and analysed using liquid chromatography mass spectrometer. In addition the KAP of cattle handlers, butcher men and meat users were collected using structured questionnaire. The data was analysed by SPSS and intercooled Stata version 7.0, 2001. Results Results are presented as percentages and frequency distributions in tabular and graphical form. From 120 individuals interviewed, only 25.83% knew about withdrawal time and had limited knowledge on effect of antibiotic residue on human health, whereas about 47.5% did not heard about antibiotic residue in meat. Tetracycline was detected in all the sampled meat 60 (100%), whereas oxytetracycline residues were detected in half 15 (50%) of the samples. In the current study doxycycline, sulphadiazine, penicillin G and enrofloxacin were not detected in all samples. Oxytetracycline residue levels ranged from 0.00 to 463.35 µg/kg for the kidney and 0.00 to 354.55 µg/kg for muscle samples. About 10% of kidney and 3.33% muscle samples collected had oxytetracycline residues above maximum residue limits. Conclusion In general, the study revealed that oxytetracycline residues were prevalent among antimicrobial residues analysed from the study area. The study indicated the presence of high antimicrobial residue and hence exposes for antimicrobial resistance of pathogens warranting coordinated effort to mitigate its health effect on the animal and hence human being.

This study aimed to assess mound abundance, the livelihood impacts of termites, and determinant factors in the Meta Robi District, Ethiopia. A descriptive research design was used for primary data collection from the three selected kebeles. Termite nests were counted from each Goxi (the sub-kebele and the smallest unit in Ethiopia) using a transect line. In addition, 190 household heads were selected randomly from each kebele, and a questionnaire survey was used to collect primary data from the respondents. Termite nests were abundant in Warabo (7.25.71 per 1000 m2), but scarce in Warke Walensu Kebele (2.25.50 per 1000 m2). Teff (49.5%) and wheat (32.6%) were the most severely affected crops by termites. The mean annual hectare of land and quintals of teff and wheat damaged per household was higher in Warabo Kebele (p

This study aimed to determine the levels of some heavy metals in the Koche River and the potential health risks. A replica of water samples was taken from 12 sampling sites purposely selected in the dry season. Heavy metal levels were determined using a flame atomic absorption spectrophotometer following the APHA (1998) procedure. Heavy metal pollution index (HPI), heavy metal evaluation index (HEI), chronic daily intake (CDI), hazard quotient (HQ), hazard index (HI), total hazard index (THI), and incremental lifetime cancer risk were calculated on the basis of the results. The heavy metals detected were Fe > Mn > Cu > Zn > Cr. The Cr, Fe, Mn, and Cu contents were above the maximum allowed limit of WHO for drinking and irrigation water at most of the sampling sites. The HPI and HEI values also surpassed the maximum limit of the study sites. The highest HPI and HEI values were found at the Yam1site. Oral ingestion represented 99.55% and 97.85% of CDItotal (CDIingestion + CDIdermal contact) in adults and children, respectively. The mean CDItotal and the noncarcinogenic risk values were found in the order of Fe > Mn > Cu > Zn > Cr in both ages. CDI, HQ, HI, and THI scores were higher in children. The HIoral and THI values were also higher than 1 in both ages except in DK 2, Sour 1, and Sour 2 sites. However, the HQdermal level was higher than 1 only for Cr in children. The ELCR obtained also indicated a high carcinogenic risk of Cr (0.75 ± 0.44 and 1.15 ± 0.66 in adults and children, respectively). In general, most of the study sites had heavy metal pollution levels that exceeded the maximum allowed limit. Therefore, effective management of sources of pollution and continuous monitoring of river quality to minimize health risks are very important.

Article Highlights The study is focused on the Floristic Composition and Diversity of Woody Plant Species in the Hereje Natural Forest. The forest contains forty-four woody species classified into 28 families with the dominant families being Fabaceae, Rubiaceae, and Combretaceae. The Agglomerative Hierarchical Cluster Analysis shows three types of plant community types, with community type two containing the greatest number of species.

