Afework Mulugeta

• Mekelle University

Background: Encephalocele is a severe neural tube birth defect, which is associated with

Background The Tigray region of Ethiopia has a significantly high prevalence of neural tube defects (NTDs), ranging from 1.31 to 2.15% of total births. The prevalence has worsened due to ongoing regional war and conflict since October 2020. This study aims to assess NTD prevalence in these challenging conditions. Methods This institution-based, re...

Background Neural tube defects (NTDs) are complex multifactorial disorders in the neurulation of the brain and spinal cord that develop in humans between 21 and 28 days of conception. Neonates with NTDs may experience morbidity and mortality, with severe social and economic consequences. Therefore, the aim of this systematic review and meta-analysi...

Background People in war-affected areas are more likely to experience excess mortality with hunger. However, information on the causes of death associated with hunger is often nonexistent. The purpose of this study was to verify and investigate hunger and hunger-related deaths after the Pretoria deal in Tigray, northern Ethiopia. Methods A cross-s...

Background Tuberculosis (TB) is Ethiopia’s leading infectious killer disease. The war in the Tigray region of Ethiopia has resulted in the disruption of TB care services. Prediction models are recommended to aid the diagnosis of TB in resource-limited settings. However, the development of such decision-support tools without the participation of end...

Background Malnutrition impedes the growth, development, and survival of children. Conflict has severely affected the livelihoods of families and caused an alarming increase in food insecurity, population displacements, and extreme poverty in Tigray. Therefore, this study aimed to assess the prevalence and factors associated with acute malnutrition...

Background Visceral leishmaniasis (VL) is an important public health problem, which mainly affects the poor rural dwelling communities in Low- and Middle-Income Countries. However, little is known about the health and economic burdens of this disease in East Africa, including Ethiopia. The aim of this study was to assess the household level economi...

Background. Despite improvements globally, child stunting remains one of the serious public health problems in Ethiopia. This study aimed to assess the distribution and determinants of stunting among under-five children in Tigray, Ethiopia. Materials and Methods. A cross-sectional survey was conducted in Tigray from June to July 2019. A total of 11...

Background The Tigray region of Ethiopia, which has been affected by civil war from 2020 to 2022, is facing an increase in tuberculosis in the damaged health system. Our study employed mathematical modeling to predict the incidence of tuberculosis and its trends during the war and in the post-conflict setting of Tigray, Northern Ethiopia. Methods...

Background Although tuberculosis is highly prevalent in low- and middle-income countries, millions of cases remain undetected using current diagnostic methods. To address this problem, researchers have proposed prediction rules. Objective We analyzed existing prediction rules for the diagnosis of pulmonary tuberculosis and identified factors with...

Background In resource-limited countries with weak healthcare systems, women of reproductive age are particularly vulnerable during times of conflict. In Tigray, Ethiopia, where a war broke out on 04 November 2020, there is a lack of information on causes of death (CoD) among women of reproductive age. This study aims to determine the underlying Co...

Introduction. Studies in Ethiopia have indicated that tuberculosis (TB) patient’s elapsed a long time before initiating treatment. Gap Statement. However, there is very limited evidence on the association of treatment initiation delay with drug resistance. Research Aim. To investigate the association of delayed treatment initiation with drug resist...

Background: Optimal Infant and Young Child Feeding (IYCF) practices are essential to meet the nutritional needs of children in the first two years of life. Poor IYCF practices coupled with high rates of infectious disease are the principal proximate causes of under nutrition during the first two years of age. Objective: The purpose of this study wa...

Background War-related sexual violence is becoming an increasing feature of conflict and security challenges and is used as a weapon of war to achieve military or political goals. It has tremendous negative short and long-term consequences for the victims, their families, and communities. Since the eruption of war in November 2020 in Tigray, many w...

[This corrects the article DOI: 10.1371/journal.pone.0231524.].

Communities afflicted by armed conflict are characterized by pervasive malnutrition and widespread hunger. For nearly two years, there has been an unbroken conflict in Tigray. However, little is understood about the coping mechanisms people used in reaction to a lack of food and a siege. This study was conducted to evaluate the coping mechanisms us...

