Explore the vast range of titles available.

Background In Ethiopia, approximately three-fourths of mothers do not deliver in health facilities. Disrespect and abuse during childbirth fallouts in underutilization of institutional delivery that upshots maternal morbidity and mortality. Thus, the ambition of this study was to assess respectful maternity care and associated factors in Harar hospitals, Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted from April 01 to July 01, 2017. A total of 425 women, delivered at Harar town hospitals, were nominated using a systematic random sampling technique. A pretested and organized questionnaire was used to collect the data. After checking for completeness, the data were entered into EpiData version 3.1 and exported to SPSS version 22.0 for cleaning and analyses. Both bivariate and multivariable logistic regression was computed to identify factors associated with respectful maternity care. Statistical significance was declared at a P -value of < 0.05. Results Data were collected on 425 women. Overall, only 38.4% (95% CI: 33.7, 42.0%) of women received respectful maternity care. Delivering at private hospitals [AOR: 2.3, 95% CI: 1.25, 4.07], having ANC follow-up [AOR: 1.8, 95% CI: 1.10, 3.20], planned pregnancy [AOR: 3.0, 95% CI: 1.24, 7.34], labor attended by male provider [AOR: 1.8, 95% CI: 1.14, 2.77] and normal maternal outcome [AOR: 2.3, 95% CI: 1.13, 4.83] were significantly associated with respectful maternity care. Conclusions Only four out of ten women received respectful care during labor and delivery. Providing women-friendly, abusive free, timely and discriminative free care are the bases to improve the uptake of institutional delivery. Execution of respectful care advancement must be the business of all healthcare providers. Furthermore, to come up with a substantial reduction in maternal mortality, great emphasis should be given to make the service woman-centered.

Enteric pathogens like Salmonella and Shigella species as well as intestinal parasites (IPs) are among the main causative agents of diarrhea in people with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), particularly in low income countries like Ethiopia. Antimicrobial resistance against commonly prescribed drugs has become a major global threat. This study, therefore, aimed at determining the magnitude of Salmonella, Shigella and IPs infections, their predicting factors, and antimicrobial susceptibility pattern among HIV infected and non-infected diarrheic patients in Dessie town, Northeast Ethiopia. A cross sectional study was conducted at three health facilities in Northeast Ethiopia between January 2018 and March 2018. Data on socio-demographic and associated risk factors were collected using structured questionnaire from 354 HIV infected and non-infected diarrheic outpatients. Fresh stool specimen was processed according to standard operating procedures. Data were entered and analyzed using SPSS version 22. Descriptive statistics was used to determine frequency, Bivariate and multivariate logistic regression analyses were performed to identify predicting factors associated with the outcome variable. P-value <0.05 were used to declare statistical significance. Among 354 diarrheic patients, 112 were HIV infected and 242 were HIV non-infected. The overall prevalence of intestinal parasite and bacterial infection among HIV infected versus non-infected, respectively, was 26 (23.2%) and 8 (7.1%) versus 50 (20.7) and 16 (6.6%). Salmonella was the highest in both groups, 6 (5.4%) vs 11 (4.5%). Most prevalent parasite was C. parvum, 9 (8%) among HIV+ while E. histolytica/dispar 39 (16.1%) among HIV-. Having bloody plus mucoid diarrhea, not utilizing latrine and drinking river or spring water were factors significantly associated with bacterial infection. Whereas, being illiterate or having primary level education, diarrhea lasting for 6-10 days, CD4 level between 200-500 cells/μl, not washing hand with soap showed significant association with IPs. The bacterial isolates were 100% susceptible to Ceftriaxone and 95.4% to Ciprofloxacin, while 100% resistant to Ampicillin and Amoxicillin. MDR was observed among 19 (79.2%) isolates. Preventing and controlling infection by enteric pathogens as well as IPs require strengthening intervention measures. The 100% resistance of isolates to commonly prescribed antibiotics calls for expanding antimicrobial susceptibility testing so as to select appropriate antimicrobial agent and prevent emergence of drug resistant bacteria.

