Prevalence and determinants of female genital amputation among adolescent girls and young women in Ethiopia: multilevel analysis.

INTRODUCTION: Female genital amputation is a harmful traditional practice that has adverse risks on health outcomes. Consequently, it affects girls and women's physical, psychological, and mental health conditions. However, evidence on female genital amputation factors among adolescent girls and young women in Ethiopia was limited. METHOD: Secondary data analysis was conducted from the 2016 Ethiopian Demographic and Health Survey. A weighted sample size included in this study was 2961 adolescent girls and young women. Data management and further analysis were performed using Stata 14 software. An adjusted odds ratio with a 95% confidence interval was used for measuring a significant relationship between factors with the outcome variable. RESULT: This study found that the prevalence of female genital amputation among adolescent girls and young women in Ethiopia was 53.4%. Among individual- and community-level variables included in the multivariable multilevel analysis: maternal age, religious status, marital status, maternal educational level, occupational status, residence areas, community uneducated level, and community mass media were significant factors for female genital amputation. CONCLUSION: The prevalence of female genital amputation among adolescent girls and young women in Ethiopia remains high. Those individual- and community-level factors influence female genital amputation among adolescent girls and young women in Ethiopia. It requires health interventions on female genital amputation to improve behavioral changes and create awareness about harmful practices.

Carpal tunnel syndrome and its associated factors among computer user bankers in South Gondar Zone, Northwest Ethiopia, 2021: a cross sectional study.

INTRODUCTION: The use of information devices like computers is skyrocketed in recent years, leading injuries. Carpal Tunnel Syndrome is a leading cause of upper extremity MSDs specially to banking workers. Hence, this paper was intended to highlight its magnitude associated factors in the study area. METHODS AND MATERIALS: Institutional based cross-sectional study was conducted from September 13, 2021 to October 09, 2021. A total of 422 private and government owned computer user bankers were participated. Simple random sampling technique was used to select the study participants. Data were collected using Durkan's compression test, flexion and compression test, Phalen's test, and Tinel's test. Multivariable logistic regression model was used to investigate the relationship between predictors and Carpal Tunnel Syndrome. P-value less than 0.05 was considered to declare as a significant and Adjusted Odds Ration for strength association between risk factors and Carpal Tunnel Syndrome. RESULT: Among 422 participants, the annual prevalence of CTS was 11.7%. Being smoker [AOR: 4.2; 95% CI: 1.76-10.26], having > 5-year work experience [AOR: 7.98; 95% CI: 3.7-17.33], movement repetition [AOR: 3.9; 95% CI: 1.66-9.4] and lack of ergonomics training [AOR: 5.2; 95% CI: 2.8-9.5] were independently associated risk factors to Carpal Tunnel Syndrome. CONCLUSION: Carpal Tunnel Syndrome was high (11.7%) among bankers in this study area. Carpal Tunnel Syndrome was predicted by smoking, length of employment, movement repetition, and not received ergonomics training. Therefore, fore the banking industry, it would be better to maintain strict follow-up and provision of ergonomics training.

Micropollutant Removal Efficiency of Advanced Wastewater Treatment Plants: A Systematic Review.

Introduction: Various review papers have been published regarding the occurrence and fate of micropollutants (MPs). MPs in the aquatic environment are still not well reviewed to generate comprehensive summaries with a special focus on their removal from wastewater using conventional and advanced treatment processes. Therefore, this review aimed to provide a synopsis of the efficiency of the advanced wastewater treatment plants in the removal of MPs. Materials and methods: A systematic search of published literature was conducted on the National Library of Medicine (NLM) database, Web of Science, Joanna Briggs Institute (JBI) database, Scopus, and Google Scholar, based on studies with evidence of removal of MPs in the wastewater treatment process. Screening of the published articles was made using pre-specified inclusion and exclusion criteria. Results: Amongst the 1545 studies searched, 21 full-length articles were analyzed that showed 7 treatment options related to the removal of MPs from wastewater. MPs from wastewater effluents were successfully and effectively removed by advanced treatment techniques. Advanced Oxidation Processes (AOPs), membrane processes, and adsorption processes have all been shown to be potential solutions for the removal of MPs in advanced treatment plants (WWTPs). But, there are 2 critical issues associated with the application of the advanced treatment options which are high operational cost and the formation of dangerous by-products and concentrated residues. Conclusion: This study identified that the removal of MPs using WWTPs was commonly incomplete with varying removal efficiency. Therefore, the adaptation and scale-up of the cost-effective and efficient combined wastewater treatment technology are vital to creating an absolute barrier to MPs emissions.

