Search Results (39)

Background: The discovery of antibiotics revolutionized healthcare by significantly reducing morbidity and mortality. However, excessive and inappropriate use has led to a global surge in antimicrobial resistance, particularly in low- and middle-income countries. This study aimed to evaluate antibiotic use patterns among inpatients at Jimma Medical Center (JMC) in Southwest Ethiopia. Methods: A longitudinal observational study was conducted in February and March 2019 at JMC, focusing on patients admitted for over 24 h who received antibiotics. Data on patient demographics, clinical indications, and antibiotics prescribed were systematically collected. Antibiotic consumption rates were measured as days of therapy (DOTs) per 100 patient-days, and utilization was classified according to the World Health Organization (WHO) AWaRe (Access, Watch, and Reserve) framework. Results: A total of 384 inpatients were included, with a male predominance (53.9%) and a median age of 24 years (IQR: 5–37). In total, 634 antibiotic regimens were prescribed. According to the WHO AWaRe classification, 48.3% (306/634) were “Access” and 51.7% (328/634) were “Watch” antibiotics. Patients were treated with antibiotics for a median duration of 4 days (IQR: 2–7), leading to a total of 2880 days of antibiotic therapy. Ceftriaxone was the most commonly prescribed antibiotic, with a usage rate of 44.65 DOTs per 100 patient-days. Substantial variability was observed in empirical antibiotic regimens among treating physicians and across wards. Culture and antibiotic susceptibility testing (AST) were performed for only 4.2% of patients, and none of the treatments were modified based on susceptibility data. Conclusions: The study highlights critical issues in antibiotic prescribing at JMC, including over-reliance on “Watch” antibiotics, predominantly ceftriaxone, limited use of AST results, and deviations from standard treatment guidelines. Addressing these challenges requires implementing antimicrobial stewardship programs, developing evidence-based local treatment guidelines, and strengthening and encouraging the use of microbiology services to improve rational antibiotic use. Full article

In the Republic of Djibouti (Horn of Africa), fractured volcanic aquifers serve as the primary water resource. The country’s climatic characteristics (arid climate, average rainfall of 140 mm/year, and absence of surface water) have led to intensive groundwater exploitation to meet increasing water demands. This study focuses on the Dalha basalts aquifer in the Dikhil region. The Dikhil region, located in the southwest of Djibouti and bordering Ethiopia, spans 7200 km². Its population is estimated at 112,000 inhabitants. The Dalha aquifer is intensively exploited to supply the region and its capital, the city of Dikhil (35,000 inhabitants). The primary objective of this work is to assess the current resources of this aquifer using numerical modeling and its capacity to meet future water demands under the impact of climate change. The RCP 2.6 (Representative Concentration Pathway) was used to simulate the climate scenario up to 2100. Superficial recharge is estimated at 3.86 × 10⁶ m³/year. The current wellfield abstraction amounts to 2.34 × 10⁶ m³/year, accounting for 60% of the aquifer’s recharge. The simulation under RCP 2.6 indicates a declining trend in the water table. These findings highlight the fragile state of the Dalha aquifer, which is critical for the socioeconomic stability of the region. Given its current vulnerability, any increase in exploitation is unsustainable, despite the growing water demand in the Dikhil region. To tackle this challenge, we recommend conducting further studies to deepen the understanding of this system and implementing a real-time monitoring network to track aquifer changes. Full article

