Southern Nations, Nationalities And Peoples Region Research Articles

Prevalence, spatial variation and determinants of zero-dose children in Ethiopia: Spatial and multilevel analyses

ObjectivesVaccination is a crucial public health intervention protecting individuals and communities from vaccine-preventable diseases. However, unvaccinated children in low- and middle-income countries pose a significant challenge. Ethiopia, a Global Alliance for Vaccines and Immunisation (GAVI)-supported country, ranks fifth in zero-dose immunisation burden, indicating concerning vaccine coverage gaps. Despite the severity of this issue, there is a dearth of research investigating the disparities, prevalence and contributing factors associated with zero-dose children in Ethiopia. This study aimed to assess the prevalence, spatial distribution and determinants of zero-dose children in Ethiopia. Study designA community-based cross-sectional study was conducted using data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). Data were collected from 21 March 2019 to 28 June 2019. MethodsThe study included a total of 1334 children aged 12–35 months (weighted sample). For spatial and multilevel analyses, ArcGIS 10.8 and Stata 17 software were used, respectively. The measure of association was determined by computing the adjusted odds ratio (AOR) at a 95 % confidence interval (95 % CI), and a p-value <0.05 was considered statistically significant. ResultsThe prevalence of zero-dose children in Ethiopia was 46.5 % (95 % CI: 43.8, 49.2). Southeast Amhara, Afar, Somali, Oromia and SNNPR (Southern Nations, Nationalities and Peoples’ Region) regions had high zero-dose proportions. Maternal age 15–19 years (AOR = 1.63; 95 % CI: 1.05, 2.64), lack of antenatal care (AOR = 1.77; 95 % CI: 1.34, 2.35), rural residence (AOR = 1.94; 95 % CI: 1.17, 3.19) and region were significantly associated to zero-dose status in Ethiopia. ConclusionsThe prevalence of zero-dose children in Ethiopia was high and the distribution exhibited significant variation across the country's clusters. Individual and community factors were key contributors. It is essential that areas with a high prevalence of zero-dose children have access to recommended childhood vaccines. This proactive approach can help protect children from morbidity and mortality caused by vaccine-preventable diseases.

Quality of hospital labour and delivery care: A multilevel analysis in Southern Nations and Nationalities People's Region of Ethiopia.

Ethiopia has one of the highest maternal mortality ratios in Africa. Few have examined the quality of labour and delivery (L&D) care in the country. This study evaluated the quality of routine L&D care and identified patient-level and hospital-level factors associated with the quality of care in a subset of government hospitals. This was a facility-based, cross-sectional study using direct non-participant observation carried out in 2016. All mothers who received routine L&D care services at government hospitals (n = 20) in one of the populous regions of Ethiopia, Southern Nations Nationalities and People's Region (SNNPR), were included. Mixed effects multilevel linear regression modeling was employed in two stages using hospital as a random effect, with quality of L&D care as the outcome and selected patient and hospital characteristics as independent variables. Patient characteristics included woman's age, number of previous births, number of skilled attendants involved in care process, and presence of any danger sign in current pregnancy. Hospital characteristics included teaching hospital status, mean number of attended births in the previous year, number of fulltime skilled attendants in the L&D ward, whether the hospital had offered refresher training on L&D care in the previous 12 months, and the extent to which the hospital met the 2014 Ethiopian Ministry of Health standards regarding to resources available for providing quality of L&D care (measured on a 0-100% scale). These standards pertain to availability of human resource by category and training status, availability of essential drugs, supplies and equipment in L&D ward, availability of laboratory services and safe blood, and availability of essential guidelines for key L&D care processes. On average, the hospitals met two-thirds of the standards for L&D care quality, with substantial variation between hospitals (standard deviation 10.9 percentage points). While the highest performing hospital met 91.3% of standards, the lowest performing hospital met only 35.8% of the standards. Hospitals had the highest adherence to standards in the domain of immediate and essential newborn care practices (86.8%), followed by the domain of care during the second and third stages of labour (77.9%). Hospitals scored substantially lower in the domains of active management of third stage of labour (AMTSL) (42.2%), interpersonal communication (47.2%), and initial assessment of the woman in labour (59.6%). We found the quality of L&D care score was significantly higher for women who had a history of any danger sign (β = 5.66; p-value = 0.001) and for women who were cared for at a teaching hospital (β = 12.10; p-value = 0.005). Additionally, hospitals with lower volume and more resources available for L&D care (P-values < 0.01) had higher L&D quality scores. Overall, the quality of L&D care provided to labouring mothers at government hospitals in SNNPR was limited. Lack of adherence to standards in the areas of the critical tasks of initial assessment, AMTSL, interpersonal communication during L&D, and respect for women's preferences are especially concerning. Without greater attention to the quality of L&D care, regardless of how accessible hospital L&D care becomes, maternal and neonatal mortality rates are unlikely to decrease substantially.

