Objectives: This study aimed to assess the prevalence and risk factors of malaria in individuals visiting health centers in the wetlands of Bahir Dar Zuria District, Northwest Ethiopia.
Methods: A cross-sectional study design was used on 422 study participants from three selected health centers from February to March 2020. Plasmodium parasite detection was examined using thick and thin blood smears, with a rapid diagnostic test. The chi-square (χ2) test was used to analyze the association between the prevalence of malaria and categorical variables, whereas binary logistic regression was used to identify potential risk factors using SPSS Version 25. For all types of tests, P-values below 0.05 were considered significant.
Results: The overall prevalence of malaria observed at the selected health centers around the wetlands of Bahir Dar Zuria District was 23.90% (95% confidence interval: 20.30-27.70%). There was a higher prevalence of malaria in males (39.78%) than in females (11.44%). The younger age group (16-30 years) was the most affected (47.76%), compared with the remaining 0-2 (19.23%), 3-15 (8.64%), 36-45 (37.25%), and above 45 years age groups (13.01%). Individuals with bed net-using habit decreased the risk of malaria infection by 99.70% compared with their counterparts (adjusted odds ratio: 0.003, 95% confidence interval: 0.001-0.011).
Conclusions: In this study, the wetlands of Bahir Dar Zuria District were found conducive to the survival and reproduction of mosquitoes, and the occurrence of malaria prevalence was very high. Therefore, wetland management practices and community mobilizations that might decrease vector abundance and malaria transmission should be strengthened in the study area.

Keywords: Bahir Dar Zuria; Malaria; Prevalence; Rapid diagnostic test; Wetlands.

Background
Digital health is a new health field initiative. Health professionals require security in digital places because cybercriminals target health care professionals. Therefore, millions of medical records have been breached for money. Regarding digital security, there is a gap in studies in limited-resource countries. Therefore, surveying health professionals’ attitudes toward digital health data security has a significant purpose for interventions.


Objective
This study aimed to assess the attitudes of health professionals toward digital health data security and their associated factors in a resource-limited country.


Methods
A cross-sectional study was conducted to measure health professionals’ attitudes toward digital health data security. The sample size was calculated using a single population. A pretest was conducted to measure consistency. Binary logistic regression was used to identify associated factors. For multivariable logistic analysis, a P value ≤.20 was selected using Stata software (version 16; StataCorp LP).


Results
Of the total sample, 95% (402/423) of health professionals participated in the study. Of all participants, 63.2% (254/402) were male, and the mean age of the respondents was 34.5 (SD 5.87) years. The proportion of health professionals who had a favorable attitude toward digital health data security at specialized teaching hospitals was 60.9% (95% CI 56.0%‐65.6%). Educational status (adjusted odds ratio [AOR] 3.292, 95% CI 1.16‐9.34), basic computer skills (AOR 1.807, 95% CI 1.11‐2.938), knowledge (AOR 3.238, 95% CI 2.0‐5.218), and perceived usefulness (AOR 1.965, 95% CI 1.063‐3.632) were factors associated with attitudes toward digital health data security.


Conclusions
This study aimed to assess health professionals’ attitudes toward digital health data security. Interventions on educational status, basic computer skills, knowledge, and perceived usefulness are important for improving health professionals’ attitudes. Improving the attitudes of health professionals related to digital data security is necessary for digitalization in the health care arena.

