Virtual Reality Could Help Assess Sexual Aversion Disorder.

Virtual reality (VR) may improve our understanding of sexual dysfunctions' manifestations, although research in this area remains limited. This study assessed the potential use of a VR Behavior Avoidance Test (VR-BAT) as a tool for examining the clinical features of Sexual Aversion Disorder (SAD): the experience of fear, disgust, and avoidance when facing sexual cues/contexts. A sample of 55 adults (≥ 18y) with (n = 27) and without SAD (n = 28) completed a self-report measure of sexual avoidance. Their anxiety, disgust, electrodermal activity, heart rate, and visual and behavioral avoidance were then examined during two VR-BATs involving sexual or non-sexual stimuli. Mixed repeated measures ANOVAs, t-tests, and correlational analyses were performed. Results showed that individuals in the SAD group reported greater anxiety and disgust compared to their non-SAD counterparts during the sexual stimuli condition. Sexual avoidance scores were largely positively related to anxiety and disgust during the VR sexual condition, and moderately negatively related to the time spent touching the virtual character's genitals. This study is important given the prevalence of sexual difficulties, such as SAD, and the new research avenues offered by emerging technologies, like VR.

The Case for Space Sexology.

Space poses significant challenges for human intimacy and sexuality. Life in space habitats during long-term travel, exploration, or settlement may: detrimentally impact the sexual and reproductive functions of astronauts, restrict privacy and access to intimate partners, impose hygiene protocols and abstinence policies, and heighten risks of interpersonal conflicts and sexual violence. Together, this may jeopardize the health and well-being of space inhabitants, crew performance, and mission success. Yet, little attention has been given to the sexological issues of human life in space. This situation is untenable considering our upcoming space missions and expansion. It is time for space organizations to embrace a new discipline, space sexology: the scientific study of extraterrestrial intimacy and sexuality. To make this case, we draw attention to the lack of research on space intimacy and sexuality; discuss the risks and benefits of extraterrestrial eroticism; and propose an initial biopsychosocial framework to envision a broad, collaborative scientific agenda on space sexology. We also underline key anticipated challenges faced by this innovative field and suggest paths to solutions. We conclude that space programs and exploration require a new perspective - one that holistically addresses the intimate and sexual needs of humans - in our pursuit of a spacefaring civilization.

Hot for Robots! Sexual Arousal Increases Willingness to Have Sex with Robots.

Robots designed to elicit sexual arousal are coming. Sexual arousal can increase our willingness to engage in risky or unconventional sexual behaviors. However, researchers have yet to examine whether this effect extends to robots. Hence, this study provides the first empirical evidence that state sexual arousal can increase our willingness to engage erotically with robots. Based on previous research, we hypothesized that levels of sexual arousal would positively predict willingness to engage erotically with robots (Hypothesis 1); and that men would be more willing to engage erotically with robots than women (Hypothesis 2). A convenience sample of 321 adults (≥18y) completed a two-part online survey measuring their willingness to have sex with, love, engage in an intimate relationship with, and be friends with a robot and a human before and after viewing a sexually explicit video. The results partly support Hypotheses 1-2. They show that state sexual arousal increases willingness to have sex with a robot, and that men are more willing to have sex and engage in an intimate relationship with a robot than women, pre- and post-manipulation. These findings are important given the rise of sex robots and their potential influence on our intimate decisions and behaviors.

Prevalence of the relative age effect among high-performance, university student-athletes, versus an age-matched student cohort.

Background: Relative age effect (RAE) refers to the over-representation of athletes born earlier in the calendar year covering a specific sport. The RAE is especially prevalent in youth sports but often persists into senior competitive levels. Objectives: To determine the prevalence and magnitude of the RAE among student-athletes in a high performance (HP) programme at a South African university, according to year, sports code and sex, compared to the general student cohort. Methods: Cross-sectional descriptive analysis of HP-student-athletes and an age-matched student cohort from 2016 to 2021. Birthdate data were extracted for the HP student-athletes (N = 950: men = 644, women = 306) and student comparison group (N = 47 068; men = 20 464; women = 26 591; not disclosed = 13). Differences were determined using Chi-squared and Fisher's exact test. Residuals examined relative age quartile differences. The steps were applied across academic years, sport code and sex. Results: The RAE was more pronounced among the student-athletes compared to the age-matched student cohort. The RAE was occasionally observed among the HP-student-athletes; however, the prevalence was inconsistent across the respective years under investigation and only noted in certain sport codes (i.e. swimming, rugby union and cricket). There were no sex differences among the HP student-athletes. Conclusion: Where the RAE was noted, the selection bias favoured the relatively older student-athletes. The mechanisms for RAE are multifactorial and complex. A combination of factors, such as competition depth, the popularity and physicality of a sport and socialisation may be involved.

