University of Gondar

Iron-Folic Acid (IFA) is a crucial process indicator, that helps to halt the burden of iron deficiency anemia worldwide, especially in low and middle income countries like Ethiopia. Iron-folic acid supplementation is a crucial method in Ethiopia to reduce maternal deaths from anemia and poor birth outcomes. Despite these initiatives, there is still extremely little adherence to IFA consumption for the 90-day or more WHO-recommended timeframe. Therefore, the aim of this study was to use the DHS 2016 information to create a predictive model for IFA consumption and figure out the key factors influencing it among Ethiopian pregnant women. A secondary data analysis of Ethiopian DHS from 2016 was performed. A total weight of sample of 3109 women (15–49) was included in this study. Data were extracted using STATA version 17 software, and imported to a Jupyter notebook for further analysis. Machin learning algorithm using different classification models were implemented. All analysis and calculation were performed using Python 3 programming language in Jupyter Notebook using imblearn, sklearn, xgboost, and shap packages. Random Forest demonstrated the best performance with accuracy of 92.93%, precision of 91.32%, recall of 94.77%, F1-score of 93.99% and AUC 94%. Region, distance to health facility, age at first marriage, household head, number of ANC visit, media exposure, community literacy, husband occupation, gravidity, family size were top predicting factors of IFA utilization among women in Ethiopia. Random Forest were best predictive models with improved performance. Highly predicting factors of IFA utilization were identified using machine learning algorithms particularly random forest. These findings can guide policymakers and program managers to target interventions more effectively, promote ANC attendance, enhance community literacy and address household-level determinants to improve IFA supplementation rates. However, as the analysis is based on cross-sectional survey data, causal inferences cannot be made.

Access to improved water and sanitation (WaTSAN) is essential for public health and sustainable development. This study examines trends, determinants, and socio-economic inequalities in WaTSAN access in Ethiopia from 2005 to 2019, and provides projections for 2025–2030 to inform Sustainable Development Goal 6 (SDG 6). A cross-sectional study was conducted using Ethiopian Demographic and Health Survey (EDHS) data from 55,736 households, with a stratified two-stage cluster sampling Technique. Multivariate decomposition and Wagstaff analysis were used to examine socioeconomic disparities in WaTSAN access, accounting for income, education, and geographic variation. Future projections employed both linear and logistic growth models with sensitivity analyses to account for methodological uncertainty. The proportion of households using improved WaTSAN sources increased from 4.66% in 2005 to 16.62% in 2019. The decomposition results show that 57.75% of the overall increase in the proportion of households using improved WaTSAN sources was due to Endowment (differences in the compositional characteristics of respondents), while 42.25% was due to Coefficient (the effect of independent variables). The Wagstaff index revealed pronounced inequalities, favoring wealthier households (0.335 [95% CI 0.2898, 0.381]) and those headed by individuals with higher education (0.1387 [95% CI 0.1047, 0.1727]). Regional and rural–urban disparities remain significant, particularly among communities with limited media exposure. Projections indicate that improved water coverage may reach 69–73% by 2030, though with substantial uncertainty (95% CIs 20–126% for the linear model, 35–100% for the logistic model). While Ethiopia has made progress in expanding WaTSAN access, significant socioeconomic and geographic disparities persist. Targeted policies, poverty reduction strategies, and increased media exposure are crucial for achieving equitable access. Projections suggest accelerated interventions are needed to achieve SDG 6 targets by 2030. The considerable uncertainty in long-term forecasts highlights the need for frequent monitoring and adaptive policy responses.

Penile zipper injuries are relatively common in pediatric patients; however, most are successfully managed conservatively. These injuries typically occur when the foreskin or penile shaft becomes entrapped within the zipper mechanism and are most frequently reported in children aged two to twelve years. While most cases are amenable to conservative management, a subset requires surgical intervention. We present a case of a 10-year-old boy with severe penile zipper entrapment that necessitated emergency circumcision following unsuccessful attempts at conservative mechanical release A non-circumcised 10-year-old boy presented to the Emergency Department after entrapping his penile skin in the zipper of his trousers while dressing. On examination, 4 cm of the dorsal skin was caught, resulting in anxiety, pain, and minor bleeding. Despite attempts to free the tissue using local anesthesia and lubricants, surgical intervention became necessary. Penile zipper entrapment is an uncommon but potentially distressing injury in children. While most cases can be managed conservatively, emergency circumcision may be required when standard release techniques fail, particularly in resource-limited settings. This case contributes to the limited literature on operative management of penile zipper injuries and underscores the importance of prompt intervention and appropriate family counselling.

