Northwest Ethiopia Research Articles

Effect of prenatal alcohol consumption on maternal anemia among pregnant women in Gondar town, Northwest Ethiopia: a retrospective cohort study.

Alcohol consumption during pregnancy can lead to multiple health, social and behavioral problems for both the mother and the offspring. Anemia is one of the major public health concerns and causes of morbidity and mortality among pregnant women with poor maternal and fetal outcomes in developing countries. This study aimed to identify the link between prenatal alcohol consumption and anemia among pregnant women in Gondar town, Northwest Ethiopia. A facility-based retrospective cohort study was conducted among 1669 pregnant women who were booked in for antenatal care in Gondar town. We used a two-stage random sampling technique to recruit and include study participants in the cohort. Data were collected using an interviewer-administered questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and anemia in pregnancy using log-binomial regression modeling. The burden of anemia in pregnancy was reported using the adjusted risk ratio (ARR) and population-attributable risk. The prevalence of anemia during pregnancy was 14.86% (95% CI 13.23 to 16.65%). Hazardous alcohol consumption during pregnancy was significantly associated with anemia in pregnancy (ARR=2.24; 95% CI 1.60, 3.15). The adjusted population-attributable risk of anemia in pregnancy related to hazardous alcohol consumption during pregnancy was 7.68%. This study revealed that anemia during pregnancy continues to be a public health concern. Regardless of timing, there is a clear association between prenatal alcohol consumption and anemia during pregnancy that suggests a need for targeted prenatal alcohol use screening, and ongoing intervention for alcoholic pregnant women.

Undernutrition and associated factors among incarcerated people in Bahir Dar and Finote Selam prison sites, Northwest Ethiopia: a cross-sectional study

BackgroundPrison is designed with punishment, correction and rehabilitation to the community in mind and these goals may conflict with the aims of healthcare. Incarcerated peoples’ dependency on the prison-limited food...

Suicidal ideation among medical and surgical inpatients at South Gondar Public Hospitals, Northwest Ethiopia, 2023: a multicenter institution-based cross-sectional study.

Suicide is a significant global public health issue impacting individuals, families, and communities across the world. People with medical and surgical conditions are at an elevated risk of experiencing suicidal thoughts. However, to the best of our knowledge, in Ethiopia, there has not been any published research that examines the magnitude and associated factors of suicidal ideation in this context. The objective of this study was to assess the prevalence of suicidal ideation among medical and surgically admitted patients in South Gondar public hospitals, Northwest Ethiopia, 2023. A multi-center institutional-based cross-sectional study was conducted in South Gondar public hospitals. A systematic random sampling technique was used to select 616 individuals with a response rate of 98.2%. Suicidal ideation was measured using the World Health Organization's Composite International Diagnostic Interview suicide module. Descriptive, bivariate, and multivariate binary logistic regressions were employed, with odds ratios and 95% confidence intervals. The significance of the association was determined with a p-value of less than 0.05. The prevalence of suicidal ideation in this study was 24.7% (95% CI: 20.8, 27.7). Poor life satisfaction (AOR = 2.64, 95% CI, 1.63, 4.3), poor social support (AOR: 3.38; 95% CI; 1.97, 5.8), being female (AOR: 1.98; 95% CI; 1.19, 3.3), depression (AOR: 2.67; 95% CI; 1.67, 4.22), prior suicidal ideation and/or attempt (AOR = 2.73, 95% CI; 1.47, 5.1), having high perceived threat (AOR = 3.0; 95% CI; 1.69, 5.29), and having poor sleep quality (AOR: 2.54; 95% CI 1.5, 4.25) were significantly associated with suicidal ideation at p-value < 0.05. The prevalence of suicidal ideation is notably high among patients hospitalized in surgical and medical wards. Effective screening, timely intervention, and enhanced support systems are essential for individuals, particularly for females, with poor social support, high perceived threat, prior suicidal ideation and/or attempt, poor sleep quality, depression, and low life satisfaction.

Symptomatic Pelvic Floor Disorders in Community-Dwelling Women in Central Gondar Zone, Northwest Ethiopia.

