Female genital mutilation: trends, economic burden of delay and basis for public health interventions.

BACKGROUND: The practice of female genital mutilation (FGM) is a health and social problem. Millions of girls and women have undergone FGM or will soon, and more information is needed to effectively reduce the practice. The aim of this research is to provide an overview of the FGM trendlines, the inequality of its prevalence, and the economic burden. The findings shed light on 30-year trends and the impact of the pandemic on planned efforts to reduce FGM which helps with public health interventions. METHODS: Temporal trend analysis, and graphical analysis were used to assess the change and inequality over the last 30 years. We included 27 countries in which FGM is prevalent. We calculated the extra economic burden of delayed interventions to reduce FGM like COVID-19. RESULTS: For the 27 countries analyzed for temporal trendlines, 13 countries showed no change over time while 14 had decreasing trends. Among the 14, nine countries, Uganda, Togo, Ghana, Benin, Kenya, Nigeria, Central African Republic, Chad, and Ethiopia had high year-decrease (CAGR - 1.01 and - 10.26) while five, Côte d'Ivoire, Egypt, Gambia, Djibouti, and Mali had low year-decrease (CAGR>-1 and < 0). Among these five are the highest FGM prevalence similar distribution regardless the wealth quintiles or residence. There is an economic burden of delay or non-decline of FGM that could be averted. CONCLUSION: Findings indicate that some countries show a declining trend over time while others not. It can be observed that there is heterogeneity and homogeneity in the FGM prevalence within and between countries which may indicate inequality that deserves further investigation. There is considerable economic burden due to delays in the implementation of interventions to reduce or eliminate FGM. These insights can help in the preparation of public health interventions.

Prevalence of ABO and Rhesus (D) Blood Group and Allelic Frequency at Blood Bank of Nigist Eleni Mohammed Hospital, Ethiopia.

Background: The purpose of this cross-sectional study was to determine the pattern of the ABO and rhesus D (RhD) blood group distribution among voluntary blood donors attending five blood donation centers at Nigist Eleni Mohammed General Hospital in Hossana, Ethiopia. Methods: A total of 1,120 participants who fulfilled the "who can give blood" criteria of the World Health Organization were selected randomly. Blood samples were collected, transported to the laboratory, and analyzed for ABO and RhD typing. The data was analyzed using descriptive statistics and chi-square correlation analysis. Results: The study found that the O blood group was the most prevalent (39.0%), followed by A (32.2%), B (22.5%), and AB (6.4%). When considering both the ABO and Rh blood groups together, 92.9% of blood donors were RhD positive, while only 7.1% were RhD negative. The distribution pattern of the ABO blood groups in Gurage Zone, Hadiya Zone, Kembata Zone, and Silte Zone showed that the O blood group was the most prevalent, followed by A, B, and AB, in that order. Conversely, the ABO blood group distribution pattern in Halaba Zone was A > O > B > AB. Civil servants from different occupational statuses were the most dominant voluntary blood donors, accounting for 53.2%, followed by students from different high schools and universities (41.9%), self-employed individuals (4.1%), and others (0.7%). The ABO blood group system had observed allele frequencies significantly different from the expected frequencies (p = 0.007), while the RhD system did not (p = 0.037). Allele frequencies for A, B, and O in the ABO system were 0.3531, 0.2576, and 0.3893, respectively. Observed frequencies for RhD-positive and RhD-negative alleles were 0.9647 and 0.0531, respectively. Conclusion: This study highlights the regional ABO and RhD blood group variations in Ethiopia, noting disparities from expected ABO allele frequencies, and identifies the O blood group predominance among donors with a high RhD-positive prevalence.

Health-related quality of life and associated factors among health care providers in the northwest of Ethiopia: a multicenter cross-sectional study, 2023.

Background: The diminished quality of life among healthcare providers (HCPs) could impact both their personal well-being and their ability to effectively fulfill healthcare needs and provide necessary facilities to the public. Furthermore, this decline in quality of life may also significantly influence the overall health of HCPs, regardless of their professional training and duties. Objectives: The aim of this study was to assess the health-related quality of life (HRQoL) and associated factors among healthcare providers at comprehensive specialized hospitals in the Northwest Ethiopia. Method: A cross-sectional study was conducted among 412 healthcare providers at comprehensive specialized hospitals in Northwest Ethiopia from June to July 2023. Study participants were enrolled using simple random sampling. Health-related quality of life (HRQoL) was measured using the World Health Organization Quality of Life Scale-Bref Version. Data entry and analysis were performed using Epi-data version 4.6.1 and SPSS version 24, respectively. Binary logistic regression was employed to assess the association between quality of life and independent variables. Variables with a p-value <0.05 at a 95% confidence interval were considered statistically significant. Result: Out of the 422 study participants approached, 412 respondents were included in the final analysis. Poor quality of life was observed in 54.6% of participants. Factors such as working hours per day (AOR = 1.85, 95% CI: 1.12; 3.05), working experience (AOR = 1.95, 95% CI: 1.04; 3.65), and the presence of chronic disease (AOR = 2.11, 95% CI: 1.18; 3.75) were significantly associated with poor quality of life. Conclusion: This study revealed that more than half of the participants experienced poor quality of life. Specific attention is needed for healthcare providers working for more than 8 h per day, those with less work experience, and those with chronic illnesses in order to improve their quality of life.

