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Loiasis is a major obstacle to ivermectin treatment for onchocerciasis control and lymphatic filariasis elimination in central Africa. In communities with a high level of loiasis endemicity, there is a significant risk of severe adverse reactions to ivermectin treatment. Information on the geographic distribution of loiasis in Africa is urgently needed but available information is limited. The African Programme for Onchocerciasis Control (APOC) undertook large scale mapping of loiasis in 11 potentially endemic countries using a rapid assessment procedure for loiasis (RAPLOA) that uses a simple questionnaire on the history of eye worm. RAPLOA surveys were done in a spatial sample of 4798 villages covering an area of 2500×3000 km centred on the heartland of loiasis in Africa. The surveys showed high risk levels of loiasis in 10 countries where an estimated 14.4 million people live in high risk areas. There was a strong spatial correlation among RAPLOA data, and kriging was used to produce spatially smoothed contour maps of the interpolated prevalence of eye worm and the predictive probability that the prevalence exceeds 40%. The contour map of eye worm prevalence provides the first global map of loiasis based on actual survey data. It shows a clear distribution with two zones of hyper endemicity, large areas that are free of loiasis and several borderline or intermediate zones. The surveys detected several previously unknown hyperendemic foci, clarified the distribution of loiasis in the Central African Republic and large parts of the Republic of Congo and the Democratic Republic of Congo for which hardly any information was available, and confirmed known loiasis foci. The new maps of the prevalence of eye worm and the probability that the prevalence exceeds the risk threshold of 40% provide critical information for ivermectin treatment programs among millions of people in Africa.

Background Malaria is the leading cause of morbidity and mortality in Ethiopia, accounting for over five million cases and thousands of deaths annually. The risks of morbidity and mortality associated with malaria are characterized by spatial and temporal variation across the country. This study examines the spatial and temporal patterns of malaria transmission at the local level and implements a risk mapping tool to aid in monitoring and disease control activities. Methods In this study, we examine the global and local patterns of malaria distribution in 543 villages in East Shoa, central Ethiopia using individual-level morbidity data collected from six laboratory and treatment centers between September 2002 and August 2006. Results Statistical analysis of malaria incidence by sex, age, and village through time reveal the presence of significant spatio-temporal variations. Poisson regression analysis shows a decrease in malaria incidence with increasing age. A significant difference in the malaria incidence density ratio (IDRs) is detected in males but not in females. A significant decrease in the malaria IDRs with increasing age is captured by a quadratic model. Local spatial statistics reveals clustering or hot spots within a 5 and 10 km distance of most villages in the study area. In addition, there are temporal variations in malaria incidence. Conclusion Malaria incidence varies according to gender and age, with males age 5 and above showing a statistically higher incidence. Significant local clustering of malaria incidence occurs between pairs of villages within 1–10 km distance lags. Malaria incidence was higher in 2002–2003 than in other periods of observation. Malaria hot spots are displayed as risk maps that are useful for monitoring and spatial targeting of prevention and control measures against the disease.

Background Africa has made notable progress against Neglected Tropical Diseases (NTDs) using a whole-of-society approach that involved everyone, though sub-Saharan Africa still faces major challenges. Since the Expanded Special Project for the Elimination of Neglected Tropical Diseases (ESPEN) was launched in 2016, over 500 million people have been treated for NTDs like onchocerciasis, lymphatic filariasis, schistosomiasis, and soil-transmitted helminthiases. Nineteen African countries have eliminated at least one NTD, yet 44 out of 52 tracked nations still need preventive chemotherapy for multiple diseases. In 2022, 81 million people received schistosomiasis treatment, but adult coverage remains low due to limited praziquantel access. This paper documents lessons and success stories from regional initiatives such as the African Programme for Onchocerciasis Control (APOC), the Onchocerciasis Control Programme in West Africa (OCP), and the Guinea Worm Eradication Programme, including success stories from specific countries in implementing NTDs programmes and other health programmes (vaccine-preventable disease programmes, malaria, and some zoonotic disease programmes) for ESPEN and similar partnerships to guide future improvements in NTD elimination efforts. Methods Programme reports from the WHO African region on NTDs, and peer-reviewed journals and other published documents were assessed, supplemented by authors’ wide experiences to gain insights into NTDs and communicable disease programme implementation across Africa. The manuscript was structured along the WHO health systems building blocks. Success stories were highlighted, lessons learned documented, and recommendations made. Contents were reviewed several times and independently by a small group. The authors’ approval was secured before journal submission. Findings and conclusions Lessons learned, and recommendations made are beneficial to partners and countries in achieving the 2030 NTDs elimination targets in the African region and beyond. They provide pathways to expanding the structure, direction, and scope of programme implementation for greater impact.

