University of Gondar

Introduction Vaccination plays a crucial role in reducing illness and death associated with diseases. Children who are unvaccinated or only partially vaccinated face greater risks of illness and death. Despite the proven benefits of vaccination, coverage remains uneven, particularly in in low- and middle-income countries (LMICs), where disparities in access and uptake can lead to significant public health challenges. This meta-analysis was aimed to evaluate the coverage of complete basic childhood vaccinations (CBCVs) and its variations among children aged 12 to 23 months. Methods Our meta-analysis included demographic and health survey reports published in any language that reported basic childhood vaccination among children aged 12 to 23 months between 2015 and 2025. A random-effects meta-analysis model was used to determine the pooled prevalence of vaccination. Sub-group analysis was performed by study characteristics to identify potential sources of heterogeneity among studies. Forest plots and tables were used to display the pooled estimates along with their corresponding 95 % confidence intervals (CIs). Results The coverage of CBCV was found to be 59.0 %, with a 95 % CI of 53.1 % to 65.0 % (I2 = 77.9 %, p < 0.001). For reports published from 2015 to 2018, the vaccination coverage was 55 %, while for reports published in 2019–2024, the pooled effect size increased to 63 %. Specific vaccine coverage rates included BCG at 86 %, Pentavalent at 67 %, Polio at 69 %, and Measles at 75 %. The vaccination rates varied by maternal education, birth order, and wealth status. Conclusion The coverage of basic childhood vaccinations in LMICs remains far below the global target of 90 % or more by 2030. Significant disparities in vaccination rates were observed, particularly related to maternal education, birth order, and household wealth status. To address these challenges, improving access to vaccinations and enhancing public education about their importance are essential steps for policymakers and health practitioners.

Zero-utilization of antenatal care (ZUANC) is a significant public health problem that increases the risks of maternal morbidity and mortality. However, the association of individual and community-level factors and the spatial clustering effects of ZUANC are often overlooked in Ethiopia. This study aimed to assess the spatial clustering and determinants of zero utilization of ANC services in Ethiopia. This study used a nationally representative sample of 3,926 women from the 2019 Ethiopian Mini Demographic and Health Survey. Multilevel binary logistic regression models were fitted. The Adjusted Odds Ratio (AOR) along with 95% Confidence Intervals (CI) was calculated, with p-values less than 0.05 considered statistically significant. The prevalence of ZUANC in Ethiopia was 25.56% (95% CI: 24.87, 27.63). It was significantly clustered across the country, with notable hotspot areas detected in Ethiopia. Besides, women with no education (AOR = 6.42; 95% CI: 3.77, 10.91) and those with primary education (AOR = 3.53, (95% CI: 2.09, 5.95) had higher odds of ZUANC. Women from poor (AOR = 2.41; 95% CI: 1.77, 3.29) and middle-income households (AOR = 1.64; 95% CI: 1.16, 2.33), those not using any contraceptive method (AOR = 1.78; 95% CI: 1.41, 2.24), women from rural areas (AOR = 2.03; 95% CI: 1.28, 3.21), and residing in the Somali regions (AOR = 5.08; 95% CI: 3.18, 7.92) also had higher odds of ZUANC. On the other hand, marriage reduced the likelihood of ZUANC (AOR = 0.26; 95% CI: 0.09, 0.73). In this study, one-fourth of pregnant women in Ethiopia had ZUANC. Therefore, targeted public health interventions to address these factors, particularly in the identified hotspot areas of ZUANC, are strongly recommended to increase ANC utilization.