Low long-lasting insecticidal net use in malaria elimination areas in Southern Ethiopia: results from community based cross-sectional study

BackgroundDespite remarkable progress in malaria burden reduction, malaria continues to be a major public health problem globally. Ethiopia has been distributing long-lasting insecticidal nets (LLINs) for free and nationwide distribution was completed in 2016. However, evidence suggests that the utilization of LLINs varies from setting to setting and from time to time due to different factors, and up-to-date evidence is required for LLIN related decision-making. Hence, this study was designed to assess LLIN utilization and its determinants in the Southern Nations, Nationalities, and People’s Region (SNNPR) of Ethiopia.MethodsA community-based cross-sectional study was conducted in Southern Ethiopia in 2019. Using multi-stage sampling, a total of 2466 households were included. The region was stratified based on the annual malaria index as high, moderate, low, and free strata. Cluster sampling was then applied to select households from high, moderate, and low strata. Data on LLIN ownership, utilization and different determinant factors were collected using household questionnaire. SurveyCTO was used to collect data and data was managed using Stata 15. Descriptive statistics and multilevel mixed-effects logistic regression were performed to identify the determinants of utilization of LLINs. Effect measures were reported using adjusted odds ratio (AOR) with 95% CI.ResultsFrom a total of 2466 households, 48.7% of households had at least one LLIN. LLIN adequacy based on family size was 23% while it was15.7% based on universal access and 29.2% based on sleeping space. From 1202 households that possessed LLIN(s), 66.0% of households reported that they slept under LLIN the night preceding the survey. However, when the total population in all surveyed households were considered, only 22.9% of household members slept under LLIN the night preceding the survey. Malaria endemicity, educational status, wealth status, and knowledge about malaria were associated with LLINs utilization. In addition, reasons for non-use included perceived absence of malaria, side effects of LLIN, conditions of LLINs, inconvenient space and low awareness.ConclusionLow LLIN coverage and low utilization were noted. A low level of utilization was associated with malaria endemicity, wealth status and level of awareness. Distribution of LLIN and continuous follow-up with community awareness creation activities are vital to improve coverage and utilization of LLINs, and to ensure the country’s malaria elimination goal.

Magnitude, associated risk factors, and trend comparisons of identified tuberculosis types among prisons in Ethiopia: A systematic review and meta-analysis.

Tuberculosis (TB) remained a major public health threat, particularly in developing countries with vulnerable groups, particularly prison inmates. A systematic review and meta-analysis of individual studies with varying prevalence rates were performed to identify risk factors associated with the recent magnitude of TB among prisoners. A systematic search of research articles on the magnitude and risk factors of TB among prisoners in Ethiopia was conducted in registers, databases, and other sources. Cochran's Q, inverse variance (I 2), sensitivity analysis, funnel plot, Begg's, and Egger's regression tests were used to check heterogeneity and publication bias. A random-effects model was used to calculate the pooled burden of TB among prisoners. The total national prevalence of TB among prisoners was 9.84% (95% confidence interval [CI]: 7.16-12.52). According to the subgroup analysis, the highest prevalence was observed in patients infected by latent TB (51.20%), the Southern nations, nationalities and people's region (SNNPR)(29.63%), studies conducted in ≤200 (17.50%) sample sizes, and from 2017 to 2022 (11.49%) study periods. TB infection among prisoners was significantly associated with a history of contact with TB patients (adjusted odds ratio [AOR] = 2.75; 95% CI: 0.98-4.52), coughing for ≥2 weeks (AOR = 0.08; 95% CI: -0.16-0.33), being incarcerated in overcrowded cells with poor ventilation (AOR = 0.39; 95% CI: -0.01-0.78), and increasing with the duration of imprisonment (AOR = 1.29; 95% CI: -0.39-2.97]. Expectably high TB magnitude is found among prison inmates in Ethiopia. Duration of incarceration, coughing, ventilation of the cell, and contact with TB patients were all predictors of TB among prisoners. The management of TB requires early diagnosis, adequate medication, and the implementation of preventative and control measures suitable for prison inmates.

Decomposition Analysis of Antenatal Care Utilization Inequities in Kembata Tembaro Zone, Southern Ethiopia.