Predictors of severe hepatotoxicity among retroviral infected adults on HAART regimen in Ilubabor Zone, Southwest Ethiopia.

Nearly half of the deaths among hospitalized human immuno deficiency virus-infected patients in the highly active antiretroviral therapy era have been attributed to liver disease. This may range from an asymptomatic mild increase of liver enzymes to cirrhosis and liver failure. Different works of literature elucidated both retroviral infection and the adverse effects of highly active antiretroviral therapy as a cause of hepatotoxicity. Individual adaptations to medications and environmental exposures, shaped by cultural norms and genetic predispositions, could potentially modulate the risk and progression of liver disease in this population. Therefore, this study aims to assess the predictors of severe hepatotoxicity in retroviral-infected adults receiving highly active antiretroviral therapy regimens within the Ilubabor Zone, Southwest Ethiopia. A facility-based cross-sectional study was conducted among adult retroviral-infected patients in five selected anti-retro virus therapy clinics from May1 to July 30/2022. A systematic sampling technique was used to select 457 study participants and Binary logistic regression statistical data analysis was used, P value < 0.05 was considered statistically significant. The prevalence of severe hepatotoxicity was 21.44% in the study population. CD+4 count < 200 cells/mm3 (AOR = 2.19, 95% CI 1.04-5.22, P = 0.01), human immunodeficiency virus co-infection with tuberculosis (AOR = 2.82, 95% CI 1.01-8.29, P = 0.03) and human immuno deficiency virus co-infection with hepatitis-B/hepatitis C virus (AOR = 5.02, 95% CI 1.82-16.41) were predictors of severe hepatotoxicity. The magnitude of severe hepatotoxicity was high among adult retroviral-infected patients on highly active anti-retroviral drug regimens. Co-infection of human immuno deficiency virus with hepatitis B virus or hepatitis C virus, tuberculosis and CD4+T-cell count below 200 cells/mm3 were predictors of severe hepatotoxicity. Therefore, HIV patients on highly active antiretroviral therapy require close attention and regular monitoring of their liver function.

Common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia, 2022: a cross-sectional study.

BACKGROUND: Common mental disorders describe the physical, mental, and social disturbances that are more prevalent in low and middle-income countries. Mothers are among the more vulnerable groups especially mothers having children with under-nutrition. However, there are limited studies about the magnitude of common mental disorders among mothers of undernourished children in Ethiopia. Therefore, we aimed to assess the magnitude of common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia. METHODS: A cross-sectional study was employed on 405 systematically selected participants. The outcome variable was assessed by a self-reporting questionnaire (SRQ-20) which was applicable and validated in Ethiopia. Data were entered and analyzed by EPi data version 5 software and SPSS version 25 respectively. Model fitness was checked by Hosmer Lemeshow's test. Logistic regression was employed to identify significant determinants. A p-value < 0.05 was used to declare association and expressed by odds ratio with a 95% CI. RESULT: In this study, the magnitude of common mental disorders was 33.16% (95% CI [28.5-38])). In multivariable analysis, six factors poor social support [AOR: 14.0, 95% CI (5.45, 35.9)], educational status [AOR: 1.95, 95% CI (1.07. 3.55)], cigarette smoking [AOR: 10.9, 95% CI (1.78, 67.01)], mother of a child with another chronic disease [AOR: 3.19, 95% CI (1.13, 8.99)], sexual violence [AOR: 4.14, 95% CI (1.38, 12.4)] and mothers with chronic disease [AOR: 3.44, 95% CI (1.72, 6.86)] were significantly associated with common mental disorders. CONCLUSION: The magnitude of common mental disorders was high. Six factors were significantly associated with common mental disorders; social support, sexual violence, maternal chronic illness, educational status, smoking, and mother of child with other chronic disease. Community awareness regarding the effect of violence, substance use, and social support on mental health should be created by the local stakeholders.

Knowledge-attitude and practice of Anthrax and brucellosis: Implications for zoonotic disease surveillance and control in pastoral communities of Afar and Somali region, Ethiopia.