Introduction: Freshwater snails, particularly snails from the genus Biomphalaria, play a key role in the transmission of schistosomiasis, a parasitic disease prevalent in tropical regions. Schistosomiasis poses a significant public health challenge in these regions, leading to chronic illness, reduced productivity, and impaired childhood development, particularly in communities with limited access to healthcare and sanitation. Understanding the seasonal and spatial variations in snail populations and infection rates is crucial for controlling schistosomiasis, especially in areas like Southwest Ethiopia, where the disease burden is high. Methods: This study was conducted in Mizan Aman, Southwest Ethiopia, across two seasons, dry and wet. A total of 1150 snail samples were collected from 20 freshwater sites, and their species, abundance, and infection status were assessed. Environmental parameters, including temperature, pH, salinity, and conductivity, were measured to analyze their impact on snail populations. Results: Four snail species were identified, Biomphalaria pfeifferi, Biomphalaria sudanica, Lymnaea natalensis, and Bulinus globosus, with B. pfeifferi and B. sudanica being the most prevalent. Snail abundance varied by site and season, with 598 in the dry season and 552 in the wet season. Snail abundance and species composition showed significant spatial variation, with higher counts in sites like Sasin and Agu 1, while some sites had no snails. Biomphalaria snails, particularly B. pfeifferi, are the principal intermediate host for Schistosoma mansoni. The overall prevalence of Biomphalaria snails exceeded 85% in both seasons, and their average infection rate in Mizan Aman was 13.5%. This infection rate showed a strong correlation (r = 0.733, p < 0.001) with the incidence of schistosomiasis cases in the community. Seasonal variation in environmental factors, such as temperature and pH, had no significant effect on snail abundance; however, water salinity showed to be correlated with snail abundance during the dry season. Furthermore, community-led vegetation clearance at selected sites significantly reduced snail abundance. Conclusions: This study highlights the seasonal and spatial dynamics of freshwater snails, particularly Biomphalaria species, in relation to schistosomiasis transmission in Mizan Aman, Southwest Ethiopia. The findings confirm that B. pfeifferi species is the predominant intermediate host for schistosoma in this region and that schistosomiasis infection rates among snails significantly correlate with human cases in the community. While environmental factors such as temperature and pH showed no significant influence on snail abundance, water salinity had an impact during the dry season. Additionally, community-led vegetation clearance was an effective intervention in reducing snail populations. These results emphasize the need for targeted, site-specific control measures integrating ecological and community-based interventions to sustainably reduce schistosomiasis transmission. Full article

Background/Objectives: Hypertension is often asymptomatic, progresses slowly, and leads to multiple secondary diseases. Thus, a regular blood pressure check is recommended. The objective of this study is to assess the intention to undergo a blood pressure check and its associated factors among adults in Southwest Shewa Zone, Ethiopia. Methods: A healthcare-facility-based cross-sectional design was utilized. A standardized questionnaire, adapted from previous research, was administered by trained interviewers. Binary logistic regression analysis was used to determine the factors the intention to undergo blood pressure checks is associated with, utilizing SPSS version 27. Results: Four hundred twenty-one participants provided a complete response, yielding a 99.7% response rate. Of these participants, 153 (36%) had had their blood pressure checked at some point. The vast majority of the study participants (387, 91.9%) did not know the normal blood pressure range. The median score for intention to undergo blood pressure check was 11 (interquartile range 10–13). Female participants were 59% less likely (adjusted odds ratio [AOR] 0.408, 95% confidence interval 0.208–0.801) to intend to undergo a blood pressure check than male participants. Participants in the poorest wealth quintile were 82% less likely (AOR 0.183, 95% CI = 0.063–0.533) to intend to undergo a blood pressure check than those in the richest quintile. Participants who intended to undergo a blood pressure check had a significantly favorable attitude (t = 10.801, p < 0.001) and lower perceived behavioral control (t = −2.865, p < 0.001) compared with those who had no intention of checking. Conclusion: A high intent to undergo a blood pressure check should prompt healthcare facilities to offer regular blood pressure check-up services. Behavioral change communication interventions should address the attitude and perceived behavioral controls of individuals associated with the intention to undergo a blood pressure check. In doing so, special attention should be given to female and economically disadvantaged populations. Full article

