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Implementation of evidence-based practice in clinical practice is crucial. Nurses and midwives play a vital role in using updated evidence. However, limited support and barriers to implementing evidence-based practice hamper the use of up-to-date evidence in clinical decision-making practice. Therefore, this study aimed to explore the implementation of evidence-based practice of nurses and midwives working in public hospitals. A qualitative descriptive study was conducted to explore the experience of implementing evidence-based practice among nurses and midwives working in public hospitals. A total of 86 participants, of which, 25 in-depth interviews, 5 FGDs having 47 participants and 14 participants were involved during observations, were considered in Amhara Region public hospitals from November 17, 2019 to April 25, 2020. The observational data, interview and FGD transcripts were imported into NVivo 12 plus to manage and analyze the data using the Computer-Assisted Data Analysis Software Program (CAQDAS). The data were analyzed through thematic content analysis. Nurses and midwives perceived that implementation of evidence-based practice is the use of research findings, guidelines, hospital protocols, books, and expert experience in clinical decision-making practice. However, there was limited support for the implementation of evidence-based practice by nurses and midwives. The lack of knowledge and skill to use evidence like research findings, time mismanagement, the lack of motivation, the lack of resources and training were the perceived barriers to the implementation of evidence-based practice. Stick to the traditional practice due to lack of incentive and unclear job description between diploma and BSc nurses and midwives were the perceived causes of the lack of motivation. The experience of evidence-based practice of nurses and midwives indicated that there was limited support for the implementation of evidence-based practice. However, research findings were rarely used in clinical decision-making practice The Knowledge, attitude towards implementing evidence-based practice, lack of resources and training, time mismanagement and lack of motivation were the barriers to the implementation of evidence-based practice. Therefore, the promotion of adopting the implementation of evidence-based practice and training on the identified barriers are mandatory.

Background Malaria is a major cause of morbidity and mortality worldwide. According to the World Health Organization 2021 malaria report, it is considered to be endemic in 85 countries and territories. Malaria elimination programmes have also faced many challenges, such as widespread asymptomatic carriers in endemic regions, and they should be considered in malaria-control programmes in endemic areas for successful transmission interruption. This study aimed to assess the prevalence of symptomatic and asymptomatic malaria infections, and associated factors in Debre Elias district communities, Northwest Ethiopia from May to Jun 2018. Methods A community-based cross-sectional study was conducted among selected kebeles in Debre Elias district, Amhara region, North-western Ethiopia. Multi-stage sampling technique was carried out to select representative households. A total of 440 randomly selected households were included, of which one individual per household was sampled for laboratory examination. Malaria prevalence was determined by light microscopy of stained blood films and using CareStart™ Malaria HRP2/pLDH (Pf/Pv) Combo rapid diagnostic test (RDT). A structured questionnaire was employed to collect socio-demographic data and associated risk factors. Data entry and analysis were carried out using Epi data 3.1 and SPSS version 23 software, respectively. The association between dependent and independent variables was explored by using bivariate and multivariate logistic regression analyses. Statistically significant association was declared at P -value of < 0.05. Results A total of 440 (333 asymptomatic and 107 symptomatic) individuals were included in this study. The overall prevalence of malaria was 5% with the majority (59.1%) of infections caused by Plasmodium falciparum. Among asymptomatic participants, 4.8% (n = 16, 95% CI = 2.6–7.3) and 4.2% (n = 14, 95% CI = 2.1–6.5) were diagnosed and confirmed by RDT and light microscopy respectively. Similarly, the prevalence of malaria among 107 symptomatic individuals was 7.5% (n = 8, 95% CI = 2.8–12.6) by either RDT or light microscopy. Utilization of insecticide-treated net (ITN), availability of ITN, house with eave, previous history of malaria infection, and family history of malaria infection were significantly associated with malaria infection ( P  < 0.05). Conclusion In this study, the prevalence of asymptomatic and symptomatic malaria was moderate. Screening of both symptomatic and asymptomatic malaria in the community is very important to scale up intervention programmes.

