Search Results (69)

Background/Objectives: Multidrug-resistant (MDR) bacterial colonization poses a significant risk for subsequent infections, especially within hospital environments. Healthcare workers can inadvertently transmit these MDR bacteria to vulnerable patients, exacerbating the problem. This study aimed to determine the colonization rates of MDR bacteria among patients and healthcare workers in a rural Ethiopian hospital with limited resources. Methods: Between 26 May and 6 June 2024, nasal, rectal, vagino-rectal exudate, and stool samples were collected from patients (n = 78) and healthcare workers (n = 11) at Gambo General Hospital (Oromia Region, Ethiopia). Samples were cultured on chromogenic media selective for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), and carbapenemase-producing Enterobacteriaceae (CPE). Bacterial identification was performed using MALDI-TOF mass spectrometry (Bruker), antimicrobial susceptibility testing using the MicroScan WalkAway system (Beckman Coulter), and genotypic characterization with the MDR Direct Flow Chip kit (Vitro). Results: MRSA nasal colonization was detected in 43.3% of patients (13/30; 95% CI: 27.4–60.8%) and 27.3% of healthcare workers (3/11; 95% CI: 6.0–61.0%) (p = 0.73). Rectal (or stool) colonization by MDR bacteria was significantly higher in pediatric patients (85.0%, 17/20; 95% CI: 62.1–96.8%) than in adults (14.3%, 4/28; 95% CI: 5.7–31.5%) (p < 0.001). Notably, a high proportion of pediatric patients harbored Escherichia coli strains co-producing NDM carbapenemase and CTX-M ESBL, and VRE strains were also predominantly isolated in this group. Conclusions: This study reveals a concerningly high prevalence of MRSA and MDR Enterobacteriaceae, especially among children at Gambo Hospital. The VRE prevalence was also substantially elevated compared to other studies. These findings underscore the urgent need for strengthened infection control measures and antimicrobial stewardship programs within the hospital setting. Full article

Stroke remains a significant global health challenge, particularly in low- and middle-income Countries (LMICs), where two-thirds of stroke-related deaths occur, and disability-adjusted life years are seven times higher compared to high-income Countries (HICs). The majority of stroke survivors suffer from upper limb impairment, severely limiting their daily activities and significantly diminishing their overall quality of life. Rehabilitation plays a critical role in restoring function and independence, but it faces challenges such as low engagement, limited customization, difficulty tracking progress, and accessibility barriers, particularly in LMICs. Immersive virtual reality (imVR) has shown promise in addressing these challenges, but most commercial imVR systems lack therapeutic design and cultural adaptation. This study aimed to develop culturally adaptable imVR games for upper limb stroke rehabilitation (ULSR) in the context of LMICs, with a particular focus on Ethiopia. The AdaptRehab VR system was developed including six imVR games (Basket Bloom, Strike Zone, TapQuest, FruitFall Frenzy, Precision Pitch, and Bean Picker Pro) through co-creation approaches involving Ethiopian and Belgian physiotherapists, stakeholders, and patients, incorporating game development mechanics in rehabilitation, such as therapeutic aims, cultural factors, feedback, automatic progression recording, task variety, and personalized rehabilitation. It was designed with the Unity 3D engine and Oculus Quest headsets, supporting controllers and hand tracking. This culturally tailored imVR platform has demonstrated significant potential to enhance ULSR accessibility, patient motivation, and outcomes in resource-constrained settings, addressing critical gaps in stroke rehabilitation solutions. In conclusion, the AdaptRehab VR system was successfully developed as a culturally contextualized imVR platform tailored to tackle ULSR challenges in LMICs, with a specific focus on Ethiopia. Full article

Face washing for trachoma, like most public health improvements, necessitates behaviour change, yet traditional educational interventions frequently fail to achieve this goal. Behavioural science frameworks offer guidance to develop alternative types of interventions, helping to translate formative research and insights about the target population and behavioural determinants into more effective strategies. This paper outlines the outputs and decision-making underlying the five-stage process we followed to translate formative research findings into intervention activities and materials: (1) synthesising formative research findings into a creative brief to guide intervention development; (2) selecting behaviour change techniques (BCTs) to address key behavioural targets; (3) selecting an overarching intervention concept; (4) developing intervention content; and (5) finalising the intervention’s Theory of Change. This paper presents our experiences and reflections on the intervention design process, using a practical example of a face washing intervention for trachoma control. The intervention was designed for delivery in the Stronger SAFE trial in rural Oromia, Ethiopia (ISCRTN 40760473). Full article

