Background Cutaneous leishmaniasis (CL) is generally caused by Leishmania aethiopica in Ethiopia, and is relatively hard to treat. Sodium stibogluconate (SSG) is the only routinely and widely available antileishmanial treatment, and can be used systemically for severe lesions and locally for smaller lesions. There is limited data on the effectiveness of intralesional (IL) SSG for localized CL in Ethiopia and therefore good data is necessary to improve our understanding of the effectiveness of the treatment. Methodology/Principal findings A pragmatic (before and after Quazi experimental) study was done to assess the effectiveness of intralesional SSG among localized CL patients at Boru Meda general hospital, Northeast Ethiopia. Patients who were assigned to intralesional SSG by the treating physician were eligible for this study. Study subjects were recruited between January and August 2021. Infiltration of intralesional SSG was given weekly to a maximum of six doses. However, when a patient’s lesions were already cured before getting 6 doses, treatment was not conintued, and patient were only asked to come for lesion assessment. Skin slit smears (SSS) were taken each week until they became negative. Outcomes were assessed at day 90, with patients who had 100% reepithelization (for ulcerative lesions) and/or flattening (for indurated lesions) defined as cured. Multi-level logistic regression was done to assess factors associated with cure. A total of 83 patients were enrolled, and final outcomes were available for 72 (86.75%). From these 72, 43 (59.7%, 95% confidence interval 0.44–0.69) were cured at day 90. Adverse effects were common with 69/72 patients (95.8%) reporting injection site pain. Factors associated with cure were age (OR 1.07 95% CI: 1.07–1.27), being male (OR 1.79, 95% CI: 1.10–2.25), size of the lesion (OR 0.79, 95% CI: 0.078–0.94) and skin slit smear (SSS) result +1 grading (OR 1.53, 95% CI: 1.24–1.73) and +2 grading (OR 1.51, 95% CI: 1.41–3.89) compared to the SSS grade +6. Conclusion Our findings revealed that intralesional sodium stibogluconate resulted in a cure rate of around 60%, with almost all patients experiencing injection site pain. This emphasizes the need for local treatment options which are more patient-friendly and have better cure rates.

Background HIV is a major public health issue, especially in developing countries. It is important to track and design successful intervention programs to explore the spatial pattern, distribution, and associated factors of HIV Seropositivity. This study therefore showed the spatial variation of HIV Seropositivity and related factors in Ethiopia. Methods A total sample of 25,774 individual data collected from the 2016 EDHS data were primarily HIV biomarkers, IR, MR, and GPS. Spatial heterogeneity analysis was used with methods such as Morans I, Interpolation, and Kulldorff ‘s scan statistic. Spatial analysis was conducted using open source tools (QGIS, GeoDa, SaTScan). Multilevel logistic regression analysis was performed using Stata14 to identify HIV-associated factors. Finally, the AOR with a 95% confidence interval was used to report the mixed-effect logistic regression result in the full model. Result The prevalence of HIV / AIDS at national level was 0.93%. The highest prevalence regions were Gambela, Addis Abeba, Harari and Diredawa, accounting for 4.79, 3.36, 2.65 and 2.6%, respectively. Higher HIV seropositive spatial clusters have been established in the Gambela and Addis Ababa regions. Multilevel analysis at the individual level being married [AOR = 2.19 95% CI: (1.11–4.31)] and previously married [AOR = 6.45, 95% CI: (3.06–13.59)], female [AOR = 1.8, 95% CI: (1.19–2.72)], first-sex at age ≤15 [AOR = 4.39, 95% CI: (1.70–11.34)], 18—19 [AOR = 2.67 95% CI: (1.05–6.8)], middle age group (25-34) [AOR = 6.53, 95% CI: (3.67–11.75)], older age group (>34) [AOR = 2.67 95% CI: (1.05–6.8)], primary school [AOR = 3.03, 95% CI: (1.92–4.79)], secondary school [AOR = 3.37, 95% CI: (1.92–5.92) were significantly associated with serropositivity. Regarding household level, place of residence [urban: AOR = 6.13 CI: (3.12, 12.06)], female-headed households (AOR = 2.24 95% CI: (1.57–3.73), media exposure [low exposure (AOR = 0.53 95% CI: (0.33–0.86), no exposure AOR = 0.39 95% CI: (0.23–0.65)] and increased household size [AOR = 0.72 95% CI: (0.65–0.8)] were associated with HIV Seropositivity. Conclusion High cluster HIV cases were found in Gambela, Addis Abeba, Harari, and Diredawa. Having a history of married, start sex at a younger age, female-headed household, urban residence, and lower household size is more affected by HIV/AIDS. So any concerned body work around this risk group and area can be effective in the reduction of transmission.