Despite the availability of an effective vaccine, the global prevalence of chronic hepatitis B (CHB) in children was estimated to range from 1.3 to 3.4%. In Ethiopia, the estimated seroprevalence of CHB in children under five years old was 2.21%. This study aimed to assess the prevalence of breakthrough hepatitis B virus (HBV) infection and its associated factors in northwest Ethiopia. A cross-sectional study was conducted in northwest Ethiopia from December 2023 to June 2024. Children aged 1–14 years who visited pediatric clinics for various medical reasons were enrolled. Hepatitis B surface antigen (HBsAg) was tested using an enzyme-linked immunosorbent assay (ELISA). Data were analyzed using SPSS version 23.0. Chi-square tests and logistic regression analyses were employed to identify predictors of breakthrough HBV infection, with statistical significance set at p  < 0.05. Among 325 vaccinated children under 15 years of age, the prevalence of breakthrough HBV infection was 2.5% (95% CI: 0.9–4.3%). The age of the children and a history of contact with individuals with CHB were significantly associated with breakthrough infection. Children aged 5–9 years were 10.7 times (OR = 10.7; 95% CI: 1.1–99.6), and those aged 10–14 years were 20.7 times more likely to be infected with HBV (OR = 20.7; 95% CI: 2.0-215.8), compared to children aged 1–4 years. Additionally, children with a history of contact with CHB individuals were six times more likely to be infected with HBV (OR = 6.1; 95% CI: 1.4–27.6). This study found an intermediate prevalence of HBV infection among vaccinated children, which raises significant public health concerns. Age and contact with individuals with CHB were found to be significant factors associated with breakthrough HBV infection. These findings highlight the need for regular evaluation of the effectiveness of vaccination programs and the implementation of targeted preventive strategies to reduce transmission.

Background and objectives Although the goal of translational research is to bring biomedical knowledge from the laboratory to clinical trial and therapeutic products for improving health, this goal has not been well achieved as often as desired because of many barriers documented in different countries. Therefore, the aim of this study was to investigate the challenges and opportunities of translating animal research into human trials in Ethiopia. Methods A descriptive qualitative study, using in-depth interviews, was conducted in which preclinical and clinical trial researchers who have been involved in animal research or clinical trials as principal investigator were involved. Data were analyzed using inductive thematic process. Results Six themes were emerged for challenges: lack of financial and human capacity, inadequate infrastructure, operational obstacles and poor research governance, lack of collaboration, lack of reproducibility of results and prolonged ethical and regulatory approval processes. Furthermore, three themes were synthesized for opportunities: growing infrastructure and resources, improved human capacity and better administrative processes and initiatives for collaboration. Conclusion and recommendations The study found that the identified characteristics/features are of high importance either to hurdle or enable the practice of translating animal research into human trials. The study suggests that there should be adequate infrastructure and finance, human capacity building, good research governance, improved ethical and regulatory approval process, multidisciplinary collaboration, and incentives and recognition for researchers to overcome the identified challenges and allow translating of animal research into human trials to proceed more efficiently.

Although breast Self-Examination is no longer tenable as a standard method to detect early breast cancer, world health organization recommends breast self -examination for raising awareness of women about breast cancer. Secondary prevention through monthly breast self-examination is the best option to tackle the rising incidence of breast cancer. Therefore, the aim of this study was to assess breast self -examination practice and associated factors. This cross-sectional study was conducted from April 23 to May 23, 2018. A total of 421 female workers in Debre Tabor Town public health facilities were included. The study participants were selected using simple random sampling technique from the study population. The collected data were checked for completeness. The data were entered and cleaned using EpiData version 3.1 then exported to SPSS version 20 for analysis. Crude odd ratio and probability value were identified for each independent variable and all independent variables with probability value of less than 0.2 were entered into multivariables logistic regression. Statistically significant associated factors were identified based on probability value (p-value) less than 0.05 and adjusted odd ratio with 95% confidence interval. The mean age of participants was 25.2 (S.D = 4.12) and 137 (32.5%) of the participants had practiced breast self -examination and 64 (15.2%) of them performed it monthly. Family history of breast cancer (adjusted OR = 6.5, CI = 1.54-21.4), Knowledge about breast -self examination (adjusted OR = 5.74, CI = 2.3-14.4) and self- efficacy in practicing breast self -examination (adjusted OR = 4.7, CI = 1.84-12.11) were significantly associated with breast self -examination practice. The study showed that the prevalence of breast self-examination was low. Family history of breast cancer, knowledge about breast self -examination and self- efficacy in practicing breast self- examination did have statistically significant association with breast self-examination practice.