Glass materials with strong physical, structural, and optical properties are in high demand in today's social and industrial sectors. Researchers have recently established the extensive uses of these widely utilized glassy materials in optoelectronic devices, aerospace, nuclear industries, etc. Optimization usually plays a significant role in the synthesis of material. Hence, this article uses the statistical optimization of multiple process parameters of the melt quenching technique for rare earth doped barium borate glass 60B2O3-(40-X)BaO-XMO (MO-Er2O3/CeO2 and X = 0.5,1.0,1.5 mol percentage)by Taguchi's Design of Experiment. The multiple performance characteristics were studied using Grey relational analysis. An experimental format for preparing the Barium Borate glass was utilized with a standard L9 orthogonal array designed by Taguchi. Grey relational analysis was used to analyze the effects of processing parameters, including melting temperature, the composition of rare-earth oxide, and melting time of glasses on density, refractive index, and indirect bandgap. Analysis of variance (ANOVA) showed the influence of process parameters on the multiple response parameters as directed by the S/N ratio of the response parameter. The prediction of optimal conditions for contributing process parameters to the multiple response parameters was estimated efficiently. Additionally, as compared to the initial conditions, the optimal confirmatory experiment exhibited a considerable improvement in the response parameters (refractive index, density, and indirect bandgap). Grey relational grade and analysis of variance (ANOVA) revealed that melting temperature to be sole factor significantly affecting multiple responses with a 95% confidence level. The objective of the work is to optimize the melt quenching process parameters and their influence on the physical and optical properties of glass for photonic applications. Using this optimization method, melt quenching was found to be the most influential parameter contributing about 73–74% in tuning the desired response parameters. The findings also revealed a very less deviation between the statistically predicted and experimental data of response parameter, with deviation ranging from 0.37 to 2.14%. This good agreement between experimental and predicted values of response parameters indicated the suitability of Taguchi method of optimization for melt quenching technique.

Heavy metal pollution is a serious problem in Ethiopian rift valley lakes, including Lake Koka, as a result of unmanaged industrial waste pollution. However, the bioaccumulation level in common carp (Cyprinus carpio), a commercially important fish species, are unknown. The aim of this research was, therefore, to assess the heavy metal bioaccumulation in edible parts of common carp in Lake Koka and the associated health risks. Three sampling sites were selected randomly for primary data collection. Four heavy metals (Cd, Cr, Pb and Zn) were analyzed in water and the edible part of the fish using Atomic Absorption Spectroscopy (AAS). The mean concentrations of Zn, Cr and Cd in the edible part of fish ranged from 0.07 to 0.36 mg kg−1, Not Detected (ND)-0.24 mg kg−1 and ND-0.03 mg kg−1, respectively. Site 2 had the highest Zn and Cd content, while Site 3 had the highest Cr content. Pb was however not identified. The amount of Cr was above the permissible limit of FAO and the bioaccumulation showed marked differences among the sampling sites (p Zn > Cd, but the values were lower than the Reference Dose limit (RfDo). The carcinogenic risk value also indicated a low health risk associated with individual metals intake. Furthermore, the hazard index of the edible part of fish was less than unity. Generally, the water quality is not a risk for the survival and reproduction of fish and the heavy metal contents in the edible parts of fish exhibited low carcinogenic risk through the food chain.

Agroforestry has been widely used in developing countries as a solution to mitigate the effects of climate variability. However, its significance to the well-being of farmers in rural communities has not been thoroughly investigated. The purpose of this study was to analyze the contribution of agroforestry practices (AFPs) to the farm income of rural families, the perceptions of farmers, and factors that affect AFPs’ contribution to household income in the Sodo Zuria district. The optimal sample size of 173 households from the three study sites was selected through a stratified random sampling procedure. Data were collected using structured interviews, focus group discussion, observation, and key informant interviews. According to the findings, most farmers in the research area had a good perception of the benefits of agroforestry methods. The yearly mean gross income from various agroforestry approaches was 15,990.90 ETB·ha−1·yr−1 for nonadopters and 32,471.24 ETB·ha−1·yr−1 for adopters, respectively. Tree and fruit tree integration with crops, animals, or pastures has the potential to significantly increase food production and farmer economic situations. Multiple linear regression analysis indicated that the size of the farm, the number of livestock, the experience of agroforestry, and the extension service affect the adoption of agroforestry practices to house farm income positively, while the size of the family negatively affects it. Agroforestry plays a critical role in reducing food poverty and enhancing farmer livelihood resilience (reducing farmers’ vulnerability to climate variability). However, determining the extent to which this is true is challenging because both farmer groups often have low levels of assets such as land and income, which limits tree planting to reaping maximum benefits from agroforestry. As a result, the government and other responsible entities should pay special attention to assisting smallholder farmers in using agroforestry practices for the sustainability of their livelihoods that have been hampered by agricultural land scarcity.

