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Tigist Bacha,1 Mahlet Abayneh,2 Dawit Bekele Tefera3 1Division of Pediatric Emergency and Critical Care, Department of Pediatrics and Child Health St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2Division of Neonatology Department of Pediatrics and Child Health St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Ohio State Global One Health LLC, Addis Ababa, EthiopiaCorrespondence: Dawit Bekele Tefera, Tel +251-912360352, Email ddawitb@gmail.comBackground: Neonatal tetanus remains a significant threat in regions with limited healthcare access, despite being preventable through vaccination. The case-fatality rate of untreated neonatal tetanus is close to 100%. Even one case of neonatal tetanus regarded as a failure of the healthcare system, making it essential to remain mindful of this disease’s relevance to public health. Two cases of neonatal tetanus are presented, highlighting the severe consequences of the disease. One infant survived after ICU treatment, while the other succumbed despite medical intervention.Conclusion: These cases underscore the critical need for clean delivery practices and Tetanus anti-toxoid vaccination for women of reproductive age. Improving access to quality antenatal healthcare and promoting clean birth practices are essential in reducing the incidence of neonatal tetanus and preventing unnecessary deaths.Keywords: neonatal tetanus, home delivery, Ethiopia

Abyou Seyfu Ambaye,1 Fiseha Yirgu Mengiste,2 Netsanet Demise,2 Manaye Tamrie Derseh,3 Abinet Abebe,2 Ashagrachew Tewabe Yayehrad,4 Bedilu Linger Endalifer1 1Departement of Pharmacy, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia; 2Departement of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia; 3Departement of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 4Departement of Pharmacy, College of Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Abyou Seyfu Ambaye, Tel +251910685947, Email aseyfu7@gmail.comBackground: Hypoglycemia occurs when the blood sugar levels are too low. In severe cases, hypoglycemia may give to seizures, coma, and sometimes death. The prevalence of hypoglycemia among patients with diabetes is likely underreported and undocumented.Methods: An institutional-based cross-sectional study was conducted among 336 study participants at the Tepi General Hospital in Southwest Ethiopia. A binary logistic regression model was used to determine the association between the prevalence of hypoglycemia and the factors associated with it. After a bivariate analysis, variables with a p value of < 0.25 were selected as a candidate for multivariable analysis. An odds ratio with a 95% CI was considered to indicate a significant association.Results: With 95% CI (52.48– 62.25) the prevalence of hypoglycemia was determined as 57.44%. Nearly 11% of the patients encounter severe hypoglycemia. Female patients had three times higher odds of experiencing hypoglycemia (aOR=3, 95% CI: 2.10, 6.39). Those with no formal education had 1.5 times higher odds of experiencing hypoglycemia (aOR = 1.5, 95% CI: 1.08, 5.45). Patients with type 1 diabetes were 3.4 times more likely to experience hypoglycemia (aOR = 3.4, 95% CI: 1.87, 7.50). Those who had been diagnosed before 10 years (aOR = 1.3, 95% CI: 1.02, 3.21) were more likely to have hypoglycemia. Furthermore, patients who consumed alcohol were 3.0 times more likely to have a history of hypoglycemia (aOR = 3.0, 95% CI: 2.03, 6.43).Conclusion: The magnitude of hypoglycemia among patients with diabetes is determined to be considerable with more than half of the participants encountered hypoglycemia. There is a strong relationship between the occurrence of hypoglycemia and sex, type of diabetes, time since diagnosis, alcohol status, and education status. Therefore, all concerned parties must pay close attention to lessen the prevalence of hypoglycemia and address the problems based on the primary contributing factors.Keywords: hypoglycemia, diabetes mellitus, insulin, Ethiopia

Purpose. The aim of this study was to assess production and management practices and technologies used by farmers for tomato and potato production, as well as their productivity. Methodology / approach. This research was conducted in Ziway-Dugda and Tiyo districts of Arsi Zone in Oromia National Regional State of Ethiopia during 2022 cropping season. Data were collected from 400 households in 10 kebeles (local administrative unit) of both districts using Kobo toolbox from respondents through face-to-face interview and descriptive analysis using SPSS version 22. Results. The results of the study showed that farmers in the study areas used different pre-harvest practices. These include cultivation tools and methods, planting locations, tomato staking, potato hilling and irrigation practices to successfully grow vegetables and increase land productivity by rotating different crops on their land. Various diseases, weeds and insects have been observed on their farms, which were managed by cultural, agronomic, mechanical and chemical management practices on tomato and potato farms during the last cropping years in the study districts. Thus, majority farmers in the study areas have used insecticides and fungicides on tomato and potato farms; but most of the weeds were removed by hand weeding. Most tomato and potato farmers have determined the type of chemical and its use from their own previous experience, in consultation with salespeople and extension agents in their regions. However, the study results showed that there are unused production and management practices for tomato and potato cultivation by some farmers. There are many production and management practices and technologies used by farmers to improve vegetable productivity in the study areas, although some farmers did not adopt improved production and management technologies, resulting in reduced production, which requires future interventions to increase their capacity through training and technology adoption. Originality / scientific novelty. This study stands out in the field of production and management practices and technologies used by smallholder tomato and potato producers due to its innovative approach and unique contribution to existing knowledge and skills. While previous studies have examined the relationship between production and management practices and technologies in an agricultural context, particularly focusing on state farms, our study focuses on small-scale tomato and potato producers. Through our thorough case study research and interview structure, we not only deepened our understanding of production and management practices in the agricultural sector, but also provided practical recommendations for improving the efficiency and sustainability of small-scale tomato and potato producers on different farms/fields. Practical value / implications. The findings of this study can be used to develop recommendations for policy makers and researchers on how to improve labour productivity in the future Thus, the policy focuses on developing strategies for producers to adopt modern production and management practices and technologies, raising farmers’ awareness of available technologies, improving management practices and increasing crop productivity in the study area.

Worku Mekonnen Sefefe,1 Destaw Biadgie Tesfaw,2 Andualem Dagne Tebikew,2 Assefa Sisay Ayenew,3 Bereket Amare Dencha,4 Temesgen Agegnehu Abebe1 1Department of Surgery, Debre Markos University (DMU), Debre Markos, Amhara, Ethiopia; 2Department of Surgery, Bahir Dar University, Bahir dar, Amhara, Ethiopia; 3Department of Surgery, Akesta General Hospital, Wollo, Amhara, Ethiopia; 4Department of Pathology, Bahir Dar University, Bahir dar, Amhara, EthiopiaCorrespondence: Worku Mekonnen Sefefe, Department of Surgery, Debre Markos University (DMU), Debre Markos, Amhara, Ethiopia, Tel +251912101424, Email workumekonnen04@gmail.comBackground: Ectopic pancreas (EP), characterized by pancreatic tissue outside its usual location, poses diagnostic challenges due to its asymptomatic nature in most cases. Gastric lesions are often symptomatic, causing epigastric pain or gastric outlet obstruction. Rarely, jejunal lesions can lead to intestinal obstruction or intussusception. The elusive preoperative diagnosis lacks specific biochemical markers, relying on intraoperative biopsy and histopathology as gold standards.Case Presentation: We present a unique case of a 37-year-old female with 12-hour crampy abdominal pain, bilious vomiting, blood-mixed diarrhea, abdominal distension, and obstructive symptoms. Imaging revealed jejunojejunal intussusception with a jejunal mass as the lead point. Intraoperatively, also identified jejunal mass as lead point. Resection of mass and end-to-end jejunojejunal anastomosis were performed, resulting in a successful outcome. Histopathological examination identified a type I ectopic pancreas within the muscularis propria. Twelve months postoperatively, the patient exhibited no stricture or recurrence.Conclusion: Ectopic pancreas, with varied symptoms, poses diagnostic hurdles. Despite the diagnostic challenges, surgical excision remains the optimal treatment for symptomatic cases. This report contributes to the limited literature on ectopic pancreas, emphasizing the importance of considering this entity in the differential diagnosis of gastrointestinal pathology.Keywords: ectopic pancreas, pancreatic heterotopia, jejunojejunal intussusception, lead point, Ethiopia

Yesuneh Tefera Mekasha,1 Sete Nigussie,2 Wegayehu Ashagre,3 Melaku Getahun Feleke,4 Abibo Wondie,5 Asnakew Mulaw,6 Bereket Dessalegn6 1Department of Veterinary Pharmacy, Pharmaceutical Quality Assurance, and Regulatory Affairs, University of Gondar, Gondar, Ethiopia; 2Department of Veterinary Pharmacy, University of Gondar, Gondar, Ethiopia; 3Doctor of Veterinary Medicine, University of Gondar, Gondar, Ethiopia; 4Department of Veterinary Pharmacy, Pharmaceutical Analysis, and Quality Assurance, University of Gondar, Gondar, Ethiopia; 5Department of Veterinary Pharmacy, Drug Supply Chain Management, University of Gondar, Gondar, Ethiopia; 6Department of Veterinary Pathobiology, University of Gondar, Gondar, EthiopiaCorrespondence: Yesuneh Tefera Mekasha, University of Gondar, Gondar, Amhara Regional State, Ethiopia, Email yesuneh.tefera@uog.edu.etBackground: The intentional and illegal misrepresentation of fake medications involves falsely indicating their source. These fraudulent medications can include products that contain either accurate or incorrect ingredients, lack proper labeling, have insufficient quantities of ingredients, and are packaged with counterfeit packaging. This unlawful activity has led to treatment failures, the development of antibiotic resistance, adverse effects, and even deaths. Hence, the objective of this study was to assess the knowledge, practice, and regulatory status of veterinary drug experts in the central Gondar zone of Ethiopia regarding counterfeit veterinary medications.Methods: From January 2023 to July 2023, a self-administered structured questionnaire was utilized to conduct a cross-sectional study in Central Gondar Zone, Ethiopia. The analysis of the data involved the application of descriptive and chi-square tests.Results: The study revealed that the majority of professionals possessed a work experience ranging from 5 to 9 years (23; 56.1%). Additionally, a total of 25 individuals (61.0%) who participated in the research had not undergone any kind of training. It was observed that a significant proportion of participants (82.9%) possessed knowledge about counterfeit veterinary drugs. Only about 63% and 36% of respondents had high knowledge and good practice concerning veterinary counterfeit drugs, respectively. Only 29.3% of participants have reported practices. Furthermore, a poor regulatory level of coordination was detected (85.4%). The study revealed a significant (χ 2 =7.6165; p = 0.022) disparity between the respondents’ practice levels and training. Respondents’ regulatory levels were also significantly associated (p < 0.05) with their sex (χ 2 = 13.34; p = 0.001) and work experience (χ 2 = 13.64; p = 0.033). The research findings also revealed a noteworthy correlation between practice and regulatory activity (χ 2 = 15.0463; p = 0.005).Conclusion: The study outlines the necessity of awareness initiatives, with a focus on the significance of veterinary experts’ knowledge, practice, and regulatory efforts in addressing the issue of counterfeit veterinary medications.Keywords: counterfeit veterinary drug, veterinary drug professionals, cross-sectional study, knowledge, practice, regulatory activity, central Gondar zone, Ethiopia

Abstract Background To ensure a child's full growth, health, and development during infancy and the early years, adequate nutrition is crucial. A crucial window of opportunity for ensuring children's proper growth and development through adequate eating exists during the first two years of life. According to the evidence of the efficacy of interventions, achieving universal coverage of optimal breastfeeding could prevent 13% of deaths in children under the age of 5 worldwide, and using complementary feeding methods appropriately would lead to an additional 6% decrease in under-five mortality. Methods From several electronic databases, all published, unpublished, and gray literature was extracted and exported into EndNote version X20. For further analysis of the review, the retrieved data from the excel sheet were imported into the statistical software program Stata version. Metanalysis was used to determine the prevalence of MAD, and a random effects model was used to estimate the pooled prevalence of MAD. The DerSimonian-Laird Random effects model (REM) was used to combine the determinant factors from all qualifying papers for the meta-analysis, and the heterogeneity was independently assessed using a χ2 test, Q statistics, and matching I2 statistics. To retrieve the extent of publication bias, funnel plots were scattered and tested for asymmetry and, additionally, Egger’s test was computed with the user-written “meta bias” command in Stata (version 11) software. To end, sensitivity analyses with trim and fill were performed. Results The pooled estimate of the overall prevalence of minimum acceptable diet in 16 studies in Ethiopia was 22% with (95% CI: 16, 28%) with a random effect model. However, eight papers were filled during trim and fill in order to counteract the small study effect. The overall filled pooled estimate was 7.9% with (95%CI: 11, 14.8%). Maternal education (primary and secondary) is 1.714 (95% CI 1.244,2.363) and 2.150(95% CI: 1.449,3.190), respectively, Ages of children with range of 12–17 months (2.158 (95% CI 1. 9,3.006) and 18–23 months 2.948(95% CI: 1.675,5.190)), Nutrition information ((1.883 (95% CI 1.169,3.032)) media exposure (1.778(95% CI: 1.396,2.265), and maternal knowledge (2.449 (95% CI 1.232, 5.027) were significantly associated with MAD. Conclusion The pooled estimate of the overall prevalence of minimum acceptable diet in 16 studies in Ethiopia were low. Maternal education (primary and secondary), ages of child with range of 12–17 month and 18–23 months, mothers having nutrition information, mothers who have media exposure,and mothers having good knowledge were significantly associated with Minimum acceptable diet. The government, NGO, and other stakeholders should focus on improving Minimum acceptable diet among 6 to 23 months of children through promoting with mass media, focuses on nutrition council during critical contact point in health facility, and doing capacity building for the mothers/caregivers.