Globally, war is the major cause of displacement from the usual place of the biological environment. The war of Tigray exposed thousands of people to internal displacement and migration. Evidence has shown that displaced people and migrants shoulder the health and economic burden to ensure survival. However, evidence of the impact of the war on hea...

Background Access to basic health services, notably child health services, is severely hampered by the armed conflict in Tigray, North Ethiopia. Little is known regarding the impacts of the armed conflict during the war in Tigray on access to child health services. The current study investigates the impact of the armed conflict on the utilization o...

Objective This study seeks to examine the impact of war on maternal mortality following an exacerbation in the dynamics of inequality in maternal health caused by the continuing conflict. Design Community‐based cross‐sectional study. Setting Tigray region of Northern Ethiopia, between November 2020 and May 2022. Population This study surveyed a...

Importance: The war in Tigray, Ethiopia, has disrupted the health care system of the region. However, its association with health care services disruption for chronic diseases has not been well documented. Objective: To assess the association of the war with the utilization of health care services for patients with chronic diseases. Design, set...

[This corrects the article DOI: 10.1017/jns.2022.29.].

Background In low-income countries, where socioeconomic adversities and perinatal distress are common, adverse birth outcomes are significant public health problems. In these settings, perinatal distress, i.e., high symptoms of anxiety, depression, and/or stress during pregnancy, may be linked with adverse birth outcomes. However, few prospective s...

Objectives This study examines the effect of continuum care for maternal health service utilisation on intention to use family planning among the pastoralist community in Ethiopia. Design A community-based cross-sectional study. Setting Data were collected from three districts of the pastoralist community of the Afar region. Participants Randoml...

Introduction: Sexual and gender-based violence (SGBV) during armed conflicts has serious ramifications with women and girls disproportionally affected. The impact of the conflict that erupted in November 2020 in Tigray on SGBV is not well documented. This study is aimed at assessing war-related SGBV in war-affected Tigray, Ethiopia. Methods: A c...

Abstract Access to water, sanitation, and hygiene (WASH) is a global public health problem. The situation is worst in conflict areas, where people are displaced from their usual homes. Household supply of WASH and the incidence of diarrhoeal disease among children during the war in Tigray are not known or documented. The objective of this study was...

Background Armed conflicts greatly affect the health, nutrition, and food security of conflict affected settings particularly children. However, no empirical data exist regarding context specific factors contributing towards acute malnutrition in the war-torn Tigray, Ethiopia. Thus, this study aimed to identify individual and community level factor...

Abstract Background Despite numerous interventions, child undernutrition continues as a problem of global concern. Although consumption of animal source foods has shown positive associations with child undernutrition, no much evidence exists on its trends and predictors among children in Tigrai. Objectives This study aimed to investigate the trends...

Abstract Background Evidence has shown that SMS text message-based health education is efective in improving exclusive breastfeeding. However, there is limited evidence on the development and design of SMS messaging intervention targeting fathers and mothers. Method This is the formative assessment and intervention design for a larger trial targe...

Background: The burden of Non-communicable diseases (NCD) is rapidly increasing in Ethiopia and remains public health problem. The diseases have led to a double burden of diseases in the country.

Background: In Ethiopia, the Women Development Group program is a community mobilization initiative aimed at enhancing Universal Health Coverage through supporting the primary healthcare services for mothers and newborns. This study aimed to assess the association between engagement in women's groups and the utilization of maternal and neonatal he...

Background Nutrition-sensitive agriculture is an effective multi-sectoral approach to address the underlying causes of malnutrition. However, successful implementation requires the involvement of different sectors to jointly plan, monitor, and evaluate key activities, which is often challenged by contextual barriers. Previous studies in Ethiopia ha...

Background Exclusive breastfeeding remains sub-optimal in low-income countries contributing to infant mortality. Mobile health (mHealth) interventions, delivered through personal mobile phones, to improve exclusive breastfeeding have shown promise, but very few include fathers or have been applied in low-income countries. The aim of this study was...

Abstract Background Due to the nutritive and immunologic benefits of breastmilk, children should be exclusively breastfed for the first 6 months of life, even during the corona virus pandemic. However, fear of transmission risk and pandemic-related restrictions could undermine the practice of breastfeeding. This study aimed to assess the knowledge,...