Background: In Ethiopia, moderate thinness (MT) is a persistent issue among children. Yet, evidence on the effects of dietary supplementation and motor skills training in these children is limited. Objective: This study aimed to assess the effect of Ready-to-Use Supplementary Food (RUSF), whether or not combined with high-intensity motor learning (HiML), on weight, height, body composition, and muscle strength in children 5–7 years old with MT living in Jimma Town, Ethiopia. Methods: A cluster-randomized controlled trial was carried out among 69 children (aged 5–7) with MT assigned to receive RUSF (n = 23), RUSF + HiML (n = 25), or no intervention (control group, n = 21). A multivariable Generalized Estimating Equations model was used and the level of significance was set at alpha < 0.05. Results:At baseline, there were no significant differences in the outcome measurements between the RUSF, RUSF + HiML, and control groups. However, after 12 weeks of intervention, there were significant mean differences in differences (DIDs) between the RUSF group and the control arm, with DIDs of 1.50 kg for weight (p < 0.001), 20.63 newton (N) for elbow flexor (p < 0.001), 11.00 N for quadriceps (p = 0.023), 18.95 N for gastrocnemius sup flexor of the leg (p < 0.001), and 1.03 kg for fat-free mass (p = 0.022). Similarly, the mean difference in differences was higher in the RUSF + HiML group by 1.62 kg for weight (p < 0.001), 2.80 kg for grip strength (p < 0.001), 15.93 for elbow flexor (p < 0.001), 16.73 for quadriceps (p < 0.001), 9.75 for gastrocnemius sup flexor of the leg (p = 0.005), and 2.20 kg for fat-free mass (p < 0.001) compared the control arm. Conclusion: RUSF alone was effective, but combining it with HiML had a synergistic effect. Compared to the control group, the RUSF and RUSF + HiML interventions improved the body composition, height, weight, and muscle strength of the studied moderately thin children. The findings of this study suggest the potential that treating moderately thin children with RUSF and combining it with HiML has for reducing the negative effects of malnutrition in Ethiopia. Future research should explore these interventions in a larger community-based study. This trial has been registered at the Pan African Clinical Trials Registry (PACTR) under trial number PACTR202305718679999. Full article

Smallholder farmers in Ethiopia face increasing challenges from climate change and variability, which threaten their food security and livelihoods. This study examines how adopting single and combined climate change adaptation practices affects their vulnerability to food insecurity in Bench Maji Zone, southwest Ethiopia. Through multistage sampling, data were gathered from 390 rural households in four climate-prone districts. The study examines the impacts resulting from both individual and combined implementations of adaptation techniques. These techniques encompass crop management practices, soil and water conservation measures, and livelihood portfolio diversification strategies. The study employed the multinomial endogenous treatment effect regression model to address selection bias and endogeneity resulting from various sources of heterogeneity, whether observed or unobserved. The results show that farmers who adopted adaptation practices were less vulnerable to food insecurity than those who did not. The study also finds that adopting multiple practices has a more significant impact than adopting single practices. Our findings suggest that implementing climate change adaptation strategies can increase the resilience of smallholder farmers in the study area and decrease their vulnerability to food insecurity. The study recommends supporting farmers in adopting these strategies through research and development, information dissemination, and collaborations among farmers, researchers, and extension services. Full article

This study identified the practices of adaptation strategies to climate change in Jimma, Bedelle, Bonga, and Sokorru urban centers using a survey of 384 households, 55 key informant interviews, 4 focus group discussions, and field observations. A cross-sectional study design was employed from 2019 to 2021. The adaptive capacity of municipalities to reduce climate extreme events was rated as poor by the majority (51%), mostly reactive measures (76%). The climate hazards identified in four urban centers were riverine and flash floods, urban heat waves, landslides, and windstorms. The urban households practiced lifestyle modification, reduce paved surfaces, the use of air conditioner, planting trees, and multiple windows. The adaptation strategies practiced by municipalities include the relocation of prone areas, the support of basic amenities, the construction of protection walls, diversion ditches, the clearance of waterways and rivers, greenery, and park development. The adaptation actions were constrained by a lack of awareness, commitment, cooperation and coordination, adaptive capacity, and participation. Gray/physical infrastructures (costly but important) as adaptation actions were hampered by the low municipal capacity. We recommend that urban authorities should incorporate climate change adaptation strategies into urban planning and development proactively to ensure future resilient climate smart urban centers of southwest Ethiopia. Full article

