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Background: Globally, 20% of all newborns are born with low birth weight (LBW). There is, therefore, an urgent need to expedite the delivery of high-impact, evidenced-based, and low-cost interventions such as kangaroo mother care (KMC (defined as continuous skin-to-skin care) and exclusive breastfeeding for this vulnerable group. Methods: A multinational World Health Organization (WHO)-supported consortium created and tested the impact of locally-specific and globally-informed phases of KMC care on KMC uptake/scale-up across multiple sites. Here we report on the study of KMC predictors that is nested within Amhara's KMC implementation trial in Amhara, Ethiopia. We used multivariate logistic regression phases to identify diverse predictors of KMC, skin-to-skin contact, and exclusive breastfeeding at hospital discharge and day 28 of life. Results: We analysed data from 860 LBW newborns. At day 28, implementation period (adjusted odds ratio (aOR) = 3.2-5.0), hospital facility (aOR = 3.0-4.6), and having multiple births (aOR = 0.31) were the strongest predictors of effective KMC. Meanwhile, previous death of a newborn, type of health facility where delivery occurred, and previous LBW delivery were predictors of effective KMC at both time points. No single factor predicted KMC, skin-to-skin contact, and exclusive breastfeeding at all time points and across all implementation periods. Having multiple births was a negative predictor for skin-to-skin contact, while the implementation period and having older fathers (>29 years) were strong positive predictors for exclusive breastfeeding at both discharge and day 28. Mothers with a previous history of neonatal death and current skin-to-skin-care uptake strongly predicted exclusive breastfeeding uptake at both time points. At discharge, however, having a history of preterm birth and neonatal death strongly predicted exclusive breastfeeding uptake, while multiple current births, current very LBW newborns, and the use of standard binders decreased the likelihood of exclusive breastfeeding. Conclusions: To achieve the effective KMC coverage target of ≥80% in Ethiopia, KMC scale-up phases may have to consider the key predictors of KMC, EBF, and SSC to effectively target beneficiaries.

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In the context of the COVID-19 pandemic, we investigated associations between specific COVID-19-related changes and its impact on generalized anxiety disorder (GAD) levels among vulnerable young adults living with HIV (YALHIV) in a low-resource setting in Southern Uganda. This research utilized data from 500 YALHIV aged 19 to 25 from the Suubi+Adherence-R2 COVID-19 Supplement study. Disruptions were assessed using an 8-item modified Coronavirus Impact Scale, while anxiety was measured with the GAD-7 questionnaire. Hierarchical logistic regression analysis and multivariate linear regression were employed, guided by the Social Determinants of Health framework. Key findings highlighted changes in routines, family income, stress from the pandemic, changes in family stress and discord, and reduced access to mental health services heightened levels of probable GAD for YALHIV during the pandemic. Additionally, female young adults showed greater levels than males. These results underscore the urgency to develop tailored support mechanisms for YALHIV, especially during challenging and unprecedented times.

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Background: Overweight or obesity is an excessive fat accumulation that impairs the health and wellbeing of the adult population throughout the world. Recently Mid upper arm circumference (MUAC) was suggested as a screening index for overweight or obesity among adolescents, but its utilization for the assessment of overweight or obesity in the adult population is not clear yet. In addition, little is known about the screening ability of MUAC for overweight or obesity in the adult population of Ethiopia. Therefore, this study aimed to evaluate the utility of MUAC for screening overweight or obesity among adult employees of Mizan Tepi University, Southwest Ethiopia. Method: A Facility -based cross-sectional study was carried out from February 21 to March 20, 2020, at Mizan Tepi University. About 585 study participants were selected by gender-based stratified sampling technique. Anthropometric data like weight, height, and MUAC were collected. Pearson's correlation between MUAC, body mass index (BMI), and age was calculated to see a relationship between them. The Receiver operating characteristics (ROC) curve was calculated to identify the screening ability of MUAC for overweight or obesity. The appropriate MUAC cutoff point for both men and women established using the Youden index. Additionally, sensitivity, specificity, positive, and negative predictive values were calculated. Result: The prevalence of overweight and obesity among the study participants was 18.1% and 4.8%, respectively. MUAC had a strong positive correlation with BMI, r = 0.65 (95% CI; 0.56-0.69). According to ROC analysis, MUAC is an excellent screening tool for male and female employees with excellent accuracy (AUC = 0.9 with 91.4% sensitivity and 76.4% specificity) and good accuracy (AUC = 0.83 with 67.2% sensitivity and 83.5% specificity), respectively. Based on the youden index, the cutoff point of MUAC to screen overweight or obesity among male and female employees was 26.91cm. Conclusion: Mid-upper arm circumference (MUAC) has an equal ability with BMI to screen overweight or obesity among adults. Therefore, MUAC can be utilized as an alternative index to screen overweight and obesity in resource-limited setups.

