Ethnoveterinary medicinal plants and their utilization by indigenous and local communities of Dugda District, Central Rift Valley, Ethiopia.

BACKGROUND: Ethnoveterinary medicinal plants have been used by the people of Dugda District in the primary health care system to treat various livestock ailments for generations, particularly, in underserved rural areas. However, these ethnoveterinary practices and medicinal plants are dwindling without proper documentation, due to undergoing socio-cultural and environmental changes. Hence, this study aimed at inventory and analysis of ethnoveterinary medicinal plants and the associated indigenous and local knowledge used in the treatment of livestock health problems in Dugda District. METHODS: Data were collected from 378 local inhabitants through semi-structured interviews, 18 focus group discussions with 6 to 8 participants in each couple with participant field observations. Informant consensus factor (ICF), fidelity-level (FL) and relative importance value (RI) were used to evaluate the agreement of informants on ethnoveterinary practices, healing potential of medicinal plants and the most multipurpose species. Using standard taxonomic procedures, voucher specimens were collected, identified and deposited at the National Herbarium of Addis Ababa University. RESULTS: In total, 64 medicinal plants of ethnoveterinary uses, belonging to 33 families were reported to treat 37 livestock health problems. Anthrax, inappetence and diarrhoea were said to be the most prevalent veterinary health problems treated by traditional medicinal plants. Family Fabaceae was the most widely reported (7 spp.), followed by Apocynaceae, Cucurbitaceae and Solanaceae (5 spp. each). Herbs were the dominant life forms (21spp.), followed by shrubs (20 spp.). The most commonly sought plant parts were leaves (55.25%), followed by roots (23.44%). The principal method of preparation was pounding remedial parts (46.85%) and mixing with cold water. The main route of administration was via oral application (72.67%), drenching diseased livestock. Withania somnifera and Kedrostis foetidissima were the most cited medicinal plants with 53 and 43 use reports (URs), respectively. ICF showed that respiratory diseases scored the highest value (0.94), while most of the reported medicinal plants were gastrointestinal agents. RI value analysis revealed that Croton macrostachyus had highest diversity of uses, followed by K. foetidissima and W. somnifera. Ethnoveterinary uses of some medicinal plants such as Phytolacca dodecandra, Calpurnia aurea, Cyphostemma cyphopetalum and Verbascum sinaiticum as prophylaxis against rabies were a new input for ethnoveterinary database. CONCLUSION: The study revealed that the people of the Dugda District are endowed with rich ethnoveterinary knowledge and medicinal plants. However, ethnoveterinary knowledge associated with medicinal plant species significantly differ (P < 0.05) between general and key informants, young and matured age groups and informants' educational level. This infers the impact of mode of ethnoveterinary knowledge transfer, literacy, modern education and globalization on ethnoveterinary uses of medicinal plant species. And also most of the medicinal plants are found in wild habitats with nearly no conservation attention. Therefore, it is imperative to implement participatory conservation actions for medicinal plants in collaboration with traditional institutions (Gada system). The disparity of ethnoveterinary knowledge could be also minimized through awareness creation among local communities about the knowledge and its revitalization. Furthermore, medicinal plants, which are widely utilized and multipurpose, should be screened for their phytochemicals, pharmacological and toxicological activities to confirm ethnoveterinary uses and for future development of veterinary pharmaceuticals.

Prevalence and associated factors of herbal medicine use among patients living with chronic disease in Ethiopia: A systematic review and meta-analysis.

Background: Complementary use of medicinal plants with prescribed drugs is becoming more widespread concern among people with chronic disease like cancer, HIV/AIDS, diabetes and hypertension. Consequently, the purpose of this review was to determine the prevalence and associated factors of herbal medicine use among patients suffering from chronic disease. Methods: This systematic review and meta-analysis was conducted by searching articles from Cochrane library, Google scholar, PubMed and African journal online. Data was extracted using Microsoft excel format and imported in to Stata software version 11 (Stata Corp LLC, TX, USA) for analysis. Statistical heterogeneity across the studies was investigated using Cochran's Q chi-square test at the significance level of <0.05 and the I2 index. A random-effects model was used to estimate the pooled prevalence of herbal medicine use. Results: Our systematic search yielded a total of 17,665 records from four databases (Google scholar (12,800), PubMed (3835), Cochrane library (30) and African journal online (12). The pooled estimate of herbal medicine use among patients with chronic disease in Ethiopia is found to be 56.94% (95% CI: 49.75, 64.12, P < 0.001). Being female (POR = 2.06, 95% CI = 1.55, 2.75, I2 = 10.0%), rural residence (POR = 2.80, 95% CI = 1.42, 5.52, I2 = 89.1%), duration of the disease greater than 5 years (POR = 6.42, 95% CI = 4.188, 9.84, I2 = 48.3%) and having complication (POR = 4.65, 95% CI = 3.75, 5.77, I2 = 0.0%) were factors associated with herbal medicine use among patients living with chronic disease. Conclusion: The study found a high prevalence of herbal medicine use among patients living with chronic disease. Being female, rural residence, duration of disease greater than 5 years and having complication were factors that are significantly associated with herbal medicine use. The prevalence of herbal medicine use among persons with chronic disease in Ethiopia presents significant implications for healthcare practice. Healthcare professionals need to adopt a patient-centered strategy that promotes open, judgment-free discussions about herbal medicine usage. Prospero registration: CRD42024498817.