Background Type 2 diabetes mellitus is a global epidemic affecting millions of individuals worldwide. It is considered a chronic metabolic disorder of impaired glucose homeostasis, associated with various long-term complications and poor prognosis of cardiovascular performance. Therefore, this systematic review aimed to determine the pooled prevalence of ECG abnormality among type 2 diabetic patients both in the hospital setting and the general population based on the existing literature. Methods This systematic review has been conducted on the ECG abnormality of patients with Type 2 diabetes. Following the establishment of eligibility criteria, a literature search was conducted using three databases and two search engines. Included articles were then screened, critically appraised, and data extracted independently by two reviewers, and any disagreements were handled by the involvement of a third party. The quality of the included studies had been assessed using the New Castle Ottawa quality assessment scale tool. Pooled prevalence and sensitivity were determined by random effect analysis. Heterogeneity was assessed by Higgins’s I², and its presence was alleviated by using sub-group analysis. Result Following the identification of 32, 785 studies, 33 publications were eligible for the review with a sample size of 31, 449. The pooled prevalence of ECG abnormality among Type 2 diabetic patients was 31% (95% CI: 25, 36%). It was 26% (95% CI: 1, 51%), and 31% (95% CI: 24, 37%) in the hospital and general/ community population, respectively. Body mass index (AOR = 5.90; 95%CI: 4.96, 7.03), duration of diabetic mellitus (AOR = 9.21; 95%CI: 9.12, 9.31), and being hypertensive (AOR = 5.17; 95%CI: 4.90, 5.46), were significantly associated factors with ECG abnormality among patients with Type 2 diabetic mellitus. Conclusion The pooled prevalence of ECG abnormality among Type 2 diabetic mellitus patients was high, while its magnitude was higher among patients attending hospital settings than in the community. Duration of diabetic mellitus, high body mass index and presence of hypertension were significant factors in this review. Moreover, we advise more longitudinal researches to determine the incidence of ECG abnormality among patients with diabetes considering time duration and sex differences. Ethical consideration Since our study was on the review of secondary data, ethical issues are not necessary

Objective This study aimed to determine the prevalence and associated factors of symptomatic dry eye disease (SDED) among adult patients with diabetes visiting five comprehensive specialised hospitals in the Amhara Region, Ethiopia. Design An institution-based cross-sectional study. Setting This study was conducted at the University of Gondar, Debretabor, Tibebe Gion, Felege Hiwot and Debre Markos comprehensive specialised hospitals in the Amhara Region, Ethiopia, from 8 May 2023 to 8 June 2023. Participants The study included 1199 adult patients with diabetes aged >18 years who lived in the Amhara Region, Ethiopia, for more than 6 months and were selected using a systematic random sampling technique. Primary and secondary outcome measures In this study, the primary outcome measure was the magnitude of SDED, and the secondary outcome measure was the associated factors of SDED. Results A total of 1134 study subjects participated in this study with a response rate of 94.5%. The prevalence of symptomatic dry eye was 40.4% (95% CI 37.7 to 43.2). Factors such as poor glycaemic control (adjusted OR (AOR)=2.58, 95% CI 1.86 to 3.58), duration of diabetes ≥10 years (AOR=2.77, 95% CI 1.95 to 3.95), proliferative diabetic retinopathy (AOR=5.58, 95% CI 2.1 to 14.39), poor eye check-up practice (AOR=1.98, 95% CI 1.49 to 2.62) and peripheral diabetic neuropathy (AOR=3.76, 95% CI 2.58 to 5.48) were significant associated factors with SDED. Conclusion In this study, the prevalence of SDED among patients with diabetes was high. Poor glycaemic control, longer duration of diabetes, proliferative diabetic retinopathy, inadequate eye check-up practices and peripheral diabetic neuropathy were significantly associated with SDED. It is recommended that healthcare providers prioritise regular monitoring of eye health in patients with diabetes, emphasising the importance of maintaining optimal glycaemic control, and routine eye check-ups for early detection and management of SDED.

