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

Background Providing timely first-aid by trained responders can reduce deaths and disabilities from road trafficaccidents, a leading global cause of death. Ethiopia ranks 19th worldwide and 4th in Africa. Therefore, this studyassesses the knowledge and, attitudes toward emergency first aid, and its factors among public transport drivers inInjibara, Ethiopia.Objective To assess the Knowledge, and Attitude towards first-aid utilization and its associated factors among PublicTransport Service Drivers in Injibara, Northwest Ethiopia, 2023.Methods A cross-sectional study was conducted involving 419 public transport drivers, selected systematicallybased on vehicle side numbers, starting with a random choice for the first respondent. Subsequent participants werechosen at every second interval (k = 2). A structured questionnaire was used to collect relevant data. Binary logisticregression was performed using SPSS V.26 to assess the associations between independent and dependent variables.The strength of these associations was measured using odds ratios and 95% confidence intervals, with a P-value < 0.05deemed statistically significant.Result The study revealed that the prevalence of good knowledge and favorable attitudes toward first-aid utilizationwas 33.2% and 38.2%, respectively. Participation in first-aid training (AOR = 0.566, p = 0.027), access to a first-aid kit(AOR = 1.65, p = 0.027), and prior experience using first-aid at accident scenes (AOR = 0.476, p = 0.014) were factorsassociated with better first-aid utilization. Drivers who had used a first-aid kit (AOR = 0.476, p = 0.014) and thoseexposed to training (AOR = 0.486, p = 0.034) demonstrated more positive attitudes toward first aid.Conclusion The knowledge and attitude toward first-aid utilization remain low. Participation in first-aid training,access to first-aid kits, and experience using them during accidents were factors associated with improvedknowledge. Additionally, drivers who have used first-aid kits and received training tend to have a favorable attitude
toward their use. Therefore, relevant authorities must enhance the availability of first-aid kits, increase the exposure ofdrivers, and provide training to drivers to increase their knowledge and favorable attitude towards first-aid utilization.Clinical trial number Not applicable.Keywords Knowledge, Attitude, First aid, Transport service, Ethiopia

BACKGRouNd: Trachoma is the leading infectious cause of blindness worldwide, particularly impacting the poorest nations, includingEthiopia.oBjECTivE: To assess knowledge, practice, and associated factors of trachoma transmission and prevention among primary school stu-dents in Addis Zemen town, South Gondar, Northwest Ethiopia, 2022.METhodS: An institution-based cross-sectional study was conducted on 407 randomly selected primary school students (grades 5-8),aged 10 to 24 years. Data collection included face-to-face interviews using structured questionnaires and an observation checklist. Epi-dataversion 4.2.0.0 and SPSS version 20 were used to enter and analyze the collected data, respectively. The data were analyzed using thedescriptive statistical method and using bivariable and multivariable logistic regression models. Variables with a P-value

Abstract: The continuous reduction in peri-urban agricultural land due to spatial urban expansionforces subsistence farmers to seek arable land through different land access strategies. Among these,land rental transactions are crucial for accessing arable land across different regions. This studyaimed to examine factors affecting land rental transactions in the peri-urban areas of the East GojjamAdministrative Zone in Ethiopia. Data were collected from 353 household heads of peri-urban areas,who were affected by expropriation. A total of 350 valid responses were analyzed using descriptiveand inferential statistics and an econometrics model. The results indicated that 58% of the respondentsparticipated in both renting and renting out land, which underlines the importance of land rentaltransactions in the peri-urban areas. Specifically, 60% of female-headed households were engagedin land rental transactions, with 14% renting in and 46% renting out land. In contrast, 38% of themale-headed respondents rented land, while only 19% rented out land. The model result identifiedsex, landholding size, number of oxen, participation in off-farm activities, and extension service assignificant determinant variables for renting land. Households made land rental agreements bothorally and in written documents, with oral agreements being more prevalent. Transaction dueswere conducted through sharecropping and fixed rents, with sharecropping being the most commonmethod. Thus, land rental transactions play pivotal roles to support the livelihoods of peri-urbansubsistence farmers.Keywords: land rental; land scarcity; peri-urban; rent; rent out; impacts; gender

