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Over 2 billion people worldwide are impacted by the global dilemma of access to clean and safe drinking water. The problem is most acute in low-income nations, where many people still use unimproved water sources such as exposed wells and surface water. Public health systems are heavily burdened by these sources since they are closely associated with the spread of waterborne illnesses. As a result, there are still many people who suffer from water-related health problems, especially in underdeveloped nations where access to healthcare is limited and sanitation is often inadequate. However, the conventional analytical techniques employed in these investigations frequently fall short of capturing the intricate relationships among many variables, which could restrict the capacity to forecast future patterns. This study aimed to provide more accurate predictions and data-driven insights that can inform policy-making, resource allocation, and interventions to address Ethiopia’s water crisis. The Ethiopia Demographic and Health Survey (EDHS-2019), which offers thorough data on socioeconomic, demographic, and water access determinants, was the data source for this study. The following six machine-learning models were used: k-nearest Neighbors, Random Forest, Support Vector Machines, Gradient Boosting Machines, and Artificial Neural Networks. To enhance model performance and prevent overfitting, Hyperparameter adjustment was accomplished via random search and 7-fold cross-validation. The model’s performance was evaluated using the standard classification metrics (accuracy, precision, recall, F1-score, and AUC). To examine the significance of features in tree-based models, permutation importance and SHAP values were utilized. In important measures such as AUC (0.8915), F1 Score (0.919), sensitivity (0.879), and specificity (0.967), the Random Forest model fared better than the other models. “Community-level poverty” was the most important predictor, followed by “household wealth index” and “age of household head,” according to feature importance analysis. Geographic differences in access to better water sources were found through spatial analysis, with rural areas being the most impacted. Using machine-learning algorithms, specifically Random Forest, has yielded significant insights into the factors influencing Ethiopia’s unimproved water supply. The results highlight the necessity of focused interventions in areas with high rates of poverty and insufficient infrastructure. These data-driven insights can help decision-makers better solve Ethiopia’s water crisis.

Sleep disturbance poses a significant health concern for older adults, as it is associated with overall health decline. Poor sleep quality increases the risk of chronic diseases, depression, anxiety, and diminished quality of life. Therefore, this study aimed to assess the prevalence of poor sleep quality and its associated factors among older adults living in the community of Gondar town, Northwest Ethiopia, in 2023. A community-based cross-sectional study was conducted in Gondar town from February 20 to April 30, 2023. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated tool. Data were coded using Epi data version 3.0 and analyzed in STATA 14. Associated factors were examined using univariable and multivariable logistic regression models. In this study a total of 845 study participants were involved with 99.5% response rate. The prevalence of poor sleep quality among elderly community was 54.6% with 95% CI (51- 58%). Age of ≥ 75 years [AOR = 3.88, 95% CI: 2.11–7.10], poor social support [AOR = 3.7, 95% CI: 2.35–5.81], physically inactive [AOR = 4.42, 95% CI: 3.11–6.26], chronic disease [AOR = 3.7, 95% CI: 2.45–5.55] and depression [AOR = 2.01, 95% (CI: 1.42–2.83)] were factors associated with poor sleep quality. 55% of community-dwelling older adults in Gondar town experience poor sleep quality, particularly those with depression, advanced age, chronic diseases, and poor social support. To address this, enhancing community support and social networking activities is recommended. Engaging in physical activities has shown to significantly improve sleep quality. Healthcare providers should conduct regular screenings for sleep quality issues and provide education about sleep hygiene to enhance sleep quality among older adults. Future researchers are encouraged to use Longitudinal studies to explore the impact of poor sleep quality in older communities.

