Social support is an important factor for psychosocial well-being and motivation to follow the treatment strictly in people with drug-resistant tuberculosis (DR-TB). Thus, this study aimed to determine the availability of social support and its association factors in people with DR-TB in selected hospitals in Ethiopia.
A cross-sectional study was conducted in Addis Ababa (at Saint Peter and ALERT hospitals) and Bishoftu Hospital in Ethiopia. The study involved 130 people with DR-TB from January to May 2023.
All adult people on DR-TB treatment for at least 2 months were enrolled consecutively from the registration book. A structured questionnaire was used to collect data. Data were entered to Open Data Kit and analysed with SPSS V.22. Descriptive statistics were used to describe the characteristics of the participants. A linear regression model was used to assess factors associated with social support.
Availability of social support from different sources.
The overall proportion of availability of social support obtained from different sources was 97.7% with 95% CI of (93.1% to 99.5%). Sex (β=0.61, 95% CI (0.28 to 0.94); p
A considerable proportion of people with DR-TB were obtaining social support from different sources. Interventions targeted female sex, single marital status and perceived social stigma are required to enhance social support conditions in people with DR-TB.
by Birhan Berihun Abebe, Abebe Girma Demissie, Habtie Bassie Felatie, Aderajew Adgo Tesema, Baye Wodajo, Wondye Ayaliew Shiferaw, Sualih Gobeze Hailu
Tomato (Solanum lycopersicum) is a widely used vegetable in Ethiopia, but its production is severely affected by late blight, early blight and bacterial wilt. This study aims to isolate Pseudomonas fluorescens as a bio-control agent against Alternaria solani. Biological control using Pseudomonas fluorescens offers a potential alternative to chemical fungicides. Rhizosphere soil and healthy tomato roots were sampled from three Kebeles in North Wollo, Ethiopia. P. fluorescens was isolated on Pseudomonas Isolation Agar, while A. solani isolated from infected leaves on Potato Dextrose Agar and confirmed pathogenic on tomato seedlings. Three isolates of P. fluorescens (Pfs12, Pfk13, Pfsa31) were screened in vitro using the dual culture method, and their efficacy was further tested in vivo under greenhouse conditions. Isolates Pfs12 and Pfk13 showed moderate effectiveness against the radial growth of A. solani, achieving percent growth inhibitions of 56.04% and 55.04%, respectively. The standard chemical treatment (mancozeb) resulted in a 54.84% growth inhibition. The control group (Pseudomonas fluorescens) also demonstrated a moderate growth inhibition of 57.65% against A. solani. Data were gathered regarding disease parameters. The day after transplanting, the percent disease index was significantly lower in all treated groups compared to the control (water). The isolate Pfsa31 achieved the lowest disease index of 24.733%, which was comparable to the standard chemical treatment at 28.467%. Both treatments were significantly different from the control (water) at 60.333%. The findings showed the bio-control potential of selected P. fluorescens isolates as effective and environmentally sustainable alternatives to synthetic fungicides for the management of early blight disease in tomato cultivation, emphasizing the importance of utilizing indigenous strains for optimal performance.Immunisation is one of the most valuable, impactful and cost-effective public health interventions which delivers positive health, social and economic benefits. Globally, 4 million deaths worldwide are prevented by childhood vaccination every year. In Ethiopia, despite huge progress being made, the routine immunisation coverage has never reached the targeted figures and planned goals. Pastoralist communities are often disproportionately under-vaccinated, and there is often a confluence of interrelated factors that drive this outcome. This study enables us to identify factors affecting immunisation service utilisation in the pastoralist communities of Ethiopia, which helps to design effective and context-specific interventions.
This study aims to explore the behavioural and social drivers (BeSDs) of routine immunisation among the communities with high numbers of zero-dose and under-immunised children in Afar, Somali and Gambella regions of Ethiopia.
