Regional and temporal variations in COVID-19 cases and deaths in Ethiopia: Lessons learned from the COVID-19 enhanced surveillance and response.

BACKGROUND: The COVID-19 pandemic is one of the most devastating public health emergencies of international concern to have occurred in the past century. To ensure a safe, scalable, and sustainable response, it is imperative to understand the burden of disease, epidemiological trends, and responses to activities that have already been implemented. We aimed to analyze how COVID-19 tests, cases, and deaths varied by time and region in the general population and healthcare workers (HCWs) in Ethiopia. METHODS: COVID-19 data were captured between October 01, 2021, and September 30, 2022, in 64 systematically selected health facilities throughout Ethiopia. The number of health facilities included in the study was proportionally allocated to the regional states of Ethiopia. Data were captured by standardized tools and formats. Analysis of COVID-19 testing performed, cases detected, and deaths registered by region and time was carried out. RESULTS: We analyzed 215,024 individuals' data that were captured through COVID-19 surveillance in Ethiopia. Of the 215,024 total tests, 18,964 COVID-19 cases (8.8%, 95% CI: 8.7%- 9.0%) were identified and 534 (2.8%, 95% CI: 2.6%- 3.1%) were deceased. The positivity rate ranged from 1% in the Afar region to 15% in the Sidama region. Eight (1.2%, 95% CI: 0.4%- 2.0%) HCWs died out of 664 infected HCWs, of which 81.5% were from Addis Ababa. Three waves of outbreaks were detected during the analysis period, with the highest positivity rate of 35% during the Omicron period and the highest rate of ICU beds and mechanical ventilators (38%) occupied by COVID-19 patients during the Delta period. CONCLUSIONS: The temporal and regional variations in COVID-19 cases and deaths in Ethiopia underscore the need for concerted efforts to address the disparities in the COVID-19 surveillance and response system. These lessons should be critically considered during the integration of the COVID-19 surveillance system into the routine surveillance system.

SARS-CoV-2 co-detection with influenza and human respiratory syncytial virus in Ethiopia: Findings from the severe acute respiratory illness (SARI) and influenza-like illness (ILI) sentinel surveillance, January 01, 2021, to June 30, 2022.

SARS-CoV-2 co-infection with the influenza virus or human respiratory syncytial virus (RSV) may complicate its progress and clinical outcomes. However, data on the co-detection of SARS-CoV-2 with other respiratory viruses are limited in Ethiopia and other parts of Africa to inform evidence-based response and decision-making. We analyzed 4,989 patients' data captured from the national severe acute respiratory illness (SARI) and influenza-like illness (ILI) sentinel surveillance sites over 18 months period from January 01, 2021, to June 30, 2022. Laboratory specimens were collected from the patients and tested for viral respiratory pathogens by real-time, reverse transcription polymerase chain reaction (RT-PCR) at the national influenza center. The median age of the patients was 14 years (IQR: 1-35 years), with a slight preponderance of them being at the age of 15 to less than 50 years. SARS-CoV-2 was detected among 459 (9.2%, 95% CI: 8.4-10.0) patients, and 64 (1.3%, 95% CI: 1.0-1.6) of SARS-CoV-2 were co-detected either with Influenza virus (54.7%) or RSV (32.8%) and 12.5% were detected with both of the viruses. A substantial proportion (54.7%) of SARS-CoV-2 co-detection with other respiratory viruses was identified among patients in the age group from 15 to less than 50 years. The multivariable analysis found that the odds of SARS-CoV-2 co-detection was higher among individuals with the age category of 20 to 39 years as compared to those less than 20 years old (AOR: 1.98, 95%CI:1.15-3.42) while the odds of SARS-CoV-2 co-detection was lower among cases from other regions of the country as compared to those from Addis Ababa (AOR:0.16 95%CI:0.07-0.34). Although the SARS-CoV-2 co-detection with other respiratory viral pathogens was minimal, the findings of this study underscore that it is critical to continuously monitor the co-infections to reduce transmission and improve patient outcomes, particularly among the youth and patients with ILI.

Intimate partner violence and health system response in Nekemte town, Western Oromia, Ethiopia, 2019: A cross-sectional study.

Objectives: To assess intimate partner violence and health system response among married women. Methods: A mixed method of quantitative and qualitative cross-sectional community-based study was conducted from August to September 2019. Later than ethical clearance, the data were collected using a pretested structured questionnaire adapted from the literature. Study participants were selected using systematic random sampling. Data collected is entered into EpiData and then exported to SPSS version 25 for analysis. The odds ratio with their 95% confidence interval was calculated. Variables with p-value < 0.25 in bivariate analysis were entered into multivariate logistic regression. Statistical significance was declared if the p-value was <0.05. Results: From all 770 sampled participants in Nekemte town, 730 married women participated in this study, yielding a response rate of 94.8%. The prevalence of intimate partner violence was 55.9%. From this study finding, no intimate partner violence screening was done for 678 (92.9%) respondents who visited health facilities. Educational status of women, partner being illiterate, occupational status being merchant, and daily laborer were associated with intimate partner violence with (adjusted odds ratio = 1.73, 95% confidence interval = (1.05-2.83)), (adjusted odds ratio = 5.94, 95% confidence interval = (1.25-12.23)), (adjusted odds ratio = 4.41, 95% confidence interval = (1.49-13.01)), and (adjusted odds ratio = 3.74, 95% confidence interval = (1.33-10.50)), respectively, were factors found to be associated with intimate partner violence Nekemte town. One of the study participants whose age was 36 years responded that, "our culture approves men's superiority; we accept intimate partner violence as part of our marital life." There is an assigned focal person and training was given to them, but screening of intimate partner violence has not started yet and it was not integrated into any maternal service in our health center. Conclusion: This study shows that in excess of half of women experience intimate partner violence. Educational status, occupation and violence seen during childhood were the factors that contributed to intimate partner violence. Educating women and partners, integrating, and strengthening a health service are important.