Getasew Mulat Bantie

For several decades, malaria has been a significant health concern in the African region. It continues to be a major contributor to illness, hospitalizations, and death, particularly among young children and pregnant women. Despite the national and regional efforts towards achieving the 2030 malaria elimination strategy, Ethiopia still faced an increment in malaria cases. While studies exist, a thorough synthesis or mapping of practices and innovative diagnostics for Malaria was previously lacking. To explore current practices and innovative diagnostics for Malaria in Ethiopia, 2024. This scoping review was conducted following Arksey and O'Malley's methodological steps to develop research questions, identify relevant studies, include/exclude studies, extract data, and report the findings. To ensure methodological quality, we used the PRISMA guideline and PRISMA-ScR checklist. Thirteen studies were eligible, and 38.5% of them were published between 2008 and 2024. The majority (84.6%) of the studies were conducted using cross-sectional study designs, while one (7.7%) of them was conducted by RCT design. Most were conducted in the Amhara region (43.75%), followed by the Oromia region (31.25%). Light microscopy, rapid diagnostic test (RDT), polymerase chain reaction (PCR), and loop-mediated isothermal amplification (LAMP) were the identified malaria diagnostics so far in Ethiopia, with each having unique advantages and limitations. The current study underscored the need for a tailored, highly accurate, user-friendly, and applicable diagnostics that addresses the unique limitations of each malaria diagnostic modality to support the malaria elimination and control strategy in Ethiopia.

Background: Malaria is an important public health issue in Ethiopia. Accurate malaria diagnosis plays a vital role in effective treatment. However, there is limited data on the diagnostic accuracy of the newly introduced rapid diagnostic test (LDH-based RDT) and existing diagnostic methods. Objective: This study aimed to compare the diagnostic accuracy of the LDH-based RDT and existing diagnostic methods among uncomplicated malaria patients, 2024. Methods: The health-facility-based cross-sectional study was conducted in Dembia and North Achefer districts of the Amhara region. A systematic sampling technique was employed to recruit 460 febrile patients. Each patient’s blood sample was investigated for Plasmodium species by RDT, followed by microscopy by different laboratory professionals. The collected blood film slide was sent to the reference laboratory center, Ethiopian Public Health Institute, for confirmatory analysis. The diagnostic accuracy was assessed, and a kappa value > 0.6 was considered as having good agreement between diagnostic techniques. Results: The sensitivity and specificity of pLDH-based RDT were 99.6 and 100% compared to reference laboratory results. There was a very good consensus between pLDH-based RDT and blood film (Kappa: 0.97, p-value = 0.0001). There was also a good consensus between blood film at the local laboratory and pLDH-based RDT (Kappa: 0.748, p-value = 0.0001). However, there was the worst disagreement between clinical diagnosis, pLDH-based RDT, and blood film (Kappa range: -0.987 to -0.739). Conclusion: This study revealed that pLDH-based RDT and microscopy had higher accuracy as per the WHO recommendation standard. This study implied that clinical diagnosis of malaria must be supported either by RDT or microscopy.

Malaria is the major public health problem in low-income countries like Ethiopia. Despite extensive interventional studies being conducted to attain the 2030 malaria elimination goals, there is limited data on the treatment outcomes of uncomplicated malaria in Ethiopia. Thus, this study aimed to assess the treatment outcomes and associated factors of uncomplicated malaria in Northwest Ethiopia. This study was conducted in two health centers, Kolla Diba and Forhe-Sankira, located in Dembia and North Achefer Districts, from April to June 2024. Data was collected from 460 study participants who presented with signs and symptoms and from parasitologically confirmed patients. Malaria was confirmed using microscopy and rapid diagnostic tests (RDT). The parasitologically confirmed patients were appointed on the 3rd, 7th, 14th, and 28th days to determine treatment outcomes for those who were parasitemic on the preceding visit or symptomatic at each visit. The collected longitudinal data was entered and cleaned by Epi-data 4.1 and then analyzed using SPSS 25 software. Descriptive statistics were computed. A binary logistic regression model was fitted to identify factors associated with unsuccessful treatment outcomes at a 95% CI, and a p-value ˂ 0.05 was considered significant. Of the 460 study participants, 234 (50.9%) were parasitologically confirmed. Treatment outcomes were determined for 224 (95.7%) patients. Ten patients were lost to follow-up. The overall unsuccessful treatment rate was 18.8%. No previous malaria attack (AOR = 18.62, 95% CI: 5.15, 67.25), being infected by Plasmodium vivax (AOR = 8.58; 95% CI: 2.85, 25.83), and coartem two times for 3 days plus primaquine for 14 days (AOR = 4.84; 95% CI: 1.83, 12.79) were the identified factors for unsuccessful treatment outcomes. This study revealed that a higher proportion of patients had an unsuccessful treatment outcome. No previous malarial attack, being infected by Plasmodium vivax, and coartem plus primaquine were the identified factors for unsuccessful treatment outcomes. We recommend that healthcare providers prescribe first-line antimalarial therapy and appoint patients for follow-up evaluation according to the national guidelines to identify treatment failure early.