Public health crisis in the refugee community: little change in social determinants of health preserve health disparities.

Structural inequities and lack of resources put vulnerable refugee communities at great risk. Refugees flee their country of origin to escape persecution and flee from war, famine and torture. Resettled refugee communities become particularly vulnerable during times of crisis due to limited English proficiency and poor social determinants of health (SDOH), which create barriers to attaining and sustaining health and wellbeing for themselves and their families. The purpose of this case study was to evaluate SDOH among a refugee community in the Southeastern United States. We surveyed the community twice during a 1-year period to assess various elements of SDOH. Among a primarily African and Southeast Asian refugee community, 76% reported difficulty paying for food, housing and healthcare during the first round of surveys. During the second round of surveys at the beginning of the Coronavirus pandemic, 70% reported lost income; 58% indicated concern about paying bills. There was little change during the 12-month study period, showing that SDOH are an enduring measure of poor health and wellbeing for this vulnerable refugee community.

Molecular characterization of Raillietina isolates from the gastrointestinal tract of free range chickens (Gallus Gallus domesticus) from the southern region of Zimbabwe using the 18S rDNA gene.

Parasitic diseases are among the major constraints of poultry production. The common internal parasitic infections occurring in poultry include cestodes and other gastrointestinal helminths. The aim of this study was to characterize Raillietina spp. from the gastrointestinal tract of free-range chickens using 18S rDNA genes. This was achieved through the DNA extraction from tapeworms isolated from the gastrointestinal tract of routine slaughtered free-range chickens using 18S and amplifying the partial 18S rDNA genes using PCR. A total of 34 intestine samples were collected from 9 different areas in Matabeleland region and tapeworms were isolated for microscopic examination and morphological characterization. All 34 chickens examined had tapeworms and morphological characterization confirmed those used in the study as belonging to the Raillietina group. DNA extraction was then successfully carried out for 9 cestode isolates followed by the PCR amplification of the 18S genes. The products were sequenced and 4 of the 9 isolates were positively identified using BLAST as Raillietina tunetensis and the other 5 were only identified as Raillietina spp. These sequences were then aligned with other known sequences of Raillietina isolates from GenBank and a phylogenetic tree was constructed using the neighbor-joining method and distance computed using the maximum composite method. The phylogenetic tree showed that three of the unidentified Raillietina species are in the neighboring position with Raillietina sonini whilst the other two are in the neighboring position with Raillietina tetragona. This is the first record of R. tunetensis in Gallus Gallus domesticus from Zimbabwe. This clustering on the phylogenetic tree however, did not differentiate samples according to geographical location showing that this tool can be used to infer phylogenetic data for speciation.

Feasibility and yield of screening for diabetes mellitus among tuberculosis patients in Harare, Zimbabwe.

SETTING: A resource-limited urban setting in Zimbabwe with a high burden of tuberculosis (TB) and human immunodeficiency virus (HIV). OBJECTIVES: To determine the feasibility and yield of diabetes mellitus (DM) screening among TB patients in primary health care facilities. DESIGN: A descriptive study. RESULTS: Of the 1617 TB patients registered at 10 pilot facilities, close to two thirds (60%) were male and 798 (49%) were bacteriologically confirmed. The median age was 37 years; two thirds (67%) were co-infected with HIV. A total of 1305 (89%) were screened for DM, and 111 (8.5%, 95% CI 7.0-10.2) were newly diagnosed with DM. Low TB notifying sites were more likely than high TB notifying sites to screen patients using random blood glucose (RBG) (83% vs. 79%; P < 0.04). Screening increased gradually per quarter over the study period. There were, however, notable losses along the screening cascade, the reasons for which will need to be explored in future studies. CONCLUSION: The study findings indicate the feasibility of DM screening among TB patients, with considerable yield of persons newly diagnosed with DM. Scaling up of this intervention will need to address the observed losses along the screening cascade.

Reproductive efficiency in naturally serviced and artificially inseminated beef cows.

