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Background Peripartum hysterectomy (PH) is a life-saving surgical procedure for severe childbirth complications such as uncontrollable bleeding, uterine rupture, or severe infection. Despite its crucial role in obstetric care, research on the prevalence of PH and the factors contributing to its necessity remains limited, necessitating further evaluation. Objective To evaluate the the prevalence, indications, and maternal outcomes of PH and identifying factors associated with maternal outcomes among women who underwent PH at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia. Methods A retrospective cross-sectional study was conducted on 162 participants using data from March 2017 to April 2023. Data were extracted from patient records between February and April 2023 and analyzed using SPSS version 26. Descriptive statistics were reported, and variables with p  < 0.25 in bivariate analysis were included in the multivariable model, with statistical significance set at p  ≤ 0.05. Results A review of 162 maternal charts involving PH showed a rate of 5.2 per 1,000 deliveries. Most hysterectomies (87%) were performed following cesarean delivery. The primary indications for PH included uterine rupture (75.3%), uterine atony (17.3%), placenta accreta (4.9%), and deep surgical site infection (1.9%). Severe maternal morbidity included wound infections (24.7%), adjacent structure injuries (8.6%), re-laparotomies (7.4%), and other complications (6.8%). Intensive care unit admission occurred in 37%, and 83.3% required blood transfusions. Maternal and perinatal mortality rates were 23.5% and 75.9%, respectively. The key predictors of maternal outcome included delivery in the study hospital, pre-operative blood pressure of < 90/60 mmHg, and pre-operative blood transfusion. Conclusion PH is a major contributor to maternal morbidity and mortality, primarily due to uterine rupture. The relatively high PH rate suggests significant maternal health challenges. To address this, improvements in preoperative care, early detection of complications, and enhanced emergency obstetric services could help reduce the need for hysterectomy and improve maternal and perinatal outcomes.

The incidence of cancer is increasing in Ethiopia, and it poses significant financial burden on households. However, data on the prevalence of household food insecurity and associated factors among adult cancer patients in Africa is scarce. This study aimed to determine the prevalence of food insecurity and identify factors associated with it among adult cancer patients in Southern Ethiopia. A facility-based cross-sectional study was conducted among 338 cancer patients from November 2023 to February 2024. Binary logistic regression model was built in RStudio. The prevalence of food insecurity among cancer patients in this study was 64.2% (95% CI: 58.96–69.16). An increase in age (AOR = 0.97 95% CI; (0.94, 0.99), being married (AOR = 0.37 95% CI; (0.19, 0.74), taking chemotherapy (AOR = 0.27 95% CI; (0.14, 0.51), and an increase in the number of chemotherapy cycles (AOR = 0.83 95% CI; (0.74, 0.92) were associated with lower odds of food insecurity. On the other hand, the odds of being food insecure was higher among participants with poorer performance status (AOR = 1.65 95% CI; (1.21, 2.32). Integrating brief food-insecurity screening into routine oncology visits can help identify patients at risk. Addressing food insecurity should be a core component of comprehensive cancer care in low-resource settings.

Globally, moderate acute malnutrition (MAM) affects approximately 5% of children below five years of age. MAM is a persistent public health problem in Ethiopia. The current approach in Ethiopia for managing MAM is a supplementary feeding program; however, this is only provided to chronically food-insecure areas. The objective of the study was to compare a local-ingredients-based supplement (LIBS) with the standard corn-soy blend plus (CSB+) in treating MAM among children aged 6 to 59 months to test the hypothesis that the recovery rate achieved with LIBS will not be more than 7% worse than that achieved with CSB+. We used an individual randomized controlled non-inferiority trial design with two arms, involving 324 children with MAM aged 6 to 59 months in Wolaita, Southern Ethiopia. One hundred and sixty-two children were randomly assigned to each of the two arms. In the first arm, 125.2 g of LIBS with 8 ml of refined deodorized and cholesterol-free sunflower oil/day was provided. In the second arm, 150 g of CSB+ with 16 ml of refined deodorized and cholesterol-free sunflower oil/day was provided. Each child was provided with a daily ration of either LIBS or CSB+ for 12 weeks. Both intention-to-treat (ITT) and per-protocol (PP) analyses were done. ITT and PP analyses showed non-inferiority of LIBS compared with CSB+ for recovery rate [ITT risk difference = 4.9% (95% CI: -4.70, 14.50); PP risk difference = 3.7% (95% CI: -5.91, 13.31)]; average weight gain [ITT risk difference = 0.10 g (95% CI: -0.33 g, 0.53 g); PP risk difference = 0.04 g (95% CI: -0.38 g, 0.47 g)]; and recovery time [ITT risk difference = -2.64 days (95% CI: -8.40 days, 3.13 days); PP difference -2.17 days (95% CI: -7.97 days, 3.64 days]. Non-inferiority in MUAC gain and length/height gain was also observed in the LIBS group compared with the CSB+ group. LIBS can be used as an alternative to the standard CSB+ for the treatment of MAM. Thus, the potential of scaling up the use of LIBS should be promoted. Pan-African Clinical Trial Registration number: PACTR201809662822990.