Civil servants' physical activity status and its associated factors in Northeast Ethiopia: applying Health Belief Model.

Background: Identifying the associated factors of the physical activity of civil servants is necessary to increase the practice of physical activity. However, limited studies addressed associated factors of civil servants' physical activity status in Ethiopia. Hence, this study assessed civil servants' physical activity status and associated factors in Northeast Ethiopia. Methods: An institution-based cross-sectional study design was conducted from 28 February to 13 March 2020 and measured physical activity using WHO physical activity definition. Four hundred and eight civil servants were interviewed using a systematic random sampling technique. A descriptive statistics and multivariable logistic regression model were used. Result: The percentage of physical activity for the civil servants of the study was only 2.38, with the prevalence of physical activity status of 64.0% (95% CI 60.4% to 67.61%). Perceived self-efficacy (adjusted OR (AOR)=1.98, 95% CI 1.15 to 4.12), cues to action (AOR=2.12, 95% CI 1.04 to 3.22) and being a health professional (AOR=2.19, 95% CI 1.13, 4.23) were main associated factors of physical activity. However, physical activity was not affected by respondents' sex (AOR=1.01, 95% CI 0.67 to 1.83), educational status (AOR=0.23, 95% CI 0.03 to 1.91), perceived barrier (AOR=0.97, 95% CI 0.91 to 1.04) or perceived benefit (AOR=1.02, 95% CI 0.95 to 1.09). Conclusion: The health profession, self-efficacy and cues to action were the main associated factors of physical activity. Hence, the Sports Bureau and Health Bureau should pay attention to providing information by focusing on improving self-confidence and creating a positive attitude toward physical activity.

A mixed-method study examined the reasons why pregnant women late initiate antenatal care in Northeast Ethiopia.

BACKGROUND: Timely initiation of antenatal care visits is crucial for ensuring optimal care and health outcomes for women and children. However, late antenatal care initiation among pregnant women in low-income countries including Ethiopia is acknowledged in the literature. Therefore, this study examined why pregnant women initiate antenatal care late in Northeast Ethiopia. METHODS: This study was done using a mixed design approach that included phenomenology and retrospective cross-sectional designs. A retrospective cross-sectional study was deployed among randomly selected 632 medical charts of women who had antenatal care visit in Legambo District primary hospital and health centers. Kaplan Meier curve was used to estimate survival time. Bi-variable and multivariable Cox-proportional hazard regression models were fitted using R-studio-1.2.5033 to identify independent predictors of antenatal care initiation time. Six vignette-based focused group discussions were held with pregnant women who had been purposefully selected. Then, a qualitative content analysis that was informed by the phenomenological theory was done. RESULTS: This study indicated that only 195 (30.9%) of women timely initiated their antenatal care follow-up. In a survival analysis, all 632 women contributed 12,474 person-weeks giving a timely antenatal care initiation rate of 15.6 per 1000 person-weeks. According to the multivariable Cox regression models, late antenatal are initiation was found among pregnant women with an unknown last normal menstruation period, no living children, no bad obstetric history, not accompanied by their partner during antenatal care visit, and who lived in a >5-kilometer radius of health facility. In a qualitative analysis, being uncertain whether the pregnancy had occurred, believing that they have a very low probability of experiencing any complications, negative experience with healthcare providers, negative influence from their immediate contacts such as the mother and mother-in-law, and socio-cultural beliefs like "Qare" were found as major reasons why they started antenatal care follow-up late. CONCLUSION: Most pregnant women in Legambo district, northeastern Ethiopia, initiate their antenatal care visits late. Based on the findings of this study, strengthening the pregnant women identification program and performing regular pregnant women's conference will help to achieve early initiation of antenatal care visits. To lessen the negative influence of their immediate contacts, it will also good to include these old moms and husbands in the conference of pregnant women.

Trends change in teen pregnancy among adolescent women in Ethiopia based on Ethiopian demographic and health surveys: Multivariate decomposition analysis.