A study was conducted to compare conception rates in 71 Tuli and 86 Afrikander beef cattle bred using either artificial insemination (AI) or the bull. Animals were bred using either artificial insemination or natural service at Matopos Research Station. Animals were grouped into three groups of heifers (parity 0; P0), second calvers (parity 1; P1) and mature cows (parity 2; P2) before being randomly assigned to one of the two breeding methods. A binary logistic regression was used for statistical analysis where breeding method (AI vs natural service) was the treatment factor and conception rate was the measured response while breed, parity and last calving date were non-treatment factors. No significant differences were observed in conception rates between breeds (P > 0.05). However, the method of breeding animals, parity and calving interval affected (P < 0.05) conception rates. The breeding method, parity and calving interval had a positive Kendall's tau-b correlation coefficients to conception. More animals were pregnant when AI (77.6%) was used compared with natural mating (56.79%). Conception rates were significantly lower (P < 0.05) in C1 compared with C2 cattle. The odds ratio for breeding method and parity are positive and significant (P < 0.05). In conclusion, the study confirms that artificial inseminated animals had similar conception rates to naturally serviced animals for both Tuli and Afrikander breeds. As such, artificial insemination technology can be used to complement or substitute natural service in indigenous cattle's of Zimbabwe.

A Literature Review of Methodologies Used in Randomized Clinical Trials of Agitation in Alzheimer's Disease.

Agitation is a common and burdensome symptom associated with Alzheimer's disease (AD). This is a narrative literature review of the designs and methods used in randomized clinical trials of agitation in patients with AD; sources range from published, to completed but not published, to ongoing studies in the past 10 years. Selection for review included blinded, randomized trials conducted to assess the effect of a pharmacological intervention for which agitation in patients with AD was among the prespecified end points. Key criteria for exclusion included open-label studies, trials of dementia not specific to AD, or mixed populations of AD and unspecified dementia. A search of PubMed and clinicaltrials.gov databases identified 36 trials for which agitation was among the prespecified end points: 18 were published trials and 18 were completed but not published or ongoing. There was significant heterogeneity among AD studies in terms of diagnostic criteria, assessment of severity of disease and agitation, sample size and powering assumptions, treatment duration, patient age and cognitive status, and outcomes measurements. Few studies used a mitigation strategy for placebo response. Accumulating evidence suggests that it is important to consider the following in trial design: thresholds for baseline severity of agitation and AD; use of prespecified accepted criteria to define agitation; and use of standardized, validated tools to measure treatment effects during a trial. Adoption of these design strategies might help improve signal detection and bring us closer to identifying the most appropriate, effective, and safe treatments for agitation in patients with AD.

Multidimensional daily diary of fatigue-fibromyalgia-17 items (MDF-fibro-17). part 1: development and content validity.

BACKGROUND: Fibromyalgia (FM), a disorder characterized by chronic widespread pain and tenderness, affects greater than five million individuals in the United States alone. Patients experience multiple symptoms in addition to pain, and among them, fatigue is one of the most bothersome and disabling. There is a growing body of literature suggesting that fatigue is a multidimensional concept. Currently, to our knowledge, no multidimensional Patient Reported Outcome (PRO) measure of FM-related fatigue meets Food and Drug Administration (FDA) requirements to support a product label claim. Therefore, the objective of this research was to evaluate qualitative and quantitative data previously gathered to inform the development of a comprehensive, multidimensional, PRO measure to assess FM-related fatigue in FM clinical trials. METHODS: Existing qualitative and quantitative data from three previously conducted studies in patients with FM were reviewed to inform the initial development of a multidimensional PRO measure of FM-related fatigue: 1) a concept elicitation study involving in-depth, open-ended interviews with patients with FM in the United States (US) (N = 20), Germany (N = 10), and France (N = 10); 2) a cognitive debriefing and pilot study of a preliminary pool of 23 items (N = 20 US patients with FM); and 3) a methodology study that explored initial psychometrics of the item pool (N = 145 US patients with FM). RESULTS: Five domains were identified that intend to capture the broad experience of FM-related fatigue reported in the qualitative research: the Global Fatigue Experience, Cognitive Fatigue, Physical Fatigue, Motivation, and Impact on Function. Seventeen of the original pool of 23 items were selected to best capture these five dimensions. These 17 items formed the basis of a newly developed multidimensional PRO measure to assess FM-related fatigue in clinical trials: the Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 (MDF-Fibro-17). CONCLUSION: Qualitative analysis, and preliminary quantitative item level data, confirmed that FM-related fatigue is multidimensional and provided strong support for the content validity of the MDF-Fibro-17. The next stage was to quantitatively evaluate the measure to confirm the factor structure, psychometric properties, sensitivity to change, and meaningful change. This has been conducted and is being reported separately.