A qualitative exploratory study was conducted in three selected regions of Ethiopia (Gambella, Somali and Afar) from 9 November 2023 to 30 December 2023. Purposive sampling was used. A total of 33 interviews were conducted in the three regions. Sample size was determined based on idea saturation. Data was collected using interview guides. The interview guide was developed after reviewing relevant literature, desk review and using the journey to health and immunisation framework. A separate interview guide was developed for the journey mapping exercise, in-depth interview, healthcare workers discussion guide, focus group discussion and observation. Data was analysed thematically.
Behavioural (lack of awareness, lack of reminder/forgetting, misperception about vaccines, negative previous experience, lost card and fear of post-vaccination adverse events).
Structural (language barrier, long distance from home to facility, high cost of transportation, long waiting time, limited training of healthcare professionals and incentives, inconvenient service hours, shortage of health professionals, disrespect by the healthcare provider), Socio-cultural (competing priorities, low community engagement, lack of decision-making autonomy, limited husband involvement, workload, rural residence and larger family size were the commonly mentioned barriers to routine immunisation uptake. On the other hand, structural (house to house visit by health extension workers, counselling about adverse events, presence of outreach service, affordability (free of charge)), behavioural and socio-cultural (knowledge of adverse event management, and respect from community) were enablers to routine immunisation service uptake in pastoralist communities.
The study found several individual and contextual factors affecting routine immunisation uptake in pastoralist communities. Context-specific and tailored interventions which address zero dose drivers should be designed so as to enhance vaccine uptake. The findings suggested the need to design context-specific interventions to address the aforementioned barriers to immunisation.
by Birtukan Gizachew Ayal, Abebe Kassa Geto, Sefineh Fenta Feleke, Ali Yimer, Atitegeb Abera Kidie, Natnael Amare Tesfa, Esuyawkal Mislu, Molla Hailu, Hassen Ahmed Yesuf
BackgroundSugar-sweetened beverages or snacks are limited in nutritional value. Excess consumption of sugar-sweetened beverages or snacks in early childhood is associated with inadequate micronutrient intake, being overweight or obese, and developing chronic diseases later in life. There is scarcity of information specific to sugar-sweetened beverages or snacks consumption prevalence and its determinants in Sub-Saharan Africa Countries. This study aimed to determine the pooled prevalence of sugar-sweetened beverage or snack consumption and its determinants among infants and young children aged 6–23 months.
MethodsA cross-sectional study design was conducted using demographic and health survey data conducted from 2019 to 2023 from twelve Sub-Saharan African countries. A weighted sample of 23,145 children aged 6–23 months was included in the study. Multilevel mixed-effects logistic regression analysis was used to determine the factors associated with the dependent variable. The level of statistical significance was declared with a p-value Results
The pooled prevalence of Sugar-sweetened beverage or snack consumption was 25.40% (95% CI: 24.84% − 25.96%). In multilevel multivariable logistic regression analysis, children aged between 9−11(AOR = 1.95 95% CI: 1.62, 2.35), 12–17(AOR = 2.83; 95% CI: 2.26, 3.54), and 18−23 months (AOR = 3.77;95% CI: 3.07, 4.63), media exposure (AOR = 1.59; 95% CI:1.28, 1.98), children from households with middle (AOR = 1.39; 95% CI: 1.11, 1.73) and rich (AOR = 2.31; 95% CI: 1.87, 2.85) wealth status, post natal checkup (AOR = 1.18; 95%CI:1.05,1.33), maternal ANC visit (AOR = 1.60; 95% CI: 1.15, 2.22), and high community media exposure ((AOR = 2.22;95%CI:1.65,5.81) were positively associated significant factors whereas currently breast feeding children (AOR = 0.70; 95% CI: 0.59,0.82), older age at first birth (AOR = 0.88,95% CI: 0.81, 0.96), presences of more than one under-5 children in the household (AOR = 0.89, 95% CI: 0.80, 0.99), mothers don’t perceive distance to health facility as big problem (AOR = 0.86; 95% CI:0.76, 0.98), and children reside in rural (AOR = 0.83;95%CI:0.68,0.95) were negatively associated with sugar sweetened beverage or snack consumption.