Topotecan is potent anti-cancer drug approved for various malignancies but hematopoietic toxicities undermine its wider application and use of its most effective dose. This study aims to improve these limitations through inhalation-delivery. The pharmacokinetics, efficacy, and toxicity of 2–5 times lower inhalation doses of topotecan dry-powder were compared with the standard intravenous (IV) delivery once/twice-a-week. Human-derived EGFR-mutant (H1975), KRAS-mutant (A549), and EGFR/KRAS wild-type (H358) orthotopic and distant lung tumors were evaluated in murine models. Inhalation of 1 mg/kg topotecan significantly improved the half-life and drug exposure (area under the curve, AUC) compared to 5 mg/kg via IV-delivery. AUCs (h*ng/mL) for inhaled/IV topotecan in plasma, lung, liver, and brain were, 831/888, 60,000/1080, 8380/4000, and 297/15, respectively; while the half-life was also greatly increased in these tissues. The average lung tumor burden of H358-derived tumors was reduced from 15.0 g to 8.4 g (44%) in rats treated once-a-week with 2 mg/kg IV and 1.8 g (88%) with 1 mg/kg inhaled topotecan, corroborating previous findings using A549- and H1975-derived orthotopic lung tumors. Importantly, inhaled topotecan showed superior efficacy in suppressing lung tumors at distant sites. The growth of H1975- and H358-derived subcutaneous xenografts were completely arrested and A549-derived tumors were significantly reduced in mice treated twice-a-week with 1 mg/kg inhaled topotecan compared to a minor (H1975 and H358) or no reduction (A549) with twice-a-week 5 mg/kg IV topotecan.

INTRODUCTION: The efficacy of chemotherapeutic agents in killing cancer cells is mainly attributed to the induction of apoptosis. However, the tremendous efforts on enhancing apoptosis-related mechanisms have only moderately improved lung cancer chemotherapy, suggesting that other cell death mechanisms such as necroptosis could be involved. In this study, we investigated the role of the necroptosis pathway in the responsiveness of nonsmall cell lung cancer (NSCLC) to chemotherapy. METHODS: In vitro cell culture and in vivo xenograft tumor therapy models and clinical sample studies are combined in studying the role of necroptosis in chemotherapy and mechanism of necroptosis suppression involving RIP3 expression regulation. RESULTS: While chemotherapeutic drugs were able to induce necroptotic cell death, this pathway was suppressed in lung cancer cells at least partly through downregulation of RIP3 expression. Ectopic RIP3 expression significantly sensitized lung cancer cells to the cytotoxicity of anticancer drugs such as cisplatin, etoposide, vincristine, and adriamycin. In addition, RIP3 suppression was associated with RIP3 promoter methylation, and demethylation partly restored RIP3 expression and increased chemotherapeutic-induced necroptotic cell death. In a xenograft tumor therapy model, ectopic RIP3 expression significantly sensitized anticancer activity of cisplatin in vivo. Furthermore, lower RIP3 expression was associated with worse chemotherapy response in NSCLC patients. CONCLUSION: Our results indicate that the necroptosis pathway is suppressed in lung cancer through RIP3 promoter methylation, and reactivating this pathway should be exploited for improving lung cancer chemotherapy.