Immediate postpartum anemia and associated factors at shewarobit health facilities, Amhara, Ethiopia, 2022: a cross sectional study.

BACKGROUND: Immediate postpartum anemia occurs when the amount of red blood cell count is reduced or hemoglobin concentration is below 10 g/dl in the immediate postpartum. It occurs primarily due to inadequate iron intake before and during pregnancy and blood loss during delivery. The aim of this study is to assess the proportion of immediate postpartum anemia and associated factors among mothers who gave birth at Shewarobit health facilities; in Amhara, Ethiopia. METHODS: Institutional-based cross-sectional study was conducted from June to September 2022. A systematic random sampling method was employed to select the study participants. The data were collected through interviewer-assisted questions. Data were entered into Epi Data software version 4.6.0.4 and exported to SPSS 21 for analysis, and descriptive statistics were computed. Logistic regression was applied, and P-values less than 0.05 were considered statistically significant. RESULTS: This study was conducted among 307 study participants and, the proportion of immediate postpartum anemia was 41.4% [95% CI: 36.7-46.6]. Having postpartum hemorrhage [AOR = 4.76, 95% CI: 2.44-9.28], not taking iron and folic acid supplementation [AOR = 6.19, 95% CI: 2.69, 14.22], having a prolonged second stage of labor [AOR = 2.52, 95% CI: 1.16-5.44], and mid-upper arm circumference < 23 cm [AOR = 2.02, 95% CI: 1.11-3.68] were factors significantly associated with immediate postpartum anemia. CONCLUSIONS: The proportion of immediate postpartum anemia was public problem in Shewarobit health facilities. Following the progress of labor using a partograph, closely monitoring and immediate intervention of PPH, and prevent undernutrition during antenatal care is recommended.

Traditional ethnobotanical knowledge and ethnomedicinal use of plants in the Tropical Rift Valley of Ethiopia.

Introduction: A wide range of floral resources are used in Ethiopia for primary healthcare. Unfortunately, due to inadequate documentation and the fact that they were verbally passed down from one generation to the next, these indigenous medicinal practices are being forgotten. The study's goal was to identify and record indigenous peoples' traditional knowledge of plant usage in the Abala Abaya District of Wolaita, Ethiopia. Methods: The collection of ethnobotanical data used a cross-sectional research design involving focus group discussions and semistructured questionnaires between January 2021 and April 2022. From each selected kebele (ward; smallest administrative unit), 50 informants (a total of 200) were selected as representative sample using a systematic random sampling technique. Results: More than 50 different human and animal illnesses have been documented to be treated by seventy-two species of plants grouped in thirty-two families. The most abundant families were Poaceae and Asteraceae (8 taxa in each). The two most often used plant parts were leaf (29%) and herbs (54%), respectively. Oral administration was the most typical mode of delivery (75%). For treating stomachache in the category of gastrointestinal illnesses, Hagenia abyssinica (Bruce) J.F.Gmel got the greatest fidelity level scores (FL = 100%). Conclusions: In Abala Abaya District, there is broad access to traditional medicinal plants that can treat ailments in both humans and animals. This study, therefore, might be a baseline piece of information for further botanical related studies in the region. Plants with the highest FL values are highly recommended for novel drug discovery.

Clinical presentation and management outcome of pediatric intussusception at Wolaita Sodo University Comprehensive Specialized Hospital: a retrospective cross-sectional study.

