Background: Antenatal care (ANC) is a preventive obstetric health-care program aimed at optimizing maternal fetal outcome through regular monitoring of pregnancy. Even if World Health Organization recommends a minimum of 4 ANC visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it due to different reasons. The purpose of this article is to identify determinants significantly influencing the ANC visit utilization of child-bearing mothers in the Kaffa, Sheka, and Bench-Maji zones of Southern Nation Nationalities and Peoples Region, Ethiopia. Methods: A total of 1715 child-bearing mothers were selected. Several count models such as Poisson, negative binomial, zero-inflated Poisson, zero-inflated negative binomial, hurdle Poisson, and hurdle negative binomial regression models were fitted to select the model which best fits the data. The parameters were estimated by maximum likelihood. Measures of goodness of fit were based on the Rootogram. Results: The data were found zeros (8.1%); the variance (3.794), which is less than its mean (3.91). Hurdle Poisson regression model was found to be better fitted with the data given. Variables are selected by backward selection method, through the analysis, zones, residence, age at first pregnancy, source of information, knowledge during danger sin, willingness, time of visit, and satisfaction, which were major predictors of ANC service utilization. The estimated odds that the number of ANC visits those child-bearing mothers made (mothers who lived in urban) are 3.52 times more likely than mothers who lived in rural keeping others variables constant and the like. Conclusion: Based on our findings, a lot of effort needs to be made by health offices to create awareness, maternal health-care programs should be expanded and intensified in rural areas, improve women’s knowledge and awareness about the risk factor of late visit, the necessary investigations and follow-up throughout the antenatal period to promote regular attendance for ANC, and fulfill the client’s satisfaction.

Background Climate and environmental factors could be one of the primary factors that drive malaria transmission and it remains to challenge the malaria elimination efforts. Hence, this study was aimed to evaluate the effects of meteorological factors and topography on the incidence of malaria in the Boricha district in Sidama regional state of Ethiopia. Methods Malaria morbidity data recorded from 2010 to 2017 were obtained from all public health facilities of Boricha District in the Sidama regional state of Ethiopia. The monthly malaria cases, rainfall, and temperature (minimum, maximum, and average) were used to fit the ARIMA model to compute the malaria transmission dynamics and also to forecast future incidence. The effects of the meteorological variables and altitude were assessed with a negative binomial regression model using R version 4.0.0. Cross-correlation analysis was employed to compute the delayed effects of meteorological variables on malaria incidence. Results Temperature, rainfall, and elevation were the major determinants of malaria incidence in the study area. A regression model of previous monthly rainfall at lag 0 and Lag 2, monthly mean maximum temperature at lag 2 and Lag 3, and monthly mean minimum temperature at lag 3 were found as the best prediction model for monthly malaria incidence. Malaria cases at 1801–1900 m above sea level were 1.48 times more likely to occur than elevation ≥ 2000 m. Conclusions Meteorological factors and altitude were the major drivers of malaria incidence in the study area. Thus, evidence-based interventions tailored to each determinant are required to achieve the malaria elimination target of the country.