Background Access to antiretroviral therapy (ART) in Ethiopia has been scaled up since the introduction of the service in 2003. Free ART was launched in 2005, resulting in fewer new human immunodeficiency virus (HIV) infections and deaths from acquired immunodeficiency syndrome (AIDS). However, immunological and clinical failures for first-line ART due to poor adherence and other factors have received less attention. Thus, this study aims to determine the magnitude and associated factors of clinical and immunological failure among HIV-positive adults after six months of first-line ART in Dire Dawa, Eastern Ethiopia. Methods A facility-based cross-sectional study was conducted using secondary data of patients on ART in all health facilities providing ART services in Dire Dawa. A total of 949 samples were collected. The data were entered into Epidata version 3.02, and the analysis was performed using SPSS version 16.0. Univariate and multivariate analyses were performed to determine the magnitude of clinical and immunological failure and identify factors significantly associated with the outcome variable. Results The magnitude of clinical and immunological failure was 22.7% ( n = 215). Of these, 33 (15%) patients were switched to second-line ART. CD4 count ≤100 cells/mm3 (AOR: 1.78, 95% CI: 1.18–2.69), poor adherence (AOR: 2.5, 95% CI: 1.19–5.25), restarting after interruption of ART (AOR: 1.93, 95% CI: 1.23–3.07), regimen change (AOR: 1.50, 95% CI: 1.05–2.15), ambulatory/bedridden functional status at the last visit on ART (AOR: 2.41, 95% CI: 1.22–4.75) and patients who died (AOR: 3.94, 95% CI: 1.64–9.45) had higher odds of failure. Conclusion The magnitude of clinical and immunological failure was high. To curb this problem, initiation of ART before the occurrence of severe immune suppression, early detection and management of failure and improved adherence support mechanisms are recommended. Restarting treatment after interruption and regimen changes-should-be-made-cautiously.

Hepatitis B virus (HBV) infection is a serious public health problem worldwide. Reports have shown that 68,600 people die of HBV infection and more than 300,000 deaths due to liver cancer secondary to hepatitis B every year globally. Women who are infected with HBV can vertically transmit the infection to their infants. This study aims to determine the prevalence of HBV infection and associated factors among pregnant women. A hospital-based cross-sectional study was conducted among pregnant women who attended antenatal care clinic (ANC) for routine pregnancy check-up between 18 March 2015 and 15 May 2015. Data were collected by face to face interview using a pre-tested questionnaire. Serum was withdrawn for each study subject and used to test for Hepatitis B Surface Antigen (HBsAg) by an enzyme linked immunosorbent assay (ELISA) test kit. Binary logistic regression analysis was used to examine the association between explanatory variables and outcome variable. The prevalence of HBV infection was found to be 6.9%. Interestingly, the history of abortion (AOR 10.9; 95% CI: 2.2-53.9), nose piercing (AOR 9.1; 95% CI: 1.34-61.79), surgical procedure (AOR 12.8; 95% CI: 1.68-97.06) and history of multiple sexual partners (AOR 16.8; 95% CI: 3.18-89.06) were significant predictors of HBV infection. This study determined that the prevalence of HBV infection among pregnant women was 6.9%, implying that it is high-intermediate endemic area, which is important public health issue needs to be addressed. History of abortion, nose piercing, surgical procedures and multiple sexual partners were significantly associated with this viral infection. Accordingly we advocate that health education programs on the mode of HBV transmission, high-risk behaviors and methods of preventions should be instituted at antenatal care clinics to raise the awareness of mothers and limit the spread of infection. It is also advisable to implement nosocomial infection prevention strategies to prevent the transmissions of HBV through health care related activities such as surgical procedures. Furthermore, all pregnant women should be screened for HBV, treated if necessary to reduce their viral loads and their children vaccinated at birth with the single-dose hepatitis B vaccine to break the cycle of mother-to-child transmission.

