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Currently in Ethiopia, young people's sexual and reproductive health services are limited and there is a growing issue of confidentiality and affordability of these health services. Moreover, the available services provided are not sensitive to the special needs of young people. Therefore, this study was aimed to assess young people's sexual and reproductive health service utilization and its associated factors in Awabel district, Northwest Ethiopia. A community based cross-sectional study was conducted among 781 randomly selected young people using a pre-tested structured questionnaires in Awabel district, Northwest Ethiopia. Data were entered into Epi data version 3.1 and analyzed using SPSS version 16.0 software. The mean age of respondents were 17.80 (+ 2.65) years. About 41% of young people had utilized sexual and reproductive health services. Young people from families of higher family expenditure, lived with mothers, participated in peer education and lived near to a Health Center were more likely to utilize sexual and reproductive health services. Furthermore, those who had a parental discussion on sexual and reproductive health (AOR (95% C.I): 2.23 (1.43, 3.46)) and ever had sexual intercourse (AOR (95% C.I): 1.88 (1.30, 2.71)) were more likely to utilize the service than their counterparts. On the other hand, those young people lived with their father and had a primary level of educational attainment was less likely to utilize the service. Utilization of sexual and reproductive health services is low which needs a great attention where; if not intervened, young people might engage in risky sexual activities. Therefore, it needs a concerted effort from all the concerned bodies to improve their service utilization and thereby reduce the burden of young people's disease and disabilities associated with sexual and reproductive health.

From various Ethiopian government food security strategies, the Productive Safety Net Program (PSNP) is one of the strategies to improve households’ consumption. As a result, the government needs to know the outcome of the program intervention for further decisions in similar poverty reduction strategies. This study examined the impact of Productive Safety Net Program intervention on food security of rural households in rural western Ethiopia. A cross-sectional survey data were gathered from a total of randomly selected 188 beneficiary and non-beneficiary sample households. Key informants interviews and focus group discussions were employed to triangulate household survey results. A Chi-square test was employed to compare the households’ food security status. The propensity score matching method was used to evaluate the impact of a Productive safety net on beneficiary households’ food security status. In this study, the Productive Safety net program has significantly increased households’ calorie intake. The beneficiaries’ households were more food secure than non-beneficiary households by 68% and54% respectively. The mean energy available for the beneficiary and non-beneficiary households is 2488.500 and 2153.394 kcal, respectively. Estimates of the average treatment effect of the treated indicated that a Productive safety net program can impact households food security by 2519.29348 kilocalories, higher in the kernel matching method. This is an encouraging indicator for Programme implementers and funding agents. Therefore, channeling further efforts on this indicator is important for a more pronounced impact of the Programme. Given a certain level of variations of different program impact studies, this study recommends further research with greater scope and at different locations on the impact of PSNP and related Food Security Programs on households’ food security status.

Managing bloodstream infections in resource-constrained regions like Ethiopia is challenging due to scarce blood culture surveillance data. To guide empirical therapy, this study determines the bacterial profiles and antimicrobial resistance patterns among patients with suspected bloodstream infections at the Amhara Public Health Institute. This retrospective study analyzed blood culture records from the Amhara Public Health Institute spanning January 1, 2020, to December 30, 2023. Blood samples were processed using standardized manual culture techniques in accordance with World Health Organization (WHO) protocols. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analysis was conducted using SPSS version 20, employing descriptive statistics and regression models, with statistical significance defined as p < 0.05. True bacterial pathogens were isolated from 50.3% (N = 340) of the 676 patients, with Gram-negative bacteria predominating (61.2%, N = 208) over Gram-positive bacteria (38.8%, N = 132). Notably, ESKAPEE pathogens accounted for 96.5% (N = 328) of all isolates, led by Klebsiella spp. (25.9%, N = 88), Enterococcus spp. (20.9%, N = 71), and S. aureus (15.6%, N = 53). Among Gram-positive isolates, high resistance was observed against oxacillin (74.5%, N = 41), penicillin (72%, N = 36), and vancomycin (51.1%, N = 24). Gram-negative isolates exhibited critical resistance to national frontline therapeutics, including ampicillin (100%, N = 24), ceftriaxone (92.4%, N = 157), and trimethoprim-sulfamethoxazole (89.4%, N = 126). Overall, multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) profiles were detected in 43.8% (N = 149), 30.5% (N = 104) and 5.3% (N = 18) of isolates with similar distributions observed among ESKAPEE strains. Sex and age were the only independent predictors of culture positivity, with female sex reducing bloodstream infection odds by 44% (p = 0.002). Conversely, neonates (≤ 28 days) and young adults (15-24 years) had 4.7 times (p = 0.001) and 9.5-times (p = 0.001) higher odds compared to elderly patients. This study reveals a severe 50.3% (N = 340) bloodstream infection rate dominated by highly resistant Gram-negative and ESKAPEE pathogens, disproportionately affecting males, neonates, and young adults. Combating this threat requires immediate antibiotic stewardship, updated guidelines, and advanced laboratory testing (anaerobic culture, minimum inhibitory concentration, and molecular sequencing) to track and manage resistance.