Training and supervision of health workers are critical components of any health system;thus, we assessed how they impact health extension workers’ (HEWs) role in non-communicable disease (NCD) service delivery in Ethiopia’s health extension program (HEP), using an in-depth qualitative study conducted in 2019.The study covered two regions—the Tigra...

Background Animal source foods (ASFs) are rich in high-quality proteins, including essential amino acids and highly bioavailable micronutrients vital for child growth and cognitive development. But, the daily consumption of ASFs among 6–23 months old children is very low in Tigray, Northern Ethiopia. Objective The study aimed to assess the effecti...

In earlier studies, we have shown that the utilization of maternal health services in rural Ethiopia was distributed in a pro-rich fashion, while the coverage of child immunization was equitably distributed. Hence, this study aimed to explore mothers' and primary healthcare workers' perceptions of inequities in maternal, newborn, and child health s...

Background World Health Organization recently acknowledged the proportion of anemia attributable to iron deficiency among under-five children could be lower than the previously assumed 50%. Ethiopia reported 8.6% and 12.3% prevalence of iron deficiency anemia by serum ferritin and soluble transferrin receptor respectively. However, evidence generat...

Background Exclusive breastfeeding remains sub-optimal in low-income countries contributing to infant mortality. mHealth interventions to improve exclusive breastfeeding have shown promise, but very few include fathers or have been applied in low-income countries. The aim of this study was to assess the effectiveness of a SMS-based breastfeeding in...

Undernutrition in children is a challenging problem in developing countries, including Ethiopia. Stunting is the most prevalent form of undernutrition. The majority of studies on childhood stunting and its associated factors focused on children, maternal and socioeconomic components. However, a few studies reported poor WaSH status and antibiotic e...

As part of the 2030 maternal and child health targets, Ethiopia strives for universal and equitable use of health services. We aimed to examine the association between household wealth, maternal education, and the interplay between these in utilization of maternal and child health services. Data emanating from the evaluation of the Optimizing of He...

Background Dietary related misconceptions during pregnancy affect the heath of mothers and their growing babies. Misconceptions vary from place to place and from community to community. Understanding of a given community’s food perceptions during pregnancy helps policy makers able to design cultural appropriate interventions. In Ethiopia, however,...

Abstract Background Undernutrition puts children in a physical and cognitive disadvantage. Animal source foods (ASFs) are important components of nutritious diets and play a significant role in increasing dietary diversity and minimizing the risk of undernutrition among children. Ethiopia still suffers from child undernutrition and there’s no adequ...

Background Limited studies in Ethiopia showed that infants and young children are at high risk of inadequate intake of energy and nutrients. However, inclusive assessment of both nutrient intakes and their food sources are lacking. We aimed at assessing energy and nutrient intakes and their food sources during religious fasting and non-fasting peri...

Background COVID-19 is one of the leading causes of morbidity and mortality and is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). A patient infected with SARS-CoV-2 is said to be recovered from the infection following negative test results and when signs and symptoms disappear. Different studies have shown different median...

(1) Background: Postpartum weight may increase compared to pre-pregnancy due to weight retention or decrease due to weight loss. Both changes could pose deleterious effects on maternal health and subsequent pregnancy outcomes. Therefore, this study aimed to assess postpartum weight change and its associated factors. (2) Methods: A total of 585 wome...

Maternity should be a time of hope and joy. However, for women in pastoralist communities in Ethiopia, the reality of motherhood is often grim. This problem is creating striking disparities of skilled birth uptake among the agrarian and pastoral communities in Ethiopia. So far, the depth and effects of the problem are not well understood. This stud...

Background Nutrition has a substantial role in the prevention, treatment, and cure of tuberculosis. Thus, nutrition assessment, counseling, and support (NACS) have been implemented as part of tuberculosis treatment. However, evidence on the barriers and facilitators (enablers) of its implementation is lacking. Objective To explore barriers and fac...

Background In earlier studies, we could show that rural Ethiopian maternal health services were distributed pro-rich, while child immunization coverage was equitably distributed. Hence, this study aimed at exploring rural Ethiopian mothers’ and primary healthcare workers’ perceptions of inequities and their causes in the provision and utilization o...