Background Induction of labor (IOL) is a medical intervention used to initiate labor artificially and has become one of the most common procedures in modern obstetrics to improve maternal and neonatal outcomes. While extensive research has focused on the methods and outcomes of labor induction, limited evidence exists regarding mothers’ lived experiences following IOL, particularly in the Ethiopian context. Objective To explore the lived experience of mothers who give birth after induction of labor at Wolaita Sodo Comprehensive Specialized Hospital, Southern Ethiopia, 2024. Methods A qualitative descriptive phenomenological study was conducted at Wolaita Sodo Comprehensive and Specialized Hospital between September and November 2023. Twelve postpartum mothers were purposively selected for in-depth interviews using a semi-structured guide. Interviews were audio-recorded, transcribed verbatim, translated into English, and supplemented with field notes. Data were analyzed thematically using Braun and Clarke’s six-phase method, supported by Open Code Software Version 4.02. Trustworthiness was ensured through the application of Guba’s criteria: credibility, transferability, dependability, and confirmability. Result Four main themes emerged: (1) emotional responses to IOL, (2) coping with IOL and support received, (3) challenges encountered during the induction process, and (4) perceived effects of IOL on the mother. Participants reported intense negative emotions such as pain, fear, anxiety, and distress. These feelings were exacerbated by systemic challenges, including overcrowded wards, lack of privacy, and inadequate environmental conditions in the labor ward. Conclusion and recommendation Mothers undergoing labor induction experience both positive and negative emotions. The stressful environment of the labor ward and the induction process negatively affect their emotional well-being. To improve maternal care outcomes, it is essential to foster effective communication between healthcare providers and mothers and to address the environmental challenges within the hospital setting.

Background Inappropriate complementary feeding is widely practiced in low and middle income countries. These contribute to undernutrition, morbidity and mortality among young children. The incidence of malnutrition in the first two years of life has been directly linked with inappropriate complementary feeding practices along with high infectious disease levels. Objective To assess the level of inappropriate complementary feeding practice and associated factors among children aged 6 to 23 months in Shashemene, Southern Ethiopia. Method A community-based cross-sectional study was conducted from July to August 2021 among 609 children aged 6 to 23 months paired with their caregivers. Systematic random sampling was used to identify study participants. Data were analyzed by using SPSS version 25 software. Binary logistic regression analysis was used to identify predictors of inappropriate complementary feeding practice. Statistical significance was determined using Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI). Results The prevalence of inappropriate complementary feeding practice among children aged 6–23 months was 55.3%. Being a mother under the age of 25 years [AOR = 2.07, 95% CI: 1.30, 3.31], aged 25–34 years [AOR = 1.82, 95% CI: 1.14, 2.91], having an occupation [AOR = 2.73, 95% CI: 1.84, 4.05], and households where husbands’ are the sole decision makers on their income [AOR = 2.41, 95% CI: 1.54, 3.77] increased the chance of inappropriate complementary feeding practice. On the other hand, mother’s whose infants were aged 9–11 months [AOR = 0.30, 95% CI: 0.19–0.45] were less likely to practice inappropriate complementary feeding. Conclusions The prevalence of inappropriate complementary feeding practice in the study area was high compared to the WHO recommendation. Child’s age, maternal age, maternal occupation, and decision-making role on income were found to be associated with inappropriate complementary feeding practice. Appropriate behavioral change communication to family and community decision-makers, and involvement of husbands in infant and young child feeding practice are recommendable.