OBJECTIVE: To assess the pattern of clinical presentations and factors associated with the management outcome of pediatric intussusception among children treated at Wolaita Sodo University Comprehensive Specialized Hospital, Ethiopia. METHODS: This retrospective cross-sectional study included the medical records of 103 children treated for intussusception from 2018 to 2020. The data collected were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, USA). RESULTS: In total, 84 (81.6%) patients were released with a favorable outcome. Ileocolic intussusception was a positive predictor, with a nine-fold higher likelihood of a favorable outcome than other types of intussusception [adjusted odds ratio (AOR), 9.16; 95% confidence interval (CI), 2.39-21.2]. Additionally, a favorable outcome was three times more likely in patients who did than did not undergo manual reduction (AOR, 3.08; 95% CI, 3.05-5.48). Patients aged <1 year were 96% less likely to have a positive outcome than those aged >4 years (AOR, 0.04; 95% CI, 0.03-0.57). CONCLUSION: Most patients were discharged with favorable outcomes. Having ileocolic intussusception and undergoing manual reduction were associated with significantly more favorable outcomes of pediatric intussusception. Therefore, nonsurgical management such as hydrostatic enema and pneumatic reduction is recommended to reduce hospital discharge of patients with unfavorable outcomes.

Iron folic acid supplementation adherence level and its associated factors among pregnant women in Ethiopia: a multilevel complex data analysis of 2019 Ethiopian mini demographic and health survey data.

Background: Iron and folic acid deficiency is a worldwide public health concern, particularly in low and middle-income countries. In Ethiopia, adherence to iron and folic acid supplements is still very low. Despite the fact that a number of studies on IFA supplementation have been conducted in Ethiopia, they do not indicate a nationwide problem and do not use advanced models to demonstrate clustering effects. The purpose of this study was to assess the level of non-adherence to iron folic acid supplementation and predictors among pregnant women in Ethiopia. Objective: To assess iron folic acid supplementation adherence level and its associated factors among pregnant women in Ethiopia using data from the 2019 Mini-Ethiopian demographic health survey. Methods: The Mini Ethiopian Demographic and Health Survey 2019 data were obtained from the official database website of the Demographic and Health Survey program (http://dhsprogram.com). The analysis included a sample of 2,356 weighted study participants. A multivariable multilevel mixed-effects logistic regression model was used Variables with p-values less than 5%) was reported as statistically significant variables in the multivariable analysis. Results: The proportion of mothers who did not adhere to iron and folic acid supplements was 81.03% (95 %CI, 79.39, and 82.56). Birth interval less than 2 years [AOR: 2.03; 95% CI: 1.12, 3.66], women ever born less than six children [AOR: 1.99; 95% CI: 1.09, 3.64], starting ANC visit during first trimester [AOR: 2.74; 95 %CI: 1.03, 7.30], region [AOR = 0.24; 95% CI: 0.10], and having a high no ANC visit in the community [AOR = 1.77; 95% CI: 1.08, 2.88] were statistically significant factors. There was Intra-Custer Correlation (ICC = 17.72%), indicating that 17.72% variability in non-adherence levels was due to clusters. Conclusion and recommendation: In Ethiopia, nearly four out of every five pregnant women did not receive iron folic acid supplementation for the recommended periods. Birth intervals, number of children, timing of ANC visits, region, and community level no ANC service were significant factors for non-adherence IFAS. As a result, the community, govern metal and non-governmental sectors enacting on health should focus on reducing non-adherence through tailored interventions on factors that influence it.

Level of Family centered care and associated factors among parents of children with cancer at tertiary level hospital, Ethiopia.

OBJECTIVE: To determining level and factors affecting Family Centered Care (FCC) in pediatric oncology unit of Tikur Anbessa Specialized hospital (TASH), Ethiopia. METHOD: A cross sectional study was conducted from June to December 2022. Three hundred ninety-three parents of children with cancer were consecutively interviewed using Measure of Processes of Care (MPOC-20). Multivariable linear regression was used to identify independent predictors of FCC. RESULT: The total MPOC 20 means was 3.71(SD = 1.04). The mean score for respectful and supportive care, coordinated and comprehensive care, enabling and partnership, providing specific information and providing general information were found to be 4.8, 4.6, 3.7, 2.3 and 2.6, respectively. Family employment (-0.33(95% CI = -0.63, -0.03; P = .029)), low family education (-0.40 (95% CI = -0.70, -0.11; P = .008)), referral cases (-0.37(95% CI = -0.59, -0.14; P = .001)), shorter time spent in hospital (-0.49(95% CI = -0.85, -0.12; P = .010)) and psychological distress (-0.01(95% CI = -0.026, -0.001; P = .028)) were associated with lower mean score of FCC. CONCLUSION: The total FCC mean score was found to be low. From the five FCC components providing general and specific information scored the lowest mean level. PRACTICE IMPLICATIONS: Mechanism to improve information delivery that address parents from different background and referred from other health facility should be in place in order to improve FCC level. In addition, the FCC should be designed to address parents of children with different lengths of stay.

