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INTRODUCTION: Tropical diseases are public health problems affecting hundreds of millions of people globally. However, the development of adequate, affordable, and accessible treatments is mostly neglected, resulting in significant morbidity and mortality that could otherwise be averted. Leishmaniasis is one of the neglected tropical diseases caused by the obligate intracellular protozoan Leishmania parasite and transmitted by the bite of infected phlebotomine sandflies. No systematic review and meta-analysis has been done to identify the prevalence and risk factors of leishmaniasis to the authors' knowledge. Therefore, the objective was to determine the prevalence and risk factors of human leishmaniasis in Ethiopia. METHODS: Eleven studies conducted in all regions of Ethiopia, which were fully accessible, written in any language, and original articles done on prevalence and risk factors of leishmaniasis, were included. STATA™ version 11.1 was used for statistical analysis. Chi-square, I2, and p values were assessed to check heterogeneity. A random effects model with heterogeneity taken from an inverse-variance model was employed to estimate the pooled effect. Subgroup meta-analysis was computed to reduce random variations among each article's point prevalence, and Egger and funnel plots were used to check for publication bias. RESULTS: The highest proportion of human leishmaniasis was reported from a study done in Amhara region (39.1%), and the lowest was reported from a survey done in Tigray (2.3%). The overall pooled prevalence of leishmaniasis was 9.13% (95% CI 5-13.27). Subgroup analysis by region revealed moderate heterogeneity (I2 = 51.8%) in studies conducted in the Southern Nations Nationalities and Peoples Region (SNNPR). The presence of hyraxes and being male were associated with an increased risk of human leishmaniasis. CONCLUSION: The prevalence of leishmaniasis in Ethiopia remains high (9.13%), with significant risk factors being male and the presence of hyraxes within a 300-m radius of the sleeping area.
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BACKGROUND: Vasectomy is one of the highly effective and non-reversible types of long-term family planning methods for men. Ethiopia has a limited number of studies on the use of vasectomy, and they are focused on men rather than married men. The current study was aimed to identify the intention to use vasectomy as a method of contraception among married men in the study setting. METHODS: A community-based cross-sectional study was conducted from February 1 - April 30, 2018. A sample of 422 married men was recruited using a systematic random sampling method. We conducted face to face interviews with a structured questionnaire (i.e. closed-ended questions). Data were entered into Epi data version 3.1 and SPSS version 23 used for data analysis. The statistical association between the outcome variable (Intention to use vasectomy) and the explanatory variables were first tested with binary logistic regression. Multivariable logistic regression was used to control for confounding effect of each predictor. RESULTS: The study findings showed that the intention to use vasectomy as a method of family planning was reported as high (24%). About 34.8% of the respondents had good knowledge and nearly a quarter (23.2%) of them had a positive attitude toward the acceptance of vasectomy use. In multivariate analysis, age range between 30 and 39 years [AOR = 2.4, 95% CI = (1.16-4.82)], having good knowledge about vasectomy use [AOR = 6.22, 95% CI = (3.17-12.21)], and having a positive attitude toward vasectomy use [AOR = 7.81, 95% CI = (4.25-14.38)] were factors significantly associated to use vasectomy as compared to their counterparts. CONCLUSION: The level of acceptance of vasectomy (24%) was high compared to the level of its use in developing countries (i.e. if acceptability translates to use). The study revealed that age, good knowledge, and a positive attitude towards the use of vasectomy were important predictors of the intention to accept vasectomy. To further promote the use of vasectomy effective communication strategies in family planning programs are needed.