Health equity has emerged as a global issue in the post-2015 Sustainable Development Goals, and Ethiopia is no exception. Despite positive improvements, inequities in maternal health service utilization among demographic groups continue to be one of Ethiopia's significant challenges in decreasing maternal mortality. This study focuses on antenatal care service discrimination among a local poor group known as the "golden hands" community in Ethiopia's Kembata Tembaro zone. The subgroup community consists of outcast artesian groups known as "golden hands," formerly known as "Fuga," who face discrimination in all aspects of life owing to their living conditions and ethnic background. A community-based comparative cross-sectional study was conducted in Ethiopia's Kembata Tembaro, zone in the Southern Nations, Nationalities, and Peoples' Region (SNNPR), from January to February 2022. The study focused on two groups, "golden hands" and "non-golden hands," consisting of women aged 15-49 years. Using stratified and multistage cluster sampling, 1,210 participants were selected, with 440 from golden hand communities and 770 from non-golden hand communities. Data was collected through translated questionnaires, and data quality was rigorously monitored. The concentration curve and index, as well as logistic-based decomposition analysis, were used to examine inequality. The statistical significance threshold was set at p < 0.05 with a 95% confidence interval. This study comprised 1,210 eligible participants, 440 of whom were golden hand community members. Discrimination accounted for 60.23% of the decreased antenatal care (ANC) service use by the golden hand community. Age, urban residence, and wealth index were the most important independent factors with statistically significant contributions to changes owing to differences in effects (discriminated difference). Since ANC service discrimination is prevalent, the government and nongovernmental organizations should take steps to ensure that marginalized groups in society, such as golden hand women, the poor, the uneducated, and rural people, have equal access to service utilization opportunities.

Spatial distribution of delayed initiation of antenatal care visits and associated factors among reproductive age women in Ethiopia: spatial and multilevel analysis of 2019 mini-demographic and health survey

ObjectivesThis study aimed to assess the spatial distribution, wealth-related inequality and determinants for delayed initiation of antenatal care (ANC) visits among reproductive-age women in Ethiopia.DesignCross-sectional study design.SettingEthiopia.ParticipantsA total of 2924...

Insights into varroa mite (Varroa destructor) infestation levels in local honeybee (Apis mellifera) colonies of Ethiopia

AbstractThe varroa mite (Varroa destructor) is the most economically important parasitic pest of honey bees (Apis mellifera) that causes global colony decline and loss. Since its first detection in Ethiopia in 2010, little is known about the current infestation levels and contributing factors to the mite's distribution across the country. In this study, we conducted a large‐scale assessment of varroa prevalence and infestation levels in managed colonies across three potential beekeeping regions of Ethiopia; Oromia, Amhara and Southern Nations, Nationalities and Peoples Region (SNNPR). A total of 360 samples from 39 apiaries were collected following standard protocols and the mite prevalence and infestation levels were determined using the established method of varroa research. Overall, 89% of sampled colonies were infested by the mite, with varying prevalence rates across the regions: 95.8% in Oromia, 85.2% in Amhara and 71.9% in SNNPR, indicating the widespread nature of the parasite throughout the country. The varroa infestation levels were lower in local hives (2.6 ± 5.9) than in frame hives (5.0 ± 0.9), and significantly higher in brood bees (5.6 ± 0.8) than in adult bees (1.93 ± 0.17) (p &lt; 0.001). Possible factors contributing to the varied mite prevalence and infestation levels in the country include differences in agro‐ecology, beekeeping practices, host age preference and the nature of bee hives. Therefore, our study provides insights into the current status of varroa prevalence and associated factors across regions in Ethiopia. Further investigation is required to explore the probable impact of the parasite on the health and productivity of local honey bees, in order to design future monitoring strategies.

Price-quality relationships for the main livestock feed types in the Ethiopian feed market

This study assessed the price-quality relationships for the major feed products in Ethiopia with a view to informing policy makers on possible avenues to develop the livestock feed sector in the country. A survey of livestock feed markets was conducted from April to May 2019 in five regions (Amhara, Southern Nations Nationalities and Peoples Region (SNNPR), Oromia, Tigray and Addis Ababa). A total of 1700 feed samples with their respective price information were collected from 202 marketplaces. The collected samples were analyzed for their crude protein (CP), neutral detergent fibre (NDF), acid detergent fibre (ADF), in vitro organic matter digestibility (IVOMD) and metabolisable energy (ME) content. Results showed considerable variability in quality within the same feed type. Pearson correlation and regression analyses showed that price-quality relationships for the feed samples were either very weak or non-existent. Wheat bran showed a weak price to quality correlation for CP (r= 0.200 at P&amp;lt;0.01), ME (r= 0.202 at P&amp;lt;0.01) and IVOMD (r= 0.221 at P&amp;lt;0.01). Among the roughages, grass hay showed slight positive price to ME correlation (r= 0.382 at P&amp;lt;0.001) and a slight negative relationship with ADF (r=-0.336 at p&amp;lt;0.005). The results of this study indicated that quality attributes have no, or a limited role in setting market prices for most feed types in the Ethiopian feed market. The fact that both good and poor-quality feeds are sold under the same label and market value affects both traders and livestock producers. Therefore, it is important to build national feed analytical capabilities to allow quality of feeds to be checked against national feed standards, particularly for concentrate feeds.