Globally, mothers are increasingly combining breastfeeding with formula milk, fresh animal milk, or powdered milk in different proportions in the world including Ethiopia. However, the spatial evidence of mixed milk feeding practice (MMFP) and its spatial predictors among mothers with 0–6 months of children is limited in Ethiopia. Hence, this study aimed to map MMFP and its spatial predictors among mothers with children aged 0–6 months in Ethiopia. A secondary data analysis was carried out using a weighted sample of 550 mothers with children aged 0–6 months. Spatial analysis techniques were employed to identify geographic hotspots and predictors of mixed milk feeding practices (MMFP) among mothers of children aged 0–6 months in Ethiopia. Statistical significance was determined at a p-value < 0.05, and the geographic weighted regression coefficients were reported. The spatial autocorrelation analysis, with a global Moran’s I value of 0.41 and a p-value < 0.001, revealed a significant clustering of MMFP in Ethiopia. Spatial hotspot analysis revealed clusters of MMFP in regions such as Addis Ababa, Dire Dawa, Amhara, Afar, Oromia, and Somali. Interpolated MMFP prevalence was observed to be high in Somalia, Afar, Addis Ababa, and Dire Dawa. Geographically weighted regression analysis indicated that higher maternal education, female-headed households, urban residence, community-level maternal literacy, wealthier households, multiple births, and child age (4–6 months) were associated with an increased likelihood of MMFP. In contrast, antenatal care (ANC) visits were associated with a reduced likelihood of MMFP with distinct geographically dependent relationships in specific regions of Ethiopia. The spatial hotspot revealed that MMFP clustered in Ethiopia specifically in urban areas of Somali, Addis Ababa, Afar, Amara, Diredawa, and Oromo regions. The geographically weighted regression analysis revealed that the educational status of mothers, female household heads, urban residents, community-level maternal literacy, rich households, multiple births, and children aged 4–6 months increases the likelihood of MMFP in Ethiopia. However, ANC visits reduce the likelihood of MMFP with distinct geographic dependent relationships in a specific region of Ethiopia. The study highlights the need to tailor region/space-specific intervention based on these geographically identified predictors in specific regions.

Background Comprehensive family planning is essential for reproductive health, allowing individuals to make informed choices about family size and enhancing maternal and child health. Long-acting contraceptives (LACs) are known for their high efficacy and consistent use. This study examines the prevalence and determinants of LAC utilization among women of reproductive-age in 11 East African countries. Methods Secondary data from Demographic and Health Surveys (2015-2022) across 11 East African nations were pooled and analyzed. The study sample included 144,414 women aged 15–49. Bivariate and multivariate regression analyses were conducted using Stata 17 to explore factors associated with LAC utilization. Results are presented as adjusted odds ratios (AOR), with statistical significance at p < 0.05. Results The prevalence of LAC utilization among reproductive-age women in East Africa is 14.87%. Women from middle-income households are 13% more likely to utilize LACs compared to those from poor households (AOR = 1.13, 95% CI: 1.08–1.18), while those from wealthy households are 15% more likely (AOR = 1.15, 95% CI: 1.11–1.20). Married women and those living with a partner are 42% more likely to utilize LACs than unmarried women (AOR = 1.42, 95% CI: 1.33–1.52). Educational attainment significantly impacts LAC utilization: women with primary education are 52% more likely (AOR = 1.52, 95% CI: 1.44–1.60), those with secondary education are 63% more likely (AOR = 1.63, 95% CI: 1.53–1.73), and women with higher education are twice as likely to utilize LACs (AOR = 2.00, 95% CI: 1.84–2.17). Conclusions LAC utilization remains relatively low in the studied East African countries. Factors positively associated with higher LAC utilization include being married, higher income, educational attainment, employment, and media exposure. Additionally, women with more than three children and those from countries with lower illiteracy and poverty rates also have higher LAC utilization. Conversely, a history of abortion, fewer health fieldworker visits, and later initiation of sexual activity and childbirth are associated with lower LAC utilization. These findings emphasize the need for targeted interventions to overcome barriers and promote LAC access and utilization.

