Introduction Functional disability in older adults refers to difficulties in performing daily activities. It is usuallyevaluated based on an individual’s ability to carry out basic activities of daily living and instrumental activities of dailyliving. Although existing studies provide valuable insights, comprehensive global data on functional disability inbasic and instrumental activities of daily living among older adults remain limited. This study aims to review existingresearch worldwide to estimate the overall pooled prevalence of functional disability in these areas.Methods Systematic searches were conducted across EMBASE, Scopus, PubMed/MEDLINE, and Google Scholar fromMay 5 to July 11, 2024. Cross-sectional studies worldwide on functional disability in basic and instrumental activitiesof daily living among adults aged 60 and older, published in English up to July 11, 2024 were included. Studies wereexcluded if they did not report the outcomes of interest, were inaccessible, case reports, low quality, review articles,or published in languages other than English. Data extraction and cleaning were performed using Microsoft Excel,and STATA version 17 was used to compute the pooled effect size with 95% confidence intervals (CIs) for functionaldisability in both basic activities of daily living and instrumental activities of daily living among older adults. Toderive these estimates, we used weighted averages, where each study’s prevalence was weighted by the inverse ofits variance. Study heterogeneity was assessed using the Cochrane I² statistic and its associated p-value. Subgroupanalysis and meta-regression were conducted to identify sources of heterogeneity. Sensitivity analysis was used toevaluate the impact of individual studies on the overall results. Publication bias was assessed with Egger’s test andfunnel plots, and was addressed through trim-and-fill analysis.Results This review includes 35 studies with a total of 133,827 participants. The pooled prevalence of functionaldisability in basic activities of daily living was estimated at 26.07% (95% CI: 19.04–32.74), while on instrumentalactivities of daily living, it was estimated at 45.15% (95% CI: 36.02–54.29). After applying the trim-and-fill method,the adjusted overall prevalence of disability in basic activities of daily living was 15.12%, (a 95% CI: 11.25–19.13%).
subgroup analysis showed highest prevalence in Africa (BADL: 42.91%, IADL: 69.34%) and lowest in Asia (BADL:19.15%, IADL: 32.66%). Participants aged 65 and above, those in institutional settings, and studies with smaller samplesizes tended to report higher levels of functional disability.Conclusions Nearly one-fourth of the study participants had functional disability related to basic activities of dailyliving, while about half experienced disability in instrumental activities of daily living. This emphasizes the needfor continued effort in improving the quality of life and support systems for individuals facing functional disability,particularly in instrumental activities.Keywords Basic activities of daily living, Functional disability, Instrumental activities of daily living, Older adults.

Background: Informed consent (IC) is a principle in medical ethics and medical law that a patient must have adequate information and understanding before making decisions about their medical care. It is very essential for both clinician and patient in surgery and should be seen as a usual activity. Knowledge is one of the main intervention tools to improve patient comprehension in informed consent for surgical patients. In Ethiopia, little is known about the knowledge level and its determinant factors toward obstetric and gynecologic surgical informed consent. Due to this reason, this study aimed to assess the level of knowledge and associated factors of surgical informed consent among patients who underwent obstetric and gynecologic surgery at Debre Markos Comprehensive Specialized Hospital.
Methods: An institutional-based cross-sectional study was conducted from 28 November to 30 December 2023, among 298 postoperative women admitted to Debre Markos Comprehensive Specialized Hospital. Data were collected using a pretested, structured interviewer-administered questionnaire by using a systematic random sampling technique. The collected data were entered into EpiData version 4.6 and then exported to SPSS statistical software version 25 for analysis. A multivariable logistic regression analysis was employed to estimate the effect of independent variables on the outcome variable. An adjusted odds ratio [adjusted odds ratio (AOR)] with a 95% confidence interval (CI) was computed to report the presence of association between the dependent and independent variables. Statistical significance was determined at a P-value of