Multicultural education: Teachers’ perceptions in Hosanna College of Education, southern nations, nationalities, and peoples’ region (SNNPR), Ethiopia

This study was intended to explore how the perceptions of teachers affect multicultural education (MCE) in diversified classrooms at Hosanna College of Education. A descriptive textual narration with a qualitative case study and purposive sampling research design were employed in this study. Semi-structured interviews and document analysis were used to collect data. The respondents were teachers at Hosanna College of Education. The findings confirmed that the perceptions of teachers were positive toward the teaching of a diverse student population. This is to say that it was evident that teachers felt a desire to provide experiences for their students to help them understand cultural diversity. Inevitably, the study acknowledged that MCE is crucial for nation-wide integration through peace building and sustaining progressive development. However, teachers had no sufficient skills and motivation to investigate studies to encourage and promote MCE because of the reluctant commitment of the College administration. Due to the absence of a strategic plan and a lack of purposeful preparation and content selection for the modular curriculum, the dimensions of MCE were not applied and incorporated into the curriculum as required. As MCE and diversity are not yet meaningfully implemented, it is recommended that teachers, regional education bureaus, policymakers, and the MoE should play a decisive role in efficiently enhancing diversity and tackle the acute problems related to MCE.

The national atlas of tsetse flies and African animal trypanosomosis in Ethiopia

BackgroundWith the largest cattle population in Africa and vast swathes of fertile lands infested by tsetse flies, trypanosomosis is a major challenge for Ethiopian farmers. Managing the problem strategically and rationally requires comprehensive and detailed information on disease and vector distribution at the national level. To this end, the National Institute for Control and Eradication of Tsetse and Trypanosomosis (NICETT) developed a national atlas of tsetse and African animal trypanosomosis (AAT) for Ethiopia.MethodsThis first edition of the atlas focused on the tsetse-infested areas in western Ethiopia. Data were collected between 2010 and 2019 in the framework of national surveillance and control activities. Over 88,000 animals, mostly cattle, were tested with the buffy-coat technique (BCT). Odour-enhanced traps were deployed in approximately 14,500 locations for the entomological surveys. Animal- and trap-level data were geo-referenced, harmonized and centralized in a single database.ResultsAAT occurrence was confirmed in 86% of the districts surveyed (107/124). An overall prevalence of 4.8% was detected by BCT in cattle. The mean packed cell volume (PCV) of positive animals was 22.4, compared to 26.1 of the negative. Trypanosoma congolense was responsible for 61.9% of infections, T. vivax for 35.9% and T. brucei for 1.7%. Four tsetse species were found to have a wide geographic distribution. The highest apparent density (AD) was reported for Glossina pallidipes in the Southern Nations, Nationalities and People's Region (SNNPR) (3.57 flies/trap/day). Glossina tachinoides was the most abundant in Amhara (AD 2.39), Benishangul-Gumuz (2.38), Gambela (1.16) and Oromia (0.94) regions. Glossina fuscipes fuscipes and G. morsitans submorsitans were detected at lower densities (0.19 and 0.42 respectively). Only one specimen of G. longipennis was captured.ConclusionsThe atlas establishes a reference for the distribution of tsetse and AAT in Ethiopia. It also provides crucial evidence to plan surveillance and monitor control activities at the national level. Future work on the atlas will focus on the inclusion of data collected by other stakeholders, the broadening of the coverage to tsetse-free areas and continuous updates. The extension of the atlas to data on control activities is also envisaged.Graphical

Woody Species Diversity, Composition, and Regeneration Status of Abbo Sacred Forest, Southern Ethiopia.

