To assess the status of women’s empowerment and its associated factors using multidimensional empowerment index in Tigray, Ethiopia.

Community-based cross-sectional study.

Tigray regional state, Ethiopia.

A sample of married pregnant women (n=1477) whose gestational age was at least 8 weeks were the study participants.

The primary outcome of the study was women’s empowerment status, assessed using 24 indicators across five key domains: decision-making power, social independence, attitudes towards violence against women, social networking and household asset ownership. Equal weight was assigned to all domains and the weight assigned to each domain was distributed equally to the indicators within the corresponding domain. Women who scored at least 80% (ie, met 4 out of 5 domains) were considered as empowered.

In total, only 8.2% (95% CI 6.9 to 9.78) of women were empowered. Intrafamilial factors: husband’s education with primary (adjusted OR (AOR): 2.66 (1.30 to 5.43), secondary AOR: 4.69 (2.23 to 9.84) and tertiary AOR: 3.60 (1.20 to 10.83)) levels, being from model households (AOR: 4.38 (1.33 to 14.47)), households with middle (AOR: 3.50 (1.13 to 8.37)) or high (AOR: 3.10 (1.25 to 7.67)) wealth index, enrolment in productive safety net programmes (AOR: 2.37 (1.25 to 4.50)) and age at first pregnancy (AOR: 1.16 (1.08 to 1.24)) were positively associated with women’s empowerment. From the community-level characteristics, dowry (AOR: 1.82 (1.10 to 5.30)) and perceived good availability of justice for women and girls (AOR: 3.00 (1.05 to 8.60)) were positively associated with women’s empowerment. Conversely, the history of an adverse pregnancy outcome was negatively associated with women’s empowerment (AOR: 0.51 (0.26 to 0.99)).

The overall status of women’s empowerment in Tigray was very low. Husband’s education, being model household, wealth index, enrolment in productive safety net programmes, dowry practice, perceived good availability of justice for women and girls and age at first pregnancy were found to be significant factors associated with women’s empowerment. In view of these empirical insights, several policy recommendations are proposed. First, interventions should focus on the identified associated factors, particularly in areas with lower empowerment scores such as partner’s education, improving access to justice for women, addressing harmful community practices such as dowry and strengthening household economic status through social protection and livelihood programmes. Second, the promotion of gender-balanced household dynamics through awareness campaigns and policy incentives could make a substantial contribution to women’s empowerment in the study area.

This study aims to assess maternal health and service utilisation and identify the key determinants across Afar, Benishangul-Gumuz, Gambella and Somali, the four developing regional states (DRS) of Ethiopia.

A community-based cross-sectional study was conducted from September 2020 to February 2021 using stratified multistage cluster sampling for permanent residents and a random route approach for refugee populations.

The study was conducted at the community level across the DRS of Ethiopia, including Afar, Benishangul-Gumuz, Gambella and Somali regions.

A total of 1226 women who gave birth within the last 12 months participated, including 1028 non-refugees and 198 refugees living in temporary settlements. The mean age of participants was 26.4 years (SD±5.7).

The primary outcome was maternal health service utilisation, defined as receiving at least one of the two services, antenatal care (8+ contacts) or postnatal care (staying in a health facility after delivery or visiting a health facility within the first 45 days postpartum and being checked for early postpartum danger signs and taking treatments accordingly).

Overall, across the four regions, only 33% of women who had given birth within the last 12 months utilised maternal health services. Regional variation (Benishangul-Gumuz region (AOR=3.269, 95% CI 2.128 to 5.021; p value

Maternal health service utilisation remains critically low in Ethiopia’s DRS. Efforts to improve maternal health outcomes should focus on expanding educational opportunities, disseminating trusted information and empowering women in household decision-making.

The study aimed to determine treatment outcome and factors affecting treatment outcomes among hospitalised patients with skin and soft tissue infections (SSTIs) at the University of Gondar Comprehensive Specialised Hospital (UOGCSH) in Ethiopia.

An institution-based prospective observational study.

UOGCSH, Northwest Ethiopia.

423 patients from all age groups with clinically diagnosed SSTIs from 25 June to 25 December 2023 at the UOGCSH were included.