United Nations is standing for Sustainable Development Goal (SDG) 6 sets the agenda to address worldwide inequality in accessing safe water and improved sanitation facilities for all by 2030. However, governments in Africa seem unable to address the issue water and of sanitation facilities, since there are problems like increasing costs of sustaining existing water sources and the requirement to deliver new facilities ahead of time. Hence, this study aimed to investigate unimproved water sources and sanitation facilities geographical variation in Ethiopia using EDHS 2019 datasets. This study was community-based cross-sectional based on nationally representative data (EMDHS 2019) to identify the demographic variability of unimproved water sources and sanitation facilities in Ethiopia. STATA 14, ArcGIS 10.7, and Kuldorff’s SaTScan 10.1 software were used in data analysis. Weighted by sampling weight was performed to do a trustworthy statistical analysis. Based on the dataset EMDHS 2019 Ethiopia access in both unimproved water sources was geographically clustered in Ethiopia. The finding revealed that, there were a significant spatial variation of unimproved water sources and sanitation facilities in Ethiopia. Hot and cold spot analysis revealed that there were parts of Ethiopia with higher levels of unimproved water sources and sanitation facilities coverage than other parts of the country. The SaTScan analysis of unimproved water sources indicated that the primary cluster was found southeast part of Ethiopia. The SaTScan analysis of unimproved sanitation facilities indicated that the primary cluster window was found in Benishangul Gumuz and the western part of Ethiopia. This study contribute to the understanding of the status of drinking water source and sanitation facilities based on recent EHDS data, which can inform policymakers in designing effective strategies that address specific regional challenges. This finding confirmed the previous EDHS 2016 that revealed spatial variation of unimproved water sources and sanitation facilities in the country. Findings implies that the persistence of water sources and sanitation facilities inequality continue in country. Hence, the result recommends responsible stakeholders working water source and sanitation facilities to guarantee Sustainable Development Goal 6 in Ethiopia. In addition to providing insight into Ethiopia’s water and sanitation facilities situation, this study highlights important areas for development that can be applied to other nations dealing with comparable problems, especially those in Sub-Saharan Africa.

Tuberculosis (TB) remains a significant public health concern, particularly in low-resource settings. The treatment outcome is a crucial indicator of the effectiveness of TB treatment programs. Assessing the current treatment outcome and its associated factors is essential for improving patient care and reducing the spread of TB. Therefore, this study aimed to assess TB treatment outcomes and their associated factors among TB patients who received treatment at public healthcare facilities in Motta Town, Northwest Ethiopia. A facility-based retrospective cross-sectional study design was employed in two TB treatment centers in Motta town from January 2017 to December 2021. The study participants were all patients diagnosed with TB who received treatment. A p -value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance. A total of 362 TB patients were included in the study. The overall treatment success rate was 88.4% (95% CI 85.1, 91.7). Male gender (AOR = 2.40, 95% CI 1.16, 4.98), normal nutritional status (AOR = 3.11, 95% CI 1.33, 7.25), HIV negative status (AOR = 3.35, 95% CI 1.31, 8.60), and non-presumptive drug resistance to TB (AOR = 3.72, 95% CI 1.74, 7.98) were significantly associated with successful TB treatment outcomes ( p  < 0.05). In the current study, nine out of ten study participants had successful TB treatment outcome rates. Male gender, normal nutritional status, non-presumed drug resistance to TB, and HIV-negative status were significantly associated with successful TB treatment outcomes. By taking risk factors associated with poor treatment outcomes like those found in this study into account, patient management and treatment can be optimized. Sufficient TB control measures for populations are imperative and could significantly reduce the nation's total TB burden.

Common mental disorders (CMDs) are a wide term that includes disorders like depression, anxiety, and somatic manifestations. Chronic kidney disease (CKD) patients are at high risk of developing a common mental disorders, which leads to a lower survival rate, poor clinical outcome, longer hospitalization, increased health-care utilization, difficulty adhering to medications, an increased risk of initiation of dialysis, poor quality of life, and an increased risk of mortality. However, there is limited study done related to common mental disorders and associated factors among chronic kidney disease patients in Ethiopia. This study aimed to assess the prevalence of common mental disorders and associated factors among chronic kidney disease patients attending referral hospitals in Amhara Regional State. An institution-based cross-sectional study design was conducted at the University of Gondar Comprehensive Specialized and Felege Hiwot Referral Hospitals from January to April 2020. The study participants were selected using systematic random sampling techniques. Common mental disorders were assessed using the Self-Reporting Questionnaire-Falk Institute (SRQ-F) tool. Data were entered into Epi Data Version 3.0 then exported into STATA 14 for analysis. Both bivariable and multi-variable binary logistic regressions were done to identify factors associated with common mental disorders. In multivariable logistic regression analysis, variables with a p -value of ≤ 0.05 were declared as a statistically associated with common mental disorders. In this study, 424 CKD patients were included, with a response rate of 100%. Among screened CKD patients, 40.8% was positive for common mental disorders, with a 95% CI (36–45%). Independent predictors of common mental disorders among CKD patients were poor social support [(AOR 3.1, 95% CI (1.67–5.77)], family history of mental disorders, [AOR 3.6, 95% CI (1.12–11.8)], comorbidity [AOR 1.7, 95% CI (1.03–2.78)], being female [AOR 2.69, 95% CI (1.72–4.20)], and duration of CKD (AOR 3.5; 95% CI (2.28–5.54). Two out of five CKD patients screened for CMDs were found to be positive. Common mental disorders were more common among CKD patients with poor social support, a family history of mental disorders, comorbidity, being female, and the duration of CKD. Therefore, screening CKD patients for common mental disorders is recommended.