Background: Immersive virtual reality (imVR) has shown promise for upper limb stroke rehabilitation (ULSR). However, optimal implementation and treatment modalities remain unclear. This systematic review and meta-analysis aimed to evaluate imVR’s efficacy in ULSR and determine optimal treatment parameters. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs), comparing imVR to conventional rehabilitation (CR) in adult stroke patients, was conducted. Databases including, the Web of Science, Scopus, and PubMed, were searched. Meta-regression further explored the relationship between intervention duration, frequency, and outcomes. Results: Twenty-three studies were included in the systematic review, representing 395 patients, with thirteen incorporated into the meta-analysis. imVR showed statistically significant improvements in the Fugl–Meyer Assessment Upper Extremity (FMA-UE) Scale (mean difference (MD) = 3.04, 95% CI [1.46; 4.62], p < 0.001) and the Box and Block Test (BBT) (MD = 2.85, 95% CI [0.70; 4.99], p = 0.009) compared to CR, but not in the Action Research Arm Test (ARAT) (MD = 3.47, 95% CI [−0.22; 7.15], p = 0.06). However, these improvements did not reach clinically significant thresholds (7 points for FMA-UE and 6 points for BBT). Clinical subgroup analysis showed significant improvements for both subacute (standardized mean difference (SMD) = 0.92, 95% CI [0.48; 1.36], p = 0.002) and chronic (SMD = 0.69, 95% CI [0.03; 1.35], p = 0.03) stroke stages. Meta-regression indicated that there was a significant positive relationship between the intervention duration and upper limb improvement. Conclusions: imVR demonstrates potential for improving upper limb motor function following stroke, particularly with longer intervention durations and individual session lengths for chronic stroke. However, the improvements observed were not clinically significant, highlighting the need for further research with larger sample sizes and standardized outcome measures to determine optimal treatment protocols. Full article

Smallholder potato farmers in Ethiopia do not realize the theoretical yield potential of the crop because they do not benefit from the advantages of using quality seed potato of improved varieties. The high disease incidence in seed potatoes has large implications on the potato farming system since the country lacks appropriate seed quality assurance mechanisms. Seed potato quality assurance relies more on the technical support provided by the national research and extension systems than the official seed certification agency. This paper elaborates systematic challenges and opportunities within the potato seed system and poses two research questions: (1) What type of seed quality assurance mechanisms (informal, quality declared, certified) are under implementation in Ethiopia? (2) How does the current seed quality assurance system operate in terms of reliability, accessibility, and quality standards to deliver quality seed potato? The data were collected through face-to-face in-depth key informant interviews with various seed regulatory laboratory managers and technicians in the Oromia, SNNP, and SWEP regions in the main seed- and ware-producing areas of Ethiopia. This was complemented by a comprehensive analysis of relevant documents. The findings show that currently there is no established procedure in place to officially certify early-generation seed potatoes. Two out of six seed quality control laboratories assessed for this study inspected seed potato fields in 2021 but as quality declared seed (QDS), and approved the fields inspected based on visual inspection alone. Our study revealed a weak linkage between early-generation seed (EGS) potato producers, commercial, and QDS seed potato producers, and seed quality control laboratories. Seed potato quality assurance operations were carried out by only a few seed regulatory laboratories with several concerns raised over the effectiveness of quality standards since seed-borne diseases, such as bacterial wilt, have been found at high frequency in the country’s seed potato system. Hence, the current procedures and challenges call for the necessity of upgrading current quality assurance in seed potato certification. Our study underlines the need for policymakers, development partners, and researchers to collaborate and pool efforts to consider transforming the quality declared system to appropriate seed certification. We recommended that institutionalizing novel plant disease diagnostics into seed regulatory frameworks is needed for sustainable potato production and food security in Ethiopia. Full article