ConclusionIn this study, one out of four children consumed sugar-sweetened beverages or snacks. Current age of child, current breastfeeding status of child, media exposure, wealth index, maternal age at first birth, post natal checkup, maternal ANC visit, number of under-five children in the household, distance to health facility, place of residence, and community level media exposure were significant factors with sugar-sweetened beverage or snack consumption. Therefore, it is recommended to raise awareness about the health risks of sugar-sweetened beverage and snack consumption, enforce restrictions on their advertisement, strengthen nutrition-focused counseling within maternal and child health services with special attention for older age children, promote breastfeeding, and give special attention to challenges related to health facility accessibility, and support for young mothers.
Acute coronary syndrome (ACS) is the leading cause of morbidity and mortality among individuals with cardiovascular disease, accounting for half of all global cardiovascular-related deaths. No prior research has examined ACS treatment outcomes and associated factors in the study area. This study aimed to evaluate the risk factors and treatment outcome of ACS patients admitted to public hospitals in Harari Regional State, Eastern Ethiopia.
A retrospective hospital-based cross-sectional study was conducted among 308 ACS patients. Patient records from admissions between 1 November 2018 and 31 October 2023 were reviewed, with data collected between 10 January and 10 February 2024 using a structured checklist adapted from previous research. Statistical analysis was performed using SPSS V.25.0, with bivariable and multivariable logistic regression identifying significant associations at a p value
The mean patient age was 56.4±16 years, with males comprising 77.3% of participants. Half (51.6%) resided in rural areas, and only 16.2% presented within 12 hours of symptom onset. Overall, 81 patients (26.3%) experienced a poor treatment outcome for ACS, including 39 (12.7%) in-hospital deaths, 24 (7.8%) referrals to higher-level facilities and 18 (5.8%) who left against medical advice. Factors significantly associated with poor outcome included hospital presentation more than 72 hours after symptom onset (AOR 2.734 (95% CI 1.006 to 7.435)), left ventricular ejection fraction (LVEF)
Poor treatment outcome was independently predicted by the presence of ischaemia features on the echocardiography, LVEF (
by Abebe Fenta, Tebelay Dilnessa, Destaw Kebede, Mekuriaw Belayneh, Zigale Hibstu Teffera, Bewket Mesganaw, Adane Adugna, Wubetu Yihunie Belay, Habtamu Belew, Desalegn Abebaw, Bantayehu Addis Tegegne, Zelalem Dejazmach, Fassikaw Kebede, Gashaw Azanaw Amare
BackgroundCo-infection with the human immunodeficiency virus (HIV) and tuberculosis (TB) is a primary cause of death and morbidity. The rate of morbidity and death from TB-HIV is still Ethiopia’s top health issue.
ObjectiveThis study aimed to assess the incidence and predictors of mortality among TB-HIV co-infected individuals on anti-TB and anti-retroviral dual Therapy at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.
MethodsA retrospective cohort study was conducted at the Debre Markos Comprehensive Specialized Hospital among 436 TB-HIV co-infected individuals. A computer-generated random sampling technique was used to select patient charts registered from September 1st, 2011, and August 31st, 2020. Epi-Data version 3.1 was used for data entry, and STATA version 13 was used for the analysis. The Kaplan-Meier survival curve was applied to estimate the cumulative survival time of the TB-HIV patients. Log-rank tests were utilized to compare the survival time across various categories of explanatory variables. Bi-variable and multivariable Cox proportional hazard models were fitted to find predictors of TB-HIV mortality.