BACKGROUND: Teenage pregnancy may adversely affect their health, economic, and social life. Evidence shows that no studies in Ethiopia used decomposition analysis to identify factors for the trend change in teen pregnancy. Therefore, this study aimed to examine the trends and identify contributing factors to teen pregnancy in Ethiopia using multivariate decomposition analysis. METHOD: We obtained the data on adolescent women from three Ethiopian Demographic and Health Surveys. A weighted sample of 3266 in 2005, 4009 in 2011, and 3381 teenagers in 2016 were involved in this study. Statistical analysis was performed using STATA 14. Multivariate decomposition analysis was used to identify contributing factors to the change in teen pregnancy. The coefficient value with a 95% confidence interval was used to identify significant factors associated with teen pregnancy. RESULTS: The prevalence of teen pregnancy in Ethiopia decreased significantly from 15.9% [95% CI: 14.3, 17.7] in 2005 to 12.5% [95% CI: 10.8, 14.3] in 2016. Multivariate decomposition analysis showed that approximately 83% of the overall change in teen pregnancy over time was due to differences in women's composition. Age, marital status, education status, working status, contraceptive use, and sexual status before age 18 were statistically significant contributing factors to the decline in teen pregnancy over time. CONCLUSION: The prevalence of teen pregnancy in Ethiopia decreased significantly over time. The overall decline in teenage pregnancy is due to differences in population composition. Public health interventions should focus on changing cultural norms or attitudes regarding early marriage and pregnancy within religious leaders and uneducated communities.

Intention to receive COVID-19 vaccine and its health belief model (HBM)-based predictors: A systematic review and meta-analysis.

The purpose of the research was to pool the intention to receive the COVID-19 vaccine and its health belief model (HBM)-based predictors, which is helpful for decision-makers and program managers around the globe. The relevant database was searched and Joanna Briggs Institute (JBI) appraisal checklist was used to evaluate the studies. I2 test and funnel plot was utilized to check heterogeneity and publication bias, respectively. DerSimonian and Laird random-effects model was used. The overall pooled intention to receive COVID-19 vaccine globally was 67.69%. Higher levels of perceived susceptibility (AOR = 1.85), perceived severity (AOR = 1.45), perceived benefits (AOR = 3.10), and cues to action (AOR = 3.40) positively predicted the intention; whereas high level of perceived barrier negatively predicted it (AOR = 0.53). Health beliefs influenced COVID-19 vaccine intention globally. This implies that individuals need sound health education and publicity about vaccines before vaccination.

Aflatoxin contamination of animal feeds and its predictors among dairy farms in Northwest Ethiopia: One Health approach implications.

Background: In dairy farming, animal feed is the first line of food safety. Animal feed can become contaminated and spoiled on farms or in storage facilities due to the diverse microorganisms that are naturally present around or on various animal feeds. This study aims to assess the level of aflatoxin and predictors in animal feeds among dairy farms in the South Gondar Zone of Ethiopia. Methods: A total of 100 samples of each animal feed ingredient (atella, hay, commercial concentrates, and cut and carry pasture) were obtained. A total of 400 animal feed ingredient samples were tested separately among 100 randomly chosen dairy farmers for aflatoxin analysis. Simultaneously, swabs from cow udders and water samples were also collected. Using a structured and pretested questionnaire, the knowledge and practices of animal feed administrators responsible for managing animal feed were also evaluated. Descriptive statistics and logistic regression models were used to identify determinants. Results: From the total animal feed analyzed, 96% was positive for aflatoxins. Feed storage facilities, feed storage duration, education of animal feed administrators, mixed concentrates, and previous training were found to be associated with aflatoxin contamination levels in animal feeds. Conclusions: The levels of aflatoxin contamination in animal feeds were found to be higher than the recommended limit; these findings suggest the spread of aflatoxin contamination between humans and animals. Furthermore, the occurrence of aflatoxins in the environment results from milk becoming contaminated with aflatoxins. A One Health strategy should therefore receive special consideration to tackle such problems and safeguard consumer safety.

Trends and factors contributing to health facility delivery among adolescent women in Ethiopia: multivariate decomposition analysis.