The World Health Organization [WHO] recommends a genotype-specific human papillomavirus [HPV] vaccination as a primary prevention strategy to control the burden of cervical cancer globally. In Ethiopia, where the non-vaccine-targeted HPV genotypes have not been adequately studied, a vaccination initiative was launched in 2018 targeting HPV-6,-11, -16, and -18 for girls aged 14–18 years. The co-existence of both vaccine-targeted and non-targeted genotypes is a serious concern, as it can accelerate cancer progression. Therefore, this study was conducted to determine the prevalence of non-vaccine-targeted HPV genotypes and assess the level of multiple infections with other genotypes in eastern Ethiopia. A health facility-based cross-sectional study including 110 women with positive HPV DNA results was conducted from April to August 2021. A structured questionnaire to collect demographic and clinical data was used. Cervical swabs were collected using L-shaped FLOQSwabs. Women's cytological profile was determined based on Pap smear test results. An automated nucleic acid extraction system using STARMag 96 ProPrep Universal Extraction Kit was utilized following the manufacturer's protocol. An amplification assay in real-time was employed to amplify and identify the HPV Late 1 [L1] gene, which is utilized for genotyping purposes. Following this, the collected data was entered into Epi data version 3.1 software, and the analysis was performed using STATA version 14. A total of 110 women [age range 30–60 years, mean age = 36.5 years and SD ± 6.9] had positive HPV DNA results and were included in the study. Among these, 108 women had valid co-testing [Pap test and HPV DNA test] results for further analysis, and the results of the remaining 2 women were rejected. Overall, the prevalence of non-vaccine-targeted HPV was 56 (51.8%, 95%CI [0.42, 0.61]), of which 28 women (25.4%, 95%CI [0.18, 0.34]) had a single non-vaccine HPV genotype infection. The remaining 29 women (26.4%, 95% CI: 0.190–0.355) experienced multiple infections. The non-vaccine-targeted genotypes of HPV-35 accounted for 11 cases (10%, 95%CI [0.06, 0.17]), HPV-68 was detected in 9 women (8.2%, 95%CI [0.04, 0.15]), HPV-56 and HPV-66 were both found in 8 cases each (7.3%, 95%CI [0.04, 0.14]) of the total. In addition, out of these 108 women, 93 (86.1%, 95%CI [0.78, 0.91]) had low-grade squamous intraepithelial lesions, 13 (12%, 95%CI [0.07, 0.20]) no intraepithelial lesion or malignancy, and two (1.9%, 95%CI [0.01, 0.07]) high-grade squamous intraepithelial lesions. Furthermore, there was no statistical difference [ p  = 0.755] between vaccine-targeted and non-vaccine-targeted genotypes as the primary cause of cervical lesions. In conclusion, the findings of the present study highlight the existence of a notable prevalence of multiple infections caused by non-vaccine-targeted HPV genotypes. Therefore, it is recommended that both the Federal and regional health bureaus to evaluate the range of hr HPV genotypes protected by the current HPV vaccine and explore the option of transitioning from the quadrivalent HPV vaccine to a novavalent vaccine that includes seven high-risk HPV genotypes.

Background Globally, pre-and post-migration TB screening are integral to controlling TB among migrants. Annually, approximately 300,000 Ethiopians migrate to the Middle East in search of job opportunities. But prior to their trip the migrants are randomly distributed by Wafid to 12 authorized clinics in Addis Ababa, for pre-migration medical screening for communicable diseases including Tuberculosis (TB), which is one of the main concerns and screened using chest X-ray (CXR). Based on the screening results, the job seekers are classified as Fit or Unfit to travel to the Middle East. This study aimed to estimate the prevalence of presumptive TB among Ethiopian Migrant Workers upon screening and identify the possible associated risk factors. Method A retrospective cross-sectional study was conducted using data between June,2023 and June, 2025 collected from three clinics utilizing Sefed Software Systems database. Ethiopian Migrant Domestic Workers (MDWs) are randomly placed for pre-migration screening to these health facilities by the Ministry of Labor and Skills. The prevalence of presumptive TB was estimated using STATA software version 14. Logistic regression model was applied to determine associations between X-ray TB diagnosis and with socio-demographic and clinical variables. Results Among 233,941 individuals screened during the study period, 10, 342 (4.42%) were deemed Unfit to travel due to abnormal CXR findings. Significant associations were observed between TB-suspects based on X-rays and several variables. Using multivariable logistic regression analysis, religion (OR = 1.24; 95% CI: 1.19–1.28); marital status (OR = 0.88; 95% CI: 0.84–0.93), age (OR = 3.35; 95% CI: 2.70–4.15), hepatitis B (OR = 1.71; 95% CI: 1.48–1.97), syphilis (VDRL) (OR = 1.97; 95% CI: 1.63–2.37) and pregnancy (OR = 1.56, 95% CI = 1.34–1.81) showed statistically significant association with potential TB status with P  < 0.05. HIV status showed marginal association (OR = 1.40; 95% CI: 0.91–2.14). Conclusion This study revealed a relatively high prevalence of presumptive TB among Ethiopian (MDWs) seeking jobs in the Middle East. The X-ray results may not be confirmatory diagnosis for TB. Therefore, further investigation is required using other confirmatory methods such as Gene Xpert or TB culture. Linking medically unfit individuals to TB care is crucial to mitigate transmission risks based on the WHO recommendations.