BACKGROUND: Escaping cell death pathways is an important event during carcinogenesis. We previously identified anti-TNFα-induced apoptosis (ATIA, also known as vasorin) as an antiapoptotic factor that suppresses reactive oxygen species (ROS) production. However, the role of vasorin in lung carcinogenesis has not been investigated. METHODS: Vasorin expression was examined in human lung cancer tissues with immunohistochemistry and database analysis. Genetic and pharmacological approaches were used to manipulate protein expression and autophagy activity in human bronchial epithelial cells (HBECs). ROS generation was measured with fluorescent indicator, apoptosis with release of lactate dehydrogenase, and cell transformation was assessed with colony formation in soft agar. RESULTS: Vasorin expression was increased in human lung cancer tissues and cell lines, which was inversely associated with lung cancer patient survival. Cigarette smoke extract (CSE) and benzo[a]pyrene diol epoxide (BPDE)–induced vasorin expression in HBECs. Vasorin knockdown in HBECs significantly suppressed CSE-induced transformation in association with enhanced ROS accumulation and autophagy. Scavenging ROS attenuated autophagy and cytotoxicity in vasorin knockdown cells, suggesting that vasorin potentiates transformation by impeding ROS-mediated CSE cytotoxicity and improving survival of the premalignant cells. Suppression of autophagy effectively inhibited CSE-induced apoptosis, suggesting that autophagy was pro-apoptotic in CSE-treated cells. Importantly, blocking autophagy strongly potentiated CSE-induced transformation. CONCLUSION: These results suggest that vasorin is a potential lung cancer–promoting factor that facilitates cigarette smoke–induced bronchial epithelial cell transformation by suppressing autophagy-mediated apoptosis, which could be exploited for lung cancer prevention.

This study examined the diversity, distribution and abundance of fish species in Upper Awash River, Ethiopia was assessed. Five sampling sites were selected along the gradient of the river. Fish sampling was carried out using Frame net of 3-mm stretched mesh size from February through April, 2018. There was a considerable variation in river depth and width at all sites. A total of 3018 fish categorized under three species belonging to the Family Cyprinidae, namely, Garra quadrimaculata, Garra dembeensis and Labeobarbus beso were identified. Garra quadrimaculata was numerically the most dominant species in all sampling sites. Perhaps, there was no fish specimen caught from S-I. Similarly, the highest and lowest number of G. dembeensis was collected from S-V (42.73%) and S-II (2.51%), respectively. The composition of L. beso was higher at S-IV (49.1%), but no L. beso collected from S-I and S-II. High number of fish was caught from the pool parts at all sites. Shannon diversity index (H’) varied between 0.14 and 0.80, and evenness index (J’) varied from 0.2 to 1.7, but H’ and J’ of S-I were zero due to the absence of species in the area. Based on Shannon index, the upper Awash River was categorized as an impacted river. Therefore, effective management of the river is very imperative for sustainable utilization of fish resources.

Intravenous (IV) topotecan is approved for the treatment of various malignancies including lung cancer but its clinical use is greatly undermined by severe hematopoietic toxicity. We hypothesized that inhalation delivery of topotecan would increase local exposure and efficacy against lung cancer while reducing systemic exposure and toxicity. These hypotheses were tested in a preclinical setting using a novel inhalable formulation of topotecan against the standard IV dose. Respirable dry-powder of topotecan was manufactured through spray-drying technology and the pharmacokinetics of 0.14 and 0.79 mg/kg inhalation doses were compared with 0.7 mg/kg IV dose. The efficacy of four weekly treatments with 1 mg/kg inhaled vs. 2 mg/kg IV topotecan were compared to untreated control using an established orthotopic lung cancer model for a fast (H1975) and moderately growing (A549) human lung tumors in the nude rat. Inhalation delivery increased topotecan exposure of lung tissue by approximately 30-fold, lung and plasma half-life by 5- and 4-folds, respectively, and reduced the maximum plasma concentration by 2-fold than the comparable IV dose. Inhaled topotecan improved the survival of rats with the fast-growing lung tumors from 7 to 80% and reduced the tumor burden of the moderately-growing lung tumors over 5- and 10-folds, respectively, than the 2-times higher IV topotecan and untreated control (p