Background: Assessment of supportive care needs for cancer patients and identifying factors affecting these needs is important for the implementation of supportive care programmes, as the burden of cancer is increasing in Ethiopia.

Background One third of global antmicrobial resistance deaths are attributed to drug resistant tuberculosis. Lost to follow-up is one of the causes of the development of acquired drug resistant tuberculosis. There is a gap in nationally representative reliable information on lost to follow-up among patients with drug-resistant tuberculosis in Ethiopia. Objective To estimate the pooled prevalence and associated factors of lost to follow-up among patients with drug resistant tuberculosis in Ethiopia. Methods Observational studies searched from PubMed, HINARI and CINAHL were screened for eligibility. After assessing the quality of studies, data were extracted using a checklist. Heterogeneity was assessed using forest plot, Q and I2. The random effects meta-analysis model was employed to pull the prevalence of lost to follow-up. Sub-group analysis and meta regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger’s and Begg’s tests. Sensitivity analysis was performed to assess the influence of individual studies on the overall estimate. The odds ratios were used to measure associations. Results The review was performed among 11 studies of which 9 were cohort studies. The sample sizes ranged from 90 to 612 and comprised a total of 3,510 participants. The pooled prevalence of lost to follow-up was 8.66% (95% CI, 5.01–13.14) with a high heterogeneity (I2 = 93.49%, p<0.001). Pulmonary multi-drug resistant tuberculosis patients were 50% less likely to loss from follow-up compared to extra pulmonary tuberculosis patients. Conclusion There was a high prevalence of lost to follow-up among multi-drug resistant tuberculosis patients in Ethiopia. Anatomical site of tuberculosis was a significant factor affecting lost to follow-up. Strengthening the health care system and patient education should be given a due emphasis. Registration number CRD42020153326; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=153326.

Introduction For critically ill patients, mechanical ventilation is considered a pillar of respiratory life support. The mortality of victims in intensive care units is high in resource-constrained Sub-Saharan African countries. The recovery and prognosis of mechanically ventilated victims are unknown, according to evidence. The goal of the study was to see how long critically ill patients on mechanical ventilation survived. Methods A retrospective follow-up study was conducted. A total of 376 study medical charts were reviewed. Data was collected through reviewing medical charts. Data was entered into Epi-data manager version 4.6.0.4 and analyzed through Stata version 16. Descriptive analysis was performed. Kaplan- Meier survival estimates and log rank tests were performed. Cox proportional hazard model was undertaken. Results Median recovery time was 15 days (IQR: 6–30) with a total recovery rate of 4.49 per 100 person-days. In cox proportional hazard regression, diagnosis category {AHR: 1.690, 95% CI: (1.150- 2.485)}, oxygen saturation {AHR: 1.600, 95% CI: (1.157- 2.211)}, presence of comorbidities {AHR: 1.774, 95% CI: (1.250–2.519)}, Glasgow coma scale {AHR: 2.451, 95% CI: (1.483- 4.051)}, and use of tracheostomy {AHR: 0.276, 95% CI: (0.180–0.422)} were statistically significant predictors. Discussion Based on the outcomes of this study, discussions with suggested possible reasons and its implications were provided. Conclusion and Recommendations Duration and recovery rate of patients on mechanical ventilation is less than expected of world health organization standard. Diagnosis category, oxygen saturation, comorbidities, Glasgow coma scale and use of tracheostomy were statistically significant predictors. Mechanical ventilation durations should be adjusted for chronic comorbidities, trauma, and use of tracheostomy.

