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Introduction: Antiretroviral Treatment (ART) has great importance in reducing viral load. Though a global effort was made to suppress viral load, the level of viral load suppression among ART patients is still high in Ethiopia. Objective: This study aims to assess the magnitude and contributing factors for viral load suppression among patients attending ART clinics in Ethiopia. Methods: The articles were searched using different databases using the guideline of reporting systematic review and meta-analysis (PRISMA). A random effect model was used to ascertain the pooled prevalence of viral load suppression in Ethiopia using STATA 14 software. Results: The pooled prevalence of suppressed viral load was 75.25% (95% CI: 68.61-81.89). Having good adherence (OR: 2.71, 95% CI 2.27, 3.15), baseline CD4 count (OR: 1.74, 95% CI 1.53, 1.96), and being female (OR: 1.41, 95% CI 1.04, 1.79) were determinants of pooled estimates of suppressed viral load. Conclusion: The pooled prevalence of suppressed viral load was 75% which is lower than the targeted level by the sustainable development goal (SDG) 2020, which was 90%. Therefore, the stakeholders should be focused on the existing strategies to decrease viral load among ART patients. They should work to adhere to patients for ART treatment.

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Regular breast self-examination is the most cost-effective method for early detection of breast cancer, especially in resource-limited countries. However, breast self-examination practice was low among reproductive-age women. Objective: This study aims to evaluate breast self-examination practice and associated factors among women of reproductive age in southeast Ethiopia. Methods: A convergent parallel mixed-methods study design was conducted on 836 women of reproductive age. An interviewer-administered questionnaire was used for the quantitative part of the study and supplemented by focus group discussions. A database was created using Epi-info version 3.5.3, and analyzed using SPSS version 20. Bivariate and multivariable logistic regressions were done to examine the effect of explanatory variables. Variables with p-value <0.05 during multivariable logistic regressions were considered as significantly associated with the dependent variable. Thematic data analysis was carried out for the qualitative study. Result: Out of 836 total participants, only 20.7% had ever heard about breast self-examination practice. Also, only 13.2% of the mothers had practiced breast self-examinations. Even though the majority of the participants during focused group discussions had knowledge about breast cancer screening, most of them stated that breast self-examination was not practiced among them. Maternal age, mother's level of education, and previous history of breast examination by health professionals were significant predictors of breast self-examination practices. Conclusion: This study reported a low prevalence of breast self-examination practice. Therefore, enhancing women's education and encouraging breast examination by health professionals are essential to increase the proportion of women performing breast self-examination.

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OBJECTIVES: People's adherence to preventive practices for COVID-19 is fundamental to controlling the transmission of the virus. Therefore, this study is aimed at assessing adherence to preventive practices for COVID-19 and associated factors among the general population in Gurage zone, Ethiopia. METHODS: A community-based cross-sectional study was conducted to assess preventive practices and associated factors for COVID-19 among adults in the Gurage zone. The study is based on health belief model constructs. The study involved 398 participants. A multistage sampling technique was employed to recruit study participants. An interviewer-administered, close-ended, structured questionnaire was used to collect data. Binary and multivariable logistic regressions were used to identify independent predictors of the outcome variable. RESULTS: The overall adherence to all recommended preventive behaviours of COVID-19 was 17.7%. The majority of respondents (73.1%) practice at least one of the recommended preventive behaviours for COVID-19. Among adults' COVID-19 preventive behaviours score, wearing a face mask was the highest (82.3%) and social distancing was the lowest (35.4%). Residence adjusted OR (AOR)) 3.42 (95% CI 1.6 to 7.31), marital status AOR 0.33 (95% CI (0.15 to 0.71)), knowledge of the absence/presence of the COVID-19 vaccine AOR 0.45 (95% CI (0.21 to 0.95)) and self-rated level of knowledge as poor AOR 0.052 (95% CI 0.036 to 0.18) and self-rated level of knowledge as not bad AOR 0.14 (95% CI 0.09 to 0.82) were significantly associated with social distancing practice. Factors affecting other COVID-19 preventive behaviours are described in the 'Results' section. CONCLUSION: Prevalence of good adherence to recommended preventive behaviours for COVID-19 was very low. Residence, marital status, knowledge of vaccine presence, knowledge of curative drug presence, knowledge of the incubation period, the self-rated level of knowledge and perceived risk to be infected with COVID-19 are significantly associated factors with adherence to preventive behaviours.