This study was aimed at assessing the prevalence and factors contributing to pelvic floor disorder (PFD) symptoms. A community-based cross-sectional study was employed among 737 women in the central Gondar Zone of Northwest Ethiopia from September to December 2022. Participants were selected using a multi-stage cluster sampling. The Amharic version of the Pelvic Floor Disorder Inventory 20 (PFDI-20) tool was employed to evaluate the occurrence of PFDs. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of PFDs. The prevalence of at least one form of PFD was 26.9% (95% CI 23.3 to 30.0%). Pelvic organ prolapse symptoms, urinary incontinence, and fecal incontinence were reported at rates of 19.9%, 19.7%, and 12.8% respectively. Factors associated with PFDs included increasing age (AOR = 3.61, 95% CI 1.01 to 6.91), residing in a rural area (AOR = 2.12, 95% CI 1.63 to 3.66), a history of difficult labor (AOR = 1.83, 95% CI 1.26 to 2.66), multiple vaginal deliveries (AOR = 2.41, 95% CI 2.18 to 3.92), home delivery (AOR = 1.29, 95% CI 1.86 to 2.93), and being postmenopausal (AOR = 1.62, 95% CI 1.55 to 2.89). Currently, more than 25% of women are experiencing distressing symptoms associated with PFDs. Contributing factors include older age, rural residence, having multiple vaginal deliveries, and postmenopausal status. Therefore, it is essential to focus on the early identification of PFD symptoms, raise awareness within the community and among women regarding the connections between advanced age, menopause, and multiparity, and advocate for family planning initiatives.

Malaria prevalence and patients’ knowledge, attitude, and preventive practices toward the disease in the Jawi District, Awi Zone, Northwest Ethiopia

BackgroundMalaria is the most important parasitic illness causing morbidity and mortality with high prevalence in tropical regions.ObjectiveThis study was aimed at evaluating the 7-year malaria trend and community awareness at Jawi Health Center and primary Hospital in Northwest Ethiopia.MethodsA retrospective and cross-sectional or prospective design were used for the study. The data was analyzed using SPSS version 22 software. The findings were considered significant at P &amp;lt; 0.05.ResultsAmong 62,624 blood films between 2015 and 2021 at Jawi Health Center, 40.9% were positive. Plasmodium falciparum accounted for 85.8%. Women had more mixed infections (P. falciparum and P. vivax) (X2 = 8.9, df = 2, P = 0.011) than men. A greater proportion (20.6%) of malaria cases was observed within the under 5 years age group and the number of malaria cases was higher in September, October, and June. The overall prevalence of malaria was found to be 25.2% and June had the highest proportion (75.6%). In total, 335 (80.9%) respondents recognized mosquito bites as the cause and fever (50%) as a clinical symptom of malaria. More than half of the respondents (60.1%) never sleep under mosquito nets.ConclusionThus, these findings have substantial implications for the trend of malaria prevalence and patient awareness of the disease which support the existing malaria control efforts.

Number of Readmissions and Its Determinants Among Patients With Heart Failure at Referral Hospitals in Amhara Region, Northwest Ethiopia: A Cross-Sectional Study Using Zero-Inflated Negative Binomial Model, 2023.

Heart failure is a leading cause of hospital readmissions in the Amhara region, Northwest Ethiopia. This study aimed to determine the number of readmissions and identify the determinants among patients with heart failure at referral hospitals in the Amhara region, Northwest Ethiopia, in 2023. A cross-sectional study was conducted with 663 heart failure patients in Amhara region referral hospitals from September 2022 to February 2023. Simple random sampling was used for patient selection, and data were collected through chart reviews and interviewer-administered questionnaires. Zero-inflated negative binomial models were applied for data analysis. Data collection tools were pre-tested for reliability and validity. Among 663 patients, 237 (35.7%) were readmitted at least once. An increased respiratory rate (IRR = 1.015; 95% CI: 1.0004, 1.031; p < 0.044) and longer medication duration (IRR = 1.011; 95% CI: 1.016, 1.051; p < 0.0001) were associated with more readmissions. Patients with poor social support had 59.4% fewer readmissions compared to those with good social support (IRR = -1.595; 95% CI: -0.02, -0.005; p < 0.041). A higher body mass index (IRR = 0.115; 95% CI: 0.035, 0.196; p < 0.004) was linked with a higher likelihood of remaining in the "always-zero" group, while an increased pulse rate reduced the odds (IRR = -0.013; 95% CI: -0.025, -0.008; p < 0.036). The mortality rate among readmitted patients was 11.39%. This study found significant readmission rates among HF patients. Factors such as respiratory rate and medication duration were linked to increased readmissions, while poor social support was associated with fewer readmissions, this likely reflects limited healthcare access in low- and middle-income countries among individuals with lower social support. The high mortality rate underscores the need for targeted interventions to improve patient outcomes.