Globally, the burden of hepatitis B virus (HBV) infection is a serious health problem for women that could be transmitted to their newborn infants. Screening and treating at an early stage help prevent the spread of this infection and its complications. Therefore, the study aimed to assess the seroprevalence and associated risk factors of HBV infection among mothers attending public health facilities in Bahir Dar, Northwest Ethiopia. A cross-sectional study was conducted in a total of 325 mothers attending Bahir Dar city public health facilities from December 2023 to June 2024. Data on sociodemographic characteristics and possible risk factors were collected using a structured questionnaire, and serum samples were screened for hepatitis B surface antigen (HBsAg) using sandwich enzyme-linked immunosorbent assays (ELISA). Data were entered and analyzed using SPSS version 23 software. Logistic regression was used to check the association between variables with an odds ratio (OR) at 95% confidence intervals (CI). P-value ≤ 0.05 was considered statistically significant. The overall seroprevalence of HBV infection was 3.4% (95% CI; 1.0–5.0). The history of sexually transmitted diseases (STDs) (AOR = 7.60; 95% CI: 1.84–31.34, p  = 0.005), history of contact with chronic hepatitis B virus-infected (CHB) family members (AOR = 20.86; 95% CI: 2.48-175.03, p  = 0.005), and female circumcision (AOR = 13.76; 95% CI: 1.63–116.80, p  = 0.016) were significantly associated risk factors with HBV infection. Generally, an intermediate seroprevalence of HBV infection was reported in this study. This showed that HBV infection is still a critical public health concern among mothers in the study area. History of contact with CHB family members, history of STDs, and female circumcision were significantly associated risk factors with HBV infection. These findings call for enhanced public health strategies to effectively reduce HBV infection in mothers.

In Ethiopia, visceral leishmaniasis (VL) is caused by Leishmania donovani. The estimated country-wide incidence of VL in Ethiopia is 3700-7400 cases/year. The balance between anthroponotic and zoonotic transmission is still unknown even though most authors believe that visceral leishmaniasis in East Africa is anthroponotic. Asymptomatic leishmania infections occur more frequently than clinically apparent visceral leishmaniasis cases. The aim of this study was to determine the prevalence of asymptomatic VL infection and assess the degree of exposure among residents in Raya Azebo Woreda villages where cases of VL were recently reported. A community based cross-sectional survey was conducted in 2013 between 1st of May and 25th of July. A total of 1099 individuals living in 314 households were included in the study. Socio-demographic and clinical data were collected from each of the participants and venous blood was also collected for the detection of antibodies to visceral leishmaniasis using Direct Agglutination Test. Leishmanin skin test was performed to detect the exposure to the parasite. Data was entered into excel and exported to SPSS version 17 for statistical analysis. Chi-square and the corresponding p-values were used to determine the statistical significance of the proportions/ratios obtained from the cross tabulated data. A p-value < 0.05 was considered statistically significant. A total of 1099 study subjects comprising 401 males and 698 females were included in the study. The overall positive leishmanian skin test and sero-prevalence rates respectively were 9.08% and 0.87%. The difference in LST positivity by age group and sero-prevalence by sex were statistically significant (P <0.01 and P<0.05 respectively). Out of the 9 sero-positive individuals, 7 had no history of travel to visceral leishmaniasis endemic areas out of Raya Azebo. In general our results suggest occurrence of VL in the study area is, very low. Our survey also indicates that due to the low incidence of the disease, and lack of awareness, some patients remain under diagnosed.