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Background: Motivating proper nutrition during childhood is the basis for optimal health, learning, productivity, and social wellbeing throughout life. Stunting is among the major public health problems. According to the Ethiopian mini demographic and health survey, the prevalence of stunting among under five children was 37%. In addition, stunting has a trans-generational effect on a mother's nutritional status. However, evidence on the causal contribution of maternal employment to stunting among under five children is not well understood in Ethiopia. This study aimed to compare the stunting status and associated factors among under five children of employed and unemployed mothers in the Gurage Zone, Southern Ethiopia, in 2021. A community-based comparative cross-sectional study was conducted among 671 (330 employed and 341 unemployed) randomly selected mother-child pairs in the Gurage Zone, Southern Ethiopia. A pretested semi-structured tool and validated anthropometric measurements were used to collect the data. The data were entered into Epi Data version 3.1 and exported to Statistical Package for Social Science (SPSS) version 23.0 for analysis. Frequency, percent, mean, median, and SD were computed and presented by using tables and figures. A bivariable and multivariable binary logistic regression analysis was conducted to assess the association between factors and outcome variables. Results: In this study, a total of 671 mother-child pairs (330 (94.60%) employed and 341 (97.70%) unemployed) participated, with a total response rate of 96%. Among the total participants, about 70 (21.2%) [95% CI: (17.0, 25.5)] and 98 (28.8%) [95% CI: (23.0, 33.4)] of children of employed and unemployed mothers, respectively, were stunted. Mothers' level of education, primary and secondary [AOR = 1.79, 95% CI: (0.8, 3.7), age between 25 and 29 years [AOR = 0.08, 95% CI: (0.006, 0.904)], monthly family income > 5,000 birr [AOR = 0.42, 95% CI: (0.00, 0.64)], and children aged between 6 and 23 months [AOR = 2.9; 95% CI: (1.48, 5.80)] were predictors of stunting among the children of employed mothers. Compared to the mothers who did not receive nutritional education [AOR = 2.5; 95% CI: (1.10, 5.60)], monthly family income of 2,000 ETB [AOR = 2.64; 95% CI: (1.34, 5.19)], sex of child (girl) [AOR = 2.3; 95% CI: (1.30, 3.80), and mothers educational status of read-and-write only [AOR = 2.9, 95% CI: (1.40, 5.80)] were predictors of stunting among the children of unemployed mothers. The nutrition intervention should focus on encouraging women's education as it increases the probability of being employed, improving the income of families by using different income-generating strategies, and strengthening the existing essential nutrition counseling strategy. Likewise, further research work on the difference between employed and unemployed mothers on stunting status is also recommended to researchers.

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Objective: The health belief model specifies that individuals' perceptions about particular behavior can predict the performance of respective behavior. So far, the model has been used to explain why people did not follow COVID-19 preventive behavior. Although we are using it, to our best knowledge, its predictive ability in COVID-19 preventive behavior is unexplored. So, this review aimed to assess the model's predictive ability and identify the most frequently related construct. Method: A systematic review was conducted to examine the predictive ability of health belief model in COVID-19 preventive behavior using research done all over the world. Preferred reporting items for systematic review and meta-analysis guidelines were used. Comprehensive literature was searched using databases such as PubMed, Google scholar, and African Online Journal to retrieve related articles. Descriptive analyses such as the proportion of studies that better explained COVID-19 prevention behavior and the significance ratio of each construct of the model were made. Result: Overall, 1552 articles were retrieved using a search strategy and finally 32 articles fulfilling the inclusion criteria undergo the review. We found that in the majority (87.5%) of the studies health belief model has a good predictive ability of COVID-19-related behavior. Overall the explained variance for health belief model ranged from 6.5% to 90.1%. The perceived benefit was the most frequently significant predictor; highest significance ratio (96.7%) followed by self-efficacy, cues to action perceived barrier, susceptibility, and severity in decreasing order. Conclusion: Health belief model has a good predictive ability of COVID-19-related behavior in the majority of reviewed studies. The perceived benefit was the most frequently significant predictor of COVID-19-related behavior. Professionals who are in need can effectively use health belief model in planning and designing interventions to prevent and control the pandemic.

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BACKGROUND: Stimulating care during childhood is the foundation for optimal health, learning, productivity, and social well-being throughout the life course. In addition, malnutrition is a major public health concern affecting up to half of children under-five years in Ethiopia. However, evidence on the causal contribution of malnutrition to delay in child development is poorly understood in Ethiopia. OBJECTIVE: To identify the relationship between different forms of malnutrition and delay in child development among children in Southwest Ethiopia. METHODS: A community-based survey was conducted among 507 randomly selected mother-child pairs in the Guraghe Zone, Southwest Ethiopia. A pretested tool and validated anthropometric measurements were used. Anthropometric indices (WFH, WFA, and HFA) were calculated in Anthros software. The data were summarized in mean, median, standard deviation, tables and charts. Bivariable and multivariable binary logistic regression (stepwise backward regression) models were fitted with nutritional status (wasting, stunting and underweight) and other potential factors associated with delay in child developmental. Adjusted odds ratios with 95% confidence intervals and p-values were reported. RESULTS: A total of 507 mother-child (12-59 months) pairs were included in the survey (97% response rate). The mean ASQ-3 score was 150 (± 23.4), with a minimum and maximum score of 45 and 270, respectively. A total of 149 (29.4%; 95% CI: 25.4-33.4) children had developmental delays, where 17.2%, 16.8%, 13.4%, 10.8%, and 10.1% had delays in gross motor, communication, problem-solving, personal-social, and fine motor skills, respectively. Children of working mothers (AOR=2.9; 1.8, 4.8), preterm births (AOR=3.2; 1.4, 7.0), early initiation of complementary feeding (AOR=2.5; 1.37, 4.6), stunting (AOR=3.0; 1.9, 4.7), underweight (AOR= 2.3; 1.1, 4.7) and low dietary diversity score (AOR=3.1; 1.3, 7.5), were predictors of developmental delay. CONCLUSION: Child development delay is a public health concern and it is strongly associated with stunting, underweight, undiversified dietary consumption, and suboptimal infant and young child feeding practices.

