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Essential newborn care practices and determinants in Ethiopia: a multilevel analysis of national survey data

Por: Mekonnen · T. S. · Delie · A. M. · Hailu · M. · Mehari · M. G. · Bizuneh · G. K. · Mengistie · B. A.
Objectives

To assess the prevalence and determinants of essential newborn care (ENC) practices among Ethiopian mothers using the 2023 Performance Monitoring for Action (PMA) dataset.

Design

A cross-sectional analysis of the nationally representative 2023 PMA Ethiopia survey.

Participants

A total of 1933 mothers with complete data on ENC practices were included.

Setting

Ethiopia, using a multi-stage stratified cluster sample.

Primary outcome measures

ENC, defined as the adoption of at least four of five WHO-recommended practices: immediate drying, delayed bathing, skin-to-skin contact, clean cord care and early initiation of breastfeeding.

Results

Overall, 32.1% (95% CI 28.1% to 36.0%) of mothers practised at least four ENC components. Coverage was highest for immediate drying (95.4%) and delayed bathing (87.3%), but lower for skin-to-skin contact (53.6%) and clean cord care (64.5%). Health facility delivery showed a strong association with higher ENC practice (adjusted OR (AOR)=106.00; 95% CI 46.14 to 243.54). Mothers who were spouses, rather than household heads, had higher odds of practising ENC (AOR=2.88; 95% CI 1.20 to 6.89) and those mothers with parity two or three had higher odds of practising ENC compared with first-time mothers (AOR=2.00; 95% CI 1.33 to 3.02 and AOR=3.39; 95% CI 1.76 to 6.53, respectively). Lack of postnatal care attendance was negatively associated with ENC (AOR=0.56; 95% CI 0.37 to 0.85). Regional disparities were observed, with mothers in the Southern Nations, Nationalities and Peoples’ region being significantly less likely to practise ENC compared with those in Addis Ababa (AOR=0.31; 95% CI 0.15 to 0.64). All results are based on weighted data to ensure national representativeness.

Conclusion

The prevalence of ENC practices remains low in Ethiopia. Health facility delivery, maternal role in the household, parity and region of residence were significant predictors of ENC practice. Strengthening facility-based delivery, promoting maternal empowerment and addressing regional disparities are essential to improving newborn health outcomes in the country and achieving Sustainable Development Goal 3.

Evaluation of <i>Pseudomonas fluorescens</i> for biocontrol of early blight (<i>Alternaria solani</i>) in tomato in North Wollo, Ethiopia

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.

Development and validation of a risk prediction model for chronic kidney disease among adult hypertensive patients having follow-up at University of Gondar Comprehensive Specialised Hospital, Ethiopia: a retrospective cohort study

Por: Tilahun · A. D. · Limenih · M. A. · Muluneh · A. G. · Hailu · W. · Anlay · D. Z. · Liyew · B. · Muche · A. A.
Objective

Chronic kidney disease (CKD) arises due to uncontrolled hypertension (HTN). HTN significantly increases the risk of complications in vital organs, mainly the kidneys. If hypertensive individuals receive early intervention, the majority of these complications and deaths from CKD can be avoided. Having a clinically applicable tool to predict the future risk of those complications can prevent early disability and premature mortality. However, to this day, there is a lack of a validated risk prediction model specifically designed for CKD of hypertensive patients in Ethiopia. We aimed to develop a risk prediction model for CKD among hypertensive patients at the University of Gondar Comprehensive Specialised Hospital (UoGCSH), Ethiopia.

Study design

A retrospective follow-up study was conducted from 1 January 2012 to 30 December 2021. The Least Absolute Shrinkage and Selection Operator regression methods were used to select predictors. The performance of the models was assessed using the Area Under the Curve and calibration plots. The internal validity of the model was evaluated using bootstrapping methods, and the model was presented as a nomogram. Decision curve analysis was conducted to assess the net benefit of the prediction model in clinical and public health contexts.

Setting

Data from patients’ medical records were collected via the Kobo Toolbox in the UoGCSH.

Participant

We followed a total of 1120 Patients diagnosed with HTN.

Results

The incidence of CKD among adult hypertensive patients was 19.82% (95% CI 17.59% to 22.26%). In the multivariable logistic regression analysis, age, residency, baseline blood pressure status, type of HTN, family history of HTN, baseline serum creatinine levels, proteinuria at baseline and dyslipidaemia were identified as statistically significant predictors of CKD. The nomogram demonstrated a discriminatory power of 91.98% (95% CI 90.09% to 93.88%) and a calibration p value of 0.327. The sensitivity and specificity of the prediction model were 80.63% (95% CI 74.81% to 85.61%) and 87.97% (95% CI 85.66% to 90.03%), respectively. The developed nomogram has a greater net benefit than using the treat-all or treat-none strategies when the threshold probability of the patient is increased.

Conclusion

The nomogram demonstrated excellent discrimination and calibration in identifying hypertensive patients at high risk of CKD. This predictive model offers clinicians a valuable tool for early identification of high-risk individuals, enabling timely interventions, personalised counselling and optimised management through close monitoring to prevent disease progression.

Sugar-sweetened beverage/snack consumption and its determinants among infant and young children aged 6–23 months in twelve Sub-Saharan African countries: Evidence from 2019–2023 Demographic Health Survey data

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

Background

Sugar-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.

Methods

A 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.

Conclusion

In 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.