ResultsThe mortality rate of TB-HIV co-infected individuals was 15.6%, with a median survival time of 42 months. Being male (Adjusted hazard Ratio (AHR)1.914;95%CI: 1.022–3.584), having CD4 count Conclusion and recommendation
The mortality rate among TB-HIV co-infected patients at Debre Markos Comprehensive Specialized Hospital was high. Being male gender, having a CD4 count below 50 cells/mm³, being ambulatory and bedridden, having low baseline weight, and having low hemoglobin were the important predictors of mortality. To reduce mortality, it is crucial to focus on the early identification and management of high-risk patients, particularly those with low CD4 counts, poor functional status, and low hemoglobin. Strengthening integrated TB and HIV care services is recommended to improve patient survival outcomes.
by Awole Seid, Zelalem Debebe, Abebe Ayelign, Bilal Shikur Endris, Mathewos Assefa, Ahmedin Jemal
BackgroundNutrition impact symptoms such as nausea, vomiting, and taste alterations are common side effects of chemotherapy and can lead to malnutrition. There is a paucity of data regarding the nutritional challenges faced by cancer patients, particularly in resource-limited settings. This study aimed to explore the lived experiences of nutrition impact symptoms among patients undergoing chemotherapy at a major cancer center in Ethiopia.
MethodsAn interpretative phenomenological analysis was conducted from November 11–29, 2024, involving 26 cancer patients treated at the Oncology Center of Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia. Both data and thematic saturation were employed to determine the sample size. Participants were selected using heterogeneous sampling, and data were collected through in-depth interviews. The interviews were audio-recorded and transcribed verbatim in Amharic, followed by a contextual translation into English. The data were analyzed using an inductive thematic analysis approach with the aid of MAXQDA24 software.
ResultsThree themes were identified: symptom burden and coping, individualized food choices, and unmet nutritional support needs. Symptoms were particularly severe during the early stages of treatment, disrupting typical dietary patterns and leading to physical limitations, negative emotional responses, and decreased productivity. The finding also revealed financial barriers to accessing nutritious foods, nutritional misinformation, and unsatisfactory experiences with hospital food.
ConclusionSymptoms vary in onset, severity, and pattern among individuals, significantly impacting their quality of life. Nutritional support is a pressing need for cancer patients. The findings underscore the critical need for dietitian-led, patient-centered nutritional interventions, along with socioeconomic support for patients undergoing chemotherapy in Ethiopia.
by Mesfin Abebe, Yordanos Sisay Asgedom, Amanuel Yosef Gebrekidan, Tsion Mulat Tebeje
BackgroundBreast cancer is the leading cause of cancer-related deaths in women globally and a significant public health burden in sub-Saharan Africa, which accounts for approximately 15% of all cancer-related mortality. In sub-Saharan Africa, breast cancer incidences increased by 247% from 1990 to 2019. In Lesotho, breast cancer is the second most common cancer affecting women, a situation worsened by a fragile healthcare system and low screening rates. Despite its high morbidity and mortality, there is limited understanding of the factors influencing breast cancer screening among women of reproductive age. This study aims to identify these factors by utilizing the newly released Lesotho DHS dataset and the Anderson Behavioral Model.
MethodsThis study utilized a cross-sectional design with data from the recent Lesotho Demographic and Health Survey (LDHS), which employed a stratified two-stage sampling method across 400 Enumeration Areas and 9,976 households. This analysis included a weighted sample of 6,413 reproductive-age women (15–49 years) to determine factors of breast cancer screening. The predisposing, enabling, and need factors were examined using the Andersen Behavioral Model. Stata version 16 was used for a multilevel mixed-effects logistic regression model. Results were presented as adjusted odds ratios (AOR) with 95% confidence intervals, and a P-value less than 0.05 was considered statistically significant.
ResultsThe prevalence of breast cancer screening among women of reproductive age in Lesotho was 22.20% (95% CI 21.19–23.23). Significant factors included age 25–34 (AOR = 1.54; 95% CI 1.26–1.88), age 35–49 (AOR = 2.10; 95% CI 1.71–2.58), healthcare facility visits in the past 12 months (AOR = 1.47; 95% CI 1.26–1.71), health insurance coverage (AOR = 1.86; 95% CI 1.36–2.53), high media exposure (AOR = 1.23; 95% CI 1.01–2.52), contraceptive use (AOR = 1.18; 95% CI 1.03–1.37), and parity: multiparous (AOR = 2.29; 95% CI 1.84–2.85) and grand multiparous (AOR = 1.67; 95% CI 1.16–2.40).