Introduction: Occupational health problems are the major issues of the world, particularly in developing countries. Sanitation workers are facing various health problems with little attention while conducting their day today activities. The review emphasizes the critical need for policies that ensure safety standards, provide proper protective gear, and establish regular health monitoring to protect workers' health and wellbeing.
Objective: The aim of the study was to assess the prevalence of respiratory symptoms and associated factors among sanitation workers in Sub-Saharan Africa.
Methods and materials: This systematic review and meta-analysis was done based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020). Literatures were searched using various database like Google scholar, Science-Direct, Pub-Med (Medline), Hinari, and Google. From eligible studies, data was extracted using Microsoft excel and exported to STATA version 14 statistical software for analysis. The prevalence of respiratory symptom was estimated using a random effect model. Publication bias was determined using Egger test and funnel plot whereas heterogeneity was evaluated using I2. Fortunately, 13 studies were included with a total participants of 4,401.
Results: The pooled prevalence of respiratory symptoms among sanitation workers was 43.79% (95% CI: 35.26, 52.33; I 2 = 97.3%, p < 0.000). Sanitation workers with a history of respiratory illness were 4.16 times more likely to have had respiratory symptoms compared to those without a history (OR: 4.16, 95% CI: 2.67, 5.66). Additionally, sanitation workers who did not wear nose/mouse masks were 2.36 times more likely to experience respiratory symptoms compared to their counterparts (OR: 2.36, 95% CI: 1.40, 3.32). Moreover, Sanitation workers with working experiences of greater than five were 1.81 times more likely to experience respiratory symptoms than those with less than 5 years working experiences (OR: 1.81, 95% CI: 1.26, 2.39).
Conclusion: Generally, half of the sanitation workers experienced respiratory symptoms. The symptoms were associated with history of respiratory illness, utilizing of nose/ mouth face mask and working experience. Hence, awareness creation session should conducted mainly for those with history of respiratory illness and poor personal protective users.

Keywords:  Sub Saharan Africa; prevalence; respiratory–epidemiology; risk factors; sanitation workers; systematic review and meta-analysis.

ntroduction: Cognitive impairment is a medical condition caused by neurodegeneration, marked by a gradualdecline in neurological, motor, psychological, and cognitive domain functions, as well as daily activities. Itprimarily affects individuals with conditions such as Alzheimer’s disease, stroke, HIV/AIDS, diabetes mellitus,cancer, epilepsy, dementia, and other chronic illnesses, as well as older adults. While some individual studieshave explored the effects of cognitive impairment, there is a lack of nationwide research to provide a compre-hensive understanding of its burden among individuals with chronic diseases.Objective: To assess the pooled prevalence of cognitive impairment and its associated factors among individualswith chronic diseases in Ethiopia.Methods: Several databases were examined to find available articles. The data were extracted and sorted inMicrosoft Excel before being exported to STATA/MP 17.0 for analysis. A random-effects Der Simonian-Lairdmodel with a 95 % confidence interval was used to pool the data. Cochrane I2 statistics and Egger’s test wereused to evaluate heterogeneity and publication bias, respectively. To determine the cause of heterogeneity,subgroup analysis was performed. A log-odds ratio was utilized to illustrate the association between cognitiveimpairment and its associated factors. P-values less than 0.05 were considered statistically significant.Result: This study included 22 individual articles comprising a total of 6818 participants. The overall prevalenceof cognitive impairment among individuals with chronic diseases was 44.43 % (95 % CI: 37.76–51.10). Studiesconducted in Addis Ababa reported a higher prevalence of 50.89 % (95 % CI: 34.59–67.19). Similarly, researchfocusing on older adults indicated the highest prevalence, at 57.58 % (95 % CI: 28.78–86.39). Participants whoare unable to read and write were 3.82 times more likely to experience cognitive impairment compared to thosewho had completed primary education (AOR = 3.82; 95 % CI: 2.97–4.91).Conclusion: This review found a high prevalence of cognitive impairment among Ethiopians with chronic dis-eases, especially in older adults and those in Addis Ababa. Illiteracy significantly increased the risk. Thesefindings highlight the need for targeted cognitive screening and integration of cognitive care into chronic diseasemanagement.
Keywords: Cognition, Cognitive impairment, Associated factors, Ethiopia

Background: Edible oil manufacturing is a labor-intensive sector with significanttechnological demands, where employees face various occupational hazards.The use of personal protective equipment (PPE) is not only a legal obligationbut also a key measure for safeguarding workers against job-related injuriesand health risks. Despite these challenges, this industry often remainsunder-researched and overlooked.Objective: To assess utilization of personal protective equipment and its keyfactors among workers in the WA edible oil factory in Debre Markos town,Ethiopia, in 2024.Methods: A cross-sectional study was conducted among employees of theWA Edible Oil Factory in Debre Markos. Using a simple random samplingmethod, 387 workers were selected to participate. Data were collectedthrough an interviewer-administered structured questionnaire, focusing on theuse of protective equipment, as well as socio-demographic, work-related,environmental, and organizational characteristics. The data were analyzed usingSPSS version 26. Logistic regression analysis was employed to identify factorsinfluencing the use of protective equipment, with the strength of associationsexpressed as odds ratios at a 95% confidence level.Results: Out of the total workforce, 214 individuals (55.3%) reportedusing personal protective equipment while on duty. The study identifiedseveral significant factors influencing personal protective equipment utilization,including receiving safety training, having access to protective equipment,regular occupational health and safety inspections, the presence of workplacesafety protocols, having three or more years of work experience, and abstainingfrom alcohol consumption and smoking.Conclusion: The utilization level of personal protective equipment amongworkers at the WA edible oil factory was found to be moderate when comparedto findings from other developing countries. Key factors influencing personalprotective equipment usage included access to safety training, availability ofprotective gear, workplace supervision, the presence of safety protocols, workexperience, and lifestyle behaviors such as alcohol and tobacco use. To improvepersonal protective equipment utilization, it is recommended to strengthenworkplace supervision, offer comprehensive safety training, and ensure theconsistent availability of safety guidelines.KEYWORDSutilization, personal protective equipment, edible oil factory, factory worker, Ethiopia