Background Countries in malaria endemic regions are determinedly making an effort to achieve the global malaria elimination goals. In Ethiopia, too, all concerned bodies have given attention to this mission as one of their priority areas so that malaria would be eradicated from the country. Despite the success stories from some areas in the country, however, malaria is still a major public health concern in most parts of Ethiopia. Therefore, this study is aimed at analysing the changing malaria trend and assessing the impact of malaria control efforts in one of the malaria endemic regions of Ethiopia. Methods Five years data on clinical malaria cases diagnosed and treated at all health facilities (including 28 Health Centres, 105 Health Posts and 2 Hospitals) in Oromia Special zone, Amhara Regional State, Ethiopia, were reviewed for the period from June 2014 to June 2019. Data on different interventional activities undertaken in the zone during the specified period were obtained from the Regional Health Bureau. Results The cumulative malaria positivity rate documented in the zone was 12.5% (n = 65,463/524,722). Plasmodium falciparum infection was the dominant malaria aetiology and accounted for 78.9% (n = 51,679). The age group with the highest malaria burden was found to be those aged above 15 years (54.14%, n = 35,443/65,463). The malaria trend showed a sharp decreasing pattern from 19.33% (in 2015) to 5.65% (in 2018), although insignificant increment was recorded in 2019 (8.53%). Distribution of long-lasting insecticidal nets (LLIN) and indoor residual spraying (IRS) were undertaken in the zone once a year only for two years, specifically in 2014 and 2017. In 2014, a single LLIN was distributed per head of households, which was not sufficient for a family size of more than one family member. Number of houses sprayed with indoor residual spray in 2014 and 2017 were 33,314 and 32,184 houses, respectively, leading to the assumption that, 151,444 (25.9%) and 141,641 (24.2%) population were protected in year 2014 and 2017, respectively. The analysis has shown that P. falciparum positivity rate was significantly decreased following the interventional activities by 3.3% (p = 0.009), but interventional efforts did not appear to have significant effect on vivax malaria, as positivity rate of this parasite increased by 1.49% (p = 0.0218). Conclusion Malaria burden has shown a decreasing pattern in the study area, although the pattern was not consistent throughout all the years and across the districts in the study area. Therefore, unremitting surveillance along implementation of interventional efforts should be considered taking into account the unique features of Plasmodium species, population dynamics in the zone, seasonality, and malaria history at different districts of the zone should be in place to achieve the envisaged national malaria elimination goal by 2030.

Background: In opposite to progressing to achieve target 3.2 of Sustainable Development Goals, which is ending preventable deaths of neonates and under-five years child by 2030, diarrheal disease continued to be the major cause of child mortality in developing countries including Ethiopia. Thus, this study aimed to assess the prevalence of diarrheal morbidity and associated factors among under-five children in southwest Ethiopia. Methodology: An institution-based cross sectional study was conducted among 2233 under-five children at three randomly selected public hospitals of southwest Ethiopia from March 1 to November 21, 2021. Data were collected from mothers/guardians of the index children selected by systematic random sampling using structured interviewer administered questionnaire. Data entered by Epi_data v.4.2 were analyzed by multivariable logistic regression. P-value <0.05 and 95% confidence-interval (CI) was used to ascertain statistical significance. Results were presented by tables and text. Result: This study had a response rate of 90.9%. The two-week prevalence of diarrhea among the under-five children was 701(34.53%). The factors associated with it were being female (AOR 0.26; 95%CI=.172-.4), age 12-23 months (AOR 4.37; 95%CI=2.32-8.24), mothers or guardian with no formal education (AOR 3.55; 95%CI=1.97-6.4), being urban resident (AOR 0.48; 95%CI=0.28-0.84), being 1st born (AOR .08; 95%CI=.03-.26), frequent hand washing (AOR .58; 95%CI=.26-.66), washing child utensils by cool-water & soap (AOR 2.8; 95%CI=2.12-3.57), unprotected water (AOR 3.6; 95%CI=2.13-6.13), having latrine (AOR .03; 95%CI=.02-.05), replacing water in storage daily (AOR .02; 95%CI=.004-.05), and child-self feeding (AOR 2.4; 95%CI=1.57-3.74).Conclusion: The prevalence of diarrheal morbidity among under-five children in southwest Ethiopia is unacceptably high. Accordingly, to reduce the morbidity, it is urgent that the parents, health extension workers, the zonal health departments, and all concerned bodies should struggle their best to strengthen the practices of diarrhea preventive methods and to avoid the risk factors.