Pneumonia is one of the major causes of morbidity and mortality among under-five years old children’s worldwide, with Ethiopia having the highest rates among Sub-Saharan African nations. Effective control and preventative measures will be made clear by comprehending the spatial, temporal, and spatiotemporal variation of pneumonia incidence among under-five children. A time series cross-sectional study design was conducted from 1 January 2013 to 31 December 2022 using pneumonia reports obtained from the Central Gondar Zone health department and Gondar administrative health department. Fifteen districts and one administrative city were included and geocoded in the study. Spatial, temporal, and space-time scan spatial statistics were employed to identify clusters of pneumonia incidence among under-five children and were performed by using Excel and the SaTScan program, and the map was plotted using ArcGIS. Pneumonia incidence among under-five children reveals a general trend of rise and seasonal variation in the study area. During this study period, 147,294 under-five cases of pneumonia were reported and males made up most cases accounting for 54.94%. The average cumulative incidence proportion was 9.1. Purely high-rate spatial clusters were detected in Dembiya, Chilga, Wogera, and Gondar Zuria between 2013 and 2018. Gondar City, Wogera, and Gondar Zuria were high-rate spatial clusters detected between 2019 and 2022. The purely temporal cluster was observed from 2017 to 2018 and 2021 to 2022. Spatiotemporal clusters were detected in Dembia, Chilga, Gondar Zuria, and Wogera from 2013 - 2018 and in Gondar City, Wogera, and Gondar Zuria from 2019 - 2022. During this period pneumonia showed seasonal variation with two major peak months namely in April and October. Under five children pneumonia was found to have spatial, temporal, spatiotemporal clustering, and seasonal patterns. Also, the incidence increased over time. Interventional and preventive strategies should be developed and given priority to the areas that have been detected as hot spots in this study to reduce the mortality and morbidity of under 5 children caused by pneumonia. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-025-05550-7.

Rabies is a viral disease that affects both animals and humans. Effectiveness of a rabies control measures depends on collaboration of dog owners. This study was conducted in North West Ethiopia to understand the intention and willingness to pay (WTP) of dog owners related to rabies control and factors affecting rabies control measures. Data was collected from 423 randomly selected dog owners in four Gondar zones, North West Ethiopia. The theory of planned behavior was used to explore the intention of dog owners towards implementing rabies control measures. Contingent evaluation method was used to evaluate WTP for rabies vaccine. Logistic regression analysis was used to test association with factors. Large majority of dog owners had positive intention to control rabies by vaccination of dogs (97% free of charge, 93% with fair price) and 94% by leashing. Majority of dog owners had a positive attitude (AT), positive subjective norms (SN) and positive perceived behavioral control (PBC) towards controlling rabies. Dog owners’ AT and SN were positively associated with intention to vaccinate dogs. Male dog owners and dog owners belonging to lower age groups had significantly higher AT towards leashing dogs. Sixty two percent of dog owners were WTP for the suggested price bid amounts; but, in general, their number decreased when price of the vaccine increased. The mean WTP for rabies vaccine was 59.25 Ethiopian Birr (1.14 USD) per year. Monthly income was associated (P < 0.05) with WTP for rabies vaccine. Dog owners who had higher income had higher odds but those who did not vaccinate their dogs in the last two years had lower odds of WTP for rabies vaccine. Intervention directed at changing AT and SN is important to increase intention of dog owners; nevertheless subsidizing rabies vaccine increase dog owners participation in dogs vaccination campaign.