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BACKGROUNDS: The frequency of poor dietary practice due to inappropriate dietary habits is higher during pregnancy compared to any other stage of the life cycle. Suboptimal dietary practices during pregnancy can increase the risk of intrauterine growth restriction, low birth weight, anemia, prenatal and infant mortality, and morbidity. Therefore, this study aimed to determine the dietary practice and associated factors among pregnant women at the public hospitals of Bench-Sheko and Kaffa zone. METHODOLOGY: An institutional-based cross-sectional study design was conducted among 566 pregnant women who attended antenatal care at the public hospitals of the Bench-Sheko and Kaffa zones. A systematic random sampling technique was employed to select the study units. The data were entered into Epi Data 3.1 and exported to Statistical Package for Social Science (SPSS) version 21 software for further analysis. Both Binary and Multivariable logistic regression analyses were used to examine the association between dependent and independent variables. The Crude Odd Ratio (COR) and Adjusted Odd Ratio (AOR) with 95% Confidence interval (CI) were calculated and the variable with P-value < 0.05 was considered statistically significant. RESULT: According to this study, only 23.7% (95% CI: 20.1, 27.4) of the study participants had a good dietary practice. The urban residents (AOR = 2.64; 95% CI:1.18, 5.92), monthly income of > 2000ETB (AOR = 2.47; 95% CI: 1.31,4.65), having nutrition information (AOR = 2.5; 95% CI: 1.14,5.52), good dietary knowledge (AOR = 2.79; 95% CI: 1.48,5.27), mothers occupation of employer (AOR = 1.88; 95% CI: 1.04,3.42) and a family size < 5 (AOR = 3.37; 95% CI: 1.32,8.65) were determinate of dietary practice. CONCLUSION: Generally, the prevalence of good dietary practice is suboptimal in the study area. Urban residency, monthly income > 2000ETB, good dietary knowledge, having nutrition information, family size < 5, and government employed mothers were the predictors of the good dietary practice in the Bench-Sheko and Kaffa zone. Therefore, providing in-service training for health professionals and assigning nutritionist to each public hospital should be done to provide health and nutrition education; and strengthen the existed nutrition counseling service for pregnant women. Moreover, the government should create sustainable income-generating activities for pregnant women.

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Background: Malnutrition affects millions of people in developing countries and contributes to poor health outcomes and nutritional status among women in the postpartum period. Lactation increases high nutritional demands and marks a significant life transition that can impact diet quality and subsequently predispose woman to high risk of overweight and undernutrition. Although, studies have been conducted on the nutritional status of lactating women, there is a gap especially on women's nutritional status during the postpartum period. Therefore, this study aimed to assess the nutritional status of postpartum women and associated factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia, 2020. Method: A community-based cross-sectional study was conducted in Shey-Bench District from March 1 to 30/2020 among 359 postpartum mothers. Bivariate analysis was employed to select candidate variables at P-value <.25 as a cut-off point. Multiple multinomial logistic regression analysis was used to identify variables significantly associated with nutritional status of the mother at P < .05 with 95% CI. Results: The study revealed that 10.3% of women were underweight and 16.7% were overweight. Employed mothers (AOR = 4.467, 95% CI [1.05-19.04]), employed husband (AOR = 0.087, 95% CI [0.021-0.370]), farmer husband (AOR = 0.084, 95% CI [0.024-0.293]), trader husband (AOR = 0.19, 95% CI [0.0614-0.616]), married mother (AOR = 0.222, 95% CI [0.088-0.560]), dietary diversity (AOR = 0.181, 95% CI [0.075-0.436]) were significantly associated with underweight and while being overweight was associated with dietary diversity, maternal age of between 15 to 24 and 25 to 34, exclusive breastfeeding, and frequency of breastfeeding. Conclusion: This study found a lower prevalence of underweight compared with overweight in the study area. Occupational status, marital status, age of the mother, dietary diversity, exclusive and frequency of breastfeeding were significantly associated factors with nutritional status of postpartum mother. We recommend strengthening the provision of nutrition education on modifiable factors with collaboration of other sectors.