Background/Objectives: Orphans’ and Vulnerable Children’s (OVC) primary caregivers (PCGs) in Ethiopia live with multiple social and emotional problems stemming from extreme poverty, war, environmental disasters, and the HIV pandemic. Family and community supports are strained, leaving OVC’s PCGs dependent on inconsistent humanitarian aid. This aid is typically focused on OVCs and does not address PCG well-being. This study aimed to assess PCG well-being and explore their perceived stress and the traditional family and community coping mechanisms. Method: Participants from the Oromia region of Ethiopia were recruited, and a mixed-methods design was employed. Six cases were included using a criterion sampling technique. An explanatory data analysis technique was used, and data were triangulated from interviews, focus group discussions, archival information, and surveys. A 36-item Well-being Measuring Tool (WMT) Likert scale was employed to measure well-being domains. Result: The results indicated that none of the PCGs reported the desirable and average summative well-being domain mean scores [25 and 23]. Among the ten well-being domains, only “spirituality” and “community cohesion” were above the average score [2.3]. The “economy” domain had the lowest score, indicating a critical deficiency [1.3]. A lack of community support could exasperate perceived stress, and well-being deficiencies were linked. Conclusions: Lack of family and community support could exacerbate feeling overlooked, unwelcome, and lonely. A policy that promotes a supportive community environment and safeguards the most vulnerable OVCs and their PCGs should be in place. This study recommends further rigorous research examining the well-being determinants of OVCs’ PCGs in Ethiopia and the role of traditional support systems in rural settings. Full article

Remote sensing offers a low-cost method for estimating yields at large spatio-temporal scales. Here, we examined the ability of Sentinel-2 satellite imagery to map field-level maize yields across smallholder farms in two regions in Oromia district, Ethiopia. We evaluated how effectively different indices, the MTCI, GCVI, and NDVI, and different models, linear regression and random forest regression, can be used to map field-level yields. We also examined if models improved by adding weather and soil data and how generalizable our models were if trained in one region and applied to another region, where no data were used for model calibration. We found that random forest regression models that used monthly MTCI composites led to the highest yield prediction accuracies (R² up to 0.63), particularly when using only localized data for training the model. These models were not very generalizable, especially when applied to regions that had significant haze remaining in the imagery. We also found that adding soil and weather data did little to improve model fit. Our results highlight the ability of Sentinel-2 imagery to map field-level yields in smallholder systems, though accuracies are limited in regions with high cloud cover and haze. Full article

Solid waste management is a major environmental challenge, especially in developing countries, with increasing amounts of waste glass (WG) and waste plastic (WP) not being recycled. In Ethiopia, managing WG and WP requires innovative recycling techniques. This study examines concrete properties with WG and WP as partial replacements for fine aggregate. Tests were conducted on cement setting time, workability, compressive strength, splitting tensile strength, and flexural strength. Concrete of grade C-25, with a target compressive strength of 25 MPa, was prepared by partially replacing fine aggregate with WP and WG. The mechanical properties were evaluated after 7 and 28 days of curing. At a 20% replacement level, workability decreased at water–cement ratios of 0.5 and 0.6 but remained stable at 0.4, leading to the selection of the 0.4 ratio for further testing. A 10% replacement of fine aggregate, using a ratio of 3% WP and 7% WG, was found to be optimal, resulting in an increase in compressive strength by 12.55% and 6.44% at 7 and 28 days, respectively. In contrast, a 20% replacement led to a decrease in compressive strength by 14.35% and 0.73% at 7 and 28 days, respectively. On the 28th day, the splitting tensile strength at the optimal replacement level was 4.3 MPa, reflecting an 8.5% reduction compared to the control mix. However, flexural strength improved significantly by 19.7%, from 12.46 MPa to 15.52 MPa. Overall, the incorporation of WG and WP in concrete enhances flexural strength but slightly reduces splitting tensile strength. Full article

Recommended vaccination at nine months of age with the measles-containing vaccine (MCV1) has been part of Ethiopia’s routine immunization program since 1980. A second dose of MCV (MCV2) was introduced in 2019 for children 15 months of age. We examined MCV1 and MCV2 coverage and the factors associated with measles vaccination status. A cross-sectional household survey was conducted among caregivers of children aged 12–35 months in selected districts of Oromia Region. Measles vaccination status was determined using home-based records, when available, or caregivers’ recall. We analyzed the association between MCV1 and MCV2 vaccination status and household, caregiver, and child factors using logistic regression. The caregivers of 1172 children aged 12–35 months were interviewed and included in the analysis. MCV1 and MCV2 coverage was 71% and 48%, respectively. The dropout rate (DOR) from the first dose of Pentavalent vaccine to MCV1 was 22% and from MCV1 to MCV2 was 46%. Caregivers were more likely to vaccinate their children with MCV if they gave birth at a health facility, believe that their child had received all recommended vaccines, and know the required number of vaccination visits and doses. MCV2 coverage was low, with a high measles dropout rate (DOR). Caregivers with high awareness of MCV and its schedule were more likely to vaccinate their children. Intensified demand generation, defaulter tracking, and vaccine-stock management should be strengthened to improve MCV uptake. Full article