ConclusionThis finding that 22.2% of reproductive age women in Lesotho underwent breast cancer screening highlights a pressing gap in preventive health efforts. The Andersen Behavioral Model underscores key determinants that significantly influence breast cancer screening uptake in our study. Significant factors included age, healthcare facility visits, health insurance coverage, media exposure, contraceptive usage, and parity. These findings underscore the need for targeted interventions that address model-based determinants to improve breast cancer screening uptake.
To estimate the pooled attrition rate among HIV-infected children receiving antiretroviral therapy (ART) and identify predictors of attrition in Ethiopia.
Systematic review and meta-analysis.
PubMed, HINARI, Web of Science, African Journals Online and Google Scholar were searched up to 20 February 2025.
Cohort studies conducted in Ethiopia that reported attrition from ART and its predictors among children, published as full-length articles in English, were included.
Three independent reviewers extracted data and assessed study quality using the Joanna Briggs Institute checklist for cohort studies. Heterogeneity was assessed using the I² statistic. Publication bias was evaluated with funnel plots and Egger’s test. A random-effects model was applied to estimate the pooled attrition rate.
Among 1093 studies identified, 14 met the inclusion criteria and were included in the analysis. The pooled attrition rate among HIV-infected children receiving ART was 6.04 per 100 person-years of observation (95% CI 4.90 to 7.44). Anaemia (HR=3.39; 95% CI 2.40 to 4.78), suboptimal ART adherence (HR=2.33; 95% CI 1.39 to 3.89) and underweight status (HR=3.43; 95% CI 2.04 to 5.78) were significantly associated with higher attrition.
The pooled attrition rate among HIV-infected children receiving ART in Ethiopia is relatively low. Nevertheless, enhanced counselling on ART adherence is crucial to further reduce attrition, and special attention should be given to children with anaemia or underweight status.
CRD420251015059.
Inappropriate medication use among surgical patients poses significant risks, including antibiotic resistance, complications, mortality, increased healthcare costs and challenges in pain management. This study aimed to assess the extent of inappropriate antibiotic and analgesic prescriptions, treatment adequacy and contributing factors.
A hospital-based cross-sectional study was conducted among patients admitted to surgical wards in three comprehensive specialised hospitals in northwest Ethiopia.
All eligible adult patients admitted to the surgical wards during the data collection period were included in the study.
The primary outcomes were the appropriateness of antibiotic and analgesic prescriptions. To assess patients’ pain perception and the effectiveness of pain management strategies, the American Pain Society Patient Outcome Questionnaire was used. The Pain Management Index was employed to evaluate the treatment adequacy. The RAND (Research and Development)-modified Delphi method was applied to reach expert consensus on best practices for antibiotic prescribing. Additionally, the national standard treatment guideline was used to benchmark prescribing practices. Binary logistic regression was used to identify factors associated with inappropriate prescriptions of antibiotics and analgesics.
The prevalence of inappropriate antibiotics use was 67.5% and 42.2% of patients received inappropriate analgesic prescriptions. Moreover, 51.6% of patients experienced inadequate pain management. Significant factors associated with inappropriate antibiotic prescription included the presence of comorbidities (adjsuted OR (AOR) 3.34, 95% CI 1.88 to 5.92), lack of laboratory tests (AOR 0.26, 95% CI 0.16 to 0.43, higher number of medications (AOR 2.71, 95% CI 1.62 to 4.52) and contaminated wound class (AOR 3.13, 95% CI 1.58 to 6.20). For inappropriate analgesic prescription, pain due to disease (AOR 8.69, 95% CI 1.73 to 4.62), mixed causes of pain (AOR 7.20, 95% CI 1.43 to 6.31), head and facial pain (AOR 0.14, 95% CI 0.05 to 0.39) and an increased number of medications (AOR 2.75, 95% CI 1.72 to 4.41) were significant factors.