Meaza Genetu,1 Debasu Damtie,1 Meseret Workineh,1 Biniam Mathewos Tebeje,1,2 Bamlaku Enawgaw,3 Tekalign Deressa1 1Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia; 3Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Background: Pregnancy is a state characterized by profound physiological hematological changes. However, hematological reference intervals being used in clinical practice in Ethiopia are derived from nonlocal general populations, despite the significant variations reported previously. The aim of this study was to determine the immunological and hematological reference intervals in healthy pregnancy among HIV-seronegative pregnant women in northwest Ethiopia.Materials and methods: A total of 200 healthy, HIV-seronegative pregnant women were enrolled from February 2015 to June 2015 in a cross-sectional study setting at Gondar University Hospital. Sociodemographic and obstetric data were collected using a structured questionnaire. Blood samples collected from each participant were used to define the immunological and hematological parameters. The mean, median, and 95% interval values were calculated for the immunological and hematological parameters. P-value

Aberrant cytosine methylation affects regulation of hundreds of genes during cancer development. In this study, a novel aberrantly hypermethylated CpG island in cancer was discovered within the TOX2 promoter. TOX2 was unmethylated in normal cells but 28% lung (n = 190) and 23% breast (n = 80) tumors were methylated. Expression of two novel TOX2 transcripts identified was significantly reduced in primary lung tumors than distant normal lung (p

Background: Today's youth are adopting a new trend: casual sex. College students are expected to engage in a range of potentially harmful sexual activities, such as casual sex. Numerous factors can lead students to engage in casual sexual encounters. However, there has been limited research on the prevalence of casual sex and related issues in higher education institutions in Ethiopia., Objective: To assess the prevalence of casual sex and its associated factors among regular undergraduate students at Debre Berhan University in 2023., Methods: From 15 May 2023, to 30 May 2023, regular undergraduate students from Debre Berhan University participated in a cross-sectional study. A total of 512 samples were collected using a multistage sampling technique. Subsequently, a simple random sampling technique was employed to select the students, with a proportionate allocation of samples distributed to randomly selected colleges, departments, and academic years. The data were collected using a structured, pretested, and self-administered questionnaire. Once the data were imported into Epi-data version 4.6 and exported to SPSS version 20 for analysis, frequencies, percentages, and tables were generated. Bivariate and multivariate logistic regression models were used to identify characteristics associated with casual sex., Results: The prevalence of casual sex among regular undergraduate students at Debre Berhan University was 31.0% 95% CI (27.2-34.6). Several factors were significantly associated with casual sex. These included students from urban areas [AOR: 2.95; 95% CI (1.66-5.24)], students with poor academic performance [AOR: 2.81; 95% CI (1.51-5.22)], alcohol consumption [AOR: 4.59; 95% CI (2.60-8.12)], attending nightclubs [AOR: 2.75; 95% CI (1.47-5.16)], watching pornography [AOR: 2.59; 95% CI (1.47-5.16)], and peer pressure [AOR: 2.24; 95% CI (1.38-3.65)]., Conclusion: The prevalence of casual sex was high among Debre Berhan University students. In order to lessen the negative effects of casual sex practices, this study found predictors that can be avoided through various interventions. Key preventative measures include improving student academic performance, providing engaging and free entertainment, restricting access to pornographic websites on university Wi-Fi, and employing peer educators., 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., (© 2024 Mathewos, Tesfahun, Aemiro and Dejene.)