Introduction Nurse burnout negatively impacts patient care quality, safety, and outcomes, while harming nurses’mental health, job satisfaction, and retention. It also imposes financial burdens on healthcare organizations throughabsenteeism, reduced productivity, and higher turnover costs, highlighting the need for research to address thesechallenges. The umbrella review methodology was selected to integrate evidence from multiple systematic reviewsand meta-analyses, offering a broad and in-depth summary of existing research to guide practice and policy. Thisapproach equips stakeholders with a holistic understanding of the multifaceted impacts of nurse burnout, facilitatingthe design of effective interventions that support nurses, enhance healthcare delivery, and optimize patientoutcomes. Consequently, this umbrella review aims to evaluate the global prevalence and contributing factors ofnurse burnout.Methods This umbrella review included 14 systematic reviews and meta-analyses identified from various databases.The quality of each study was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR II). Data wereextracted using Microsoft Excel and analyzed with STATA 17.0. Heterogeneity was measured using Higgin’s I2 Statistics,and summary prevalence estimates were calculated with the Der Simonian-Laird random-effects model. Meta-regression and subgroup analyses were conducted to identify the source of high heterogeneity. Publication bias wasassessed using funnel plots and Egger’s regression test, with the former providing a visual assessment of bias and thelatter offering a statistical method to detect asymmetry.Results The global prevalence of nurse burnout was evaluated in three areas: emotional exhaustion (33.45%, 95%CI 27.31–39.59), depersonalization (25.0%, 95% CI 17.17-33.00), and low personal accomplishment (33.49%, 95% CI28.43–38.55). Emotional exhaustion was most common among nurses working during the COVID-19 pandemic(39.23%, 95% CI 16.22–94.68). Oncology nurses experienced the highest rate of depersonalization (42%, 95% CI16.71–77.30), while nurses in intensive care units reported the highest rate of low personal accomplishment (46.02%,95% CI 43.83–48.28).
Conclusions Nurse burnout is prevalent worldwide, often marked by a sense of low personal accomplishment.Several factors contribute to this issue, including role conflict, negative emotions, family problems, moral distress,stress, commuting distance, predictability of work tasks, and workplace advancement.Keywords Nurse, Burnout, Determinant factors, And umbrella review

Background Microcephaly and macrocephaly, which are abnormal congenital markers, are associated withdevelopmental and neurologic deficits. Hence, there is a medically imperative need to conduct ultrasound imagingearly on. However, resource-limited countries such as Ethiopia are confronted with inadequacies such that access totrained personnel and diagnostic machines inhibits the exact and continuous diagnosis from being met.Objective This study aims to develop a fetal head abnormality detection model from ultrasound images via deeplearning.Methods Data were collected from three Ethiopian healthcare facilities to increase model generalizability.The recruitment period for this study started on November 9, 2024, and ended on November 30, 2024. Severalpreprocessing techniques have been performed, such as augmentation, noise reduction, and normalization.SegNet, UNet, FCN, MobileNetV2, and EfficientNet-B0 were applied to segment and measure fetal head structuresusing ultrasound images. The measurements were classified as microcephaly, macrocephaly, or normal using WHOguidelines for gestational age, and then the model performance was compared with that of existing industry experts.The metrics used for evaluation included accuracy, precision, recall, the F1 score, and the Dice coefficient.Results This study was able to demonstrate the feasibility of using SegNet for automatic segmentation,measurement of abnormalities of the fetal head, and classification of macrocephaly and microcephaly, with anaccuracy of 98% and a Dice coefficient of 0.97. Compared with industry experts, the model achieved accuracies of92.5% and 91.2% for the BPD and HC measurements, respectively.Conclusion Deep learning models can enhance prenatal diagnosis workflows, especially in resource-constrainedsettings. Future work needs to be done on optimizing model performance, trying complex models, and expandingdatasets to improve generalizability. If these technologies are adopted, they can be used in prenatal care delivery.Clinical trial number Not applicable.Keywords Microcephaly, Macrocephaly, Congenital abnormality, HC, BPD