Lost to follow-up (LTFU), defined as interrupting anti-TB treatment for ≥ 8 consecutive weeks or missing anti-retroviral therapy (ART) appointments for > 90 days, is a barrier to TB/HIV coinfection management. Poor treatment adherence, a driver of multidrug resistance in TB/HIV, poses critical challenges to case management. Overestimating effect sizes when considering mutually exclusive events, like LTFU from ART and anti-TB treatment, can occur if sources of error are not properly accounted for in competing events. However, studies estimating the effect sizes of predictors of time to LTFU using competing risk analysis are scarce. Hence, this study aimed to investigate the predictors of time to LTFU among adults with TB/HIV coinfection. We conducted a multicenter facility-based retrospective follow-up study. We randomly selected 471 TB/HIV coinfected adults. Data were extracted using standardised checklists. The LTFUs from ART and anti-TB treatment were events of interest and competing events, respectively, and others were censored. The data were entered into Epi data and then exported to Stata and Rstudio. Statistical differences were tested by Gray’s test, and the cumulative incidence of each event was estimated by a cumulative incidence function. Bivariable and multivariable competing risk regression models were fitted, and variables with p values < 0.05 were considered significant predictors. Incidence rates of LTFU for ART and TB treatment were 3.90 and 19.17 per 1000 person-months of observation (PMOs), respectively. The predictors of ART LTFU included rural residence (adjusted subdistribution hazard ratio (SDHR): 3.39), WHO stage IV (SDHR: 2.88), haemoglobin < 11 g/dl (SDHR: 3.56), and opportunistic infections (OIs) (SDHR: 3.65). For TB treatment LTFU, significant predictors were rural residence (SDHR: 0.11), divorced (SDHR: 2.81), widowed (SDHR: 5.92), BMI < 18.5 (SDHR: 0.41), ambulatory functional status (SDHR: 2.59), adverse drug effects (SDHR: 2.87), and poor ART adherence (SDHR: 5.72). Considering errors in competing events, ART LTFU was higher among rural dwellers, individuals with advanced disease, nutritional deficits, or adverse drug effects requiring prioritised, multifaceted interventions. Targeted strategies such as intensified monitoring, adherence counselling, nutritional support, proactive management of drug-related side effects, marital instability, OIs and poor ART adherence should be integrated into the existing ART/TB program to mitigate LTFU.

Background Monotonous and less diversified diets are associated with micronutrient deficiency. Evidence on maternal dietary intakes during pregnancy is essential to achieve the 2025 global nutrition target and reduce maternal and child mortalities. This study assessed pregnant women’s dietary diversity and identified factors associated with inadequate dietary diversity in East Gojjam Zone. Methods We conducted a community-based cross-sectional study between April and June 2016. Eight hundred thirty-four pregnant women were randomly sampled. The Women Dietary Diversity Score tool developed by the Food and Agricultural Organization (FAO) and Food and Nutrition Technical Assistance (FANTA) was used. Data were entered into EpiData with double entry verification, and analysis was done using IBM SPSS version 20. Level of significance was set to P  < 0.05 with 95% confidence interval (CI) to identify the independent factors associated with inadequate dietary diversity. Results The mean (±SD) dietary diversity score was 3.68 (±2.10). Inadequate dietary diversity was prevalent in 55% [95% CI (52.3–59.3%)] of pregnant women, or indirectly micronutrient was inadequate in more than half of the pregnant women. Commonly consumed dietary groups were legumes, nuts, and seeds (85.5%) followed by starchy staples (64.7%). Inadequate dietary diversity was higher among non-educated [Adjusted Odds Ratio (AOR) = 7.30, 95% CI (2.35–22.68)] compared to college and above completed women. Wealth index had significant association with dietary diversity, in which women in the poorest [AOR = 8.83, 95% CI, (1.60–48.61)], poorer [AOR = 6.34, 95% CI (1.16–34.65)], poor [AOR = 8.46, 95% CI (1.56–45.70)], and richer [AOR = 6.57, 95% CI (2.16–20.01)] had higher odds of inadequate dietary diversity. Those who had not received dietary counseling had three folds [AOR = 3.31, 95% CI (1.49–7.35)] of inadequate dietary diversity compared to their counterparts. Less likelihood of inadequate dietary diversity was among women with an increased meal frequency [AOR = 0.53, 95% CI (0.38–0.74)]. Conclusion Consumption of less diversified food during pregnancy is common in the study area. Adequacy of micronutrients is insufficient for more than half of the studied pregnant women. We conclude that being non-educated affects pregnant women to depend on less diversified diet. Providing dietary counseling during pregnancy can improve nutritional practice for pregnant women.