BACKGROUND: Anthrax and brucellosis are endemic national priority zoonotic diseases in Ethiopia. This study assess the possible factors explaining the current limited information available on animal and human cases in pastoral communities. METHODS: Two questionnaire surveys gathered data from 509 pastoralists and 51 healthcare providers between February and April 2019 in five districts of Afar and the Somali region (SRS). RESULTS: Among the 51 healthcare providers, 25 (49%) and 38 (74.5%) had heard of brucellosis, and anthrax, respectively. Of those, only 3 (12%) and 14 (36.8%) knew the symptoms of brucellosis and Anthrax. None of the Health Extension Workers knew any disease symptoms. Healthcare providers recalled two human cases of brucellosis and 39 cases of Anthrax in the last 12 months, based on symptom-based diagnosis. Pastoralists had a moderate level of knowledge about diseases in their animals, with over half (52.4%; n = 267/509) understanding that animals can transmit diseases to people. Overall, 280 out of 508 (55.1%) and 333 out of 507 (65.7%) pastoralists had heard of brucellosis and Anthrax, respectively. Among the latter, 282 (51.3%) knew at least one preventive measure for Anthrax. However, disease knowledge among women was poor. Despite their knowledge, pastoralists engaged in risky unprotected animal handling, animal product consumption/usage as well as husbandry behaviors exposing them to pathogens and favoring the spread of diseases. They identified Anthrax as the most important zoonosis (47.6%) and as one of top three diseases suspected to cause mortality in their livestock. Pastoralists highlighted lack of vaccine coverage, availability and their timely administration. Both, pastoralists and healthcare providers stated the lack of disease awareness and the unavailability of drugs in the market as important challenges. Health facilities lacked protocols and standard operating procedures for managing zoonotic diseases, and did not have access to laboratory confirmation of pathogens. CONCLUSION: Our study revealed significant under-reporting of Anthrax and brucellosis, and weak prevention and response in humans, mostly associated with poor disease knowledge of healthcare providers. Ability to respond to animal outbreaks was limited by vaccine and drugs availability, timely vaccine administration and the mobility of pastoralists.

Tuberculosis treatment outcomes and associated factors among tuberculosis patients treated at healthcare facilities of Motta Town, Northwest Ethiopia: a five-year retrospective study.

Tuberculosis (TB) remains a significant public health concern, particularly in low-resource settings. The treatment outcome is a crucial indicator of the effectiveness of TB treatment programs. Assessing the current treatment outcome and its associated factors is essential for improving patient care and reducing the spread of TB. Therefore, this study aimed to assess TB treatment outcomes and their associated factors among TB patients who received treatment at public healthcare facilities in Motta Town, Northwest Ethiopia. A facility-based retrospective cross-sectional study design was employed in two TB treatment centers in Motta town from January 2017 to December 2021. The study participants were all patients diagnosed with TB who received treatment. A p-value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance. A total of 362 TB patients were included in the study. The overall treatment success rate was 88.4% (95% CI 85.1, 91.7). Male gender (AOR = 2.40, 95% CI 1.16, 4.98), normal nutritional status (AOR = 3.11, 95% CI 1.33, 7.25), HIV negative status (AOR = 3.35, 95% CI 1.31, 8.60), and non-presumptive drug resistance to TB (AOR = 3.72, 95% CI 1.74, 7.98) were significantly associated with successful TB treatment outcomes (p < 0.05). In the current study, nine out of ten study participants had successful TB treatment outcome rates. Male gender, normal nutritional status, non-presumed drug resistance to TB, and HIV-negative status were significantly associated with successful TB treatment outcomes. By taking risk factors associated with poor treatment outcomes like those found in this study into account, patient management and treatment can be optimized. Sufficient TB control measures for populations are imperative and could significantly reduce the nation's total TB burden.

Health related quality of life and its predictive factors on cervical cancer patients in two teaching hospitals, Addis Ababa, Ethiopia.

BACKGROUND: Cervical cancer is the second most prevalent and the leading cause of cancer related deaths among Ethiopian women; and about three fourth are diagnosed at advanced stages. Cervical cancer can affect the health-related quality of life (HRQOL) in multiple ways. The main aim of this study was to describe the HRQOL of cervical cancer patients and the predictive factors using validated tools. METHODS: Institution based cross-sectional study was conducted among 264 cervical cancer patients using the validated Amharic version of European Organization for Research and Treatment of Cancer (EORTC) modules; QLQ-C30 and QLQ CX24. Descriptive statistics were used to summarize the raw data. One way ANOVA was used to determine the significance of mean differences between the dependent and independent variables. Binary and multivariable regression analysis were used to measure the association between Global Health Status and independent factors. The level of significance was set at p-value < 0.05. RESULTS: On EORTC QLQ-C30 scales, the mean Global Health Status (GHS) was 42.57 ± 23.31. The least and highest affected functions were physical and social, mean (SD) = 76.39 ± 23.24 and 50.40 ± 32.19, respectively. The financial difficulty was the most affected among the symptom scales, 57.83 ± 35.34. Only physical function and financial difficulty have shown an independent association with GHS, (AOR = 0.21, 95% CI = 0.05-0.84), (AOR = 0.21 95% CI = 0.07-0.59), respectively. Illiterate, can read and write, were among the predictor factors that showed an independent association with the Global Health Status. Among the EORTC QLQ-CX24 symptom scales, the highest affected score was for sexual worry, mean (SD) = 51.81 + 32.197. CONCLUSIONS: In an effort to improve the Global Health Status of cervical cancer patients in Ethiopia; physical function and financial difficulty should be the priority areas. The Illiterate and those who lack formal education need due attention in order to improve the health-related quality-of-life.

