Gebremeskel Kibret Abebe

Background: Rabies is a major global public health problem, with case fatality rate approaching 100% once clinical symptoms appear, causing severe neurological complications and significant social and economic burdens. Ethiopia bears a high burden of rabies, with the disease remaining endemic and contributing to considerable vaccine-preventable deaths, largely due to low community awareness, inadequate preventive practices, and limited access to timely post-exposure prophylaxis. Although studies have examined community knowledge, attitudes, and preventive practices regarding rabies in Ethiopia; however, the reported findings vary across studies. Objectives: This review was conducted to estimate the pooled prevalence and identify associated factors of community knowledge, attitudes, and preventive practices related to rabies prevention in Ethiopia. Design: Systematic review and meta-analysis. Data Sources and Methods: A comprehensive and systematic literature search was conducted in PubMed/MEDLINE, EMBASE, ScienceDirect, Semantic Scholar, Google Scholar, the Cochrane Library, and the National Institute for Health and Care Excellence (NICE), together with relevant grey literature to identify studies reporting on community knowledge, attitudes, and preventive practices regarding rabies in Ethiopia. Data on prevalence estimates and associated determinants were extracted using Microsoft Excel and subsequently analyzed using Stata version 17.0. A random-effects model was applied to estimate the pooled prevalence, and subgroup analyses were performed to explore potential sources of heterogeneity among the included studies. Publication bias was assessed through visual inspection of funnel plots and Egger’s regression test. The methodological quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) critical appraisal checklist. Results: A total of 27 studies involving 11,964 participants were included in the final analysis. The pooled estimates of good knowledge, favorable attitudes, and good preventive practices toward rabies were 60.36%, 58.56%, and 54.62%, respectively. Individuals living in urban areas, formal education and previous exposure to rabies were positively associated with good knowledge of rabies prevention. Conclusions: Community awareness, attitudes, and preventive behaviors toward rabies in Ethiopia remain suboptimal, with disparities among rural populations and individuals with lower educational status. The findings highlight the need for focused education intervention, improved availability of vaccination and post-exposure services, and enhanced collaboration through the One Health approach. Future efforts should focus on scaling up community awareness and preventive behaviors to support rabies control. Registration: Not registered.

Epilepsy is a major public health issue in Africa. Among individuals with epilepsy, the prevalence of depression is estimated to be two to three times high

Background Diabetes ketoacidosis occurs at an estimated rate between 4.6 and 8 episodes per 100 patient-years in individuals with diabetes. Up to 47% of diabetes-related ketoacidosis deaths have been reported in East Africa, which is an unacceptably high rate. Socioeconomic factors, including cost and the unpredictability of insulin supplies, as well as social, cultural, and economic factors, contribute to the difficulty in controlling ketoacidosis in patients in Africa. Objectives To conduct systematic review and meta-analysis on mortality and its predictors among diabetic ketoacidosis patients in East Africa: A 2025 Systematic review and meta-analysis. Methods A Comprehensive search of MEDLINE (via PubMed), the Cochrane Database of Systematic Reviews, UpToDate, EMBASE, and NICE (National Institute for Health and Care Excellence) was performed to identify studies reporting mortality and its predictors in adult patients with diabetes ketoacidosis in East Africa. A Random effect- model was applied for pooled diabetes ketoacidosis mortality incidence. The quality of the studies was assessed using the Newcastle-Ottawa scale. The evaluation of publication bias revealed no evidence of bias. Results The final analysis included 2,260 patients from 11 studies. The pooled incidence of mortality among patients with diabetic ketoacidosis in East Africa was 12.02% (95% CI: 5.99–18.04; I2 = 89.9%; p < 0.001). Comorbidity (OR = 2.15; 95% CI: 1.56–2.74) and sepsis (OR = 1.77; 95% CI: 1.60–1.95) were found to be significant predictors of diabetic ketoacidosis related mortality. Conclusion The overall incidence of mortality among adult patients with diabetic ketoacidosis in East Africa remains high. The presence of comorbidity and sepsis increases mortality among adult patients with diabetic ketoacidosis.

Cerebral palsy (CP) is the most common motor disability in childhood which causes a child’s behavioral, feeding, and sleep difficulties. It remains a poorly studied health problem in Africa. The main aim of this study was assessing the pooled prevalence of Cerebral Palsy (CP) and its clinical characteristics in Africa context. Systematic review and meta-analysis were conducted using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search articles from electronic databases (Cochrane library, Ovid platform) (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, Maternity and Infant Care Database (MIDIRS). The last search date was on 12/05/ 2023 G. C. A weighted inverse variance random-effects model was used to estimate the pooled estimates of cerebral palsy and its types. The subgroup analysis, publication bias and sensitivity analysis were done. Studies on prevalence and clinical characteristics of cerebral palsy were included. The primary and secondary outcomes were prevalence and clinical characteristics of cerebral palsy respectively. A total of 15 articles with (n = 498406 patients) were included for the final analysis. The pooled prevalence of cerebral palsy in Africa was found to be 3·34 (2·70, 3·98). The most common type is spastic cerebral palsy accounting 69·30% (66·76, 71·83) of all cases. The second one is quadriplegic cerebral palsy which was found to be 41·49% (33·16, 49·81). Ataxic cerebral palsy accounted 5·36% (3·22, 7·50). On the other hand, dyskinetic cerebral palsy was found to be 10.88% (6·26, 15·49). About 32·10% (19·25, 44.95) of cases were bilateral while 25·17% (16·84, 33·50) were unilateral. The incidence of cerebral palsy in Africa surpasses the reported rates in developed nations. Spastic and quadriplegic subtypes emerge as the most frequently observed. It is recommended to channel initiatives toward the strategic focus on preventive measures, early detection strategies, and comprehensive management protocols.