Power transmission lines in Ethiopia are experiencing an alarmingly high frequency of unexplained outages triggered by environmental factors, which significantly undermine the reliability of the country’s power system. This paper presents investigations aiming to identify those among the unexplained fault records that have been caused by pollution induced flashovers. An identification method is developed, which associates the contextual fault features, such as information about the characteristics of the fault, fault location, and time of day, as well as month of its occurrence with local meteorological/climatic and environmental conditions. A total number of 4231 unexplained faults, recorded between 2015 and 2022, were analyzed. Among them, 1045 faults (24.7%) were identified as being most likely caused by pollution induced flashovers. The entire network suffered from more than 130 pollution-induced flashovers annually with a frequency of about 0.8 faults/100 km/year. The fault frequency strongly differed among the grid regions, being highest in the Northeast and lowest in the Southwest region. Moreover, the performed analyses also concentrated on the evaluation of the pollution performance of various insulator types employed in the network. The results indicate that porcelain insulators have the highest pollution-induced flashover intensity of 1.47 faults/year/1000 units, followed by silicone rubber polymeric composite insulators and glass insulators with the respective intensities of 1.21 and 0.83 faults/year/1000 units. These results indicate that despite the high expectations towards the pollution performance of silicone rubber polymeric insulators, their use in the Ethiopian climatic and environmental conditions appears to be unsatisfactory. Full article

This study aimed to analyze farmers’ perceptions of maize production constraints and determine the effects of push–pull technology (PPT) on crop yield, pest control, and improving soil fertility status. Increasing fertilizer prices and pesticide prices, FAWs (fall armyworms) and stemborers, declining soil fertility, and drought are the main maize production constraints in the area. Seventy percent of the respondents indicated that an increase in input prices such as those of fertilizer and seeds is the major constraint in the area, while FAWs (55%) and stemborers (44.3%) were ranked the third and fourth major constraints. About 67% of farmers reported that stemborer damage to maize in PPT plots was either minimal or non-existent. Fifty-five percent of farmers stated that the damage caused to maize by FAWs was low or that there was no damage in PPT plots. PPT reduced stem borer infestation from 83% to 44%. The yield gained from PPT plots ranged from 18% to 31%. Soil samples taken from PPT plots showed improved soil organic carbon, organic matter, total nitrogen, and cation exchange capacity. Full article

Ethiopia has a high potential for the production of honey and other apiary products due to its ideal agroecology. This potential is, however, not yet well utilized due to weak production and valorization systems. The study analyzed beekeeping systems and their honey value chain to detect the barriers and to explore ways to better exploit the existing potential. Descriptive statistics, a SWOT and PESTEL matrix, and system mapping were utilized for analysis. Ethiopian beekeeping is still dominated by traditional production systems, followed by modern and transitional systems, differing in types of beehives and the average amount of honey yield. The combined SWOT-PESTEL analysis revealed challenges like a limited supply and high cost of modern beehives, shortage of credit, absence of a honey marketing legal framework, pest and predator attacks, absconding, and uncontrolled application of agrochemicals. Opportunities include the globally increasing demand for honey, availability of good investment policy, conducive agroecology, and support from NGOs. The less productive techniques of smallholder beekeepers’ crude honey production for local beverage making affected the good use of the potential and minimized its contribution to the local and national economy. On the contrary, strengthening private investors and cooperatives towards the production of fully and semi-processed honey impacted the utilization of the potential positively. Full article

