Ethiopian Journal of Health and Biomedical Sciences
The Ethiopian Journal of Health and Biomedical Sciences (EJHBS) is an open-access, multidisciplinary journal and the flagship publication of the University of Gondar. We are dedicated to advancing evidence-based knowledge and providing a global platform for the Ethiopian perspective in the health and biomedical sciences. Scope and focus EJHBS prioritizes high-quality research that addresses the unique challenges of low- and middle-income countries (LMICs). We seek to bridge the gap between bench science and bedside application in the following domains: Public and global health: Epidemiology, health systems, equity, and environmental health. Clinical sciences: Patient care and medical education. Biomedical sciences: Pharmacology, microbiology, and biochemistry. Health policy: Quality improvement Rigorous peer review and neutrality To ensure the highest scholarly standards, EJHBS employs a double-blind peer review process. While hosted by the University of Gondar, EJHBS maintains strict editorial independence. Manuscripts from host-institution authors are managed by external editors and evaluated by independent reviewers from outside the university to ensure impartial decision-making. Articles are assessed on methodological rigor, ethical compliance (IRB), and their potential to impact global health policy. Article types We welcome a diverse range of scholarly contributions: Original research Systematic reviews/meta-analyses Clinical Case Reports Protocols/Methodologies Editorials, Commentaries, and Brief Communications Open science commitment EJHBS operates as an open-access journal. Articles are published under the Creative Commons Attribution 4.0 International (CC BY 4.0) license. This model ensures that research is freely available to read, download, and redistribute globally without barriers, fostering maximum "citedness" and scientific impact. Submission and management All submissions are managed through our secure online portal. Authors are required to provide ORCID iDs to ensure global visibility and correct attribution of their scholarly work.
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Prevalence and Antimicrobial Resistance Patterns of Gram-Negative Bacteria at Amhara Public Health Institute, Northwest Ethiopia: A Six-Year Retrospective Study
Background: The global rise of multidrug-resistant Gram-negative bacteria presents a major public health challenge, particularly in low- and middle-income countries. Limited antimicrobial resistance surveillance data in Ethiopia hampers evidence-based treatment and policy decisions. Objective: This study assessed the prevalence and antimicrobial resistance patterns of Gram-negative bacteria isolated over six years (2018–2024) at the Amhara Public Health Institute (APHI), Northwest Ethiopia. Methods: An institution-based retrospective study was conducted using archived microbiology laboratory data from January 2018 to December 2024. All culture-confirmed Gram-negative bacterial isolates with complete antimicrobial susceptibility test results were included. Antimicrobial susceptibility test was performed using the Kirby–Bauer disk diffusion method according to the CLSI guidelines. Data were analyzed SPSS version 26 software. Chi-square tests were used to assess the associations between outcome and demographic variables. Statistical significance was declared at p < 0.05. Results: A total of 350 Gram-negative isolates were analyzed. Escherichia coli (29.4%, 95% CI: 24.6–34.2) and Klebsiella spp. (27.7%, 95% CI: 23.0–32.4) were the predominant isolates. Overall, 53.2% of isolates were classified as MDR. Highest resistance rates were observed against chloramphenicol (97.3%), sulfonamides (80.3%), and ampicillin (82.4%). The isolates showed the lowest resistance against Carbapenems (24.9%). Age (χ² = 106.69, p < 0.001) and sex (χ² = 12.86, p = 0.045) were significantly associated with multidrug resistance bacterial infection. Conclusion: More than half of Gram-negative isolates were multidrug resistant in the study area. Strengthening AMR surveillance, antimicrobial stewardship programs, and routine culture-based diagnosis is urgently required.
Copyright (c) 2026 Alemayehu Abate, Michael Getie, Gizeaddis Belay , Desalew Salew https://creativecommons.org/licenses/by-nc/4.0
Oral Cancer Awareness among Patients Visiting Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Background: Despite oral cancer being largely preventable and early detection significantly improving treatment outcomes, public awareness of its risk factors, early signs, and symptoms remains low, particularly in low-resource settings. In Ethiopia, late presentation is common, contributing to poor prognosis and increased morbidity. However, there is limited evidence regarding patients’ knowledge and awareness of oral cancer in Addis Ababa. This gap in information hinders the development of targeted educational and preventive strategies. Objectives: To assess the awareness and knowledge of oral cancer among patients visiting Tikur Anbessa Specialized Hospital (TASH) to inform community education programs and early detection initiatives. Methods: An institution-based cross-sectional study was conducted among 221 adult patients attending the Department of Dentistry and Oral and Maxillofacial Surgery at TASH from May to June 2023. Data were collected using a structured interviewer-administered questionnaire assessing awareness and knowledge of oral cancer, including risk factors, signs, symptoms, and preventive measures. Knowledge was measured using a composite score, and participants scoring ≥ the mean (2.11) were classified as having good knowledge. Associations between socio-demographic factors and knowledge were first explored using Chi-square tests, followed by multivariable logistic regression to identify independent predictors of good knowledge, with p < 0.05 considered statistically significant. Results: Among participants (mean age 37.1 ± 13.8 years; 60.2% female), 75.1% (n = 166) had never heard of oral cancer. Among those aware (24.9%, n = 55), the primary sources of information were media (58.2%, n = 32), while only 18.2% (n = 10) received information from health professionals. Cigarette smoking (69.2%) and alcohol consumption (55.2%) were the most recognized risk factors, whereas family history (38.4%), poor oral hygiene (46.6%), and advanced age (36.2%) were less frequently identified. Awareness of signs and symptoms was low, with less than 40% identifying non-healing ulcers (38.9%) or abnormal swelling (33.0%). Overall, knowledge was poor among most participants. Urban residence (p = 0.0008) and higher education (p = 0.001) were significantly associated with better knowledge; gender was not. Conclusion: Awareness and knowledge of oral cancer were low, highlighting the need for targeted community education, patient counseling by health professionals, and integration of oral cancer information into routine dental care to improve early detection and reduce disease burden.
Copyright (c) 2026 Feven Abera Mamo, Gelana Garoma Ararso, Demerew Dejene Dana https://creativecommons.org/licenses/by-nc/4.0
From Response to Resilience: Sustaining Vigilance after Ethiopia's first Marburg Virus Disease Outbreak
Copyright (c) 2025 Awoke Derbie, Daniel Mekonnen, Aschalew Gelaw https://creativecommons.org/licenses/by-nc/4.0
Impact of Human Resources for Health flooding Strategy on Quality of ANC and Intrapartum care service in Ethiopia: A quasi-experimental pre-post study
Background: Ethiopia has implemented a Human Resources for Health (HRH) flooding strategy since 2011 to rapidly expand the availability of health professionals nationwide. Although this approach is expected to strengthen the healthcare workforce, its effects on healthcare quality and service delivery outcomes have not been comprehensively evaluated. Objective: This study assessed the association between the HRH flooding strategy and maternal healthcare quality, with a focus on antenatal and intrapartum care, to inform strategies for optimizing the effectiveness of workforce investment. Methods: A quasi-experimental pre-post design with propensity score matching was employed to evaluate changes in care quality following implementation of the HRH flooding strategy. Data were pooled from two rounds of the Ethiopian Demographic and Health Survey (EDHS), using the 2011 EDHS as the pre-intervention control group and the 2016 EDHS as the post-intervention group. The primary outcomes were the quality of antenatal care (ANC) and intrapartum care provided. Results: The quality of ANC was 27.1% (95% CI: 25.7–28.6) in the treatment group compared to 8.5% (95% CI: 7.5–9.6) in the control group. Similarly, the quality of intrapartum care was 44.0% (95% CI: 42.4–45.6) and 20.8% (95% CI: 19.3–22.5) in the treatment group and control group, respectively. The average treatment effect of the HRH flooding strategy was associated with a 13.5 percentage-point improvement in the quality of ANC and a 23.3 percentage-point improvement in the quality of intrapartum care. Using a 0.01 caliper, radius matching achieved a strong balance between treatment and control groups. Conclusion: Implementing the HRH flooding strategy is positively associated with improvements in the quality of ANC and intrapartum care services in Ethiopia. However, these findings should be interpreted with caution, as unmeasured confounding factors, including concurrent health system programs, may have contributed to the observed effect.
