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Background Cholera remains a disease of public health importance in Nigeria associated with high morbidity and mortality. In November 2014, the Nigeria Field Epidemiology and Laboratory Training Programme (NFELTP) was notified of an increase in suspected cholera cases in Gomani, Kwali Local Government Area. NFELTP residents were deployed to investigate the outbreak with the objectives of verifying the diagnosis, identifying risk factors and instituting appropriate control measures to control the outbreak. Methods We conducted an unmatched case-control study. We defined a cholera case as any person aged ≥5 years with acute watery diarrhea in Gomani community. We identified community controls. A total of 43 cases and 68 controls were recruited. Structured questionnaires were administered to both cases and controls. Four stool samples from case-patients and two water samples from the community water source were collected for laboratory investigation. We performed univariate and bivariate analysis using Epi-Info version 7.1.3.10. Results The mean age of cases and controls was 20.3 years and 25.4 respectively ( p value 0.09). Females constituted 58.1% (cases) and 51.5%(controls). The attack rate was 4.3% with a case fatality rate of 13%. Four stool (100%) specimen tested positive for Vibrio cholerae . The water source and environment were polluted by indiscriminate defecation. Compared to controls, cases were more likely to have drank from Zamani river (OR 14.2, 95% CI: 5.5–36.8) and living in households(HH) with more than 5 persons/HH (OR 5.9, 95% CI: 1.3–27.2). Good hand hygiene was found to be protective (OR 0.3, 95% CI: 0.1–0.7). Conclusion Vibrio cholerae was the cause of the outbreak in Gomani. Drinking water from Zamani river, living in overcrowded HH and poor hand hygiene were significantly associated with the outbreak. We initiated hand hygiene and water treatment to control the outbreak.

Introduction Neonatal jaundice is the discoloration of the skin, sclera, and mucosa resulting from an excessive accumulation of bilirubin within the tissue and plasma. Every year, around 1.1 million newborn babies worldwide experience severe hyperbilirubinemia and the majority reside in Sub-Saharan Africa and South Asia. Evidences on determinants of neonatal jaundice are limited in Ethiopia, particularly in our study area. Objective To identify the determinants of neonatal jaundice among neonates admitted to neonatal intensive care unit in hospitals of Gurage zone, Southern Ethiopia, 2022. Method Hospital-based unmatched retrospective case-control study was employed by reviewing one-year medical record of neonates from June 1, 2021 to May 30, 2022 in Gurage zone selected hospitals. The sample size was calculated by using Epi Info version 7 and study participants were selected by using a simple random sampling technique. Data were collected through a data extraction format. The data was entered using Epi data version 3.2 and exported to SPSS version 25 for analysis. Bivariate and multivariable logistic regression analysis were employed at 95% confidence interval for the existence of the association. P-value < 0.05 was used to identify the level of statistical significance. Result In this study, 375 neonatal medical charts which includes 125 cases and 250 controls were input into the data analysis process. Neonatal sepsis (AOR: 2.38; with 95% CI: 1.35–4.17), cephalic hematoma (AOR: 4.92; with 95% CI: 2.61–9.26), polycythemia (AOR: 3.60; with 95% CI: 2.03–6.34), prematurity (AOR: 4.57; 95% CI: 2.45–8.49), birth asphyxia (AOR: 2.26; 95% CI: 1.27–4.02), and breastfeeding (AOR: 5.35; 95% CI: 1.90–15.0) were the determinants of NNJ. Conclusion This study identifies preterm birth, newborn polycythemia, birth asphyxia, neonatal sepsis, breastfeeding, and cephalic hematoma as significant determinant factors in neonatal jaundice.