The occurrence of extreme precipitation events always leads to a mass of disasters. In this study, based on daily precipitation data from 20 meteorological stations in Ethiopia, we performed a detailed analysis of patterns and trends of ten extreme precipitation indices during 1990–2020. Our study revealed that different topographic conditions on the Ethiopian Plateau, Ethiopian savanna and Ethiopian desert resulted in great differences in patterns and trends of extreme precipitation. Notably, extreme precipitation intensity indices (Rx1day, Rx5day, SDII) and amount indices (R95pTOT) showed significant downward trends in the eastern desert (averagely −1.0 mm/year, −3.0 mm/year, −0.25 mm day⁻¹/year, −6.0 mm/year) and upward trends in the northern plateau and southern savanna (averagely 0.3 mm/year, 0.4 mm/year, 0.05 mm day⁻¹/year, 3.0 mm/year). These implied that extreme precipitation events decreased in the eastern desert and increased in the northern plateau and southern savanna during the past thirty years. Annual trends of the CDD index were upward (0.5 to 1.9 days/year) in most of Ethiopia while those of the CWD index were close to zero in most of Ethiopia, indicating that Ethiopia faced a longer duration of drought in the past thirty years. Moreover, we revealed that the local mean temperature, local mean precipitation, Southwest Asian summer monsoon and West African summer monsoon have significant impacts on the intensity, amount and duration of extreme precipitations in Ethiopia. Full article

Cooperative learning is more effective in a well-managed classroom with diverse ethnic, linguistic, and religious backgrounds. To that end, this study examined the state of applications of cooperative learning and student diversity in polytechnic colleges in southwest Ethiopia. A qualitative research methodology, specifically grounded theory design was employed to achieve the research purpose. The empirical data was gathered from 20 educational officials through in-depth interviews at sample polytechnic colleges. Student diversity found to have a significant influence on how cooperative learning is implemented. It has also been found that the perception of department heads towards diversity has a significant influence on the application of cooperative learning. The study’s findings also showed that managing diversity among students and interacting with peers within groups and from other groups has a positive influence on cooperative learning. In conclusion, the application of cooperative learning is affected by perceptional and structural factors of student diversity. Thus, this research recommends further study to be conducted on the relationship between diversity management and cooperative learning. Full article

This study assesses the perceptions and vulnerability of the farming communities to climate change in the southwestern parts of Ethiopia. Climate change vulnerability assessment is a prerequisite to designing climate change adaptation strategies. A multistage cluster sampling technique was used to select four of the six zones from the southwestern parts of Oromia. Close-ended and open-ended questionnaires were used to assess household perceptions of climate change and the degree of vulnerability to climate change by using five household capitals: natural, social, financial, physical, and human capital. Data were collected from 442 households in 4 districts: Jimma Arjo, Bako Tibe, Chewaka, and Sekoru. The vulnerability of the farming communities was assessed using the households’ livelihood vulnerability index. A total of forty indicators from five capitals were applied to calculate household livelihood vulnerability to climate change. Household perceptions of climate change had a statistically significant relationship with changes in rainfall pattern (75.6%, p < 0.001), temperature pattern (69.7%, p < 0.001), drought (41.6%, p = 0.016), flood (44.1%, p = 0.000), and occurrence of early (53.2%, p < 0.001) and late rain (55.9%, p < 0.001). The results show that households in the Sekoru district were the most vulnerable (0.61), while households in the Jimma Arjo district were less vulnerable (0.47) to the effect of climate change. Household vulnerability to climate change is mainly related to the occurrence of drought, lack of much-needed infrastructure facilities, and weak institutional support. Links with financial organizations are also lacking in the household. The findings of this study will help policymakers to address the impact of climate change. To support disaster risk management on the one hand and increase the resilience of vulnerable societies to climate change on the other, we recommend a detailed assessment of the remaining districts of the region. Full article