Chronic kidney disease (CKD) is a major public health concern worldwide, especially among people with diabetes mellitus (DM), which is the main cause of morbidity and mortality. In Ethiopia, the burden of CKD on DM patients is compounded by a variety of socioeconomic and healthcare-related issues. Despite the increased risk of developing CKD in DM patients, comprehensive studies on the prevalence and associated factors of CKD in this population are rare. To address this gap, this study aimed to estimate the pooled prevalence and associated factors of CKD among DM patients in Ethiopia. This systematic review and meta-analysis was carried out through an investigation of published studies in Ethiopia. A systematic literature search was performed using electronic databases such as PubMed, EMBASE, Scopus, and Google Scholar. A random-effects model was used to estimate the pooled prevalence of CKD and the odds ratio (OR) with a 95% confidence interval. The I² statistic was used to measure heterogeneity among the included studies, with a p-value < 0.05 indicating statistical significance. Publication bias was evaluated via a funnel plot and Egger's test, and subgroup, sensitivity, and meta-regression analyses were also performed. Out of the 19 included studies, the estimated pooled prevalence of CKD among DM patients in Ethiopia was 18% (95% CI 14.0, 22.0). In addition, age ≥ 60 years (OR = 3.07, 95% CI: 2.44, 3.87), rural residence (OR = 1.40, 95% CI: 1.01, 1.95), duration of DM > 5 years (OR = 2.47, 95% CI: 1.62, 3.77), proteinuria (OR = 3.30, 95% CI: 2.23, 4.88), HDL-C level < 40 mg/dL (OR = 3.08, 95% CI: 2.28, 4.16), and family history of CKD (OR = 2.58, 95% CI: 1.62, 4.09) were factors significantly associated with the prevalence of CKD among DM patients. The prevalence of CKD in Ethiopia was high, affecting nearly two in five individuals with diabetes. In addition, factors such as older age, rural residence, longer DM duration, positive proteinuria, lower HDL-C levels, and a family history of CKD were significantly associated with CKD prevalence. Therefore, targeted public health interventions, such as screening, education, and awareness programs, are highly recommended to mitigate this problem. PROSPERO (2024: CRD42024576958).

Introduction Sexual dysfunction is characterized by difficulties that interfere with achieving satisfying sexual activity, affecting desire, arousal, orgasm, and overall satisfaction. A recent study in Ethiopia identified heart failure as one of the most common cardiovascular diseases in the country. Sexual dysfunction significantly affects the quality of life in individuals with heart failure, yet it often goes underdiagnosed and underreported. Understanding the prevalence of sexual dysfunction and the factors influencing sexuality in these patients is essential. Therefore, the primary objective of this study was to determine the prevalence of sexual dysfunction among patients with heart failure in Gondar City and the northern and western zones of Gondar public hospitals. Method This study included 423 participants diagnosed with heart failure, selected through simple random sampling from January 3 to February 30, 2024. Data were collected using an interviewer-administered questionnaire covering socio-demographic, behavioral, and clinical information. Sexual dysfunction in males was assessed using the International Index of Erectile Function-5, while the Female Sexual Function Index-6 was used for females. Data were entered into Epidata version 3.6 and later exported to SPSS version 25 for analysis. Binary logistic regression was employed to identify factors associated with sexual dysfunction, with a significance level set at p ≤ 0.05. Result A total of 423 heart failure patients participated in the study, achieving a 100% response rate. The results indicated a significant prevalence of sexual dysfunction, affecting 57.92% of participants (95% CI 54.76%–63.76%). Female participants reported a higher prevalence of sexual dysfunction, with 63% of the 138 female heart failure patients affected. Among the 285 male participants, 55.4% (158 patients) were identified as having erectile dysfunction. Multivariable logistic regression analysis revealed that factors such as body mass index, age, insufficient physical activity, and smoking were significantly associated with sexual dysfunction in females. In males, erectile dysfunction was significantly linked to diabetes mellitus, heart failure classification, age, and insufficient physical activity. Conclusion and recommendation This study identified a high prevalence of sexual dysfunction, with females being more affected than males. Additionally, the research identified several factors influencing sexual dysfunction among patients with heart failure, including BMI, age, cigarette smoking, diabetes mellitus, and the classification of heart failure. The study recommends that healthcare providers and other stakeholders take proactive measures to alleviate the burden of sexual dysfunction in patients with heart failure. Strategies should focus on controlling the severity of heart failure symptoms, effectively managing comorbidities, and addressing factors such as body weight, psychological well-being, and behavioral patterns. By targeting these areas, healthcare providers can work toward minimizing the risk of sexual dysfunction and improving the overall quality of life for patients with heart failure.