Copyright (c) 2026 Adane Kebede, Endalkachew Dellie, Melak Jejaw, Misganaw Guadie Tiruneh, Getachew Teshale, Demiss Mulatu Gebru, Kaleb Assegid Demissie https://creativecommons.org/licenses/by-nc/4.0
Factor Structure Analysis and Total Score Correlation of the Insomnia Severity Index and the Ford Insomnia Response to Stress Test in Patients with Multiple Somatic Complaints
Background: Insomnia and sleep reactivity are common among patients presenting with multiple somatic complaints. The Insomnia Severity Index (ISI) and the Ford Insomnia Response to Stress Test (FIRST) are widely used instruments to assess insomnia severity and sleep reactivity, respectively. However, their factor structures and interrelationships have not been examined in this population. Objective: To determine the factor structure and internal consistency of the ISI and FIRST and assess the correlation between their total scores among patients with multiple somatic complaints. Materials and Methods: A cross-sectional study was conducted among 111 adult psychiatric outpatients presenting with multiple somatic complaints at Obafemi Awolowo University Teaching Hospitals Complex, Nigeria. Sociodemographic data were collected, and participants completed the ISI and FIRST questionnaires. Exploratory Factor analysis using maximum likelihood extraction with varimax rotation was applied to the ISI, while principal component analysis was used for the FIRST. Internal consistency was assessed using Cronbach’s alpha. Correlation and simple linear regression analyses were performed to evaluate associations between the instruments. Results: Data from 110 participants were analyzed (mean age 39.4 ± 8.7 years; 58.2% female). The ISI demonstrated a two-factor structure explaining 47.22% of the variance, with an overall Cronbach’s alpha of 0.67. The FIRST demonstrated a single-factor structure explaining 56.40% of the variance, with excellent reliability (Cronbach’s alpha = 0.90). A significant positive correlation was observed between ISI and FIRST scores (r = 0.40, p < 0.01). Linear regression analysis showed that sleep reactivity accounted for 15% of the variance in insomnia severity (Adjusted R² = 0.150, p < 0.01). Conclusion: The ISI and FIRST demonstrated acceptable construct validity and reliability in this population. Sleep reactivity was significantly associated with insomnia severity, supporting the clinical utility of FIRST in identifying individuals at risk for insomnia.
Copyright (c) 2026 Celestine Mume https://creativecommons.org/licenses/by-nc/4.0
Seroprevalence of Hepatitis B Virus Infection among people Living with HIV Attending at the Dangila Health Center, Northwest Ethiopia
Background: Hepatitis B virus (HBV) co-infection remains a significant cause of liver-related morbidity and mortality among people living with HIV/AIDS. Shared transmission routes increase the risk of co-infection, and HIV accelerates the progression of HBV-related liver disease despite widespread antiretroviral therapy (ART). However, there is limited up-to-date evidence on the seroprevalence and associated factors of HBV among HIV patients in the study area. Objective: To assess the seroprevalence of HBV infection and identify associated risk factors among adults living with HIV attending at the Dangila Health Center, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from June to August 2020 among 384 HIV-positive adults. Socio-demographic, behavioral, and clinical data were collected using a structured questionnaire and medical record review. Serum samples were tested for hepatitis B surface antigen (HBsAg) and anti-HCV antibodies using rapid test kits. Logistic regression analyses were performed to identify factors independently associated with HBV infection. A p-value <0.05 was considered statistically significant. Results: The prevalence of HBV infection was 4.4% (17/384), indicating intermediate endemicity. No HCV infection was detected. In multivariate analysis, history of tooth extraction (AOR=3.17; 95% CI: 1.03–9.82), sexually transmitted diseases (AOR=3.53; 95% CI: 1.09–11.47), and multiple sexual partners (AOR=9.68; 95% CI: 2.45–38.24) were independently associated with HBV infection. Conclusion: HBV co-infection remains a public health concern among HIV-positive individuals in this setting. Routine HBV screening, vaccination, and targeted behavioral interventions should be strengthened within HIV care programs.
Copyright (c) 2026 Bogale Desta , Abaineh Munshia, Desalegn Adisu, Alemayehu Abate https://creativecommons.org/licenses/by-nc/4.0
Review on the epidemiology of astrovirus infections in East Africa and its public health significance
Gastroenteritis remains a major global health concern, causing an estimated 2.3 billion illnesses and 1.3 million deaths annually (1). Enteric viruses are responsi-ble for nearly 70% of these cases, with more than 20 distinct viral agents identi-fied to date (2). Among the most common viral causes of diarrhea are members of the Reoviridae, Adenoviridae, Caliciviridae, and Astroviridae families (3). Since their initial discovery in 1975, astrovirus (AstVs) has been recognized as important etiologic agents of viral gastroenteritis , particularly among infants and young children worldwide, with the burden disproportionately higher in low-and middle-income countries (4, 5). Astroviruses are non-enveloped, icosahedral viruses measuring approximately28–30 nm in diameter, and are distinguished by their characteristic star-like ap-pearance. They belong to the Astroviridae family and have a single-stranded, positive-sense RNA genome of about 6.8 kb in length, which is organized into three open reading frames (ORFs). The ORF1a and ORF1b encode non-structural proteins, while ORF2 encodes capsid proteins (4). The Astroviridae family includes two genera: Mamastrovirus and Avastrovirus. Human infections are primarily associated with Mamastrovirus species, particularly MAstV-1, MAstV-6, MAstV-8, and MAstV-9. The classic HAstVs (HAstV-1 to HAstV-8) belong to MAstV-1, while recently identified novel strains include HAstV-MLB (MAstV-6), HAstV-VA2/4 and HMO-A (MAstV-8), and HAstV-VA1/3, HMO-B/C, and PS (MAstV-9)(6). While several studies from East African countries have reported the presence of HAstVs among under-five children, most have lacked in-depth genetic characterization. Nevertheless, both classic and novel astrovirus types have been detected in the region. Six of the eight classic HAstV types, excluding HAstV-6 and HAstV-7, have been reported in the region. In Ethiopia, HAstV positivity ranged from 3.6% to 5.3%, with genotypes HAstV-1, 2, 3, and 8 detected (7, 8). In Kenya, positivity rates varied between 2.8% and 9.7% across multiple studies, with both classic and non-classic genotypes such as MLB and VA strains identified (9, 10-12). Malawi (1.9%), Sudan (3%), Madagascar (2.1%), and Tanzania (0.4%) also reported HAstV cases (113-16), with Malawi and Madagascar identifying multiple genotypes including HAstV-1 to 5 and HAstV-8 (15, 16). Detection methods varied slightly (RT-PCR, ELISA, EIA). Astroviruses are primarily associated with gastroenteritis; how-ever, growing evidence also indicates their capacity to cause extra-intestinal infections, including meningitis and encephali-tis (5, 17). These severe manifestations are often linked to nov-el astrovirus strains. In Tanzania, MLB1 and MLB2 strains were detected among febrile children, while the AV1 was iden-tified in a nasopharyngeal sample from another febrile child (18, 19). Although HAstVs predominantly affect children (4), they have also been detected in the elderly, immunocompro-mised individuals, and even healthy adults (20). In immuno-compromised patients, infections tend to be more severe and may involve the central nervous system (20, 5). In tropical climate settings, astrovirus infection often follow seasonal pat-terns, with increased incidence during the rainy season, possi-bly due to increased viral stability in cool, moist environments and greater indoor crowding. Outbreaks have been documented in high-density communal environments such as schools, day-care centers, military facilities, and swimming pools (6). Transmission of HAstVs is mainly fecal-oral, as confirmed by volunteer studies (21), although the role of other transmission routs warrants further investigation. Despite the recognized global burden of astrovirus-related gas-troenteritis, particularly in young children, research in East Africa remains limited in both population level coverage and depth. Most available studies are confined to under-five chil-dren, with little attention to infections in adults, elderly, or im-munocompromised populations. Comprehensive genomic based evidence is lacking, with limited data on genotype diver-sity, recombination potential, and the emergence of novel strains. Additionally, extra-intestinal manifestations, potential environmental reservoirs, zoonotic transmission, and seasonal patterns are underexplored in the regional context. To address these knowledge gaps, expanded active surveillance and mo-lecular studies are urgently needed. Further research should include diverse age groups, clinical presentation, and compre-hensive one health approach studies to understand of the trans-mission dynamics and detail virological properties. F Further-more, integration of astrovirus monitoring into public health surveillance programs, alongside investment in vaccine and antiviral development, will be crucial for reducing the disease burden and preventing future outbreaks.