Multidimensional daily diary of fatigue-fibromyalgia-17 items (MDF-fibro-17): part 2 psychometric evaluation in fibromyalgia patients.

BACKGROUND: The Multidimensional Daily Diary of Fatigue-Fibromyalgia-17 instrument (MDF-Fibro-17) has been developed for use in fibromyalgia (FM) clinical studies and includes 5 domains: Global Fatigue Experience, Cognitive Fatigue, Physical Fatigue, Motivation, and Impact on Function. Psychometric properties of the MDF-Fibro-17 needed to demonstrate the appropriateness of using this instrument in clinical studies are presented. METHODS: Psychometric analyses were conducted to evaluate the factor structure, reliability, validity, and responsiveness of the MDF-Fibro-17 using data from a Phase 2 clinical study of FM patients (N = 381). Confirmatory factor analyses (CFA) were performed to ensure understanding of the multidimensional domain structure, and a secondary factor analysis of the domains examined the appropriateness of calculating a total score in addition to domain scores. Longitudinal psychometric analyses (test-retest reliability and responder analysis) were also conducted on the data from Baseline to Week 6. RESULTS: The CFA supported the 17-item, 5 domain structure of this instrument as the best fit of the data: comparative fit index (CFI) and non-normed fit index (NNFI) were 0.997 and 0.992 respectively, standardized root mean square residual (SRMR) was 0.010 and the root mean square error of approximation (RMSEA) was 0.06. In addition, total score (CFI and NNFI both 0.95) met required standards. For the total and 5 domain scores, reliability and validity data were acceptable: test-retest and internal consistency were above 0.9; correlations were as expected with the Global Fatigue Index (GFI) (0.62-0.75), Fibromyalgia Impact Questionnaire (FIQ) Total (0.59-0.71), and 36-Item Short Form Health Survey (SF-36) vitality (VT) (0.43-0.53); and discrimination was shown using quintile scores for the GFI, FIQ Total, and Pain Numeric Rating Scale (NRS) quartiles. In addition, sensitivity to change was demonstrated with an overall mean responder score of -2.59 using anchor-based methods. CONCLUSION: The MDF-Fibro-17 reliably measures 5 domains of FM-related fatigue and psychometric evaluation confirms that this measure meets or exceeds each of the predefined acceptable thresholds for evidence of reliability, validity, and responsiveness to changes in clinical status. This suggests that the MDF-Fibro-17 is an appropriate and responsive measure of FM-related fatigue in clinical studies.

Dynamical properties and thresholds of an HIV model with super-infection.

Super-infection by multiple HIV-1 subtypes, previously thought restricted to high risk groups, has now been reported in the general heterosexual populations at relatively the same incidence rate as in high risk groups. We present a simple deterministic HIV model with super-infection by two HIV-1 subtypes. Mathematical characteristics including the basic reproductive number $(\mathcal{R}_0)$, invasion threshold $(\mathcal{R}_{21},\mathcal{R}_{12})$ and conditions for asymptotic stability are derived. In the absence of super-infection the model exhibits competitive exclusion, and all equilibria are globally attracting if they exist except for the disease free which is a saddle for $\mathcal{R}_0>1.$ The results show that the subtype with the dominant reproductive number exceeding unity dominates the weaker subtype forcing it to extinction regardless of the size of the reproductive number. On the other end, super-infection may promote subtype co-existence whenever the minimum of the subtype specific reproductive numbers $(\mathcal{R}_1,\mathcal{R}_2)$ and the invasion reproductive numbers $(\mathcal{R}_{12},\mathcal{R}_{21})$ exceed unity. Our results demonstrate that if the partial reproductive numbers $(\mathcal{R}_1~\mbox{and}~\mathcal{R}_2 )$ and the invasion reproductive number for the weaker subtype $(\mathcal{R}_{21})$ satisfy $\mathcal{R}_2<1,~\mathcal{R}_1>1~\mbox{and}~\mathcal{R}_{21}>1,$ then primary infection by subtype $1$ may stay the extinction of subtype $2$ despite its relatively low reproductive fitness. For certain parameter ranges, hysteresis (including backward bifurcation) occurs with possible differences in the asymptotic level of disease prevalence. Super-infection may thus facilitate the continued re-generation of reproductively noncompetent subtypes whose subtype specific reproductive numbers will be less than unity while at the same time allowing for the mutual coexistence and persistence of multiple strains. Persistence and co-existence of multiple strains has detrimental effect on vaccine design and development and administration of ART where one or more of the strains are drug resistant.