Counterfeit and substandard drug products pose significant public health challenges, affecting millions of people worldwide in both developed and developing countries. These products compromise healthcare systems, reduce treatment efficacy, and endanger patient safety. Therefore, this study assessed strategies to reduce the circulation of counterfeit and substandard drugs, identify potential factors leading to their circulation and evaluate the role of community pharmacy professionals in combating counterfeit and substandard drugs in Ethiopia. A cross-sectional multi-center survey of community pharmacy professionals in the Amhara region of Ethiopia was conducted over four months, from May to August 2024. Data were collected using a self-administered, pre-tested questionnaire. Descriptive statistics were used to summarize the different variables and are presented in tables and figures. Among the 276 community pharmacy professionals approached, 255 completed the questionnaire, resulting in a response rate of 92.4%. Approximately, 90% of the participants agreed that weak enforcement of drug laws and legislation contributes to the circulation of counterfeit and substandard drugs in the country. As a strategy, 95.7% of the participants believed that strict enforcement and proper implementation of drug laws by pharmacy regulatory agencies can help control counterfeit and substandard drugs. Approximately 85.7% of the participants agreed that educating the public about the risks of counterfeit and substandard drugs and protective strategies is crucial in reducing their circulation. Almost all participants (98%) acknowledged the pharmacist’s responsibility to purchase medicines from certified drug sources and distributors. and a similar portion of the participants (96.8%) agreed that pharmacists should report counterfeit and substandard drugs to the regulatory officials. The current study revealed that strict enforcement of drug laws, development of the local pharmaceutical industry, educating the public about counterfeit and substandard drugs, and monitoring online sales of drugs can significantly contribute to combating counterfeit and substandard drugs.

Cervical cancer is the fourth most prevalent type of cancer in women globally. Early detection and treatment of precancerous cervical lesions and human papillomavirus (HPV) infection are strongly advised to decrease the incidence of cervical cancer and death. Cervical cancer is a major public health concern in low- and middle-income nations, where screening and treatment options are constrained. Thus, the main objective of this umbrella review was to determine the pooled uptake of cervical cancer screening and its determinants in Africa. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol for this umbrella review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with reference number CRD42024518297. We conduct a systematic and comprehensive search by using Google Scholar, PubMed, Scopus, Hinari, and Science Direct, from January 1, 2014, to September 20, 2024. The data were extracted using Microsoft Excel spreadsheet. The methodological quality of the included studies was examined using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The statistical analysis was carried out using STATA version 17, which includes descriptive analysis, forest plots for prevalence, funnel plot, and an Egger test to examine publication bias. A random-effects model was used to determine the pooled effect estimate. Publication bias was checked by using the funnel plot and Egger's tests. This umbrella review included 11 systematic reviews and meta-analysis studies across Africa with a total of 143,327 study participants. The overall prevalence of cervical cancer screening practice in Africa was 20.94% (95% CI: 15.84%-26.04%). Women's level of knowledge (AOR: 3.22, 95% CI: 1.64-6.33), positive attitude toward CCS (AOR: 2.48, 95% CI: 2.18-2.81), perceived vulnerability to cervical cancer (AOR = 3.57, 95% CI: 2.75, 4.63), and history of STIs (AOR = 4.89, 95% CI: 3.14, 7.62) were significantly associated with cervical cancer screening practice. In conclusion, the combined estimate of cervical cancer screening use in Africa remains much lower (20.94%) than the World Health Organization (WHO) recommendations target (70%). It indicates that there is a large gap that requires being addressed in collaboration to reduce the burden of cervical cancer and its morbidity and mortality across the continent. Therefore, healthcare professionals, policymakers, and other stakeholders shall implement effective strategies such as empowering women, improving the knowledge and attitude towards cervical cancer screening, advocacy, and expanding screening programs to all eligible women to increase utilization of cervical cancer screening.