Introduction: The magnitude of poor sleep quality among people with asthma is widespread and has detrimental consequences, including a higher chance of having poor work performance, an increase in the frequency of asthma attacks, an increase in the need for overnight hospitalization, and a worse health related quality of life. However, it has not been well studied, especially in low-income countries like Ethiopia. This study's objective was to assess the degree of sleep quality and related factors among people with asthma who had follow-up visits at public hospitals in the East Gojjam Zone.
Methods: An institutional-based cross-sectional study design was conducted among 406 people with asthma through consecutive sampling techniques at public hospitals in East Gojjam Zone from June 6 to July 1, 2022. Sleep quality was measured by the Pittsburgh Sleep Quality Index through a face-to-face interview, and the collected data were entered into Epi Data version 4.4.2 and exported to SPSS version 25 for analysis. Logistic regression was fitted to assess the association between dependent and independent variables. Variables with a P-value

Background: Children on the streets are still vulnerable to early and unsafe sexual experiences. Having multiple sexual partners and the limited use of condoms were major risk factors for the spread of sexually transmitted diseases among youths in Ethiopia.
Objective: This study aimed to explore the risk factors of sexual and reproductive health problems, service utilization, and challenges among street youths in the East Gojjam Zone.
Method: A phenomenological study design was employed on street youths residing in the East Gojjam Zone. Study participants were purposively recruited from four town administrations in the East Gojjam Zone. The primary study unit was street youths who live in the zone. Eight in-depth interviews and eight focus group discussions were conducted. The data were audio recorded and analyzed using inductive thematic analysis.
Results: In this study, the risk factors that exposed street youths to sexual and reproductive health problems included low perceived susceptibility, lack of awareness of sexual and reproductive health, having multiple sexual partners, exposure to pornographic films, and utilization of alcoholic drinks and substances. Mainly, those street youths who were engaged in transactional sexual relationships were utilizing condoms consistently and had regular HIV screening tests. In addition, few street youths ever utilized maternal and child health services. The unsupportive behavior of health professionals, the absence of exact data, the health system, and lack of specific responsible organization on the sexual and reproductive health of street youths were considered major challenges.
Conclusion and recommendation: Most of the street youths were not utilizing reproductive health services. Limitation on the accessibility of sexual and reproductive health services to this segment of the population was the main contributing factor. So, the health system and policy should take front-line responsibility for the sexual and reproductive health of street youths and consider convenient reproductive health service programs for them.

Keywords:  Risk factors; Sexual and reproductive health service utilization; Street youths.

Flooding exacerbates health challenges by spreading waterborne diseases like diarrhea throughthe destruction of sanitation infrastructure and contamination of drinking water sources. However,evidence on the prevalence and contributing factors of diarrheal diseases among under-five childrenin the Dasenech district is limited. This study aimed to assess the prevalence of acute diarrhea andits determinants among under-five children in flood-affected areas of the South Ethiopia region. Acommunity-based cross-sectional study was conducted from July 1 to July 15, 2024, in flood-affectedareas of the Dasenech district, involving 696 under-five children. Five kebeles were purposivelyselected, followed by the proportional allocation of households, after which a systematic samplingtechnique was applied to identify study participants. Data were collected using a pretested andstructured questionnaire administered by trained interviewers. Multivariable logistic regressionanalysis was performed to identify factors associated with acute diarrhea, with statistical significanceset at p < 0.05 and a 95% confidence interval (CI). The prevalence of acute diarrhea was 31.6% (95%CI: 28.7–34.3%). Significant predictors of acute diarrhea included non-adherence to exclusivebreastfeeding (AOR: 2.14, 95% CI: 1.65–3.98), lack of latrines (AOR: 12.08, 95% CI: 9.77–13.13), unsafedisposal of child excreta (AOR: 3.86, 95% CI: 2.38–6.26), home delivery (AOR: 6.02, 95% CI: 5.53–8.82),and a recent history of diarrhea among mothers or caregivers (AOR: 3.14, 95% CI: 1.33–5.66). Acutediarrhea is highly prevalent among under-five children in the Dasenech district. The findings underscorethe need for targeted public health measures, such as improving waste management, promotingexclusive breastfeeding, constructing and utilizing latrines, and addressing maternal and caregiverhealth, to mitigate the burden of diarrheal diseases in this vulnerable population.Keywords Acute diarrhea, Dasenech district, Ethiopia, Flood-affected, Under-five childrenDiarrhea is defined as an increase in bowel movement frequency or a change in stool consistency, commonlyidentified as the passage of three or more loose or watery stools within a 24-h period1. This condition oftenresults from intestinal infections caused by bacteria, viruses, or parasites, which are closely associated withlimited access to safe water and inadequate sanitation facilities2. Inadequate water and sanitation contributeto over 94% of the four billion annual cases of diarrhea worldwide3,4. This condition claims approximately twomillion lives each year, representing 4% of global mortality. Alarmingly, 1.3 million of these deaths occur amongchildren annually5.