BackgroundGlobally, approximately 1.9 million cases of tuberculosis (TB) were attributable to undernutrition. Nearly 19 000 deaths occur annually in Ethiopia due to TB. TB makes undernutrition worse and undernutrition deteriorates the body’s defence system thus increasing the chance of developing an active illness. However, there is a dearth of studies regarding undernutrition among adult patients with TB in the study setting.ObjectiveThis study aimed to assess the magnitude of undernutrition and its associated factors among adult patients with TB in the South Ethiopia Region.DesignWe conducted a multicentre cross-sectional study using structured and pretested questionnaires.SettingsThe study was conducted from 5 August 2022 to 5 September 2022, among adult patients with TB on follow-up care in the South Ethiopia Region.ParticipantsThree hundred ninety-eight randomly selected adult patients with TB on follow-up care in public healthcare facilities in the Southern Ethiopia region participated in the study.MethodsData were collected using structured and pretested questionnaires. Anthropometric measurements were taken by calibrated instruments. EpiData V.3.1 was used for data entry. Data analysis was done by SPSS V.25. Tables, graphs and texts were used to present descriptive statistics. Variables with a p value <0.25 in bivariable logistic regression were candidates for multivariable logistic regression. A p value <0.05 with a 95% CI was used to declare the statistical significance.ResultsThe magnitude of undernutrition was 46.5%, 95% CI 41.5% to 51.5%. Rural residence (adjusted OR (AOR)=3.94, 95% CI 2.52 to 6.17), positive HIV status (AOR=2.65, 95% CI 1.65 to 4.268) and family history of TB (AOR=2.62, 95% CI 1.65 to 4.15) were factors significantly associated with undernutrition.ConclusionOur finding indicated that undernutrition among adult patients with TB was relatively high in the study setting compared with similar research reports. Undernutrition was significant among rural residents, positive HIV status and family history of TB. Therefore, we recommend that emphasis should be given to rural residents, positive HIV status and families with a history of patients with TB to decrease its burden.

IntroductionThe prevalence of neural tube defects (NTDs) is higher in Ethiopia than most other countries, and ~84% of Ethiopian women of reproductive age (WRA) have folate insufficiency, a major risk factor for NTDs. Salt fortification with folic acid is a potential strategy to improve women’s folate status, but data are needed on the acceptability, nutritional impact and safety of folic acid fortification of iodised salt.Methods and analysisThe study is designed as a community-based, household-randomised, dose–response trial. A total of 360 non-pregnant WRA 18–49 years of age will be randomly assigned to one of three intervention arms: (1) iodised salt fortified with 30 ppm folic acid to provide ~200 µg folic acid/day; (2) iodised salt fortified with 90 ppm folic acid to provide ~600 µg folic acid/day; or (3) iodised salt (comparator). The preweighed salts will be delivered to participants’ homes biweekly for 26 weeks; unused salt will be collected and weighed. Fasting, venous blood samples will be collected at baseline, end line and a randomly assigned intermediate time point for assessment of folate, iodine, vitamin B12 and other micronutrient status biomarkers. Women’s dietary intakes, including discretionary salt consumption, will be measured using weighed food records; 24-hour urine specimens will be analysed for sodium and iodine excretion. Primary outcomes are women’s consumption of study salts, change in biomarkers of folate and iodine status and prevalence of adverse events. Results will be analysed using analysis of covariance models to estimate group mean differences for continuous outcomes, controlling for baseline measurements, and log-binomial or modified Poisson regressions for categorical outcomes. Prespecified effect modifications will be explored.Ethics and disseminationThe study has been approved by the Ethiopian Public Health Institute’s Institutional Review Board, and the protocol has been registered with ClinicalTrials.gov (registration number NCT06223854). Study results will be published in open access scientific journals and disseminated nationally in Ethiopia.Trial registration number NCT06223854.

Background In Ethiopia, 12.5% of children below 5 years are wasted, and 9.7% are moderately wasted. The present strategy for the management of moderate acute malnutrition (MAM) is a supplementary feeding program; however, this is only provided to chronically food-insecure areas. This randomized controlled non-inferiority trial examines if Local ingredients-based supplement (LIBS) is as effective as corn-soya blends plus (CSB+) in treating moderate acute malnutrition among children aged 6–59 months. Methods A randomized controlled non-inferiority trial will be conducted with moderately wasted children aged 6 to 59 months in Wolaita, Ethiopia. The calculated sample size is 324 (i.e. with 162 children in each of two arms, to be assigned by randomization). The daily ration will be: 100 g of LIBS plus 25.2 g of sugar with 8 ml oil in the intervention group, and 150 g of CSB+ with 16 ml of oil in the control group. These interventions will be provided for a maximum period of 12 weeks, with follow-up performed on a weekly basis. Data analysis will be done using SPSS and STATA software. Both intention-to-treat and per protocol analyses will be done. Hazard ratio and Kaplan-Meier (log rank) curves of survival analysis will be done to predict the probability of recovery rate. Logistic regression will be used to test for interactions between independent and dependent variables. Analysis of variances, t-tests, fisher’s exact test and chi-square tests will be used to assess baseline characteristics. Conclusions This paper will introduce to the existing research locally available nutritious foods which have the potential to enhance recovery from moderate acute malnutrition and to reduce the burden of malnutrition. The perceptions of mothers on feeding children with local ingredient-based supplementary food to assist recovery from moderate acute malnutrition will be the focus of in a qualitative study to follow; this will provide a further contribution in an evolving area of research. Trial registration Pan-African Clinical Trial Registration number: PACTR201809662822990 , retrospectively registered on 11/09/2018.