Background Community health workers and volunteers are vital for the achievement of Universal Health Coverage also in low-income countries. Ethiopia introduced community volunteers called women’s development group leaders in 2011. These women have responsibilities in multiple sectors, including promoting health and healthcare seeking. Objective We...

Objective To assess a broad range of factors associated with pre-pregnancy nutritional status, a key step towards improving maternal and child health outcomes, in Ethiopia. Design A baseline data analysis of a population-based prospective study. Setting Kilite-Awlaelo Health and Demographic Surveillance Site, eastern zone of Tigray regional state...

Background : Previous studies in Ethiopia indicated that tuberculosis (TB) patient’s elapse long time before treatment initiation. However, there is very limited evidence on the association of delay to initiate treatment with treatment outcome. Objective : To investigate the association of time to treatment initiation delay with treatment outcomes...

Improving nutrition for young children remains an urgent priority globally. Ethiopia has made great strides over the last two decades in improving health and nutrition for children. The task of scaling improved nutrition services now turns to addressing progress on the regional level. This research sought to highlight regional disparities identifie...

Background Breastfeeding is considered the biological norm and essential to reduce infant morbidity and mortality. Mothers are responsible for breastfeeding but the support of others, including their partners is an influential determinant. The aim of this study was to compare antenatal breastfeeding knowledge, attitudes, and perceived breastfeeding...

Background Women’s development group leaders are volunteer community health workers in Ethiopia who, among other duties, promote health and prevention of diseases. They link and extend essential health services from health posts to households. Objective To assess the characteristics, knowledge, and practice of women’s development group leaders in...

Objective: In marginalized setting, under-nutrition and illnesses due to infectious agents create a vicious circle. In our previous study, we reported that easy-to-do hand hygiene interventions were effective in preventing intestinal parasite infections (IPIs) and reduce the rate of anaemia among school-aged children. The aim of this study was to...

A majority of the world’s population now live in areas with a mobile telephone network. This expansion of the network enables people to use more mobile phone functionalities such as short message service, multimedia, and the Internet. Mobile phone–based health (mHealth) interventions have been considered to have benefits in low-income countries. Th...

Background Adolescence is a time of tremendous physical growth and mental development, with high nutrient requirements. Ethiopia is among the countries with a high prevalence of nutritional deficiencies among the women of reproductive age group, whilst adolescent girls from rural areas suffered disproportionately. However, there is a dearth of evid...

Objective: The study aimed to identify the effects of the individual-level and community-level factors on the use of family planning (FP) among married women in the pastoralist community of Ethiopia. Design: A community-based cross-sectional study was conducted in September 2018. Data were analysed using R software. To determine the fixed effect...

Background: Investigating effects of calcium diets on blood pressure can contribute to development of diet based recommendations for health. Epidemiologic data suggest contradicting evidence relationship between dietary calcium intake and pregnancy-induced hypertension. So, this study aimed to determine the effect of calcium nutrition education on...

This study aimed to describe the gross phytochemical constituents of Aloe elegans Todaro gel and evaluate the characteristics and quality of lab-made hair washing formulations prepared from the gel to show its potential in formulating hair washing shampoos. A. elegans gel mass was prepared from mature, healthy leaves collected from natural stand. S...

Background Delayed treatment initiation of Tuberculosis patients results in increased infectivity, poor treatment outcome, and increased mortality. However, there is a paucity of evidence on the delay in new adult pulmonary Tuberculosis patients to initiate treatment in Tigray, Northern Ethiopia. Objective To assess the factors associated with tre...

Abstract Background Early initiation of breastfeeding (EIBF) is defined as initiation of breastfeeding within 1 h of birth. This is also the time colostrum is secreted with its potential benefits. Globally, two out of five under 5 children die in the first month of life, more than a third of which being on the first day. Neonatal mortality is still...

Anaemia has prevailed as a mild to severe public health problem in Ethiopian women of reproductive age. Many studies carried out on anaemia have been limited to sub-national assessments and subgroups of women. The effects of potential factors thought to affect anaemia and severity levels of anaemia have not been well considered. Therefore, this stu...

Background: Delayed treatment initiation of tuberculosis (TB) increases disease progression and development of complications which may lead to a higher level of infectiousness, clinical severity and increased mortality. But published evidences that investigated the effect of delayed initiation of treatment on clinical severity and level of infecti...