Length of hospital stay and its factor associated among neonates with perinatal asphyxia in the Northwest Amhara Region, Northwest Ethiopia 2023: a multicentre retrospective cross-sectional study

ObjectiveTo determine the length of hospital stay and related factors in newborns with perinatal asphyxia in comprehensive specialised hospitals in Northwest Ethiopia.DesignA multicentre institutional-based cross-sectional study.SettingTertiary hospitals in Northwest Amhara...

Anemia and its predictors among patients on hemodialysis, at Felege Hiote Referral Hospital, Northwest Ethiopia, 2022: a retrospective cohort study

ABSTRACT Background Anemia is a critical complication among hemodialysis patients, often leading to poor outcomes. This study aimed to assess anemia prevalence and identify predictors among hemodialysis patients at Felege Hiote Referral Hospital, Northwest Ethiopia, in 2022. Research design and methods A retrospective cohort study analyzed 410 hemodialysis patients from January 2018 to February 2022. Data was collected from medical records, entered using Epi-data Version 4.1, and analyzed with STATA Version 14. Kaplan-Meier survival curves assessed survival time, while Cox regression identified anemia predictors. Results Of 410 patients, 66 (16.1%) developed anemia, with an incidence rate of 7.9 per 100 person-years (95% CI: 3.1–13.5). Significant predictors included female sex (IRR: 1.5, p = 0.04), rural residence (IRR: 2.5, p = 0.01), low body mass index (IRR: 1.6, p = 0.02), and congestive heart failure (IRR: 6.9, p = 0.02). Conclusions Anemia prevalence among hemodialysis patients is high, with key predictors including gender, residence, body mass index, and comorbidities. Interventions targeting these factors, especially in rural areas, could reduce anemia incidence. Study limitations include single-center data, incomplete variables, and lack of causality.

Incidence and predictors of adverse birth outcomes among women who gave birth at Assosa general hospital, Northwest Ethiopia: a retrospective cohort study.

Adverse birth outcomes are a significant public health problem worldwide, particularly in low- and middle-income countries. Adverse birth outcomes have significant immediate and long-term health consequences for infants and their families. Understanding the determinants of adverse birth outcomes is crucial to effective interventions. For this purpose, this study aimed to assess the incidence and predictors of adverse birth outcomes among women who gave birth at Assosa General Hospital. An institution-based retrospective cohort study design was used to select 715 mothers who gave birth at the hospital. The study participants were selected by using simple random sampling. Bivariate and multivariable logistic regression analyses were executed to identify predictor variables of adverse birth outcomes. Finally, a multivariable logistic regression model at P-value < 0.05 and adjusted relative risk (ARR) with 95% CI were used to declare predictor variables that were statistically significant with adverse birth outcomes. The majority, 465 (65.0%), of mothers were in the 20-34 year age group. The mean age of mothers was 26.9 (± 5.5 SD) years. This study revealed that the incidence of adverse perinatal outcomes was 29.7% (95% CI: 26.3-33.1). The common adverse birth outcomes identified in this study were low birth outcomes (159, 22.2%), preterm birth outcomes (14.8%), birth defects (5.7%), and stillbirth outcomes (3.9%). This study revealed that variables such as antenatal care, hemoglobin, mid-upper arm circumference, malaria status, and hypertension were statistically significant predictors of adverse birth outcomes. Statistically significant independent predictors of adverse birth outcomes were included fewer than 4 prenatal care visits (aRR = 3.53, 95% CI: 1.58, 5.37), malaria cases (aRR = 10.74, 95% CI: 6.56, 17.57), pregnancies with hypertensive disorders (aRR = 3.41, 95% CI: 2.17, 6.47), hemoglobin < 11g/dl (aRR = 3.68, 95% CI: 2.42, 5.74), and a MUAC < 23 (aRR = 5.90, 95% CI: 3.98, 10.80). There was a high incidence of adverse birth outcomes in the study area. This study revealed that inadequate antenatal care follow-up, malaria, hypertension, hemoglobin < 11g/dl, and a mid-upper arm circumference < 23cm were predictors of adverse birth outcomes. Governments and health authorities should prioritize policies and programs that are aimed at reducing adverse birth outcomes. Improving maternal health services, nutrition education, early diagnosis, and treatment can help to manage most of these predictors.