Cutaneous leishmaniasis (CL) is a significant public health issue, caused by various Leishmania species. In Ethiopia, L. aethiopica is typically recognized as the primary causative agent of CL. However, emerging Leishmania species from regions with limited foci indicate the possibility of additional isolates. Identification of Leishmania species causing CL is essential for understanding epidemiology, predicting outcomes, and managing the disease effectively. Thus, this review intends to identify and map the distribution of existing and newly emerging CL-causing agents in Ethiopia. A comprehensive search of electronic databases was conducted to identify relevant studies. The search included electronic databases such as PubMed, Science Direct, Cochrane Library, Hinari-Reserch4Life, Google Scholar, and other search sources for English articles published between 2000 and 2024. The quality of the included studies was assessed using the JBI quality appraisal tool. This study adhered to the PRISMA guidelines. Data were extracted using a Microsoft Excel 2010 and data obtained were then reported using tables and figures. The evidence was summarized using a narrative synthesis. Out of the studies reviewed, seven met the inclusion criteria, with the majority being cross-sectional studies. Our findings confirm L. aethiopica as the primary cause of CL in Ethiopia, accounting for 97.2% of cases, in line with its established prevalence across nearly all endemic regions of the country. A key finding was the identification of L. donovani as a newly recognized cause of CL, confirmed through ITS-1 HRM PCR and HSP70 amplicon sequencing, accounting for 2.8% of cases in the reviewed studies, particularly in the northern endemic foci. The reviewed studies mainly used the ITS-1 region as the primary molecular marker for identifying Leishmania species associated with CL, while the HSP70 marker was also employed to ensure more accurate species identification. Given that L. aethiopica is the main species associated with CL in Ethiopia. A noteworthy finding is the identification of L. donovani as a newly isolated causative agent of CL in the country. These findings are essential for directing public health campaigns and supporting scientists in developing better CL diagnosis and treatment alternatives in Ethiopia.

Mental health mobile applications are a cost-effective and scalable answer to the world's psychiatrist shortage and limited access to care in remote areas. However, there is currently no mobile application for providing mental health interventions in Ethiopia. Therefore, this project aimed to develop and test the preliminary effectiveness and acceptability of an Android-based mobile application for mental health information, psychological self-testing, and treatment recommendation during COVID-19 and beyond. We conducted a preliminary assessment to review experiences and demands associated with the mental health mobile apps. Object-oriented modeling and the Agile Development software development methodology were employed. Android Studio's layout editor, resource management, palette, and theme editor were used. We utilized Java as the programming language for writing application code, eXtensible Markup Language (XML) to construct the overall structure of the app, and SQLite to save data locally on the user’s device. To ensure quality, tests were performed on a regular basis throughout the development process. The project developed an Android-based mobile app for mental health information, psychological self-testing, and treatment recommendations for COVID-19. A preliminary assessment found no existing mobile apps for mental health care. Of participants, 94.6% believed mental health apps benefit the public, patients, and healthcare professionals. However, some individuals opposed the app due to concerns about self-treatment and medication misuse. The study indicates a high demand for a mental health mobile app, but few participants fear self-treatment or drug abuse. Apps that support native languages are recommended, and nonpharmacological treatments should be used in conjunction with clinician consultation.

Background Retaining women on the maternal continuum of care pathway remains a significant challenge for the healthcare system. Digitalizing primary healthcare system using community health workers is a key strategy to enhance maternal healthcare utilization in Ethiopia. However, the effectiveness of digitalizing community health system using frontline health system workers is uncertain. Objective To determine the effect of electronic community health information system intervention on maternal continuum of care in northwest Ethiopia. Methods A pre-post experimental study was conducted in Wogera district, northwest Ethiopia. Data were collected at household level from April to May 2022 including a total of 830 women with children with age less than one-year. A log-binomial logistic regression model was used to estimate the effect of electronic community health information system on the maternal continuum of care and its predictors. Relative risk with a 95% confidence interval was reported, with a p-value of <0.05 considered statistically significant. Results The study revealed that 10.6% women were fully retained on the maternal continuum of care before the intervention while 32.5% after the intervention(p < 0.001). Women in the intervention cluster had 3.12 times higher coverage of maternal continuum of care(ARR: 3.12,95%CI: 2.20–4.41). In addition, primary education(ARR: 1.54, 95%CI:1.14, 2.08), secondary and above education(ARR: 1.61, 95%CI:1.08,2.39); pregnancy intention (ARR: 1.67, 95%CI: 1.11,2.51), and women’s autonomy in healthcare decision making (ARR: 2.02, 95%CI: 1.03, 3.97) were significantly associated with maternal continuum of care. Conclusions Electronic community health information system improved maternal continuum of care. Maternal health service programs in rural should consider the implementation of electronic community health information system. Provision of women’s education, prevention of unintended pregnancy, and enhancement of autonomy of women in healthcare decision making should be emphasized to improve maternal continuum of care.

