IntroductionThe emergence of MDR-TB remained a major public health threat particularly in developing countries. With increased prevalence and complexity of treatment, the burden of MDR-TB challenged the country. It is of an important; the epidemiology of drug resistant TB is not well understood. There are few studies conducted to assess the prevalence, determinants and treatment outcome of MDR-TB with inconclusive finding. Therefore, we aimed to conduct a systematic review and meta-analysis on Epidemiology of MDR-TB in Ethiopia, So that policy makers and other stalk holders could have pooled evidence on the problem to make a decision.MethodsThe review was conducted through a systematic literature search of articles published between 1997 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of MDR-TB prevalence, determinants and treatment outcome was estimated with a random-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot.ResultsThe 34 studies that were retained for final analysis enrolled a total of 7461 TB or MDR-TB patients. We found that 2.18% (95% CI 1.44–2.92%) of newly diagnosed and 21.07% (95% CI 11.47–30.67%) of previously treated patients have MDR-TB with overall prevalence of 7.24% (95% CI 6.11–8.37). History of previous treatment is the major determinant (pooled OR = 4.78 (95% CI 3.16–6.39)), while contact history and adherence also contributed. In this review the pooled death computed among 5 articles showed that 12.25% (95% CI 9.39–15.11%) of MDR-TB patients were died in the course of treatment. Complication, drug side effects and HIV infection were the main determinants for the death.Conclusion and recommendationThe prevalence is by far higher than the previous reports. It is mainly associated with history of previous treatment along with contact history. However, the treatment outcomes are comparable with previous studies, yet it is a concern. Comorbidities, drug side effects and HIV sero-positivity were the determinants. Thus, proper treatment of drug susceptible TB and early detection and treatment of MDR-TB before complication develops along with prevention of drug side effect and contacts with MDR-TB cases are very important.

Background Globally malaria remains one of the high burden diseases particularly in developing countries. Ethiopia is one of the sub-Saharan countries highly endemic to malaria. Although, recently the burden of malaria was reduced remarkably through public health interventions designed during the Millennium Development Goals, it is still a major public health problem in Ethiopia. Hence, measuring the burden of the disease and assessing the trend is very important for monitoring the extent and changes over a period of time. Objective This study aimed to assess the burden of malaria in terms of death and Disability-Adjusted Life Years lost (DALY) between 2000 and 2016. Methods The research used data from Global Health Estimate 2016; that originally collected the information through vital registration, verbal autopsy, surveys, reports, published scientific articles, Global Burden of Disease study (GBD 2016) and modeling. Results In 2016 there were an estimated 2,927,266 (95% CI, 525,000-6,983,000) new malaria cases in Ethiopia. It caused an estimated 4,782 deaths (95% CI 122.5–12,750) with a crude death rate of 4.7/100,000 and Age-standardized death rate (ASDR) of 4.9/100,000 population. However, the number of deaths due to malaria declined by 54% from the 2000’s record of 10,412 deaths (95% CI 98.8–16180) within 16 years and ASDR declined by 63% from the 2000 record. In the same year, DALY due to malaria was 365,900 years (187,000 years among male and 178,900 years among females). It contributed for 0.78% of the total DALY in Ethiopia and 1% of the global DALY due to malaria. Around 332,100 life years (YLL) were lost and 35,200 years were lived with disability (YLD) due to malaria. Mortality and DALY related to malaria is slightly higher among males; and under 5 children are highly affected. Conclusion and recommendation Although, the burden of malaria is remarkably declining in Ethiopia; with a higher level of mortality and DALY, it still remained one of the public health problems. Therefore, strengthening the existing malaria prevention program is important to eliminate the disease within the target period.

