BackgroundSince 2002/03, an estimated 4.7 million nets have been distributed in the Southern Nations, Nationalities and Peoples Region (SNNPR) among an at risk population of approximately 10 million people. Evidence from the region suggests that large-scale net ownership rapidly increased over a relatively short period of time. However, little is known about how coverage is being maintained given that the last mass distribution was in 2006/2007. This study sought to determine the status of current net ownership, utilization and rate of long lasting insecticide-treated nets (LLIN) loss in the previous three years in the context of planning for future net distribution to try to achieve sustainable universal coverage.MethodsA total of 750 household respondents were interviewed across malarious, rural kebeles of SNNPR. Households were randomly selected following a two-stage cluster sampling design where kebeles were defined as clusters. Kebeles were chosen using proportional population sampling (PPS), and 25 households within 30 kebeles randomly chosen.ResultsApproximately 67.5% (95%CI: 64.1–70.8) of households currently owned at least one net. An estimated 31.0% (95%CI 27.9–34.4) of all nets owned in the previous three years had been discarded by owners, the majority of whom considered the nets too torn, old or dirty (79.9%: 95%CI 75.8–84.0). Households reported that one-third of nets (33.7%) were less than one year old when they were discarded. The majority (58.8%) of currently owned nets had ‘good’ structural integrity according to a proportionate Hole Index. Nearly two-thirds of households (60.6%) reported using their nets the previous night. The overriding reason for not using nets was that they were too torn (45.7%, 95% CI 39.1–50.7). Yet, few households are making repairs to their nets (3.7%, 95% CI: 2.4–5.1).ConclusionsResults suggest that the life span of nets may be shorter than previously thought, with little maintenance by their owners. With the global move towards malaria elimination it makes sense to aim for sustained high coverage of LLINs. However, in the current economic climate, it also makes sense to hark back to simple tools and messages on the importance of careful net maintenance, which could increase their lifespans.

BackgroundDespite known gender-specific differences in terms of prevalence, transmission and exposure to neglected tropical diseases (NTDs), there is limited discussion of the influence of gender in NTD programmes and interventions. There is a paucity of research on how gender interacts with NTD service provision and uptake. This study, part of broader implementation research in Ethiopia, applied a gender lens to health seeking for five NTDs: lymphatic filariasis, podoconiosis, schistosomiasis, soil-transmitted helminth infection and trachoma. Methodology/principal findingsThe study was conducted in a district of the Southern Nations, Nationalities, and Peoples' Region of Ethiopia where the five NTDs are prevalent. A qualitative methodology was adopted to explore participants' perspectives and experiences. Data generation methods included 20 interviews and four focus group discussions. Community members, volunteer Health Development Army leaders, Health Extension Workers and a range of health workers at the health post, health centre and hospital level (n = 59) were purposively sampled. Interviews and focus group discussions were audio recorded, transcribed verbatim into English then analysed through open coding, drawing on constant comparative methods.Gender related factors affected care seeking for NTDs and were described as reasons for not seeking care, delayed care seeking and treating NTDs with natural remedies. Women faced additional challenges in seeking health care due to gender inequalities and power dynamics in their domestic partnerships. Participants recommended raising community awareness about NTDs, however this remains problematic due to gender and social norms around appropriate discourse with members of the opposite gender.PLOS Neglected Tropical Diseases | https://doi. Funding:The study was co-funded by COMDIS-HSD (comdis-hsd.leeds.ac.uk), a research consortium funded by UK aid from the UK government (www.gov.uk/government/ organisations/department-for-internationaldevelopment). The views expressed in this manuscript do not necessarily reflect the funder's Conclusions/significanceThe findings from this study provide crucial insights into how gender interacts with accessing health services, at different levels of the health system. If we are committed to leaving no one behind and achieving universal health coverage, it is essential to address gender disparities to access and utilisation of interventions delivered by national NTD programmes. Author summaryThis study provides insights into how gender influences peoples' access to health services for neglected tropical diseases (NTDs). There is considerable evidence to show that women and girls suffer a greater NTD burden due to their higher levels of poverty, lower education and social status. The psychological and social consequences of NTDs also tend to be worse for women. There is an urgent need to integrate NTDs into basic healthcare services, yet there is little evidence that can support a gender-based approach of how best to do so. This study...