Male involvement in infant care is an effective intervention to improve infant health outcomes. However, evidence regarding male involvement in infant care and its associated factors is limited in Ethiopia. To assess the male involvement in infant care and associated factors among infants less than one year in Bibugn district of Ethiopia. A community-based cross-sectional study was conducted among 606 participants from April 1-30/2023. A systematic sampling technique was used to select each study participant. Data was collected using interviewer-administered questionnaires. Data were entered into Epi data 4.6 and analyzed using statistical Product Service and Solution (SPSS) version 2 5. Both descriptives, mean, frequency and analytical statistics were employed. Variables with a p-value of less than 0.25 in bivariate logistic regression were entered into a multivariate logistic regression to identify associated factors. Statistical significance was declared at p < 0.05. The prevalence of male involvement in infant care was 42.2% with a 95% CI (38.26-46.12). Male who did not attend formal education (AOR = 0.24, 95% CI = 0.14-0.43), having one child (AOR = 5.66, 95%CI = 2.94-10.88), having male infants (AOR = 2.51, 95% CI = 1.60-3.95), first infant order (AOR = 2.70, 95% CI = 1.36-5.39), having adequate knowledge towards infant care (AOR = 5.56,95% CI = 0.12-0.28), and having favorable attitude towards infant care (AOR = 1.70,95% CI = 0.34-0.99) were factors associated with male involvement in infant care. Less than 50% ( 50%) of males are involved in their infant care. Educational status of males, number of infants, male infants, male knowledge, and attitude towards infant care were significantly associated with involvement in infant care. Therefore, efforts should be directed at improving males' educational status, knowledge, and attitude to improve their engagement in caring for their infants.

Keywords: Bibugn district; Ethiopia; Infant care; Male involvement.

Background: Staphylococcus aureus is a major pathogenic bacterium associated with high morbidity and mortality worldwide. It exhibits resistance to multiple antibiotics, complicating treatment options. Despite its clinical significance, there is limited data on the prevalence of S. aureus infections and the patterns of methicillin and inducible clindamycin resistance, particularly in Ethiopia. Understanding these resistance trends is essential for guiding appropriate therapy and improving patient outcomes.
Objective: To assess the prevalence of S. aureus, methicillin and inducible clindamycin resistance patterns, and associated factors among patients with suspected bacterial infection at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.
Method: A hospital-based cross-sectional study was conducted among patients suspected of bacterial infections from 10 June 2023 to 28 February 2024. Blood, wound swab, cerebrospinal fluid, urine, eye swab, synovial fluid, ear swab, and pleural fluid were collected aseptically and inoculated onto appropriate media. S. aureus was identified based on colony morphology, Gram staining, DNase test and biochemical tests. Antimicrobial susceptibility testing was performed on the isolates using the disk diffusion and the D-test techniques based on CLSI guideline. Data were entered into SPSS version 26 for analysis. Logistic regression was applied to assess the relationship between predictors and the outcome variable. A P-value of ≤ 0.05 with a 95% CI was considered statistically significant.
Results: Among the 339 study participants, 38 (11.2%) (95% CI: 8-15) tested positive for S. aureus. Of these isolates, 14/38 (36.9%) were resistant to methicillin, 5/38 (13.1%) isolates were resistance to clindamycin by routine disk diffusion test whereas 10/38 (26.3%) isolates exhibited inducible clindamycin resistance using the D-test. The level of multidrug resistance was noted in 10/38 (26.3%) of the isolates. Significant factors associated with S. aureus infection included illiteracy (AOR = 13.51; 95% CI: 3.56-21.90; P = 0.018), having larger family size (AOR = 12.14; 95% CI: 2.38-20.43; P = 0.024), and income level of less than 3,000 ETB (AOR = 6.20; 95% CI: 1.03-30.09; P = 0.046).
Conclusion: The study revealed an 11.2% occurrence of S. aureus among the study participants, with a substantial proportion exhibiting methicillin resistance (36.9%) and inducible clindamycin resistance (26.3%). These findings highlight a higher burden of clindamycin resistance in MRSA, underscoring the need for routine D-test screening to guide appropriate antibiotic therapy. Additionally, factors such illiteracy, low income and residing in rural areas were associated with S. aureus infection. Targeted health education initiatives should be implemented, especially in rural areas and among populations with low literacy levels, to improve hygiene practices and reduce transmission.

Keywords: Ethiopia; S. aureus; antimicrobial resistance; inducible clindamycin resistance; methicillin resistance; prevalence.

The use of long acting contraceptive methods is a commonpractice among women seeking to prevent unintended pregnanciesand plan their families. This study seeks to identify factors associ-ated with the practice of long-acting contraceptive methods, par-ticularly in a conflict-affected area in Awi zone, North WestEthiopia. A cross-sectional study was conducted on a multistagerandom sample of 1,334 women’s. Bivariable and multivariablebinary logistic regression has been applied to identify determinantfactors. Among the 1,334 women surveyed, 25.49% reportedusing long-acting contraceptive methods. The analysis revealedthat women’s educational level, wealth index, being visited byhealth extension, marital status, use of children as a source ofincome, and occupational status of women were factors signifi-cantly hindering the use of long-acting contraceptive methods inthe area. In conclusion, higher contraceptive use was observedamong educated, married women, women who used children as asource of income, and women employed by the government. It istherefore recommended that government officials in Awi Zone andpolicy makers should implement programs to increase female edu-cation and employment, which could lead to greater use of contra-ceptive methods for effective family planning.
Key words: Awi Zone, contraceptive methods, family planning, multiple logistic regression, Ethiopia.