Chernet Tafere,1 Bereket Bahiru Tefera,2 Adane Yehualaw,1 Desalegn Getnet Demsie,3 Belayneh Kefale,4 Kebede Feyisa,5 Malede Berihun Yismaw,4 Endalamaw Aschale,4 Zenaw Debasu,4 Zewdu Yilma,1 Zegaye Agmassie,4 Ibrahim Abdela Siraj,1 Ashagrachew Tewabe Yayehrad,1 Sileshi Mulatu,6 Destaw Endeshaw7 1Department of Pharmaceutics, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 2Department of Social Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 3Department of Pharmacology, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 4Department of Clinical Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 5Department of Pharmacognosy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 6Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 7Department of Adult health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, EthiopiaCorrespondence: Chernet Tafere, Tel +251924524636, Email cheru004@gmail.comBackground: Opioid use is a major global public health problem, affecting 16 million individuals worldwide. According to a 2023 WHO report, out of the 600,000 substance-related deaths worldwide, 80% were attributed to opioid use. Pharmacists play a vital role in reducing unnecessary opioid exposure while facilitating access to non-opioid alternatives. To do so, pharmacists should have sufficient knowledge regarding opioid-containing medications and a positive attitude about opioid use problems.Objective: This study aimed to evaluate community pharmacists’ knowledge of opioid-containing medications and their attitude toward opioid use problems.Materials and methods: A cross-sectional study was conducted using a self-administered, structured questionnaire distributed to 105 community pharmacists from July 1– 30, 2023 in Bahir Dar City, Ethiopia. The tool included demographic information and questions designed to assess participants’ knowledge and attitudes.Results: Out of the 105 pharmacists included in this study, majority were males (54.3%), nearly half held a bachelor’s degree (49.5%), and slightly above one-third had over a decade experience (39%). Regarding knowledge and attitude towards opioids, 62 individuals (59%) exhibited good knowledge, and 64 (61%) demonstrated less stigma toward opioid usage. Factors affecting knowledge include: education level (AOR (95% CI): 8.43 (1.76– 40.35) and 9.93 (1.04– 85.33) for bachelors and postgraduates respectively and age 1.45 (1.20– 1.77)]. Meanwhile, experience [AOR (95% CI): 4.64(1.20– 17.90) and 4.29 (1.23– 15.05)] for 5– 9 years and ≥ 10 years respectively and education level [AOR (95% CI): 4.08 (1.40– 11.93) for bachelors and 6.40 (1.42– 28.96)] for postgraduates were linked to attitude.Conclusion: A gap in knowledge and more stigmatizing behavior was observed among community pharmacists. These findings imply the importance of tailored educational interventions to address knowledge gaps and promote positive attitudes toward opioid usage among community pharmacists. Therefore, it is imperative to deliver up-to-date information on opioids, emphasizing their high addiction potential, to ensure pharmacists are well-equipped with the latest information.Keywords: opioids, pain management, community pharmacists, knowledge, attitude, Ethiopia

Mesfin Yimam Zegeye,1 Tewodros Yosef,2,3 Abyot Asres2 1Department of EMT, Mizan Aman Health Science College, Mizan Aman Town, Southwest Ethiopia Regional State, Ethiopia; 2Public Health Department, Mizan Tepi University, Mizan Aman Town, Southwest Ethiopia Regional State, Ethiopia; 3School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, AustraliaCorrespondence: Mesfin Yimam Zegeye, Department of EMT, Mizan Aman Health Science College, Mizan Aman Town, Southwest Ethiopia Regional State, Ethiopia, Email mmmsfyi23@yahoo.comIntroduction: Diabetes mellitus (DM) is a serious non-communicable disease (NCD) that represents a major health and development challenge of the 21st century. Ethiopia is the leading country among the top five high-burden African countries for the number of people with diabetes. To address problems within the population, it is important to assess the prevalence of diabetes and identify the risk factors associated with its diagnosis.Objective: The study aims to determine the prevalence of diabetes and identify its associated factors among office workers of Mizan-Aman Town administration and Bench Sheko Zone Sector Office.Methods: A sector office-based cross-sectional study was conducted on 559 randomly selected employees of Mizan Aman Town Administration and Zonal Office from June 5 to June 30, 2022. Fasting plasma glucose was tested, and the result ≥ 126 mg/dL was used to diagnose DM. Data were entered using Epi Data version 4.0.2 and exported to the Statistical Package for the Social Sciences (SPSS version 26) for analysis. Bivariate analyses were included in the multivariable model with p < 0.25. Adjusted odds ratios (AOR) with a confidence interval (CI) of 95% are reported, with a significance level of p < 0.05.Results: The overall prevalence of Diabetes was 9.4% with 95%CI(7.1,12.1)). Among the participants,60.8% were men, 58.2% of workers were aged 40 years or older, and the mean age was 39.7 ± 9.9 years. Having hypertension (AOR 3.85, 95% CI (1.7,7.4), family history of diabetes (AOR 4.5, 95% CI (1.2, 15.8), physical inactivity defined as failure to participate in moderate intensity activities at work, sitting ≥ 180 minutes per day (AOR = 3.57, 95% CI (1.1, 11.0)) and having central obesity AOR: 3.25, 95% CI (1.5, 6.7) independently associated with higher odds of DM. However, those having good knowledge of DM (AOR=0.26, 95% CI: (0.10, 0.6)) and consuming fruits and vegetables greater than five servings per week (AOR=0.32 95% CI (0.1, 0.7)) predicted lower odds of DM.Conclusions and Recommendations: The prevalence of DM among office workers was high and is associated with lifestyle, family history, dietary practices, and knowledge about DM. Therefore, arranging regular screening programs at the workplace and promotion of healthy diet, exercise, and awareness creation are needed to lower the prevalence.Keywords: diabetes mellitus, office workers, Mizan-Aman, prevalence, Ethiopia

Abel Teklit Haile,1,2 Robel Gemechu Haile,1– 3 Esrom Hagos Gebrehiwot,1– 3 Eden Workalemahu Abeje1– 3 1Research Department, Saint Peter Specialized Hospital, Addis Ababa, Ethiopia; 2Department of Internal Medicine, Wollo University, Dessie, Ethiopia; 3School of Public Health, Gamby Medical and Business College, Addis Ababa, EthiopiaCorrespondence: Abel Teklit Haile, Email teklitabelhaile@gmail.com; Robel Gemechu Haile, School of Public Health, Gamby Medical and Business College, Addis Ababa, Ethiopia, Email robelgemechu439@gmail.comBackground: The association of COVID-19 with venous thromboembolism is of particular interest as there are reports that have associated thrombotic events with the pandemic. COVID-19 may predispose to venous thromboembolism. There is initial evidence suggesting that individuals with COVID-19 may be more prone to developing venous thromboembolism (VTE). This study aims to assess venous thromboembolism and associated factors in 19 patients admitted to Addis Ababa’s field hospital for COVID-19.Objective: To identify associated factors that affect the development of thromboembolism in patients admitted with the diagnosis of COVID-19.Methods: To determine the risks of VTE patients, an institution-based case control research was conducted using SPSS version 26, multivariable binary logistic regression analysis was used.Results: Significant factors associated with the development of VTE in COVID-19 patients included having a severe case (AOR = 0.38, 95% CI = 0.149– 0.961), risk factors for VTE (AOR = 2.57, 95% CI = 1.18– 5.33), diabetes (AOR = 3.745, 95% CI = 1.715– 8.176), chest pain (AOR = 4.13, 95% CI = 1.89– 9), stage 1 hypertension levels (AOR = 3.67, 95% CI = 1.37– 9.836), and hospital anticoagulation (AOR = 11.78, 95% CI = 5.25– 26.4).Conclusion: The results of VTE in individuals with COVID-19 imply a direct association between severe COVID-19 and diabetes, having risk factors, hypertension, and hospital anticoagulation.Keywords: COVID-19, venous thromboembolism, case control, logistic regression, Addis Ababa, Ethiopia

Kidu Gidey, Solomon Girmay Aregawi, Berhane Yohannes Hailu, Solomon Weldegebreal Asgedom, Yirga Legesse Niriayo Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, EthiopiaCorrespondence: Kidu Gidey, Email kidu.gidey@mu.edu.etIntroduction: Antimicrobials are among the most commonly misused medications, leading to antimicrobial resistance, and therefore demand more attention. There are limited studies documenting “antimicrobial use-related problems” in developing countries, especially in pediatric patients.Objectives: This study aimed to evaluate the prevalence of antimicrobial use-related problems and risk factors among hospitalized pediatric patients.Materials and Methods: A hospital-based prospective observational study was conducted in Ayder comprehensive specialized hospital (ACSH) in the Tigray region, Ethiopia. The participants of the study were pediatric patients aged ≤ 15 years who were admitted with a diagnosis of infectious disease between September 2019 and November 2019.Results: A total of 232 pediatric patients were included in the study. Of these, 59.5% of the patients were male and the mean age (SD) of the patients was 5.8 (5.2) years. Of the 232 patients surveyed, a total of 177 antimicrobial use-related problems were identified. One or more antimicrobial use-related problems have occurred in more than half of the patients (53.9%). The commonest antimicrobial use problems were unnecessary antimicrobial therapy (22.8%) followed by need additional antimicrobial therapy (16.4%). In a multivariate logistic regression model, patients with comorbidities (Adjusted odds ratio (AOR): 1.84, 95% confidence interval (CI): 1.04– 3.27) and hospital stays exceeding one week (AOR=1.88, 95% CI: 1.08– 3.26) were predictors of antimicrobial use-related problems.Conclusion: Antimicrobial use-related problems were found in a significant proportion of pediatric patients. Addressing these issues necessitates collaborative efforts, emphasizing targeted education, strengthened antimicrobial stewardship, ensuring responsible antimicrobial use and enhancing pediatric care.Keywords: antimicrobial use-related problems, pediatric, Ethiopia

Kal Kidane,1 Zewdie Aderaw Alemu,2 Tolesa Diriba Biratu,2 Leja Hamza Juhar3 1Kidney Transplantation Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 2School of Public Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaCorrespondence: Tolesa Diriba Biratu, Tel +251923717514, Email toliyediriba@yahoo.comBackground: The COVID-19 epidemic is a rapidly shifting situation that has resulted in significant regulatory reforms and widespread initiatives to deal with the initial crisis and its effects. The COVID-19 pandemic has had a significant impact on transplantation activities. The COVID-19 pandemic has caused various important challenges in the kidney transplant industry.Objective: To identify the factors influencing COVID-19 severity in kidney transplant and non-kidney transplant patients at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.Methods: A comparative cross-sectional study was conducted. This study included 364 patients (182 kidney transplants and 182 non-kidney transplants). A systematic random sampling was used to select the respondents. Professional nurses collected data for this study using a data extraction tools. Data were analyzed by using SPSS version 25 software. A multivariable logistic regression analysis was performed to identify the association between independent variables and COVID-19 severity with adjusted odds ratio (AOR), and 95% CI for AOR and P-value for testing significance.Results: This study included 364 patients. Off the total, 34.1% developed severe COVID-19. In Multivariable logistic regression analysis, patients with 60 years and above age groups (AOR = 4.73; 95% CI: 1.86, 12.02), aged 40– 59 years (AOR = 2.70; 95% CI: 1.17, 6.22), chest congestion (AOR = 4.49; 95% CI: 2.37, 8.50), history of muscle or body aches (AOR = 0.47; 95% CI: 0.22, 0.99) shortness of breath (AOR = 3.03; 95% CI: 1.36, 6.74), changed or lost sense of taste or smell (AOR = 2.77; 95% CI: 1.34, 5.71), and muscle pain (AOR = 3.05; 95% CI: 1.40, 6.65) were significant variables associated with COVID-19 severity after adjusting for other variables.Conclusion: The study revealed that 34.1% of patients had severe COVID-19. The majority of these patients underwent non-kidney transplants. Age groups and symptoms, such as chest congestion, shortness of breath, changed or lost sense of taste or smell, and muscle pain, were significant predictors of COVID-19 disease severity.Keywords: COVID-19, severe, multivariable, regression, St. Paul‘s, Addis Ababa, Ethiopia

