Habtamu Dessie Mitiku

Early neonatal mortality is a serious public health issue in Ethiopia. Therefore, this study aimed to map the regional disparities and identify factors contributing to early neonatal mortality in Ethiopia over time. Ethiopian demographic and health survey (2000–2019) dataset were utilized. A total of 80,286 early neonates was included in this study. Logit based decomposition analysis was employed to understand the contributing factors for the change in early neonatal mortality over time. Getis Ord GI* statistic was performed to identify the cold and hot spots of the early neonatal mortality in Ethiopia. In addition, kriging interpolation was used to predict the burden of early neonatal mortality in the unsampled areas of the country based on the observed data. Early neonatal mortality trends in Ethiopia has been decline from 43 in 2000 to 33 in 2019 per 1000 live births. It was spatially clustered, with significant hotspots in the Benishangul Gumuz and some areas of Oromia, Tigray, Amhara and Somali regions. In the logit multivariable decomposition analysis babies born in rural (B − 0.0002, 95% CI − 0.002 to − 0.001), Women had partner (B − 0.0005, 95% CI − 0.0007 to − 0.0003), preceding birth interval ≥ 2 years (B − 0.008, 95% CI − 0.005 to − 0.001), Health facility delivery (B − 0.001, 95% CI − 0.003 to − 0.001), had ANC visits (B − 0.02, 95% CI − 0.03 to − 0.01), early initiations of breastfeeding (B − 0.002, 95% CI − 0.003 to − 0.001), multiple pregnancies (B − 0.002, 95% CI − 0.003 to − 0.001), and mothers education higher (B − 0.004, 95% CI − 0.006 to − 0.002) were a substantial factors that contribute to the change in the decline in early neonatal mortality in Ethiopia over time. Strengthen maternal and newborn care, expand skilled birth attendance, enhance antenatal and postnatal services, and utilize spatial evidence to inform targeted policy and resource allocation.

Introduction Road traffic accidents are a serious public health challenge in Ethiopia’s Amhara region. This study provides pooled estimates of road traffic accidents related injuries, death and risk factors. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched PubMed/Medline, Web of Science, Scopus, Google Scholar, African Journals Online, EMBASE databases and grey literatures from 10 January to 15 March 2025 using Medical Subject Headings terms and Boolean operators. Studies published since 2020 were screened to ensure the inclusion of the most recent and contextually relevant evidence, and data were extracted independently by two reviewers using a standardised Excel sheet form. Quality was assessed via the Joanna Briggs Institute checklist. Random-effect models were employed due to heterogeneity. Meta-analysis was conducted using STATA V.14.0 software. Subgroup analysis and meta-regression were performed to identify factors and source of heterogeneity. Small study effects and publication bias were examined through funnel plots and Egger’s/Begg’s tests. Results 12 studies (n=5222) were included. Pooled prevalence of road traffic accidents related death was 33% (95% CI 23% to 48%) and injury 48% (95% CI 28% to 58%). Meta-regression showed no significant effects of publication year, zone, study design or sample size. Key risk factors included driver-related issues (young age, inexperience, speeding, phone use, alcohol/fatigue driving, overloading), poor vehicle/road and environmental conditions. Conclusions Road traffic accidents related injuries and death burden remain high in the Amhara region, driven mainly by risky driver’s behaviour, suboptimal infrastructure and environmental conditions. Strengthening safety regulations and sustained behavioural interventions are urgently needed. PROSPERO registration number CRD 420251003488

Background Soft-tissue sarcomas are an uncommon group of neoplasms that can be fatal, especially in metastatic settings. Thus, this study aimed to assess the demographic, pathological, clinical, and treatment patterns of soft tissue sarcoma at the Tikur Anbesa Specialized Hospital in Ethiopia. Methods A retrospective cross-sectional study was conducted on patients with soft tissue sarcomas who visited the Tihur Anbesa Specialized Hospital, Ethiopia, between August 2017 and August 2021GC. A total of 190 samples were taken. Data from health management information system logbooks and medical records were collected, with only histopathology-confirmed cases included, while those with incomplete data were excluded. Analysis was performed using SPSS version 25, and ethical clearance was obtained from Addis Ababa University College of Health Sciences. Results A total of 320 patients were registered between August 2017 and August 2021; 190 patients were available for this study, and 130 were lost. The median age was 32 years of age and male sex was commonly affected, accounting 61.6%, and female sex accounted 38.4%. The common sites were extremities, accounting for 48.9% of cases. The Commonest presenting symptoms were mass and pain, accounting for 93.2% and 77.9% of cases, respectively. The common histological subtypes were undifferentiated sarcoma, rhabdomyosarcoma, and synovial sarcoma, accounting 50%, 15.8%, and 6.3% cases, respectively. The grade of the lesions was described in 67.3% of patients. Of the lesions whose grade was described, 56.8% were high grade lesions. In all cases, 58.3% of the patients underwent surgery as the primary treatment modality. Only 50.5% of cases were started treatment with curative intent, and 49.5% of the patients started their treatment with palliative treatment. Conclusions The pattern of soft tissue sarcomas showed a heterogeneous distribution in terms of demography, clinical presentation, treatment, and pathological subtypes. The advanced stage of initial clinical presentation and substandard work-up and therapy make it unique from cases reported in other parts of the world.