Currently, national governments of onchocerciasis endemic African countries are working towards the elimination of the disease using mass drug administration (MDA) with ivermectin as a primary strategy. Attainment of this goal requires implementation of prolonged high MDA coverage in all endemic areas, and vigilant monitoring and evaluation of the program. This study was thus conducted with the purpose of i) providing estimate of ivermectin coverage, ii) validating the MDA coverage reported through community drug distributors (CDDs), iii) determining the factors associated with MDA coverage, and iv) estimating the difference between MDA program reach and survey coverage rates following MDA campaign carried out in May 2017 in Asosa and Yeki districts in Ethiopia. A community-based cross-sectional study was conducted among 2,824 study participants in Asosa and Yeki districts. A total of 50 kebeles (smallest administrative units) were randomly selected from the two districts. A systematic sampling was employed to select study households from the 50 kebeles . Then, a household member was randomly selected for the interview. Univariate and multivariate logistic regression analysis were used to determine the odds ratio and to observe the associations between the MDA survey coverage and the variables used. Eighty-seven percent (2458/2824) of the respondents from both districts responded that they were offered ivermectin during the May 2017 MDA campaign. At the district level, 1182 individuals from Yeki and 1276 from Asosa, received the drug, that indicate 88.5% and 85.8% MDA program reach in Yeki and Assosa districts, respectively. Whereas, a total of 366 individuals were not offered ivermectin in both study districts. Of these, 47(12.8%), 143(39.1%), and 176(48.1%) did not receive the drug because of program implementation-related reasons, ineligibility criteria, and personal issues, respectively. Of the 1488 and 1336 respondents in Asosa and Yeki, 1272 and 1182 participants took the drug, resulting in survey coverage rate of 85.5% (95% CI: 83.6–87.2%) and 88.5% (95% CI: 86.7–90.1%), respectively. Multivariable logistic regression analysis revealed significantly low survey coverage rate in females (AOR = 0.5, 95%CI: 0.3–0.6; p<0.001) and in those whose age ranges between 15–24 years (AOR = 0.5, 95%CI: 0.3–0.8; p = 0.007) and 25–34 years (AOR = 0.5, 95%CI: 0.3–0.9; p = 0.021) in Asosa. The researchers believe that the current study generated operational evidence on MDA program reach and coverage rates in two study districts in Ethiopia. The survey coverages were lower than the recommended 90% minimum threshold for success. Only Yeki district reached the 90% threshold survey coverage. Both districts had reported higher coverages than the survey estimates (even outside the 95% CI), thus, were not validated. The majority (60.9%) of the reasons for not receiving the drug were related to program implementation and recipients`personal issues. Efforts must therefore be directed to enhance MDA coverage in future rounds via proper MDA planning and implementation, such as allocating adequate time to the MDA activities, health education, and mobilizing of all segments of the population, including adolescents and the youth. The researchers also recommend such studies to be extended to other MDA programs for other neglected tropical diseases (NTDs).

Background Onchocerciasis (river blindness), caused by the filarial worm species Onchocerca volvulus , is a serious vector-borne neglected tropical disease (NTD) of public health and socioeconomic concern. It is transmitted through the bite of black flies of the genus Simulium , and manifested in dermal and ocular lesions. Ninety-nine percent of the total global risk and burden of onchocerciasis is in Africa. This scoping review examines the key challenges related to the elimination of onchocerciasis by 2020–2025 in Africa, and proposes recommendations to overcome the challenges and accelerate disease elimination. To find relevant articles published in peer-reviewed journals, a search of PubMed and Google Scholar databases was carried out. Main text Rigorous regional interventions carried out to control and eliminate onchocerciasis in the past four decades in Africa have been effective in bringing the disease burden under control; it is currently not a public health problem in most endemic areas. Notably, transmission of the parasite is interrupted in some hyperendemic localities. Recently, there has been a policy shift from control to complete disease elimination by 2020 in selected countries and by 2025 in the majority of endemic African countries. The WHO has published guidelines for stopping mass drug administration (MDA) and verifying the interruption of transmission and elimination of human onchocerciasis. Therefore, countries have revised their plans, established a goal of disease elimination in line with an evidence based decision to stop MDA and verify elimination, and incorporated it into their NTDs national master plans. Nevertheless, challenges remain pertaining to the elimination of onchocerciasis in Africa. The challenge we review in this paper are: incomplete elimination mapping of all transmission zones, co-endemicity of onchocerciasis and loiasis, possible emergence of ivermectin resistance, uncoordinated cross-border elimination efforts, conflict and civil unrest, suboptimal program implementation, and technical and financial challenges. This paper also proposes recommendations to overcome the challenges and accelerate disease elimination. These are: a need for complete disease elimination mapping, a need for collaborative elimination activities between national programs, a need for a different drug distribution approach in conflict-affected areas, a need for routine monitoring and evaluation of MDA programs, a need for implementing alternative treatment strategies (ATSs) in areas with elimination anticipated beyond 2025, and a need for strong partnerships and continued funding. Conclusions National programs need to regularly monitor and evaluate the performance and progress of their interventions, while envisaging the complete elimination of onchocerciasis from their territory. Factors hindering the targeted goal of interruption of parasite transmission need to be identified and remedial actions should be taken. If possible and appropriate, ATSs need to be implemented to accelerate disease elimination by 2025.