Copyright (c) 2025 Aschalew Gelaw https://creativecommons.org/licenses/by-nc/4.0
Prevalence and associated factors of periodontal disease in Ethiopia: systematic review and meta-analysis
Background: Periodontal disease, a chronic bacterial infection of the periodontium, is the major cause of tooth loss, masticatory dysfunction, and edentulism. These outcomes adversely affect nutritional status, self-esteem, and quality of life, while also contributing to significant healthcare costs and socio-economic burden. Although oral diseases affect approximately 3.5 billion people globally, with 75% residing in low- and middle -income countries, the national prevalence of periodontal disease in Ethiopia remains undetermined. Objective: This review aimed to determine the pooled prevalence and associated factors of periodontal disease in Ethiopia. Method: A systematic search was conducted across PubMed, Scopus, Embase, and Google Scholar to identify relevant studies on periodontal disease in Ethiopia, from inception to April 2023, with no language restrictions. Data were extracted using Microsoft Excel and analyzed in Stata version 17. The pooled prevalence and associated factors were estimated using a random-effects mode due to the high heterogeneity. Heterogeneity was assessed using the Higgs I2 statistic and the Cochrane Q test. Subgroup and sensitivity analyses were conducted to explore source of heterogeneity. The review adhered to the PRISMA guidelines, and the protocol was registered in PROSPERO (CRD42023415994). Result: Thirteen studies comprising 10,744 participants were included. The pooled prevalence of periodontal disease in Ethiopia was 35% (95% CI: 25% – 45%) with substantial heterogeneity (I2=99.46%). The highest prevalence was reported in Addis Ababa (42%; 95% CI: 29% to 55%) and among institutionalized individuals (49%; 95% CI: 44 – 55%). Regular toothbrushing was associated with lower odds of periodontal disease (OR = 0.26; 95% CI: 0.24 – 0.28), while male gender (OR = 0.72, 95% CI: 0.64 – 0.80) and carbohydrate intake (OR = 0.54, 95% CI: 0.44 – 0.65) were significantly associated with a reduced risk of periodontal disease in Ethiopia. Conclusion: Periodontal disease affects approximately one in three Ethiopians, with higher prevalence among institutionalized populations. Key determinants include inadequate oral hygiene, female gender, and dietary habits. These findings underscore the need for targeted oral health interventions, including the promotion of regular tooth brushing and dietary modification. National policies should support standardized diagnostic guidelines and integrate oral health services into broader community health programs.
Copyright (c) 2025 Amare Teshome Tefera, Nebiyou Bekele, Shegaye Shumet, Martha Solomon, Tigist Mulugeta, Dessie Abebaw https://creativecommons.org/licenses/by-nc/4.0
Assesment of the Impact of Energy Drink Consumption on Nutritional Status of Undergraduate Students in Ogun State, Nigeria
Background: Energy drink consumption is increasingly common among adolescents and young adults, particularly university students in Nigeria. The potential nutritional implications of these beverages, which are often high in sugar and calories, warrant investigation. Objectives: This study aimed to assess the impact of energy drink consumption on the nutritional status of undergraduate students in Ogun State, Nigeria, with particular focus on its contribution to daily caloric intake and potential associations with Body Mass Index (BMI). Method: A descriptive cross-sectional study was conducted between April and June 2024 among undergraduate students at a federal tertiary institution in Ogun State. A multi-stage sampling technique was used to select 250 students across 10 academic departments. Data were collected using a validated, semi-structured, self-administered questionnaire addressing socio-demographic characteristics, energy drink consumption patterns, and influencing factors. Anthropometric measurements were obtained following standardized procedures, and BMI was calculated. Data were analyzed using SPSS version 26.0, with statistical significance set at p < 0.05. Result: The majority of respondents (44.4%) were aged 20-22 years, followed by 23-25 years (26.8%), 17-19 years (21.2%), and ≥25 years (7.6%). BMI categorization showed that 74%were within the normal weight range, 11.2% were underweight, 12% were overweight, and 2.8% were obese. Regarding energy drink consumption, 32.8% reported intake several times a month, 14.8% consumed once per week, and 7.2% consumed daily. The variety of available flavors (22%) were a key motivator for consumption. No statistically significant association was found between frequency of energy drink consumption and BMI categories (p = 0.051). Conclusion: Energy drink consumption is prevalent among university students in Ogun State, driven in part by flavor preferences. However, this study found no significant short-term impact on nutritional status as measured by BMI. Longitudinal studies are recommended to assess potential long-term health effects of regular energy drink consumption .
Copyright (c) 2025 Jumoke Ilo, Abiodun Ifebajo, Abimbola Yusuf, Oluseye Onabanjo https://creativecommons.org/licenses/by-nc/4.0
Modeling Determinants of Time to Death of Stroke Patients at Harar Regional State, Ethiopia: Application of Shared Frailty Models
Background: Stroke, a condition caused by interrupted blood flow to the brain, is the second leading cause of death worldwide and a major contributor to morbidity and disability. Despite its global impact, there remains a need for more comprehensive and flexible statistical models to better understand the timing of stroke-related mortality. This study addressed this gap by applying robust shared frailty models to stroke patient data. Objective: The main purpose of this study was to identify the factors influencing time to death among stroke patients using shared frailty models, accounting for hospital-level clustering effects. Methods: A retrospective study was conducted at Harar Regional State, Ethiopia, across three hospitals: Harar General Hospital, Jegol hospital, and Hiwot Fana Specialized University Hospital. A total of 224 stroke patients admitted to medical wards between September 1, 2020, and November 1, 2023, were included. Data was coded, cleaned, and entered in to SPSS version 25 and further analyzed using R-Studio. The presence of clustering (frailty) effects among hospitals was evaluated, and different shared frailty models were compared to identify the best-fitting model. Results: Of the total 224 stroke patients, 51(22.77%) died during the study period, while 173 (77.23%) were censored. The median survival time was estimated at 14 days, highlighting the acute nature of the disease. The Weibull-inverse Gaussian shared frailty model provided the best fit for the data, accounting for unobserved heterogeneity across hospitals. Significant predictors of shorter time to death included hypertension (φ = 2.118; 95% CI: 1.145-3.917), cardiac disease (φ = 2.667; 95% CI: 1.343-5.296), diabetes mellitus (φ = 3.035; 95% CI: 1.1.560-5.906), atrial fibrillation (φ = 3.247; 95% CI: 1.619-6.511), and presence of basic complications (φ = 2.983; 95% CI: 1.477-6.023). Conclusion: This study highlights the importance of hospital-level clustering effects in survival analysis of stroke patients. The significant frailty effect suggests variability in outcomes across hospitals, underlining the need for tailored interventions. Clinicians and hospital administrators should consider these differences when managing stroke patients, emphasizing timely follow-up, individualized care, and resource allocation to improve survival outcomes.
Copyright (c) 2025 Alebachew Abebe, Kumela Ayansa, Kasahun Takele https://creativecommons.org/licenses/by-nc/4.0
Gene Mutations Conferring for Second-Line Drug-resistant Tuberculosis in Amhara Region: Eight-years Retrospective Study
Background: Tuberculosis (TB) is an infectious disease that can affect various organs, though it primarily targets the lungs. The global emergence of highly drug-resistant TB strains has significantly undermined treatment and control efforts. Resistance in Mycobacterium tuberculosis is mainly attributed to spontaneous mutations in chromosomal genes. However, data on specific gene mutations associated with second-line drug resistance remain limited in the Amhara Region of Ethiopia. Objective: This study aimed to assess the gene mutations associated with second-line drug-resistant tuberculosis among patients in the Amhara Region, Northwest Ethiopia. Method: A retrospective study was conducted from January 1, 2016, to January 30, 2023. Drug resistance-associated gene mutations were identified using the Genotype MTBDRsl line probe assay. Data were analyzed using SPSS version 26 statistical software. Chi-square test were applied to examine associations between gene mutations and socio-demographic characteristics, with a significance level set at p < 0.05. Result: A total of 308 presumptive multidrug-resistant TB (MDR-TB) patients were tested for second-line drug susceptibility. Of these, 165 (53.6%) were male, and the majority (n = 177, 57.5%) were aged 25 - 44 years. HIV co-infection was observed in 41 (13.3 %) patients. Fluoroquinolone (FLQ) resistance due to gyrA mutation at position A90V was identified in 1 (0.3%) isolate. Resistance to second-line injectable drug was observed in 10 (3.2%) isolates, indicated by missing wild-type (WT) bands or mutations in the rrs gene. Among these, 2 (0.6%) had rrs mutations at position A1401G, and 1 (0.3%) at position G1484T. HIV status was significantly associated with FLQ-resistant TB (χ² = 5.42, p = 0.02), and the year of testing was significantly related to the prevalence of resistance to second-line injectable drugs (χ² = 13.71, p= 0.05). Conclusion: This study highlights the presence and distribution of gyrA and rrs gene mutations associated with second-line drug resistance in M. tuberculosis isolates from the Amhara Region. The significant association between HIV status and FLQ-resistance underscores the need for integrated TB-HIV management. Routine molecular testing for resistance-conferring mutations is recommended prior to initiating fluoroquinolones and second-line injectable drugs in MDR-TB patients.