Background: Postoperative mortality is one of the six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. This study aimed to assess the magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia. Methods: This systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Ten studies were included in this Systematic review and meta-analysis. The risk of bias for each study was assessed using the Joanna Briggs Institute quality appraisal scale. Publication bias was checked using a funnel plot and Egger’s regression test. Heterogeneity across studies was assessed by I² statistics. STATA version 17 software was used for analysis. A random effect model and the DerSimonian–Laird method of estimation was used to estimate the pooled magnitude of postoperative mortality. Odds ratios with 95% CIs were calculated to determine the associations of the identified factors with postoperative mortality. Results: The results revealed that the pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was 4.53% (95% CI :3.70–5.37). An American Society of Anesthesiologists score greater than or equal to III [adjusted odds ratio (AOR): 2.45, 95% CI: 2.02, 2.96], age older than or equal to 65 years (AOR: 3.03, 95% CI: 2.78, 3.31), and comorbidity (AOR: 3.28, 95% CI: 1.91, 5.63) were significantly associated with postoperative mortality. Conclusion and recommendations: The pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was high. The presence of comorbidities, age older than 65 years, and ASA physical status greater than III were significantly associated with postoperative mortality. Therefore, the Ministry of Health and other concerned bodies should consider quality improvement processes.

Background: Fighting health threats, especially the rise of new infectious diseases, is one of the main responsibilities of healthcare workers. However, their knowledge and attitudes toward monkeypox have not yet been assessed. Therefore, this study aimed to assess the knowledge, attitude, and factors associated with monkeypox infection among healthcare workers at Injibara General Hospital, Northwest Ethiopia. Methods: Institution-based cross-sectional study was conducted from December 1– 30, 2022. Data were collected using a structured self-administered questionnaire. A simple random sampling technique was used to select study participants. Descriptive statistics and multivariable logistic regression analyses were computed. The degree of association was interpreted using an odds ratio with a 95% confidence interval and a p-value < 0.05. Results: Among the 200 healthcare workers who participated, 38.5% (95% CI: 32.5%– 45%) and 62% (95% CI: 55– 68.5%) had good knowledge and positive attitudes regarding monkeypox respectively. Having a master’s degree or above (AOR = 11.25: 95% CI: 2.03– 62.33), being vaccinated against COVID-19 (AOR = 2.60: 95% CI: 1.37– 4.94), and having access to information about monkeypox (AOR = 3.37: 95% CI: 1.33– 8.50) were the factors associated with good knowledge. Furthermore, a positive attitude was significantly associated with being 30 years of age or older (AOR = 2.95: 95% CI: 1.55– 5.60) and having access to information about monkeypox (AOR = 4.14: 95% CI: 2.06, 8.30). Conclusion: Both good knowledge and positive attitudes were relatively low among healthcare workers. Factors such as age, education level, COVID-19 vaccination status, and access to information about monkeypox were significantly associated with the knowledge and attitude of healthcare workers. To enhance the knowledge and attitude of healthcare workers, hospitals should consider offering educational upgrades, hosting educational events like seminars, conferences, webinars, and campaigns, and ensuring comprehensive coverage of the topic in medical curricula.

Background: Nurses with reduced work ability had a high risk of disability pension, sickness absences, retirement intention, and leave their job and profession early. Nurses frequently suffer from job related stress, occupational fatigue and sleep problems, which can further compromise their work ability. Aims of the study: The aim of this study was to assess perceived work ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022. Methods: A multicenter, an institutional based, cross-sectional study was conducted among 410 nurses working in five selected Referral hospitals, found in the Northwest of Amhara regional state, Northwest Ethiopia, 2022. The data were collected using a structured, self-administered questionnaire and entered using Epi info version 7.2.5 software, analyzed using SPSS version 25. Summary statistics (median or IQR for continuous data and frequency and percentage for categorical variables) were used. The ordinal logistic regression was used to assess’ the presence of association between dependent and independent variables. Results: The findings of this study revealed that 59.0% of nurses had poor level of work ability, whereas 34.4% and 6.6% of nurses had sub-optimal and optimal level of work ability respectively. Multivariable ordinal logistic regression revealed that being male [AOR = 2.43; 95% CI (1.52, 3.91)], being BSC nurse [AOR = 0.21; 95% CI (0.08, 0.51)], nurses who had poor sleep quality [AOR = 0.34; 95% CI (0.12, 0.98)] and nurses who had chronic disease [AOR = 0.18; 95% CI (0.08, 0.41)] were significantly associated with nurses’ level of work ability, p-value < 0.05. Conclusions: In this study, the prevalence of poor level of work ability among nurses was high. Nurses with a female sex, nurses who had chronic disease, BSC holders and nurses who had poor sleep quality had a poor level of work ability. The federal Minister of health and the study hospitals collaborative with concerned stakeholders to design strategies to enhance work ability among nurses.