Adverse fetal birth outcomes and its associated factors among mothers with premature rupture of membrane in Amhara region, Ethiopia.

BACKGROUND: Adverse birth outcomes are the leading cause of neonatal mortality worldwide. Ethiopia is one of the countries struggling to reduce neonatal mortality through different strategies, but neonatal mortality remains high for many reasons. Despite adverse birth outcomes being a public health problem in Ethiopia, the contribution of Premature rupture of the membrane to the adverse fetal birth outcome is neglected and not well explained in our country. This study aims to assess fetal birth outcomes and associated factors among mothers with all types of PROM at Specialized Hospitals in Amhara Region, Ethiopia. METHODS: A facility-based cross-sectional study design was applied among 538 mothers with premature rapture of the membrane at Amhara region specialized hospitals. A simple random sampling technique was employed to select the medical charts diagnosed with all types of PROM and giving birth in the hospital within the period from July 8, 2019, to July 7, 2021. The data was collected using a checklist, entered into EPI Data version 3.1, and analyzed using SPSS version 23. A binary logistic regression model was used to see the association between independent and dependent variables. A P-value <0.05 was used to declare the statistical significance. The AOR with 95% CI was used to measure the strength of the association. RESULT: Adverse birth outcome among all types of Premature rupture of membrane mothers was 33.1% [95% CI 29.2-37.2]. Rural residents [AOR = 2.94, 95% CI:1.73-4.97], have a history of urinary tract infection [AOR = 6.87, 95% CI: 2.77-17.01], anemia [AOR = 7.51, 95% CI: 2.88-19.62], previous history of adverse birth outcome [AOR = 3.54, 95% CI: 1.32-9.47] and less than two years interpregnancy interval [AOR = 6.07, 95% CI: 2.49-14.77] were positively associated with adverse birth outcome compared to their counterparts. CONCLUSION: The adverse birth outcome was high in the Amhara region as compared to the World Health Organization's estimated figure and target; the target is less than 15%. History of the previous adverse birth outcome, residence, urinary tract infection, Anemia, and interpregnancy interval had an association with adverse birth outcomes. Therefore, strengthening close follow-up for mothers who had previous adverse birth outcomes, screening and treatment of urinary tract infection, anemia prevention, and maximizing birth interval are recommended for reducing adverse birth outcomes.

The burden attributable to primary headache disorders in children and adolescents in Ethiopia: estimates from a national schools-based study.

BACKGROUND: We previously reported high prevalences of headache disorders among children (6-11 years) and adolescents (12-17 years) in Ethiopia. Here we provide data on headache-attributed burden collected contemporaneously from the same study participants. Part of the global schools-based programme within the Global Campaign against Headache, the study is the first to present such data from sub-Saharan Africa. METHODS: A cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. The child or adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaires were self-completed under supervision by pupils in class. Headache diagnostic questions were based on ICHD-3 beta but for the inclusion of undifferentiated headache (UdH). RESULTS: Of 2,349 eligible participants, 2,344 completed the questionnaires (1,011 children [43.1%], 1,333 adolescents [56.9%]; 1,157 males [49.4%], 1,187 females [50.6%]; participating proportion 99.8%). Gender- and age-adjusted 1-year prevalence of headache, reported previously, was 72.8% (migraine: 38.6%; tension-type headache [TTH]: 19.9%; UdH: 12.3%; headache on ≥ 15 days/month (H15+): 1.2%). Mean headache frequency was 2.6 days/4 weeks but, with mean duration of 2.7 h, mean proportion of time with headache was only 1.0% (migraine: 1.4%; TTH: 0.7%; H15+: 9.1%). Mean intensity was 1.8 on a scale of 1-3. Symptomatic medication was consumed on about one third of headache days across headache types. Lost school time reportedly averaged 0.7 days over the preceding 4 weeks, representing 3.5% of school time, but was 2.4 days/4 weeks (12.0%) in the important small minority with H15+. However, actual absences with headache the day before indicated averages overall of 9.7% of school time lost, and 13.3% among those with migraine. Emotional impact and quality-of-life scores reflected other measures of burden, with clear adverse impact gradients (H15 + > migraine > TTH > UdH). CONCLUSIONS: The high prevalence of headache among children and adolescents in Ethiopia, who represent half its population, is associated with substantial burden. Lost school time is probably the most important consequence. Estimates suggest a quite deleterious effect, likely to be reflected in both individual prospects and the prosperity of society.