This study was conducted in Abbo Sacred Forest in Wonsho district, Sidama Zone of Southern Nations, Nationalities, and People's Region (SNNPR), southern Ethiopia, to investigate the woody species diversity, vegetation structure, and regeneration status of the forest. A systematic sampling design was employed to collect vegetation data. Sixty quadrats of 20 m × 20 m were laid at every 200 m interval between each quadrat and 400 m apart between each line transect following the altitudinal gradient. Quadrats of 20 m × 20 m were used to record DBH and the height of all woody plant species reaching a height of ≥2 m and a DBH of ≥2 cm. For the inventory of seedlings and saplings, five subplots of 2 m × 2 m, one at the center and the other four on each corner of the main quadrat, were used. DBH, height, seedling, and sapling density of woody species were recorded in each quadrat. The data were analyzed by using Shannon-Wiener diversity and equitability indices, and the structural analysis was carried out based on frequency, density, DBH, height, and basal area/ha-1. The importance value index was also computed. Regeneration status was computed by comparing the density data of saplings and seedlings with those of mature trees. A total of 63 woody species belonging to 56 genera and 35 families were identified. Three endemic species to Ethiopia were recorded. Analysis of selected woody species showed diverse population structures. The findings of this study revealed that small trees and shrubs dominated the forest, suggesting its status under a secondary stage of development. Some woody species require urgent conservation measures. Therefore, local and regional stakeholders should integrate and work together to develop and implement sound conservation and management strategies that encourage the sustainable utilization of forest resources.

The contribution of community health systems to resilience: Case study of the response to the drought in Ethiopia.

BackgroundEthiopia’s exposure to the El Niño drought (2015-2016) resulted in high malnutrition, internally displaced people, and epidemics of communicable diseases, all of which strained the health system. The drought was especially challenging for mothers and children. We aimed to identify salient factors that can improve health system resilience by exploring the successes and challenges experienced by a community-based health system during the drought response.MethodsWe collected data via key informant interviews and focus group discussions to capture diverse perspectives across the health system (eg, international, national, district, facility, and community perspectives). Data were collected from communities in drought-affected regions of: 1) Somali, Sitti Zone, 2) Hawassa, Southern Nations, Nationalities, and Peoples’ Region (SNNPR), and 3) Tigray, Eastern Zone. Data were analysed using a deductive-inductive approach using thematic content analysis applied to a conceptual framework.ResultsA total of 94 participants were included (71 from the communities and 23 from other levels). Key themes included the importance of: 1) organized community groups linked to the health system, 2) an effective community health workforce within strong health systems, 3) adaptable human resource structures and service delivery models, 4) training and preparedness, and 5) strong government leadership with decentralized decision making.ConclusionsThe results of this study provide insights from across the health system into the successes and challenges of building resilience in community-based health systems in Ethiopia during the drought. As climate change exacerbates extreme weather events, further research is needed to understand the determinants of building resilience from a variety of shocks in multiple contexts, especially focusing on harnessing the power of communities as reservoirs of resilience.

Exploring experiences of quarantined people during the early phase of COVID-19 outbreak in Southern Nations Nationalities and Peoples' Region of Ethiopia: A qualitative study.

BackgroundEthiopia enforced extremely rigorous contact tracing and mandatory quarantine for all suspected contact and travelers entering the country for a period of 14-days duration during the early phases of the COVID-19 outbreak. Several studies investigated the experience of quarantined people because of COVID-19 or previous outbreaks. However, quarantine is often perceived differently in different cultures because of its historical association with class, gender, ethnicity, politics, and prejudices. To our knowledge, there is limited literature on quarantine experience in Ethiopia related to either COVID-19 or other infectious diseases. Therefore, this study was aimed to explore quarantine experience of people in Southern Nations Nationalities and Peoples’ Region (SNNPR) of Ethiopia during early phase of COVID-19 pandemic.MethodsThe study implemented an exploratory qualitative research design using a phenomenological approach. Face-to-face in-depth interviews were conducted with purposively recruited 29 respondents. Digitally recorded audio files have been listened to several times and verbatim transcriptions were done. The transcribed narratives were examined independently and content analysis was carried out through reading and re-reading the verbatim several times, open coding, grouping, categorizing, and abstracting the final themes.ResultsThree broad themes were identified and characterized the experiences of quarantined people due to COVID-19. These themes were a) handling of the suspected person, b) adverse effects of quarantine and c) coping strategies. In addition, quarantine refusals; injustice in quarantine; quarantine errors; psychological distress; physiological changes; social effects; financial losses; personal and social coping strategies were the emerged sub-themes.ConclusionsThis study explored a range of complex experiences of quarantined people because of the COVID-19 outbreak in SNNPR. The quarantined people included in this study were adversely affected psychologically, physiologically, socially, and economically. They also experienced quarantine errors and injustice. There is a need to gather clear justification for close contact before forcing the suspect for mandatory quarantine. In addition, there is a need to develop risk communication strategy to approach suspected contacts for quarantine. Moreover, assessing psychological, physiological, social, and economic impacts of quarantine on the individuals while they are in quarantine and after release could be important. The use of personal and social coping strategies including psychosocial support may lessen the adverse impacts of the quarantine.