Copyright (c) 2025 Gizeaddis Belay Mersha, Mekonnen, Bogale, Kebede, Amera, Abate, Tazeb Molla, Alemayehu Abate, Belay Bezabih https://creativecommons.org/licenses/by-nc/4.0
Evaluation of Crystal® VC Rapid Diagnostic Test kit to detect Vibrio cholerae from fecal samples in Ethiopia
Background: The Crystal® VC Rapid Diagnostic Test (RDT) has been shown to be a sensitive, rapid, cost-effective, and time-efficient tool for detecting V. cholerae. Although this test has advantages in terms of sensitivity and specificity, there are no reports on how well it performs across different regions and during various seasons in Ethiopia to assess its robustness. Objective: The study aimed to evaluate the diagnostic performance of Crystal® VC RDT rapid Diagnostic Test to detect V. cholerae from fecal samples in Ethiopia. Method: A cross-sectional study was conducted from October 2022 to February 2024 at cholera outbreak sites across Ethiopia. A total of 361 fecal samples were collected and tested concurrently using Crystal® VC RDT and standard culture methods. Sensitivity, specificity and positive and negative predictive value of the Crystal® VC RDT were calculated using culture as the gold standard. Agreement between the two diagnostic methods was assessed using Cohen’s Kappa statistic. Data analysis was performed using SPSS version 25 and MedCalc computer software. Results: Of the 361 fecal samples analyzed, 123 (34%) were confirmed positive for Vibrio cholerae by culture. The Crystal® VC RDT demonstrated a sensitivity of 98.4% (95% CI: 94.3% –99.8%) and a specificity of 52.1% (95% CI: 45.6%–58.6%).The PPV was 51.5% (95% CI: 48.1%–54.8%) and the NPV was 98.4% (95% CI: 94.0%–99.6%). The test showed a moderate agreement with culture (kappa =0.679). Conclusion: Crystal® VC RDT demonstrate high sensitivity and excellent NPV, making it a valuable tool for early detection and rapid response during cholera outbreaks. Despite lower specificity, the test’s speed and ease use support its utility in field settings and epidemiological surveillance in resource-limited areas.
Copyright (c) 2025 Abebaw Bitew, Aschalew Gelaw https://creativecommons.org/licenses/by-nc/4.0
Antimicrobial susceptibility profile of blood culture isolates of Enteric fever pathogens at tertiary care teaching hospital of Western Uttar Pradesh, India
Background: Enteric fever is remains a significant public health concern globally, with its impact exacerbated by the rise of antimicrobial resistance, which is largely driven by indiscriminate and irrational antibiotic use. Continuous surveillance of local antimicrobial resistance trends is essential to guide effective treatment protocols and curb the spread of drug- resistance strains. Objective: This study aimed to determine the prevalence, antibiotic sensitivity patterns, and extended-spectrum beta-lactamase (ESBL) production in culture-confirmed enteric fever cases caused by Salmonella enterica. Method: A retrospective, laboratory record-based cross-sectional study was conducted at a rural tertiary care teaching hospital. Blood culture data from July 2017 to June 2019 were reviewed to identify S. enterica isolates and assess their antibiotic susceptibility patterns. Data were analyzed using Microsoft Excel 2010 and summarized using descriptive statistics (frequencies and percentages). The chi-square test was applied to determine statistical significance, with p-value < 0.05 considered significant. Result: Out of 512 blood samples processed for culture and sensitivity, 35 (6.8%) yielded Salmonella species Isolates. Salmonella typhi accounted for (n = 30, 86%), followed by Salmonella paratyphi A (n = 5, 14%). S. typhi isolates showed 100% susceptibility to Imipenem, > 90% susceptibility to third-generation cephalosporins, and high susceptibility to Aztreonam (90%), Cefepime (90%), Levofloxacin (86.67%) and Ciprofloxacin (70%). S. paratyphi A strains showed complete susceptibility (100%) to Cefixime, Ceftazidime, Ceftriaxone, Amikacin, and imipenem, and 80% susceptibility to Levofloxacin, Cefotaxime, Cefepime, and Azatreonam. A low level of multidrug resistance was observed, but resistance to Nalidixic acid was notably high. Conclusion: The findings highlight the importance of performing blood cultures and antibiotic susceptibility testing in all suspected enteric fever cases. The emergence of antimicrobial resistance underscores the urgent need for antimicrobial stewardship programs to regulate and rationalize antibiotic use and prevent the spread of multidrug-resistance Salmonella strains.
Copyright (c) 2025 Dr.Abhishek Mehta, Dr.Vijay Singh Rajak, Dr.Dharmendra Singh Gurjar, Dr.Sagar Jain https://creativecommons.org/licenses/by-nc/4.0
Emergence and spread of carbapenemase producing Gram negative bacteria in Ethiopia: a call for action
Carbapenems are considered last-resort antibiotics used for the treatment of multidrug-resistant (MDR) Gram negative bacterial (GNB) infection, particularly in hospital settings. However, the emergence of carbapenem resistant bacteria is threatening the effectiveness of these vital antibiotics (1). Globally, the most common resistance mechanism to carbapenems is the production of carbapenemase enzymes (2). The worldwide distribution of carbapenemases is dynamic, with emerging resistance hotspots. The spread of carbapenem resistant bacteria is facilitated by factors such as travel, medical tourism, and antibiotic overuse. Globally, the most common carbapenemases include K. pneumoniae carbapenemases (KPC), New Delhi metallo-b-lactamases (NDM), Verona integronencoded metallo-b-lactamases (VIM), imipenemase (IMP) and oxacillinases (OXA), such as OXA-23, OXA-58, and OXA-48 (2). The distribution of these enzymes varies globally. NDM is prevalent in South Asia, the Middle East, and is increasingly found in Africa and Europe, while KPC dominates in North and South America, Southern Europe, and China. VIM and IMP are common in Europe, South America, and Asia. OXA-48 is widespread in Turkey, North Africa, and Europe, whereas OXA-23 and OXA-58 are frequently detected across Asia, South America, and Africa (3). In Ethiopia, the occurrence of carbapenemase-producing GNB was first reported in 2017, with A. baumannii producing NDM (4). Since then, additional studies have revealed the presence of a variety of carbapenemases, including NDM, OXA-48, OXA-23, OXA-58, OXA-51-like, and KPC-42. These carbapenemases have been detected in a range of pathogens such as K. pneumoniae, A. baumannii, P. aeruginosa, E. coli, and other Enterobacteriaceae isolated from both patients and environmental samples (5-10). Among these, NDM is the most prevalent carbapenemase detected in Ethiopian isolates. Moreover, co-harboring of multiple carbapenemases, mostly in combination with NDM, has been frequently reported, particularly in K. pneumoniae and A. baumannii. This co-resistance significantly complicates treatment options, making it more challenging to manage infections (6, 7, 9, 10). The few available studies in Ethiopia reported an alarming rise in carbapenem-resistant pathogens in the country and recommended the urgent need for enhanced surveillance, infection control measures, and antimicrobial stewardship to mitigate the threat of MDR infections. Therefore, further research to better understand the epidemiology of carbapenem-resistant bacteria in Ethiopia, and capacity-building initiatives for healthcare providers are crucial for early detection and effective management of MDR infections.
Copyright (c) 2025 Mizan Kindu https://creativecommons.org/licenses/by-nc/4.0
Antioxidant activity of the leaves extracts of Boscia coriacea Graells and Uvaria leptocladon Oliv
Background: Synthetic antioxidants used for the management of oxidative stress have been shown to have severe side effects. Some medicinal plants that belong to the genus Uvaria and Boscia contain chemicals with antioxidant properties such as flavonoids and alkaloids. Objective: This study was aimed to evaluate the antioxidant activities of the leaf extracts of Boscia coriacea Graells and Uvaria leptocladon Oliv. Method: Fresh leaves of B. coriacea and U. leptocladon were collected in April 2021 from Alie and Konso, located in Southern Ethiopia. First, the leaves of the medicinal plants were dried in dark conditions. Maceration extraction method was used to extract the powdered leaf of Boscia coriacea and Uvaria leptocladon. The crude extract of B. coriacea was fractionated using chloroform (CHCl3), methanol (CH3OH), CHCl3: CH3OH(1:1 v/v) and petroleum ether. The crude extract of U. leptocladon was fractionated using CHCl3, ethanol (C2H6OH), and ethyl acetate (C4H8O2). Evaluation of the antioxidant activity was done using 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2’-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS), and ferric reducing antioxidant power (FRAP) assays. Data analysis was done using one-way analysis of variance. Result: The antioxidant evaluation demonstrated that the leaf extracts of B. coriacea and U. leptocladon have 2,2-diphenyl-1-picrylhydrazyl and 2,2’-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid radical scavenging activity. Based on IC50 value, the CH3OH: CHCl3 (1:1) fraction of B. coriacea (IC50=38.2 μg/mL) and the C2H6OH fraction of U. leptocladon (IC50=30.5 μg/mL) are highly active in 2,2-diphenyl-1-picrylhydrazyl free radical scavenging activity. The total flavonoid content in the CH3OH:CHCl3 fraction of B.coricea and in the C2H6OH fraction of U.leptocladon were calculated to be 136.8±0.04 mg/g of extract and 172.9±0.41 mg/g of extract, respectively. The total phenol content in the CH3OH: CHCl3 fraction of B.coricea and in the C2H6OH fraction of U.leptocladon were calculated to be 145 ± 0.025 mg/g and 187.7 ± 0.055 mg/g, respectively. The CH3OH: CHCl3 (1:1) fraction of B. coriacea and the C2H6OH fraction of U. leptocladon showed the highest ferric reducing antioxidant power. The antioxidant effects of the leaf extract of B. coriacea are due to β-sitosterol and lucidine-type compound. The antioxidant effects of the leaf extract of U. leptocladon are attributed to β-sitosterol, β-sitosterol glucoside, and α-humulene. Conclusion: The leaf extracts of B. coriacea and U. leptocladon have high antioxidant activity. Further study is needed to determine the mechanism of action of compounds isolated from the leaf extracts of B. coriacea and U. leptocladon.