Background Low back pain, the most commonly reported musculoskeletal problem, is a major burden on individuals, health systems and social care systems with the indirect cost being predominant. It results in disability, poor service, low quality of life and sickness absences in working places. The problem of low back pain and its risk factors among hotel housekeepers are not well known in Ethiopia. Therefore, this study was aimed to investigate the prevalence and identify determinants of low back pain among hotel industries’ housekeepers in Gondar town, Ethiopia. Methods Institutional based cross-sectional study was conducted from March to May 2017. A systematic random sampling technique was applied to select 422 study participants, and the data was collected by a standardized Nordic questionnaire for the analysis of musculoskeletal symptoms. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. The significance level was obtained at 95% CI and p -value ≤ 0.05. Results The prevalence of low back pain among hotel housekeepers in Gondar town was 58.1% (95% CI: 53.6, 62.8%). Being temporary employee (AOR: 3.22), type of job which requires reaching/overstretching (AOR: 2.93), engaging in a job that requires repetitive bending (AOR: 1.97), making > 30 beds per day (AOR: 3.19) signified the significant risk factors for low back pain. However, hotel housekeepers who were satisfied in their current job were less impacted by low back pain (AOR: 0.49). Conclusion A high proportion of hotel housekeepers in this study reported they had low back pain. Employment pattern, rest break taken, reaching/overstretching, repetitive bending, job satisfaction, training related to health and safety and numbers of beds making were among the factors associated with low back pain. Hence, ergonomic measures focusing on correcting the arrangement of work station, rest breaks and changing some equipment are potentially important targets to reduce the problem.

BackgroundCotton dust induced respiratory disorders are dramatically increased over the globe, especially the problem is serious in developing countries. Respiratory symptoms, such as cough, phlegm, wheezing, shortness of breath, chest tightness, chronic bronchitis, and byssinosis are common among workers exposed to cotton dust. However, in Ethiopia, the magnitude of the problem is not well known and information is limited about the risk factors. Therefore, this study was aimed to assess the prevalence of respiratory symptoms and associated factors.MethodsA Comparative cross-sectional study design was employed. A total of 413 (276 exposed and 137 unexposed) participants were included in the study. Stratified and simple random sampling techniques were used to select exposed and unexposed groups to cotton dust respectively. Multivariable binary logistic regression analyses was performed to identify variables associated with respiratory symptoms and adjusted odds ratio (AOR) was used to determine the strength of associations. Significance level was obtained at 95% confidence interval (CI) and p-value ≤0.05.ResultsThe prevalence of self-reported respiratory symptoms was 47.8% (95% CI: 41.3, 53.7%) and 15.3% (95% CI: 9.6, 22.3%) among exposed and control groups respectively. Sex (AOR = 2.1, 95% CI: 1.29, 3.45), service year (AOR = 2.38, 95% CI: 1.19, 4.71) and ventilation (AOR = 2.4, 95% CI: 1.17, 4.91) were factors significantly associated with respiratory symptoms. Furthermore, working department such as; ginning (AOR = 5.1, 95% CI: 2.13, 12.16), spinning (AOR = 4.96, 95% CI: 2.18, 11.29), weaving (AOR = 5.9, 95% CI: 2.46, 14.27) and blowing working departments (AOR = 5.14, 95% CI: 1.4, 18.94) were significantly associated with respiratory disorders.ConclusionsThe prevalence of self-reported respiratory symptoms was higher among workers exposed to cotton dust than unexposed workers. Sex, service year, working department and work unit ventilation were predictor variables for respiratory symptoms. Thus, reducing exposure to dust, adequate ventilation and improving the hygiene of working departments are needed to reduce respiratory symptoms.