Assessment on Beeswax Production, Processing and Marketing in Selected Districts of Kafa Zone, Southern Nations Nationalities and Peoples Region (SNNPR), Ethiopia

The study was conducted in the three districts of Kafa Zone of Southern Nations Nationalities and Peoples Region being; Chena, Gimbo and Gesha and three peasant associations (PAs) from each district. The main intention was to identify the production, processing and marketing status of beeswax. The districts were purposively selected based on their potential for honey and beeswax production and marketing. The survey data was collected from 239 selected beekeepers and key informants. According to the survey’s result, 94.98% of beekeepers do not practice any processing of honey and sale it in crude form. Only 24(13%) of the respondents practicing collection of beeswax from old combs, ‘tej’ houses and discarded or broken combs while the majorities (87%) of them discarding it as a byproduct. Of those who were collecting beeswax, only 7(29%) were processing it for selling to central markets and other local purposes such as foundation sheet making, smearing top bars and traditional candle/‘tuaf’making. This implies the trends of collecting, processing and marketing of beeswax is at its very infant stages at beekeepers level .Whereas, local mead houses and cooperatives are considered the major actors engaged in processing and marketing of beeswax. According to personal observation during survey, local mead houses are the major sources where beeswax is readily available year round. However, the overall management practice of beeswax at this market segment is very poor. Keywords: beeswax; production, processing; marketing; Kafa zone. DOI: 10.7176/FSQM/119-03 Publication date: September 30 th 2022

Psychosocial factors associated with malaria care-seeking in rural Ethiopia

BackgroundEthiopia’s National Malaria Control and Elimination Program aims to diagnose all suspected malaria cases within 24 h of fever onset and provide prompt treatment for confirmed cases. This study explored psychosocial factors associated with no-, delayed- and prompt- care-seeking among female caregivers of children under five years with fever in rural Ethiopia.MethodsHousehold surveys were conducted from 2016–2019 among female caregivers (N = 479) of children under five years old with fever in Oromia; Amhara; Southern Nations, Nationalities, and Peoples Region (SNNPR); and Tigray. Prompt and delayed care-seeking were defined as seeking treatment within ≤ 24 h or > 24 h of symptom onset respectively. Contextual factors explored included sociodemographic factors, household supply of bed nets, exposure to health messages, and household vulnerability (a measure of financial access to food, shelter, schooling, and medical treatment). Ideational factors included psychosocial factors related to care-seeking (knowledge, self-efficacy, response efficacy, attitudes, involvement in decision-making, and household social support).ResultsThe prevalence of fever among children under five years was 18% (ranging from 9% in Tigray to 34% in SNNPR. Overall, 45% of caregivers of children with fever sought care promptly, while 23% delayed care-seeking and 32% sought no care. Prompt care-seeking rates were higher among caregivers with positive attitudes toward prompt care-seeking (48%), involved in decision-making (48%) or perceived equitable gender norms in the community (65%). Caregivers with a high care-seeking ideation had increased odds of prompt care-seeking (aOR: 2.65; 95% CI: 1.74–4.02). Significant contextual factors included residence in the Oromia region (aOR: 2.99; 95% CI:1.40–6.41), caregivers age 35–49 years (aOR: 0.49; 95% CI: 0.26–0.95), residence in vulnerable households (aOR: 2.01; 95% CI: 1.28–3.18).ConclusionsAmong this rural Ethiopian population, prompt care-seeking was low but positively influenced by both ideational and contextual psychosocial factors occurring at the caregiver level. Multi-sectoral interventions at the individual, community, and health facility levels are needed to improve prompt care-seeking. These include social behavior change interventions to improve ideation, complemented by health facility interventions to ensure provision of high-quality services and structural interventions to increase educational attainment in these rural settings.