Background: Trachomatous trichiasis (TT) is a painful, potentially blinding eye condition that can be managed through epilation or surgery. Women are affected by TT approximately twice as often as men and are believed to face gendered barriers to receiving surgical care to prevent vision loss., Methods: We used data from 817 cross-sectional surveys conducted during 2015-2019 in 20 African countries to estimate the prevalence difference (PD) between female and male eyes for four outcomes potentially indicating gender-related differences in TT management: (1) received surgery and developed postoperative TT (PTT), (2) never offered surgery, (3) offered surgery but declined it, and (4) offered epilation but never offered surgery., Results: The prevalence was modestly elevated among female eyes compared with male eyes for having PTT (PD:1.8 [95% confidence limits (CL): 0.6, 3.0]) and having declined surgery for the eye (PD: 6.2 [95% CL: 1.8, 10.7]). The proportion offered epilation was similar by gender (PD:0.5 [95% CL: -0.4, 1.3]), while never having been offered surgery was somewhat more prevalent among male eyes (PD: -2.1 [95% CL: -3.5, -0.7])., Conclusions: Our results suggest potential gender differences in TT management. More research is needed to determine the causes and implications of the observed differences., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Purpose: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys., Methods: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported., Results: Between 29 th February 2016 and 24 th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma., Conclusion: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets.

Prior to the intensified civil and armed conflicts in Ethiopia, remarkable progress was made in the health sector, which has persuaded the Ministry of Health to give special focus on building a responsive and resilient health system in the second five-year health sector transformation plan (HSTP II 2021-2025). However, the years-long civil and armed conflicts have been fueling the COVID-19 crisis and have caused multi-sectoral infrastructure damage, human life loss, and economic crisis. In 2021 alone, the conflict causes more than five million internal displacements of persons (IDP) and thousands civilian deaths. Review of reported government data has shown that 3,508 health posts, 750 health centers, and 76 hospitals were partially or completely damaged in four regions. Looting of medical equipment and facilities for amenities was devastating. More than 19 million people were affected by the armed and civil conflicts between 2020 and 2021. Unless peace is ensured across the nation the sooner possible, it is foreseen that the devastation may further worsen, and recovery may be a far-fetched possibility. Therefore, in addition to restoration of the disrupted health services, it is the right time for the Ministry of Health to incorporate the humanitarian-development nexus as a joint strategy with the Disaster Prevention and Preparedness Commission (DPPC) to ensure a resilient health system for similar multifaceted conflict-related health crisis, disasters, and infectious outbreaks., (© 2023 Yifru Berhan, et al.)

Background: The fifth Millennium Development Goal (MDG) targeted at improving maternal health. In this regard, Ethiopia has shown substantial progresses in the past two decades. Nonetheless, these impressive gains are unevenly distributed among Ethiopian women with different socio-economic characteristics. This study aimed at investigating levels and trends of skilled delivery service, and wealth and education related inequalities from 2000 to 16., Methods: Longitudinal data analysis was conducted on Ethiopian Demographic and Health Survey (EDHS) data of 2000, 2005, 2011 and 2016. The outcome variable was skilled delivery, while data on economic status and education level were used as dimensions of inequality. Rate Ratio (RR) and Rate Difference (RD) inequality measures were applied. STATA for windows version 10.1 statistical software was utilized for data analysis and presentation. The strength of association of inequality dimensions with the outcome variable was assessed using a 95% confidence interval., Results: From total deliveries, 5.62%, 6.3%, 10.8% and 28% of them were attended by skilled birth attendant in 2000, 2005, 2011 and 2016 respectively. In the most recent survey (EDHS 2016), proportion of births attended by skilled birth attendance among women who completed secondary and above education was about 5.42 [95% CI (4.53, 6.09)] times more when compared to women with no formal education. Proportion of births attended by skilled birth attendance among women in the richest quintile was about 5.11 [95% CI (3.98, 6.12)] times higher than that of women in the poorest quintile. Moreover, gap of inequality on receiving skilled delivery service has increased substantially from 24.2 (2000) to 53.8 (2016) percentage points between women in the richest and poorest quintiles; and from 44.9 (2000) to 76.0 (2016) percentage points between women who completed secondary and above education and women with no formal education., Conclusions: Skilled birth attendance remained low and virtually unchanged during the period 2000-2011, but increased substantially in 2016. Gap on wealth and education related inequalities increased linearly during 2000-16. Most pronounced inequalities were observed in women's level of education revealing women with no formal education were the most underserved subgroups. Encouraging women in education and economic development programs should be strengthened as part of the effort to attain Universal Health Coverage (UHC) of Sustainable Development Goals (SDGs) in Ethiopia.