Purpose. The aim of this study is to identify the determinants of market orientation of smallholder tomato producers and to determine the status of market performance along the market chain using the example of Zewaydugda district of Ethiopia. Methodology / approach. This research was conducted at Zewaydugda district in Oromia regional state of Ethiopia. For conducting this study, we selected five kebeles which are the smallest administrative units in the country, and a total of 191 smallholder tomato producers randomly. We used descriptive analysis, marketing performance analysis and econometrics models to analyse the data. We used a kobo toolbox to collect the data from the respondents. We collected the data from respondents using a face-to-face interview in 2022. Results. The crop marketability index (CMI) showed that 82.96 % of the produced tomatoes were sold to the market with an average selling price of 1143.2 Birr per quintal and the average market orientation index (MOI) of producers was 30.54 % and it means that farmers are moderately market oriented in tomato production in the study area. The econometrics result of Ordinary Least Squares (OLS) estimation showed that, family size, access to credit, access to improved seed, and amount of land allocated for tomato production significantly affects the farmer’s market orientation. In addition, the result of market performance analysis showed that 61.64 % of the total gross marketing margin accounted for by traders while 38.36 % – by producers. Furthermore, the study identified that: lack of fair sales price, lack of market information, poor linkage with other value chain actors, and perishability were the dominant marketing problems faced by tomato producers. Originality / scientific novelty. Our research stands out in the field of market orientation and the performance of smallholder tomato producers due to its innovative approach and unique contributions to existing knowledge. While previous studies have explored the relationship between market orientation and performance in agricultural contexts, particularly focusing on large-scale operations, our study specifically targets smallholder tomato producers, a demographic often overlooked in research. Thanks to our thorough empirical investigation and theoretical framework, we not only advance the understanding of market orientation in the agricultural sector but also provide actionable recommendations to enhance the performance and sustainability of smallholder tomato producers in diverse market environments. Practical value / implications. The findings of this research can be used for policy makers. Thus, policies focusing on reducing illegal brokers, increasing farmers’ awareness to allocate more cultivable land, reducing the price difference among producers and traders, enhancing farmers to get access to credit and access to improved seed, strengthening market linkages among the value chain actors needs better attention to improve tomato producers’ market orientation and marketing performance of the study area.

Background: Clinicians rely on local antimicrobial resistance pattern data to guide empiric treatment for seriously ill patients when culture and antimicrobial susceptibility testing results are not immediately available. Objective: This study aimed to analyse 5-year trends in antimicrobial resistance profiles of Escherichia coli and Klebsiella pneumoniae isolates. Methods: Bacteriology reports from 2017 to 2021 at the Ethiopian Public Health Institute were analysed retrospectively. Isolates were identified using either the VITEK 2 Compact system, the BD Phoenix M50 instrument, or conventional biochemical tests. Antimicrobial susceptibility testing was conducted using either the Kirby-Bauer disk diffusion method or the VITEK 2 Compact system and BD Phoenix M50 systems available at the time of testing. The Cochran Armitage trend test was employed to test the significance of antimicrobial resistance trends over time. P-values less than 0.05 were considered statistically significant. Results: Of the 5382 bacteriology reports examined, 458 (9%) were on E. coli and 266 (5%) were on K. pneumoniae. Both K. pneumoniae (88%) and E. coli (65%) demonstrated high resistance to extended-spectrum cephalosporins. However, both K. pneumoniae (14%) and E. coli (5%) showed lower rates of resistance to carbapenems compared to other antimicrobials. In K. pneumoniae, resistance to carbapenems (from 0% to 38%; p 0.001) and ciprofloxacin (from 41% to 90%; p 0.001) increased significantly between 2017 and 2021. Conclusion: Both organisms showed very high resistance to broad-spectrum antibiotics. Additionally, K. pneumoniae demonstrated a statistically significant rise in ciprofloxacin and carbapenem resistance. What this study adds: This study emphasises the significance of regular reporting of local antimicrobial resistance patterns as this information can guide appropriate empiric therapy and efforts to address antimicrobial resistance issues.

Diriba Alemayehu Gadisa,1 Esayas Tadesse Gebremariam,1 Getnet Yimer,2,3 Efa Deresa Urgesa4 1Pharmacy Department, College of Medicine and Health Sciences, Ambo University, Ambo, Oromia, Ethiopia; 2Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 3Penn Center for Global Genomics & Health Equity, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 4Contract Director Management Department, Ethiopian Pharmaceutical Supply Service, Addis Ababa, EthiopiaCorrespondence: Diriba Alemayehu Gadisa, Email diriba.alemayehu@ambou.edu.et; direalexphar@ymail.comBackground: Deprescribing is essential for reducing inappropriate medication use and polypharmacy. For a holistic approach, it is essential to know how older adult patients and their caregivers perceive deprescribing.Objective: To assess the attitude of older adult patients and caregivers towards deprescribing medication at Ambo University Referral Hospital.Methodology: Institutional-based cross-sectional study was conducted using the revised Patients’ Attitude Towards Deprescribing tool (rPATD). The data was analyzed using the SPSS-25 software. Backward linear regression and logistic regression were used to measure association between outcome and determinant variables. The two-sided P-value ≤ 0.05 with 95% confidence interval was utilized for reporting significant factors.Results: One hundred fifty-six (81.3%) of the respondents (ie, 85.0% of older adult and 77.2% of caregivers) agreed to stop one or more of their regular medications if the physician said it was possible despite 98 (51.0%) of them (ie, 49.0% of older adult and 53.3% of caregivers) being satisfied with their/their care recipient’s medications. On the overall aggregate mean score, the respondents had a neutral position (2.6– 3.59) regarding the burden and concerns of stopping medications whereas the majority of them disagree (1.0– 2.59) with the inappropriateness of the medication they were taking and agreed (3.6– 5.0) with the need for their involvement in treatment decision making. Concerns about stopping medicine scores (AOR = 0.440, 95% CI = 0.262– 0.741, P = 0.035) and perceived levels of medication inappropriateness (AOR = 0.653, 95% CI = 0.456– 0.936, P = 0.020) was significantly associated with the willingness to discontinue and overall satisfaction with their medicine regimen respectively.Conclusion: The majority of older adult patients and caregivers would like to deprescribe if the physicians recommended it. The perceived concerns of stopping and inappropriateness of the medicines were associated with the willingness to deprescribe and overall satisfaction with their medicine respectively. Healthcare providers should prompt the deprescribing process with older adult patients and caregivers by addressing their concerns about stopping medications.Keywords: attitude, caregiver, deprescribing, older adult patients, Ethiopia

Meseret Alemu,1 Girmay Adhena,2 Nega Assefa,3 Yadeta Dessie3 1Department of Reproductive Health, Lemmo District Health Office, Hossana, Southern Ethiopia; 2Department of Reproductive Health, International Medical Corps, Gambella, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Girmay Adhena, Email girmayrh@gmail.comBackground: Male partner involvement in reproductive health services is an important strategy to decrease maternal and child morbidity and mortality. Despite this, little attention is given to this issue around the globe, particularly in Africa, where male dominance is high. This study aimed to assess male partner involvement in institutional delivery services in Lemmo district, Southern Ethiopia.Methods: A community-based cross-sectional study was conducted among 614 male participants. A multistage sampling technique was used to select study samples. A structured, pretested, and interviewer-administered questionnaire was used to collect the data. Male involvement in institutional delivery was measured using six yes or no items. The participants were asked if they communicated with relatives and health care providers, saved money, arrange transportation, decide to give birth at an institution, and arrange blood donation. Binary and multivariable logistic regression was used to identify associated factors. An adjusted odds ratio with 95% CI was used to show the strength and direction of the association. Variables with a p-value < 0.05 were considered statistically significant.Results: A total of 251 (43.1%, 95% CI: (39.2, 46.9)) male partners were involved in the institutional delivery services of their partner. Primary educational level [AOR=2.2, 95% CI: (1.361, 3.532)], secondary and above educational level [AOR=2.4, 95% CI: (1.46, 4.01)], having good knowledge [AOR=3 (95% CI: (2, 4.49)], positive perception [AOR=3.66, 95% CI: (2.45, 5.46)], and discussing institutional delivery with their spouse [AOR=1.99, 95% CI: (1.3, 2.99)] were significantly associated factors.Conclusion: More than two out of five male partners were involved in the institutional delivery services of their partner. Attending formal education, having good knowledge, positive perception, and discussing institutional delivery with a spouse were significantly associated factors. Strengthening male partner involvement in reproductive health services and enhancing the culture of reproductive inter-spousal communication through couple counseling and peer-to-peer group sessions at a facility and community level are important measures.Keywords: male involvement, institutional delivery, Lemmo, Ethiopia

Helina Abebe Kurbi,1,2 Solomon Mekonnen Abebe,3 Nestanet Worku Mengistu,3 Tadesse Awoke Ayele,1 Alemayehu Teklu Toni4 1Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Kotebe Metropolitan University, Menelik II Health Science College, Department of Mental Health, Addis Ababa, Ethiopia; 3Department of Nutrition institute of public health, college of medicine and health sciences, university of Gondar, Gondar, Ethiopia; 4Department of Pediatrics and School of Medicine, Institute of Public health, college of Medicine and health sciences, university of Gondar, Gondar, EthiopiaCorrespondence: Helina Abebe Kurbi, Email helusimren@gmail.comBackground: The prevalence of prenatal common mental disorders afflicting the global community, including Ethiopia, is thriving. Therefore, a time-efficient and valid screening tool is required. This study aimed to culturally adapt and validate the self-reporting questionnaire-20 tool developed by the World Health Organization among pregnant mothers in Ethiopia.Methods: A total of 310 pregnant women completed the questionnaire at two selected health centers in the regional state of Amhara. The World Health Organization’s Self Reporting Questionnaire-20 tool was first translated into Amharic by two experts. The back translation was done by two English experts. Internal consistency and reliability were assessed using Cronbach’s alpha. Convergent and discriminant validity were assessed using composite reliability and extracted mean variance. SRQ-20 was tested for reliability and validity using principal components analysis and the Kaiser-Meyer-Olkin measure of sample adequacy with a cutoff value of 0.50 for each item.Results: The Kaiser-Meyer-Olkin measure (KMO = 0.733) for sample adequacy and the Bartlett’s sphericity test for the identity matrix indicated that the data were amenable to exploratory factor analysis. Principal components analysis identified six factors that explained 64% of the variation in the self-report questionnaire 20. Cronbach’s alpha was 0.817 for the entire scale and the extracted mean variance was greater than 0.5 for all factors, indicating convergent validity. The extracted mean variance, composite reliability, and factor loadings were all greater than 0.75 for all factors in this study, indicating that convergent validity was satisfactory and that discriminatory validity was also satisfied. The composite factor reliability scores ranged from 0.74 to 0.84, and the square roots of the mean variances were greater than the factor correlation scores.Conclusion: The interview-based, culturally-adapted 20-item Amharic version of the SRQ-20 tool demonstrated good cultural adaptation and was also found to be valid and reliable in the present context.Keywords: antenatal common mental disorders, cultural adaptation, factor analysis, SRQ-20, Ethiopia

Background: Inland dry ports in Ethiopia serve as extended destinations for goods transported by sea, especially under the international multimodal transport system, to fulfil customs formalities. Ethiopia’s multimodal transport law gives carriers lien rights to detain cargo and documents to recover all sums payable under multimodal contracts. However, the country’s customs law gives customs the right to sell abandoned goods by auction and collect duties and taxes before any other payments are made. Objectives: This study critically examines current regulations and practices relating to carriers’ lien rights to recover uncollected charges on goods abandoned at inland dry ports. Method: A qualitative case study design is used to analyse the challenges and provide solutions for multimodal transport operators dealing with abandoned goods at inland terminals. Results: A major reason for abandonment is that the proceeds of sales of abandoned goods are insufficient to pay for taxes and logistics expenses. The Ethiopian Shipping and Logistics Services Enterprise has lost an estimated 1.5 million USD annually from abandoned containers in multimodal transport. Conclusion: Based on the legislation and court of appeal precedents presented in this paper, multimodal transport operators’ uncollected charges should take priority over tax and duties for the proceeds of selling abandoned goods. As Ethiopia is a landlocked country, it needs to resolve this issue to ameliorate its multimodal transport system. Contribution: This paper suggests revising existing regulations and practices relating to unclaimed goods at inland terminals to recoup logistics costs ahead of tax. This will facilitate multimodal transport services’ use of inland terminals as extended destinations of seaports.