Progression of chronic HBV to cirrhosis, end-stage liver disease (ESLD), and hepatocellular carcinoma (HCC) is more rapid in HIV positive individuals than those with HBV alone; however, the distribution of HBV seromarkers in HIV infected individuals on antiretroviral therapy (ART) is not well described. To address this problem, we assessed the distribution of hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs) among HIV infected adults on ART in Eastern Ethiopia. A cross-sectional study was conducted from September 2017 to February 2018. Socio-demographic, behavioral and health related factors, and clinical data were collected using questionnaire and checklist. Plasma samples were tested for HBsAg, anti-HBc and anti-HBs seromarkers using ELISA. Data were double entered into EpiData 3.1, cleaned, exported to and analyzed using STATA 13. Descriptive and logistic regression analysis were conducted and statistical significance was decided at p≤0.05. A total of 901 participants were included and the prevalence of HBsAg was found to be 11.7% [95%CI (10, 14)]. Among the co-infected, 47.6% were also positive for anti-HBc, of which 58% were on an ART containing tenofovir (TDF). Among those screened for the three seromarkers, 38.1% were negative for all and 21% were positive only for anti-HBc (IAHBc). Being single, history of genital discharge and taking ART with TDF combination were significantly associated with HBV co-infection (p≤0.05). There is high burden HBV co-infection among individuals on ART. The unmet need of HBV screening prior to ART initiation leaves many co-infected individuals without appropriate management including therapy, close monitoring or vaccination when indicated, impacting disease prevention.

Extended-spectrum beta-lactamases (ESBLs) producing Gram-negative bacteria are public health threats. This study aims to characterize ESBL-producing Gram-negative bacteria (GNB) isolated from surgical site infection patients. A multicenter cross-sectional study was conducted at four hospitals located in central (Addis Ababa), southern (Hawassa), northern (Debre Tabor), and Southwestern (Jimma) parts of Ethiopia. A wound culture was performed among 752 surgical site infection (SSI) patients where 286 GNB were confirmed using MALDI-TOF; of which 135 were subjected to whole genome sequencing using the Illumina (HiSeq 2500) system. The overall genotypic frequencies of ESBL-producing GNB were 57.8%. The detection of ESBL-producing GNB at Hawassa, Debre Tabor, Jimma, and Addis Ababa was 21.5%, 19.3%, 29.6%, and 29.6%, respectively. The detection frequency of bla CTX−M , bla TEM , and bla SHV genes was 51.8%, 40%, and 8.1%, respectively. The most frequently detected ESBL gene was bla CTX−M−15 (56.4%). Both bla TEM−1B (41%) and bla SHV−187 (5.1%) were the most frequently detected variants of bla TEM and bla SHV , respectively. The molecular epidemiology of ESBL-producing GNB among surgical site infection patients in Ethiopia showed many variants of ESBL genes. Good antimicrobial stewardship and standard bacteriological laboratory services are necessary for the effective treatment of ESBL-producing GNB.