Epilepsy is one of the most common neurological disorders in the world and contributes to various psychiatric illnesses. Depression is one of the most frequent comorbid psychiatric disorders that affect the quality of life in people with epilepsy. Despite this impact, depression continues to be under-recognized and undertreated. Therefore, this study aimed to assess the magnitude of depression and its associated factors among people with epilepsy at Wolaita Sodo University Hospital, South Ethiopia, 2021. A hospital-based cross-sectional study was conducted from April 2021 to May 2021. A systematic random sampling technique was used to select 423 samples of people with epilepsy, and interviewer-administered structured questionnaires were employed. The Patient Health Questionnaire with 9 items was used to assess depression. A logistic regression model was used to determine the association between the outcome and independent variables. A 95% CI and odds ratio with a corresponding p-value < 0.05 were used to determine the strength of association. The overall magnitude of depression among people with epilepsy in this study was 49.2%. Educational status; unable to read and write (AOR = 3.43, 95% CI 1.09, 10.7), being female (AOR = 2.54, 95% CI 1.43, 4.52), perceived stigma (AOR = 5.96, 95% CI 2.88, 12.3), poor social support (AOR = 2.88, 95% CI 1.28, 6.48), poor medication adherence (AOR = 4.60, 95% CI 2.46, 8.63), and seizure frequency above 5 times per month (AOR = 5.59, 95% CI 1.72, 18.1) were independent predictors of depression among people with epilepsy at p-value < 0.05. In this study nearly half of the people with epilepsy had depression. Educational status; inability to read and write, being female, perceived stigma, poor social support, poor medication adherence, and seizure frequency of above 5 times per month were independent predictors of depression among people with epilepsy. Therefore, screening depression in people with epilepsy and appropriate management critically needed attention to reduce the effects of the problems.

Eimeria species are a prevalent coccidian parasite impacting chicken production, leading to substantial economic losses in Ethiopia’s poultry sector. This study aims to investigate the prevalence of Eimeria species, assess associated risk factors, and identify prevalent Eimeria species and gross lesions. Thus, a cross-sectional study was conducted from November 2023 to May 2024 in the South Gondar Zone, Northwest Ethiopia. 516 chickens were randomly selected and examined for coccidian oocysts using the flotation technique. Patho-anatomical examinations were performed on 60 positive chickens to identify the various Eimeria species of chicken further. Binary logistic regression was utilized to calculate the odds ratios for associated risk factors. The overall prevalence of chicken coccidiosis in this study was 20.3% (105/516). Age (AOR = 0.46, P = 0.001) and breed (AOR = 1.73, P = 0.023) were found to be significantly associated with the occurrence of coccidiosis (P < 0.05). However, no statistically significant associations were observed with sex, study area, or management practices (P > 0.05), although the management system was considered a confounding factor. The most important identified Eimeria species were E. tenella (21.95%), E. brunetti (19.51%), E. acervulina (17.07%), E. necatrix (14.63%), and E. maxima (4.88%). These findings indicated that Eimeria-caused coccidiosis is a growing challenge to poultry production in South Gondar, highlighting the need for targeted control measures and improved management practices.