BACKGROUND: Although an increase in health facility delivery in Ethiopia over time, adolescent women giving birth at health facilities is still low. Health facility delivery is crucial to improving the health of women and their newborns' health by providing safe delivery services. We aimed to examine the trend change and identify factors contributing to health facility delivery in Ethiopia. METHODS: We analyzed the data on adolescent women obtained from three Ethiopian Demographic and Health Surveys. A total of weighted samples were 575 in 2005, 492 in 2011, and 378 in 2016. Data management and further statistical analysis were done using STATA 14. Trends and multivariate decomposition analysis were used to examine the trends in health facility delivery over time and the factors contributing to the change in health facility delivery. RESULTS: This study showed that the prevalence of health facility delivery among adolescent women in Ethiopia increased significantly from 4.6% (95% CI 3.2-6.7) in 2005 to 38.7% (95% CI 33.9-43.7) in 2016. Decomposition analysis revealed that around 78.4% of the total change in health facility delivery over time was due to the changes in the composition of adolescent women and approximately 21.6% was due to the changes in their behavior. In this study, maternal age, place of residency, wealth index, maternal education, frequency of ANC visits, number of living children, and region were significant factors contributing to an increase in health facility delivery over the study periods. CONCLUSION: The prevalence of health facility delivery for adolescent women in Ethiopia has increased significantly over time. Approximately 78.4% increase in health facility delivery was due to adolescent women's compositional changes. Public health interventions targeting rural residents and uneducated women would help to increase the prevalence of health facility delivery.

Multilevel analysis of individual and community level factors associated with the application of cow dung and oil on the umbilical cord stump in Ethiopia.

Background: Hygienic umbilical cord care is one of the essential interventions advocated to reduce neonatal mortality. However, traditional cord care measures-applying cow dung and oil-that have harmful health consequences are commonly practiced in Ethiopia. Hence, in this study, it was planned to analyze individual and community-level factors associated with the application of cow dung and oil on the umbilical cord stump in Ethiopia. Methods: Data from the 2016 Ethiopian demographic and health survey were used to identify individual and community level factors associated with women's practice of applying cow dung and oil on the umbilical cord stump of their neonate. Taking into account for the hierarchical structure of the data; multilevel binary logistic regression analysis has been employed to a nationally representative weighted sample of 7,168 women. Results: In Ethiopia, 780 (10.88%) with 95% CI (10.18-11.62) women apply oil and/or cow dung on the neonate's umbilical cord stump. Age increase by one year [AOR = 0.97; 95% CI (0.94-0.99)] and giving birth in a health facility [AOR = 0.61; 95% CI (0.42-0.89)] were individual-level factors that reduced women's practice of applying cow dung and oil on the umbilical cord stump of their neonate. Whereas, rural residence [AOR = 2.54; 95% CI (1.28-5.06)] was the predictor at the community level that raised the practice of applying cow dung and oil on the neonate's umbilical cord stump. Conclusion: This nationwide study revealed that a significant number of mothers in Ethiopia still apply cow dung and/or oil on the umbilical cord stump of their neonates. Both the individual and community level characteristics: maternal age, place of delivery, and residence were found to have significant influence on the practice of applying cow dung and/or oil on the umbilical cord stump in Ethiopia. Thus, to reduce neonatal mortality due to avoidable umbilical cord infections, clean cord care practice strategies should be designed by considering these factors.

Clinical Prediction Model Development and Validation for the Detection of Newborn Sepsis, Diagnostic Research Protocol.

Background: Neonatal sepsis is a leading cause of sickness and death in the entire world. Diagnosis is usually difficult because of the nonspecific clinical symptoms and the paucity of laboratory diagnostics in many low- and middle-income nations (LMICs). Clinical prediction models may increase diagnostic precision and rationalize the use of antibiotics in neonatal facilities, which could lead to a decrease in antimicrobial resistance and better neonatal outcomes. Early detection of newborn sepsis is critical to prevent serious consequences and reduce the need for unneeded drugs. Objective: The aim is to develop and validate a clinical prediction model for the detection of newborn sepsis. Methods: A cross-sectional study based on an institution will be carried out. The sample size was determined by assuming 10 events per predictor, based on this assumption, the total sample sizes were 467. Data will be collected using a structured checklist through chart review. Data will be coded, inputted, and analyzed using R statistical programming language version 4.0.4 after being entered into Epidata version 3.02 and further processed and analyzed. Bivariable logistic regression will be done to identify the relationship between each predictor and neonatal sepsis. In a multivariable logistic regression model, significant factors (P< 0.05) will be kept, while variables with (P< 0.25) from the bivariable analysis will be added. By calculating the area under the ROC curve (discrimination) and the calibration plot (calibration), respectively, the model's accuracy and goodness of fit will be evaluated.

Raw cow milk nutritional content and microbiological quality predictors of South Gondar zone dairy farmers in Ethiopia, 2020.