Anxiety among cancer patients: A cross-sectional study at The University of Gondar comprehensive specialized hospital.

Anxiety is a prevalent psychological issue among cancer patients, significantly affecting their quality of life and potentially influencing treatment outcomes. This study aims to investigate the prevalence and associated factors of anxiety among cancer patients at the University of Gondar Comprehensive Specialized Hospital in Northwest Ethiopia. A cross-sectional study design was used, involving 384 cancer patients, selected by systematic random sampling technique, from the oncology ward. Data were collected using the Generalized Anxiety Disorder 7-item (GAD-7) scale and the Oslo Social Support Scale (OSS-3). Descriptive and inferential statistics, including bi-variable and multi-variable logistic regression analyses, were employed to analyze the data. The prevalence of anxiety was 88.3%, with 34.4% of patients experiencing severe anxiety, 29.2% moderate anxiety, and 24.7% mild anxiety. Significant predictors of anxiety included participants age>= 61years (AOR = 2.99, 95% CI = 1.31-6.79), participants age 30-60 years (AOR = 4.13, 95% CI = 1.53-11.07), female sex (AOR = 2.04, 95% CI = 1.02-4.07), advanced cancer stage (AOR = 3.08, 95% CI = 1.11-8.53), and ongoing treatment (AOR = 2.40, 95% CI = 1.14-5.10). The study found a high prevalence of anxiety among cancer patients, compared to the previous studies, highlighting the need for integrated psycho-oncology services. Specific interventions are necessary for high-risk groups, including older patients, females, and those with advanced-stage cancer.

Incidence and factors associated with postoperative headache among adult elective surgical patients at the university of gondar comprehensive specialized hospital, northwest Ethiopia, 2022: a prospective follow-up study

BackgroundPostoperative headache is a medical condition that has a strong association with future recurrence and chronic headache, higher morbidity and mortality, extended hospital stays, poor quality of life and high financial burden. Despite, having these consequences, there are limited studies in the study area.ObjectiveThis study aimed to assess the incidence and associated factors of postoperative headache among adult elective surgical patients at the University of Gondar Comprehensive Specialized Hospital Northwest Ethiopia, April 9 to 20 June 2022.MethodsAn institution -based follow- up study was conducted from April 9 to June 20, 2022, at the University of Gondar Comprehensive Specialized Hospital, after ethical approval and 424 patients were included. Postoperative headache was assessed with patient interview and the response was dichotomized as present or absent. Data was collected through chart review and patient interviews using a questionnaire. Data was entered into Epidata 4.6.0 and statistical analysis was performed using stata version 14.01. Descriptive statistics was conducted to summarize patient information and determine the outcome’s incidence. Binary logistic regression was conducted to identify factors associated with postoperative headache. Variables with P-value < 0.05 were considered statistically significant.ResultsThe overall incidence of postoperative headache in the first three postoperative days was 54.3% (228) and the response rate was 99%. Previous history of headache (AOR = 4.83, CI = 2.42 9.73), prolonged fasting (AOR = 2.28, CI = 1.44–3.60), general anesthesia (AOR = 1.96, CI = 1.25–3.07), intraoperative hypotension (AOR = 1.74,CI = 1.06–2.88), being female (AOR = 1.62,CI = 1.06–2.54) and caffeine consumption(AOR = 1.60,CI = 1.02–2.52) were significant factors associated with postoperative headache and most of patients 89(21.2%) had moderate headache.Conclusion and recommendationsMore than half of patients were suffered from postoperative headache. Use of general anesthesia, having prior history of headache, being female, intraoperative hypotension, caffeine consumption and prolonged preoperative fasting were strongly associated with postoperative headache. The problem needs regular assessment and treatment.