Primary treatment outcomes were early apparent clinical response within 48–72 hours and treatment failure after 72 hours of optimal antibiotic therapy. Secondary treatment outcomes included hospital length of stay (HLOS) and in-hospital mortality. Multiple linear regression assessed factors influencing the HLOS, and multivariable logistic regression identified predictors of treatment failure.

The average HLOS was 13.46±3.01 days. Of the patients, 39.3% had an early clinical response within 48–72 hours, whereas 34.4% had treatment failure. At 0.7%, the in-hospital death rate was modest. Living in a rural area (adjusted OR (AOR) 5.54, 95% CI 2.67 to 11.37), having concurrent illnesses (AOR 2.11, 95% CI 1.10 to 4.07) and starting antibiotics later than 12 hours (AOR 0.08, 95% CI 0.04 to 0.17) were significantly associated with treatment failure. Concomitant disorders and complex comorbidities were also associated with longer HLOS, whereas higher socioeconomic level, oral step-down therapy, early antibiotic initiation and early clinical response were linked to better results and shorter hospital stays.

Timely antibiotic initiation, efficient source control, patient comorbidities and socio-economic considerations affect the treatment course for SSTIs. Prolonged treatment and the frequent use of ‘watch’ and ‘reserve’ antibiotics underscore the need for improved antimicrobial stewardship. In this situation, optimising clinical results and minimising HLOS requires prompt clinical evaluation and customised antibiotic therapy. However, the single-centre design and potential residual confounding may introduce bias.

Social support is an important factor for psychosocial well-being and motivation to follow the treatment strictly in people with drug-resistant tuberculosis (DR-TB). Thus, this study aimed to determine the availability of social support and its association factors in people with DR-TB in selected hospitals in Ethiopia.

A cross-sectional study was conducted in Addis Ababa (at Saint Peter and ALERT hospitals) and Bishoftu Hospital in Ethiopia. The study involved 130 people with DR-TB from January to May 2023.

All adult people on DR-TB treatment for at least 2 months were enrolled consecutively from the registration book. A structured questionnaire was used to collect data. Data were entered to Open Data Kit and analysed with SPSS V.22. Descriptive statistics were used to describe the characteristics of the participants. A linear regression model was used to assess factors associated with social support.

Availability of social support from different sources.

The overall proportion of availability of social support obtained from different sources was 97.7% with 95% CI of (93.1% to 99.5%). Sex (β=0.61, 95% CI (0.28 to 0.94); p

A considerable proportion of people with DR-TB were obtaining social support from different sources. Interventions targeted female sex, single marital status and perceived social stigma are required to enhance social support conditions in people with DR-TB.

Immunisation is one of the most valuable, impactful and cost-effective public health interventions which delivers positive health, social and economic benefits. Globally, 4 million deaths worldwide are prevented by childhood vaccination every year. In Ethiopia, despite huge progress being made, the routine immunisation coverage has never reached the targeted figures and planned goals. Pastoralist communities are often disproportionately under-vaccinated, and there is often a confluence of interrelated factors that drive this outcome. This study enables us to identify factors affecting immunisation service utilisation in the pastoralist communities of Ethiopia, which helps to design effective and context-specific interventions.

This study aims to explore the behavioural and social drivers (BeSDs) of routine immunisation among the communities with high numbers of zero-dose and under-immunised children in Afar, Somali and Gambella regions of Ethiopia.

A qualitative exploratory study was conducted in three selected regions of Ethiopia (Gambella, Somali and Afar) from 9 November 2023 to 30 December 2023. Purposive sampling was used. A total of 33 interviews were conducted in the three regions. Sample size was determined based on idea saturation. Data was collected using interview guides. The interview guide was developed after reviewing relevant literature, desk review and using the journey to health and immunisation framework. A separate interview guide was developed for the journey mapping exercise, in-depth interview, healthcare workers discussion guide, focus group discussion and observation. Data was analysed thematically.

Behavioural (lack of awareness, lack of reminder/forgetting, misperception about vaccines, negative previous experience, lost card and fear of post-vaccination adverse events).