"Trust in God, but tie your donkey": Holy water priest healers' views on collaboration with biomedical mental health services in Addis Ababa, Ethiopia.

This exploratory qualitative study examines holy water priest healers' explanatory models and general treatment approaches toward mental illness, and their views and reflections on a collaborative project between them and biomedical practitioners. The study took place at two holy water treatment sites in Addis Ababa, Ethiopia. Twelve semi-structured interviews with holy water priest healers found eight notable themes: they held multiple explanatory models of illness, dominated by religious and spiritual understanding; they emphasized spiritual healing and empathic understanding in treatment, and also embraced biomedicine as part of an eclectic healing model; they perceived biomedical practitioners' humility and respect as key to their positive views on the collaboration; they valued recognition of their current role and contribution in providing mental healthcare; they recognized and appreciated the biomedical clinic's effectiveness in treating violent and aggressive patients; they endorsed the collaboration and helped to overcome patient and family reluctance to the use of biomedicine; they lamented the lack of spiritual healing in biomedical treatment; and they had a number of dissatisfactions and concerns, particularly the one-way referral from religious healers to the biomedical clinic. The study results show diversity in the religious healers' etiological understanding, treatment approaches and generally positive attitude and views on the collaboration. We present insights and explorations of factors affecting this rare, but much needed collaboration between traditional healers and biomedical services, and potential ways to improve it are discussed.

Spatial variations and determinants of iron containing foods consumption among 6-23 months old children in Ethiopia: spatial, and multilevel analysis.

Consuming foods high in iron benefits metabolic processes as well as the development of the neonatal and fetal brain. Despite the significance of eating foods high in iron for public health, Ethiopian practices are still limited when compared to the World Health Organization's (WHO) assessment of its consumption of such foods. This study used the Ethiopia Demographic and Health Survey (EDHS) to evaluate the consumption of iron-rich foods, regional clustering, and related characteristics among children aged 6-23 months. The information was taken from the typical EDHS 2019 dataset, which included a weighted sample of 1572 young children aged 6-23 months old in total. Utilizing Kuldorff's SaTScan version 9.6 software, spatial scan statistics were produced. Software from ArcGIS 10.8 was used to display the regional distribution of inadequate consumption of foods high in iron. Utilizing multilevel or mixed effects logistic regression analysis, the associated determinants for a healthy diet rich in foods containing iron were found. In the final model, a P-value of < 0.05 was announced as a statistical significance variable. Overall, in Ethiopia, children aged 6-23 months consumed iron-rich foods at a rate of 27.14% (95% CI 24.99-29.39). Poor intake of foods heavy in iron is concentrated in Ethiopia's regional states of Afar, a sizable portion of Amhara, Oromia, Tigray, Somali, Gambela, and SNNPS. Primary and secondary education (AOR = 1.73, CI 95%: 1.23, 2.41), and (AOR = 1.97,CI 95%: 1.25, 3.10), having ≥ 2 under five children, and current status of breastfeeding (AOR = 0.62 (CI 95%: 0.45, 0.84), and (AOR = 0.32, CI 95%: 0.23, 0.44), giving birth at health facilities (AOR = 1.51, CI 95%: 1.06, 2.13),being from Afar and Somali regions (AOR = 0.39, 95%: 0.17, 0.93), and (AOR = 0.26, CI 95%: 0.10, 0.69) have shown statistically significant association with the outcome variable respectively. In Ethiopia, providing high-iron meals and supplements to under-2-year-old children represents minimal, but persistent, public health expenses. Based on the identified determinants, the Ethiopian federal ministry of health and other stakeholders should pay special attention to the locations designated as hot spots for maternal and child health service enhancement to promote the consumption of iron-rich meals among children aged 6-23 months.

Magnitude and its associated factors of neonatal jaundice among neonates admitted to the neonatal intensive care unit of Dessie Town public hospitals, Amhara region, Ethiopia, 2020: a multicenter cross-sectional study.