Background: Healthcare-associated infections occur in patients under medical care, which is a major public health issue in hospitals worldwide. The prevalence is two to three folds higher in developing countries compared to developed countries. Inanimate objects used by healthcare professionals such as gowns, mobile phones, and stethoscopes are highly prone to bacterial contamination from the healthcare setting. In Ethiopia, there is a paucity of published data on the bacterial profile and susceptibility patterns of an isolates.
Objective: To determine the bacterial profile and antimicrobial susceptibility patterns from inanimate objects used by healthcare professionals and associated factors at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.
Methods: A cross-sectional study was conducted at Debre Markos Comprehensive Specialized Hospital from inanimate objects from April 10, 2023 to June 30, 2023 using simple random sampling technique with lottery method. Socio-demographic data was collected using a structured questionnaire. A swab sample from healthcare professionals' gowns, mobile phones, and stethoscopes were collected and inoculated onto blood agar, chocolate and MacConkey agar. Isolates were identified and characterized by colony morphology, Gram staining and biochemical tests. Antimicrobial susceptibility testing was performed in all isolates by the disk diffusion technique on Muller Hinton agar according to CLSI, 2022 guidelines. Data was entered into EPI-Data and analyzed using SPSS version 25. Logistic regression model was used. Variables with p-value ≤ 0.25 in bivariable logistic regression was fitted to multivariate logistic regression analysis. A p-value of ≤ 0.05 with 95%CI was considered statistically significant.
Result: A total of 376 healthcare professionals' inanimate objects were included from 191 study participants. Overall, 60.1% (226/376) (95%CI: 55.1-65) inanimate objects were contaminated. The proportion of bacterial contamination was (65.1%; 82/126), (60.3%; 76/126) and (54.8%; 68/124) for mobile phones, gowns and stethoscopes, respectively. Staphylococcus aureus was the most frequent isolate accounting (22.1%; 83/376) followed by Staphylococcus epidermidis (17.0%; 64/376), Escherichia coli (8.8%; 33/376) and Pseudomonas aeruginosa (4.9%; 18/376). Working in gynecology/ obstetrics wards (AOR: 8.69; 95%CI: 1.09-69.41, P = 0.041), did not disinfect mobile phones (AOR: 2.69; 95%CI: 1.15-6.25; P = 0.021) and stethoscopes regularly (AOR: 3.06, 95%CI: 1.23-7.59; P = 0.016), carry mobile phones with patient care materials (AOR: 2.72; 95%CI: 1.18-6.29, P = 0.019) and not taken infection prevention training (AOR:3.91; 95%CI:1.71-8.93; P = 0.001) were significantly associated with bacterial contamination.Most Gram-negative bacteria were resistant to ampicillin, trimethoprim-sulfamethoxazole and amoxacilline-clavunic acid, while Gram-positive isolates showed high level of resistant to penicillin. On the other hand, meropenem, for Gram-negative and clindamycin for Gram-positive bacteria showed lower level of resistance. Multidrug resistance among Gram-positive and Gram-negative bacteria were (62.6%; 92/147) and (75.3%; 64/85), respectively with over all MDR (67.2%, 156/232).
Conclusion: Inanimate objects commonly used by healthcare professionals are important sources of bacterial contamination. S. aureus, S. epidermidis and E. coli were the predominant isolates. Most Gram-negative bacteria were resistant to ampicillin while Gram-positive isolates showed high level of resistant to penicillin. All healthcare professionals should regularly disinfect their inanimate objects to prevent bacterial colonization and potential spread of infection.

In many regions of Ethiopia, particularly in the study area, high-quality livestock feed is scarce, particularly during the dry season.Indigenous browse species could potentially ofer alternative sources of feed, but their potential has not been fully exploited, owingto a lack of detailed information. Without detailed information on the nutritional value of indigenous browse species, it is difcultto assess their suitability as feed sources. Tis knowledge gap indicates that even if these plants are abundant, they may not be usedefectively because their nutritional benefts are not well understood. Te objective of the present study was to fll this gap bysystematically evaluating the biomass yield and nutritional content of indigenous browse species. Te mean biomass yields forvarious indigenous browse species varied signifcantly (p < 0.05) among species, with Ficus thonningii producing the highest,whereas the biomass yields of Vernonia amygdalina were the lowest. Arundinaria species exhibited the highest NDF content(68.5%), whereas V. amygdalina had the lowest NDF content (46.8%). Te crude protein content varied signifcantly (p < 0.05)among the species, with Acacia albida having the highest (20.3%), whereas the crude protein content of Carissa edulis was thelowest (13.3%). Hence, the crude protein content of all indigenous browse species is sufcient to meet the maintenance needs ofcattle, sheep, and goats because, as stated by Kearl and NRC, the crude protein levels required for maintenance in these animalsrange from 7% to 10%. Te crude protein content of indigenous browse species is sufcient to meet the milk production re-quirements of sheep and goats because the crude protein levels required for milk production for these animals range from 12% to16%. For lactating dairy cows and growing beef cattle, Kearl recommended CP values of 14%–18% and 12%–16% required,respectively. Terefore, indigenous livestock producers should incorporate these species into their production systems to enhanceproductivity. Tis approach can also help mitigate the high costs associated with concentrate feeds, which are typically expensive.Keywords: biomass; browse species; nutritional composition; species composition