Biting Hour and Host Seeking Behavior of Aedes Species in Urban Settings, Metema District, Northwest Ethiopia

Background: Aedes species transmit arboviral diseases, such as dengue, chikungunya, yellow fever, and Zika. The diseases cause severe sickness, mortality, and economic losses. This study describes the biting hour and host-seeking behavior of Ae. aegypti and Ae. vittatus in three towns. Recently, chikungunya and dengue infections were reported in the study sites. Methods: Biting hour and host-seeking behaviors of Ae. aegypti and Ae. vittatus were studied from June to September 2023, in Genda-Wuha, Kokit, and Metema-Yohannes towns, Metema district, Northwest Ethiopia. CDC-LT traps were set running indoors and outdoors for 24 h closer to humans sleeping inside unimpregnated mosquito nets. At the same time, CDC-LT traps were set running overnight closer to domestic animals’ shelters located within a 50-m radius of the main residence. Mosquitoes trapped in CDC-LT were collected every hour. The study was conducted four times in each town during the wet season. A chi-square test was employed to examine biting hour and host-seeking behavior. Results: Aedes aegypti was observed to be highly exophilic and active during the daylight hours. Aedes aegypti exhibited a peak biting rate between 07:00 and 08:00 with the biting rate of 4.5/person/hour followed by from 17:00 pm to 18:00 pm with the biting rate of 3.75/person/hour. The hourly biting rate of Ae. aegypti differed significantly. Its peak indoor biting rate was from 19:00 to 20:00 with the rate of 2.00 bites/person/hour followed by from 08:00 to 09:00 with the rate of 1.50 bites/person/hour and the biting rates differed significantly across the hours (F = 240.046; p = 0.001). Aedes vittatus also exhibited a biting rate similar to that of Ae. aegypti. Both Ae. aegypti and Ae. vittatus were abundantly collected from nearby human sleeping arrangements than from the shelters of cattle, sheep, goats, and donkeys. The highest proportions of Ae. aegypti (91.21%) and Ae. vittatus (89.87%) were unfed. Conclusions: Aedes aegypti and Ae. vittatus exhibited peak biting rates during morning and early night hours that aligned with the active daily routine practices of the local community. This could potentially expose the inhabitants to viral diseases transmitted by Ae. aegypti and Ae. vittatus.

Unpacking power dynamics in participatory communication among agricultural sector stakeholders

This article explores power dynamics within participatory communication process among stakeholders in the agricultural sector of northwest Ethiopia. This study underpinning the article used qualitative data collected from key informant interviews, focus group discussions, and observations. Concepts from participatory development communication theory, the theory of communicative action, and power typology were used as analytical frameworks. The article underscores how political elites, structural hierarchies, experts, and cultural influence dominate participatory communication platforms, marginalising the voices of smallholder farmers and other stakeholders. These actors not only dominate discussions, but also shape decisions, as their ideas were taken for granted uncritically. This dominance mirrors existing broader political and cultural power structures, which marginalise smallholder farmers and other less powerful stakeholders, limiting inclusivity in decision-making. The findings underscore the need for equitable power redistribution to foster more equitable and inclusive decision -making in participatory platforms.

Neonatal near miss and associated factors among neonates delivered at East Gojjam zone public health hospitals, Northwest Ethiopia

Neonatal mortality and morbidity is a significant public health issue globally, particularly in low-income countries including Ethiopia. This study aimed to determine the proportion and associated factors of neonatal near misses among newborns delivered at public hospitals in the East Gojjam zone of Northwest Ethiopia. A facility-based cross-sectional study was conducted from April 21 to June 20, 2023, among 560 newborns and their mothers in randomly selected five public hospitals. Data was collected using an interviewer-administered questionnaire, medical record review, and a standard checklist with a systematic random sampling technique in each proportionally allocated hospital. The data was entered using 4.6 Epi-data software and exported to SPSS version 25. Bivariable and multivariable logistic regression analyses were performed using a backward stepwise approach method, and statistical significance was declared at a 95% confidence interval with a p-value < 0.05. A total of 552 participants responded to the study, with a response rate of 98.6%. The prevalence of neonatal near miss was 41.3% with a 95% confidence interval of 37.1–45.3. Unplanned pregnancy (AOR = 4.91, 95% CI: 2.43–9.94), current obstetric complications at birth (AOR = 5.48, 95% CI: 2.92–10.27), pregnancy-induced hypertension (AOR = 2.75, 95% CI: 1.23–6.12), premature rupture of membrane (AOR = 3.40, 95% CI: 1.71–6.78), mother referred from other healthcare facilities (AOR = 7.12, 95% CI: 4.01–12.63), delivered on-duty time (AOR = 5.04, 95% CI: 2.94–8.65), less than three ultrasound scans (AOR = 3.71, 95% CI: 2.11–6.53), and no ultrasound scan (AOR = 9.44, 95% CI: 2.55–34.99) were significantly associated with neonatal near miss. The prevalence of neonatal near-misses was 41.3% (95% CI: 37.1%, 45.3%). Unplanned pregnancy, obstetric complications at birth, ultrasound scan, premature rupture of membrane, pregnancy-induced hypertension, and mothers referred from other healthcare facilities, and delivered on-duty time were significant factors associated with neonatal near misses.