Incidence of intraoperative hypotension and its factors among adult traumatic head injury patients in comprehensive specialized hospitals, Northwest Ethiopia: a multicenter observational study.

INTRODUCTION: Traumatic head injury (THI) poses a significant global public health burden, often contributing to mortality and disability. Intraoperative hypotension (IH) during emergency neurosurgery for THI can adversely affect perioperative outcomes, and understanding associated risk factors is essential for prevention. METHOD: A multi-center observational study was conducted from February 10 to June 30, 2022. A simple random sampling technique was used to select the study participants. Patient data were analyzed using bivariate and multivariate logistic regression to identify significant factors associated with intraoperative hypotension (IH). Odds ratios with 95% confidence intervals were used to show the strength of association, and P value < 0.05 was considered as statistically significant. RESULT: The incidence of intra-operative hypotension was 46.41% with 95%CI (39.2,53.6). The factors were duration of anesthesia ≥ 135 min with AOR: 4.25, 95% CI (1.004,17.98), severe GCS score with AOR: 7.23, 95% CI (1.098,47.67), intracranial hematoma size ≥ 15 mm with AOR: 7.69, 95% CI (1.18,50.05), and no pupillary abnormality with AOR: 0.061, 95% CI (0.005,0.732). CONCLUSION AND RECOMMENDATION: The incidence of intraoperative hypotension was considerably high. The duration of anesthesia, GCS score, hematoma size, and pupillary abnormalities were associated. The high incidence of IH underscores the need for careful preoperative neurological assessment, utilizing CT findings, vigilance for IH in patients at risk, and proactive management of IH during surgery. Further research should investigate specific mitigation strategies.

Stabilizing time and its predictors among 1-59 months old children managed for severe acute malnutrition during the humanitarian crisis in Tigray regional state of Ethiopia, 2023: a prospective cohort study.

BACKGROUND: Higher rate of acute malnutrition is observed in emergencies compared to non-emergency settings and severe acute malnutrition upsurges alarmingly and become deadly in humanitarian crises due to lack of food, lack of quality water supply and insufficient healthcare. Research is one learning tool by identifying strength and areas of improvement. However, little is known about outcomes of therapeutic feeding programmes in comparison with the standard indicators set in humanitarian setting. METHODS: Health facility based prospective cohort study was conducted using routinely collected programme data of children hospitalized to the inpatient therapeutic feeding center in suhul general hospital from January 1st, 2023 to June 30, 2023. Data was collected using a form developed relating to the federal ministry of health standard management protocols for severe acute malnutrition then it was cleaned, coded and entered to EpiData version 4.2.0 and then exported to SPSS version 25 for analysis. RESULTS: From 184 children, 96.2% were stabilized while the remaining 3.8% were censored with overall median stabilizing time of 8 days. Weight gain was used as one of the discharging criteria for infants less than six months and their mean weight gain found to be 12.89 g per kilogram daily. Appetite test (AHR = 0.338; 95% CI: 0.221-0.518), blood transfusion (AHR = 5.825; 95% CI: 2.568-13.211), IV fluid resuscitation (AHR = 2.017; 95% CI: 1.094-3.717), IV antibiotics (AHR = 2.288; 95% CI: 1.164-4.500) and NG tube feeding (AHR = 1.485; 95% CI: 1.065-2.071) were identified as significant predictors of stabilizing time. CONCLUSION: All the outcome indicators for stabilization center are consistent with the SPHERE association set of standards during humanitarian intervention. The hospital and other concerned humanitarian organizations should focus on sustaining these achievements as suhul hospital is the main treatment center for children suffering from severe acute malnutrition in the northwest zone of Tigray regional state. Further pre-post experimental studies which compare the stabilizing time before and after crisis are recommended.

Incidence and predictors of mortality among neonates admitted with birth asphyxia to neonatal intensive care unit of West Shewa Zone Public Hospitals, Central Ethiopia.