Molecular analysis of selected paramphistome isolates from cattle in southern Africa.

Paramphistomes are parasites of domestic and wild ruminants, the effects of which in animal health remain underestimated. Very few studies in Africa have been done using molecular techniques to resolve situations associated with taxonomical groupings and epidemiology of these parasites. In this study, the genetic variability of nine representative paramphistome isolates collected from southern African countries, namely Botswana, South Africa, Zambia and Zimbabwe, was assessed using both morphological and internal transcribed spacer 2 (ITS2) rDNA sequence data. Morphological characterization and identification were carried out using median sagittal sections of the paramphistomes. DNA of the individual paramphistomes was isolated, the ITS2 rDNA was amplified, purified and sequenced. The sequences were submitted to GenBank, which assigned them the following accession numbers: KP639631, KP639630, KP639632, KP639633, KP639634, KP639635, KP639636, KP639637 and KP639638. These sequences were used for phylogenetic analysis using MEGA 6. Morphological characterization revealed three species of paramphistomes belonging to three different sub-families: one Stephanopharynx compactus isolate, a member of the Stephanopharyngidae sub-family; one Carmyerius dollfusi isolate, a member of the Gastrothylacidae sub-family; and seven Calicophoron microbothrium isolates belonging to the Paramphistomidae sub-family. ITS2 sequence analysis using BlastN results indicated that this is the first report of S. compactus (KP639630) and C. dollfusi (KP639636). Phylogenetic reconstruction of the paramphistome isolates revealed three separate clades representing the three species. However, the clade with all the C. microbothrium isolates was the only one that was supported by a higher bootstrap value of 92%, although there was no differentiation of the isolates according to geographical locations. The low divergence values on the ITS2 sequences of the C. microbothrium isolates indicate that ITS rDNA sequences can be used as a molecular tool to infer knowledge for resolving taxonomic groupings.

Development and application of a dispersive liquid-liquid microextraction method for the determination of tetracyclines in beef by liquid chromatography mass spectrometry.

A rapid, cost effective and environmentally friendly extraction method, based on dispersive liquid-liquid microextraction (DLLME) was developed for the determination of six tetracyclines in meat destined for human consumption. Meat extracts were analysed for tetracyclines using liquid chromatography tandem mass spectrometry (LC-MS/MS), a sensitive and selective analytical technique. Various factors influencing the pre-concentration of tetracyclines such as sample pH, type and volume of both disperser solvent and extraction solvent were optimized. Validation parameters such as calibration function, limit of detection (LOD), limit of quantification (LOQ), detection capability (CCα), decision limit (CCß), accuracy and precision were established according to Commission Decision 2002/657/EC. Linearity in the range of 25-200 µg kg(-1) was obtained with regression coefficients ranging from 0.9991 to 0.9998. Recoveries of spiked blank muscle samples at three levels (50, 100 and 150 µg kg(-1)) ranged from 80% to 105% and reproducibility was between 2% and 7%. LODs and LOQs ranged from 2.2 to 3.6 µg kg(-1) and from 7.4 to 11.5 µg kg(-1) respectively while CCα ranged from 105 to 111 µg kg(-1) and CCß ranged from 107 to 122 µg kg(-1). The proposed method compared well with the existing accepted dispersive solid phase extraction method and was successfully applied to the pre-concentration and determination of tetracyclines in meat samples. Eleven of the thirty bovine muscle samples obtained from local abattoirs and butcheries were found to contain residues of two tetracycline antibiotics (chlortetracycline and oxytetracycline), with oxytetracycline being the most detected. Concentration levels of the tetracycline residues detected in bovine muscle samples were lower (12.4 and 68.9 µg kg(-1)) than the stipulated European Union maximum residue level (MRL) of 100 µg kg(-1), hence the meat was fit for human consumption. From this work it can be concluded that the DLLME is indeed a greener sample preparation method and could be used as an alternative to dispersive solid phase microextraction (dSPE).

Assessment of insulin action on carbohydrate metabolism: physiological and non-physiological methods.

Carbohydrate metabolism in humans is regulated by insulin secretion from pancreatic ß-cells and glucose disposal by insulin-sensitive tissues. Insulin facilitates glucose utilization in peripheral tissues and suppresses hepatic glucose production. Any defects in insulin action predispose an individual to glucose intolerance and Type 2 diabetes mellitus. Early detection of defects in insulin action could provide opportunities to prevent or delay progression of the disease state. There are different approaches to assess insulin action. Initial methods, such as peripheral insulin concentration and simple indices, have several limitations. Subsequently, researchers developed methodologies using intravenous glucose infusion to determine glucose fluxes. However, these methodologies are limited by being non-physiological. Newer, innovative techniques that have been developed are more sophisticated and physiological. By modelling glucose kinetics using isotope dilution techniques, several robust parameters can be obtained that are physiologically relevant and sound. This brief review summarizes most of the non-physiological and physiological methodologies used to measure the variables of insulin action.