Comparative performance of microscopy, rapid diagnostic tests, and multiplex real-time PCR for detection of malaria parasites among pregnant women in northwest Ethiopia

BackgroundLow malaria parasitaemia is a diagnostic challenge in pregnancy, leading to false negative microscopy and rapid diagnostic test (RDT) results. However, these submicroscopic or subpatent infections could cause adverse pregnancy outcomes. Thus, evaluating the diagnostic performance of microscopy, RDT, and multiplex qPCR in pregnancy is vital for informed decisions.MethodsA total of 835 peripheral blood and 372 placental blood samples were collected from 835 pregnant women attending first antenatal care or admitted for delivery at selected health facilities in northwest Ethiopia between November 2021 and July 2022. In multiplex qPCR, all microscopy and/or RDT positive samples were extracted and amplified individually, whereas all samples negative by both RDT and microscopy were extracted after pooling ten samples together and tested for Plasmodium genus. The diagnostic performance of microscopy, RDT, and multiplex qPCR in pregnancy was compared and evaluated against each other.ResultsUsing multiplex qPCR as a reference test, microscopy had a sensitivity of 73.8% (95% confidence interval (CI): 65.9–80.7) and 62.2% (95% CI: 46.5–76.2) to detect Plasmodium parasites in peripheral and placental blood samples, respectively, with a 100% (95% CI: 98.9–100) specificity in both samples. Similarly, the RDT had a sensitivity of 67.6% (95% CI: 59.3–75.1) and a specificity of 96.5% (95% CI: 94.9–97.8) for Plasmodium infection diagnosis in peripheral blood and a sensitivity of 62.2% (95% CI: 46.5–76.2) and a specificity of 98.8% (95% CI: 96.9–99.7) in placental blood samples. Considering microscopy as a reference test, multiplex qPCR showed a sensitivity of 100% (95% CI: 96.6–100) and a specificity of 94.8% (95% CI: 93.0–96.3) to diagnose Plasmodium infections in both peripheral and placental blood samples. Pooled multiplex qPCR detected 34 peripheral and 12 placental blood Plasmodium infections from microscopy and RDT negative samples. The pooled assay obviated about half of the reactions and its testing costs. Microscopy showed almost perfect agreement (κ = 0.823) with multiplex qPCR for detecting malaria parasites in pregnancy, whereas the RDT showed a substantial agreement (κ = 0.684).ConclusionMultiplex qPCR had a better performance for Plasmodium infection diagnosis in pregnancy compared to microscopy and RDT. Pooled multiplex qPCR could be a sensitive and resource-efficient strategy for epidemiological surveillance of Plasmodium infections in pregnancy.

Practice of balanced scorecard implementation and its contributing factors among public primary hospital professionals in Central Gondar zone, Northwest Ethiopia.