Background: Raw milk is a good growth medium for microbes because of its neutral pH and nutrient content. In Ethiopia; few studies were done to assess the microbial quality of raw cow milk. But, none of them focused on the nutrient content of raw cow milk. Therefore; this study aimed at evaluating raw cow milk nutrient content and predictors of microbial quality of raw cow milk among milk in the dairy farmers of South Gondar zone (SGZ), Ethiopia. Methods: A community-based cross-sectional study was conducted from January to May 2020. 160 randomly selected raw cow milk, water, and utensil samples each were collected for microbial analysis. Besides, nutrient content indicators such as TotalSolid (TS), and Specific Gravity (SG) were analyzed from milk samples. Sequentially, The Knowledge, Attitude, and Practices (KAP) of millers were also assessed using a pretested structured questionnaire. Chi-square test and multiple linear regression models were used. Results: The overall mean SG and TS of raw cow milk were 1.027 (95% CI, 1.013-1.039) and 12.55% (95%CI, 12.20%-12.89%) respectively.38.13% had the better nutrient content, and the rest, 61.87% of raw cow milk hadn't the better nutrient content. Besides, the mean (SD) in log CFU/100mL-1of the Escherichia coli count of raw cow milk was 15 (0.3). Educational status, milk handling experience, KAP of milkers, water microbial count, Nutrient content, and microbial load of milk utensils were independently predicted microbial quality of raw cow milk. Conclusions and implications: The result signifies that the raw cow milk hadn't better nutrient content and the educational status and KAP of milkers, and the qualities of water were the major factors affecting the microbial quality of raw cow milk. It could greatly affect the Food and Nutrition Security of the country. Hence, measures should be taken to enhance the KAP of milkers for improving this enteropathy.

Magnitude of Work-Related Musculoskeletal Disorders and its Associated Factors Among Computer User Bankers in South Gondar Zone, Northwest Ethiopia, 2021.

Introduction: Musculoskeletal disorders (MSDs), which are the leading cause of workplace health problems; affect workers, employers, and society as a whole following direct and indirect cost. Bankers are expected to perform at computer workstations for long periods of time. As a result, they are at risk of developing musculoskeletal disorders. Hence, this study intends to assess magnitude of work related musculoskeletal disorders and its predictors among computer user bankers in this study area. Material and methods: Institutional based cross-sectional study was conducted from September to December 2021. A total of 422 private and Public own computer user bankers were participated. Simple random sampling technique was used to select the study participants. Binary logistic regression model was used to investigate the relationship between dependent and independent variables. P value less than .05 at 95% CI was considered as a significant association between dependent and independent variables. Result: Overall, 245 (58.8%) of computer-user bankers were suffered work-related musculoskeletal disorders in the previous 12 months. Aged 30 and above [AOR:6.5 (1.7-24.6)], no regular physical exercise [AOR: 6.03 (2.2-16.3)], not received ergonomics training [AOR: 5.46 (2.2-13.1)] and working in awkward posture [AOR: 8.76 (2.9-25.9)] were significantly associated to work related musculoskeletal disorders in the previous 12 months. Conclusion: The magnitude of musculoskeletal disorders among computer user bankers was high. Implementing proper working posture, regular physical exercise, avoiding prolonged use of computer and receiving ergonomics training will reduce the burden of musculoskeletal disorders among computer user bankers. The implications of the findings enhance the need for training supervision, cascading tasks taking the age of workers in to account, sustained supply of work station materials and promoting physical exercise by banks to their workers uninterruptedly.

Incidence of Death and Its Predictors of COVID-19 in Amhara Region, Ethiopia: A Retrospective Follow Up Study.