Onchocerciasis is mainly found in western part of Ethiopia and there is no evidence of transmission in the east ward. However, some zones (Bale, Borena, and West Arsi) are suspected for transmission given the area has fast flowing rivers and is covered with vegetation. Therefore, this study was conducted to map onchocerciasis transmission in those zones. About 19 villages were selected based on proximity to the rivers, representation of districts, zones, and vegetation covers, whereas the study participants, all village residents of age > 5 years with good health condition, were skin sniped and examined using microscopy. In this study a total of 2560 study participants were surveyed of which 1332 were female (52%) and 122 were male (48%). The age group of 21–30 years was highest (34.4%) and that of age > 51 years was the lowest (3.1%) study participants. The survey result revealed that none of the study participants regardless of age, sex, and location demonstrated skin snip Onchocerca microfilariae. The prevalence of microfilariae and community microfilarial load (CMFL) were 0% and 0 mf/s, respectively. The finding implied that there is no onchocerciasis in the area and, therefore, there is no need for interventions. Black fly distribution, cytotaxonomic study, and intraborder cross transmission monitoring are recommended.

BACKGROUND: Onchocerciasis can be effectively controlled as a public health problem by annual mass drug administration of ivermectin, but it was not known if ivermectin treatment in the long term would be able to achieve elimination of onchocerciasis infection and interruption of transmission in endemic areas in Africa. A recent study in Mali and Senegal has provided the first evidence of elimination after 15-17 years of treatment. Following this finding, the African Programme for Onchocerciasis Control (APOC) has started a systematic evaluation of the long-term impact of ivermectin treatment projects and the feasibility of elimination in APOC supported countries. This paper reports the first results for two onchocerciasis foci in Kaduna, Nigeria. METHODS: In 2008, an epidemiological evaluation using skin snip parasitological diagnostic method was carried out in two onchocerciasis foci, in Birnin Gwari Local Government Area (LGA), and in the Kauru and Lere LGAs of Kaduna State, Nigeria. The survey was undertaken in 26 villages and examined 3,703 people above the age of one year. The result was compared with the baseline survey undertaken in 1987. RESULTS: The communities had received 15 to 17 years of ivermectin treatment with more than 75% reported coverage. For each surveyed community, comparable baseline data were available. Before treatment, the community prevalence of O. volvulus microfilaria in the skin ranged from 23.1% to 84.9%, with a median prevalence of 52.0%. After 15 to 17 years of treatment, the prevalence had fallen to 0% in all communities and all 3,703 examined individuals were skin snip negative. CONCLUSIONS: The results of the surveys confirm the finding in Senegal and Mali that ivermectin treatment alone can eliminate onchocerciasis infection and probably disease transmission in endemic foci in Africa. It is the first of such evidence for the APOC operational area.