Background: Neonatal jaundice is a prevalent illness affecting approximately 60%-80% of newborns. In severe cases, it can result in severe neurological distress. Approximately 1.1 million neonates are affected annually on a global scale, with the vast majority living in sub-Saharan Africa and southern Asia. It is common in newborns in the first week of life. This study aims to assess the magnitude and determinants of jaundice in newborns admitted to the neonatal intensive care unit (NICU) of public hospitals in the city of Dessie in northern Ethiopia. Methods: An institutional cross-sectional study was conducted at the NICU at Dessie town public hospitals from 30 March to 30 April 2020. A systematic random sampling procedure was used to select the study participants. Data were collected through face-to-face interviews with mothers using a structured questionnaire and by reviewing neonatal medical records using a checklist. Binary logistic regression analysis was used to identify the determinants of neonatal jaundice. A significance level of less than 0.05 was used to declare the statistical significance in the final model. Results: A total of 218 neonates with their mothers were included in the study. The prevalence rate of neonatal jaundice was found to be 28.4%. The major associated factors for neonatal jaundice were sepsis [adjusted odds ratio (AOR): 10.13, 95% confidence interval (CI) = 2.36, 43.56], preterm < 37 weeks (AOR: 6.03, 95% CI = 1.41, 25.79) low APGAR score < 7 (AOR: 7.34, 95% CI = 1.34, 39.65), ABO incompatibility (AOR: 24.55 95% CI = 1.58, 68.83), prolonged labor (AOR 9.03, 95% CI = 1.67, 48.33), and Rh incompatibility (AOR = 30.40, 95% CI = 2.01, 66.20). Conclusion: The magnitude of neonatal jaundice among neonates was determined to be high. Therefore, both maternal and neonatal factors contributed significantly to the management of neonatal jaundice and also influenced the use of phototherapy treatment. Proper consideration of these factors is crucial for the prevention and treatment of neonatal jaundice.

Influence of socio-demographic factors on medicinal plant knowledge among three selected ethnic groups in south-central Ethiopia.

BACKGROUND: The influence of socio-demographic variables was widely explored to evaluate their impact on indigenous and local ethnobotanical knowledge. However, the studies conducted in Ethiopia mainly focused on rural areas. They were limited to exploring and documenting ethnobotanical knowledge and the associated impacts of socio-demographic variables in rural-urban interface areas among ethnic groups. Hence, this study aimed to document plant-based indigenous and local ethnomedicinal knowledge and the associated impacts of socio-demographic variables among selected three ethnic groups in south-central Ethiopia. METHODS: Ethnobotanical data were collected using semi-structured interviews with 189 key informants, floristic species inventories, and field observations. Quantitative approaches were used to evaluate the use values (UV) of the most important medicinal plants, the informant consensus factor (ICF), fidelity level (FL), relative popularity level (RPL), and rank-order priority (ROP). Statistical tests were applied to evaluate the influences of socio-demographic factors and associations between variables on local ethnobotanical knowledge across ethnic groups in different informant categories. RESULTS: Statistical analysis revealed significant differences (p < 0.05) in the mean number of medicinal plants reported among age categories. There was also a positive association between the respondent's age and plant knowledge acquisition. Croton macrostachyus Hochst. ex Delile, Albizia gummifera C.A.Sm., Zingiber officinale Roscoe, Aloe macrocarpa Tod., Gymnanthemum amygdalinum (Delile) Sch.Bip., Calpurnia aurea (Aiton) Benth, and Allium sativum L. had the highest use values among ethnic groups. The highest informant consensus factor values were recorded for circulatory system disorders (0.68) followed by febrile illness and reproductive organ complications (0.66 each) across the three studied ethnic groups. The highest FL, RPL, and ROP values were noted for Lactuca inermis Forssk., Moringa stenopetala (Baker f.) Cufod., Withania somnifera (L.) Dunal, Allium sativum L., Citrus limon (L.) Osbeck, Ricinus communis L., Schinus molle L., Antiaris toxicaria (J.F.Gmel.) Lesch., Brucea antidysenterica J.F.Mill., Echinops kebericho Mesfin, Ocimum jamesii Sebald, Afrocarpus falcatus (Thunb.) C.N.Page, Searsia natalensis (Bernh. ex Krauss) F.A.Barkley, and Ricinus communis L. across ethnic groups in the study areas, which showed the conformity of knowledge on species curing potential and their prevalent uses. CONCLUSION: The study revealed that the ethnic groups of Gedeo, Oromo, and Sidama have considerable indigenous and local ethnobotanical knowledge practices. Statistical analysis shown high variation in the acquisition of local ethnobotanical knowledge among age groups, which boosted our understanding of the effects of socio-demographic factors on the local ethnobotanical knowledge dynamics. Thus, this finding advocates for efforts to repair the observed generation gap via continued professional support and educating local communities to preserve traditional knowledge and practices through systematic documentation.

