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Small-scale urban agriculture is associated with positive health and environmental outcomes. Previous studies examined factors that drive people to grow foods in urban areas mainly drawing on qualitative data. This research investigates quantitatively what determines consumer preferences for growing foods in community gardens, informing efforts to upscale urban agriculture. We conducted choice experiments in North America and performed latent class analysis of contextual and intrapsychic factors affecting consumers’ preferences for growing foods in cities. Results show that providing tools and guidance are the most important contextual factors affecting community garden participation. The preferences of proponents of growing foods are explained by their high subjective knowledge about growing foods and reasons tied to the benefits of participating in community gardening. Opponents of growing foods at community gardens are characterized by low knowledge. The findings can be used to design policies that promote sustainable food systems in urban areas.

Background Globally, antimicrobial resistance (AMR) is a complex public problem, which is mainly fuelled by inappropriate use of antimicrobials. Rational use of antimicrobials is the main strategy for the prevention of AMR, which can be achieved by changing the prescribers’ behavior and knowledge. Hence, this study aimed to assess knowledge and attitude of paramedical students regarding antimicrobial resistance, which helps to rationalize the use of antimicrobials. Methods An institutional based cross-sectional study was performed on 323 graduates paramedical students at the University of Gondar, Ethiopia. Participants were invited to complete a self-reported structured questionnaire on hard copy. The data were summarized using summary statistics such as the median. Furthermore, Kruskal Wallis test, at the level of significance of 0.05, was conducted to compare group difference. Results Among 360 eligible paramedical students, 323 (90%) of them participated and most of them were males 202 (62.5%). Nearly 96% of the participants perceived that antimicrobial resistance is a catastrophic and preventable public problem but about half of the participants (55%) had a poor level of knowledge. It was also found that there was a statistically significant knowledge and attitude difference across the department ( p -value< 0.0001) and ( p  = 0.002), respectively. Furthermore, those participants who had a good level of knowledge had greater attitude rank as compared to those who had a moderate and poor level of knowledge ( p -value< 0.0001). Conclusion Majority of the participants viewed antimicrobial resistance as a preventable public problem if appropriate strategies are formulated. Nonetheless, most of them had a poor knowledge regarding antimicrobial resistance, and their knowledge and attitude significantly vary across their field of study. This result implicates that improving the students’ level of knowledge about antimicrobial resistance might be an approach to flourish their attitude and to rationalize their antimicrobial use.

PurposeThe main purpose of this study is to examine the impact of different dimensions of institutional quality indices on the economic growth of Sub-Saharan African (SSA) countries.Design/methodology/approachThe study uses a panel data set of 31 SSA countries from 1991 to 2015 and employs a two-step system-GMM (Generalized Method of Moments) estimation technique.FindingsThe study's empirical results indicate that investment-promoting and democratic and regulatory institutions have a significant positive effect on economic growth; however, once these institutions are taken into account, conflict-preventing institutions do not have a significant impact on growth.Practical implicationsThe study's findings suggest that countries in the region should continue their institutional reforms to enhance the region's economic growth. Specifically, institutions promoting investment, democracy and regulatory quality are crucial.Originality/valueUnlike previous studies that use either composite measures of institutions or a single intuitional indicator in isolation, the present study has employed principal component analysis (PCA) to extract fewer institutional indicators from multivariate institutional indices. Thus, this paper provides important insights into the distinct role of different clusters of institutions in economic growth.

Background The coronavirus disease 2019 (COVID-19) has emerged as a global health and economic security threat with staggering cumulative incidence worldwide. Given the severity of projections, hospitals across the globe are creating additional critical care surge capacity and limiting patient routine access to care for other diseases like tuberculosis (TB). The outbreak fuels panic in sub-Saharan Africa where the healthcare system is fragile in withstanding the disease. Here, we looked over the COVID-19 containment measures in Ethiopia in context from reliable sources and put forth recommendations that leverage the health system response to COVID-19 and TB. Main text Ethiopia shares a major proportion of the global burden of infectious diseases, while the patterns of COVID-19 are still at an earlier stage of the epidemiology curve. The Ethiopian government exerted tremendous efforts to curb the disease. It limited public gatherings, ordered school closures, directed high-risk civil servants to work from home, and closed borders. It suspended flights to 120 countries and restricted mass transports. It declared a five-month national state of emergency and granted a pardon for 20 402 prisoners. It officially postponed parliamentary and presidential elections. It launched the ‘PM Abiy-Jack Ma initiative’, which supports African countries with COVID-19 diagnostics and infection prevention and control commodities. It expanded its COVID-19 testing capacity to 38 countrywide laboratories. Many institutions are made available to provide clinical care and quarantine. However, the outbreak still has the potential for greater loss of life in Ethiopia if the community is unable to shape the regular behavioral and sociocultural norms that would facilitate the spread of the disease. The government needs to keep cautious that irregular migrants would fuel the disease. A robust testing capacity is needed to figure out the actual status of the disease. The pandemic has reduced TB care and research activities significantly and these need due attention. Conclusions Ethiopia took several steps to detect, manage, and control COVID-19. More efforts are needed to increase testing capacity and bring about behavioral changes in the community. The country needs to put in place alternative options to mitigate interruptions of essential healthcare services and scientific researches of significant impact.