Background Pneumonia is the single largest infectious disease that causes more under-five morbidity and mortality than any other infectious disease in the world, including Ethiopia. The aim of this study is to assess determinants of pneumonia among under-five children in the South West Shewa Zone, Oromia Region, Ethiopia, 2021. Methods We used an unmatched case-control study design from March 15 to April 30, 2021, in the South West Shewa Zone, Ethiopia. A sample of 398 (199 cases and 199 controls) participated in the study. Trained data collectors through a pre-tested structured questionnaire collected data. We used Epi Info to enter data and analyzed using SPSS version 23. We described our data using descriptive statistics. We identified predictors of pneumonia using logistic regression analysis. We declared predictors of pneumonia at a P-value of 0.05 or less. Results Breastfeeding for less than 6 months [AOR:3.51, 95%CI:(1.12,11.00)], lack of Vitamin A supplementation [AOR:3.56,95%CI:(1.58, 8.05)], history of URTI [AOR:9.66, 95%CI:(4.69,19.87)], family child care practices [AOR:6.46, 95%CI, (2.83,14.76)], sleeping with three to five persons in a room [AOR:2.90, 9%CI: (1.23,6.84)], having above five persons in a room [AOR: 3.88, 95%CI: 1.02,14.77), use of wood as a source of fuel [AOR = 3.02 95% CI: 1.41,6.46)] and not opening windows [AOR:2.56 95%CI: (1.21,5.41)] were independent factors of pneumonia among under five children. Conclusion Pneumonia is associated with breastfeeding for less than 6 months, lack of vitamin A supplementation, history of URTI, types of childcare practice, indoor overcrowding, use of wood as a source of fuel, and not opening windows. Therefore, exclusive breastfeeding, improving vitamin A supplementation, early control of respiratory tract infection through promoting good hygiene and ventilation strategies in crowded homes, and promoting how to reduce indoor air pollution through affordable clean stoves will be relevant interventions to reduce under-five pneumonia.

A critical question in invasion biology involves the relative importance of propagule rain and community invasibility. For plant invasions, invasibility is often related to disturbance, but few studies of forest invaders have simultaneously investigated both canopy and ground-level disturbance. We investigated the relative importance of seed rain, canopy disturbance, and soil disturbance in a mature forest in Maryland on the recruitment of four invasive species: wine raspberry (Rubus phoenicolasius Maxim.), Japanese barberry (Berberis thunbergii DC), multiflora rose (Rosa multiflora Thunb.), and Japanese stiltgrass [Microstegium vimineum (Trin.) A. Camus]. Using complete censuses of a 9-ha plot at two points in time (2011-12 and 2014), we mapped new recruits, and related their locations to canopy and soil disturbance, as well as to a seed rain index based on locations of reproducing plants and seed-dispersal kernels. We found that propagule rain, as measured by the seed rain index, was a significant predictor of recruitment for B. thunbergii, R. phoenicolasius, and M. vimineum. For R. multiflora, seed sources were not located, precluding assessment of propagule rain, but recruitment was linked to canopy disturbance, as was recruitment of M. vimineum. However, because reproduction of R. phoenicolasius and, in some years, of B. thunbergii is higher in treefall gaps, these gaps experience higher propagule rain, with the result that recruitment is indirectly associated with these gaps. Ground-layer disturbance was an important predictor of recruitment only for B. thunbergii. Our findings reveal that the importance of propagule rain is the most consistent driver of recruitment, but canopy or ground-layer disturbance promotes recruitment of some invasive plant species.

Background Globally, in 2017, there were nearly 1.7 billion cases of childhood diarrheal diseases, and it is the second most important cause of morbidity and mortality among under-five children in low-income countries, including Ethiopia. Sanitary conditions, poor housing, an unsanitary environment, insufficient safe water supply, cohabitation with domestic animals that may carry human pathogens, and a lack of food storage facilities, in combination with socioeconomic and behavioral factors, are common causes of diarrhea disease and have had a significant impact on diarrhea incidence in the majority of developing countries. Methods A community-based unmatched case-control study was conducted on 407 systematically sampled under-five children of Jimma Geneti District (135 with diarrhea and 272 without diarrhea) from May 01 to 30, 2020. Data was collected using an interview administered questionnaire and observational checklist adapted from the WHO/UNICEF core questionnaire and other related literature. Descriptive, bivariate, and multivariate binary logistic regression analyses were done by using SPSS version 20.0. Result Sociodemographic determinants such as being a child of 12–23 months of age (AOR 3.3, 95% CI 1.68–6.46; P  < 0.05) and mothers’/caregivers’ history of diarrheal diseases (AOR 7.38, 95% CI 3.12–17.44; P  < 0.05) were significantly associated with diarrheal diseases among under-five children. Environmental and behavioral factors such as lack of a hand-washing facility near a latrine (AOR 5.22, 95% CI 3.94–26.49; P  < 0.05), a lack of hand-washing practice at critical times (AOR 10.6, 95% CI 3.74–29.81; P  < 0.05), improper domestic solid waste disposal (AOR 2.68, 95% CI 1.39–5.18; P < 0.05), and not being vaccinated against rotavirus (AOR 2.45, 95% CI 1.25–4.81; P < 0,05) were found important determinants of diarrheal diseases among under-five children. Conclusion The unavailability of a hand-washing facility nearby latrine, mothers’/caregivers’ history of the last 2 weeks’ diarrheal diseases, improper latrine utilization, lack of hand-washing practice at critical times, improper solid waste disposal practices, and rotavirus vaccination status were the determinants of diarrheal diseases among under-five children identified in this study. Thus, promoting the provision of continuous and modified health information programs for households on the importance of sanitation, personal hygiene, and vaccination against rotavirus is fundamental to decreasing the burden of diarrheal disease among under-five children.