Abstract: Diarrheagenic Escherichia coli (DEC) are the leading cause of infectious diarrhea and posea significant global, regional, and national burden of disease. This study aimed to investigate theprevalence of six DEC pathotypes in children with diarrhea and determine their antibiotic resistancepatterns. Samples from 107 diarrheagenic children were collected and processed for Escherichiacoli (E. coli). Single-plex PCR was used to detect target virulence genes as well as characterize andcategorize DEC pathotypes. Antibiotic resistance patterns were determined by the Kirby–Bauerdisk diffusion method. E. coli was detected in 79 diarrheal stool samples, accounting for 73.8% ofthe samples collected. Additionally, 49.4% (39 out of 79) of the isolates harbored various typicalvirulence factors. Results revealed six pathotypes of virulence: enterotoxigenic E. coli (ETEC) (53.8%),enteropathogenic E. coli (EPEC) (12.8%), enteroaggregative E. coli (EAEC) (10.3%), Heteropathotypes(7.8%), Shiga toxin-producing E. coli (STEC), and enterohemorrhagic E. coli (EHEC) (7.7% each).The isolates exhibited high antibiotic resistance against trimethoprim/sulfamethoxazole (82.1%),amoxicillin (79.5%), ampicillin (74.4%), gentamicin (69.2%), and streptomycin (64.1%). An overalloccurrence of 84.6% of multiple-drug resistance was observed in the isolates, with resistance rangingfrom three to four antibiotic classes. Our findings revealed a high level of pathogenic E. coli that werehighly resistant to multiple categories of antibiotics among children in the Awi zone. These findingshighlight the potential role of pathogenic E. coli in childhood diarrhea in tropical low-resourcesettings and underscore the need for continued research on the characteristics of pathogenic andantibiotic-resistant strains.Keywords: children; diarrheagenic Escherichia coli; resistance; virulent genes; Awi zone

Background: Developmental delay is a group of disorders that cause commondeficits of adaptive and intellectual function in children. It happens when achild fails to achieve one aspect of developmental skills. Limited informationis available regarding the prevalence of developmental delay among childrenaged 12–59 months in the study area. Therefore, this study aimed to assessthe prevalence of developmental delay and its associated factors among thispopulation.Methods: A community-based cross-sectional study was conducted inDembecha district among 702 children aged 12–59 months. Data were gatheredthrough face-to-face interviews, and by taking anthropometric measurementsusing a pretested structured questionnaire. Data were entered into Epi Dataversion 4.2 software and exported into Statistical Package for Social Science(SPSS) version 25 software for analysis. The WHO Anthro software was used toanalyze anthropometric-related data. Bivariable and multivariable binary logisticregression analyses were done to identify factors associated with developmentaldelay. The odds ratio with a 95% Confidence Interval (CI) was estimated todetermine the strength of the association.Results: The prevalence of developmental delay among children was 26.7%(95% CI: 23.5, 30.2). Toddler child age (AOR = 2.60; 95% CI: 1.42, 4.87), lowbirth weight (LBW; AOR =4.90; 95% CI: 2.14, 11.48), cesarean section mode ofdelivery (AOR = 8.60; 95% CI: 3.93, 18.65), preterm delivery (AOR = 2.5; 95% CI:1.28, 4.74), early initiation of complementary feeding (AOR = 8.40; 95% CI: 3.61,19.63), stunting (AOR = 2.90; 95% CI: 1.67, 5.22) inadequate meal frequency(AOR = 3.20; 95% CI: 1.74, 5.94), and inadequate dietary diversity (AOR = 3.10;95% CI: 1.68, 5.85) were significantly associated with child developmental delay.Conclusion: The prevalence of developmental delay among children was highin Dembecha district compared to the global prevalence. Child developmentaldelay was associated with toddler child age, LBW, cesarean section mode of