Modeling the spatial distribution of Culicoides species (Diptera: Ceratopogonidae) as vectors of animal diseases in Ethiopia

Culicoides biting midges (Diptera: Ceratopogonidae) are the major vectors of bluetongue, Schmallenberg, and African horse sickness viruses. This study was conducted to survey Culicoides species in different parts of Ethiopia and to develop habitat suitability for the major Culicoides species in Ethiopia. Culicoides traps were set in different parts of the country from December 2018 to April 2021 using UV light Onderstepoort traps and the collected Culicoides were sorted to species level. To develop the species distribution model for the two predominant Culicoides species, namely Culicoides imicola and C. kingi, an ensemble modeling technique was used with the Biomod2 package of R software. KAPPA True skill statistics (TSS) and ROC curve were used to evaluate the accuracy of species distribution models. In the ensemble modeling, models which score TSS values greater than 0.8 were considered. Negative binomialregression models were used to evaluate the relationship between C. imicola and C. kingi catch and various environmental and climatic factors. During the study period, a total of 9148 Culicoides were collected from 66 trapping sites. Of the total 9148, 8576 of them belongs to seven species and the remaining 572 Culicoides were unidentified. The predominant species was C. imicola (52.8%), followed by C. kingi (23.6%). The abundance of these two species was highly influenced by the agro-ecological zone of the capture sites and the proximity of the capture sites to livestock farms. Climatic variables such as mean annual minimum and maximum temperature and mean annual rainfall were found to influence the catch of C. imicola at the different study sites. The ensemble model performed very well for both species with KAPPA (0.9), TSS (0.98), and ROC (0.999) for C. imicola and KAPPA (0.889), TSS (0.999), and ROC (0.999) for C. kingi. Culicoides imicola has a larger suitability range compared to C. kingi. The Great Rift Valley in Ethiopia, the southern and eastern parts of the country, and the areas along the Blue Nile and Lake Tana basins in northern Ethiopia were particularly suitable for C. imicola. High suitability for C. kingi was found in central Ethiopia and the Southern Nations, Nationalities and Peoples Region (SNNPR). The habitat suitability model developed here could help researchers better understand where the above vector-borne diseases are likely to occur and target surveillance to high-risk areas.

Sub-sampling a large physical soil archive for additional analyses to support spatial mapping; a pre-registered experiment in the Southern Nations, Nationalities, and Peoples Region (SNNPR) of Ethiopia

The value of physical archives of soil material from field sampling activities has been widely recognized. If we want to use archive material for new destructive analyses to support a task, such as spatial mapping, then an efficient sub-sampling strategy is needed, both to manage analytical costs and to conserve the archive material. In this paper we present an approach to this problem when the objective is spatial mapping by ordinary kriging. Our objective was to subsample the physical archive from the Ethiopia Soil Information System (EthioSIS) survey of the Southern Nations, Nationalities and Peoples Region (SNNPR) for spatial mapping of two variables, concentrations of particular fractions of selenium and iodine in the soil, which had not been measured there. We used data from cognate parts of surrounding regions of Ethiopia to estimate variograms of these properties, and then computed prediction error variances for maps in SNNPR based on proposed subsets of the archive of different size, selected to optimize a spatial coverage criterion (with some close sample pairs included). On this basis a subsample was selected.This is a preregistered experiment in that we have proposed criteria for evaluating the success of our approach, and are publishing that in advance of receiving analytical data on the subsampled material from the laboratories where they are being processed. A subsequent short report will publish the outcome. The use of preregistered trials is widely recommended and used in areas of science including public health, and we believe that it is a sound strategy to promote reproducible research in soil science.

Time to Recovery from Covid-19 and Its Predictors Among Patients Admitted to Treatment Centers of Southern Nations Nationalities and Peoples Region (SNNPR), ETHIOPIA: Multi-Center Retrospective Cohort Study.

BackgroundThe world is currently facing a pandemic of Coronavirus Disease 2019 (Covid-19). It has caused significant morbidity and mortality. So far little is known about recovery time (prolonged hospital stay) from Covid-19 and its determinants in Ethiopia as well as in the study area. Therefore, the aim of this study was to determine time to recovery from Covid-19, and identify predictors of time to recovery among patients admitted to treatment centers of Southern Nations Nationalities and Peoples Region (SNNPR).Methods and MaterialsA facility-based retrospective cohort study was conducted among Covid-19 patients admitted to care centers of SNNPR from May 30, 2020 to October 15, 2021. A sample of 845 patients was included in the study. Summarization of the data was done using mean (standard deviation) and median (inter quartile range). Kaplan–Meier Survival Curve was used to estimate recovery time from Covid-19 and the independent effects of covariates on recovery time was analyzed using multivariable Cox-proportional hazard model.ResultsThe incidence density of recovery was 8.24 per 100 person-days (95% CI: 7.67, 8.85). The overall median recovery time was 10 days (IQR: 8–16 days). Critical stage of Covid-19 (aHR = 0.19, 95% CI: 0.12, 0.29), severe stage of Covid-19 (aHR = 0.40, 95% CI: 0.29, 0.56), mechanical ventilation (aHR = 0.20, 95% CI: 0.073, 0.56) and treatment center (aHR = 0.68, 95% CI: 0.51, 0.90) were significant predictors of recovery rate among Covid-19 patients.ConclusionThe median time to recovery from Covid-19 was relatively short. The incidence density of recovery was 8.24 per 100 person-days. The hazard of recovery was lower for patients at higher levels of Covid-19 severity and for patients in need of mechanical ventilation. Early identification of severity levels of the patients is required at the time of admission. Special attention, critical follow–up and management is warranted for patients at higher levels of Covid-19 severity.