Background Fertility is the element of population dynamics that has a vital contribution toward changing population size and structure over time. The global population showed a major increment from time to time due to fertility. This increment was higher in south Asia and sub-Saharan Africa including Ethiopia. So this study targeted the factors affecting fertility among married women in Ethiopia through the framework of multilevel count regression analysis using the 2016 Ethiopian Demographic and Health Survey data. Methods Secondary data set on the birth records were obtained from the 2016 Ethiopia Demographic and Health Survey. The survey was a population-based cross-sectional study with a two-stage stratified cluster sampling design, where stratification was achieved by separating every region into urban and rural areas except the Addis Ababa region because it is entirely urban. A two-level negative binomial regression model was fitted to spot out the determinants of fertility among married women in Ethiopia. Results Among the random sample of 6141 women in the country, 27,150 births were recorded based on the 2016 Ethiopian Demographic and Health Survey report. The histograms showed that the data has a positively skewed distribution not extremely picked at the beginning. Findings from the study revealed that the contraception method used, residence, educational level of women, women’s age at first birth, and proceeding birth interval were the major predictors of fertility among married women in Ethiopia. Moreover, the estimates from the random effect result revealed that there is more fertility variation between the enumeration areas than within the enumeration areas. Conclusion Unobserved enumeration area fertility differences that cannot be addressed by a single-level approach were determined using a two-level negative binomial regression modeling approach. So, the application of standard models by ignoring this variation ought to embrace spurious results, then for such hierarchical data, multilevel modeling is recommended.

Honey is a natural, sugary and sticky liquid that is produced from the nectars of flowers by the bees. This study aimed to analyze the concentration of some selected heavy Metals in honey samples. 1 g of honey sample was digested by a hot plate using 9ml of HNO3 and 3ml of H2O2. The concentrations of the heavy metals in the digested were detected using a flame atomic absorption spectrometer. The results of this study found that the concentrations of the heavy metals in the honey samples were ranged from 1.97 to 2.04 µg/g for Zn, 1.93 µg/g to 2 µg/g for Cu, 0.83 to 1.01 µg/g for Mn, 0.25 to 0.45 µg/g for Cr, 0.025–0.031 µg/g for Cd. However, Pb was not detected in all honey samples. Hence, the levels of heavy metals found were below the permitted levels set by the World Health Organization. From the results, the levels of heavy metals found were below the permitted levels set by the World Health Organization. Thus, the heavy metals in the sampled honey are safe for human consumption in these selected areas.

The double burden of infectious diseases such as tuberculosis (TB) and HIV disproportionately affects Africa. Our objective was to summarize the prevalence of extrapulmonary TB (EPTB) among people living with HIV/AIDS (PLWHA) in sub-Saharan Africa (SSA). We searched PubMed and Google Scholar for studies done on the prevalence of EPTB among PLWHA which published in English from 1990 to 2017. We also searched bibliographic indices and browsed through reference lists of articles and journals. We critically appraised the quality of articles and abstracted the data with Joanna Briggs Institute (JBI) checklists. We used Review Manager Software (version 5.3) and Compressive Meta-analysis Software (version 2.2) for analysis. Finally, we summarized the effect estimate by using random-effects model and explored potential sources of heterogeneity by subgroup and sensitivity analyses. We assessed publication bias by funnel plot and statistical test. Finally, we used PRISMA format for reporting. We included, in this review, 31 studies that fulfilled our inclusion criteria, with a total population of 28,659. The prevalence estimate of EPTB among PLWHA ranged from 6.4% (95% CI: 3.8, 9.0) to 36.8% (95% CI: 28.6, 45); random-effects pooled prevalence of EPTB among PLWHA was found to be 20% (95% CI: 17, 22; heterogeneity: τ =0; χ =509.09, degrees of freedom [ ]=30, <0.00001; =94%). No evidence of publication bias was observed ( =0.44 for Egger's regression analysis and =0.11 for Begg's rank correlation analysis). We can conclude from our analyses that the prevalence of EPTB among PLWHA was high. It is necessary to give emphasis for EPTB, especially when screening TB among PLWHA, widening the spectrum of screening to include all EPTB sites in the countries with high EPTB and/or HIV prevalence in the general population.