Postoperative anemia has been observed to increase the risk of oxygen deprivation, postoperative morbidity, and mortality. However; the prevalence of postoperative anemia prevalence in Ethiopia remains poorly understood. Reports from various literatures regarding postoperative anemia prevalence aboard are also inconsistent. This study aimed to determine the prevalence of postoperative anemia and associated factors among post-surgical patients. A hospital-based cross-sectional study was conducted involving 409 post-surgical patients. Data were collected using an interviewer-administered semi-structured questionnaire. Bivariable and multivariable analyses were performed using the Statistical Package for Social Science 23.0 program to determine the association between the independent variables and the surgical outcomes. The hemoglobin test result revealed that 203 (49.6%) of the participants were anemic at the time of hospital discharge. The study found that patients older than 50 years, unemployed, those with preoperative anemia, an American Society of Anesthesiologist physical status score of IV, emergency surgery, intraoperative blood loss greater than 500 ml, and hospital stay longer than 2 weeks were at significantly increased risk for postoperative anemia. The prevalence of postoperative anemia was high. Clinicians must be aware of the risk factors associated with postoperative anemia to minimize complications and improve patients’ perioperative quality of life.

Sleep disturbance poses a significant health concern for older adults, as it is associated with overall health decline. Poor sleep quality increases the risk of chronic diseases, depression, anxiety, and diminished quality of life. Therefore, this study aimed to assess the prevalence of poor sleep quality and its associated factors among older adults living in the community of Gondar town, Northwest Ethiopia, in 2023. A community-based cross-sectional study was conducted in Gondar town from February 20 to April 30, 2023. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated tool. Data were coded using Epi data version 3.0 and analyzed in STATA 14. Associated factors were examined using univariable and multivariable logistic regression models. In this study a total of 845 study participants were involved with 99.5% response rate. The prevalence of poor sleep quality among elderly community was 54.6% with 95% CI (51- 58%). Age of ≥ 75 years [AOR = 3.88, 95% CI: 2.11–7.10], poor social support [AOR = 3.7, 95% CI: 2.35–5.81], physically inactive [AOR = 4.42, 95% CI: 3.11–6.26], chronic disease [AOR = 3.7, 95% CI: 2.45–5.55] and depression [AOR = 2.01, 95% (CI: 1.42–2.83)] were factors associated with poor sleep quality. 55% of community-dwelling older adults in Gondar town experience poor sleep quality, particularly those with depression, advanced age, chronic diseases, and poor social support. To address this, enhancing community support and social networking activities is recommended. Engaging in physical activities has shown to significantly improve sleep quality. Healthcare providers should conduct regular screenings for sleep quality issues and provide education about sleep hygiene to enhance sleep quality among older adults. Future researchers are encouraged to use Longitudinal studies to explore the impact of poor sleep quality in older communities.

Background Climate change is making the existing health problems worse and also introducing new health problem and therefore calls for a wider evaluation of climate sensitive global diseases. The review sought to assess and collate quantitative and qualitative evidence on the effects of climate change on global health, more specifically, infectious and respiratory diseases, the impacts of extreme weather events as well as the implications for mental health with the view of establishing appropriate sustainable and resilience public health measures and policies. Methodology A scoping review of observational studies carried out between the years 2000 and 2024, synthesized information on climate-sensitive health outcomes: infectious diseases, severe weather events, and mental illnesses. This analysis was based on data from PubMed, Scopus, Web of Science and Cochrane Library, where appropriate, utilizing meta-extraction and Meta-analysis techniques. Results A total of 3077 studies were screened, and 96 articles were included for quantitative and qualitative analysis, highlighting the significant health risks posed by climate change. Key areas of concern identified include climate-sensitive infectious diseases, respiratory and cardiovascular conditions, food- and water-borne illnesses, and mental health effects. Rising temperatures and variable rainfall patterns increase the incidence of diseases like malaria (up to 50%) and dengue (8–10% per 1 °C rise). Extreme weather events, such as heatwaves and floods, contribute to a 30% rise in respiratory diseases and a 25% increase in cardiovascular conditions. Food- and water-borne illnesses are more prevalent in regions like Africa (30–40%) due to climate change. Additionally, climate change exacerbates mental health issues, leading to conditions like post-traumatic stress disorder (PTSD), anxiety, and depression. Conclusion and recommendations Climate change amplifies global public health risks, worsening diseases and creating new challenges. To address this, enhance machine learning climate sensitive disease surveillance, strengthen climate resilience health infrastructure, and integrate health into climate adaptation and mitigation strategies, promote sustainable agriculture, improve WASH infrastructure, and foster global collaboration.