Background: Cisplatin-based chemotherapy regimen associated nephrotoxicity is a significantadverse effect that restricts the standard dose of cisplatin by impairing renal function. There is alack of data on cisplatin-based chemotherapy-induced nephrotoxicity (CIN) in Ethiopian patientswith gynecological cancer. This study evaluated the factors associated with CIN and its impact onthe survival status of patients with gynecological cancer at Northwest Ethiopia oncology centers.Methods: This institutional-based retrospective cohort study included patients with gynecologicalcancer who received cisplatin-based chemotherapy between 2020 and 2021 at NorthwestEthiopia oncology centers. CIN was evaluated using the Common Terminology Criteria forAdverse Events (CTCAE) version 4 criteria and Kidney Disease Improving Global Outcomes(KDIGO) Guideline. A logistic regression model was used to identify the factors associated withCIN. The Cox proportional hazards regression model was used to determine the impact of CINonpatients survival. The cutoff point was a P value of < 0.05 for declaring statistical significance.Results: A total of 394 patients with gynecological cancer were included in the final analysis. Theincidence of CIN was 27.9 % (95 % CI 23.4,32.7). Old age (≥60 years) [adjusted odds ratio(AOR)=1.7,95 % confidence interval (CI) (1.1–2.9); P=0.039],low serum albumin (50 mg/m2) [AOR=2.6,95% CI (1.4–4.7), P=0.002]were significantly associated with CIN.CIN[(adjusted hazard ratio(AHR)=3.2,95 % CI (2.7–9.5), P=0.004]and cisplatin dose reduction [AHR=2.7,95 % CI(1.7–4.3) P=0.021] were significant factors of death among patients with gynecological cancer.Conclusion: More than a quarter of patients receiving cisplatin-based chemotherapy developedCIN, which negatively affected their survival. This study recommends that prescribers pay specialattention to patients with older age, lower serum albumin levels, and high-dose cisplatin toimprove renal function and survival. Cisplatin-based chemotherapy-induced nephrotoxicitysignificantly affects the survival of gynecological cancer patients.
Keywords: Gynecological cancer, Cisplatin, Nephrotoxicity, Factors, Impact, Ethiopia

IntroductionCancer is a leading cause of global morbidity and mortality, significantly impairing patients’quality of life (QoL). Integrated Palliative Care (IPC) has been proposed as a holisticapproach to enhance quality of life by addressing patients’ physical, emotional, and psy-chosocial needs. While some studies suggest Integrated Palliative Care improves qualityof life more than standard care, the evidence remains inconclusive. This systematic reviewand meta-analysis aim to evaluate the comparative impact of Integrated Palliative Careversus standard care on the quality of life in cancer patients.MethodsA comprehensive search of databases including PubMed, Cochrane Library, and Embase wasconducted. We selected randomized controlled trials (RCTs) comparing Integrated Palliative Careand standard care for cancer patients, focusing on the quality of life as measured by validatedtools such as the EORTC QLQ-C30 and FACT-G. Data were pooled using a random-effectsmodel to account for study heterogeneity. Subgroup and sensitivity analyses were also performed.ResultsNine randomized controlled trials involving 1,794 patients met the inclusion criteria.Meta-analysis showed that Integrated Palliative Care significantly improved quality oflife compared to standard care (SMD = 3.25; 95% CI: 1.20–5.30; p < 0.001). Studiesconducted in Asia showed the highest standardized mean difference (SMD = 6.15; 95%CI: 3.07–9.23; p < 0.001), followed closely by studies from Africa (SMD = 6.0; 95% CI:5.13–6.87; p < 0.001), compared to those from other regions. Similarly, research focusingon lung cancer patients showed the greatest standardized mean difference of (SMD =6.15; 95% CI: 3.07–9.23; p < 0.001) relative to other cancer types. Furthermore, studies
involving newly diagnosed cancer patients recorded the highest standardized mean differ-ence of (SMD = 5.69; 95% CI: 4.57–6.80; p < 0.001).ConclusionIntegrated Palliative Care significantly enhances the quality of life in cancer patients comparedto standard care. These findings support integrating Integrated Palliative Care into oncologypractices to provide comprehensive, patient-centered care that addresses both physical andemotional needs. Further research should explore long-term benefits across diverse populations.