Burden and risk factors of cutaneous leishmaniasis in Ethiopia: a systematic review and meta-analysis.

Cutaneous leishmaniasis (CL) is a major public health problem in Ethiopia. About 30 million people are at risk, and there are 20,000 to 50,000 new cases annually. It is maintained by rock hyraxes and Phlebotomus sand flies. Different studies showed the presence and risk factors of CL. However, there is no study on the pooled prevalence and risk factors. This study aimed to determine the pooled prevalence and risk factors of CL in Ethiopia. We retrieved published articles from different databases. The review was conducted based on PRISMA guidelines. The meta-analysis was done with Stata software version 14. The forest plot with random-effect model and inverse variance index was used to estimate the pooled prevalence with 95% confidence interval and heterogeneity of articles, respectively. A total of 99,226 people from 19 studies were screened. The overall pooled prevalence of CL was 20.4% with 95% CI (15.67-25.13%). The pooled prevalence is a weighted average of results of the included 19 studies. Highest pooled prevalence, 65.39% (95% CI: 61.14-69.47%), was in Southern Nations, Nationalities and Peoples' Region (SNNPR), and the lowest was 1.53% (95% CI: 1.43-1.63%) in Amhara Region. Children were the most affected age group. Living in a home close to farmlands, outdoor sleeping behavior, the presence of gorge, hyrax, cracked walls, animal dung, and other cases in the neighborhood were identified as risk factors for CL. There is high burden of CL in Ethiopia. Larger surveys are required. Health education on the prevention and control strategies shall be implemented.

Response of maize yield to nitrogen, phosphorus, potassium and sulphur rates on Andosols and Nitisols in Ethiopia

Summary The use of fertilizers in balanced and adequate amounts is a prerequisite for increasing crop productivity and production. Unbalanced plant nutrient management continues to be a major factor contributing to low maize (Zea mays L.) yields due to lack of information on the dose–responses to macronutrients on different soil types in Ethiopia. This study was carried out to quantify maize yield response and agronomic efficiency of varying application rates of nitrogen (N), phosphorus (P), potassium (K) and sulphur (S) under balanced application of other nutrients across two soil types in Ethiopia. Field trials were set up on 29 farmers’ fields in four districts of Oromia and Southern Nations, Nationalities and Peoples Region (SNNPR) for three consecutive cropping seasons (2014–2017). The treatments consisted of six rates of N, P and S each and eight rates of K combined with balanced application of the remaining macronutrients, zinc (Zn) and boron (B). The treatments were laid out in randomised complete blocks design with three replicates per farm. Using nutrient dose–response modelling, the agronomic optimum rates of N, P, K and S were estimated at 46, 40, 17 and 10 kg ha−1 on Nitisols, with balanced application of the other nutrients. On Andosols, the optimum rates of N, P and S were estimated at 184, 20 and 30 kg ha−1, respectively, but the optimum K rate could not be estimated. The predicted maximum yields obtained with balanced nutrient application were lower on Andosols (3397–3640 kg ha−1) than on Nitisols (4630–6094 kg ha−1). Using the Mitscherlich dose–response model, the percentage deficiencies of N, P, K and S were estimated to be 1.3–3.3 times more on Nitisols than Andosols. Consequently, agronomic efficiencies of N, P, K and S were significantly lower on Andosols than on Nitisols. It is concluded that balanced application of 46 kg N ha−1, 40 kg P ha−1, 17 kg K ha−1, 10 kg ha−1 S, 2 kg Zn ha−1 and 0.5 kg B ha−1 could be recommended for maize on Nitisols in the study area. Although this recommendation may also apply to Andosol, further research is needed as the productivity of Andosols appears to be limited by constrains other than N, P, K, S, Zn and B. We also recommend a shift from the blanket fertilizer recommendations to site-specific nutrient management based on good understanding of the variations in crop response with soil type and agroecology and appropriate soil and plant analyses.