Introduction Providing patient centered palliative care is essential to enhance the wellbeing of patients with life-limiting illnesses and their families. As the demand for palliative care services increases and the cancer burden grows in Ethiopia, it is crucial to know how much these services are patient centered and what factors may determine it. Therefore, this study assess the level and determinant factors of patient-centeredness for adult cancer patients’ palliative care services in public hospitals found in Addis Ababa. Method and materials A cross-sectional mixed method was employed from May 16 to August 19, 2024. A total of 407 adult cancer patients, 7 key informant interviews and five in-depth interviews were included. The quantitative data was collected using Kobo collect tool version 2.023.21 and exported to STATA version 14 for analysis. Binary and multi-variable logistic regression with 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR) were fitted to identify factors associated with the patient-centeredness of care. Qualitative data was recorded, transcribed and thematically analyzed by using Open Code software version 4.0.1. Results Patient-centeredness care for adult cancer patients was 77.9%. age group 30–39 (AOR: 3.52, 95% CI: 1.21, 10.21), being divorced (AOR: 0.14 95%, CI: 0.06, 0.37), monthly income > 12,000 Birr (AOR: 0.36, 95 CI: 0.156, 0.836), health literacy (AOR: 0.08, 95% CI: 0.02, 0.25), intimacy with the provider (AOR: 0.14 95% CI: 0.02, 0.75), service easiness (AOR: 0.34, 95% CI: 0.17, 0.67), and appointment waiting time (AOR: 0.4 95% CI: 0.19, 0.83) were found to be significant factors for patient-centeredness of palliative care service. Conclusion and recommendations The magnitude of patient-centered care for adult cancer patients in palliative care was 77.9%. Most patients felt respected and involved in decision-making, and their physical and emotional comfort was maintained. However, only one-third of them reported ease of access to services. Age, marital status, income, participation in decision-making, intimacy with providers, ease of access, and appointment length was the significant factors. Recommendations include improving service coordination, reducing waiting time, fostering emotional connections between patients and providers, and offering tailored support to single or widowed patients to enhance patient-centered care.

Sesame (Sesamum indicum L.) is a major oilseed crop globally, and white sesame is a key contributor to the foreign exchange earnings of Ethiopia. The main production districts of white sesame in Ethiopia are Humera, Metema, Tegedie, Mirab-Armachiho and Tachi-Armaciho. This study assessed the levels of trace metals (Fe, Cu, Zn, Mn and Ni) in white sesame seeds from these regions and evaluated the associated health risks to consumers. A total of 53 samples were collected from 19 farmer villages across the five districts. Homogenized samples from each village were analyzed using the acid digestion method followed by flame atomic absorption spectroscopy (FAAS). The limit of detection of the method ranged from 0.75 to 865 mg/kg, and the limit of quantitation ranged from 2.55 to 28.8 mg/kg for the different elements analyzed. The recovery of the method was in the range of 90.9‒99.6%. The results showed trace metal levels ranging from 164 ± 6 to 381 ± 4 mg/kg for Fe, 94.0 ± 1.9 to 126 ± 0.8 mg/kg for Zn, 11.8 ± 0.4 to 14.2 ± 0.4 mg/kg for Cu, 11.9 ± 0.9 to 15.0 ± 0.7 mg/kg for Mn and 16.2 ± 1.1 to 21.0 ± 1.2 mg/kg for Ni across the production districts. One-way ANOVA revealed significant differences (p < 0.05) in trace metal concentrations among the districts, indicating a geographical effect on the trace metal content of sesame. Importantly, the study found no non-carcinogenic health risks from the analyzed metals for either adult or child consumers. These findings suggest that the trace metal levels in the sesame seeds are within safe limits for human consumption.