BACKGROUND: Birth asphyxia is still one of the primary causes of newborn mortality worldwide. Similarly, the risk of newborn asphyxia in Ethiopia remains unacceptably high. Thus, studies on the incidence and predictors of mortality among newborns admitted with birth asphyxia are crucial to addressing this problem. As a result, the purpose of this study was to assess the incidence and predictors of mortality among neonates admitted with birth asphyxia to the neonatal intensive care units (NICUs) of West Shewa Zone Public Hospitals in Central Ethiopia. METHODS: An institution-based retrospective cohort study was conducted among 760 asphyxiated neonates admitted to the NICUs of West Shewa Zone Public Hospitals between 30 March 2021 and 30 April 2023. The data were collected using CSEntry and analysed bu using Stata V.17. Bivariate and multivariate Cox proportional hazard regression analyses were carried out, and significant predictors were found using a 95% CI and a p<0.05. RESULTS: A total of 760 asphyxiated neonates were followed for a total of 6880 neonatal days. At the end of follow-up, 263 (34.6%) of the neonates died (95% CI 31.3% to 38.1%), which resulted in a mortality incidence of 10.6/100 person-days of observation. Chewing khat (adjusted HR, AHR 2.21; 95% CI 1.13 to 4.31), home delivery (AHR 1.45, 95% CI 1.1 to 1.9), lack of antenatal care follow-up (AHR 1.44, 95% CI 1.08 to 1.89), hypothermia (AHR 1.56, 95% CI 1.12 to 2.17), hypoglycaemia (AHR 2.23, 95% CI 1.91 to 2.25) and obstructed labour (AHR 1.4, 95% CI 1.02 to 1.91) were found to be the significant predictors of neonatal mortality among asphyxiated neonates at a p≤0.05. CONCLUSION AND RECOMMENDATION: The magnitude of neonatal mortality among asphyxiated neonates in the study area was high. Therefore, in order to significantly reduce the risks of birth asphyxia and subsequent newborn death, all interested stakeholders should take these predictors into consideration.

Prevalence of Protozoan Pathogens Among Diarrheic Children Under 5 Years in Public Hospital of Ethiopia During the Global COVID 19 Pandemic.

Acute childhood diarrhea is one of the leading causes of childhood morbidity and mortality in sub-Saharan African countries. Entamoeba histolytica and Giardia lamblia are the common cause of childhood diarrhea in the region. However, there are only few studies on protozoa causing diarrhea in sub-Saharan African countries. This study was conducted to investigate the relative prevalence and explore risk factors of E. histolytica and G. lamblia among diarrheic children of under 5 years in a public hospital of Ethiopia. A retrospective study was conducted among diarrheic children at Hiwot Fana hospital, Ethiopia. Records of all diarrheic children less than 5 years who had sought medical treatment in the hospital from September 1, 2020 to December 31, 2022 were included. Data were collected from 1257 medical records of the children using a structured data-collection format. Data were entered into an Excel sheet and exported into SPSS version 22 for data processing and analysis. Descriptive statistical tests, Chi-square, and logistic region analysis were applied to determine predictors of protozoa infections. Of the 1257 cases, 962 (76.5%) had watery diarrhea and the remaining 239 (19.0%) had dysentery. The combined prevalence of E. histolytica and G. lamblia among diarrheic children was 11.8% (95% CI: 9.6-13.4). As the age of children increased, the frequency of these two protozoan infections was significantly increased compared to children with other causes. There were more diarrhea cases during the summer season including those associated with E. histolytica and G. lamblia. This study revealed that 1 in 10 causes of diarhhea among young children in the study area was likely caused by E. histolytica and G. lamblia. These findings call for community-based safe water and food safety interventions in order to reduce childhood diarrhea caused by protozoan infections in resource-poor settings.

Geographical distribution of emergency obstetric and neonatal care signal functions in Ethiopian health facilities: 2021-2022 Ethiopian service Provision Assessment (SPA).

BACKGROUND: The maternal mortality ratio in Ethiopia is still high, with an estimate of 412 deaths per 100,000 live births in 2016. Signal functions for emergency obstetric and neonatal care must be accessible and usable in order to successfully prevent maternal deaths. It is an important strategy to reduce maternal and newborn morbidity and mortality in countries with limited resources. Hence, an assessment of the availability of fully functioning EmONC services and their coverage per 500,000 people in Ethiopia is crucial. METHODS: This study is a retrospective analysis of data from the Ethiopian Service Provision Assessment Survey (ESPA), a national-level survey data source. Data collection for the survey took place from August 11, 2021, to February 4, 2022. For this investigation, 905 healthcare facilities in total were evaluated for the availability of emergency obstetric and new-born care (EmONC) services at all hospitals, selected health centers, and private clinics were evaluated. Descriptive data analysis was done by the using statistical package for social science version 26 (SPSS) to run frequency and cross-tabs. Global Positioning System (GPS) (arc map 10.8) Software was used for spatial distribution in order to locate the physical accessibility of EmONC providing health facilities on flat map surfaces. It was projected based on Ethiopia's geographic coordinate system at Adindan UTM zone 370N. RESULTS: Of 905 health facilities, only 442 (49%) could provide fully functioning BEmONC, and 250 (27.6%) health facilities have been providing fully functioning CEmONC. The overall coverage of BEmONC ratios in Ethiopia is 1.5-3.77 per 500,000 population and CEmONC (0.83-2.1) per 500,000 populations. Regions such as Amhara, SNNPR and Addis Ababa had found to have high BEmONC ratio. The geographical distribution of the EmONC showed that the central areas of the country, such as southwest Shewa and east Shewa, the Oromia region, the northern areas of the South Nation, nationalities, and peoples regions (SNNPR), including the Gurage zone and the Wolaita-Soddo zone, and the middle areas in the Amhara region (west Gojjam or around Bahir Dar town), and the southern areas, Debra Tabor and Debre Birhane zones, all had greater access to facilities offering complete EmONC services. CONCLUSION: Comprehensive emergency obstetrics and neonatal care (CEmONC) in Ethiopia met WHO recommendations, despite basic emergency obstetric and neonatal care (BEmONC) falling below those standards in Ethiopia. There are extremely large disparities in the accessibility of both basic and comprehensive emergency obstetrics and neonatal care in Ethiopia. Thus, Strategic planning is needed to improve infrastructures and inputs for EmONC services, particularly in remote areas of the country. Additionally, private facilities ought to place a priority on the provision of these services.