Copyright (c) 2025 Sintayehu Tseha, Yalemtsehay Mekonnen, Asnake Desalegn, Mesfin Tadesse, Paulos Getachew, Melaku Wondafarsh https://creativecommons.org/licenses/by-nc/4.0
Investigation of hepatotoxic effect of cement-dust in occupationally exposed individuals at Malete, Kwara State, North Central Nigeria
Background: Cement is pivotal in advancing Nigeria's economic and infrastructural development amid rapid urbanization, where the demand for robust infrastructure underscores its integral contribution to meeting developmental requirements. While respiratory concerns have been extensively studied, the impact on the liver with the central role of detoxification remains a critical yet under explored dimension of occupational health. Objective: Thus, this study investigated the hepatic effect of cement dust exposure among occupationally exposed individuals in North Central Nigeria. Methods: A comparative cross-sectional study was conducted at Kwara State University Malete, Kwara State, North Central Nigeria, to compare the hepatic profiles of 60 individuals occupationally exposed to cement with 60 non-exposed who served as controls between June and October, 2022. Ethical approval was obtained from the Kwara State Ministry of Health, and informed consent was secured from each participant. Five (5) milliliters of blood were collected, and hepatic profiles were analyzed using standard spectrophotometric methods. Both descriptive and inferential statistics were used to investigate the comparison and correlation between the duration of exposure to cement dust and hepatic profiles among the study participants. Results: The study revealed a significant increase in alanine aminotransaminase (ALT) and alkaline phosphatase (ALP) activities among individuals exposed to cement (ALT: 30.58 ± 11.54, ALP: 181.68 ± 26.25) compared to non-exposed controls (ALT: 19.90 ± 7.26; ALP: 163.68 ± 29.92) at a significance level of p < 0.05. Additionally, the duration of cement dust exposure demonstrated a significant positive correlation with gamma-glutamyl transferase (GGT) activity (r = 0.363; p = 0.004). Conversely, no significant positive correlation was observed between the duration of cement dust exposure and the activities of aspartate aminotransferase (AST) (r = 0.190; p = 0.147), ALT (r = 0.016; p = 0.904), ALP (r = 0.178; p = 0.175), and direct bilirubin (r = 0.057; p = 0.664). Furthermore, the duration of cement dust exposure showed a negative and non-significant correlation with total protein (r = -0.098; p = 0.455), albumin (r = -0.097; p = 0.461), and total bilirubin (r = -0.156; p = 0.233). Conclusion: The study suggests that occupational exposure to cement dust may pose a risk of developing hepatotoxicity in the future.
Copyright (c) 2025 AKEEM OLAYINKA BUSARI https://creativecommons.org/licenses/by-nc/4.0
Common chest radiographic patterns and associated factors of among drug-resistant tuberculosis patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2020
Background: Drug-Resistant Tuberculosis (DR-TB) is a multifaceted public health problem. Determining the common chest radiographic patterns, degree of lung damage, and associated factors is vital in the early detection and treatment of DR-TB. Despite the availability of x ray, there are gaps in chest radiographic patterns of DR-TB disease in Ethiopia. Objectives: This study aimed to identify common radiologic patterns among pulmonary DR-TB patients. Method: A hospital-based cross-sectional study was conducted among 182 DR-TB patients who had an archive of baseline chest radiographs at the University of Gondar Comprehensive Specialized Hospital from September 2010 to October 2020. The socio-demographic and radiographic patterns were depicted using descriptive statistics. A multivariable binary logistic regression model was applied to identify associated variables with extensive DR-TB diseases at a p < 0.05. Result: Out of 182 DR-TB patients, 112 (61.54%) had patchy consolidation followed by focal fibrotic changes (37.91%) and focal nodular opacities (26.92%). Of all DR-TB patients, 19% had extensive pulmonary DR-TB disease. Patients’ marital status was significantly associated with extensive (advanced) DR-TB disease. The odds of having advanced TB disease were 0.15 among those with single marital status (AOR: 0.15, 95% CI: 0.03, 0.68). Conclusion: This study highlighted that the most common chest radiographic feature of DR-TB was patchy consolidation followed by fibrosis and focal nodular opacities. Additionally, the study showed that close to one out of five DR-TB patients had extensive (advanced) DR-TB disease. Marital status had a significant association with extensive (advanced) DR-TB disease.
Copyright (c) 2025 Temesgen Tadesse https://creativecommons.org/licenses/by-nc/4.0
Anatomic variation of the Palmaris longus muscle: A study using the Anatomage Table
Background: The palmaris longus muscle, located in the superficial anterior compartment of the forearm, plays a crucial role in wrist flexion. Objective: This study aimed to investigate the anatomical variation (presence or absence) of the palmaris longus using the Anatomage Table 10.0, a cutting-edge virtual dissection tool. Method: The research was conducted at the University of Global Health Equity's simulation laboratory in Rwanda from June 10 to June 15, 2024. Five cadavers (2 female, 3 male) with varying resolutions were used to examine the muscle's anatomy. Prior to data collection, instructors received training, and a pilot study ensured the reliability and validity of the research. Virtual dissection and labeling of the palmaris longus muscle and corresponding nerves were performed, while preserving key anatomical structures. Result: The study revealed a bilateral absence of the palmaris longus muscle in one cadaver. Conclusion: Our findings on palmaris longus muscle variability highlight the significance of anatomical variations in treatment outcomes and patient care, contributing to the growing understanding of their clinical implications. This variability is crucial for surgeons and clinicians to consider when performing forearm surgeries and diagnosing conditions like carpal tunnel syndrome.
Copyright (c) 2025 Abebe Muche https://creativecommons.org/licenses/by-nc/4.0
The role of health extension workers in combating hypertension in Ethiopia
Ethiopia faces a triple disease burden of communicable diseases, non-communicable diseases (NCDs), and injuries (1), with hypertension affecting nearly one in four adults (2). Hypertension is the major modifiable risk factor for cardiovascular disease (CVD) morbidity and mortality, accounting for more than half CVD-related deaths (3). Several community-based studies in Ethiopian cities revealed a high prevalence of hypertension, ranging from 25.1% to 31.9% in the Amhara region (4, 5), 25% to 32.3% in Addis Ababa (6, 7), and 19.7% to 35.2% in southern Ethiopia (8, 9). In rural areas, nearly one in five adults also suffers from hypertension (2), highlighting its growing public health significance. Early detection and management of hypertension are critical for improving the care cascade (10), preventing complications (11), and saving lives (12). However, hypertension remains largely underdiagnosed and poorly managed, making hypertension an iceberg disease. The 2018 Ethiopian NCDI Commission summary report showed that less than 40% of hypertensive patients were diagnosed, 28% of those diagnosed patients received treatment, and only 26% of those treated had their blood pressure adequately controlled (13). A study in Ethiopia also showed that 77% of the population had never undergone blood pressure measurement (14), and 60% were unaware of their hypertension status (5). Another study in the rural districts of northwest Ethiopia also identified 84% of adults with hypertension were unaware of their condition (15), underscoring the urgent need for community-based interventions to improve early detection, treatment, and care. Even though the Ministry of Health Ethiopia sets a goal in its second health sector transformation plan to increase the proportion of individuals with controlled blood pressure from 26% to 60% by 2025 (16), challenges such as a shortage of health care providers and limited access to healthcare remain the most significant barriers to providing care at the primary health care level (17). One strategy to bridge the gap between the community and the health system in other contexts is task-sharing, in which specific tasks are shared from more qualified healthcare providers to a less trained cadre, such as community health workers (18). This approach reduces time and transportation costs for patients and brings healthcare services closer to the community. A study in northwest Ethiopia indicated that community-based hypertension screening led by HEWs can improve awareness, treatment, and control of hypertension in the community (19). Health extension workers-led home-based multicomponent interventions, which provided home health education, behavioural counseling, and referral to a nearby health facility, have been shown to enhance linkage to hypertension care and lead to a significant reduction of high blood pressure, with a higher proportion of patients achieving optimal blood pressure control (20). To implement this strategy, integrating it into primary healthcare services at the village and health post level in rural areas is essential. However, successful implementation of the strategy requires scaling up of hypertension training programs for health extension workers and their supervisors, provision of standardized protocols, provision of adequate blood pressure measuring equipment, and regular supportive supervision.