The majority of the patients admitted to surgical wards were found to receive inappropriate antibiotic and analgesic medications. Prescribers should pay attention to patients with comorbid diseases, receiving multiple medications. Additionally, routine laboratory tests are essential for guiding antibiotic therapy and improving patient outcomes in surgical wards.
Gestational trophoblastic disease, characterised by abnormal proliferation of trophoblastic tissue in the placenta during pregnancy, contributes to maternal morbidity and mortality. This study aimed to estimate the pooled prevalence and histopathological patterns of gestational trophoblastic disease in Africa, where previous studies have reported inconsistent findings.
Systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.
We searched PubMed, ScienceDirect, Hinari and Google Scholar for studies published between January 2000 and January 2024.
Institution-based observational studies from African countries reporting the prevalence and/or histopathological patterns of gestational trophoblastic disease, using total deliveries as the denominator.
Data were extracted into Excel and analysed using Stata V.17. Pooled estimates were calculated using a random-effects model with Knapp-Hartung adjustment. Heterogeneity was assessed with Cochran’s Q test and the I² statistic, and study quality was evaluated using the Joanna Briggs Institute tool.
Of the 2252 studies identified, 33 were included, comprising 2885 gestational trophoblastic disease cases from eight countries. The pooled prevalence of gestational trophoblastic disease in Africa was 4.35 per 1000 deliveries (95% CI 3.26 to 5.45, I2=99.8%). The pooled prevalence of hydatidiform mole, invasive mole and choriocarcinoma in Africa was 3.49 per 1000 deliveries (95% CI 2.45 to 4.52, I2=99.7%), 0.47 per 1000 deliveries (95% CI 0.14 to 0.79, I2=72.2%) and 0.97 per 1000 deliveries (95% CI 0.54 to 1.40, I2=99.1%), respectively.
This review indicated the prevalence of gestational trophoblastic disease was high. Hydatidiform mole was the predominant histopathological pattern observed. Routine antenatal screening is needed for early detection. Further research should be conducted to identify risk factors and evaluate strategies for the prevention and management of the disease.
CRD42024504268.
This study aims to assess the level of cardiovascular disease (CVD) risk and its associated determinants among hypertensive patients in Jigjiga, Somali Region, Ethiopia using the WHO 10-year CVD risk score.
An institution-based cross-sectional study design was employed.
Hypertensive patients aged 40–74 years in two public hospitals in Jigjiga, Somali Region, Ethiopia, from 20 December 2023 to 20 February 2024.
Randomly selected 344 hypertensive patients aged 40–74 years with a duration of 1 year or more from the time of diagnosis and at least having 6-month follow-up.
10-year CVD risk level was assessed by using WHO 10-year CVD risk score. Risk levels were categorised as low (
Associated factors influencing CVD risk.
The study included 341 hypertensive individuals, with a 99.1% response rate. Of the respondents, 58.9% were men. The overall prevalence of CVD risk within the coming 10 years was 134 (39.3%; 95% CI: 34.1% to 44.5%). Multivariable logistic regression analysis identified age, khat chewing, smoking and comorbid conditions as significant independent predictors of CVD risk. Specifically, individuals aged 60–69 years had an adjusted OR (AOR) of 3.97 (95% CI: 1.94 to 8.16) and those aged 70–74 years had an AOR of 2.99 (95% CI: 1.57 to 5.71). Khat chewers had an AOR of 2.58 (95% CI: 1.22 to 5.46), smokers an AOR of 3.44 (95% CI: 1.59 to 7.48) and individuals with comorbidities an AOR of 2.42 (95% CI: 1.47 to 3.99).
There is a significant increase in 10-year CVD risk among hypertensive patients in the study area. Age, khat chewing, smoking and comorbidities were independent predictors. Regular CVD risk screening for older patients, focused health education to reduce khat and tobacco use and integrated management of comorbidities are essential to lower future cardiovascular risk.