Premature rupture of membranes is responsible for increased perinatal mortality and neonatal morbidity. Therefore, identifying the determining factors is essential for minimizing its adverse impact. Despite the existence of this problem in the study area, there is a gap in identifying the factors affecting its occurrence. We investigate the determinants of premature membrane rupture among mothers receiving labor care at three public hospitals public hospitals in the Northeast Ethiopia, from December 1, 2022, to March 30, 2023. Unmatched case‒control study was conducted and a total of 353 participants (118 cases and 235 controls) receiving labor care were recruited. The data were collected using a face to face interview and card review, entered into EpiData 4.6 and analyzed using STATA version 17. As a result; previous caesarian section (AOR: 2.11; 95% CI: 1.05–4.23), history of abortion (AOR: 3.68; 95% CI: 1.70–7.94), history of premature membrane rupture (AOR: 3.89; 95% CI: 1.73–8.71), chronic cough (AOR: 4.23; 95% CI: 1.47–12.18), mid-upper arm circumference < 23 cm (AOR: 3.47; 95% CI: 1.53–7.84), suspected sepsis (AOR: 2.99; 95% CI: 1.25–1.99), and presence of urinary tract infection (AOR: 3.14; 95% CI: 1.50–6.60) were determinants of premature membrane rupture. These findings underscore previous history of C/S, abortion, PROM, presence of different infections and malnutrition are associated with the case. This highlighting the need for comprehensive prenatal care.

Background Stunting remains one of the most common malnutrition problems among children in Ethiopia. Identifying the risk factors of stunting assists health planners to prioritize prevention strategies, and is a fundamental step for intervention. Therefore, this study aimed to assess factors associated with stunting among children aged 6–59 months in Bensa district, Sidama Region, South Ethiopia, 2018. Methods A facility-based unmatched case-control study was conducted from January 10 to March 10, 2018, on a sample of 237(79 cases and 158 controls) children aged 6–59 months with their respective mothers/caretakers. Data were collected using a structured, face-to-face interviewer-administered questionnaire and standard physical measurements. The data were entered into EP INFO version 7 and WHO Anthro software and analyzed using SPSS version 20. The variables were entered into the multivariable model using the backward stepwise regression approach. Multivariable logistic regression analysis was used to identify factors associated with stunting. Adjusted odds ratio (AOR) with 95% confidence interval (95%CI) and p-value <0.05 was used to declare the significance. Results Sex distribution was almost equal (Males = 52.3%, Females = 47.7%).The mean (standard deviation) age of cases and controls was 27.35 (±12.71) and 28.70 (±13.27) months respectively. The risk factors for stunting were diarrhea in the past two weeks (AOR = 2.71, 95% CI: 1.42–5.16), being male (AOR = 2.37, 95% CI: 1.224–4.59), inappropriate exclusive breastfeeding (AOR =2.07, 95%CI: 1.07–4.01), having less than or equal to three under-five children in the household (AOR = 2.18, 95%CI: 1.03–4.64), and mothers who had no formal education (AOR =3.28, 95%CI :1.56–6.924). Conclusions Diarrhea in the past two weeks, sex of a child, inappropriate exclusive breastfeeding, number of under-five children in the household, and mothers who had no formal education were the risk factors of stunting. Thus organized efforts aimed at focus on prevention of diarrhea as part of an overall public health strategy for improving child health and nutrition. Educating mothers/caretakers on the importance of exclusive breastfeeding should be considered. Moreover, mothers need to be encouraged to space birth between children through the use of family planning services.