Background Globally, surgical site infections (SSI) are the most commonly reported healthcare-associated infections. Methods A multicentre study was conducted among patients who underwent surgical procedures at four hospitals located in Northern (Debre Tabor), Southern (Hawassa), Southwest (Jimma), and Central (Tikur Anbessa) parts of Ethiopia. A total of 752 patients clinically studied for surgical site infection were enrolled. The number of patients from Debre Tabor, Hawassa, Jimma, and Tikur Anbessa, hospitals was 172, 184, 193, and 203, respectively. At each study site, SSI discharge culture was performed from all patients, and positive cultures were characterized by colony characteristics, Gram stain, and conventional biochemical tests. Each bacterial species was confirmed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI TOF). An antimicrobial susceptibility test (AST) was done on Mueller–Hinton agar using the disk diffusion method. Logistic regression analysis was used to assess associations of dependent and independent variables. A p-value < 0.05 was considered statistically significant. Data were analysed using STATA 16 software. Results Among 752 wound discharge cultures performed, 65.5% yielded growth. Among these, 57.9% and 42.1% were Gram-negative and Gram-positive isolates, respectively. In this study, a total of 494 bacteria were isolated; Staphylococcus aureus (31%), Escherichia coli (20.7%), and Klebsiella pneumoniae (9.8%) were the most common. Rare isolates (0.8% each) included Raoultella ornithinolytica, Stenotrophomonas maltophilia , Alcalignes faecalis, Pantoea ecurina, Bacillus flexus, and Paenibacillus tylopili . Enterobacteriaceae showed high levels of resistance to most of the tested antibiotics but lower levels of ertapenem (32.9%), amikacin (24.3%), imipenem (20.3%), and meropenem (17.6%) resistance. Multidrug-resistant (MDR) frequency of Enterobacteriaceae at Debre Tabor, Hawassa, Jimma, and Tikur Anbessa hospitals was 84.5%, 96.5%, 97.3%, and 94%, respectively. Ages ≥ 61 years (AOR = 2.83, 95% CI: 1.02–7.99; P 0.046), prolonged duration of hospital stay (AOR = 4.15, 95% CI: 2.87–6.01; P 0.000), history of previous antibiotics use (AOR = 2.83, 95% CI: 1.06–2.80; P 0.028), history of smoking (AOR = 2.35, 95% CI: 1.44–3.83; P 0.001), emergency surgery (AOR = 2.65, 95% CI: 1.92–3.66; P 0.000), and duration of operation (AOR = 0.27, 95% CI: 0.181–0.392; P 0.000) were significant risk factors. Conclusion The most prevalent isolates from Gram-positive and Gram-negative bacteria across all hospitals were S. aureus and E. coli, respectively . Many newly emerging Gram-negative and Gram-positive bacteria were identified. Variation between hospitals was found for both SSI etiology type and MDR frequencies. Hence, to prevent the emergence and spread of MDR bacteria, standard bacteriological tests and their AST are indispensable for effective antimicrobial stewardship.

Background Acinetobacter baumannii is an opportunistic pathogen that can cause a variety of nosocomial infections in humans. This study aimed to molecularly characterize extended-spectrum beta-lactamase (ESBL) producing and carbapenem-resistant Acinetobacter species isolated from surgical site infections (SSI). Methods A multicentre cross-sectional study was performed among SSI patients at four hospitals located in Northern, Southern, Southwest, and Central parts of Ethiopia. The isolates were identified by microbiological methods and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antibiotic susceptibility was determined using disk diffusion. The presence of phenotypic ESBL and carbapenemase production was detected by employing standard microbiological tests, including combined disk diffusion (CDT). ESBL and carbapenem resistance determinants genes were studied by polymerase chain reaction (PCR) and sequencing. Results A total of 8.7% Acinetobacter species were identified from 493 culture-positive isolates out of 752 SSI wounds. The species identified by MALDI-TOF MS were 88.4% A. baumannii , 4.7% Acinetobacter pittii , 4.7% Acinetobacter soli , and 2.3% Acinetobacter lactucae. Of all isolates 93% were positive for ESBL enzymes according to the CDT. Using whole genome sequencing 62.8% of the A. baumannii harbored one or more beta-lactamase genes, and 46.5% harbored one or more carbapenemase producing genes. The distribution of beta-lactamases among Acinetobacter species by hospitals was 53.8%, 64.3%, 75%, and 75% at JUSH, TASH, DTCSH, and HUCSH respectively. Among ESBL genes, bla CTX−M alleles were detected in 21.4% of isolates; of these 83.3% were bla CTX−M−15 . The predominant carbapenemase gene of bla OXA type was detected in 24 carbapenem-resistant A. baumannii followed by bla NDM alleles carried in 12 A. baumannii with bla NDM−1 as the most common. Conclusions The frequency of Acinetobacter species that produce metallobetalactamases (MBLs) and ESBLs that were found in this study is extremely scary and calls for strict infection prevention and control procedures in health facilities helps to set effective antibiotics stewardship.