Melioidosis is a significant health problem in tropical and subtropical regions, especially inSoutheast Asia and Northern Australia. Recurrent melioidosis is a major obstacle to eliminatingthe disease from the community in these nations. This work aims to propose and analyzea human melioidosis model with recurrent phenomena and an optimal control model byincorporating time-dependent control functions. The basic reproduction number (𝑅0) of theuncontrolled model is derived using the method of the next-generation matrix. Using theconstruction of a Lyapunov functional, we present the global asymptotic dynamics of theautonomous model in the presence of recurrent for both disease-free and endemic equilibria. Theglobal asymptotic stability of the model’s equilibria shows the absence of a backward bifurcationfor the model in both cases, whether in the absence or presence of relapse. The sensitivityanalysis aims to identify the parameters that have the most significant impact on the model’sdynamics. Furthermore, qualitative analysis of the model’s global dynamics and the changingeffect of the most influential parameters on 𝑅0 are supported by numerical experiments, with theresults being illustrated graphically. The model with time-dependent controls is analyzed usingoptimal control theory to assess the impact of various intervention strategies on the spread ofthe epidemic. The numerical results of the optimality system are carried out using the Forward–Backward Sweep method in Matlab. We also conducted a cost-effectiveness analysis using twoapproaches: the average cost-effectiveness ratio and the incremental cost-effectiveness ratio.
Keywords: Melioidosis model; B.pseudomallei; Recurrent; Global stability; Optimal control; Cost-effective strategy

This study investigates the status of biomass stove usage in East Gojjam, Ethiopia, and evaluates the health, economic, and environmental benefits of an improved biomass stove which was designed and fabricated using locally available materials. Major challenges in the study areas were uses of traditional three-stone stoves, which are inefficient and produce harmful emissions. The study aims to assess the status of stoves used, source, amount and type of biomass consumption per household, to analyze the health impact of improved biomass stove with conventional stove and to analyze the economic and environmental impact of the conventional and improved stove.Two stove models were fabricated: one for household use and another for institutional settings. Construction materials included angle iron, sheet metal, ceramic tiles, sand, and clay for insulation. Eucalyptus wood a commonly used local biomass fuel was standardized for all testing, including oven drying and storage procedures. Performance evaluation was based on cooking time, fuel consumption, and emissions (CO and PM2.5), using laboratory and field tests. Additional data were collected through surveys, interviews, focus group discussions, and direct observations from 400 households across three districts: Dejen, Yedwuha and Debrework.According to the result; the improved biomass stove significantly outperformed the conventional three stone stove: reducing cooking time by 51.61%, fuel consumption by 12.34%, carbon monoxide emissions by 99.72%, and PM2.5 emissions by 75.52%. It also demonstrated substantial environmental benefits, including lower firewood demand and reduced deforestation. Economically, households saved over 3,225 birr per year in fuel and time costs.In conclusion, the improved biomass stove offers a viable, scalable solution to Ethiopia’s household energy and health challenges. Its adoption can significantly mitigate household air pollution, improve public health, reduce environmental degradation, and strengthen economic resilience, particularly for women and children. The study recommends expanding the dissemination of the improved biomass stoves through targeted policy support, community education, and financing mechanisms.

Illnesses associated with consuming infected milk and milk products are a widespread problem inlow and middle-income countries. Shiga toxin-producing Escherichia coli (STEC) is a bacteriumcommonly found in raw milk and causes foodborne diseases ranging from mild diarrhea to severehemorrhagic colitis and hemolytic uremic syndrome. This study aimed to investigate the viru-lence gene and antimicrobial resistance profiles of Shiga toxin-producing E. coli strains isolatedfrom raw milk in dairy farms in and around Bahir Dar town. Raw milk samples (n = 128)collected from December 2021 to July 2022 were cultured, and E. coli strains were isolated usingstandard methods. Shiga toxin-producing E. coli strains were identified genotypically by thepresence of the virulence markers using a single-plex polymerase chain reaction. The antibioticsusceptibility testing of Shiga toxin-producing E. coli isolates was done by the agar disk diffusionmethod. In total, 32 E. coli isolates were recovered from milk samples from lactating animals. PCRscreening of these isolates resulted in 19 (59.3%) positives for Shiga toxin-producing E. coli. Thestx2 gene was detected in 53% of cases, followed by stx1 (31%) and eae (16%. The STEC isolateswere highly sensitive to ciprofloxacin (94.7%) and kanamycin (89.5%), while exhibiting signif-icant resistance to amoxicillin (89.5%) and streptomycin (73.7%). The present study points outthe occurrence of virulent and antibiotic-resistant Shiga toxin-producing E. coli strains in raw milkthat could pose a potential risk to public health. Further analysis by whole genome sequencing isnecessary for an in-depth assessment and understanding of their virulence and resistance factors.Moreover, large-scale studies are needed to identify the prevalence and potential risk factors andto prevent the spread of antibiotic-resistant STEC strains in the milk production chain.