Goat flock abortion: a retrospective study at Abergelle Agricultural Research Center, Tigray, Ethiopia.

BACKGROUND: Small ruminants are the principal component of livestock production in Tigray region, Ethiopia. But their productivity is affected by various factors. According to farmers and expert observation, goat abortion is among the leading causes of production losses in Tanqua-Abergelle district. However, study findings that examine the extent of distribution and economic impact of abortion cases in goats in the district are scarce. This retrospective study investigated the occurrence of abortion and its associated risk factors in three goat breed types at Abergelle Agricultural Research Center goat breeding site over a seven year period. The study included a total of does above one year old, and data were collected from a casebook that was specifically prepared for abortion cases. A thorough follow up was conducted to identify abortion cases. Additionally, a community survey was conducted in selected villages where the research center is located. RESULTS: The overall abortion proportion was 29.8% in the goat farm. Begait goat breeds had the highest abortion proportion (50.9%, CI 0.36-0.64) in 2015/16. Multivariate logistic regression analysis identified year, season, age and breed as major risk factors of abortion occurrence at flock level. Accordingly, the likelihood of goats experiencing abortion during the dry season (proportion = 34) was 1.87 times higher compared to those in the wet season (proportion = 22.8). Begait breeds had a higher incidence of abortion (proportion 37.5%, OR 4.87, CI 2.49-10.35) compared to other breeds. Age was negatively associated with abortion, suggesting that older goats (OR = 0.67) had a higher relative risk than younger goats (OR = 0.57). Moreover, the study noted a high incidence of abortion during the years 2014/15 to 2016/17 (proportion = 35.7-39.7). Within-breed analysis revealed that age and season were significant risk factors for Abergelle and Begait breeds, respectively by using a multivariate logistic regression analysis. A community survey indicated that 89.7% households responded their goats experienced abortion. CONCLUSIONS: This study highlighted the high prevalence of goat abortion at Abergelle and identifies important risk factors associated with its occurrence. The findings can inform targeted interventions to reduce abortion rates and improve goat productivity in the district.

Spatiotemporal dynamics of cholera epidemics in Ethiopia: 2015-2021.

Since the onset of the seventh cholera pandemic, Ethiopia has been affected by recurrent epidemics. However, the epidemiology of cholera in this country remains poorly understood. This study aimed to describe cholera outbreak characteristics in Ethiopia from 2015 to 2021. During this period, Ethiopia experienced four epidemic waves. The first wave involved nationwide outbreaks during the second half of 2016 followed by outbreaks predominantly affecting Somali Region in 2017. The second wave primarily affected Tigray and Afar Regions. During the third wave, multiple smaller-scale outbreaks occurred during 2019. The fourth wave was limited to Bale Zone (Oromia Region) in 2021. Overall, a north to south shift was observed over the course of the study period. Major cholera transmission factors included limited access to safe water and sanitation facilities. Severe weather events (drought and flooding) appear to aggravate cholera diffusion. Cholera transmission between Ethiopia and nearby countries (Kenya and Somalia), likely plays a major role in regional cholera dynamics. Overall, this study provides the first understanding of recent spatiotemporal cholera dynamics in Ethiopia to inform cholera control and elimination strategies.

Comparison of analysis methods to classify cholera hotspots in Ethiopia from 2015 to 2021.