Background Diarrheagenic Escherichia coli (E. coli) is a zoonotic pathogen that contaminates abattoir workers,slaughter environments, slaughter equipment, and carcasses during abattoir processing. Infection with E. coliis associated with the consumption of contaminated food and water, and it is a potential threat to the healthand welfare of both humans and animals. Hence, this study aimed to detect diarrheagenic E. coli and assess itsantibiogram profile in two abattoir settings, in one health lens.Methods A cross-sectional study in one health approach was conducted from December 2020 to June 2021. Atotal of 384 samples from abattoir workers’ hands, carcasses, knives, cattle feces, abattoir water and effluents werecollected. Bacterial culture and biochemical tests were conducted to isolate E. coli, while conventional polymerasechain reaction was performed to identify virulence genes. The antibiogram of diarrheagenic E. coli was tested againstnine antimicrobials using the Kirby Bauer disk diffusion method.Results A total of 115 (29.95%) E. coli were isolated from the 384 samples, and from these isolates, about 17 (14.8%)were confirmed to be diarrheagenic E. coli (DEC). Among the DEC pathotypes, nine (52.94%), five (29.4%), and three(17.65%) were Shiga toxin-producing, enterohemorrhagic, and enterotoxigenic E. coli, respectively. While 14 (82.35%)DEC isolates harbored the stx2 gene, five (29.41%) the eae gene, five (29.41%) the hlyA gene and three (17.65%)harbored the st gene. All the DEC isolates were resistant to erythromycin and vancomycin; whereas, they weresusceptible to ampicillin, nalidixic acid and norfloxacin. Furthermore, 64.7% of DEC isolates showed resistance to bothceftazidime and kanamycin and 88.24% of the isolates showed multidrug resistance.Conclusion This study detected DEC isolates having different virulence genes, which showed single and multipleantimicrobial resistance. Given the existing poor hygienic and sanitary practices along the abattoir-to-table food
chain, coupled with the habit of raw meat consumption, this result indicates a potential public and animal health riskfrom the pathogen and antimicrobial resistance.Keywords Abattoir setting, Antibiogram profile, Carcasses, Diarrheagenic E. Coli, Virulence genes

ABSTRACT While it is dependent on erratic rainfall and subject to drought and low productivity, agriculture is still the dominant economic activity in Ethiopia. Climate-Smart Agriculture (CSA) technology adoption enhances productivity, resilience, and climate mitigation, yet its adoption by smallholder farmers in Ethiopia’s West Gojjam Zone remains limited despite government promotion. However, research on the factors behind the determinants of the low adoption rate is limited in the study area. The main objectives of this study were to investigate the factors influencing the adoption of five CSA-aligned practices: crop diversification, livestock diversification, irrigation, agroforestry, and the application of chemical fertilizers across selected woredas. Data were generated using structured questionnaires, key informant interviews, and focus groups from a total of 236 households selected using a multistage sampling technique. The analysis made by a multivariate probit model revealed that significant determinants included the gender of the household head, education, farm size, income, irrigation access, credit availability, extension services, and farming experience. Findings suggest that enhancing crop and livestock diversification requires expanding irrigation access, strengthening extension services, and integrating climate-smart advisory programs to equip farmers with essential skills and resources. Additionally, improving credit access, providing climate information through mobile phone SMS for free, and promoting farmer training can boost irrigation adoption, while targeted awareness campaigns can encourage experienced farmers to adopt modern irrigation technologies. Keywords: Adoption; Climate-Smart Agricultural Practices; Multivariate probit, West Gojjam