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

Malaria and leptospirosis are emerging vector-borne diseases that pose significant global healthproblems in tropical and subtropical regions. This study aimed to develop and analyze amathematical model for the transmission dynamics of malaria-leptospirosis co-infection withoptimal control measures. The model’s dynamics are examined through its two sub-models:one for malaria alone and the other for leptospirosis alone. We apply a next-generationmatrix approach to derive the basic reproduction numbers for the sub-models. By using thereproduction number, we demonstrate the local and global asymptotic stability of both disease-free and endemic equilibria in these sub-models. We perform numerical experiments to validatethe theoretical outcomes of the full co-infection model. The graphical results show that malaria-leptospirosis co-infection will be eradicated from the population through time if 𝑅0𝑚𝑙 < 1.Conversely, if 𝑅0𝑚𝑙 > 1, the co-infection will persist in the population. Furthermore, weinvestigate an optimal control model to demonstrate the impact of various time-dependentcontrols in reducing the spread of both diseases and their co-infection. We use the forward–backward sweep iterative method to perform numerical simulations of the optimal controlproblem. Our findings of the optimal control problem imply that strategy 𝐷, which incorporatesall optimal controls, namely malaria prevention 𝜔1(𝑡), leptospirosis prevention 𝜔2(𝑡), insecticidecontrol measure for malaria 𝜔3(𝑡), control sanitation rate of the environment 𝜔4(𝑡) is the mosteffective in minimizing our objective function. We also conduct a cost-effectiveness analysis toidentify the predominant strategy in terms of cost among the optimal strategies.
Keywords: Malaria, Leptospirosis, Co-infection, Global stability, Optimal control, Numerical simulations, Cost-effective strategy

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.

Small scale irrigation (SSI) technologies offer a promising solution to address challenges of low agricultural productivity, unreliable rainfall, and rural poverty in Ethiopia. However, their performance and sustainability remain inconsistent, particularly in regions like East Gojjam Zone, Amhara Region. This study aimed to assess the adoption trends, performance challenges, and economic viability of furrow irrigation and motor pump systems across two districts Debre Elias and Machakel. A cross sectional, mixedmethods design was employed, drawing on data from 280 smallholder farmers selected through a multistage sampling procedure. Descriptive analysis showed moderate irrigation access, but a 25.4% overall defect rate raised concerns about technology reliability. Binary logistic regression identified income, credit access, and training as key factors reducing defect occurrence, while motor pump use and larger irrigated areas increased risk. Economic analysis revealed that furrow systems were more profitable, yielding a higher five year Net Present Value and Benefit Cost Ratio than motor pumps. Despite these gains, sustainability challenges persisted, including soil degradation and inefficient water use. The study also found notable district level variation, with furrow systems dominating in Debre Elias due to affordability, and topography favoring gravity flow and motor pumps preferred in Machakel for their productivity potential. Qualitative findings highlighted high maintenance costs and limited institutional support as barriers to sustained use. Based on these insights, the study recommends strengthening farmer access to credit, improving training services, and upgrading irrigation technologies to enhance the long term impact of SSI on smallholder livelihoods and agricultural sustainability

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.

Background Due to the high burden of mortality from acute communicable and non-communicable diseases,emergency department’s mortality has become one of the major health indices in Ethiopia that should be evaluatedregularly in every health institution. However, there are inconsistencies between studies, and there is no systematicreview or meta-analysis study about the prevalence of mortality in the emergency department. Therefore, this studyaimed to determine the pooled prevalence of mortality and identify its determinants in the emergency departmentsof Ethiopian hospitals.Methods This systematic review was conducted according to the guidelines of Preferred Reporting Items forSystematic Reviews and Meta-Analyses (PRISMA) and has been registered with PROSPERO. A structured search ofdatabases (Medline/PubMed, Google Scholar, CINAHL, EMBASE, HINARI, and Web of Science) was undertaken. Allobservational studies reporting the prevalence of mortality of patients in emergency departments of Ethiopianhospitals, and published in English up to December 16, 2023, were considered for this review. Two reviewersindependently assess the quality of the studies using the Joanna Briggs Institute (JBI) critical appraisal tool. A meta-analysis using a random-effects model was performed to estimate the pooled prevalence. The heterogeneity ofstudies was assessed using I2 statistics, and to identify the possible causes of heterogeneity, subgroup analysis andmeta-regression were used. Egger’s test and funnel plots were used to assess publication bias. STATA version 17.0software was used for all the statistical analyses. A p-value less than 0.05 was used to declare statistical significance.Results A total of 1363 articles were retrieved through electronic search databases. Subsequently, eighteen studiescomprised 21,582 study participants were included for analysis. The pooled prevalence of mortality among patients inthe Emergency Department (ED) was 7.71% (95% CI: 3.62, 11.80). Regional subgroup analysis showed that the pooledprevalence of mortality was 16.7%, 12.89%, 10.28%, and 4.35% in Dire Dawa, Amhara, Oromia, and Addis Ababa,respectively. Moreover, subgroup analysis based on patients’ age revealed that the pooled prevalence of mortalityamong adults and children was 8.23% (95% CI: 3.51, 12.94) and 4.48% (95% CI: 2.88, 6.08), respectively. Being a ruralresident (OR; 2.30, 95% CI: 1.48, 3.58), unconsciousness (OR; 3.86, 95% CI: 1.35, 11.04), comorbidity (OR; 2.82, 95% CI:1.56, 5.09), and time to reach a nearby health facility (OR; 4.73, 95% CI: 2.19, 10.21) were determinants of mortality forpatients in the emergency departments.
Conclusion and recommendations This study found that the overall prevalence of mortality among patients inemergency departments of Ethiopian hospitals was high, which requires collaboration between all stakeholdersto improve outcomes. Being a rural resident, unconsciousness, comorbidity, and time elapsed to reach healthfacilities were determinants of mortality. Improving pre-hospital care, training healthcare providers, early referral, andimproving first-line management at referral hospitals will help to reduce the high mortality in our country.Keywords Associated factors, Emergency department, Ethiopia, Meta-analysis, Mortality