Rainwater collection systems play a crucial role in enhancing water availability in regions with low precipitation. This study focused on identifying potential rainwater harvesting (RWH) locations in drought-prone areas, specifically the Borena zone of Oromia and the regional states of Somali. This research leveraged geospatial techniques and a multi-criteria decision analysis (MCDA) to assess feasible RWH sites. The dataset comprises essential factors such as rainfall, drainage density, slope, soil texture type, and land use/land cover. These thematic layers serve as inputs for analysis, with each factor being weighted using the Analytical Hierarchy Process (AHP) method based on its significance. Reclassifying factors into subclasses facilitates suitability analysis. The weighted linear combination (WLC) technique is applied to identify and prioritize potential rainwater harvesting (PRWH) locations based on four suitability classes: highly suitable, moderately suitable, low suitability, and unsuitable. Our findings reveal that 1% of the study area, covering approximately 3288 km², is highly suitable for RWH. Areas with moderate suitability constitute approximately 12% (37,498 km²), while regions with low suitability, representing the majority, encompass about 75% (242,170 km²). Additionally, 13% (41,000 km²) of the study area is deemed unsuitable for RWH. The proposed technique for identifying suitable RWH sites is adaptable to other low-precipitation regions. However, before implementing RWH structures, further research is imperative. This study proposed the exploration of socioeconomic variables in future research and urged for an in-depth examination of various aspects of environmental sustainability. Our research paves the way for adapting rainwater harvesting systems to align with community needs and life cycles while also exploring the socio-economic and environmental dimensions of sustainability for future study. The insights offer promising solutions to address the urgent issues associated with water scarcity. This should include comprehensive site depictions, an exploration of social and economic activities, and the meticulous preparation of a cost-benefit analysis. Full article

Introduction: Ethiopia introduced a second dose of measles-containing vaccine (MCV2) in 2019 to provide further protection against measles and further progress toward elimination. However, the sub-optimal coverage of both MCV1 and MCV2 suggest challenges with vaccine uptake. In this qualitative study, we explored barriers to the uptake of MCV2 among caregivers, community leaders, and healthcare workers (HCWs). Method: A qualitative study was conducted between mid-April and mid-May 2021. We selected ten woredas (districts) in the Oromia Region, Ethiopia, stratified by settlement type (urban/rural), MCV1 coverage (high ≥ 80%; low < 80%), and history of measles outbreaks between June 2019 and June 2020. Experiences surrounding barriers to MCV2 uptake were discussed via focus group discussions (FGDs) and in-depth interviews (IDIs) with caregivers of children 12–23 and 24–36 months and key informant interviews (KIIs) with HCWs who administer vaccines and with community leaders. Participants were recruited via snowball sampling. Recorded data were transcribed, translated to English, and analyzed using ATLAS.ti v.09. Results: Forty FGDs and 60 IDIs with caregivers, 60 IDIs with HCWs, and 30 KIIs with community leaders were conducted. Barriers among caregivers included lack of knowledge and awareness about MCV2 and the vaccination schedule, competing priorities, long wait times at health facilities, vaccine unavailability, negative interactions with HCWs, and transportation challenges. At the community level, trusted leaders felt they lacked adequate knowledge about MCV2 to address caretakers’ questions and community misconceptions. HCWs felt additional training on MCV2 would prepare them to better respond to caretakers’ concerns. Health system barriers identified included the lack of human, material, and financial resources to deliver vaccines and provide immunization outreach services, which caretakers reported as their preferred way of accessing immunization. Conclusions: Barriers to MCV2 uptake occur at multiple levels of immunization service delivery. Strategies to address these barriers include tools to help caretakers track appointments, enhanced community engagement, HCW training to improve provider–client interactions and MCV2 knowledge, and efforts to manage HCW workload. Full article

Stroke is the second most common cause of death worldwide, and it greatly impacts the quality of life for survivors by causing impairments in their upper limbs. Due to the difficulties in accessing rehabilitation services, immersive virtual reality (IVR) is an interesting approach to improve the availability of rehabilitation services. This systematic review evaluates the technological characteristics of IVR systems used in the rehabilitation of upper limb stroke patients. Twenty-five publications were included. Various technical aspects such as game engines, programming languages, headsets, platforms, game genres, and technical evaluation were extracted from these papers. Unity 3D and C# are the primary tools for creating IVR apps, while the Oculus Quest (Meta Platforms Technologies, Menlo Park, CA, USA) is the most often used headset. The majority of systems are created specifically for rehabilitation purposes rather than being readily available for purchase (i.e., commercial games). The analysis also highlights key areas for future research, such as game assessment, the combination of hardware and software, and the potential integration incorporation of biofeedback sensors. The study highlights the significance of technological progress in improving the effectiveness and user-friendliness of IVR. It calls for additional research to fully exploit IVR’s potential in enhancing stroke rehabilitation results. Full article