Objectives: The objective of this study was to assess the prevalence and the associated factors of family contact screening practice. Methods: An institution-based cross-sectional study was conducted among 403 randomly selected pulmonary tuberculosis index cases from 1st May to 30th June 2020. Data were collected through a face-to-face interviewer-administered questionnaire. Multivariable logistic regression was performed. Results: The prevalence of family contact screening was 55.3%, (CI: 60–50). Having family support for care and treatment (AOR = 2.21, 95% CI: 1.16–4.21), waiting time of less than 60 min (AOR = 2.03, 95% CI: 1.28–3.21), receiving health education on TB prevention and treatment (AOR = 1.86), 95% CI: 1.05–3.29), and having good knowledge about TB prevention (AOR = 2.76, 95% CI: 1.77–4.294) were factors associated with family TB contact screening practice. Conclusion: This study revealed that the prevalence of family contact screening was low as compared to national and global targets. Factors associated with family contact screening practice were: the presence of family support, shorter waiting time, health education offered by healthcare workers, and a good level of knowledge of the index cases.

Antimicrobial resistance is a major public health problem worldwide, particularly in developing countries. The effectiveness of currently available antimicrobial is decreasing due to the increasing prevalence of resistant strains among bacterial isolates. This study aims to determine the antimicrobial resistance profile of bacterial isolates from different clinical specimens at Amhara Public Health Institute. A retrospective analysis was conducted using data extracted from the WHONET 2024 database from July 1, 2022, to December 31, 2024, at the Amhara Public Health Institute bacteriology and mycology reference laboratory. The age range of the patients included in this study was 1-96 years, and the mean age of the patients was 33.44 ± 17.36 years. The data included demographic characteristics of patients, types of bacterial isolates and antimicrobial resistance profiles, which were analyzed using SPSS version 20 statistical software. The descriptive statistics were displayed as percentages and frequencies. The chi-square test was used to determine the prevalence of bacterial isolates from patients by age and sex. P-values below 0.05 were seen as a sign of a statistically significant difference. A total of 1165 specimens were processed, resulting in a culture-positive rate of 41% (478/1165) for bacterial pathogens isolated from clinical specimens. The majority of bacterial isolates were from stool (55%; 263/478), urine (20%; 96/478), wound (12.9%; 62/478), and blood (9.8%; 45/478), respectively. Of these, Gram-negative bacteria accounted for 89.1% (426/478) and Gram-positive bacteria accounted for 10.8% (52/478). The predominant bacterial isolates were Vibrio cholerae 54.6% (261/478), E. coli 16.1% (77/478), Klebsiella spp 6% (29/478), S. aureus 4.6% (22/478) and Enterococcus spp 2.9% (14/478). In this study Proteus spp 67.6% (46/68), A. baumannii 58.4% (31/53), and Klebsiella spp 64.1% (136/212) were identified as the most resistant bacteria to the tested antimicrobial. S. aureus shows resistance to tobramycin 100% (1) and penicillin 100% (17), oxacillin 84.6% (11/13) and tetracycline 63.6% (7/11). Enterococcus spp resistance to vancomycin 85.7% (6/7), penicillin 72.7% (8/11) and ampicillin 62.5% (5/8). In total, 53.1% (254/478) of the bacterial isolates were classified as multidrug-resistant (MDR), with 93.7% (238/ 254) being Gram-negative bacteria. Both Gram-negative and Gram-positive isolates showed high levels of resistance to commonly used antimicrobial. To address the problem of antimicrobial resistance, healthcare providers should focus on responsible antimicrobial prescribing practices based on local antibiogram data.