Little is known about the epidemiology of malaria during pregnancy in areas of unstable (epidemic-prone) transmission (UT) in sub-Saharan Africa. In cross-sectional studies, peripheral malaria parasitemia was identified in 10.4% of women attending antenatal care clinics at 1 stable transmission (ST) site and in 1.8% of women at 3 UT sites; parasitemia was associated with anemia in both ST (relative risk [RR], 2.0; P<.001) and UT (RR, 4.4; P<.001) sites. Placental parasitemia was identified more frequently during deliveries at ST sites (12/185; 6.5%) than at UT sites (21/833; 2.5%; P=.006). Placental parasitemia was associated with low birth weight at the ST site (RR, 3.2; P=.01) and prematurity at ST (RR, 2.7; P=.04) and UT (RR, 3.9; P=.01) sites and with a 7-fold increased risk of stillbirths at UT sites. The effectiveness and efficiency in Ethiopia of standard preventive strategies used in high-transmission regions (such as intermittent preventive treatment) may require further evaluation; approaches such as insecticide-treated bednets and epidemic preparedness may be needed to prevent adverse pregnancy outcomes

Severe acute malnutrition is a major cause of illness and death among children under the age of five in Ethiopia. However, there is limited evidence regarding the success of treatment and the length of hospital stays for children with severe acute malnutrition. The objective of this research was to assess the recovery period from severe acute malnutrition and determine potential predictors of recovery. A retrospective follow-up study was conducted. Children aged 6–59 months with severe acute malnutrition who had been treated at the therapeutic feeding unit were selected using a simple random sampling technique. The data was analyzed using Stata v14. Descriptive statistics were used to compute the nature of the variables. Kaplan-Meier with the log-rank test was used to test for the presence of differences in categorical variables. Model goodness of fit and assumptions were checked by the Cox-Snell residual and global tests, respectively. A p-value of 0.25 in the bivariable Cox regression analysis was used for the multivariable Cox regression analysis. Variables with p values less than 0.05 in the multivariable Cox regression were considered significant predictors of recovery time from severe acute malnutrition. In this study, the median recovery time was nine days, with an interquartile range of 7 to 11 days. The incidence rate of recovery was 11.24%. Children who had marasmus, pneumonia at admission, anemia at admission, had not been fully vaccinated, had not received vitamin A, and had not received plumpy’Nut had a statistically significant association with the time to recovery of severe acute malnutrition. Marasmus, pneumonia, and anemia at admission were the predictors that delayed the recovery time of children from their severe acute malnutrition. On the contrary, children who had been given vitamin A and plumpy nuts were the predictors that fastened recovery time. Therefore, special attention should be given to children who have marasmus, comorbidities like pneumonia, and anemia to shorten their recovery time from their severe acute malnutrition status.

Adverse pregnancy outcomes continue to pose a significant global public health challenge, especially in low- and middle-income countries. Although preconception care (PCC) interventions are advised to address this problem, their adoption remains inadequate, supported by scarce evidence particularly in conflict-impacted areas such as Tigray, Ethiopia, where rates of poor outcomes like neural tube defects are notably higher than in other regions. This study investigates the experience of pregnant women regarding the use of PCC in the Tigray, northern Ethiopia. A community-based cross-sectional study was conducted from July 31 to August 16, 2024, involving 764 pregnant women in their first or second trimester. Participants were consecutively enrolled from clusters until the predetermined sample size was achieved. Data were collected through interviewer-administered questionnaires in accordance with World Health Organization, and Centers for Disease Control and Prevention, and national guidelines. PCC uptake was measured as the receipt of any service component (screening, counseling, or management) during healthcare consultations. We used SPSS version 27.0 to analyze PCC uptake and its associated factors. Descriptive and binary logistic regression statistics were used in the analysis. Finally, data was presented using text, tables, and figures as appropriate. In this study, the overall uptake of PCC services was 7.2%. All participants in the current pregnancy were exposed to at least one risk factor for adverse pregnancy outcomes. Factors such as women's decision-making power, having information about PCC, HIV screening during the current pregnancy, and perceived susceptibility to preconception risks showed a statistically significant positive association with the uptake of PCC services. The uptake of PCC services was very low. Addressing the low uptake of PCC services requires a multifaceted strategy, including public health campaigns via media and social forums, strengthened health extension programs, and the integration of a reproductive life plan tool to improve health-seeking behavior among women.