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BACKGROUND: Gestational diabetes mellitus (GDM) is a high glucose level detected during pregnancy and usually it disappears after 42 days of post partum. The aim of this research was to assess the maternal and newborn effects of GDM in resource limited settings. METHODS: A prospective cohort was implemented in the five referral hospitals of Amhara region. Data were collected using both primary data collection tool and reviewing the patients' charts. Descriptive statistics were used to describe the effects of GDM on the pregnancy outcomes, fractional regression was used to estimate the proportion of weight gain in the first 3 months, Poisson regression was used to identify the effects of GDM on the episodes of childhood infectious diseases, independent sample t-test was used to estimate the effects of GDM on the newborn serum zinc and vitamin D levels. RESULTS: A total of 3459 women were included with a response rate of 85.56%. Cesarean section rate among GDM mother was 40.3% and among GDM free mothers was 7.1%. In the first 3 months, the weight gains of infant born from GDM mothers were 53% higher than infant born from GDM free mothers. GDM increases the risk of infectious disease episodes by 4 folds. GDM decreases the neonatal serum zinc and vitamin D levels. CONCLUSION: GDM increases the maternal complications of pregnancy; GDM significantly depletes the newborn micronutrient levels and increase the episodes of infectious diseases during the infancy periods.

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BACKGROUND: The outbreak of the novel coronavirus disease 2019 (COVID-19) pandemic presented a great threat to the physical and mental health of the general population. Patients with chronic disease have always been vulnerable to stressful life conditions. Therefore, determining the perceived stress and coping strategies among chronic disease patients is crucial to minimize the mental health consequences related to the outbreak. OBJECTIVE: This study aimed to determine COVID-19-related stress and coping strategies among adults with chronic disease in southwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted among 613 randomly selected adults with chronic disease in southwest Ethiopia. A multiple linear regression analysis was used to determine the relationship between the COVID-19-related stress score and coping strategy types, and independent sample t-tests and ANOVA tests were conducted. Statistical significance was accepted at p-values <0.05. RESULTS: More than two-thirds of study participants (68.4%) were moderately stressed, 13.9% were severely stressed, and 17.8% had low levels of perceived stress. Active coping (ß=1.238, 95% CI: 0.0 to 2.477), denial (ß=3.678, 95% CI: 2.44 to 4.915), behavioral disengagement (ß=3.669, 95% CI: 2.193 to 5.146), self-blame (ß=1.722, 95% CI: 0.146 to 3.297), and religion (ß=3.443, 95% CI: 2.028 to 4.858) coping strategies positively predicted the COVID-19-related stress score. Only the acceptance coping strategy (ß=-2.710, 95% CI: -3.926 to -1.493) negatively predicted the COVID-19-related stress score. CONCLUSION: Significant numbers of participants suffered from moderate to severe perceived stress levels due to the COVID-19 outbreak. Both adaptive and maladaptive coping strategy types were significantly associated positively and negatively with perceived stress score among adults with chronic disease. There were significant differences in the mean scores of perceived stress and categories of variables such as family size, duration of disease, and age of the participants.

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BACKGROUND: Glycemic control is the level of glucose in diabetes patient. Evidence regarding glycemic control is scarce in resource-limited settings, and this study was conducted to generate information regarding the prevalence and predictors of glycemic control among diabetes mellitus patients attending their care from the referral hospitals of the Amhara region, Ethiopia. METHODS: A cross-sectional study design was implemented. A simple random sampling technique was used. Data were collected from March 2018 to January 2020. The data were collected using interviews, chart review, and blood samples. Hemoglobin A1c was measured using high-performance liquid chromatography. Data were entered into Epi-info software and analyzed by SPSS software. Descriptive statistics were used to estimate the prevalence of glycemic control; linear regression was used to identify the predictors of HbA1c. RESULTS: A total of 2554 diabetes patients were included giving for the response rate of 95.83%. The mean age of the study participants was 54.08 years [SD (standard deviation) ± 8.38 years]. The mean HbA1c of the study participants was 7.31% [SD ± 0.94%]. Glycemic control was poor in 55.32% [95% CI: 53.4%-57.25%] of diabetes patients. The glycemic control of diabetes patients was determined by BMI (ß 0.1; [95% CI: 0.09-0.1]), type 2 diabetes (ß -0.14; [95% CI: -0.11-0.16]), age (ß 0.22; [95% CI: 0.02-0.024]), duration of the disease (ß 0.04; [95% CI: 0.037-0.042]), the presence of hypertension (ß 0.12; [95% CI:0.09-0.16]), regular physical exercise (ß -0.06; [95% CI: -0.03-0.09]), medication adherence (ß -0.16; [95% CI: -0.14-0.18]), and male (ß 0.34; [95% CI: 0.31-.037]). CONCLUSION: The glycemic control of diabetes patients was poor, and it needs the attention of decision-makers.