Background: Risk factors associated with COVID-19 incidence of death would aid to notify the most favorable management strategies, hang about undecided, Moreover, studies regarding this issue are limited in Ethiopia and no region-wise study is conducted. Hence, the study investigated the COVID-19 incidence of death and its predictors in the Amhara regional state, Ethiopia. Methods: A facility-based retrospective survey was conducted at all Amhara regional state COVID-19 treatment centers from 13 March 2020, through 13 January 2022. Epidata version 3.1 and STATA version 14 were used for data entry and analysis, respectively. Linearized survey analysis in a stratified Cox regression model was fitted to identify independent risk factors. P-value with 95% CI for hazard ratio was used for testing the significance at alpha 0.05. Results: A total of 28,533 study participants were analyzed in this study. Of these, 2873 (11.2%) died and 25,660 (88.8%) were recovered from COVID-19. The death rate was 11.78 per 1000 person-days of observation with a median survival time of 32 days with IQR [12, 44]. Patients with co-morbidities (AHR = 1.54: 95% CI: 1.51-1.55), patients with age <5-year (AHR = 1.69: 95% CI: 1.78-1.81) and patients with age 60+ years (AHR = 2.91: 95% CI: 1.79-3.99), patients with asymptomatic diseases condition (AHR =1.15: 95% CI: 1.01-1.19), and being male (AHR = 1.22: 95% CI: 1.18-1.27) were independent significant risk factors of death from COVID-19. Conclusion: A relatively high incidence of death from COVID-19 was found in this study. Significant risk factors were identified as patients with age <5 years, patients with age 60+ Years, being male, patients having at least one comorbid condition, and patients with asymptomatic disease conditions. These factors should be taken into consideration for a strategy of quarantining and treating COVID-19 patients.

Occurrence of drug-resistant enteric bacteria and associated factors among food handlers of the Mass Catering Center: A laboratory-based cross-sectional study.

This study aimed to determine antimicrobial- resistance (AMR) enteric bacterial load and associated factors among Food Handlers (FHs) ofMass Catering Center (MCC), Ethiopia. From January to June 2020, a laboratory-based cross-sectional study was conducted using the standard Swab microbiological analysis method and the Kirby-Bauer disc diffusion method on 160 randomly selected FHs and food serving areas and analyzed with RStudio- 1.2.5033 for contamination, resistance level, and source determination. The contamination of AMR Escherichia coli was33.3% (95% CI, 31.5%, 36.4%), Salmonella 30% (95% CI, 29.8%, 36.0%) and Shigella 20% (95% CI, 19.2%, 26.9%) among the hand of FHs serving in MCC. The contamination was more likely associated with low work experience [AOR, 1.42 (95% CI: 1.22-1.87)], a low educational level [AOR, 1.62 (95% CI: 1.52-189)], irrational drug use characteristics [AOR, 1.75(95% CI: 1.64-2.00)], lack of sufficient food safety knowledge [AOR, 1.52 (95% CI: 1.32-1, 67)] of the FHs and the sanitary condition of the food serving area [AOR:1.98 (95% CI, 1.45, 2.53)]. The contamination of the hand of FHs serving in the MCC with AMR enteric FBB at the University cafeteria could indicate the likelihood of the occurrence of foodborne outbreaks.

Trend change in delayed first antenatal care visit among reproductive-aged women in Ethiopia: multivariate decomposition analysis.

BACKGROUND: Early first antenatal care visit is a critical health care service for the well-being of women and newborn babies. However, many women in Ethiopia still start their first antenatal care visit late. We aimed to examine the trend in delayed first antenatal care visit and identify the contributing factors for the trend change in delayed first antenatal care visits in Ethiopia over the study period 2000-2016. METHOD: We analyzed the data on reproductive-aged women from the four consecutive Ethiopian Demographic and Health Surveys to determine the magnitude and trend of delayed first antenatal care visit. A weighted sample of 2146 in 2000, 2051 in 2005, 3368 in 2011, and 4740 women in 2016 EDHS were involved in this study. All statistical analysis was undertaken using STATA 14. Multivariate logistic decomposition analysis was used to analyze the trends of delayed first antenatal care visit over time and the contributing factors to the change in delayed first antenatal care visit. RESULTS: The prevalence of delayed first antenatal care visit in Ethiopia decreased significantly from 76.8% (95% CI 75.1-78.6) in 2000 to 67.3% (95% CI 65.9-68.6) in 2016. Decomposition analysis revealed that 39% of the overall change in delayed first antenatal care visit overtime was due to differences in women's composition, whereas 61% was due to women's behavioral changes. In this study, residence, husband's education, maternal occupation, ever told about pregnancy complications, cesarean delivery and family sizes were significantly contributing factors for the decline in delayed first antenatal care visit over the study periods. CONCLUSION: The prevalence of delayed first antenatal care visit in Ethiopia among women decreased significantly over time. More than halves (61%) decline in delayed first antenatal care visits was due to women's behavioral changes. Public health interventions targeting rural residents, poor household economic status and improving awareness about pregnancy-related complications would help to reduce the prevalence of delayed first antenatal care visit.