The COLOSS research association has been assessing honey bee colony losses, associated risk factors and management, focusing on Western countries but with a progressive international expansion. Here, we report the first survey on the loss rates of colonies in 2022/2023 in Ethiopia using COLOSS monitoring survey tools. A face-to-face interview questionnaire survey was conducted on 64 beekeepers selected from Oromia and Tigray regions. This covered 1713 honey bee colonies distributed in 68 apiaries. The percentages of colonies lost were significantly different between Oromia (24.1%) and Tigray (66.4%) regions. Colony losses were attributed as unsolvable queen problems (8% in Oromia; 10% in Tigray), natural disaster (32%; 82%), and empty hives or dead colonies (60%; 8%). The loss rate was significantly affected by queen replacement (p < 0.0001), use of natural comb (p < 0.0001), feed supplementation (p < 0.0001), region (p < 0.0001), varroa treatment (p < 0.0001), colony splitting (p < 0.01), and merging (p < 0.01). Beekeepers in Oromia managed more colonies and implemented improved practices compared to those in Tigray. However, all beekeepers in Oromia detected at least some bees with signs of deformed wing virus, compared to 76% of beekeepers in Tigray. In conclusion, the colony loss rate was significantly different between Oromia and Tigray regions due to differences in natural disasters, management, environment and health factors. Full article

Poultry may face simultaneous exposure to aflatoxin B1 (AFB1) and tiamulin (TIA), given mycotoxin contamination and antibiotic use. As both mycotoxins and antibiotics can affect cytochrome P450 enzymes (CYP450), our study aimed to explore their interaction. We developed UHPLC-MS/MS methods for the first-time determination of the interaction between TIA and AFB1 in vitro and in vivo in broiler chickens. The inhibition assay showed the half maximal inhibitory concentration (IC₅₀) values of AFB1 and TIA in chicken liver microsomes are more than 7.6 μM, indicating an extremely weak inhibitory effect on hepatic enzymes. Nevertheless, the oral TIA pharmacokinetic results indicated that AFB1 significantly increased the area under the plasma concentration-time curve (AUC_last) of TIA by 167% (p < 0.01). Additionally, the oral AFB1 pharmacokinetics revealed that TIA increased the AUC_last and mean residence time (MRT) of AFB1 by 194% (p < 0.01) and 136%, respectively. These results suggested that the observed inhibition may be influenced by other factors, such as transport. Therefore, it is meaningful to further explore transport and other enzymes, involved in the interaction between AFB1 and TIA. Furthermore, additional clinical studies are necessary to thoroughly assess the safety of co-exposure with mycotoxins and antibiotics. Full article

In most developing countries, smallholder farms are the ultimate source of income and produce a significant portion of overall crop production for the major crops. Accurate crop distribution mapping and acreage estimation play a major role in optimizing crop production and resource allocation. In this study, we aim to develop a spatio–temporal, multi-spectral, and multi-polarimetric LULC mapping approach to assess crop distribution mapping and acreage estimation for the Oromia Region in Ethiopia. The study was conducted by integrating data from the optical and radar sensors of sentinel products. Supervised machine learning algorithms such as Support Vector Machine, Random Forest, Classification and Regression Trees, and Gradient Boost were used to classify the study area into five first-class common land use types (built-up, agriculture, vegetation, bare land, and water). Training and validation data were collected from ground and high-resolution images and split in a 70:30 ratio. The accuracy of the classification was evaluated using different metrics such as overall accuracy, kappa coefficient, figure of metric, and F-score. The results indicate that the SVM classifier demonstrates higher accuracy compared to other algorithms, with an overall accuracy for Sentinel-2-only data and the integration of optical with microwave data of 90% and 94% and a kappa value of 0.85 and 0.91, respectively. Accordingly, the integration of Sentinel-1 and Sentinel-2 data resulted in higher overall accuracy compared to the use of Sentinel-2 data alone. The findings demonstrate the remarkable potential of multi-source remotely sensed data in agricultural acreage estimation in small farm holdings. These preliminary findings highlight the potential of using multi-source active and passive remote sensing data for agricultural area mapping and acreage estimation. Full article