Intimate Partner Violence (IPV) remains a persistent public health and social problem among women in Africa, with severe physical, emotional, and sexual consequences that hinder well-being and socio-economic development. Despite ongoing global and regional efforts, evidence on the prevalence and determinants of IPV across East African countries is limited, fragmented, and often focused on single countries. A more comprehensive, regional-level understanding is crucial to guide targeted interventions and policies This study aimed to provide a comprehensive assessment of IPV among married women in East Africa by (1) estimating the prevalence of physical, emotional, and sexual IPV across 12 countries, and (2) identifying individual-, household-, and community-level factors associated with IPV using a structural equation modeling (SEM) approach. By integrating multi-country data, the study seeks to generate region-wide evidence that can inform prevention strategies and policy responses to gender-based violence in East Africa. A nationwide community based cross-sectional study was conducted in 12 East African countries as part of the Demographic, and Health Survey (DHS) in the region. The study gathered data from 56,657 married women through structured questionnaires. Descriptive findings were presented as percentages with a 95% confidence interval. To identify factors associated with different types of IPV (physical, emotional, and sexual), a Generalized Structural EquationModel was used. Adjusted odds ratios (AOR) with a 95% confidence interval were used to determine the significant factors related to IPV. The pooled prevalence of overall IPV in East Africa countries was 38.03% (95% CI: 33.23, 43.08). The highest prevalence of IPV was found in Uganda (53.24%), whereas the lowest was in Comoros (10%). Older age, secondary/higher education, wealth, current working status, attitude towards wife beating, husband’s educational status, husband’s current working status, and husband’s drinking alcohol were factors associated with physical violence. Regarding emotional violence, older age, primary education, wealth, media exposure, current working status, smoking cigarettes, women’s decision-making autonomy, attitude towards wife beating, husband’s education, and husband’s drinking alcohol were significant factors. Finally, regarding sexual violence, factors such as rural residence, better education, wealth, working status, women’s decision-making autonomy, husband’s education, and husband’s drinking alcohol were associated with it. The findings indicate a high prevalence of IPV among married women in East Africa. Key factors for physical violence include age, education, economic status, and attitudes toward domestic violence, while emotional and sexual violence are linked to women’s decision-making autonomy and their partners’ behaviors. To address IPV, comprehensive education and awareness programs are essential, emphasizing gender equality and healthy relationships. Additionally, policies should focus on enhancing women’s economic empowerment and decision-making autonomy, supported by community initiatives to challenge harmful norms.

ABSTRACT Energy poverty remains a major challenge of the 21st century. It reflects a trade‐off between satisfying current energy demands and protecting the environment. Similarly, in North Gondar, the sector continues to challenge socioeconomic development and adversely affects household health and the environment, with limited progress in switching to clean energy sources. Household fuel preference plays a central role in shaping this transition. This study examined the extent of solid biofuel usage and household energy choice behavior in Northwest Ethiopia, using data collected from 384 randomly selected households and a multivariate probit model to capture the interrelated nature of fuel choices. The results indicate a heavy reliance on solid biomass, which accounts for 90% of cooking energy use and 76% of lighting energy consumption. Empirical findings reveal that households living in urban areas, with higher incomes and better educational backgrounds, are more likely to adopt cleaner energy sources. Older households, those living far from markets, and households with larger livestock holdings continue to rely on traditional biomass fuels. The study concludes that household energy choice in the area follows a fuel‐stacking pattern rather than a simple linear transition along the energy ladder. On the basis of the insights, the study recommends strengthening public awareness campaigns, prioritizing pro‐poor energy transition measures, supporting afforestation efforts, and promoting environmentally friendly biomass practices to improve household energy use and accelerate the transition to clean energy sources in Northwest Ethiopia.

Diabetic retinopathy incidence in Australasia is highly variable, highest in institution-based cohorts and among Indigenous Australians. HbA1c is the only determinant consistently and significantly associated with both onset and progression. Because most evidence predates modern diabetes care, future prospective cohorts should adopt standardised, multifactorial designs to generate contemporary, comparable data and reduce persistent inequities in eye-care access.