Background: Contraceptive compliance has become a major health concern around the globe, particularly in rural parts of Ethiopia. Therefore, this study aimed to assess contraceptive compliance among rural women of the reproductive age group in the Awi zone, Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted on 2341sampled rural women’s reproductive age group from Jan to April 30; 2021G.C. Multistage random sampling was employed. A multilevel logistic regression model was used to identify the predictors of contraceptive compliance, which allows us to account for the random component. Intra-cluster correlation coefficient (ICC) statistics were also computed to measure the variation between clusters. Results: Results showed that prevalence of contraceptive compliance in the selected districts of Awi zone was 17.1%. At individual level, women’s aged 35– 49 (AOR = 0.50, 95% CI 0.28, 0.90), married women’s (AOR = 8.81, 95% CI 4.62, 16.66), had 1 to 2 living children (AOR = 1.15, 95% CI 1.06, 1.40), women’s work status hard (AOR = 5.80, 95% CI 2.85, 11.82) and moderate (AOR = 4.71, 95% CI 2.39, 9.28), long-acting (AOR = 1.84, 95% CI1.28, 2.64) and positive attitude (AOR = 2.71, 95% CI1.16, 6.33) and at hierarchical level (group level), mass media exposure (AOR = 1.78, 95% CI 1.32, 2.41) and enforcement exposure (AOR = 1.77, 95% CI 1.19, 2.65) were significant factors of contraceptive compliance. Moreover, results for the intra-class correlation coefficient show that variation exists between clusters. Conclusion: Individual-level (women’s age, married women’s, number of living children, women’s work status, type of contraceptive method and attitude) and community-level (mass media exposure and enforcement exposure) were found to be significant factors associated with compliance in Awi zone.

Soil-transmitted helminthiasis (STHs) and undernutrition are common health problems in developing countries. Several reports showed that STH and undernutrition are often associated. The main aim of this study was to determine the association of STH and undernutrition among schoolchildren in Mettu town, Southwest Ethiopia. A cross-sectional study design was employed. To collect socio-demographic data, semi-structured questionnaire and physical observation were used. Kato-Katz technique and Anthropometric measurements were also considered to see STH infection and determine the nutritional statuses of the study participants respectively. Then, the data generated from the study was managed using Chi-square test and logistic regression analysis to determine the association of demographic variables with infections of helminthes and assess the risk factors for nutritional status of the study participants respectively. As a result, among the 392 study schoolchildren, 331 (84.4%) children were positive for different species of STH and undernutrition accounted 32.6%. Ascaris lumbricoides (39.0%), Trichuris trichiura (32.9%) and hookworm (28.1%) are the predominant STH identified from the study participants. Age, maternal educational and occupation status, and fingernail status of children were found significantly associated (p < 0.05) with the risk of getting STH. Bivariate logistic regression analysis showed that, age (AOR 2.18, 95% CI 1.53, 6.59), maternal illiteracy (AOR 0.13, 95% CI 0.91, 0.34) and maternal occupation (AOR 1.67, 95% CI 1.08, 5.91) were major co-founding factors for the prevalence of STH among study participants. In addition, children with T. trichiura infection were more likely (P < 0.01) to suffer from undernutrition (AOR 0.52, 95% CI 0.31, 0.83). Thus, the findings revealed the high prevalence of STH and it has significant association with undernutrition among school age children in the study area. Anti-helminthic mass drug administration and maternal health education should be anticipated to curve the tragedy.

Background: The neonatal period is the most critical time of human life for diseases. Neonatal morbidity and mortality are significant contributors to under-five morbidity and mortality in a low-income country like Ethiopia. Women are one of the key actors for the improvement of maternal, neonatal, and child healthcare utilization. However, there's no evidence on the association of women’s decision-making autonomy with neonate death at a national level in Ethiopia. Therefore, this study aimed to assess the neonatal mortality and associated factors in Ethiopia. Methods: A total of 5128 neonates born 5 years before the survey from the Ethiopian Demographic and Health Survey 2016 were reviewed. A multivariable logistic regression model was employed to assess the effect of women's autonomy and identify the determinate predictors of neonate death risk. Results: The rate of neonatal mortality in Ethiopia was 20.7 per 1000 live births). Women's hadn't autonomy in health care increase neonatal death by 2.72 times compared with those that had autonomy. Hadn't postnatal care was caused grown neonatal death by 5.48 times (AOR 5.48, 95% CI 1.29, 23.26). Delivering at a health institution had 0.61 times lowered neonatal death risk compared with delivering at of health institution without a health facility (AOR 0.61, 95% CI 0.38,0.97). Breastfeeding immediately within 1 h after birth had 0.17 times reduce neonatal death risk compared with not initiation of breastfeeding (AOR 0.17, 95% CI 0.12, 0.26). Women's gave birth single had 0.09 times reduced neonatal death risk than those that gave birth multiple (AOR 0.09, 95% CI 0.05, 0.18). Unknowingly, male neonates had a 1.84 times higher risk of death than females (AOR 1.84, 95% CI 1.20, 2.81). Conclusions: Neonatal mortality rate was significantly related to women's hadn't decided power on health care, hadn't postnatal care, delivered out of health institution, breastfed not immediately, and gave birth multiple. It is important to encourage mothers autonomy, use postnatal care service, and deliver in health institutions.