Background Stillbirth is a substantially under-recognized adverse pregnancy outcome that predominantly occurs in low-middle-income countries. In 2019, Eswatini’s stillbirth rate was 13.2 per 1,000 births, higher than global targets. However, there is limited research on stillbirths in Eswatini. This study analyzed factors associated with stillbirths among women giving birth in four selected hospitals. Methods A multi-center unmatched case-control study was conducted using secondary data sources from July 1 to December 31, 2021. Birth records of 268 stillbirths (cases) and 1,151 live births (controls) were selected using consecutive and systematic random sampling, respectively. A piloted data extraction tool was used to extract data. Logistic regression ( p  < .05, 95% CI) was used to estimate crude and adjusted odds ratios for factors associated with stillbirths, with the final model developed through backward selection. Results Factors highly significant and strongly associated with stillbirths (p ˂0.001) included lack of iron and folic acid supplementation (aOR = 2.32; CI = 1.50–3.5), positive rapid plasma regain test (aOR = 7.30; CI = 2.39–22.29), hypertensive disorders of pregnancy (aOR = 3.49; CI = 1.99–6.09), antepartum hemorrhage (aOR = 17.04; CI = 4.53–64.09) birth before arrival (aOR = 1.87; CI = 1.75–2.51), meconium-stained liquor grade II (aOR = 11.42; CI = 4.30-30.35), and fetal complications (aOR = 3.17; CI = 1.99–5.11). Other significant factors include alcohol consumption, having eight or more antenatal care visits, abnormal amniotic fluid volume, use of traditional remedies, gestational diabetes, and anemia. Conclusion Stillbirth remains a significant public health burden in Eswatini, with key associated factors that are preventable, highlighting critical gaps in antenatal care. Therefore, strengthening routine screening, and integrated maternal health services offers a cost-effective strategy to reduce stillbirth rates and improve outcomes.

Background Globally, prematurity is a major determinant of morbidity and mortality contributing 30–40% of neonatal mortality. The consequences of preterm deliveries are enormous with developmental and childhood complications as well as high economic and psycho-social burden on the parents (family) and society. Some risk factors include ever having preterm delivery, multiple births and some medical conditions like sexually transmitted infection and urinary tract infections but these have not been ascertained in our study area. Much research into these risk factors is needed in Ghana. We assessed the obstetric determinants of preterm delivery. Methods We conducted a 1:2 unmatched case-control study in Greater Accra Regional Hospital (GARH) -Ridge, a secondary referral facility in Accra, Ghana (from October, 2015 -May, 2016). A case was a mother who delivered between 28 and 36 weeks of gestation (preterm) and a control was a mother who delivered after 37 to 42 completed weeks (term). We used structured questionnaire to collect data, reviewed maternal and foetal records using a checklist. Categorical variables were analysed and expressed as frequencies and proportions. We determined the association between obstetric factors and preterm delivery with multiple logistic regression. Significance level of the strength of association was determined at 95% CI and p -value < 0.05. Results We recruited 390 mothers, 130 had preterm deliveries (cases) and 260 had term deliveries (controls). Experiencing premature rupture of membrane (aOR: 2.3; 95% CI:1.0–5.5), pre-eclampsia/eclampsia (aOR: 3.4; 95% CI: 1.0–11.9) were found to be associated with preterm delivery. However, four or more ANC visit was protective factor for preterm delivery (aOR: 0.2; 95% CI: 0.1–0.4). Conclusion Premature rupture of membrane, hypertensive complications and antepartum haemorrhage were found to be risk factors associated with preterm delivery in Ridge Hospital. Health workforce providing ANC services need to identify risk factors and refer these mothers to the doctor for early management and improved outcome decreasing preterm delivery.

Background Early HIV diagnosis and access to treatment is one of the most effective ways to prevent its further spread and to protect the health of those living with the virus. However, delay in diagnosis is the major risk factor for uptake of and response to antiretroviral therapy. Methods Institution-based unmatched case-control study design was used in the study. The study was conducted in Debre-Markos and Finote-Selam Hospitals, Northwest Ethiopia. Cases were people living with HIV who had CD4 count <350cells/mm 3 or WHO clinical stage III and IV regardless of the CD4 count at first presentation and controls were those who had CD4 count ≥350cells/mm 3 or WHO clinical stage I and II. If both criteria were available, the CD4 count was used in the study as World Health Organization recommended. A total of 392 respondents (196 cases and 196 controls) were recruited and selected systematically. The data were collected by trained nurses using chart review and interviewer administered structured questionnaire. Binary Logistic Regression Model was used to identify the factors associated with late HIV diagnosis. Results About 95.9 % of study participants provided complete response. Having no understanding, compared to having understanding, about HIV/AIDS (AOR = 1.7, 95 %CI = 1.08–2.79) and ART (AOR = 2.1, 95 %CI: 1.25–3.72), being tested as a result of symptoms/ illness, compared to being tested for risk exposure (inverted AOR =2.5, 95 %CI: 1.64–4.76), and acquiring HIV through sexual contact, compared to acquiring it through other modes (AOR = 2.5, 95 %CI = 1.52–4.76) were positively and independently associated with late HIV diagnosis. Conclusions Unlike perceived HIV stigma, having no understanding about HIV and ART, being tested for presence of symptoms/illness, and acquiring HIV through sexual contact were independent and significant factors for late HIV diagnosis.