Background: The full pentavalent (DPT-HepB-Hib) vaccination is the main strategy to prevent five communicable diseases in early childhood, especially in countries with huge communicable disease burdens like Ethiopia. Exploring spatial distributions and determinants of full pentavalent vaccination status in minor ecological areas in Ethiopia is crucial for creating targeted immunization campaigns and monitoring the advancement of accomplishing sustainable development goals. This study aimed to investigate the spatial disparities and determinants of full pentavalent vaccination among 12-23-month-old children in Ethiopia. Method: The data on pentavalent vaccine uptake was found in the Ethiopian Health and Demographic Survey (EDHS, 2019). A two-stage cluster sampling method was applied to collect the EDHS data. The enumeration area was the primary sample unit while the household served as the secondary sampling unit. The geographical variations of full pentavalent vaccine uptake were explored using Quantum Geographic Information System (QGIS) software. The significant predictors of full pentavalent vaccination were identified using a simple logistic regression model through R version 4.1 software. Result: The national full pentavalent vaccine uptake was 59.2%. The spatial distribution of full pentavalent vaccine uptake was not uniform in Ethiopia. Spatial cluster analysis revealed that most of low coverage regions for full pentavalent vaccine uptake were Afar, Somali, and Harari. The regions with the highest and lowest rates of vaccine uptake were Tigray and Harari region, respectively. Maternal age of 35–49 years (AOR = 3.42; 95% CI: 1.99, 5.87), and 25–34 years (AOR = 1.55; 95% CI: 1.17, 2.19), primary education attended (AOR = 1.51; 95%CI: 1.07, 2.11), richness wealth index (AOR = 1.96; 95% CI: 1.40, 2.75), birth order of 1–3 (AOR = 1.88; 95% CI: 1.19, 2.96), and delivery in the health facility (AOR = 3.41: 95% CI: 2.52, 4.61) were the determinants of full pentavalent vaccine uptake in Ethiopia. Conclusion: Ethiopia’s full pentavalent vaccine uptake was far lower than the global target. Older maternal age, maternal education, wealth index, birth order, and giving birth in a health facility were the determinants of full pentavalent vaccine uptake. Special attention should be given to Afar, Somali, and Harari regions, to strengthen the vaccine uptake. Moreover, improved socioeconomic status and getting maternal health services during delivery are necessary to enhance vaccine uptake.

Introduction. Common mental health disorders (CMD) during pregnancy are a public health concern because of the implications for the mother and infant’s health during pregnancy and after birth. The prevalence and factors related to common mental disorders vary globally. Therefore, this study assessed the magnitude and factors associated with common mental disorder among pregnant women attending ANC follow-up in North Wollo Zone, Northeast Ethiopia. Methods. An institutional-based cross-sectional study was conducted in North Wollo, Amhara Region, Northeast Ethiopia. A multistage sampling technique was used to select 777 study participants. The common mental disorder was assessed by using SRQ-20. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Logistic regression analysis was done to identify the independent variables associated with common mental disorders. Independent variables with a value less than 0.05 were considered significantly associated with CMD. Results. The magnitude of CMD was 18.1% (95% CI: 15.5, 21.0). Factors significantly associated with CMD were the educational level of participants ( , 95% CI: 0.06, 0.48), husband’s educational status ( , 95%: 4.18, 29.66), unplanned pregnancy ( , 95% CI: 1.26, 5.09), self-reported complication on the current pregnancy ( , 95% CI: 0.05, 0.21), self-reported complication during the previous delivery ( , 95% CI: 1.39, 8.18), undernutrition ( , 95%: 1.26, 3.81), high psychosocial risk ( , 95% CI: 9.69, 43.59), having a legal issue ( , 95%: 1.12, 3.79), and relationship problem ( , 95% CI: 3.59, 14.53). Conclusions and Recommendation. One in five pregnant women has common mental disorder. Educational status of the participants and their spouses, unplanned pregnancy, self-reported complication during current and previous pregnancy, psychosocial risk, and legal and relationship problems were the main determinants of common mental disorders. Therefore, screening pregnant women for mental disorders and provision of necessary mental health services are recommended to minimize the adverse health outcome of CMD during pregnancy.