Introduction: Women’s decision-making autonomy is extremely important for the development of maternal, neonatal, and child healthcare utilization. However, there's no evidence on the association of women’s decision-making autonomy with neonatal mortality rate at a national level in Ethiopia. Therefore, this study aimed to assess the effect of women's autonomy on neonatal mortality rate and its associated factors in Ethiopia. Methods: A total of 5,128 neonates born 5 years before the survey from Ethiopian Demographic and Health Survey 2016 were reviewed. A multivariable logistic regression model was employed to assess the effect of women's autonomy and identify the determinate predictors of neonate death risk. Results: The rate of neonatal mortality in Ethiopia was 20.7 per 1000 live births). Women's hadn't autonomy in health care increase neonatal death by 2.72 times compared with those that had autonomy. Hadn’t postnatal care was caused to grown neonatal death by 5.48 times (AOR 5.48, 95%CI: 1.29, 23.26). Delivering at a health institution had 0.61 times lowered neonatal death risk compared with delivering at of health institution without a health facility(AOR 0.61, 95% CI: 0.38,0.97). Breastfeeding immediately within 1hr after birth had 0.17 times reduce neonatal death risk compared with not initiation of breastfeeding(AOR 0.17, 95% CI: 0.12,0.26). Women's gave birth single had 0.09 times reduced neonatal death risk than those that gave birth multiple (AOR 0.09, 95% CI: 0.05,0.18). Unknowingly, male neonates had a 1.84 times higher risk of death than females (AOR 1.84, 95%CI: 1.20,2.81). Conclusion: Neonatal mortality rate was significantly related to women's hadn't deciding power on health care, hadn’t postnatal care, delivered out of health institution, breastfed not immediately, and gave birth multiple. It is important to encourage mothers autonomy, use postnatal care service, and deliver in health institutions.

Objective: Chronic heart failure is a complex clinical syndrome of functional or structural impairment in the heart. Even though the occurrences of heart failure is increasing in the world, there has been limited researches on the management of chronic heart failure in outpatient, particularly in the study area. Therefore, this studywas amed for the management of outpatients with chronic heart failure. A Retrospective cohort study was conducted from January 1, 2010, to December 30, 2016,on outpatient’s follow-up at Wollo governmental hospitals. A required sample of 487 patients were selected by using a simple random sampling method. Proportional hazard with weibull distribution was modelled since its coefficients more precise than other parametric Cox models. Result: Weibull proportional hazard model result showed that risk factors related to mortality were Age (HR=1.04,p=0.000),Rural in residence (HR=1.74,p=0.003),having poor Nutritional status(HR=3.12, p=0.000),Systolic blood pressure(HR=1.01,p=0.037),having Coronary Artery disease (HR=3.70, p=0.006), having Pneumonia (HR=1.91, p=0.015 and infection with Tuberculosis bacillus (HR=1.87, p=0.000) were found statistically significant. Hence, early identifying and treating of Chronic heart failure and improving a strategies of frequent monitoring and follow up for outpatients is highly recommended . Keywords:Chronic heart failure, Retrospective cohort study, Outpatient, treatment, Wollo, Ethiopia

Pregnancy is a happy time for women and their families although it can also a period of concern and anxiety, for some women, lose their babies during early or late pregnancy, give birth earlier than the expected date or face low birth weight. Therefore, this study aimed to assess the prevalence of adverse birth outcomes and associated factors among women who delivered in the North Wollo zone, northeast Ethiopia. The prevalence of adverse birth outcomes among women who delivered in North Wollo zone was 31. 8%. Living in rural area (AOR = 1.8; 95% CI 1.13, 2.78), age ≥ 34 years (AOR = 2.2; 95% CI 1.21, 4.05), mid-upper-arm circumference < 23 cm (AOR = 3.1; 95% CI 1.90, 4.94), multigravida women (AOR = 1.8; 95% CI 1.08, 3.06), lack of antenatal care visit (AOR = 2.1; 95% CI 1.02, 4.40) and complications during pregnancy (AOR = 2.1; 95% CI 1.23, 3.55) were significantly associated with adverse birth outcomes. The prevalence of adverse birth outcomes was high and is a major public health problem in Ethiopia particularly in the study area. Hence, increasing the access to health institutions, developing strategies to prevent and treat complications, and providing focused antenatal care follow-up for pregnant women is recommended.