Yeniewa Kerie Anagaw,1 Marshet Mulugeta Yeheyis,2 Wondim Ayenew,3 Gizachew Kassahun Bizuneh4 1Department of Pharmaceutical Chemistry, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Internal Medicine St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia; 3Department of Social & Administrative Pharmacy, School of Pharmacy, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Pharmacognosy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Yeniewa Kerie Anagaw, Email yeniewa21@gmail.comBackground: Acute coronary syndrome (ACS) patients need intense therapy and diagnostic evaluation for improved treatment. In Ethiopia, where patient deaths and hospital stays are rising, the ACS treatment is thought to be not very effective.Methods: A retrospective cross-sectional study was conducted at St. Paul Hospital. The data were collected from patients medical records using a structured data abstraction checklist from 2018 to 2020. The data was entered, analyzed, and interpreted using SPSS version 24 software.Results: Of 157 ACS patients, 69 (43.9%) had a STEMI diagnosis. Age was 63.69 years on average (SD: 8.23). The typical amount of time between the onsets of ACS symptoms to hospital presentation was 79.3 hours (3.3 days). For 104 (66.2%) patients, hypertension was the main risk factor for the development of ACS. Killip class III and IV patients made up about 3.8% of the ACS patients at St. Paul hospital. An EF of less than 40% was present in 36.3% of patients. Loading doses of aspirin (90.4%), anticoagulants (14%), beta-blockers (82.8%), statins (86%), clopidogrel (7.6%), and nitrates (2.5%) are among the medications taken inside hospitals. Of 157 ACS patients, 6 (3.8%) patients with medical records examined died while receiving treatment in the hospital, while 151 (96.2%) patients were discharged alive.Conclusion: STEMI was the most common diagnosis for ACS patients at St. Paul Hospital. The two main hospital events for these patients were CHF and cardiogenic shock.Keywords: acute coronary syndrome, treatment outcome, Killip class, Ethiopia

Abstract Background With the largest cattle population in Africa and vast swathes of fertile lands infested by tsetse flies, trypanosomosis is a major challenge for Ethiopian farmers. Managing the problem strategically and rationally requires comprehensive and detailed information on disease and vector distribution at the national level. To this end, the National Institute for Control and Eradication of Tsetse and Trypanosomosis (NICETT) developed a national atlas of tsetse and African animal trypanosomosis (AAT) for Ethiopia. Methods This first edition of the atlas focused on the tsetse-infested areas in western Ethiopia. Data were collected between 2010 and 2019 in the framework of national surveillance and control activities. Over 88,000 animals, mostly cattle, were tested with the buffy-coat technique (BCT). Odour-enhanced traps were deployed in approximately 14,500 locations for the entomological surveys. Animal- and trap-level data were geo-referenced, harmonized and centralized in a single database. Results AAT occurrence was confirmed in 86% of the districts surveyed (107/124). An overall prevalence of 4.8% was detected by BCT in cattle. The mean packed cell volume (PCV) of positive animals was 22.4, compared to 26.1 of the negative. Trypanosoma congolense was responsible for 61.9% of infections, T. vivax for 35.9% and T. brucei for 1.7%. Four tsetse species were found to have a wide geographic distribution. The highest apparent density (AD) was reported for Glossina pallidipes in the Southern Nations, Nationalities and People's Region (SNNPR) (3.57 flies/trap/day). Glossina tachinoides was the most abundant in Amhara (AD 2.39), Benishangul-Gumuz (2.38), Gambela (1.16) and Oromia (0.94) regions. Glossina fuscipes fuscipes and G. morsitans submorsitans were detected at lower densities (0.19 and 0.42 respectively). Only one specimen of G. longipennis was captured. Conclusions The atlas establishes a reference for the distribution of tsetse and AAT in Ethiopia. It also provides crucial evidence to plan surveillance and monitor control activities at the national level. Future work on the atlas will focus on the inclusion of data collected by other stakeholders, the broadening of the coverage to tsetse-free areas and continuous updates. The extension of the atlas to data on control activities is also envisaged. Graphical Abstract

Sintayehu Wolka,1 Mamo Dereje Alemu,1 Markos Gobana,1 Gemu Tiru Bati,1 Hizikiyas Gerawork,1 Zeleke Abebaw1,2 1Health System Strengthening Directorate, Ministry of Health, Addis Ababa, Ethiopia; 2Institute of Public Health, University of Gondar, Gondar, EthiopiaCorrespondence: Sintayehu Wolka, Ministry of Health-Ethiopia, P.O. Box 1234, Addis Ababa, Ethiopia, Email sintayehuwolka4@gmail.comBackground: Ethiopia has been implementing Mobile Health and Nutrition Teams (MHNTs) to improve the accessibility of essential healthcare services for unreached populations with poor infrastructure to ensure health for all target by Universal health coverage (UHC). However, the current implementation status of this MNHT is not assessed.Objective: This study aimed to capture the current implementation status of the MHNT from the program managers, supporting partners and decision makers at each level of the health system structure in Afar and Somali regions.Methods: We conducted qualitative study with phenomenological study design. The data was collected from RHB MHNT coordinator, woreda health office MHNT coordinator, MHNT leader and representatives from implementing partners. The interview guides were developed using the CFIR framework.Results: Out of the 17 respondents, 13 responded all the standard service packages a MHNT is expected to deliver (76.5%). Overall, the KIIs mentioned that the MHNTs are effective in ensuring access and quality of health services. MHNT strategy has high demand and acceptability by the community and the service providers. The main barrier to program implementation is the gap in service integration within and across sectors. Inadequate staffing of the MHNT, gaps in ensuring proper professional mix, frequent turnover of contract health workers, and skill gaps hamper effective and sustainable implementation of the program.Conclusion: MHNT establishment, effectiveness, acceptability and sustainably in the implementing woredas of Afar and Somali Regions is very promising. The culture of MHNT documentation and reporting needs some improvement. Besides, community engagement and government ownership are good drivers for sustainability of MHNT. Standardizing and adding additional professionals with capacity building is crucial to ensuring service quality. Furthermore, community mobilization and woreda leadership commitment boosting will be needed for granting sustainability. Finally, national scale up of this alternative strategy is recommended through standardized implementation modality.Keywords: Mobile Health and Nutrition Team, Consolidated Framework for Implementation Research, implementation, Ethiopia

Mesfin Mammo,&ast; Mihiretu Alemayehu,&ast; Gizachew Ambaw&ast; School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia&ast;These authors contributed equally to this workCorrespondence: Gizachew Ambaw, Wolaita Sodo, Ethiopia, Tel +251918556340, Email gizachewambawkase@gmail.comIntroduction: Primary dysmenorrhea is a highly prevalent gynecological problem and one of the most common causes of school absenteeism among school adolescents. Nearly, half of females with primary dysmenorrhea missed school or work at least once per cycle. Therefore, this study aimed to assess the prevalence of primary dysmenorrhea and its associated factors among female students in Wolaita soddo town high schools.Methods: An institution-based cross-sectional study was conducted among female students at Wolaita soddo town high schools from October 1– 30/2021. A total of 733 students were selected using a simple random sampling technique. The data were entered using Epi data version 3.1 and exported to SPSS version 25 for analysis. Binary logistic regression analysis was used. Variables with a p-value of < 0.05 in the multivariable logistic regression analysis model were considered statistically significant.Results: The prevalence of primary dysmenorrhea was 70% (95% CI (66.6%, 73.4%)). Factors such as age < 18 years (AOR 2.55; 95% CI (1.77, 3.68)), long duration of menstrual flow (AOR 2.72; 95% CI (1.42, 5.17)), irregular menstrual cycle (AOR 2.39; 95% CI (1.68, 3.41)), family history of dysmenorrhea (AOR 2.46; 95% CI (1.67, 3.64)) and skipping breakfast (AOR 1.62; 95% CI (1.13, 2.33)) were associated with primary dysmenorrhea.Conclusion: The prevalence of primary dysmenorrhea was high among high school students in the study area. Being younger age, long menstrual flow duration, irregular monthly menstrual cycle, family history of dysmenorrhea, and skipping breakfast were determinants of primary dysmenorrhea.Keywords: primary dysmenorrhea, prevalence, adolescents, menstruation, Ethiopia

Tsegaye Eneyew Tiruneh,1 Girma Alem,2 Mekuanint Taddele,3 Zewedu Minewey Tizazu,1 Fasil Kefale Minale,1 Kasaye Demeke Alemu4 1Department of Nursing, Debre Markos Comprehensive Specialized Hospital, Debre Markos, Ethiopia; 2Department of Nursing College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 3Departments of Public Health College of Health Sciences, Injibara University, Debre Markos, Ethiopia; 4Department of HIV/AIDS Prevention Care and Treatment, International Center for AIDS Care Program/ICAP, Bahir Dar, EthiopiaCorrespondence: Tsegaye Eneyew Tiruneh, Tel +251920273593, Email Tsegayeeneyew30@gmail.comBackground: Colostomy is one of the commonest lifesaving procedures worldwide with aims of decompression of an obstructed colon or diversion of feces. Colostomy care is important to improve the quality of life of the patient, yet information is scarce concerning knowledge, attitude, and role of nurses on colostomy care in Ethiopia generally and in Amhara region specifically.Objective: This study aimed to assess knowledge, attitude, perceived responsibility, and associated factors regarding colostomy care among nurses working in surgical units at Amhara region general and referral hospitals, Ethiopia.Methods: A cross-sectional, mixed method study was conducted from March 1 to 30, 2020 using a census method. The data were collected using semi-structured, self-administered questionnaire and in-depth interview. Analytic schemes including bivariable and multivariable logistic regression were computed considering P-value < 0.05 to identify statistically significant factors. Qualitative data were analyzed with thematic content analysis.Results: In the current study, the adequate knowledge of nurses was found to be 40.4% (95% CI: 35.4– 45.8). Clinical experience, colostomy care guidelines, gave care for colostomy patient, ever received colostomy care training, and read professional literature regularly were significantly associated with adequate knowledge. Favorable attitude of nurses was found to be 49.6% (95% CI: 45– 54.5). Presence of colostomy care guidelines, gave care for colostomy patients, and adequate knowledge were significantly associated with favorable attitude. Nurses have a strong professional perception of caring for colostomy patients but lack of training, inadequate supplies, and lack of professional perquisite are barriers identified.Conclusion: In the present study, nearly half of nurses had only adequate knowledge and favorable attitude, but the majority of nurses perceived their responsibilities towards colostomy care. Therefore, taking part in care, developing guidelines, providing training and fulfilling nurses’ perquisite are needed to enhance the knowledge, attitude, and responsibility of nurses towards colostomy care.Keywords: colostomy care, knowledge, attitude, perceived responsibility

Asrat Wolde,1 Nigatu Dessalegn2 1Department of Psychiatry, School of Medicine, Mizan Tepi University, Mizan Aman, Ethiopia; 2Department of Pediatric Health Nursing, Mizan Tepi University, Mizan Aman, EthiopiaCorrespondence: Asrat Wolde, Department of Psychiatry, School of Medicine, Mizan Tepi University, Mizan Aman, Ethiopia, Tel +251916389179, Email Asratwolde2017@gmail.comBackground: Posttraumatic stress disorder (PTSD) is a chronic, impairing mental disorder that develops after exposure to a traumatic event. Despite many factors putting adolescent girls at risk of PTSD, little is known about the prevalence and how adolescent girls cope with the PTSD burden. So, this study aimed to investigate the prevalence of PTSD and associated factors among adolescent girls in three selected towns in Southwest Ethiopia.Methods: A community-based cross-sectional study was conducted among 397 adolescent girls from May 27 to July 27, 2021. The participants were selected by a systematic random sampling method. PTSD and substance use disorder were assessed by DSM V criteria for mental disorders. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a p-value less than 0.05 in the final fitting model were stated as independent predictors of PTSD.Results: The prevalence of PTSD among the adolescent girls was 22%, and about three in four (72.7%) of the adolescent girls developed PTSD after exposure to sexual violence. Furthermore, PTSD was associated with Khat use disorder (AOR, 95% CI: 2.79 (1.47– 5.30), alcohol use disorder (AOR, 95% CI: 5.27 (2.21– 12.60), and suicidal behavior (AOR, 95% CI: 2.12 (1.20– 3.74)).Conclusion: The prevalence of PTSD was high among adolescent girls, and suicidal ideation or attempt, khat use disorder, and alcohol use disorder were risk factors for PTSD. Therefore, early screening for PTSD and comorbid risk factors among this particular age group and managing accordingly is warranted.Keywords: sexual violence, adolescent girls, khat use disorder, suicide, posttraumatic stress disorder, Ethiopia