Copyright (c) 2024 Dr. Destaw Fetene, Shitaye Alemu Balcha, Tadesse Awoke Ayele, Asmamaw Atnafu, Kassahun Alemu Gelaye https://creativecommons.org/licenses/by-nc/4.0
Enhancing adolescent nutritional behaviour through school food club interventions
Background: There is a growing concern over the rising prevalence of malnutrition among adolescents in Africa. This issue is largely attributed to the decline in dietary quality during this crucial stage, which compromises the ability to meet nutritional needs and increases vulnerability to various illnesses and nutrition-related diseases. Understanding the factors that can enhance adolescent nutritional behavior is essential to addressing this public health challenge. Objective: This study aimed to investigate the impact of adopting School Food Clubs (SFC) on the nutritional behavior (NB) of adolescents in private secondary schools in Ibadan, Oyo State, Nigeria. Method: With a quasi-experimental design, two Local Government Areas (LGAs) were randomly assigned as the Intervention Group (IG; Ibadan South West) and Comparison Group (CG; Ibadan North). Three private secondary schools with existing SFCs were randomly selected from each group. A total of 162 adolescents (IG=85, CG=77) interested in SFC were recruited. Quantitative assessments were performed using a semi-structured questionnaire at baseline and post-intervention. Result: Knowledge, attitude, self-efficacy, and practice scores significantly increased in the IG post-intervention compared to the CG. The SFC adoption positively influenced knowledge (21.7±3.1), attitude (22.3±2.8), self-efficacy (24.4±3.1), and practice (22.2±5.0) scores at the 3-month follow-up. The study revealed consistent improvements across these variables, indicating a significant positive relationship between SFC adoption and NB promotion. Conclusion: The School Food Club demonstrated effectiveness in promoting the nutritional behavior of adolescents in Ibadan. The study suggests that SFCs have the potential for sustainable positive nutritional behavior changes among the target population and recommends their encouragement in other schools. This research contributes valuable insights into addressing the increasing prevalence of malnutrition among adolescents, emphasizing the need for interventions that focus on holistic nutritional behavior improvements through innovative and sustainable platforms like SFCs
Copyright (c) 2024 Ibukunoluwa Tubi, Oyediran Oyewole, Omonigho Simon Umukoro https://creativecommons.org/licenses/by-nc/4.0
Factors associated with magnitude of exchange of sexually explicit contents among high school students: a cross sectional study
Background: “Exchange of sexually explicit content” refers to behaviors such as sending or receiving nude or partially nude images, and sexually suggestive texts and calls via cell phones or other electronic media. As mobile technology is increasingly used to form and maintain social relationships, sexual content-sharing practices are becoming common among young people, contributing to technology-driven sexual risks. Despite this prevalence, there is a paucity of evidence on the prevalence of sexually explicit content-sharing among high school students. Objective: This study aims to assess the magnitude of exchange of sexually explicit materials and associated risk factors among high school students. Method: A cross-sectional study design using a stratified sampling technique was employed applied to 590 students from April 18, 2022 to May 03, 2022. Data was collected through structured, self-administered questionnaire. Data were coded and entered into Epi-Data version 3.1 and exported to SPSS version 25 for analysis. The degree of association between dependent and independent variables was assessed using bivariable and multivariable logistic regression analysis. Variables with p-value of less than 0.05 were considered significant. Result: Overall about 220(38.4%) (95% CI 34.4-42.5) of high school students were actively engaged in exchange of sexually explicit contents. Associated factors were being male (AOR=2.08, 95%CI 1.37, 3.16), being in grade 12 (AOR=3.29, 95%CI1.84, 5.89), living with mother (AOR=7.49, 95%CI 4.01, 14.01), living with father (AOR= 7.06,95% CI2.99,16.66), having a social media account (AOR=3.35, 95%CI1.87, 6.07), free internet access (AOR=2.29,95%CI1.49,3.49) and having a low religiosity scale (AOR=1.67, 95% CI1.10, 2.54). Conclusion: This study indicated that being male, having a low religiosity scale, living with a single parent, and visiting variety of social media were the major predictors associated with exchange of sexually explicit contents in Debre Markos high school students. There is a vital need to inform students of the consequences of this behavior on sexual health. Guardians or parents should strengthen their child’s religious faith and parent their children together instead of individually. The purpose of information communication technology (ICT) materials in schools should be clearly explained to the students as being for the sole purpose of information gathering and not for illicit purpose.
Copyright (c) 2024 Mehari Ambaw, Belisty Mengist Zelek Mengist Zelek https://creativecommons.org/licenses/by-nc/4.0
Physicochemical and microbiological quality of water in public outdoor swimming pools in South Nations Nationalities People Regional State, Southern Ethiopia: Cross-sectional study
Background: Swimming is a fashionable and wonderful form of recreational activity, sport, rehabilitative treatment and is generally considered to be healthy exercise for both young and old people. However, the risk of infection has been linked to faecal contamination of the swimming pool due to faeces released by bathers, contaminated source water or as the result of direct animal contamination. Swimmers are infected when they swallow contaminated pool water. Objective: This study was aimedto assess the physicochemical and microbiological quality of water in public swimming pools in South Nations Nationalities People Regional State, Southern Ethiopia. Method: A cross-sectional study was carried out to determine quality of water in swimming pool from July, 2018 to November, 2018. A purposive sampling technique was used to select swimming pools. Physicochemical and microbiological tests were made on water sample from selected pools. Descriptive statistics were performed to construct tables for physical parameters, chemical parameters, total plate counts (TPC), thermotolerant coliform (fecal coliform), and E. coli. Result: A total of 12 swimming pools were included in this study and 54 water samples were collected. All the swimming pool water samples were beyond World Health Organization’s (WHO) recommendation for both PH level and conductivity. Almost all, 91.7% (11/12) of the swimming pools were violated the WHO Standard of Heterotrophic Plate Count (HPC). Five out of twelve swimming pools) were not comply with the WHO limit (<1/100ml) for thermotolerant (faecal) coliform count. Four of the total swimming pools were confirmed for the presence of thermotolerant Escherichia coli (E. coli). Conclusion: All the participated swimming pools violate the WHO recommendation for PH value and conductivity. In addition, all water samples were contaminated with mold. Half of the outdoor swimming pools violate for the lower limit value of WHO for thermotolerant (faecal) coliform count. No parasites were detected in all the swimming pools.
Copyright (c) 2024 Mesfin Woku https://creativecommons.org/licenses/by-nc/4.0
Predictors of neonatal mortality in Tigray Regional State, Northern Ethiopia: a comparison of parametric survival models’ approaches
Background: The neonatal age is the most vulnerable time for survival in which children appeare at the highest risk of dying in their lives.Ethiopia has pledged to lower under-five child mortality rates since 2015 despite being one of the SSA nations to have achieved the fourth Millennium Development Goal (MDG4). The neonatal mortality rate (NMR) is still a significant public health issue in Ethiopia, and it is getting worse in the Tigray region. Neonatal mortality dataset from retrospective cross-sectional study research is also scarce. Objective: This study was aimed to assess the predictors of neonatal mortality in the Tigray region of northern Ethiopia. Method: A retrospective cross-sectional study design was conducted from 18, January, 2016 to 27, June 2016. In this study a total of 716 neonates were selected. Neonatal mortality risk factors include predictor variables such as neonate and mother demographics, health, and environmental factors. The study used descriptive statistics, Kaplan-Meier comparisons, and parametric survival models, and comparisons were also performed to select suitable forecasting model analyses. Result:The overall NMR experienced was 4.3 neonatal deaths per 100 total live births. The estimated mean follow-up time of neonates was 10.0 days [95% CI: 9.67, 10.30] in the Tigray region. The multivariable Weibull-regression model analysis revealed that predictors being multiple birth type (AHR = 10.9, 95% CI: 3.4, 35.5) and home delivery (AHR = 10.5, 95% CI: 3.0, 36.6) were critically important risk predictors associated with a higher NMR. Conclusion: The prevalence of NMR showed that the NMR in the Tigray region was greater than the national average.The current study identified the multiple birth type and home delivery of the neonates as crucial predictor factors for NMR. Interventions should be improved to these factors that significantly decrease the NMR problem among neonates.