Background In most African countries where a legitimate vital registration system is lacking, physicians often review verbal autopsy (VA) data to determine the cause of death, while there are concerns about the routine practicality, accuracy, and reliability of this procedure. In Ethiopia where the burden of tuberculosis (TB) remains unacceptably high, reliable VA data are needed to guide intervention strategies. This study aimed to validate the InterVA model against the physician VA in tracking TB-related mortality in Ethiopia. Methods From a sample of deaths in Addis Ababa, Ethiopia, VAs were conducted on TB-related mortality, physician-certified verbal autopsy (PCVA) through multiple steps to ascertain the causes of death. InterVA model was used to interpret the causes of death. Estimates of TB-related deaths between physician reviews and the InterVA model were compared using Cohen’s Kappa (k), Receiver-operator characteristic (ROC) curve analysis, sensitivity, and specificity to compare agreement between PCVA and InterVA. Results A total of 8952 completed PCVA were used. The InterVA model had an optimal likelihood cut-off point sensitivity of 0.64 (95% CI: 59.0–69.0) and specificity of 0.95 (95% CI: 94.9–95.8). The area under the ROC curve was 0.79 (95% CI: 0.78–0.81). The level of agreement between physician reviews and the InterVA model to identifying TB-related mortality was moderate (k = 0.59, 95% CI: 0.57–0.61). Conclusion The InterVA model is a viable alternative to physician review for tracking TB-related causes of death in Ethiopia. From a public health perspective, InterVA helps to analyze the underlying causes of TB-related deaths cost-effectively using routine survey data and translate to policies and strategies in resource-constrained countries.

While the impact of government interference to the religious domain has long been discussed in previous literature, empirical evidence on the nexus between government intervention to religion and individuals’ giving to religious organizations remains limited. In this study, we aim to fill this gap and examine whether government intervention affects individuals’ giving to faith-based charities. To this end, a survey data conducted in 20 European countries and two measures of government intervention to religion were used. Our empirical investigation based on multilevel logistic regression, after controlling for possible confounding factors at individual and country levels, indicates that government regulation of religion has a significant negative impact both on religious donation and volunteering. The findings of the present study add substantially to our understanding of nexus between government and religion and will serve as a base for future studies.

Background: Diabetic Ketoacidosis (DKA) is the most common and yet potentially life-threatening acute complication of diabetes that progresses rapidly to death and requires immediate medical intervention. Objective: To assess the DKA management and treatment outcome/in-hospital mortality and its predictors among hospitalized patients with DKA at the Medical ward of Shashemene Referral Hospital (SRH). Method: A retrospective study was conducted at the Medical Ward of SRH from 01 February 2015 to 31 January 2017. A systematic random sampling technique was used to select study subjects based on the inclusion criteria. Thus, of 236 reviewed charts, only 225 patients with DKA fulfilled inclusion criteria. Treatment outcome was considered good for patients who have shown improvement at discharge, while poor for patients who left against medical advice or died in the hospital. Logistic regression analysis was done to determine independent predictors for treatment outcome/in-hospital mortality using SPSS version 20 with statistical significant at P ⩽ .05. Results: Of 225 patients with DKA, 124 (55.1%) were male. Regular insulin was prescribed to all patients and antibiotics were administered to 87 (38.7%). Potassium supplementation was given only for 28 (12.4%). Non-adherence to insulin treatment (n = 91; 40.4%) and infection (n = 66; 29.3%) were the principal DKA precipitating factors. Even though 73.8% of hospitalized patients with DKA have shown good treatment outcomes, DKA contributed 12% in-hospital mortality. The result of multivariate logistic regression analysis shown that hypoglycemia is the only independent predictor for in-hospital mortality[P = .03]. Moreover, the independent predictors for poor DKA treatment outcome were found to be smoker [P = .04], Urinary tract infection (UTI) relative to other co-morbid condition [P < .001], severe hypokalemia which increase risk of poor treatment outcome by around 4 times [P = .02], and use of Metronidazole as a concurrent medication relative to other concurrent medication [P = .03]. Conclusion: There was a high in-hospital mortality rate due to correctable causes. This mortality is unacceptable as it was majorly related to the poor practice of potassium supplementation and hypoglycemia due to insulin. Thus, clinicians and stakeholders should have to focus on modifiable factors (hypokalemia, UTI, and hypoglycemia) to reduce poor treatment outcome/in-hospital mortality.