In Ethiopia’s Gambella Region, agro-pastoralist households rely on both crop farming and livestock, often adopting mobile settlement patterns in response to environmental and economic challenges. While mobility affects land use, labor allocation, and agricultural output, its influence on crop diversification has been little studied. This research investigates the effect of mobile settlement on crop diversification among 384 households using a mixed-methods approach, including surveys, focus group discussions, and key informant interviews. The Simpson Diversification Index and Endogenous Switching Regression were applied to quantify and analyze crop diversification patterns. Findings showed that overall crop diversification is limited among agro-pastoralists influenced by socio-economic and environmental factors. Moreover, mobile settlement reduced crop diversification by 0.34 units among mobile households and by 0.45 units among non-mobile households. The study concludes that mobile settlement negatively impacts crop diversification, potentially undermining household resilience and food security. To improve diversification, it is recommended to enhance irrigation infrastructure, strengthen extension and training services, expand market access, provide financial support schemes, and implement local resource management strategies.

After substantial progress in malaria control, Ethiopia's Amhara Region experienced a marked resurgence since 2018. The relative contributions of climate variability, environmental context, intervention coverage, and unmeasured factors to this resurgence remain inadequately quantified. This study used a Bayesian spatiotemporal framework to estimate factor associations with malaria incidence, decompose spatial versus temporal climate effects, and identify persistent hotspots. We conducted an ecological district-level panel analysis of 13,944 district-month observations from 166 districts (January 2018-December 2024). Monthly confirmed malaria counts (total,Plasmodium falciparum,P. vivax) were modelled using Bayesian hierarchical negative binomial regression with BYM2 spatial and AR(1) temporal random effects, fitted with integrated nested Laplace approximation. Covariates included lagged rainfall, temperature, NDVI, elevation, and programmatic indicators (ITN ownership, IRS protection, and larval source management [LSM] intensity). Climate covariates were decomposed into between-district (spatial) means and within-district (temporal) deviations. Sensitivity analyses included alternative IRS protection windows and district fixed-effects models. A total of 5,746,571 confirmed cases were reported (64.3%P. falciparum, 35.7%P. vivax). Mean monthly incidence increased 5.5-fold from 1.19 per 1,000 (2018) to 6.53 per 1,000 (2024), while regional mean maximum temperature showed a small declining trend over the period. In fully adjusted models, higher lagged maximum temperature and rainfall were associated with higher incidence, and elevation was protective. IRS protection, higher ITN ownership, and higher LSM intensity were each associated with lower incidence; effect directions were consistent in within-district sensitivity analyses, although residual confounding and measurement error cannot be excluded. Climate-incidence associations were predominantly spatial (between-district) rather than temporal (within-district), suggesting that geographic ecological suitability explains much of the spatial patterning, rather than temporal warming trends explaining the resurgence. Districts with persistently elevated residual spatial risk (exceedance probability of residual RR > 1.25) clustered in low-elevation western border areas. Malaria resurgence in Amhara (2018-2024) occurred alongside strong spatial climatic and elevational gradients and was not consistent with a temporal warming-driven explanation at the regional scale. Remaining unexplained spatiotemporal variation highlights the likely importance of unmeasured drivers (e.g., conflict-related service disruption, vector/insecticide resistance dynamics, and population mobility). Climate-informed, spatially targeted intervention packages prioritizing districts with persistently high residual risk are warranted.

ABSTRACTGitelman syndrome (GS) is a rare autosomal recessive tubulopathy characterized by hypokalemic metabolic alkalosis, hypomagnesemia, and hypocalciuria. A 27‐year‐old woman presented with a witnessed syncopal episode, progressive weakness, and nausea. She reported a 3‐year history of muscle cramps, paresthesias, salt craving, and nocturia, with only transient correction of hypokalemia despite supplementation. Examination showed orthostatic hypotension and proximal muscle weakness, and ECG revealed flattened T and prominent U waves. Laboratory tests demonstrated severe hypokalemia (2.7 mmol/L), metabolic alkalosis, hypomagnesemia, renal potassium wasting, hypocalciuria, elevated renin and aldosterone, and a negative diuretic screen, consistent with GS. Severe hypokalemia is arrhythmogenic; ECG changes and syncope in this patient prompted monitored cardiac care and urgent correction. She was treated with intravenous and oral potassium and magnesium plus amiloride, leading to symptomatic improvement but persistently low‐normal potassium levels (3.3–3.7 mmol/L). Genetic testing confirmed a pathogenic SLC12A3 variant. This case underscores the importance of considering GS in young adults with unexplained hypokalemia and the difficulty of achieving full biochemical correction despite optimal therapy.