Determinants of low birth weight among newborns delivered at Mettu Karl comprehensive specialized hospital, southwest Ethiopia: a case-control study.

Low birth weight is a newborn delivered with birth weight of less than 2500 g regardless of gestational age is called. It is a significant issue affecting over 30 million infants worldwide. Thus, the study determine factors associated with low birth weight among newborns delivered at Mettu Karl Comprehensive Specialized Hospital, Southwest Ethiopia. A facility-based case-control study was conducted with 336 newborns (112 cases and 224 controls) from September 12 to December 23, 2022. The study population was newborns with birth weights of 2500 g to 4000 g as controls and newborns with birth weights < 2500 g were cases. Simple random sampling techniques were used to recruit study participants with a ratio of 1 to 3 cases to controls, respectively. Data was collected by interviews and a checklist. Data were entered and analysed using SPSS version 23. Binary and multivariate logistic regression analyses were computed to identify factors associated with low birth weight, a p-value less than 0.05 was used to declare the strength of statistical significance. A total of 327 newborns were contacted, yielding a 97% response rate. MUAC < 23 cm (AOR = 2.72, 95% CI 1.24 to 6.19), inadequate diet diversification (AOR = 4.19, 95% CI 2.04 to 8.60), lack of iron and folic acid supplementation (AOR = 2.94, 95% CI 1.25 to 6.88), history of hypertension (AOR = 2.55, 95% CI 1.09 to 6.00), and lack of nutritional counselling (AOR = 4.63, 95% CI 2.22 to 9.64) were determinants of low birth weight. Low birth weight is linked to residence, maternal MUAC, hypertension history, and ANC visit. Lifestyle modifications, early detection, management, and nutrition information can reduce risk.

The Lived Experience of Ethiopian Women After Mastectomy due to Breast Cancer: A Qualitative Study.

BACKGROUND: The impact of breast absence on women's lived experiences is not well studied in Sub-Saharan Africa particularly in Ethiopia, with implications for service design. This study aimed to explore the lived experiences of Ethiopian women after mastectomy due to breast cancer. METHODS: A qualitative study approach was used to explore the experiences of women who underwent a mastectomy at the oncology unit of Tikur Anbessa Specialized Hospital. Before the commencement of the study, consent was obtained from each respondent. An in-depth interview was conducted with twelve post-mastectomy women using a semi-structured interview guide. Audio-recorded data were transcribed verbatim and translated into English. Data were coded, sorted, and themes were developed manually based on the thematic analysis. RESULTS: Five themes illustrating the impact on the women's life after mastectomy were identified and categorized into (1) Perceived alteration in physical and psychosocial aspects, (2) Perceived social support, and adapting to life after mastectomy. CONCLUSION: Our finding suggests that women who underwent mastectomy need holistic care including physical, psychosocial, and emotional support from their family, society, and healthcare professionals.

Predictor of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia: a case-control study.

BACKGROUND: Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia. METHODS: Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association. RESULT: The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14-4.8), no formal education (AOR = 4.4, 95% CI: 1.94-9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24-5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0-12.7). CONCLUSION: In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.

Diagnostic accuracy of barium enema versus full-thickness rectal biopsy in children with clinically suspected Hirschsprung's disease: A comparative cross-sectional study.