Globally, a Balanced Scorecard (BSC) is used to measure healthcare institutional performance. Thus, since 2010, Ethiopia has adopted and implemented BSC in all its civil service organizations. Ineffective implementation of this tool has a significant impact on the healthcare performance. The health sector's healthcare provision, customer satisfaction, customer retention, organizational profit, changes and improvements in the healthcare delivery practice are affected by the implementation of BSC tools. However, no evidence or study indicates the implementation of BSC practice in the Ethiopian context. Thus, this study aimed to assess the magnitude of BSC implementation practice and associated factors among healthcare providers at public primary hospitals in the Central Gondar zone, Northwest Ethiopia. A mixed methods study was carried out at public primary hospitals from May 25 to June 26, 2022, in Central Gondar zone with 404 study participants. Study participants were selected using a systematic random sampling technique for the quantitative part, and 12 study subjects were chosen purposively for the qualitative part. Bi-variable and multivariable logistic regression analyses were done. The strength of associations was measured using the adjusted odds ratio (AOR) at 95% CI and a p-value of less than 0.05 in the multivariable analysis to declare significant factors. Thematic analysis was applied for the qualitative data using open code 4.03 version software. The implementation practice of BSC was found at 48.5% (95% CI: 43.6, 53.4%) with a response rate of 95.28%. Teamwork (AOR: 2.68, 95% CI; 1.53, 4.69), organizational communication (AOR: 3.24, 95% CI: 1.79, 5.89), and availability of infrastructure (AOR: 2.03, 95% CI; 1.14, 3.64) were significantly associated to balanced scorecard implementation practice. The implementation practice of BSC was poor compared to the national standard and the findings of prior studies. Thus, concerned stakeholders need to focus on improving and working on organizational communication channels, teamwork, and infrastructure fulfilment to facilitate the implementation practice of a balanced scorecard.

Intention to use mobile phone-based TB screening among HIV patients in Debre Tabor Town public health facilities, Northwest Ethiopia: a cross-sectional study

BackgroundTo ensure fair access to TB screening, early diagnosis of TB infections, and timely starting of appropriate treatment, mobile technology tools provide convenience and feasibility for communities with limited infrastructure. This study aimed to assess the intention to use mobile-based TB screening among HIV patients in Debre Tabor Town Public health facilities, in Ethiopia.MethodA facility-based cross-sectional study was conducted among 423 HIV patients. Data was collected from May 23 to July 11, 2022, through the use of an interviewer-administered questionnaire. Epi-data 4.6 was utilized for data entry, and analysis was performed using Stata 14. Binary logistic regression analysis was employed to assess factors associated with the outcome variable. A P-value of less than 0.05 was considered statistically significant.ResultAround 70.7% of HIV patients indicated their intention to use mobile phone-based TB screening services. being employed, (AOR = 2.93; 95% CI: 1.35–6.34), experience reading received text messages (AOR = 2.81; 95% CI: 1.05–7.49), perceived usefulness (AOR = 7.29; 95% CI: 4.00 -13.31), perceived ease of use (AOR = 2.15; 95% CI: 1.17–3.95) clients having clinical follow-ups at the hospital (AOR = 3.03; 95% CI: 1.63–5.62) are significantly associated with intention to use mobile phone-based TB screening.ConclusionIn conclusion, approximately 70.7% of HIV clients intend to use mobile phone-based TB screening services, which is higher compared to previous studies. Factors such as employment status, experience reading received text messages, perceived usefulness, perceived ease of use, and having clinical follow-ups at a hospital were found to be significantly associated with the intention to use mobile phone-based TB screening. Healthcare providers, mobile health developers, and policymakers should take into account these factors when developing and deploying mobile phone-based TB screening initiatives.

Trends, seasonal variations and forecasting of chronic respiratory disease morbidity in charcoal producing areas, northwest Ethiopia: time series analysis.

This study analyzed the trend, seasonal variations and forecasting of chronic respiratory disease morbidity in charcoal producing areas, northwest Ethiopia, aiming to provide evidences in planning, designing strategies, and decision-makings for preparedness and resource allocation to prevent CRD and reduce public health burden in the future. The trend, seasonal variation, and forecasting for CRD were estimated using data collected from the three zones of Amhara region annual reports of DHIS2 records. Smoothing decomposition analysis was employed to demonstrate the trend and seasonal component of CRD. The ARIMA (2, 1, 2) (0, 0, 0) model was used to forecast CRD morbidity. The model's fitness was checked based on Bayesian information criteria. The stationarity of the data was assessed with a line chart and statistically with the Ljung-Box Q-test. SPSS version 27 was utilized for statistical analysis. The annual morbidity rate of CRD has shown an increasing trend in both sexes over a seven-year period among people aged 15 years and older. Seasonal variation in CRD morbidity was observed. The smoothing decomposition analysis depicted that the seasonal component was attributed to 44.47% and 19.16% of excess CRD cases in the period between September to November, and June to August, respectively. A substantial difference among the three zones of the Amhara region in CRD morbidity rate was noted, with the highest observed in the Awi zone. Forecasting with the ARIMA model revealed that CRD-related morbidity will continue to increase from 2020 to 2030. The study revealed that the CRD morbidity rate has shown an increasing trend from 2013 to 2019. Seasonal variation in the CRD morbidity rate was observed, with the highest peak from September to November. The morbidity attributed to CRD will continue to increase for the next ten years (2020-2030). Therefore, this study could potentially play a groundbreaking role. Further study is warranted to understand the risk factors and facility readiness through a further understanding of seasonality and future trends.