Background Globally, moderate acute malnutrition (MAM) affects approximately 5% of children below five years of age. MAM is a persistent public health problem in Ethiopia. The current approach in Ethiopia for managing MAM is a supplementary feeding program; however, this is only provided to chronically food-insecure areas. The objective of the study was to compare a local-ingredients-based supplement (LIBS) with the standard corn-soy blend plus (CSB+) in treating MAM among children aged 6 to 59 months to test the hypothesis that the recovery rate achieved with LIBS will not be more than 7% worse than that achieved with CSB+. Methods and findings We used an individual randomized controlled non-inferiority trial design with two arms, involving 324 children with MAM aged 6 to 59 months in Wolaita, Southern Ethiopia. One hundred and sixty-two children were randomly assigned to each of the two arms. In the first arm, 125.2 g of LIBS with 8 ml of refined deodorized and cholesterol-free sunflower oil/day was provided. In the second arm, 150 g of CSB+ with 16 ml of refined deodorized and cholesterol-free sunflower oil/day was provided. Each child was provided with a daily ration of either LIBS or CSB+ for 12 weeks. Both intention-to-treat (ITT) and per-protocol (PP) analyses were done. ITT and PP analyses showed non-inferiority of LIBS compared with CSB+ for recovery rate [ITT risk difference = 4.9% (95% CI: -4.70, 14.50); PP risk difference = 3.7% (95% CI: –5.91, 13.31)]; average weight gain [ITT risk difference = 0.10 g (95% CI: -0.33 g, 0.53 g); PP risk difference = 0.04 g (95% CI: -0.38 g, 0.47 g)]; and recovery time [ITT risk difference = -2.64 days (95% CI: -8.40 days, 3.13 days); PP difference -2.17 days (95% CI: -7.97 days, 3.64 days]. Non-inferiority in MUAC gain and length/height gain was also observed in the LIBS group compared with the CSB+ group. Conclusions LIBS can be used as an alternative to the standard CSB+ for the treatment of MAM. Thus, the potential of scaling up the use of LIBS should be promoted. Trial registration Pan-African Clinical Trial Registration number: PACTR201809662822990.

In Ethiopia, moderate acute malnutrition (MAM) is a persistent public health problem. The current management approaches for MAM among children are counseling in food‐secure settings and food supplementation in chronically food‐insecure areas. The objective of this study was to develop a local ingredients‐based supplement (LIBS) for treating MAM among children. Collection of food ingredients (pumpkin seed, amaranth grain, flaxseed, peanut, and emmer wheat) was made. Sorting, soaking, drying, roasting, and milling of ingredients were done. Nutrient analysis was done using triplicate measurements of each nutrient. One‐way ANOVA was used to analyze differences in means with ± standard deviation of nutrient measurements among the supplements. The nutrient content of four developed LIBS ranged from 20.3 g to 22.5 g for protein, 29.3 g to 33.5 g for fat, 509.5 kcal to 570.0 for kcal, 6.0 g to 8.5 g for fiber, 2.8 g to 3.7 g for moisture, and 2.1 g to 4.3 g for ash. The mineral and antinutrient components ranged from 75.6 mg to 115.6 mg for calcium, 473.1 mg to 570.2 mg for potassium, 79.3 mg to 114.4 mg for sodium, 4.1 mg to 5.6 mg for zinc, 8.2 mg to 10.2 mg for iron, 442.6 mg to 470.4 mg for phosphorous, and 2.1 mg to 4.3 mg for phytate. The LIBS with the highest portion of pumpkin seed had significantly highest amounts of protein, fat, calories, iron, zinc, and potassium. The results found were within the recommended range of required nutrients for the treatment of children with MAM. Therefore, LIBS may be used for the management of children with MAM. Moderate acute malnutrition is a persistent problem in developing country. The objective of this study was to develop a local ingredients‐based supplement for treating moderate acute malnutrition among children. The results found were within the recommended range of required nutrients for the treatment of children with moderate acute malnutrition.