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BACKGROUND: The continuing rise in the burden of noncommunicable diseases (NCDs) is a key global health agendum due to the fact that NCDs cause more deaths than all other causes combined together. Although measuring the burden of NCD is very important to improve the existing health care systems and to monitor the progress of the program, a comprehensive estimate is lacking in Ethiopia. Hence, we aimed to systematically analyze the existing evidence to bring a solution. METHODS: The research used data from the Global Burden of Disease Study (GBD 2016) and Global Health Estimates 2016 that originally collected the information through vital registration, verbal autopsy, surveys, reports, and modeling. RESULTS: In 2016, NCD caused an estimated 274998.8 (95% CI: 211290.2-362882.1) deaths among all ages and both genders with a crude death rate of 268.5/100000 and age-standardized death rate (ASDR) of 554.7/100000 population. It contributed to 39.3% of the total death, 53% of ASDR, and 34% of DALYs. The number of deaths and DALYs from NCD has increased by 38% and 31.5%, respectively, whereas CDR and ASDR from NCD have declined by 10.3% and 12.5%, respectively. Cardiovascular diseases, malignant neoplasms, digestive diseases, respiratory diseases, diabetes mellitus, and neurological conditions were the leading level 2 causes of ASDR due to NCD, while ischemic heart disease, stroke, other circulatory diseases, cirrhosis of the liver, and COPD were the top 5 causes of ASDR from NCD at level 3 causes. Conclusion and Recommendation. The burden of NCD was remarkably increased between 2000 and 2016. It carries the highest burden of ASDR. Cardiovascular diseases and malignant neoplasms were the two most common causes of mortality and DALYs. Therefore, the existing disease prevention strategies should be strengthened by incorporating strategies addressing noncommunicable diseases.

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BACKGROUND: Determination of infection rates of snail populations is one of the basic tools for epidemiological studies of snail borne diseases. In this study, we opted to determine the trematode infection of freshwater snails in the Omo-Gibe River Basin, southwest Ethiopia. METHODS: We collected snail samples from 130 observation sites in lakes, wetlands, rivers, reservoirs and irrigation canals surveyed during the dry season (March to May) in 2016. The snail samples were examined for trematode infections by cercarial shedding immediately after collection. Habitat conditions, water quality, human water contact practices and other human activities were assessed at each survey site. A redundancy analysis (RDA) was used to examine the relationship between cercarial infection and environmental variables. The statistical significance of eigenvalues and cercariae-environment correlations generated by the RDA were tested using Monte Carlo permutations at 499 permutations. RESULTS: A total of 3107 snails belonging to five species were collected. The most abundant species was Biomphalaria pfeifferi, representing 66% of the total collection. Overall, 109 (3.6%) of the snails were found infected with trematodes (cercariae). Biomphalaria pfeifferi was found to be the most highly infected, accounting 85% of all infected snails. A total of eight morphologically different types of cercariae were recorded, which included: Echinostoma cercariae, brevifurcate apharyngeate distome cercariae, amphistome cercariae, brevifurcate apharyngeate monostome cercariae, xiphidiocercariae, longifurcate pharyngeate distome cercariae, strigea cercariae and unidentified cercariae. Brevifurcate apharyngeate distome cercariae, and Echinostoma cercariae were the most abundant cercariae, accounting for 36 and 34% of all infection, respectively. The mean concentration of water conductivity and 5 days biological oxygen demand were higher in irrigation canals and lake sampling points. Human activities such as open field defecation, urination, livestock grazing, farming, and swimming were highly correlated with trematode infection. CONCLUSIONS: The abundance, occurrence and infection rates of snail species were largely influenced by water physicochemical quality, sanitation and water contact behaviour of the inhabitants. Human activities, such as open field defecation and urination, livestock grazing, farming, and swimming were important predictors of the abundance of cercariae. Therefore, awareness creation should be implemented for proper containment of excreta (urine and faeces) and reducing human and animal contacts with surface waters to reduce snail-borne disease transmission.

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