Ethiopia aims to eradicate peste des petits ruminants (PPR) by 2027 through a risk-based vaccination strategy (RBVS); however, outbreaks continue to occur. This cross-sectional study (January–May 2024) evaluated RBVS performance by assessing flock- and maternal-level antibody immunity, providing field-based evidence to inform PPR control and eradication efforts. A total of 594 serum samples were collected using simple random sampling to assess flock ( n  = 508) and maternal ( n  = 86) antibody immunity. All samples were tested for PPRV antibodies using a competitive enzyme-linked immunosorbent assay (c-ELISA). Overall individual animal-level antibody immunity was 65.35% (332/508), while at the flock level only 22.27% of flocks (6/22) had ≥ 80% of animals with detectable antibodies. Multivariable logistic regression showed significant differences in immune status by age group ( p  < 0.05). Adult (284/428, 66.36%) and older (26/33, 78.79%) small ruminants were approximately three and four times more likely to be seropositive than young animals (52.21%), respectively. Significant district-level variation was also observed: animals in Basona-werena (116/146, 79.45%) were three times more likely to be seropositive than those in Menz-mama (88/155, 56.77%). Overall maternal antibody immunity in kids and lambs was 52.3%, with 61.29% (95% CI: 42.19–78.15) in kids and 47.27% (95% CI: 33.65–61.20) in lambs. This study demonstrates insufficient maternal and flock-level antibody immunity against PPRV in vaccinated small ruminants, with levels below the recommended 80% threshold. To improve coverage, vaccination efforts should prioritize young animals, districts with low antibody levels, and areas with poor past performance. Strengthening surveillance, refining vaccination strategies, enhancing sero-monitoring, and ensuring efficient vaccine distribution are essential for effective PPR control and eventual eradication.

Background Diabetic Ketoacidosis (DKA) is a critical and potentially fatal complication predominantly seen in individuals diagnosed with Type 1 Diabetes Mellitus (T1DM), though it may also arise in those with Type 2 Diabetes Mellitus (T2DM) under specific circumstances. Although DKA is preventable through effective diabetes management strategies, the consequences can be severe if the condition is not addressed promptly. The timely recognition of DKA, coupled with suitable medical treatment, is essential to enhance patient outcomes and mitigate the risk of enduring complications related to this condition. The objective of this research was to identify the risk factors of DKA in diabetic patients receiving care at public hospitals in the East Gojjam Zone of Northwestern Ethiopia. Methods An unmatched case-control study was carried out in selected public hospitals located in the East Gojjam Zone between April 10 and July 30, 2023. Five public hospitals were randomly selected, and a systematic random sampling technique was employed to recruit 408 study participants. Logistic regression analysis was performed to identify variables significantly associated with the outcomes, using a significance level of P  < 0.05 and a 95% confidence interval. Results The study included 102 cases and 306 controls. Several key risk factors for DKA were identified, including the absence of regular follow-up [AOR = 2.21, 95% CI (1.31–3.71)], not being a member of health insurance [AOR = 3.30, 95% CI (1.75–6.24)], distance from a health facility greater than 5 km [AOR = 1.85, 95% CI (1.09–3.14)], infection [AOR = 2.15, 95% CI (1.12–3.89)], and reduction in insulin dosage [AOR = 2.13, 95% CI (1.19–3.83)]. Conclusions The findings declared that lack of regular follow-up, living more than five kilometers from a healthcare facility, reducing insulin doses without adequate medical guidance, lack of community-based health insurance, and the presence of infections significantly increase the likelihood of DKA. Therefore, healthcare providers should intervene on the identified risk factors for DKA to prevent the occurrence of DKA.

Introduction: Ventilator-associated pneumonia refers to pneumonia that happens at least 48 hours after endotracheal intubation. It is associated with high economic costs, longer attributable lengths of stay in the hospital, and high mortality. Therefore, this study aims to determine the incidence and predictors of ventilator-associated pneumonia among adult intensive care unit admitted patients at Bahir Dar Specialized Hospitals. Methods: A retrospective follow-up study was conducted among 312 adult intensive care unit admitted patients. A data extraction checklist was used to collect the data. The collected data were coded, cleaned, and entered into EpiData version 3.1 and exported to SPSS version 22 and STATA version 14 for analysis. Descriptive analysis was done by using tables, text and percentages. Bivariable and multivariable log binomial analyses were conducted to identify predictors of ventilator-associated pneumonia. Variables having p-value <0.05 were considered statistically significant. Results: The study found that 27.9% (95% CI: 23%-33%) of patients developed ventilator-associated pneumonia and the incidence rate of VAP was 45.7 per 1000 ventilator days. Patient's stay more than or equal to 14 days (ARR: 13, 95% CI: 9.3-31) and 7-13 days on MV (ARR: 7.2, 95% CI: 6.2-11), blood transfusion (ARR: 2.8, 95% CI: 1.1-6.9), low GCS (ARR: 2.5, 95% CI: 1.3-5.1), use of corticosteroid (ARR: 2.1, 95% CI: 1.1-4.1), and supine head position (ARR: 8.1, 95% CI: 1.7-40 (were identified as independent predictors of ventilator associated pneumonia. Conclusion: Nearly one-fourth of the participants developed ventilator-associated pneumonia. Duration of ventilation, blood transfusion, corticosteroid use, supine head position, and low Glasgow coma scale were significant predictors of ventilator-associated pneumonia. Keywords: ventilator-associated pneumonia, predictors, incidence, intensive-care unit, adult patients, Ethiopia