Antenatal care visits during the first trimester of the pregnancy stage provide opportunities for women to improve their health, prevent disease, and identify and manage pregnancy and childbirth complications. However, delayed first antenatal care visit is a major leading cause of pregnancy and childbirth complications, and many women in Ethiopia still start ANC visits late. Hence, we aimed to examine the trends in delayed first antenatal care visits and identify the contributing factors for the trend change in delayed first antenatal care visits in Ethiopia over the study period (2000­2016). We obtained data on women aged 15­49 years from four consecutive Ethiopian Demographic and Health Surveys (EDHSs) conducted in 2000, 2005, 2011, and 2016. We extracted both response and independent variables for this study from the Kids Record (KR file) data set. The prevalence of delayed first ANC visit has significantly decreased from 76.8% [95% CI 75.1, 78.6] in 2000 to 67.3% [95% CI 65.9, 68.6] in 2016 over the last sixteen years in Ethiopia. The overall trend change in delayed first antenatal care visits over the study periods was due to the difference in women's composition of selected characteristics and women's behavioral changes on ANC initiation. More than halves (61%) decline in delayed first ANC visits among reproductive-aged women was due to women's behavioral change, and 39% was due to change in women's composition over time. The significant contributing factors for the decline in delayed first antenatal care visits over the study period were residence, husband's educational level, mass media exposure, ever told about pregnancy complications, cesarean delivery and family sizes. Changes in the composition of women's characteristics according to residence areas, media exposure, ever told about pregnancy complications, cesarean delivery and family sizes were statistically significant variables for the decline in delayed first ANC visit over time. Only husbands who had secondary and above education were attributable to women's behavioral change on ANC services.

Descriptive Analysis of Typhoid Fever Surveillance Data in the Jimma Zone, Southwest Ethiopia (2015-2019).

INTRODUCTION: Typhoid fever is a major cause of morbidity and mortality around the globe, and it is a serious illness in developing countries. Typhoid fever is prevalent in Ethiopia, and the burden differs with diverse demography, environment, and climate. The study aimed to determine the incidence of typhoid fever cases by person, place, and time. METHOD: A descriptive cross-sectional study was conducted among the five years (2015-2019) of surveillance data of typhoid fever in the Jimma Zone, Oromia Region, Ethiopia. The data were extracted from the zonal health management information system database from May to June 2020. SPSS version 21 was used to enter and analyze the data. Descriptive analysis was used to assess the distribution of typhoid fever incidence in time, place, and personal groups. RESULT: A total of 36,641 individuals suffered from typhoid fever during the five years. Among these, 18,972 (51.8%) were females and 17,669 (48.2%) were males. Incidence of typhoid fever was found as follows: 216, 198, 203, 264, and 299 cases per 100,000 persons were reported during 2015, 2016, 2017, 2018, and 2019, respectively. Typhoid fever cases were increased by 1.4 from 2015-2019. A high incidence of cases was observed at the start of wet months. The majority of the investigated cases were identified in Kersa, 4,476 (12.2%), Gomma, 4,075 (11.1%), and Mana, 3,267 (8.9%), woredas. Of the total, 151 (0.4%) of the reported cases were admitted for inpatient care. During the five years of surveillance data, death was not reported from all woredas. Conclusion and Recommendation. Typhoid fever was a major public health problem in the Jimma Zone for the last 5 years, and it was increased through the years. Zonal health departments should strengthen the interventions focused on the woredas that had a high burden of typhoid fever at the start of the wet months.

Dietary diversity (DD) and associated factors among Lactating women (LW) in Pawie district, Northwest, Ethiopia, 2019: community-based cross-sectional study.