Aloe L. species (Aloaceae) are ethnobotanically very valuable plants in many communities and civilizations. Nonetheless, very few species are extensively studied to explore their applications in the pharmaceutical and medical, cosmetic and personal care, food and beverage, and detergent industries. This study evaluated the characteristics and quali...

Background: Breastfeeding, particularly exclusive breastfeeding, is essential to ensure the short- and long-term health of infants and mothers. Sub-optimal breastfeeding practices currently take place in low income countries contributing to morbidity and mortality. This research explored the challenges and opportunities around exclusive breastfeed...

Background Breastfeeding is considered the biological norm and essential to reduce infant morbidity and mortality. Mothers are responsible for breastfeeding but the support of others, including their partners is an influential determinant. The aim of this study was to compare and contrast antenatal breastfeeding knowledge, attitudes, and perception...

Background: Breastfeeding is considered the biological norm and essential to reduce infant morbidity and mortality. Mothers are responsible for breastfeeding but the support of others, including their partners is an influential determinant. The aim of this study was to compare antenatal breastfeeding knowledge, attitudes, and perceived breastfeedin...

Background: Breastfeeding is considered the biological norm and essential to reduce infant morbidity and mortality. Mothers are responsible for breastfeeding but the support of others, including their partners is an influential determinant. The aim of this study was to compare antenatal breastfeeding knowledge, attitudes, and perceived breastfeedin...

[This corrects the article DOI: 10.1371/journal.pone.0225707.].

Background: Delayed treatment initiation of tuberculosis (TB) increases disease progression and development of complications which may lead to a higher level of infectiousness, clinical severity and increased mortality. But published evidences that investigated the effect of delayed initiation of treatment on clinical severity and level of infectio...

Background Community-based management of acute malnutrition has been reported effective in terms of recovery rate, but recovered children may be at increased risk of developing acute malnutrition after returning to the same household (HH) environment. Objective Compare the magnitude and factors associated with acute malnutrition among recovered an...

Introduction : Adolescence is a time of tremendous physical growth and mental development, with high nutrient requirements. Ethiopia is among a country with high prevalence of nutritional deficiencies among the women of reproductive age group whilst adolescent girls from rural suffer from it disproportionally. However, there is dearth of evidence r...

Background In Ethiopia, inappropriate feeding including prelacteal feeding is one of the immediate causes of undernutrition. The objective of this study was to assess the magnitude and associated factors of prelacteal feeding practices among mothers of children aged less than one year in Rural Pastoralist Communities of Afar, Ethiopia. Methods A cr...

Introduction:Adolescence is a time of tremendous physical growth and mental development, with high nutrient requirements. Ethiopia is among a country with high prevalence of nutritional deficiencies among the women of reproductive age group whilst adolescent girls from rural suffer from it disproportionally. However, there is dearth of evidence reg...

Background Animal source foods provide high-quality protein and essential micronutrients within the human diet and are of particular significance for the health and development of children. Despite the availability of domestic livestock in rural households of Ethiopia, the diets of children are often monotonous and mainly cereal-based with low ener...

Objective: The objective of this study was to assess the determinants of overweight and obesity among children under 5 years in Ethiopia. Results: Data from a total of 672 (224 cases and 448 controls) under 5 years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI 1.29, 5.34), boys (AOR = 1.56, 95% CI 1.10, 2.22) an...

Objective The objective of this study was to assess the determinants of overweight and obesity among children under five years in Ethiopia. Results Data from a total of 672 (224 cases and 448 controls) under five years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI: 1.29, 5.34), boys (AOR = 1.56, 95% CI: 1.10, 2.22)...

Objective The objective of this study was to assess the determinants of overweight and obesity among children under five years in Ethiopia. Results Data from a total of 672 (224 cases and 448 controls) under five years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI: 1.29, 5.34), boys (AOR = 1.56, 95% CI: 1.10, 2.22)...

Objective The objective of this study was to assess the determinants of overweight and obesity among children under five years in Ethiopia. Results Data from a total of 672 (224 cases and 448 controls) under five years of age children were included in the study. Urban residence (AOR = 2.63, 95% CI: 1.29, 5.34), boys (AOR = 1.56, 95% CI: 1.10, 2.22)...