Community-directed treatment with ivermectin (CDTi) is the primary strategy employed to control and eliminate human onchocerciasis in Ethiopia. After long-term mass distribution for onchocerciasis, ivermectin is expected to have additional benefits beyond the envisioned targets by reducing the burden of other co-endemic parasitic infections as to STHs. To date, studies focused on the collateral impact of CDTi on STH in Ethiopia are scanty. Two community-based cross-sectional surveys (baseline in 1997 and post-CDTi in 2017) were conducted to evaluate the impact of long-term CDTi employed to control and eliminate onchocerciasis on the burden of STH infections in Yeki district of southwest Ethiopia. Stool samples were collected and examined using Ritchie`s concentration and Kato-Katz techniques in the baseline and current study, respectively. Overall, 188(38.3%, 95% Confidence interval (CI) 34.1–42.7%) individuals were positive at least for any of the STH species from 491 study participants in the post-CDTi. The prevalence of A . lumbricoides , hookworms, and T . trichiura was 11.2% (95% CI 8.7–14.3%), 16.3% (95% CI 13.3–19.8%), and 29.9% (95% CI 26.1–34.1%), respectively. Individuals aged 5–9 years had a significantly higher prevalence of A . lumbricoides (Adjusted odds ratio (AOR) 6.5, 95% CI 1.7–25.4), T . trichuria (AOR 8, 95% CI 2.6–25.1), and any STH infection (AOR 5, 95% CI 1.7–14.7) than those of ≥ 51 years. Also, significantly higher prevalences of T . trichuria infection were observed in individuals aged 10–14 years (AOR 4.1, 95% CI 1.7–9.9), 15–20 years (AOR 3.1, 95% CI 1.2–8.1), 21–30 years (AOR 2.4, 95% CI 1.1–5.5), and 31–40 years (AOR 3.2, 95% CI 1.3–7.5) compared with those of ≥ 51 years. The prevalence of A . lumbricoides was significantly higher in males (AOR 0.5, 95% CI 0.3–0.9). Of the 491 study participants, only data from 400 individuals who had not been involved in a mass drug administration (MDA) with other STH anthelmintics were considered in the comparative analysis. Before CDTi, the prevalence of A . lumbricoides , T . trichiura , hookworm, and any STH infection was 47.1% (95% CI 41.6–52.7%), 3.3% (95% CI 1.8–5.9%), 37.9% (95% CI 32.7–43.5%), and 58.8% (95% CI 53.2–64.1%), respectively. Long-term CDTi considerably reduced the prevalences of A . lumbricoides and hookworm by 76.2% and 56.9%, respectively (p < 0.001). Nonetheless, CDTi did not affect the prevalence of T . trichiura infection and, in contrast, it was significantly higher in the current study (P < 0.001). Overall post-CDTi prevalence of any STH infection was considerably lower than reported in the baseline (p < 0.001). It is evidenced that long-term CDTi for onchocerciasis control and elimination had additional benefits by reducing the prevalence of STH infections specifically of A . lumbricoides and hookworm, but had no impact on infections with T . trichuria . Our finding of additional health benefits of large-scale ivermectin administration taking it will aid to increase positive engagement and sustain participation of communities during MDA campaigns, and strengthen governmental and non-governmental organizations (NGOs) support for the undergoing national onchocerciasis elimination program.