The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) is slowly rising in Ethiopia for the past few decades. Therefore, novel classes of antibiotics are indispensable to combat the increased incidence of newly emerging multidrug-resistant bacteria like MRSA. Terrestrial flora is considered as a reservoir of novel bioactive secondary metabolites as they have provided us with the largest array of natural products. In this background, the present study is intended to evaluate the in-vitro antibacterial efficacy of five medicinal plants (Ocimum lamiifolium Hochst. ex Benth., Rosmarinus officinalis L, Catharanthus roseus Linn., Azadirachta indica A. Juss and Moringa stenopetala Bac) against a panel of seven biofilm-forming MRSA. The leaves of the plants were extracted in organic solvents of varying polarity and the resultant crude extracts of respective medicinal plants were inspected for their antimicrobial activity by well diffusion technique. Minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) of the plant extracts against MRSA were determined by the broth dilution method. Besides, an anti-biofilm assay of the most potent plant extract was also performed, after which its chemical constituents were delineated by combined Gas Chromatographic and Mass Spectroscopic profiling (GC-MS). The results revealed that, of the five plants, three species including M. stenopetala, R. officinalis, and O. lamifolium exhibited significant antibacterial activity. Organic solvents with high and medium polarity were excellent in extracting antimicrobials compared to nonpolar solvents. The broadest and highest rank of activity was observed in the crude ethanolic extract of M. stenopetala. Based on the MIC/MBC ratio, the crude ethanolic extract of M. stenopetala was determined to be bacteriostatic. Anti-biofilm assay showed that the extract of M. stenopetala fairly inhibited the growth of MRSA in the preformed biofilm matrix. The GC-MS analysis of M. stenopetala revealed the presence of twelve compounds with antimicrobial activity. The present study provides new insight into the development of novel drug leads to the management of MRSA.

Background Novel coronavirus is a global pandemic and killed many individuals, including health care professionals. It caused stress on the health care system of all countries. Presently, studies are emerging regarding the COVID-19 pandemic in different aspects. However, a few have explored barriers that affecting the practice of preventive measures for the COVID-19. As such, the study aimed to fill these research gaps in the study setting. Methods A semi-structured interview guide was used to conduct this phenomenological study among 16 key informants. Key informants were recruited by the purposive sampling method. To analyze that data, thematic content analysis was employed by using an inductive approach in NVivo 12 Pro software. Results In this study, six main themes were identified with the sub-themes. Overview of COVID-19 pandemic (with the six sub-themes), consequences (with the two sub-themes), perceived practice (with four sub-themes), perceived barriers (with four sub-themes), newfangled activities (with three sub-themes), and suggestion for improvement (with seven sub-themes) were the major themes. The participants perceived the influence of shortage of personal protective equipment and solutions for hand hygiene, negligence and ignorance, inadequate infrastructure, lack of training, and lack of attention and recognition for the staff on the practice of preventive measures. Conclusions This study showed a gap in preventive measure practices for the COVID-19 in the health care system. Community influences, health care provider related barriers, institutional barriers, and lack of communication and support affect the practice. Hence, attention should give to fulfill the necessary supplies in the health facilities, improve the infrastructures, and equip health professionals by providing capacity-building activities. Besides, health care workers must recognize, and attention is needed.

Background. The continuing rise in the burden of noncommunicable diseases (NCDs) is a key global health agendum due to the fact that NCDs cause more deaths than all other causes combined together. Although measuring the burden of NCD is very important to improve the existing health care systems and to monitor the progress of the program, a comprehensive estimate is lacking in Ethiopia. Hence, we aimed to systematically analyze the existing evidence to bring a solution. Methods. The research used data from the Global Burden of Disease Study (GBD 2016) and Global Health Estimates 2016 that originally collected the information through vital registration, verbal autopsy, surveys, reports, and modeling. Results. In 2016, NCD caused an estimated 274998.8 (95% CI: 211290.2–362882.1) deaths among all ages and both genders with a crude death rate of 268.5/100000 and age-standardized death rate (ASDR) of 554.7/100000 population. It contributed to 39.3% of the total death, 53% of ASDR, and 34% of DALYs. The number of deaths and DALYs from NCD has increased by 38% and 31.5%, respectively, whereas CDR and ASDR from NCD have declined by 10.3% and 12.5%, respectively. Cardiovascular diseases, malignant neoplasms, digestive diseases, respiratory diseases, diabetes mellitus, and neurological conditions were the leading level 2 causes of ASDR due to NCD, while ischemic heart disease, stroke, other circulatory diseases, cirrhosis of the liver, and COPD were the top 5 causes of ASDR from NCD at level 3 causes. Conclusion and Recommendation. The burden of NCD was remarkably increased between 2000 and 2016. It carries the highest burden of ASDR. Cardiovascular diseases and malignant neoplasms were the two most common causes of mortality and DALYs. Therefore, the existing disease prevention strategies should be strengthened by incorporating strategies addressing noncommunicable diseases.