Copyright (c) 2024 gebru gebremeskel gebrerufael https://creativecommons.org/licenses/by-nc/4.0
The association between ABO blood groups and norovirus infections among patients suffering from diarrheal disease in Northwest Ethiopia
Background: Norovirus (NoV) infection is a significant cause of diarrhea worldwide. However, all individuals are not equally affected due to environmental, viral, and host factors, particularly ABO blood groups. Indeed, data that describes the association between NoV infection and the ABO blood group is limited in Ethiopia, and this needs to be investigated. Objective: This study aimed to assess the relationship between ABO blood groups and NoV infection in Northwest Ethiopia. Method: A health-facility-based cross-sectional study was conducted from May 2021 to November 2021 by enrolling 550 participants with diarrhea. Fecal samples were collected and analyzed by reverse transcription PCR to identify NoVs. To further genotype the positive samples, a viral protein-1-coding gene was sequenced. In addition, blood samples were collected and tested to identify blood groupsby using the tube hemagglutination technique. The data were analyzed using SPSS version 23. Logistic regression analysis was done to assess the association between NoV infection and the independent variables. Result: Among the 550 enrolled participants, 519 (94% response rate) provided the required clinical samples and epidemiological data. The majority of the study participants (249/519; 48%) had O blood group.Among the NoV-positive study subjects, the majority (34/46, 74%) were in blood group O, followed by blood group A individuals (9/46, 19.6%).The risk of NoV infection was higher for patients with blood group O than for blood group B (AOR = 1.5, 95%CI = 2–15, P= 0.01), but there was no association for other blood groups.At least one NoV-GII was identified in each of the blood groups, while NoV-GI affected individuals with blood groups O and A. Besides, GII.3 and GII.21 genotypes were common among blood group O individuals, while most (75%) blood group A individuals were susceptible to GII.17 infections. Conclusion: The positivity rate of NoV infection was considerably high among individuals with blood group O. Norovirus-GII can infect all blood groups, while NoV-GI selectively affects blood groups A and O. Further large-scale studies are warranted to assess the relevance of this observation and other genetic factors.
Copyright (c) 2024 Dessie Tegegne, Aschalew Gelaw, Demeke Endalamaw, Getachew Ferede, Baye Gelaw https://creativecommons.org/licenses/by-nc/4.0
Recent Updates on the Epidemiology and Immunizations of Measles Virus in Ethiopia
Measles virus (MeV) remains a major cause of morbidity and mortality worldwide, with an increasing burden on children under five years of age (1). The disease is highly contagious and characterized by a prodromal illness of fever, coryza, cough, and conjunctivitis followed by the appearance of a generalized maculopapular rash. The primary routes of measles transmission are person-to-person via aerosolized droplets or by direct contact with nasal and throat secretions (2). The World Health Organization (WHO) reported an estimated 128,000 deaths globally attributable to measles in 2021(3). In Ethiopia, 182 deaths were recorded between 2021 and 2023, resulting in a case fatality ratio (CFR) of 1.1%. Since 2021, the annual number of confirmed measles cases has increased significantly, from 1953 in 2021 to 9291 in 2022 and 6933 in 2023. There was an approximately fivefold increase in confirmed measles cases between 2021 and 2022. Surprisingly, among the confirmed measles cases, more than 64% have not received the vaccine (4). MeV is a negative-sense single-stranded RNA virus belonging to the family Paramyxoviridae (5, 6). The genome of MeV is approximately 15.9 kb long (1). The virion is composed of six types of proteins. Among these proteins, hemagglutinin (H), fusion (F) and matrix (M) proteins make up the envelope, whereas nucleoprotein (N), phosphoprotein (P) and large protein (L) make up the nucleocapsid. Although measles is a monotypic virus, genetic and antigenic variation has been detected in wild-type viruses (7). On the basis of genetic variability in the nucleoprotein (N), eight (A-H) clades and 24 distinct genotypes (A, B1-B3, C1-C2, D1-D11, E, F, G1-G3, and H1-H2) of MeV are recognized (6, 8–11). The genotypic distribution of MeV varies across the six WHO regions. According to the few available reports, genotype B3 is endemic in African countries, including Ethiopia (9, 12). Studies on the genetic diversity of MeVs help to trace transmission pathways, allow the detection of imported cases, and classify suspected cases as caused by vaccine or wild-type strains (13). Due to the limited number of virology laboratories in resource-limited countries, there is a paucity of information on the genotypic distribution of MeV. Several immunoassay techniques are available for the detection of measles virus from oral secretions, blood and urine samples. Nucleic acid based detection methods such as Reverse transcriptase polymerase chain reaction (RT-PCR) are highly sensitive and specific, and provides genotypic information. However, RT-PCR assays are expensive and rarely available. Enzyme linked immunosorbent assays (ELISAs) based detection of measles specific IgM is the commonly used method in the routine surveillance and detection of measles in Ethiopia (14). The disease is vaccine preventable. Cognizant of this, the WHO introduced the measles vaccine in 1963 for the first time (1). The vaccine is based on a live attenuated strain of measles prepared in lyophilized form. The WHO recommends two doses of the vaccine: the first dose of measles-containing vaccine (MCV1) at nine months of age and the second dose (MCV2) at least one month after the first dose (15). In Ethiopia, vaccination started in 1980 with the use of MCV1 (16). Later, in 2019, MCV2 vaccination was started. In 2021, the rates of vaccination coverage of MCV1 and MCV2 were estimated to be 54% and 46%, respectively (4, 17). Studies indicated that the coverage of MCV2 could be as low as 12.4% nationally, with some areas showing higher rates (42.5%) but still far from the ideal 95% coverage (18). Despite the use of both the MCV1 and MCV2 vaccines, measles outbreaks persist in Ethiopia, particularly affecting children under five years of age. Evidently, outbreaks were reported in 44 woredas in eight regions of the country (4). To identify the actual causes for the frequent outbreaks, nationwide assessment is necessary. Different fragmented studies reported that low subnational vaccination coverage, poor nutrition, and the clustering of unvaccinated children were the contributing factors (16). In recent years, conflict, forced displacement and other humanitarian crises have disrupted childhood vaccinations and contributed to the resurgence of measles in Ethiopia. Furthermore, cultural beliefs, insufficient awareness, and behavioral characteristics of the population have affected treatment and other management strategies for this disease (4). The prevention and control measures for the elimination of measles virus are clear. Prioritizing measles vaccination, strengthening surveillance, and conducting catch-up campaigns are essential for controlling outbreaks and maintaining elimination. Research into barriers to vaccination, molecular epidemiology, and vaccine storage and handling is crucial. Adequately equipping healthcare workers and establishing robust surveillance systems are paramount to swiftly identifying and containing outbreaks. Building resilient public health infrastructure and ensuring uninterrupted vaccination can prevent measles outbreaks, ensuring a healthier future for Ethiopian children.
Copyright (c) 2024 Aschalew Gelaw https://creativecommons.org/licenses/by-nc/4.0
Time to Recovery from Undernutrition and Its Predictors among Patients with Multidrug-Resistant Tuberculosis in Addis Ababa, Ethiopia
Background: Multidrug-resistant/rifampin-resistant tuberculosis is an emerging epidemic disease worldwide. Estimating the duration of recovery from malnutrition and identifying its determinants are crucial for practical and evidence-based public health decision-making among patients with multidrug-resistant tuberculosis who are experiencing non-nutrition. This study aimed to assess the time to recovery from undernutrition and its predictors among multidrug-resistant/rifampin-resistant tuberculosis patients in Addis Ababa. Methods: We conducted a retrospective analysis of patients who received MDR-TB treatment in Addis Ababa, Ethiopia, from June 1, 2017, to July 30, 2022. The records of 381 MDR-TB patients were randomly selected using a simple random sampling technique. The data were collected using a pretested and structured data extraction checklist. Descriptive statistics were performed using graphs and frequencies. We constructed bivariable and multivariable Cox regression models to identify predictors of undernutrition among patients with multidrug-resistant tuberculosis. Results: The undernutrition recovery rate was 8.353 per 1000 person-days. The median nutritional recovery time of the entire cohort of the study was 86 days, with an interquartile range of ±57.12 days. Age ≥ 55 years (AHR = 0.33, 95% CI = 0.15 - 0.75), living in a single room (AHR = 1.49, 95% CI =1.09 - 2.03), low household income (AHR = 0.62, 95% CI = 0.44 - 0.88), and co-infection with HIV (AHR = 0.28, 95% CI = 0.17 – 0.46) were found to be significant predictors of nutritional recovery time. Conclusion: In this study, we found that approximately 77% of the malnourished patients recovered, with a median recovery time of 86 days. Age, housing condition, HIV status, and household income were found to be predictors of nutritional recovery time. Health care providers should place special emphasis on patients who are HIV positive, are old and have a low household income to improve nutritional recovery time.