Cholera continues to represent a major public health concern in Ethiopia. The country has developed a Multi-sectoral National Cholera Elimination Plan in 2022, which targets prevention and control interventions in cholera hotspots. Multiple methods to classify cholera hotspots have been used in several countries. Since 2014, a classification method developed by United Nations Children's Fund has been applied to guide water, sanitation and hygiene interventions throughout Sub-Saharan Africa based on three outbreak parameters: frequency, duration and standardized attack rate. In 2019, the Global Task Force on Cholera Control (GTFCC) proposed a method based on two parameters: average annual cholera incidence and persistence. In 2023, an updated GTFCC method for multisectoral interventions considers three epidemiological indicators (cumulative incidence, cumulative mortality and persistence,) and a cholera-case confirmation indicator. The current study aimed to classify cholera hotspots in Ethiopia at the woreda level (equivalent to district level) applying the three methods and comparing the results to optimize the hotspot targeting strategy. From 2015 to 2021, cholera hotspots were located along major routes between Addis Ababa and woredas adjacent to the Kenya and Somalia borders, throughout Tigray Region, around Lake Tana, and in Afar Region. The multi-method comparison enables decision makers to prioritize interventions according to a sub-classification of the highest-priority areas.

Predictors of neonatal mortality among neonates admitted to the neonatal intensive care unit at Hawassa University Comprehensive Specialized Hospital, Sidama regional state, Ethiopia.

BACKGROUND: Despite promising efforts, substantial deaths occurred during the neonatal period. According to estimates from the World Health Organization (WHO), Ethiopia is among the top 10 nations with the highest number of neonatal deaths in 2020 alone. This staggering amount makes it difficult to achieve the SDG (Sustainable Development Goals) target that calls for all nations to work hard to meet a neonatal mortality rate target of ≤ 12 deaths per 1,000 live births by 2030. We evaluated neonatal mortality and it's contributing factors among newborns admitted to the Neonatal Intensive Care Unit (NICU) at Hawassa University Comprehensive Specialized Hospital (HUCSH). METHODS: A hospital-based retrospective cross-sectional study on neonates admitted to the NICU from May 2021 to April 2022 was carried out at Hawassa University Comprehensive Specialized Hospital. From the admitted 1044 cases over the study period, 225 babies were sampled using a systematic random sampling procedure. The relationship between variables was determined using bivariate and multivariable analyses, and statistically significant relations were indicated at p-values less than 0.05. RESULTS: The magnitude of neonatal death was 14.2% (95% CI: 0.099-0.195). The most common causes of neonatal death were prematurity 14 (43.8%), sepsis 9 (28.1%), Perinatal asphyxia 6 (18.8%), and congenital malformations 3 (9.4%). The overall neonatal mortality rate was 28 per 1000 neonate days. Neonates who had birth asphyxia were 7.28 times more probable (AOR = 7.28; 95% CI: 2.367, 9.02) to die. Newborns who encountered infection within the NICU were 8.17 times more likely (AOR = 8.17; 95% CI: 1.84, 36.23) to die. CONCLUSION: The prevalence of newborn death is excessively high. The most common causes of mortality identified were prematurity, sepsis, perinatal asphyxia and congenital anomalies. To avert these causes, we demand that antenatal care services be implemented appropriately, delivery care quality be improved, and appropriate neonatal care and treatment be made available.

Health Professionals' knowledge and practice on basic life support and its predicting factors in Ethiopia: Systematic review and meta-analysis.

BACKGROUND: Basic Life Support (BLS) is a sequence of care provided to patients who are experiencing respiratory arrest, cardiac arrest, or airway obstruction. Its main purpose is to maintain the airway, breathing, and circulation through CPR. This review aimed to estimate the pooled prevalence of Health Professionals' knowledge and practice on basic life support in Ethiopia. METHOD: Eligible primary studies were accessed from international database (PubMed, Google Scholar, Hinari databases) and grey literatures found in online repositories. The required data were extracted from those studies and exported to Stata 17 for analysis. A weighted inverse-variance random-effects model and Der Simonian-Laird estimation method were used to compute the overall pooled prevalence of Health Professional's knowledge, practice of basic life support and its predictors. Variations across the included studies were checked using forest plot, funnel plot, I2 statistics, and Egger's test. RESULT: A total of 5,258 Health Professionals were included from 11 studies. The pooled prevalence of knowledge and practice outcomes on basic life support in Ethiopia were 47.6 (95% CI: 29.899, 65.300, I2: 99.21%) and 44.42 (95% CI: 16.42, 72.41, I2: 99.69) respectively. Educational status of the Professional's was significantly associated with knowledge outcome. Those who had degree and above were 1.9 times (AOR: 1.90 (1.24, 2.56)) more likely knowledgeable on basic life support than under degree. CONCLUSION: The overall pooled estimates of Health Professionals knowledge and practice on basic life support was considerably low. The educational status of the Health Professionals was significantly associated with knowledge outcome. The Health Professionals and responsible stakeholders should focus on the basic life support at Health Institutions. The professionals should advance their knowledge and skill on basic life support for the patients.