The prevalence of diabetes mellitus has been increasing in the past few decades. Mortality and morbidity have increased faster in low- and middle-income countries than in high-income countries. In Ethiopia it has been a practice to handle most diabetes mellitus patients in general and referral hospitals which in turn caused over burden in these hospitals. Besides, the possibility of implementing diabetic care service in primary health care facilities is not assessed in Ethiopia. The aim of this study was to decentralize and implement diabetic service in primary health care facilities in Tigray. The study was conducted in Tigray region, at Hagereselam primary hospital from September 2019 to September 2020. A pilot study which aimed to bring diabetes services to non-specialized health care facilities. Diabetic patients who were on follow up in tertiary hospital (Ayder Comprehensive Specialized Hospital) were moved to Hagereseam primary hospital voluntarily, which is the main study site. The data were collected by trained health professionals and the data collection tool was adapted and developed from national guideline and analysed through SPSS 21. Independent t-test and chi-square was applied to compare the outcomes among study participant groups. The mean and median Fasting Blood Sugar (FBS) level was 171mg/dl and 151.5 (IQR = 109.5-180.7) respectively. and the mean difference of FBS with randomly selected patients in a referral hospital was 3.55 (p = 0.8) which shows no significant difference. Mean systolic BP and haemoglobin A1c were 114.2 mmHg and 8.34% respectively. There is no significant difference in the diabetes service among the primary and tertiary hospital. Diabetes service can be decentralized to primary health care facilities without compromising the quality of diabetic care. Further large implementational study is necessary to overcome the problems in the decentralization of service delivery in diabetes service.

Introduction Neonatal jaundice affects up to 85% of live births and is largely preventable and treatable when identified and managed early. Delayed or inadequate treatment, however, may lead to irreversible complications and death. Despite the availability of effective interventions, treatment outcomes in many developing countries remain suboptimal. Moreover, evidence on treatment outcomes and their predictors among jaundiced neonates in the study area is limited. Therefore, this study aimed to determine the treatment outcomes of neonatal jaundice and identify associated predictors among neonates admitted to public hospitals in Bahir Dar City, Ethiopia, in 2024. Method A retrospective follow-up study was conducted among 420 jaundiced neonates admitted to public hospitals in Bahir Dar city from January 1, 2020, to December 30, 2023. Study participants were selected using a simple random sampling technique. Data were entered into Epi-Data 4.6 and analyzed using SPSS version 26. Both descriptive and inferential statistical analysis was performed. Binary logistic regression with 95% confidence interval (CI) was used to identify predictors of poor treatment outcomes. Variables with a p-value < 0.20 in the bivariable analysis were included in the multivariable analysis, and statistical significance was declared at p  < 0.05. Model fitness was assessed using the Hosmer–Lemeshow goodness-of-fit test. Findings were presented using text, tables and figures. Result Out of 432 eligible neonatal records, 420 charts were reviewed, yielding a completeness rate of 97.2%. The proportion of poor treatment outcomes among jaundiced neonates was 11.7% (95% Confidence Interval: 8.7%, 14.8%). Significant predictors of poor treatment outcomes included origin of admission (Adjusted Odds Ratio = 2.57; 95% Confidence Interval: 1.06–6.22), rhesus incompatibility (Adjusted Odds Ratio = 2.64; 95% Confidence Interval: 1.05–6.67), neonatal sepsis (Adjusted Odds Ratio = 4.54; 95% Confidence Interval: 1.82–11.3), temperature instability (Adjusted Odds Ratio = 3.38; 95% Confidence Interval: 1.15–9.90) and use of intermittent phototherapy (Adjusted Odds Ratio = 2.90; 95% Confidence Interval : 1.22–6.89). Conclusion and Recommendation The study revealed that moderate proportion of neonates with jaundice experienced poor treatment outcomes in public hospitals of Bahir Dar City. Poor treatment outcomes were significantly associated with referral origin, rhesus incompatibility, neonatal sepsis, temperature instability, and the use of intermittent phototherapy. These findings emphasize the importance of early identification and timely management of high-risk neonates, strengthening referral systems, ensuring effective and continuous phototherapy, and improving the management of comorbid conditions to enhance treatment outcomes of neonatal jaundice.