Yeshialem Kenore,1 Solomon Abrha,2 Amanuel Yosef,2 Temesgen Bati Gelgelu2 1Hawassa University Comprehensive Specialaized Hospital, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, EthiopiaCorrespondence: Amanuel Yosef, Tel +251 918451138, Email amanuelyosef77@gmail.comIntroduction: Hypertension is commonly defined as a persistently raised blood pressure in which systolic blood pressure reading (SBP) is greater than or equal to 140 mmHg and diastolic blood pressure (DBP) is greater than or equal to 90 mmHg. The comorbidity of hypertension and diabetes mellitus is complex and is associated with a high risk of complications. However, there are limited studies on determinants of hypertension among patients with diabetes in Ethiopia. Therefore this study aimed to identify the determinants of hypertension among patients with diabetes mellitus in public hospitals of the Kambata Tambaro Zone, Ethiopia.Methods and Materials: A hospital-based unmatched case-control study was conducted among a total sample of 326 patients with diabetes from June 17, 2021 to August 17, 2021. This study was conducted in five public hospitals. The data were entered into EpiData version 3.1 software and exported to and analyzed using SPSS software version 25.0. Bivariable and multivariable binary logistic regression analyses were used to determine the association between the dependent and independent variables.Results: Of the 336 study participants, 326 diabetic patients (163 cases and 163 controls) were interviewed resulting in a response rate of 97%. Age group ≥ 50 years (Adjusted Odds Ratio = 7.00, 95% CI = 1.69– 28.9), inactivity in physical exercise (AOR = 5.84, 95% CI = 2.47– 13.81), patients who have a history of drinking alcohol (AOR = 2.61, 95% CI = 1.35– 5.03) and patients who had poor knowledge on diabetes (AOR = 3.04, 95% CI = 1.69– 5.47) were more likely to develop hypertension among diabetic patients.Conclusion: This study concluded that age, inactivity in physical exercise, history of alcohol intake and poor knowledge were determinants of hypertension among diabetic patients.Keywords: determinants of hypertension, diabetes, patients, Ethiopia

Masresha Derese Tegegne, Sisay Maru Wubante Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Masresha Derese Tegegne, Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, PO Box 196, Tel +251935474755, Email masresha1derese@gmail.comBackground: Ethiopia’s government has planned to digitize the healthcare industry. However, most implementations fail due to various technological and personnel barriers. As a result, this systematic review aimed to comprehensively examine evidence regarding the barriers to adopting information communication technology in the Ethiopian healthcare system.Methods: This systematic review was conducted by searching the major databases, such as Medline, PubMed, Scopus, Science Direct, Google, Google Scholar, and other online databases. The authors looked for, analyzed, and summarized information about barriers to ICT adoption in the healthcare system. This study included nine articles that described barriers to ICT adoption in the Ethiopian healthcare system.Results: This systematic review identified 15 barriers to adopting ICT in the healthcare system. The reviewed articles looked into technological barriers to ICT adoption, such as ICT skill, ICT knowledge, a lack of training opportunities, a lack of computer literacy, a lack of computer access, inadequate internet connectivity, and a lack of experience with ICT were cited as barriers to ICT implementation in Ethiopia’s healthcare system. Furthermore, organizational components such as Lack of job satisfaction, Lack of Refreshment training, poor staff initiation, management problem, poor infrastructure, and lack of resources remained barriers to ICT adoption in Ethiopia’s healthcare system.Conclusion: This review confirmed that lack of training in ICT, poor ICT knowledge, Poor ICT skill, and a lack of computer access were the most common barriers to adopting ICT in the Ethiopian healthcare system. Therefore, it is recommended that the emphasized barriers to ICT adoption be addressed in order to modernize the current Ethiopian healthcare system.Keywords: barriers, ICT, HIT, healthcare system, Ethiopia

Usha Rani Kandula, Eshete Teklewold, Yoseph Zemene, Dinkinesh Begna, Techane Sisay Tuji Department of Clinical Nursing, College of Health Sciences, Arsi University, Asella, EthiopiaCorrespondence: Usha Rani Kandula, Department of clinical nursing, College of Health Sciences, Arsi University, Oromia Region, P.O. Box-396, Asella, Ethiopia, Tel +251-939052408, Email neha2010dec@gmail.com; usharani2020@arsiun.edu.etBackground: The central nervous system assessment is typically perceived as a complicated exam that would be both time-consuming and challenging. A disciplined approach and directed guidelines can ameliorate much of the difficulties involved. Nursing staff should have the required knowledge of neurological examination is intended to facilitate the physician in clinical check-ups, which would lead to the client’s enhanced well-being.Objective: The study’s goal is to determine the “Effect of implementing an educational program regarding neurological examination on nurses”.Methods: Quasi-experimental research work was carried out at Asella teaching referral hospitals in the Oromia Region of Ethiopia to assess the effect of implementing an educational program regarding neurological examination on nurses. To hand pick up 56 study samples, a convenient sampling technique was asserted. At first, a comprehension set of questions on neurological examination has been used to undertake a pre-measurement evaluation, which was accompanied by a two-week self-administered intervention in an educational program regarding the neurological examination. Followed that, the same comprehension set of questions on neurological examination was used for post-measurement evaluation among nursing professionals. The acquired data was entered into epi-info version-7 for coding and error prevention and transferred to SPSS version 22 for analysis employing descriptive and inferential statistics, and after the results of the research have been contextualized.Findings: The investigation outcomes showed that the pre-measurement mean and SD were 13.02± 2.62, while the post-measurement mean and SD were 22.63± 3.21. The paired-t-test resulted in t=26.24 (p=0.00, df-55, S*) for the effect of implementing an educational program regarding neurological examination among nurses. Whereas, linear multiple regression was explained with no statistically significant association between pre-measurement knowledge and the study’s demographic factors.Conclusion: The study strongly indicates that there is a significant effect of implementing an educational program regarding neurological examination among nurses.Keywords: effect, implementation, educational program, neurological examination, Nurses Oromia Region, Ethiopia

Beniam Daniel,1 Liyew Agenagnew,1 Abdulhalik Workicho,2 Mubarek Abera1 1Department of Psychiatry, Jimma University, Jimma, Ethiopia; 2Department of Epidemiology, Jimma University, Jimma, EthiopiaCorrespondence: Beniam Daniel, Tel +251923289326, Email beni12dani@gmail.comBackground: Cognition is one of the most complex functions of the human brain, and major neurocognitive disorders affect this function causing a wide array of problems in an individual’s life. Screening for major neurocognitive disorders can be helpful in designing and implementing early interventions.Purpose: This study was designed to assess the reliability and validity of the Montreal Cognitive Assessment (MoCA) tool to detect major neurocognitive disorders among older people in Ethiopia.Methods: One hundred and sixteen randomly selected older adults in Ethiopia were involved in a cross-sectional study. The Diagnostic and Statistical Manual of Mental Disorders criteria for major neurocognitive disorders was used as a gold standard. Data were analyzed using STATA v16 statistical software. Receiver operating curve analysis was performed, and inter-rater, internal consistency reliabilities, content, criterion and construct validities were determined. Statistically significance was declared at a p-value of < 0.05.Results: The study had a 100% response rate. The mean age of the study participants was 69.87 ± 7.8. The inter-rater reliability value was 0.96, and Cronbach’s alpha was 0.79. The optimal cutoff value was ≤ 21, and Montreal Cognitive Assessment has an area under curve value of 0.89. The sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values of MoCA are 87.18%, 74.03%, 3.35, 0.17, 63%, and 91.9%, respectively. The tool also has good concurrent and construct validities.Conclusion: The Montreal Cognitive Assessment tool was a reliable and valid tool to detect major neurocognitive disorder. It can be incorporated into the clinical and research practices in developing countries.Keywords: major neuro-cognitive disorder, validity and reliability, Montreal Cognitive Assessment, Ethiopia

Belachew Tegegne,1 Feruza Yimam,2 Zemen Mengesha Yalew,1 Mekuriaw Wuhib,1 Leul Mekonnen,1 Yibeltal Asmamaw Yitayew,3 Sewunet Ademe,1 Dejen Tsegaye,4 Yeshiambaw Eshetie,5 Muluken Chanie6 1Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Nursing, Tropical College of Medicine, Dessie, Ethiopia; 3Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 4Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia; 5Department of Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 6Department of Nursing, Debre Tabor Health Science College, Debre Tabor, EthiopiaCorrespondence: Zemen Mengesha Yalew, Tel +251 91-805-7019, Email zeme.mengesha141414@gmail.comBackground: Wound infection is caused by pathogenic organisms invading viable tissue surrounding a localized defect or excavation in the skin or underlying soft tissue. Nurses have a critical role in wound care and dressing selection, and they should strive to stay current in this ever-changing field. To prevent wound infection, it is essential to improve wound-care knowledge and practice.Objective: To assess knowledge and practice of wound care and associated factors among nurses working in government hospitals of South Wollo Zone, Ethiopia.Methods: A hospital-based cross-sectional study design was used among 422 randomly selected nurses in government hospitals in South Wollo. A pretested structured self-administered questionnaire was used to collect data. Data were entered in EpiData 4.4.2 and exported to SPSS 25.0 for analysis. Descriptive statistics and bivariate and multivariate logistic regression were applied. Variables with P value < 0.05 were considered statistically significant for knowledge and good practice of wound care.Results: According to the findings, 40.3% and 51.0% had good knowledge and practice of wound care, respectively. Holding a bachelor’s degree or above (AOR 3.27, 95% CI 1.97– 5.43) and training (AOR 3.71, 95% CI 2.37– 5.81) were significantly associated with knowledge of wound care. More than 10 years of experience (AOR 3.15, 95% CI 1.96– 5.04), training (AOR 3.75, 95% CI, 2.38– 5.85), and not having a patient load (AOR 3.15, 95% CI 1.96– 5.04) were significantly associated with wound-care practices.Conclusion: Nurses’ wound-care knowledge and practice were low. Knowledge and practice on wound care were determined by educatio, training, patient load, and experience. Nurses should get training and share experience.Keywords: wound care, knowledge, practice, Ethiopia

Belayneh Alemayehu,1 Nebiyou Tafesse,2 Eden Chanyalew1 1Department of Nursing and Midwifery, Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia; 2Department of Public Health, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Belayneh Alemayehu, Department of Nursing and Midwifery, Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia, Tel +251920772457, Email belaynehalexel@gmail.comBackground: Child sexual abuse is a serious breach of basic human rights and is responsible for numerous adverse squeals and widespread global public health concern. The highest prevalence of child sexual abuse was seen in Africa. In Ethiopia, a study was conducted in Jimma town, and the study indicates that the prevalence of violence among high-school children was 62.5%. Despite this fact, it often remains unrecognized and unidentified. Thus, the aim of the study was to assess the magnitude of child sexual abuse and its associated factors among children treated in public hospitals of Addis Ababa, Ethiopia.Methods: An institutional-based cross-sectional quantitative design study was conducted on 422 children. Study participants were selected by systematic random sampling. The data were collected through a face-to-face interview. The data were analyzed by SPSS version 26. By considering a 95% confidence level and a P value of < 0.05, binary logistic regression was used to identify factors associated with child sexual abuse.Results: A total of 422 children participated. Among these, 42.7% of them experienced sexual abuse. Children older than 15 years were 2 times more likely to face sexual abuse than those whose age is less than 10 years [AOR = 2.27 (95% CI: 1.23– 4.19)]. Children who chew khat and smoke were abused more likely compared with their counterparts. The odds of having sexual abuse in a child with mental illness were six times more likely than children who do not have mental illness [AOR = 5.945 (95% CI: 1.642– 21.528)].Conclusion and Recommendations: The magnitude of child sexual abuse in Addis Ababa was high. Children age, sex, khat chewing, physical disability, mental illness, smoking, and alcohol use were factors associated with child sexual abuse. Children with mental illness and physical disabilities should be treated and supported with special attention.Keywords: child sexual abuse, associated factors, Addis Ababa, Ethiopia