BACKGROUND: Low Dietary Diversity (DD) result in severe problem among the vulnerable group in low-income countries (LICs), whose diets are predominantly starchy staples. Lactating Women (LW) from LICs are considered a nutritionally vulnerable group. It results in many consequences on the health and well-being of children, households, communities, and the nation. However, there is little empirical evidence on factors contributing to low DD among LW in Ethiopia and the proposed study site. Therefore, this study aimed at assessing the DD and associated factors among LW in Pawie district, Northwest Ethiopia. METHODS: A Community-based cross-sectional study was conducted among 806 LW from March to May 2019 G.C. DD assessed using 24 h dietary recall methods with structured questionnaires.A mean dietary diversity score (DDS) was computed for ten food groups. Food insecurity measured using a 9-item Household Food Insecurity Access Scale (HFIAS). The multivariable logistic regression model was used to see the relevant associations. The variables which have a significant association with DD were identified based on AOR, P-value ≤ 0.05, and 95% Cl. RESULTS: A total of 806 LW aged 15-49 years were interviewed with a response rate of 100%. About two-third of LW had low DD (<5 food groups). Fathers occupation being daily laborer [AOR = 1.82, 95% CI (.339, 9.784)], birth interval less than 24 months [AOR = 3.7, 95 % CI (1.743, 7.885)], family size greater than six members [AOR = 1.55, 95 % CI (1.046, 2.313)] and food insecurity [AOR = 2.23, 95 % CI (1.626, 3.066)] were more likely associated with the low DD among LW compared to their counterpart. CONCLUSION: The DD among LW was low. Low Dietary Diversity was statistically associated with low birth intervals, large family sizes, and food insecurity. Hence, attention should be paid to the identified factors of low DD of LW to improve their health, and that of their children as well as their family.

The Trend of Malaria Cases, Positivity Rate, and Determinant Factors in the Amhara Regional State, Ethiopia: A Mixed Method.

OBJECTIVES: The objectives of this study were to evaluate the trend of malaria cases and test positivity rate and explore determinant factors in the Amhara Regional State, Ethiopia. METHODS: A mixed study design (retrospective record data review and case study) was employed among 67 malaria officers from all zones in the region by using proportional allocation and the 1995 to 2020 malaria document review. 1995 to 2020 trend analysis was conducted using RStudio-1.2.5033. Vignette Focus Group Discussions (FGDs) were used to dig the possible factors for malaria case buildup using the purposive sampling technique, and a qualitative content analysis was used. RESULTS: The overall mean test positivity rate (TPR) was 21.9%, and about 80% of the land of the region was malarious, and 68% of the population was at risk of malaria in the study area from the data records of 1995 to 2020. The year 2012 to 2016 had the peak confirmed malaria cases, while the year 2016 to 2018 dramatically reduced followed by an increase in 2019/2020. The vignette FGDs identified that poor performance on Larval Source Management (LSM) and net utilization, no stock of some antimalarial medicine and supply, quality of malaria diagnosis services, the low commitment of leaders, and climatic anomalies facilitated surge of the disease in 2019/2020. No real accountability at all levels, low coverage of targeted vector control interventions, resource constraint, data quality and use for informed decision making, security issues and Internally Displaced Population (IDP) in various parts of the country, and the COVID-19 pandemic were the possible causes for case buildup. CONCLUSIONS: This result revealed that the malaria incidence rate showed a remarkable decline. However, the average TPR was 21.9%. Hence, it provided the ongoing feedback, mass fever test and treatment, training to health professionals, and ongoing supportive supervision (SS) and mentorship, improved net utilization and indoor residual spraying (IRS) operation and close follow-up and conducted sensitization workshop, spot messages were transferred through mass media, and temporary case treatment and prevention centers at farm sites established may surpass the threshold of malaria.

Occurrence and associated factors of aflatoxin M1 in raw cow milk in South Gondar Zone, North West Ethiopia, 2020.

Aflatoxin M1 is the most significant toxin of milk and milk products. It is immunosuppressive, mutagenic, and carcinogenic compounds to humans. Therefore, this study was aimed to evaluate the concentration of aflatoxin M1 and its determinants in raw cow milk sample intended for human consumption in South Gondar Zone, Ethiopia. A cross-sectional study was conducted on a total of 100 dairy farmers from January to February 2020. Around 50 ml, 100 raw milk samples were collected for aflatoxin M1 analysis. A simple random sampling technique was applied to get the households. Binary and multivariate logistic regressions were used to see the association between predictor and outcome variables. From the 100 dairy farmers who had participated, 38% had heard about aflatoxin in the milk sample. Aflatoxin M1 was detected in the 99(99%) raw milk samples, of these 41 (41%) exceeded the limit of the European Union. The logistic regression analysis result showed that residence, awareness about the level of aflatoxin in the milk sample, management mold-contaminated animal feed, animal feed storage facility, and grazing systems were significantly associated with the high level of aflatoxin in the milk sample. Almost all milk samples analyzed were positive for aflatoxin M1, and 41% of samples were above the limit set by European Union. Many easily manageable and preventable factors were associated with higher levels of aflatoxin M1 in the milk sample than the European Union limit, which suggests continuous monitoring of milk and milk products is necessary.