Occupational safety is a critical concern for disease prevention and control at healthcare facilities. Medical waste handlers, in particular, are those most exposed to occupational hazards among healthcare workers. Therefore, this cross-sectional study was conducted to evaluate safety practices and associated factors among healthcare waste handlers in four public hospitals, southwest Ethiopia from 15 March to 30 May 2022. The study included 203 healthcare waste handlers. The data were collected using an interviewer-administered questionnaire and observational checklists. The overall performance of occupational safety practices among healthcare waste handlers was 47.3% (95%CI; 40.3, 54.2). Waste handlers with an educational status of secondary and above (AOR 4.95; 95%CI 2.13, 11.50), good knowledge of infection prevention and safety practices (AOR 4.95; 95%CI 2.13, 11.50), training in infection prevention and safety practices (AOR 2.57; 95%CI 1.25, 5.29), and adequate access to safety materials (AOR 3.45; 95%CI 1.57, 7.60) had significantly better occupational safety practices than their counterparts. In general, medical waste handlers’ occupational safety practices were found to be inadequate. Waste handlers’ knowledge of safety measures and training, educational level, and availability of safety materials were predictors of safe occupational practices. Therefore, appropriate strategies and actions are needed to ensure the safe occupational practices of healthcare waste handlers. Full article

Yellow fever (YF) is an emerging and re-emerging arboviral disease transmitted through the bites of infected Aedes mosquitoes, primarily in the genus Aedes. Several outbreaks of yellow fever have been documented in southern Ethiopia. Four outbreaks have been documented since 2012, suggesting that southern Ethiopia is prone to YF outbreaks. Understanding the transmission cycle is pivotal to managing arboviral disease outbreaks, and the aims of the present study were to investigate the mosquito species that most likely contributed to the recent YF outbreaks and to study their behaviors. Therefore, the present study aimed to evaluate which species of Aedes mosquitoes contribute to the YF virus transmission, the outbreaks that have occurred and their behaviors (biting and resting) in the region. Two districts were selected on the basis of recent YF outbreak history. A longitudinal entomological survey was conducted to collect adult mosquitoes by using human landing catches (HLC), mechanical mouth aspirators and pyrethrum sprays. Collections were conducted twice a month for six months, from February 2019 to July 2020. The mosquitoes were identified by species by using morphological keys and molecular techniques. A total of 1689 mosquitoes were collected, of which 93.7% (1582/1689) were members of the genus Aedes and 6.3% (107/1689) of the genus Culex. A total of 58.7% (991/1689) of the mosquitoes were captured in the Ofa District and 41.3% (698/1689) from the Boko Dawula District. The largest number of mosquitoes, 97.9% (1653/1689), were collected during the wet season. A total of 1582 members of the Aedes simpsoni complex were collected, where 57.7% (913/1582) were from the Ofa District and 42.3% (669/1582) were from the Boko Dawula District. Molecular identification showed that members of the Aedes simpsoni complex accounted for 99.5% (404/406), while Aedes aegypti, detected only in the Ofa District, accounted for only 0.5% (2/406). The mosquitoes were pooled and tested for YFV, dengue virus (DENV, serotype 1–4) and chikungunya virus (CHKV) by using qPCR. None of the 934 Aedes simpsoni tested were positive for any arboviruses. The human-biting activities of Ae. simpsoni complex were peaked between 8:00–9:00 and 16:00–17:00, mostly outdoors, both within the villages and the forests. The largest numbers of Aedes simpsoni complex resting mosquitoes were collected from the leaves of the Abyssinian banana, Ensete ventricosum, suggesting that they are the preferred resting places. Although the tested Ae. simpsoni complex was negative for arboviruses; the morning and afternoon activities of the species complex coincide with peak human outdoor activities in these areas and may therefore pose the highest risk of transmitting YFV to humans. The extremely low abundance of Aedes aegypti suggests a minor role in arbovirus transmission in southern Ethiopia. It is of great importance that expanded surveillance activities of arboviruses to include reservoir hosts and sylvatic vectors to the chances of devising and implementing effective control measures. Full article