Belayneh Kefale,1 Melaku Tadege Engidaw,2 Desalegn Tesfa,2 Mulugeta Molla,3 Malede Berihun Yismaw1 1Clinical Pharmacy Unit and Research Team, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia; 2Department of Social and Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia; 3Pharmacology and Toxicology Unit, Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, EthiopiaCorrespondence: Belayneh Kefale, Clinical Pharmacy and Research Unit, Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia, Email bkefale5@gmail.comIntroduction: In cervical cancer therapy, there is a high prevalence of drug-related problems (DRPs) due to the high toxicity and complexity of most antineoplastic regimens. However, there is a paucity of data about DRPs among patients with cervical cancer in Ethiopia. Hence, the present study was aimed at investigating management practices and DRPs among patients diagnosed with cervical cancer.Methods: A registry-based retrospective cohort study was employed among cervical cancer patients at the oncology center of Felege Hiwot Comprehensive Specialized Hospital (FHCSH). All patients with a histologically confirmed diagnosis of cervical cancer from January 2016 to December 2020 were included. Relevant information was recorded by reviewing medical records. The possibility of DRPs was evaluated by comparing with standard guidelines. Logistic regression analysis was employed.Results: A total of 184 cervical cancer patients were included, with a mean age of 50.2± 10.7 years. A total of 216 DRPs were identified from 93 cervical cancer patients, translating to a prevalence of 50.5% and a mean of 2.32± 1.11 DRPs per patient. ADR (27.3%), DDI (25%), and the need for additional drug therapy (22.2%) were the most prevalent DRPs. DRPs were associated with the presence of co-morbidity (AOR = 4.23, 95% CI = 1.78– 10.05, p = 0.001), complications (AOR = 2.99, 95% CI = 1.28– 6.99, p = 0.011), being treated with ≥ 5 medications (AOR = 5.1, 95% CI = 2.38– 10.95, p < 0.001), being stage II (AOR = 0.14, 95% CI = 0.02– 0.90, p = 0.038), and stage III (AOR = 0.04, 95% CI = 0.01– 0.32, p = 0.003).Conclusion: Cisplatin-based chemotherapy was the frequently used therapeutic option. Co-morbidity and complication status, number of medication and stage of cancer were significantly associated with DRPs. The study highlights the need of clinical pharmacy services to optimize drug therapy and reduce DRPs.Keywords: drug-related problems, cervical cancer, Felege Hiwot Comprehensive Specialized Hospital, Ethiopia

Asrat Wolde,1 Wadu Wolancho,2 Yeshitila Belay,2 Asamirew Alemu,3 Ashenaf Asefa,3 Tsehaye Gebremedhin3 1Department of Psychiatry, Mizan Tepi University, Mizan Aman, South West Regional State, Ethiopia; 2Department of Nursing, Jimma University, Jimma, Oromia Regional State, Ethiopia; 3Department of Nursing, Mizan-Tepi University, Mizan Aman, South West Regional State, EthiopiaCorrespondence: Asrat Wolde, Department of Psychiatry, Mizan Tepi University, Mizan Aman, South West Regional State, Ethiopia, Tel +251916389179, Email Asratwolde2017@gmail.comBackground: Elderly abuse and comorbid problematic substance use, disability, and physical and mental illness have been major problems in low-income countries. In most countries, the elderly are the most neglected segment of the population, and there is insufficient information about elderly abuse perpetration or victimization in low-income countries like Ethiopia. Therefore, this study was aimed to assess elderly abuse perpetration or victimization among the elderly in Mizan Aman town, southwest Ethiopia.Methods: A community-based cross-sectional study design was conducted among 268 elderly people from May to June, 2021, by using a systematic sampling technique. The elderly abuse and the ASSIST tools were used to assess the elderly abuse and khat, alcohol, cannabis, and tobacco use disorders, respectively. Moreover, multimorbidity and physical disability were also assessed. Data were entered into EpiData version 3.1 and exported to the Statistical Package for Social Science Version 23. A logistic regression model was used to identify independent predictors of elderly abuse.Results: The prevalence of elder abuse was 41.8%, and the prevalence of poly substance, alcohol, khat, and tobacco use disorder was 32.5%, 19.4%, 12%, and 4.5%, respectively. Besides, the comorbidity of physical disability and multiple chronic diseases was 8% and 24.6%, respectively. Moreover, physical disability (AOR = 5.652, CI = 1.459, 21.894), multimorbidity (AOR = 3.972, CI = 1.898, 8.314), substance use disorder (AOR = 3.877, CI = 1.814, 8.286), age above 80 years (AOR = 8.452, CI = 2.273, 31.425), and poor social support (AOR = 3.372, CI = 1.043, 10.903) were positively associated with elderly abuse.Conclusion: The magnitude of elder abuse and comorbid multimorbidity, physical disability, and substance use disorder was high, and having multiple chronic diseases, physical disability, substance use disorder, advanced age, and poor social support were risk factors for elderly abuse.Keywords: elderly abuse, perpetration, victimization, khat use disorder, physical disability, multimorbidity, Ethiopia

Amsalu Taye Wondemagegn,1 Abay Mulu2 1Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia; 2Department of Anatomy, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Amsalu Taye Wondemagegn, Department of Biomedical Sciences, School of Medicine, Debre Markos University, P.O. Box: 269, Debre Markos, Amhara Regional State, Ethiopia, Tel +251 921815441, Email 50amsalu@gmail.comIntroduction: Scientific evidence regarding relationships between developmental status and nutritional status of children aged under five years old is scarce, particularly in Africa. Thus, the objective of the present study is to evaluate the relationships between nutritional status and developmental status among children aged under five in Gojjam, Ethiopia.Methods: A cross-sectional study was conducted on 390 child–mother pairs from December 1– 30 2021. Developmental status, nutritional status and related data were collected using age and stage questionnaire 3rd edition (ASQ-3) and measurements of body dimensions and other physical characteristics. Body dimensions data was obtained by measurement of height and weight of children aged under five years. Logistic regression analysis was executed to identify factors related with poor child developmental status. Adjusted odds ratio (AOR) and 95% CI was estimated to reveal the strength of association and statistical significance were declared at p-value less than 5%.Results: The overall prevalence of developmental delay in the current study among under five years children was 22.6%. Moreover, in this study the prevalence of stunting, wasting and being underweight was 36.3%, 14.2% and 20.3%, respectively. Developmental delay among under-five children was significantly associated with experiencing repeated diseases during pregnancy (AOR: 2.43; 95% CI:1.38, 4.28), short birth interval (AOR: 2.78; 95% CI :1.52, 5.09), stunting (AOR: 2.61;95% CI: 1.41, 4.84), wasting (AOR: 3.68;95% CI: 1.61, 8.37) and being underweight (COR: 3.28;95% CI: 1.91, 5.63).Conclusion: The overall developmental delay prevalence among under-five children in the present study was 22.6%. The prevalence of stunting, wasting and being underweight was 36.3%, 14.2% and 20.3%, respectively. Maternal diseases, birth interval and nutritional status of children aged under five years were among the factors which revealed statistically significant associations with developmental delay of under-five children. We recommend the concerned body to work on improving maternal health status during pregnancy, to enable mothers to adequately space subsequent births, and to work on improving the nutritional status of women and children in the current study area in order to improve the developmental status of children aged under five.Keywords: child neurodevelopment, child developmental status, nutritional status, under-five children, Ethiopia

Kalid Seid, Tsehaye Gebremedhin Department of Nursing, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan, South West Ethiopia Peoples’ Region, EthiopiaCorrespondence: Kalid Seid, Department of Nursing, College of Medicine and Health Sciences, Mizan-Tepi University, PO Box 260, Mizan, South West Ethiopia Peoples’ Region, Ethiopia, Tel +251 92-831-7127, Email kalidseid7@gmail.comBackground: Diversity is a challenge and an opportunity, resulting in a change toward providing services suited to clients’ cultural needs and desires. Nurses working with culturally diverse populations face unique challenges because of the coexistence of diverse cultural and ethnic societies. Hence, the study’s purpose has been to evaluate the current state of cultural competence and the factors that influence it among nurses in Southwest Ethiopia.Methods: From December 1 to December 30, 2021, nurses at eight public healthcare facilities in southwest Ethiopia were enrolled in a facility-based cross-sectional study. Participants were selected using a simple random sampling. A self-administered questionnaire was used to collect the data. Epi data 4.1 was used to enter the data, and SPSS version 26 was used for analysis. To identify factors associated with cultural competence, bivariate and multivariable linear regression analyses were performed. The significance level was set at p < 0.05.Results: Two hundred thirty-seven nurses took part in the study, yielding an 86.1% response rate. The mean age was 28.83 years (standard deviation = ± 5.48). The mean cultural competence score among healthcare professionals was 1.95 ± 0.32. Marital status (p < 0.05) and the use of healthcare interpreters (p < 0.05) were significantly associated with cultural competence.Conclusion: Nurses had a low level of cultural competence. Cultural competence varies according to a number of factors, including marital status and the use of healthcare interpreters. Nurses are better suited to focus on the ethnic diversity of their patients, which necessitates the provision of cultural competence training for nurses.Keywords: culture, cultural competence, ethnic diversity, nurses, Ethiopia

Alelgne Feleke,1 Metadel Adane,1 Asha Embrandiri,1 Gete Berihun,1 Zebader Walle,2 Awoke Keleb,1 Helmut Kloos3 1Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USACorrespondence: Alelgne Feleke; Metadel Adane, Email alelgnefe@gmail.com; metadel.adane2@gmail.comBackground: Knowledge, attitudes, and misconceptions of students about COVID-19 (coronavirus disease) prevention have been examined in relatively few studies. This study aimed to assess the knowledge, attitudes and misconceptions about COVID-19 prevention practices among high and preparatory school (grades 9 to 12) students in Dessie City, Ethiopia.Methods: This school-based cross-sectional study used a pre-tested structured questionnaire and direct observations from March 1 to 30, 2021 in 5 high and preparatory school students in Dessie City, Ethiopia. The sample size was proportionally allocated in each school based on the number of students registered in the first semester, stratified by grade level, and section. Data analysis employed 3 binary logistic regression models (Models I, II and III) with 95% CI (confidence interval). Bivariate analysis (crude odds ratio [COR]) and multivariable analysis (adjusted odds ratio [AOR]) were used. Variables with P-values < 0.3 in the bivariate analysis were retained in the multivariable logistic regression analysis for each model. Variables with significance levels P< 0.05 in the multivariable analysis of each model was identified as significant factors.Results: The levels of good knowledge, positive attitudes, and low misconceptions were 74.8%, 60.2%, and 56.1%, respectively. After adjusting for the covariates, grade 12, positive attitude and living in households with more than 5 members were identified as factors significantly associated with good knowledge about COVID-19 prevention practices. Good knowledge of COVID-19 prevention practices, household size > 5, infection prevention and control (IPC) training, and low level of misconceptions were factors significantly associated with positive attitudes, whereas students age ≥ 18 years, positive attitude, and IPC training were factors significantly associated with less misconceptions about COVID-19 prevention measures.Conclusion: The prevalence of good knowledge, positive attitude, and low level of misconceptions of prevention practices for COVID-19 among students was relatively low. Therefore, Dessie City Health and Education Department and each high and preparatory school should implement continuous monitoring programs to ensure high prevention awareness and promote preventive behavior towards COVID-19.Keywords: COVID-19, knowledge, attitudes, misconceptions, high and preparatory school, students, Dessie City, Ethiopia