Background Human Immunodeficiency Virus (HIV) is continued as a major public health problem, especially in developing countries. Therefore, this study aimed to estimate the effect of counseling, antiretroviral therapy (ART) and relationship on disclosing HIV positive status to sexual partner among adult HIV patients in Ethiopia. Methods The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) was used during this review. The study included both published and unpublished studies which were conducted in Ethiopia until the end of 2019. Different electronic databases (PubMed, Cochrane library, CINAHL, Global Health, HINARI and Google scholar) were searched. Data were extracted in Microsoft Excel sheet and STATA/SE 14 was used to meta-analysis. I2 and Egger test statistics were used to test heterogeneity and publication bias respectively. Results Twenty-two articles with 8,873 adult HIV infected peoples were included in this systematic review and meta-analysis. The pooled magnitude of disclosing HIV status to sexual partner was 74.63% [95% CI: (67.79, 81.47)]. Counseled [AOR = 4.96, 95% CI: (2.87, 8.55)], ART initiated [AOR = 4.78, 95% CI: (3.84, 5.94)] and who had a smooth relationship before HIV testing [AOR = 6.82, 95% CI: (3.49, 13.33)] were significantly associated with disclosing HIV status to sexual partner. Conclusions Disclosing HIV positive status to sexual partner in Ethiopia was low as the government invested in partner notification. Counseling, ART initiation and smooth relationship before HIV testing were significantly associated with disclosing HIV status to sexual partner. The government needs to strengthen pre and post HIV test counseling even after treatment started to increase disclosing status. Registration The protocol of this systematic review and meta-analysis was registered in the PROSPERO with a specific registration number: CRD42020161276; https://clinicaltrials.gov/.

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Background Focused antenatal care is directed at sustaining maternal health and improving fetal wellbeing to ensure birth of a healthy neonate. Failure to implement focused antenatal care can result in inability to reduce maternal and perinatal morbidity and mortality in low income countries. Due to evidence-practice gaps, however, thousands of maternal, fetal and neonatal lives are still lost every day, mostly from preventable causes. This study aimed to assess focused antenatal care package’s intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods A cross-sectional study design was employed and a total of 898 women who gave birth in the last 6 months prior to data collection were included. Also 16 health extension workers, working in ten selected health posts, were included. Interviews and self-administered questionnaires were used to collect data from mothers and health extension workers. Ten [10] health posts were audited to assess availability and functionality of drugs and supplies to provide focused antenatal care. Mothers were asked whether or not the required level of care was provided. Health extension workers were provided with self-administered questionnaires to assess socio-demographic characteristics, reception of training, facilitation strategies for the implementation of focused antenatal care and ability to classify danger signs. Multilevel linear regression analysis was performed to identify individual and organizational level’s factors influencing focused antenatal care package intervention fidelity. Results Overall weighted average focused antenatal care package intervention fidelity (implemented as intended/planned) was 49.8% (95% CI: 47.7–51.8), which means the average number of focused antenatal care package interventions women received is 49.8%. Health extension workers implemented 55.1% and skilled providers (nurses, midwives, health officers or medical doctors) 44.9% of focused antenatal care package interventions. Overall antenatal care coverage, irrespective of frequency (at least one visit), was 752/898 women (83.7%; 95% CI: 81.3–86.1); 263/752 women (35.0%; 95% CI: 31.6–38.4) received at least four antenatal visits and only 46/752 women (6.1%; 95% CI: 4.4–7.8) received all recommended components of focused antenatal care. Previous pregnancy-related problems, paternal education and implementation of facilitation strategies were found to be significant factors enhancing focused antenatal care package intervention fidelity. Conclusion Focused antenatal care package intervention fidelity in the study area was low; this may imply that the current level of maternal, perinatal and neonatal mortality might be partly due to the low level of focused antenatal care intervention fidelity. Improving implementation of facilitation strategies is highly required to contribute to the reduction of those mortalities.