Aims: Pertussis, also known as whooping cough, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. Though vaccines are the most successful and cost-effective way of preventing pertussis, the outbreak of pertussis is still high in the Amhara region. The study aimed to investigate the pertussis infection in Simada district, North West Ethiopia, 2021. Methods: A community-based active surveillance was conducted in the Simada district from December 3/2020 to January 05/2021. A total of 43 cases was identified using the modified Centers for Disease Control and Prevention (CDC) pertussis diagnosis criteria and line lists. The collected data were entered into the Epi-data (Epidemiological Data) version 3.1 and analyzed using R version 4.03 software and descriptive statistics computed. Results: A total of 43 cases were identified with an overall attack rate of 7.1 per 1000 population. All complicated cases occurred in children under four years of age. The most affected groups were females. There was an interrupted routine immunization service in the cluster at the health post-level to associate vaccination coverage with the occurrence of a pertussis outbreak. The outbreak was reported after three days of the occurrence of more transmission from person to person. Conclusion: The outbreak of pertussis was high and the children were suffering. It is advisable to build capacity, consolidate routine vaccination services, and enhancing the vaccine cold chain management system, surveillance and early treatment of infected patients to control the expansion of pertussis.

Despite mortality in intensive care units (ICU) being a global public health problem, it is higher in developing countries, including Ethiopia. However, insufficient evidence is established concerning mortality in the ICU and its predictors. This study aimed to assess the magnitude of ICU mortality and its predictors among patients at Tibebe Ghion specialized hospital, Northwest Ethiopia, 2021. A retrospective cross-sectional study was conducted from February 24th, 2019, to January 24th, 2021. Data were collected from medical records by using pretested structured data retrieval checklist. The collected data was entered into Epi-data version 3.1 and analyzed using R version 4.0 software. Descriptive statistics computed. A simple logistic analysis was run (at 95% CI and p-value < 0.05) to identify the determinants for ICU mortality. A total of 568 study participants’ charts were reviewed. The median length of ICU stay was four days. Head trauma and shock were the leading causes of ICU admissions and mortality. The overall mortality rate of the ICU-admitted patients was 29.6% (95% CI: 26%, 33%). Admission in 2020 (AOR = 0.51; 95%CI: 0.31, 0.85), having altered mentation (AOR = 13.44; 95%CI: 5.77, 31.27), mechanical ventilation required at admission (AOR = 4.11; 95%CI: 2.63, 6.43), and stayed < 5 days in the ICU (AOR = 3.74; 95%CI: 2.31, 6.06) were significantly associated with ICU mortality. The magnitude of the ICU mortality rate was moderate. Years of admission, altered mentation, mechanical ventilation required at admission, and days of stay in the ICU were the predictors for ICU mortality. This finding underscores the importance of interventions to reduce ICU mortality.

Background: Infant mortality remains a public health challenge in Ethiopia. Exploring infant mortality will aid in tracking the progress toward achieving sustainable development goals. Objective: The study aimed to explore the geographical variations and associated factors of infant mortality in Ethiopia. Method: A total of 11,023 infants from the 2016 Ethiopian Demographic and Health Survey (EDHS) data were extracted and included in the analysis. EDHS used a two-stage cluster sampling design with a census enumeration area as the primary sampling unit and households as the secondary sampling unit. Arc GIS software was used for spatial analysis using clusters for exploring geographical variations in infant mortality. A binary logistic regression was employed using R software to identify the significant determinants of infant mortality. Results: The study revealed that the spatial distribution of infant mortality was non-random in the country. Infants whose mothers not receiving ANC (AOR = 1.45; 95%CI: 1.17, 1.79), not breastfed status (AOR = 3.94; 95%CI: 3.19, 4.81), poor wealth index (AOR = 1.36; 95%CI: 1.04, 1.77), male infants (AOR = 1.59; 95%CI: 1.29, 1.95), birth order of six or above (AOR = 3.11; 95%CI: 2.08, 4.62), small birth size (AOR = 1.27; 95%CI: 1.26, 1.60), birth spacing [(≤ 24 months (AOR = 2.29; 95%CI: 1.79, 2.92), 25–36 months (AOR = 1.16; 95%CI: 1.12, 1.49)], multiple births (AOR = 6.82; 95%CI: 4.76, 10.81), rural residence (AOR = 1.63; 95%CI: 1.05, 2.77) and regions [Afar (AOR = 1.54; 95%CI: 1.01, 2.36), Harari (AOR = 1.56; 95%CI: 1.04, 2.56), and Somali (AOR = 1.52; 95%CI: 1.03, 2.39)] were the determinants of infant death in Ethiopia. Conclusions: There is a great geographical disparity in infant mortality rates across regions. Afar, Harari, and Somali regions were verified as hot spot areas. ANC usage, breastfed status, wealth index, sex of the infant, birth order, birth size, birth spacing, birth type, residence, and region were the determinants of infant death in Ethiopia. Therefore, appropriate interventions need to be implemented in the hot spots to alleviate the risk factors for infant mortality.