Development of a dispersive liquid-liquid microextraction method for the determination of fluoroquinolones in chicken liver by high performance liquid chromatography.

A simple and cost effective sample pre-treatment method, dispersive liquid-liquid microextraction (DLLME), has been developed for the extraction of six fluoroquinolones (FQs) from chicken liver samples. Clean DLLME extracts were analyzed for fluoroquinolones using liquid chromatography with diode array detection (LC-DAD). Parameters such as type and volume of disperser solvent, type and volume of extraction solvent, concentration and composition of phosphoric acid in the disperser solvent and pH were optimized. Linearity in the concentration range of 30-500 µg kg(-1) was obtained with regression coefficients ranging from 0.9945 to 0.9974. Intra-day repeatability expressed as % RSD was between 4 and 7%. The recoveries determined in spiked blank chicken livers at three concentration levels (i.e. 50, 100 and 300 µg kg(-1)) ranged from 83 to 102%. LODs were between 5 and 19 µg kg(-1) while LOQs ranged between 23 and 62 µg kg(-1). All of the eight chicken liver samples obtained from the local supermarkets were found to contain at least one type of fluoroquinolone with enrofloxacin being the most commonly detected. Only one sample had four fluoroquinolone antibiotics (ciprofloxacin, difloxacin, enrofloxacin, norfloxacin). Norfloxacin which is unlicensed for use in South Africa was also detected in three of the eight chicken liver samples analyzed. The concentration levels of all FQs antibiotics in eight samples ranged from 8.8 to 35.3 µg kg(-1), values which are lower than the South African stipulated maximum residue limits (MRL).

Anaphylaxis to artesunate?

Artesunate, an artemissin derivative is a highly efficacious and relatively safe antimalarial agent. Common adverse reactions to artemissin derivatives are nausea, vomiting, anorexia and dizziness. More serious but less-frequent toxic effects of artesunate use are neutropenia, anemia, hemolysis, elevated liver enzymes and severe allergic reactions. However, anaphylactic reaction to artesunate is a rare entity. Here, we report a case of anaphylaxis to parenteral artesunate and its successful management in a female patient to whom intravenous artesunate was administered during surgery under general anesthesia.

Predictors of tobacco smoking and smokeless tobacco use among adults in Bangladesh.

INTRODUCTION: To examine predictors of current tobacco smoking and smokeless tobacco use among the adult population in Bangladesh. MATERIALS AND METHODS: We used data from the 2009 Global Adult Tobacco Survey (GATS) in Bangladesh consisting of 9,629 adults aged ≥15 years. Differences in and predictors of prevalence for both smoking and smokeless tobacco use were analyzed using selected socioeconomic and demographic characteristics that included gender, age, place of residence, education, occupation, and an index of wealth. RESULTS: The prevalence of smoking is high among males (44.7%, 95% confidence interval [CI]: 42.5-47.0) as compared to females (1.5%, 95% CI: 1.1-2.1), whereas the prevalence of smokeless tobacco is almost similar among both males (26.4%, 95% CI: 24.2-28.6) and females (27.9%, 95% CI: 25.9-30.0). Correlates of current smoking are male gender (odds ratio [OR] = 41.46, CI = 23.8-73.4), and adults in older age (ORs range from 1.99 in 24-35 years age to 5.49 in 55-64 years age), less education (ORs range from 1.47 in less than secondary to 3.25 in no formal education), and lower socioeconomic status (ORs range from 1.56 in high wealth index to 2.48 in lowest wealth index. Predictors of smokeless tobacco use are older age (ORs range from 2.54in 24-35 years age to 12.31 in 55-64 years age), less education (ORs range from 1.44 in less than secondary to 2.70 in no formal education), and the low (OR = 1.34, CI = 1.0-1.7) or lowest (OR = 1.43, CI = 1.1-1.9) socioeconomic status. CONCLUSION: Implementation of tobacco control strategies needs to bring special attention on disadvantaged group and cover all types of tobacco product as outlined in the WHO Framework Convention on Tobacco Control (FCTC) and WHO MPOWER to protect people's health and prevent premature death.