Streptococcus pyogenes carriage rate, associated factors and antimicrobial susceptibility profiles among urban and rural schoolchildren at Gondar city, Northwest Ethiopia

Streptococcus pyogenes remains one of the top ten causes of mortality from infectious diseases. Children in low-income nations have high carrier rates of Streptococcus pyogenes, which can serve as a source of infections, including simple superficial infections that may lead to invasive and post-streptococcal diseases, particularly among schoolchildren. This study aimed to assess the prevalence of Streptococcus pyogenes, associated factors, and antimicrobial susceptibility profiles among urban and rural public schoolchildren in Gondar City, Northwest Ethiopia. A school-based comparative cross-sectional study was conducted via a multistage sampling technique among elementary schoolchildren from April to June 2022 in Gondar City. Sociodemographic and clinical data were collected via a pretested structured questionnaire. Standard microbiological methods were used to collect and process throat swabs to isolate Streptococcus pyogenes. An antimicrobial susceptibility test was performed via the disk diffusion method. Epi-Info version 7.2.5 was used to enter the data, which were then exported to SPSS version 25 for analysis. Logistic regression analysis was used to determine the strength of associations between variables, and p < 0.05 was considered statistically significant. The overall prevalence of Streptococcus pyogenes in 438 children was 11.2% (n = 49), with 71.43% (35/49) being urban and 28.57% (14/49) being rural. Low-income parents, hospital admission history, and cigarette smoking in the home were found to be substantially linked with Streptococcus pyogenes carriage among students (p < 0.05). All the Streptococcus pyogenes isolates were susceptible (100%) to penicillin and cefotaxime, but 18.8% and 12.25% of the isolates were resistant to amoxicillin and tetracycline, respectively. The prevalence of Streptococcus pyogenes throat carriage among was intermediate. All the isolates were sensitive to penicillin and cefotaxime, but 18.8% and 12.25% of the isolates were resistant to amoxicillin and tetracycline, respectively. Thus, regular screening and surveillance of Streptococcus pyogenes among schoolchildren should be conducted to minimize carriage or infections and maintain the rational use of antimicrobials. Health education about cigarette smoking in the house also needs to be provided to and the community.

Plant community and structural pattern analyses of Abraham Sacred Forest in Amhara Regional State, northwest Ethiopia.

Owing to its topographic variations, Ethiopia is a biodiversity-rich country. However, the long-term degradation of resources has resulted in isolated forest patches largely around sacred places. Thus, this work was aimed to evaluate the plant community formation and structural dynamics of the Abraham Sacred Forest patch. Data were collected from 60 plots located on transect lines. Five subplots (4 m2), four at each corner and center, were set to collect juveniles' data. Individuals of each species and cover abundance were recorded, and adults' stem girth was measured. Hierarchical cluster analysis was used to identify plant communities. A Kruskal-Wallis followed by Tukey's honestly significant difference test was performed to check the statistical significance among the plant communities. Shannon-Wiener diversity index, equitability index, and non-parametric species richness estimators were used to quantify species diversity, evenness, and richness, respectively. Structural parameters and size class ratios were used to analyze the vegetation structure and regeneration status. Seventy wood species, distributed in 62 genera and 38 families, were recorded. Fabaceae was the most species-rich (10 species) family. Three plant communities were identified. A Kruskal-Wallis test indicated that the community types showed significant differences (P < 0.05) with respect to altitude and slope. The density and basal area of the forest were 4580.4 ha-1 and 35.18 m2ha-1 respectively. The inverted J-shaped pattern in DBH classes implies a good reproduction status. However, importance value index and regeneration status analyses revealed that certain species, like Astropanax abyssinicum (Hochst. ex. A. Rich) Seem, Myrica salicifolia Hochst. ex. A. Rich and Dombeya torrida (G.F.Gmel) Bamps, require conservation priority.