Copyright (c) 2024 Tilahun Yemanu Birhan, Melsew Yihunie Belay, Getahun Mengistu, Adugnaw Zeleke Alem https://creativecommons.org/licenses/by-nc/4.0
Sexual and Reproductive Health Service Utilization among Young Disabled People in Ethiopia: a cross-sectional study
Background: In Ethiopia, the delivery of sexual and reproductive health services (SRHSs) to young people with disability (YPWD) is poorly understood, as such they are often marginalized and not recognized as being sexual. This study, therefore, aimed to assess the sexual and reproductive health service utilization and associated factors among young people with disability in Ethiopia. Methods: In 2012, a cross-sectional survey was conducted in Addis Ababa, Ethiopia; 426 young people with disability aged 10-24 years were systematically selected and included in the study. Data were collected by trained interviewers using a standardized questionnaire and analyzed using Predictive Analytics Software (PASW), version 20. All analyses used an alpha level of 0.05 (two-tailed) to determine statistical significance. Results: Only one-fourth of the young people with disability (26.1%) had ever utilized sexual and reproductive health services. The most commonly cited reasons for seeking sexual and reproductive health services were to get contraceptives (48.1%), to get condoms (21.2%), and for HIV counseling and testing (21.2%). Sixty-three percent of the sexually active young people with disability had ever used a modern contraceptive method, and 54.3% had ever used a condom. Fifty-six percent of the participants had ever been tested for HIV. Being older, female, and literate were found to be important putative determinants of sexual and reproductive health service use according to logistic regression analysis. The main reasons for not utilizing sexual and reproductive health services were the inconvenience of health institutions (48.8%) followed by poor handling and scolding by the service provider (22.1%). Conclusions: This study revealed that many young people with disability in Ethiopia experience barriers to access sexual and reproductive health services, particularly due to inconvenient health institutions and poor handling by service providers. Not surprisingly, education plays an important role in sexual and reproductive health service use. However, the higher likelihood of using sexual and reproductive health services by older females, as in our study, could be evidence of a societal misconception that SRHSs are only for adults and women. It could also be an indication of the increased risk of females for sexual and reproductive health problems and the increased vulnerability associated with a lack of access to sexual and reproductive health services for younger people with disability. Therefore, an effort has to be made by program and policymakers, and other concerned parties to raise disability-related awareness at the societal level to foster respect for the rights and dignity of persons with disabilities. There is also a need to intervene on the available and upcoming sexual and reproductive health services and programs to make them youth and disability friendly.
Copyright (c) 2024 Tigist Kassa, Tobias Luck, Marion Michel, Samuel Kinde Birru, Steffi G. Riedel-Heller https://creativecommons.org/licenses/by-nc/4.0
Obstetric ultrasound screening service utilization among pregnant women in public hospitals in Addis Ababa, Ethiopia: Barriers and Enablers, 2022: a cross-sectional study
Introduction: All pregnant women should receive an obstetric ultrasound scan before 24 weeks gestation, according to the World Health Organization. However, this can be influenced by a number of barriers, particularly in developing countries. This study aimed to assess reasons for utilization of obstetric ultrasound screening services and barriers to its access among pregnant women in public hospitals of Addis Ababa, Ethiopia. Method: A descriptive cross-sectional study was done on 404 pregnant women from June 21 to September 20, 2022, in public hospitals in Addis Ababa. Simple and systematic random sampling was used to select the study area and eligible individuals, respectively. Bivariate and multivariable logistic regressions were used to identify factors associated with the dependent variables. An odds ratio with a 95% confidence interval with a p-value less than 0.05% was considered statistically significant. Finding: In this study, 70.3% of pregnant women utilized prenatal ultrasound. The study participants reported different reasons for utilizing ultrasound services: pregnancy complications; to assess the health status of the baby; to determine the age of the pregnancy and fetal position, and fetal sex determination were the main reasons. The main barriers to utilizing ultrasound were identified as waiting time, financial cost, being attended by students, distance to the service, and lack of privacy. Conclusion: In the current study, the number of pregnant women utilizing obstetric ultrasound was lower than the World Health Organization recommendation, and diverse barriers influenced utilization of this service. By reducing the cost and patients' waiting time, and increasing awareness of the value of the service, utilization of ultrasound can be improved.
Copyright (c) 2024 Zegeye Wubeshet, Almaz Gadisa, Eneyew Belay https://creativecommons.org/licenses/by-nc/4.0
Sero-prevalence of HBV and associated factors among HIV positive adults attending ART clinic at Nekemte Specialized hospital, Nekemte, Western Ethiopia
Background: Hepatitis B is a major global health problem and potentially life-threatening liver infection caused by hepatitis B virus. It is more common in HIV infected individuals. The aim of this study was to assess the sero-prevalence of hepatitis B infection and associated factors among HIV positive adults on Antiretroviral Therapy (ART). Method: A hospital based cross-sectional study was conducted from March to June, 2021.Samples were taken from randomly selected HIV positive adults visiting an ART clinic using a single population proportion formula. Blood sample were tested for HBsAg and data entered into Epi-data software 3.1, transferred to SPSS version 20 and analyzed. A difference was considered statistically significant at p value <0.05. Result: Among 384 HIV positive adults on ART selected for this study, 199 (51.8%) were males and 185(48.2%) were females. Twenty-two (5.7%) individuals were sero-positive for HBsAg, of which 9 (2.3%) and 13 (3.4%) were females and males, respectively. Among the 384 adults, 22.7% of them had been married, and 9.1%, 40.9%, and 25% had been widowed, divorced and single, respectively and significantly associated with the presence of HBsAg at a 5% level of significance [AOR = 4.02; P = 0.041]. Similarly, regarding CD4 count, among the study subjects 0% of them had 200-250cells/µl and 251-300cells/µl, and 0.8%, 1.3%, and 3.6 % had <200cells/µl, 301-500cells/ µl and >500cells/ µl respectively and significantly associated with the presence of HBsAg at a 5% level of significance [AOR = 1.03; P = 0.034]. Conclusion: The prevalence of HBsAg was found to be moderate in HIV positive adults on ART. HBV infection had no significant effect on ART treatment progress or virological suppression. ART treatment had no association with HBV sero-negativity.CD4 counts had significant association with HBV infection. Provision of routine screening for HBV–HIV co-infected individuals and promoting awareness of this risk creation is necessary to advance treatment strategies.
Copyright (c) 2024 Fantahun Sirata, Mebrate Dufera, Girmaye Kenasa https://creativecommons.org/licenses/by-nc/4.0
Current updates and challenges of malaria in its pre-elimination period
Malaria is one of the major public health problems and caused by five types of plasmodium species. Plasmodium falciparum and Plasmodium vivax species pose the greatest threat (1). Global malaria infection and death rates have continued virtually unchanged since 2015. The world is currently off track to achieve the 90% reduction in the malaria case incidence and mortality rate goal by 2030 (2). According to the latest World malaria report, there were 247 million cases of malaria in 2021 compared to 245 million cases in 2020. The estimated number of malaria deaths stood at 619 000 in 2021 compared to 625 000 in 2020. Over the 2 peak years of the pandemic (2020–2021), COVID-related distractions directed to about 13 million more malaria cases and 63 000 more malaria deaths. The WHO African Region continues to carry an extremely high share of the global malaria burden. In 2021 the Region accounted for about 95% of all malaria cases and 96% of deaths. Children under 5 years of age covered about 80% of all malaria deaths in the Region (3). In the last a few years, struggles to eliminate malaria has gained a remarkable momentum, and several countries have attained this goal — but it has confronted numerous dares. The latest reports of artemisinins resistance in Plasmodium falciparum followed by the signal of chloroquine resistance in Plasmodium vivax, and reduced susceptibility of synthetic pyrethroids used in long lasting insecticide nets are some issues hampering the elimination hard works (4). Moreover, invasion of Asian vector Anopheles stephensi in various countries including Africa have added to the hitches (5, 6). In addition, deletion of histidine rich protein 2 and 3 (Pfhrp2/3) genes in P. falciparum in many countries has reported and this threatens the point-of-care diagnosis of this disease (7-9). It is needed to revisit the strategies adopted by a few countries which have made malaria elimination possible (10). Currently, promising new vaccine is under development. The world’s first malaria vaccine, RTS, S/AS01, has been deployed in malaria endemic areas. This vaccine acts against Plasmodium falciparum, the deadliest malaria parasite globally and the most prevalent in Africa. Implementation of the malaria vaccine through pilot introductions in Ghana, Kenya and Malawi has resulted in substantial reduction in deadly severe malaria and a drop in child deaths. The first malaria vaccine is safe and effective, and, if implemented broadly, the vaccine could save tens of thousands of lives each year (11). As of March 2023 WHO report, more than 1.3 million children had received at least 1 dose of the vaccine. Twenty-nine countries in Africa have expressed interest in adopting the malaria vaccine as part of their national malaria control strategies (12). Establishment of regular surveillance system on antimalarial drugs, diagnostic performances, vector control measures in malaria endemic areas, and development and evaluation of new malaria prevention and controlling tools are highly important for national health policy makers and respective stake holders for the successful malaria elimination efforts.
Copyright (c) 2023 Ayalew Jejaw https://creativecommons.org/licenses/by-nc/4.0