Background and Aims: Hirschsprung's disease (HSD) remains a common cause of pediatric intestinal obstruction. Barium contrast enema (BE) is the primary imaging modality for the evaluation of clinically suspected cases. Here, we aimed to assess the diagnostic accuracy of BE in children with clinically suspected HSD when compared to a gold standard full-thickness rectal biopsy (FTRB). Methods: We recruited and consecutively enrolled children with clinically suspected HSD at two tertiary teaching hospitals. Participants underwent BE imaging and two radiologists interpreted the findings independently. Participants further underwent FTRB by pediatric surgeons as the confirmatory test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) with the area under the curve (AUC) were calculated on Stata version 14.2, taking FTRB as the standard. Results: We enrolled 55 cases, of which 49 completed the evaluation and were included in the final analysis. The median age was 9.4 months (interquartile range: 2-24], with a male-to-female ratio of 4.4:1. The sensitivity, specificity, PPV, and NPV of BE were 0.95 (95% confidence interval [CI] [0.81-0.99]), 0.73 (95% CI [0.39-0.94]), 0.92 (95% CI [0.82-0.97]), and 0.80 (95% CI [0.50-0.94]), respectively. On AUC, the diagnostic accuracy of BE compared to the confirmatory FTRB was 0.84 (95% CI [0.69-0.98]). The diagnostic accuracy was higher in neonates (ROC: 1.00) when compared to infants (ROC: 0.83) or those above 1 year of age (ROC: 0.798). HSD-suggestive BE findings were associated with absence of ganglion cells on FTRB (χ 2 = 23.301, p < 0.001). Inverted rectosigmoid ratio and transition zone were more sensitive in detecting HSD of 0.92 (95% CI [0.74-0.98]) and 0.81 (95% CI [0.63-0.92]), respectively. Conclusion: BE is sufficiently accurate in the diagnosis of children with HSD, suggesting BE would likely be used to inform surgical management in settings where confirmatory biopsy is lacking. However, clinical judgment is warranted in interpreting negative BE findings.

A Qualitative Study on Psychosocial Challenges of Patients With Cancer in Ethiopia Using the Social-Ecological Model.

Cancer diagnosis and treatment can be physically arduous, disrupting patients' social and work lives. Understanding the extent of these problems is key to addressing patients' needs, but specific psychosocial challenges have not yet been well studied in resource-limited settings. A qualitative study was conducted in the capital and two regions of Ethiopia with the aim of exploring psychosocial challenges among cancer patients. A total of 14 in-depth interviews (IDIs) and 16 focus group discussions (FGDs) were done with cancer patients, health professionals, community representatives, and religious leaders. Four separate interview guides were used to facilitate the interviews and discussions. All transcribed documents, field notes, and reflexive memos were entered into NVivo 12 software, and deductive thematic analysis using the social-ecological model was applied to summarize the main findings. At an individual level, emotional distress, suicidal risk, denial, and refusal of treatment were identified immediately after diagnosis while hopelessness, feeling depressed, and fear of death were commonly reported psychosocial challenges during the course of treatment. Involvement of family members in major treatment decisions was recognized at an interpersonal level. Our result also revealed that cancer patients had strong social support from family members and close friends. In the community, traditional medicine and religious rituals were considered an alternative treatment for cancer. The findings indicate that counselling and psychoeducation are crucial for cancer patients, family members, and close friends. Awareness creation programmes should be delivered through collaboration with religious leaders and traditional healers.

The potential of Ethiopian medicinal plants to treat emergent viral diseases.

Ethiopians have deep-rooted traditions of using plants to treat ailments affecting humans and domesticated animals. Approximately 80% of the population continues to rely on traditional medicine, including for the prevention and treatment of viral diseases. Many antiviral plants are available to and widely used by communities in areas where access to conventional healthcare systems is limited. In some cases, pharmacological studies also confirm the potent antiviral properties of Ethiopian plants. Building on traditional knowledge of medicinal plants and testing their antiviral properties may help to expand options to address the global pandemic of COVID-19 including its recently isolated virulent variants and prepare for similar outbreaks in the future. Here, we provide an ethnobotanical and pharmacological inventory of Ethiopian medicinal plants that might contribute to the prevention and treatment of viral diseases. We identified 387 species, about 6% of Ethiopia's known flora, for which records of use by local communities and traditional herbalists have been documented for the treatment of viral diseases. We provide a framework for further investigation and development of this vital resource much anticipated to help combat emergent viral diseases along with existing ones in Ethiopia and elsewhere.

Lived Experience of People with Type 1 Diabetes in North East Ethiopia; Psycho-Social and Economical Perspective, a Phenomenological Study.

Objective: To explore lived experience of people with type 1 diabetes in North East Ethiopia; psycho-social and economical perspective. Methods: A descriptive phenomenological study was conducted to explore the lived experience of people with type 1 diabetes in North East Ethiopia; psycho-social and economical perspective from March 02 to March 25, 2020. A heterogeneous purposive sample method was used to choose the participants. The lead investigator used an in-depth interview to collect data, using an audio recorder and an interview guide. The data were analysed using the thematic analysis method. Atlas. ti software version 7 was used to facilitate the data analysis process. Results: A total of 13 participants were enrolled in this study. The participants age range were 14 to 70 years and their duration of diabetes since diagnosis were from 8 months to 16 years. The three interconnected themes that emerged from the analysis are: (1) psychological experience with two sub-themes (psychological problems due to diabetes including fear and coping strategies for psychological problems), (2) social experience, which has five categories (influence on intimate relationships, influence on social participation, disclosure status, social isolation and stigma, social support, and influence on education); and (3) economic experience. Conclusion: Fear was one of the psychological experiences felt by people with type 1 diabetes. Although type 1 diabetes is a biomedical problem, it is also accompanied by other psychological and socio-economic issues, that require a holistic approach to address it. So, health professionals should strengthen health information dissemination programs.