Mulusew Andualem Asemahagn School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaCorrespondence: Mulusew Andualem Asemahagn, Email muler.hi@gmail.comBackground: Tuberculosis (TB) remains one of the top health problems in Ethiopia, and over one-third of estimated TB cases remain undetected. This study examined the magnitude and factors of missed opportunities for TB investigation at public health facilities in Northwest Ethiopia.Methods: A facility-based cross-sectional study was conducted among 412 adult patients with TB symptoms from 34 randomly selected public health facilities. Data on socio-demographics, TB symptoms, and clinical status were collected by an exit interview. A patient was considered missed for TB investigation if he/she had at least one symptom suggestive of TB but did not receive a sputum smear and/or x-ray evaluation to rule out TB. We computed descriptive and analytical statistics using SPSS version 26. A negative binomial regression analysis was used to identify factors associated with missed opportunities for TB investigation. Statistical significance was determined at a p-value less than 0.05.Results: A total of 412 presumptive TB patients, 235 (57%) females and 247 (60%) rural dwellers were interviewed. The mean age of respondents was 35 ± 8 years and 228 (55.3%) were from health centers. Over two-thirds, 284 (69%) were new patients, 62 (15%) were HIV positive and 78 (19%) had diabetes mellitus (DM). Fifty patients with symptoms suggestive of TB did not receive sputum evaluation services. Inability to read and write, having DM, having normal body mass index and facility type they visited were significant factors to missing opportunities to get TB investigations.Conclusion: A significant number of patients with symptoms suggestive of TB were missed for sputum evaluation to rule out TB. Education level, comorbidity, nutritional status and type of facility patients attended were factors of missing opportunities for TB investigation. Thus, improving quality of TB diagnosis, screening TB among all types of patients, and paying attention to screen illiterate people are crucial to avoid missing potential TB cases.Keywords: TB, missed investigation, factors, patients, public health facilities, Ethiopia

Zinash Adal,1 Gamechu Atomsa,1 Gemechu Tulu2 1School of Nursing, Faculty of Health Science, Jimma Institute of Health, Jimma University, Jimma, Ethiopia; 2Kuyu General Hospital, Oromia Regional Health Bureau, Oromia, EthiopiaCorrespondence: Gemechu Tulu, Kuyu General Hospital, Oromia Regional Health Bureau, Gerba Guracha, Ethiopia, Tel +251-901-142-299, Email gemechutul@gmail.comBackground: Patient satisfaction is an important aspect of the quality of care in the inpatient setting. In neonatal intensive care units (NICUs), parent satisfaction and their experiences are fundamental to assessing clinical practice and improving the quality of care delivered to infants and parents. In developing countries like Ethiopia, the satisfaction of parents of neonates requiring intensive care is often overlooked. Thus, the study aimed to assess parental satisfaction with neonatal intensive care unit services and associated factors.Methods: A hospital-based, cross-sectional study was conducted at Jimma University Medical Center from July to August, 2021. Parents of admitted newborn infants were selected by convenience sampling. Data were collected using a structured questionnaire adapted from Empowerment of Parents in Intensive Care (EMPATHIC). Data were entered into Epidata 4.6 and exported into SPSS Version 25 for analysis. Bi-variable and multivariable logistic regression analyses were used to identify factors associated with parental satisfaction.Results: Of 122 eligible parents, 114 (93.5%) participated. Parental satisfaction with NICU services was 57.9% [95% CI: (49.1%, 66.7%)]. More than half (60.5%) of the parents responded that their baby gets better care in the incubator/bed. Compassionate and respectful care [AOR = 5.88, 95% CI: (2.19– 15.78)] was significantly associated with parental satisfaction.Conclusion: A sizable proportion of the parents was not satisfied with the services of the neonatal intensive care unit at Jimma Medical Centre. Compassionate and respectful care is associated with parental satisfaction. The results of this study support strengthening a culture of family-centered care via compassionate and respectful care.Keywords: Jimma Medical Center, parental satisfaction, neonatal intensive care unit, Ethiopia

Introduction: Respiratory Distress Syndrome (RDS) is a frequent neonatal emergency worldwide. The prevalence varies with gestational age (GA) being higher among preterm babies. Preterm birth is the world’s primary cause of newborn deaths and RDS is the leading cause of death in premature infants, including in Ethiopia. Objectives: To identify the determinant factors of the immediate outcomes of RDS in the neonatal intensive care unit (NICU), University of Gondar Specialized and Comprehensive Hospital (UoGSCH). Method: A hospital-based prospective descriptive analytical cross-sectional study was conducted from February to September 2020. Results: A total of 162 neonates were enrolled; there were 87 (53.7%) males and 75 (46.3%) females. Of these 106 (65.4%) were discharged with improvement, 4 (2.5%) discharged with complications, and 52 (32.0%) died; 50% of deaths occurred within the first 24 hours of age. The odds of mortality for those admitted below 6 hours of age was 6.14 times higher (AOR=6.14, 95% CI:1.63 23.03) than those admitted aged 6 hours and above. Babies born to primiparous mothers were more than twice as likely to die (AOR=2.49, 95% CI:1.05 5.87) than babies born to multiparous mothers. Neonates who were delivered in other facilities had 3.78 times increased odds of mortality (AOR=3.78, 95% CI: 1.23 11.57). Conclusion: Age at admission, site of referral, parity and gestational age (GA) had a significant association with neonatal mortality due to RDS.

This study was conducted to assess the causes, experience and Mitigating mechanism of school dropout among primary school students in Benchi-Maji zone Shey Bench Wereda. The study mainly attempted to answer research questions like the major reason that leads students' to drop out, the experiences of dropouts while they were out of school and mitigating mechanism of school dropout. The study adopted a qualitative research approach, and non-probability sampling techniques were used to identify participants of the study. An in-depth interview and focus group discussions are utilized as the main tools of data collection. Interviews were conducted with key informants like homeroom teachers, principal's parents, and students. Thirty-three (33) participants were involved in an interview, and three focus group discussion is comprising 10 participants in each group were conducted accordingly. Generally, data were collected from 63 purposively sampled participants. The researcher transcribed the notes taken while having an interview and FGD with children's (students), teachers and parents. The transcription, which is written in the Amharic language was translated to English as accurately as possible and presented in a narrative way through thematic analysis. Poverty, the absence of motivation and interest, peer pressure and school-related difficulties were identified as the main cause of school dropout. With regard to the experience of dropouts, the majority of dropouts engaged in helping families, leave the area in search of jobs and create different work opportunities to deal with life. In addition working with financial aid organizations, GOs, NGOs, eliminating illiteracy of the society through awareness creation programs, developing a good interpersonal relationship with students, a participating community in educational programs are among major mechanisms identified by stakeholders as a mitigating mechanism of school dropout. Finally based on the findings, conclusions and recommendations were made.

Background: With the largest cattle population in Africa and vast swathes of fertile lands infested by tsetse flies, trypanosomosis is a major challenge for Ethiopian farmers. Managing the problem strategically and rationally requires comprehensive and detailed information on disease and vector distribution at the national level. To this end, the National Institute for Control and Eradication of Tsetse and Trypanosomosis (NICETT) developed a national atlas of tsetse and African animal trypanosomosis (AAT) for Ethiopia. Methods: This first edition of the atlas focused on the tsetse-infested areas in western Ethiopia. Data were collected between 2010 and 2019 in the framework of national surveillance and control activities. Over 88,000 animals, mostly cattle, were tested with the buffy-coat technique (BCT). Odour-enhanced traps were deployed in approximately 14,500 locations for the entomological surveys. Animal- and trap-level data were geo-referenced, harmonized and centralized in a single database. Results: AAT occurrence was confirmed in 86% of the districts surveyed (107/124). An overall prevalence of 4.8% was detected by BCT in cattle. The mean packed cell volume (PCV) of positive animals was 22.4, compared to 26.1 of the negative. Trypanosoma congolense was responsible for 61.9% of infections, T. vivax for 35.9% and T. brucei for 1.7%. Four tsetse species were found to have a wide geographic distribution. The highest apparent density (AD) was reported for Glossina pallidipes in the Southern Nations, Nationalities and People's Region (SNNPR) (3.57 flies/trap/day). Glossina tachinoides was the most abundant in Amhara (AD 2.39), Benishangul-Gumuz (2.38), Gambela (1.16) and Oromia (0.94) regions. Glossina fuscipes fuscipes and G. morsitans submorsitans were detected at lower densities (0.19 and 0.42 respectively). Only one specimen of G. longipennis was captured. Conclusions: The atlas establishes a reference for the distribution of tsetse and AAT in Ethiopia. It also provides crucial evidence to plan surveillance and monitor control activities at the national level. Future work on the atlas will focus on the inclusion of data collected by other stakeholders, the broadening of the coverage to tsetse-free areas and continuous updates. The extension of the atlas to data on control activities is also envisaged. [ABSTRACT FROM AUTHOR]

Gezahegn Terefe Atnafu,1 Nurilign Abebe Moges,2 Moges Wubie,2 Getnet Gedif2 1Anti-Retroviral Treatment Clinic, Dembecha Health Center, Dembecha, Amhara Region, Ethiopia; 2Department of Public Health, Debre Markos University, Debre Markos, Amhara Region, EthiopiaCorrespondence: Getnet GedifDepartment of Public Health, Debre Markos University, P.O.Box: 251-269, Debre Markos, Amhara Region, EthiopiaTel +251-58-771-4281Fax +251-58-771-1764Email get4ged@gmail.comBackground: Viral load suppression among people living with HIV is the main goal of antiretroviral therapy (ART). The most cause for high viral load is poor adherence to ART. World Health Organization (WHO) recommends intensive enhanced adherence counseling for people with a high viral load, which is greater or equal to 1000 RNA copies per mL and at least on treatment for six months. However, little is known about the outcome of enhanced adherence counseling. The study aimed to assess the incidence of viral load suppression after enhanced adherence counseling and its predictors among HIV-positive adults in high caseload health facilities in the Amhara region, Ethiopia.Methods: An institution-based retrospective follow-up study was employed among 346 HIV-positive adults enrolled in enhanced adherence counseling in a high caseload health facility in the West Gojjam zone from June 2016 to June 2020. The data on relevant variables were collected from the patient’s medical cards by trained data collectors. The collected data were entered into EpiData version 3.1 and then exported to Stata version 14 for analysis. Descriptive analysis was performed to describe the variables. Cox proportional regression model was used to identify independent predictors of viral load suppression after enhanced adherence counseling.Results: Overall, 51.73% of the study participants achieved viral load suppression after enhanced adherence counseling. The incidence of viral load suppression rate was 11.17 per 100-person month. During the multivariate analysis, it was observed that being female (AHR = 1.50, 95% CI: 1.05– 2.15), CD4 count of greater than or equal to 350 cells/mm3 (AHR = 1.98, 95% CI: 1.12– 3.51) and no recurrent OI (AHR = 1.85, 95% CI: 1.06– 3.24) were an independent predictor of viral load suppression after enhanced adherence counseling.Conclusion: Incidence of viral load suppression rate was still far from the WHO target (70%). Therefore, higher priority should be given to patients with low CD4 counts with improved enhanced management of opportunistic infections.Keywords: HIV/AIDS, antiretroviral therapy, viral load suppression, predictors, enhanced adherence counseling, Ethiopia

Hailemichael Kindie Abate, Chilot Kassa Mekonnen, Yohannes Mulu Ferede Department Medical Nursing, University of Gondar, Gondar, EthiopiaCorrespondence: Hailemichael Kindie Abate Email haile206k@gmail.comBackground: Depression is the most common mental health disorder among HIV-positive pregnant mothers, which increases mortality, poor quality of life; it also increases the burden of disease. Depression hurts birth outcomes and maternal health.Objective: To assess depression and its associated factors among HIV-positive pregnant women attending antenatal care at Northwest Amhara referral hospitals, 2021.Methods: An institution-based cross-sectional study was conducted among 291 HIV-positive pregnant mothers from March 15, 2021 to April 30, 2021 at Northwest Amhara referral hospitals. Census was applied to reach the study participants. An interviewer-administered questionnaire was used for data collection. A binary logistic regression was conducted to see the relationship between dependent variables and independent. Those variables having a p-value of ≤ 0.05 were found to be statistically associated with the response.Results: Depression among HIV-positive pregnant women was found to be 28.7% [95% CI (24.8– 33.40)] with a response rate of 96.04. Age ≥ 30 years [AOR = 1.32, 95% CI (1.24– 3.35)], urban residency [AOR = 1.76, 95% CI (1.57– 4.61)], having first pregnancy < 18 years [AOR = 3.82, 95% CI (1.54– 17.34)], known HIV serostatus during pregnancy [AOR = 1.29, 95% CI (1.08– 2.47)], and COVID-19-related knowledge [AOR = 0.32, 95% CI (0.12– 1.12) were significantly associated with depression.Conclusions and Recommendations: Nearly one-third of the pregnant women attending antenatal care were depressed. The age of the mother, residence, known HIV serostatus during pregnancy, age in the first pregnancy, and COVID-19-related knowledge were significantly associated with depression, and strengthening the existing care provided was the recalled interventions to combat antenatal depression during the COVID-19 pandemic.Keywords: COVID-19, depression, prevalence, HIV positive mothers, pregnancy, referral hospitals, Ethiopia