Stakeholders’ perspectives on barriers and enablers of chronic kidney disease care in Ethiopia: A qualitative study

by Daniel Bekele Ketema, Min Jun, Sradha Kotwal, Workagegnehu Hailu, Martin Gallagher, Rohina Joshi

Background

Chronic kidney disease (CKD) is a growing public health problem in Ethiopia. However, evidence on the health system and contextual factors influencing CKD care remains limited. This study explored the barriers and facilitators to CKD care from the perspectives of healthcare providers and other stakeholders.

Methods

A descriptive qualitative study was conducted using purposive and maximum variation sampling to recruit healthcare providers (including general practitioners, nephrologists/internists, nurse) and non-communicable disease (NCD) officers and program coordinators. Interviews were audio recorded, transcribed, and thematically analysed, underpinned by the Theoretical Domains Framework version 2.

Results

Fifteen participants (six general practitioners, five nephrologists/internists, one nurse, and three NCD program officers and coordinators) were included. About 40% of participants had over six years’ experience. Key barriers to CKD care included patient misconceptions, low patient and healthcare provider awareness, shortage of health workforce, knowledge gaps among junior healthcare providers, limited resources, high out-of-pocket costs, absence of registries for CKD, weak referral systems, inconsistent access to medicines and diagnostics, lack of structured training, and conflict-related disruptions. Facilitators included adherence to guidelines by senior staff, inclusion of CKD into national non-communicable disease strategies, and increased use of media for public health education.

Conclusions

Addressing key barriers and enhancing prioritisation of CKD by clinicians and policymakers is critical. Strengthening workforce capacity, awareness, referral systems, and integration into national strategies offers opportunities to improve CKD care.

Low back pain among academic staff at a university in Ethiopia: a cross-sectional study

Por: Hailu Tesfaye · A. · Abere · G. · Demoze · L. · Yitageasu · G. · Mekonnen · T. H.
Objective

Low back pain (LBP) is a common occupational health problem among academic staff, often associated with prolonged sitting, poor ergonomics and psychosocial stress. This study aimed to assess the prevalence of LBP and its associated factors among academic staff at a university in Ethiopia.

Design and setting

A cross-sectional survey was conducted among academic staff at the University of Gondar (Gondar, Ethiopia) using simple random sampling from March to April 2021.

Participants

A total of 607 workers participated in the study.

Outcome measures

A self-administered, structured Nordic Musculoskeletal Questionnaire was used to assess the occurrences of LBP over the past 12 months. Data were analysed using Stata (V.14), and associations between variables were examined using binary logistic regression. Results are presented as adjusted ORs (AOR) with 95% CIs, with statistical significance set at p

Results

The prevalence of LBP in the last 7 days was 44.8% (95% CI 40.8% to 48.86%), and over the past 12 months it was 55.68% (95% CI 51.63% to 59.68%). A significant difference in 7-day prevalence was observed between female and male participants (39.86% vs 15.81%, respectively; ² = 0.887; p=0.02). In the multivariable logistic regression analysis, being female was associated with higher odds of LBP (AOR=1.72; 95% CI 1.15 to 2.57; p=0.009), as was working more than 8 hours per day (AOR=1.45; 95% CI 1.02 to 2.10; p=0.038), physical inactivity (AOR=1.88; 95% CI 1.30 to 2.72; p=0.001) and prolonged standing during work hours (AOR=1.63; 95% CI 1.03 to 2.59; p=0.036).

Conclusion

The prevalence of LBP among academic staff is high. Targeted interventions are recommended to address LBP, focusing on gender-sensitive strategies to mitigate the additional burden on female staff, time management to reduce long working hours and workplace programmes to limit sedentary behaviour, encourage physical activity and improve ergonomic awareness.

Quality of care for people with chronic kidney disease: a systematic review and meta-analysis

Por: Ketema · D. B. · Wallace · H. · Hailu · W. · Badve · S. V. · Ronksley · P. · Neuen · B. L. · Pecoits-Filho · R. · Gallagher · M. · Kotwal · S. · Perkovic · V. · Joshi · R. · Jun · M.
Objectives

Guideline-based strategies to prevent chronic kidney disease (CKD) progression and complications are available, yet their implementation in clinical practice is uncertain. We aimed to synthesise the available evidence on the concordance of CKD care with clinical guidelines to identify gaps and inform future CKD care.

Design

Systematic review and meta-analysis.

Data sources, participants, and outcomes

We systematically searched MEDLINE (OVID), EMBASE (OVID) and CINAHL (EBSCOhost) (to 18 July 2025) for observational studies of adults with CKD reporting data on the quality of CKD care. We assessed data on quality indicators of CKD care across domains that related to patient monitoring (glomerular filtration rate and albuminuria), medications use (ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), statins) and treatment targets (blood pressure (BP) and HbA1c). Pooled estimates (95% CI) of the percentage of patients who met the quality indicators for CKD care were estimated using random effects model.

Results

59 studies across 24 countries, including a total of 3 003 641 patients with CKD, were included. Across studies, 81.3% (95% CI: 75% to 87.6%) of patients received eGFR monitoring, 47.4% (95% CI: 40.0% to 54.7%) had albuminuria testing, and 90% (95% CI: 84.3% to 95.9%) had BP measured. ACEIs/ARBs were prescribed among 56.7% (95% CI: 51.5% to 62%), and statins among 56.6% (95% CI: 48.9% to 64.3%) of patients. BP (systolic BP ≤140/90 mm Hg) and HbA1c (

Conclusions

Current evidence shows substantial variation in CKD care quality globally. Guideline-concordant care varied according to quality measures and across patient groups, with gaps in indicators like albuminuria testing. These findings underscore the need for effective quality improvement strategies to address gaps in CKD care, including increased albuminuria testing for risk stratification, together with systematic measures for monitoring care quality.

PROSPERO registration number

CRD42023391749.

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