Determinants of Jaundice Among Neonates Admitted to Neonatal Intensive Care Unit of Mizan Tepi University Teaching Hospital, Southwest Ethiopia, 2021: Unmatched Case Control Study.

Background. Jaundice is a common problem in the neonatal period, and it is one of multiple factors found in children who die. Despite the majority of pathological jaundice public health consequences, there is no evidence on risk factors of pathological jaundice among neonates in Southwest Ethiopia. Therefore, this study aimed to identify factors associated with jaundice requiring phototherapy management in neonates admitted to the neonatal unit of a university teaching hospital in Southwest Ethiopia (Mizan-Tepi). Methods. Facility-based, unmatched case-control study was conducted among 240 (80 cases and 160 controls) in the Neonatal Intensive Care Unit of Mizan-Tepi University Teaching Hospital. Neonates with pathological jaundice and neonates without pathological jaundice were considered as cases and controls, respectively. Data were collected using a structured questionnaire, and extraction checklist, including information on maternal demographics, obstetrics, and neonatal factors. Simple random sampling techniques were used to select respondents. Bivariate and multivariable analyses were used to examine the association. Finally, statistical significance was declared at a P-value < .05. Results. In this study, 237 mothers with their neonates were included, making a response rate of 98.7%. The mean birth weight of cases and controls was 2330.3 ± 698.9 and 2699.3 ± 686.7 g, respectively. Hypothermia (AOR = 4.28; 95% CI: [1.72-10.67], cesarean delivery (AOR = 4.09; 95% CI: [1.69-9.93]), breast milk feeding (AOR = 2.97; 95% CI: [1.04-8.47]) and being male (AOR = 2.67; 95% CI: [1.17-6.13]) were significantly associated with jaundice. Conclusion. Most of the risk factors of neonatal jaundice were found to be modifiable. Therefore, early prevention and recognition of identified factors are recommended.

Effectiveness of simulation-based cesarean section education on improving non-physician clinician midwife's competency in performing cesarean section in Ethiopia: a quasi-experimental study.

BACKGROUND: Simulation-based education enhances fundamental and clinical knowledge, procedural abilities, teamwork, and communication skills, as well as quality of care and patient safety. Due to excessive clinical loads and a lack of physicians, even classic teaching methods like bedside instruction are constrained in low-income settings. Thus, this study aimed to ascertain if simulation-based cesarean section education successfully raises non-physician clinician midwives' competency in Ethiopia. METHODS: A quasi-experimental study design triangulated with a qualitative design was implemented. Sixty Masters Clinical Midwifery students (29 intervention and 31 control) were taken in 5 universities. Three questionnaires (knowledge, confidence levels, and skills) were used. Qualitative data was also collected from 14 participants. The data were analyzed using SPSS version 25. Descriptive and inferential analyses were conducted. P < 0.05 was used for statistical significance. A difference-in-difference with a 95% confidence level was employed to control the potential confounders for knowledge and self-confidence. Multiple linear regression was fitted to identify the independent effect of simulation-based education interventions while controlling for other variables. Thematic analysis was performed using MAXQDA 2020. RESULT: The age of the respondents varies from 24 to 34 years, with the control group's mean age being 28.8 (± 2.3) years and the intervention group's mean age being 27.2 (± 2.01) years. The intervention and control groups' pre-intervention and post-intervention knowledge scores showed a statistically significant difference. There was a substantial increase in self-confidence mean scores in both the intervention and control groups and between the pre-intervention and post-intervention periods in both the intervention and control groups. Furthermore, there was a substantial improvement in cesarean section skills in the intervention group as compared to the control group (59.6 (3.3) vs. 51.5 (4.8). The qualitative findings supported these. CONCLUSIONS: The study showed that simulation-based education improved students' procedural knowledge, self-confidence, and skills. As a result, professional care teams can create simulation-based teaching packages to help students prepare for their residency.