Aklilu Tekeba,1 Yohanes Ayele,2 Belay Negash,3 Tigist Gashaw4 1Micheta Community Pharmacy, Daro Lebu Health Office, West Harerghe, Ethiopia; 2Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Hawassa University, Hawassa, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4Department of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, EthiopiaCorrespondence: Tigist GashawDepartment of Pharmacology and Toxicology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, PO Box 235, Harar, EthiopiaTel +251-91-202-7244Fax +256668081Email yekalabel@gmail.comBackground: Self-medication is one aspect of self-care that has been shown to benefit primary health care. When done correctly, it provides significant benefits to customers, such as self-reliance and cost savings. Inappropriate methods, on the other hand, such as incorrect self-diagnosis and therapy selection, can be disastrous. The COVID-19 pandemic context may benefit the community in easing the burden on the health system. There have been no studies conducted on this possibility in the context of COVID-19 in a selected area, hence the purpose of this study was to determine the extent of and factors associated with self-medication among clients visiting community pharmacies in west Harerghe, Ethiopia from June 1 to 30, 2020.Methods: This institution-based cross-sectional study used a systemic random sample of 416 community-pharmacy clients. To collect data, face-to-face interviews were conducted using pretested semistructured questionnaires modified from established techniques. EpiData 3.1 was used to enter data and SPSS 24 for analysis. To determine factors associated with self-medications, bivariate and multivariate logistic regression analyses were performed. AORs with 95% CIs are used to report associations, and the level of significance was set at P< 0.05.Results: The proportion of people self-medicating was 73.6% (95% CI 69.2%– 77.9%). Self-medications were significantly associated with age 18– 24 years (AOR 9.28, 95% CI 3.56– 24.21) and 25– 34 years (AOR 3.54, 95% CI 1.35– 9.27), Amhara ethnicity (AOR 1.72, 95% CI 1.01– 2.94), current single status (AOR 0.28, 95% CI 0.15– 0.51), government employment (AOR 0.31, 95% CI 0.12– 0.82), and limited knowledge (AOR 2.31, 95% CI 1.40– 3.79).Conclusion: Three in four participants practiced self-medication in the era of COVID-19. Repetition was significantly associated with age, ethnicity, current marital status, type of occupation, and knowledge about self-medications. An alternative medical care–delivery system by all health-care providers and increasing community awareness should be promoted.Keywords: self-medication, community pharmacy, COVID-19, Ethiopia

Mohammed Gebre,1 Nigatu Addisu,2 Ayantu Getahun,3 Jenber Workye,4 Busha Gamachu,5 Ginenus Fekadu,5 Tesfa Tekle,5 Bizuneh Wakuma,6 Getahun Fetensa,6 Balisa Mosisa,5 Getu Bayisa7 1Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Pharmacy, College of Health and Medical Sciences, Dilla University, Dilla, Ethiopia; 3Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 4Department of Pharmacy, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia; 5Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 6Department of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 7Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaCorrespondence: Mohammed Gebre Email mohammed.gebre@aau.edu.etPurpose: A high prevalence of medication errors in older adults are due to a combination of different factors such as polypharmacy, polymorbidity, enrolment in several disease-management programs, and fragmentation of care that causes medication errors in all age groups. This study aims to assess the incidence and determinants of medication errors among hospitalized adults in medical wards of Nekemte Specialized Hospital (NSH), West Ethiopia.Patients and Methods: A prospective observational study design was conducted at Nekemte Specialized Hospital among hospitalized adults from October 30, 2018 to January 30, 2019. Data were collected by using checklist-guided observation and review of medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, logistic regression analysis was used. Statistical significance was considered at a p-value < 0.05.Results: A total of 351 patients were included in the present study. The mean age of the patients was 40.67+15.78 years. A total of 813 medication errors were recorded. The most common stage for medication errors was physician ordering 263 (32.4%). In the multivariable analysis, age ≥ 65 years (AOR: 2.54, 95%CI: 1.12– 5.75, p=0.025), hospital stay ≥ 7 days (AOR: 2.16, 95%CI: 1.17– 3.98, p=0.014), number of medication taken (AOR: 1.75, 95%CI: 1.13– 2.73, p=0.013) and presence of comorbidity (AOR: 1.57, 95%CI: 1.01– 2.46, p=0.049) had shown statistical significance in predicting medication errors.Conclusion: Medication errors are common at Nekemte Specialized Hospital with an incidence of 48.3 per 100 orders, 231.6 per 100 admissions, and 433.4 per 1000 patient days. In particular, adults with older age, increased hospital stay, a greater number of medications, and presence of comorbidities were at greater risk for medication errors.Keywords: medication error, incidence, determinants, adults, Ethiopia

Erdaw Tachbele,1,2 Samuel Kyobe,3 Fred Ashaba Katabazi,3 Edgar Kigozi,3 Savannah Mwesigwa,3 Moses Joloba,3 Alebachew Messele,1 Wondwossen Amogne,2 Mengistu Legesse,1 Rembert Pieper,4 Gobena Ameni1 1Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia; 2College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3College of Health Sciences, Makerere University, Kampala, Uganda; 4Janssen Biopharma, South San Francisco, CA, USACorrespondence: Erdaw Tachbele Tel +251 911642880Email erdawt@yahoo.comPurpose: This study was conducted to investigate the drug resistance mutations and genetic diversity of HIV-1 in ART experienced patients in South Omo, Ethiopia.Patients and Methods: A cross-sectional study conducted on 253 adult patients attending ART clinics for ≥ 6 months in South Omo. Samples with VL ≥ 1000 copies/mL were considered as virological failures (VF) and their reverse transcriptase gene codons 90– 234 were sequenced using Illumina MiSeq. MinVar was used for the identification of the subtypes and drug resistance mutations. Phylogenetic tree was constructed by neighbor-joining method using the maximum likelihood model.Results: The median duration of ART was 51 months and 18.6% (47/253) of the patients exhibited VF. Of 47 viraemic patients, the genome of 41 were sequenced and subtype C was dominant (87.8%) followed by recombinant subtype BC (4.9%), M-09-CPX (4.9) and BF1 (2.4%). Of 41 genotyped subjects, 85.4% (35/41) had at least one ADR mutation. Eighty-one percent (33/41) of viraemic patients harbored NRTI resistance mutations, and 48.8% (20/41) were positive for NNRTI resistance mutations, with 43.9% dual resistance mutations. Among NRTI resistance mutations, M184V (73.2%), K219Q (63.4%) and T215 (56.1%) complex were the most mutated positions, while the most common NNRTI resistance mutations were K103N (24.4%), K101E, P225H and V108I 7.5% each. Active tuberculosis (aOR=13, 95% CI= 3.46– 29.69), immunological failure (aOR=3.61, 95% CI=1.26– 10.39), opportunistic infections (aOR=8.39, 95% CI= 1.75– 40.19), and poor adherence were significantly associated with virological failure, while rural residence (aOR 2.37; 95% CI: 1.62– 9.10, P= 0.05), immunological failures (aOR 2.37; 95% CI: 1.62– 9.10, P= 0.05) and high viral load (aOR 16; 95% CI: 5.35 51.59, P < 0.001) were predictors of ADR mutation among the ART experienced and viraemic study subjects.Conclusion: The study revealed considerable prevalence of VF and ADR mutation with the associated risk indicators. Regular virological monitoring and drug resistance genotyping methods should be implemented for better ART treatment outcomes of the nation.Keywords: HIV-1, genetic diversity, acquired drug resistance, ART experienced, South Omo, Ethiopia

Deresse Daka,1,2 Getahun Hailemeskel,1,2 Demissie Assegu Fenta2 1School of Medical Laboratory Science, College of Medicine and Health Science, Hawassa University, Hawassa, Sidama, Ethiopia; 2Department of Medical Laboratory, Comprehensive Specialized Hospital, College of Medicine and Health Science Hawassa University, Hawassa, Sidama, EthiopiaCorrespondence: Demissie Assegu FentaSchool of Medical Laboratory Science, College of Medicine and Health Science, Hawassa University, P. O. Box: 1560, Hawassa, Sidama, EthiopiaTel +251 911 02 01 89Fax +251 462 12 21 22Email demissieasegu@yahoo.comBackground: Female sex workers (FSWs) are a marginalized group having limited healthcare access and poor-quality care. Inevitably, they are vulnerable to sexually transmitted infections including hepatitis B virus. It is one of the most serious and major public health problems, with an increased risk of transmission and acquisition of the infection. Hence, this study was aimed to assess the prevalence and associated factors of HBV infection among FSWs in southern Ethiopia.Methods: A cross-sectional study was conducted from November to February 2019 at Hawassa city among ISHDO confidential clinics among 383 FSWs using respondent-driven consecutive sampling techniques to select study participants using a standardized questionnaire. The blood samples were collected to detect viral surface antigen using ELISA. Data were entered into SPSS version 21. Descriptive and logistic regression analysis was used.Results: The overall prevalence of HBV was 35 (9.2%) (95% CI=6.3– 12.1). Among 381 FSWs, 249 (65.4%) of them had stayed for 2– 5 years in sexual work. A total of 240 (63%) of them used condoms consistently during sexual practice. In multivariate analysis, FSWs who did not use a condom during sexual practice were 6-times more at risk than those who used a condom (AOR=6.38, CI=2.04– 18.51). Condom breakage (AOR=2.10, CI=1.95– 4.65), use of stimulants (AOR=3.25, CI=1.59– 18.63), history of STI (AOR=2.15, CI=1.02– 6.93), and genital ulcer (AOR=4.64, CI=1.31– 11.35), number of sexual partners (AOR=3.25, CI=1.59– 7.47), sex during menses (AOR=5.85, CI=1.29– 21.44), sexual assault (AOR=2.93, CI=1.23– 9.01), sharp material sharing (AOR=4.98, CI=1.34– 10.95), and history of abortion (AOR=2.46, CI=1.18– 12.19) were statistically associated with HBV infection.Conclusion: The prevalence of HBV infection in this study was relatively high compared to the general population. Factors like sociodemographic, behavioral, and previous information were associated with HBV infection. There is a need for ongoing screening of this high-risk population to inform planning for vaccination and preventive measures.Keywords: hepatitis B virus, female sex workers, Hawassa, Ethiopia

Hiluf Maldey,1 Sumeya Tadesse,2 Adugnaw Zeleke Alem,3 Haftamu Mamo Hagezom,4 Zenawi Hagos Gufue5 1Department of Clinical Pharmacy, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 2Department of Clinical Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Psychiatry, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 5Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, EthiopiaCorrespondence: Hiluf Maldey Email redaemaldey354@gmail.comPurpose: To determine the time to euthyroidism and its determinants among thyrotoxicosis patients on anti-thyroid drug attending the medical and ambulatory clinics of South Tigrai General Hospitals, Ethiopia, 2015– 2020.Methods: A multi-center retrospective cohort study was conducted from March 30, 2020, to July 30, 2020, among adult thyrotoxicosis patients who received anti-thyroid medications in the medical and chronic ambulatory clinics of South Tigrai General Hospitals, Ethiopia. Epi-data manager version 3.1 software was used for data entry and then exported to STATA version 15 for windows for analysis. Cox proportional hazards regression model was used to determine the determinants of time to euthyroidism and the summary measures of the adjusted hazard ratio with a 95% CI were presented, and P-value < 0.05 used to declare the statistical significance.Results: One hundred and seventy-five (51.9%) thyrotoxicosis patients become euthyroid with the median time to euthyroidism of 9 months, IQR (6– 12) months, with a total of 5542 person-months of observation. Age greater than 40 years (AHR = 0.7; 95% CI 0.54– 0.96), toxic multi-nodular goiter (AHR = 0.69; 95% CI 0.60– 0.87), World Health Organization goiter size three (AHR = 0.78; 95% CI 0.54– 0.82) and baseline free thyroxin (AHR = 0.96; 95% CI 0.80– 0.99) were the independent determinants of delayed time to euthyroidism.Conclusion: The time to euthyroidism was longer than the expected time. High baseline free thyroxin, toxic multinodular goiter, elderly patients, and patients with World Health Organization goiter size three were determinants of delayed time to euthyroidism.Keywords: thyrotoxicosis, propylthiouracil, euthyroid, South Tigrai, Ethiopia