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BACKGROUND: This study was conducted to estimate the prevalence, determinants of hepatitis B, hepatitis C and the survival of tuberculosis patients until drug-induced hepatitis. METHODS: Prospective cohort study design was implemented. The data were collected from September 2016 - May 2019. Systematic random sampling was used to select the study participants. Baseline data were collected before the patient starts DOTS, the sign of liver toxicity was assessed every week. Tuberculosis treatment outcomes and WHO clinical stage was recorded at the end of 6th months. Descriptive statistics were used to estimate the prevalence of hepatitis B, hepatitis C viral infections and their effect on tuberculosis treatment outcomes. Binary logistic regression was used to identify the determinants of hepatitis B and C infections. The Kaplan Meier survival curve was used to estimate the survival of tuberculosis patient and Cox regression was used to identify the predictors of drug-induced hepatitis. RESULTS: A total of 3537 tuberculosis patients were followed. The prevalence of hepatitis B and C viral infection among tuberculosis patients were 15.1 and 17.3% respectively. Hepatitis B viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. Hepatitis C viral infection among tuberculosis patients was associated with alcohol, sex, HIV, chronic illness. The incidence density for liver toxicity among tuberculosis patients was 843/15707 person-months and liver toxicity was determined by HIV, Hepatitis B, Hepatitis C, the severity of tuberculosis and chronic illnesses. CONCLUSION: Decision-makers should consider incorporating screening for hepatitis B and C viral infection during tuberculosis treatment.

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As basic data, the river networks and water resources zones (WRZ) are critical for planning, utilization, development, conservation and management of water resources. Currently, the river network and WRZ of world are most obtained based on digital elevation model data automatically, which are not accuracy enough, especially in plains. In addition, the WRZ code is inconsistent with the river network, hindering the efficiency of data in hydrology and water resources research. Based on the global 90-meter DEM data combined with a large number of auxiliary data, this paper proposed a series of methods for generating river network and water resources zones, and then obtained high-precision global river network and corresponding WRZs at level 1 to 4. The dataset provides generated rivers with high prevision and more accurate position, reasonable basin boundaries especially in inland and plain area, also the first set of global WRZ at level 1 to 4 with unified code. It can provide an important basis and support for reasonable use of water resources and sustainable social development in the world.

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BACKGROUND: Pre-analytical phase of overall laboratory testing system continues to be the major source of errors that affect patient safety and health care system. One of the activities in this phase is venous blood collection (VBC), the most common type of specimen drawn or sent to clinical laboratories for further analysis; and the source for a potentially numerous types of errors. In this study, we focused on determining and comparing desirability/undesirability of activities during VBC in Ethiopian hospitals among different groups of professionals. METHODS: We conducted a cross-sectional comparative study in three government hospitals in South Ethiopia from February 2012 to September 2012. Randomly selected professionals who participate in VBC in outpatient and inpatient departments were requested to fill in structured and pretested questionnaire regarding their practice of VBC and their replies were categorized as 'desirable' and 'undesirable' according to Clinical and Laboratory Standards Institute (CLSI) standard. Then, data was analyzed using Medcalc® version 12.1.4 software. P value of less than 0.05 was considered as statistically significant. RESULTS: In our study, 120 professionals were included among which 15.8% (n = 19) were laboratory professionals while the remaining 84.2% (n = 101) were non-laboratory professionals. Conscious patient identification in pre-collection phase of VBC and position of patients' hands in actual collection phase of VBC involved the highest proportion of undesirability among both groups of professionals. However, in the post collection phase, specimen transferring from syringes to test tubes (15.8%) and mixing specimen with additives (63.4%) involved highest proportions of undesirability among laboratory and non-laboratory professionals respectively. Laboratory professionals reported better desirable practice in patient identification frequency, labeling and checking expiry dates of test tubes, specimen transfer and transport practices. CONCLUSION: In conclusion, preparatory activities of VBC involved the highest proportions of undesirable practices among both groups of professionals. However, relatively better proportions of desirability were seen among laboratory professionals than non-laboratory professionals in some pre- and post-collection phase activities. The difference might be seen as a result of better qualification, education and training experience on VBC among laboratory professionals.

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