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Background. Road traffic accidents (RTAs) remain an important public health issue worldwide. Psychoactive substance use is one of the main contributors to the occurrence of traffic accidents, and its use by truck drivers is a global problem. Also, psychoactive substance use is a commonly observed behavior among truck drivers. To the best of our knowledge, no evidence shows the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia. Therefore, this study was aimed at assessing the prevalence and factors associated with psychoactive substance use among truck drivers in Ethiopia. Methods. A cross-sectional study was conducted among 400 systematically selected truck drivers at Modjo dry port in Ethiopia, from February 1 to March 1, 2018. The data were collected through face-to-face individual interviews using a structured questionnaire. The collected data were entered into EpiData version 4.2.0.0 and analyzed using SPSS version 20. Binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. The level of significance was declared at p value < 0.05 in the multivariable binary logistic regression analysis. Results. Of the 400 truck drivers interviewed, the overall one-month self-reported prevalence of psychoactive substance use was 70% ( n = 280 ). In the multivariable binary logistic regression analysis, aged 38 years and above ( AOR = 0.40 , 95% CI [0.23-0.69]), Christianity religion ( AOR = 0.52 , 95% CI [0.28-0.97]), college and university education ( AOR = 3.47 , 95% CI [1.27-9.47]), having a family size of 3 or more ( AOR = 0.34 , 95% CI [0.20-0.60]), having 6 or more hours spent sleeping at night ( AOR = 0.46 , 95% CI [0.28-0.75]), and rest breaks between driving ( AOR = 2.13 , 95% CI [1.14-3.97]) were significantly associated with psychoactive substance use. Conclusion. The one-month prevalence of psychoactive substance use among truck drivers was remarkably high. We can conclude that psychoactive substance use is a public health problem among truck drivers, which is a major threat to themselves and others on the road. The sociodemographic and occupational factors are the factors associated with drivers’ psychoactive substance use. Therefore, devising health education and counseling program for drivers to tackle the problem plays paramount importance.

Background Type 2 Diabetes mellitus (T2DM) has been a global pandemic resulting in physical, financial and psychosocial crises. Thus, it is important to investigate pooled effectiveness of Diabetes Self-Management Education (DSME) on glycemic control among T2DM patients. Objective The aim of this systematic review and meta-analysis is to investigate the association between DSME or Support (DSME/S) and glycemic control among T2DM patients. Methods The systematic review and meta-analysis will include studies conducted throughout the world from 2010 to 2019. T2DM patients and their clinical, anthropometric, biomarkers from baseline to end line will be recorded. We will search all relevant articles from five databases namely; Cochrane Library, BioMed Central, MEDLINE (EBSCOhost), MEDLINE/PubMed and SCOPUS. Key terms will be used for questing relevant articles. Further efforts will be made to check quality of studies base on quality assessment instruments. Finally, the report will be made according Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Pooled standard mean difference in HbA1c will be used to calculate the effect size between the variables with random effects analysis assumption. Further subgroup analysis will be carried out for assessing the risk difference among groups. Conclusion Based on the existing and eligible researches this systematic review and meta-analysis will bring the best evidence on the effectiveness of DSME/S on glycemic control among the T2DM patients. Moreover, the subgroup analysis will inform the effectiveness heterogeneity based on continent, International Diabetes Federation (IDF) region, intervention period, World bank economic classification and glycemic markers used to follow the patients. The proposed review has been registered in the International PROSPERO website with registration number CRD42020124236. Electronic supplementary material The online version of this article (10.1007/s40200-020-00584-3) contains supplementary material, which is available to authorized users.

Background. Early age at first sexual practice is a public health issue and now common around the world especially in the developing countries. The development of effective strategies to reduce the adverse consequences of early sexual initiation becomes real when sufficient data is available. Therefore, this study is aimed at assessing the prevalence and factors associated to early sexual initiation among college students in southwest Ethiopia. Methods. A cross-sectional study was conducted among 453 college students in southwest Ethiopia from April to May 2018. A two-stage stratified sampling technique was used to select the study participants. The data were collected using structured pretested self-administered questionnaire. The collected data were entered using Epi-Data version 4.2.0.0 and analyzed using SPSS version 20. Logistic regression models were fitted to assess the effect of independent variables on the outcome variable. Significance was declared at p < 0.05 in the multivariable logistic regression analysis. Results. The proportion of early sexual initiation among college students was 17.9%, 95% CI (14.4%-24.4%). The mean age of sexual intercourse was 17.6 (±2 SD) years. Nearly three-fourths (73.4%) of the respondent’s reason for early sexual intercourse was falling in love. More than half (62.2%) of the respondents used a condom for their first sexual intercourse. The factors associated with early sexual initiation were being female ( AOR = 2.09 and 95% CI [1.17-2.35]), chewing khat ( AOR = 7.05 and 95% CI [3.81-13.1]), exposed to pornographic materials at age < 18 years ( AOR = 3.57 and 95% CI [1.94-6.89]), and poor knowledge of sexually transmitted diseases ( AOR = 8.69 and 95% CI [3.52-21.5]). Conclusion. The prevalence of early sexual initiation among college students was alarmingly high. This may be associated with a huge burden of poor sexual and reproductive health. Therefore, creating awareness of the factors and related negative sexual and reproductive health effect of early sexual initiation for young peoples through the use of mass media (television and radio), school teachers, and parents plays a paramount importance.