Background: Currently, the worldwide prevalence and incidence of multidrug-resistant tuberculosis (MDR-TB) is drastically increasing. The main objective of this study was modeling the time-to-death of patients with MDR-TB at St. Peter’s Specialized Hospital, Addis Ababa, Ethiopia, by using various parametric shared frailty models. Study Design: A retrospective study design was used. Methods: The study population was TB patients with MDR at St. Peter’s Specialized Hospital from January 2016 through December 2019. Exponential, Weibull, and log-normal were used as baseline hazard functions with the gamma and inverse Gaussian frailty distributions. All the models were compared based on Akaike’s Information Criteria. Results: The overall median time to death was 11 months and 123 (33.5%) patients died. Patients who lived in rural areas had shorter survival time than those who lived in urban areas with an accelerated factor of 0.135 (P=0.002). Patients with a history of anti-TB drug consumption had a short survival time than those without such a history with an accelerated factor of 0.02 (P=0.001). The variability (heterogeneity) of time to death of patients in the region for the selected model (Weibull-inverse Gaussian shared frailty model) was θ=0.144 (P=0.027). Conclusion: The MDR-TB patients with weight gain, khat and alcohol consumption, clinical complication of pneumothorax and pneumonia, extrapulmonary TB, and history of anti-TB drug consumption as well as those who lived in rural areas had a shorter survival time, compared to others. There was a significant heterogeneity effect in the St. Peter’s Specialized Hospital. The best model for predicting the time to death of MDR-TB patients was Weibull-inverse Gaussian shared frailty model.

Diabetes is a group of diseases marked by high or low level of glucose resulting from defects in insulin production, insulin action or both. The objective of this study is to model time-to-first recovery of adult diabetic patients using Cox Proportional Hazards model. A retrospective data was obtained from Jimma University Specialized Hospital diabetic patient clinic whose age ≥ 18 years and under treatments in between September 2010 and August 2013 are included in the study. Time of fasting blood sugar level to reach the first normal range, 70-130 mg/dl of blood were the response variable. Cox Proportional Hazard model were used. Types of diabetic, bodyweight at baseline, fasting blood sugar at baseline, sex and age of patients are significantly associated with time to first recovery of diabetic patients. These variables are important factors that should be considered during the selection phase a treatment (combination of treatments) for diabetes.

Background Determining the trends and treatment outcomes of TB in health facilities is very important to inform better management of the disease and control efforts. Nevertheless, data from the rural, urban and suburban settings of Ethiopia show variability and inconsistency. This study was designed to evaluate trends and treatment outcomes of tuberculosis patients at Tepi Health Center and to identify the predictors of unsuccessful treatment outcome. Method Retrospective review of TB cases registered in Tepi health center between June 2011 and May 2018 was conducted using data extracted from medical records of TB patients. Structured data extraction form was prepared and used to extract socio-demographic, clinical and outcome data of study cases. Case definition and the treatment outcome of patients were ascertained and reported in accordance with World Health Organization guideline. Binary logistic regression model was fit to identify predictors of unsuccessful outcome. Results A total of 1651 TB patients registered at Tepi Public Health Center in between June 2011 and May 2018, were included in the study. Of all 924 (56%) were males and 1053 (63.8%) cases were in between the age range of 15 and 35 years. HIV-status of 1019 TB cases were unknown and 189 (11.4%) of participants were HIV-positive. Four hundred fifty seven (27.7%) cases were diagnosed with extra pulmonary TB (EPTB) and 1194 (72.3%) were pulmonary TB patients out of which, 376 (73.6%) were smear-positive pulmonary TB (PTB+). Overall treatment success rate (TSR) of patients was 80.4% (1327/1651), while it was 84.8% (134/158), 80.2% (410/511), and 78.3% (148/189) among the transfer-in, PTB+, and HIV + cases, respectively. Higher numbers of successful treatment outcomes were recorded among new patients (82.7%) and EPTB cases (84.7%). The cure rate were 73.6% (376/511) and 18% (34/189) among patients with PTB+ and HIV+, respectively. Multiple logistic regression analysis indicated that residence sites (OR 0.763 (0.584, 0.996) and TB/HIV co-infection (OR 0.661 (0.444, 0.985), were significantly associated with the treatment outcome. Rural residence was 27.1% less likely to have successful treatment. There was significant heterogeneity in the odds of having successful treatment outcomes across years of initiating treatment. Conclusion Treatment success rate among study cases was lower than the WHO’s target and further efforts like availability of TB clinics in nearby sites and reducing rate of HIV infection should be made to improve rate of successful treatment outcome.

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