Structural (language barrier, long distance from home to facility, high cost of transportation, long waiting time, limited training of healthcare professionals and incentives, inconvenient service hours, shortage of health professionals, disrespect by the healthcare provider), Socio-cultural (competing priorities, low community engagement, lack of decision-making autonomy, limited husband involvement, workload, rural residence and larger family size were the commonly mentioned barriers to routine immunisation uptake. On the other hand, structural (house to house visit by health extension workers, counselling about adverse events, presence of outreach service, affordability (free of charge)), behavioural and socio-cultural (knowledge of adverse event management, and respect from community) were enablers to routine immunisation service uptake in pastoralist communities.

The study found several individual and contextual factors affecting routine immunisation uptake in pastoralist communities. Context-specific and tailored interventions which address zero dose drivers should be designed so as to enhance vaccine uptake. The findings suggested the need to design context-specific interventions to address the aforementioned barriers to immunisation.

Acute coronary syndrome (ACS) is the leading cause of morbidity and mortality among individuals with cardiovascular disease, accounting for half of all global cardiovascular-related deaths. No prior research has examined ACS treatment outcomes and associated factors in the study area. This study aimed to evaluate the risk factors and treatment outcome of ACS patients admitted to public hospitals in Harari Regional State, Eastern Ethiopia.

A retrospective hospital-based cross-sectional study was conducted among 308 ACS patients. Patient records from admissions between 1 November 2018 and 31 October 2023 were reviewed, with data collected between 10 January and 10 February 2024 using a structured checklist adapted from previous research. Statistical analysis was performed using SPSS V.25.0, with bivariable and multivariable logistic regression identifying significant associations at a p value

The mean patient age was 56.4±16 years, with males comprising 77.3% of participants. Half (51.6%) resided in rural areas, and only 16.2% presented within 12 hours of symptom onset. Overall, 81 patients (26.3%) experienced a poor treatment outcome for ACS, including 39 (12.7%) in-hospital deaths, 24 (7.8%) referrals to higher-level facilities and 18 (5.8%) who left against medical advice. Factors significantly associated with poor outcome included hospital presentation more than 72 hours after symptom onset (AOR 2.734 (95% CI 1.006 to 7.435)), left ventricular ejection fraction (LVEF)

Poor treatment outcome was independently predicted by the presence of ischaemia features on the echocardiography, LVEF (

To estimate the pooled attrition rate among HIV-infected children receiving antiretroviral therapy (ART) and identify predictors of attrition in Ethiopia.

Systematic review and meta-analysis.

PubMed, HINARI, Web of Science, African Journals Online and Google Scholar were searched up to 20 February 2025.

Cohort studies conducted in Ethiopia that reported attrition from ART and its predictors among children, published as full-length articles in English, were included.

Three independent reviewers extracted data and assessed study quality using the Joanna Briggs Institute checklist for cohort studies. Heterogeneity was assessed using the I² statistic. Publication bias was evaluated with funnel plots and Egger’s test. A random-effects model was applied to estimate the pooled attrition rate.

Among 1093 studies identified, 14 met the inclusion criteria and were included in the analysis. The pooled attrition rate among HIV-infected children receiving ART was 6.04 per 100 person-years of observation (95% CI 4.90 to 7.44). Anaemia (HR=3.39; 95% CI 2.40 to 4.78), suboptimal ART adherence (HR=2.33; 95% CI 1.39 to 3.89) and underweight status (HR=3.43; 95% CI 2.04 to 5.78) were significantly associated with higher attrition.

The pooled attrition rate among HIV-infected children receiving ART in Ethiopia is relatively low. Nevertheless, enhanced counselling on ART adherence is crucial to further reduce attrition, and special attention should be given to children with anaemia or underweight status.

CRD420251015059.

Inappropriate medication use among surgical patients poses significant risks, including antibiotic resistance, complications, mortality, increased healthcare costs and challenges in pain management. This study aimed to assess the extent of inappropriate antibiotic and analgesic prescriptions, treatment adequacy and contributing factors.

A hospital-based cross-sectional study was conducted among patients admitted to surgical wards in three comprehensive specialised hospitals in northwest Ethiopia.

All eligible adult patients admitted to the surgical wards during the data collection period were included in the study.

The primary outcomes were the appropriateness of antibiotic and analgesic prescriptions. To assess patients’ pain perception and the effectiveness of pain management strategies, the American Pain Society Patient Outcome Questionnaire was used. The Pain Management Index was employed to evaluate the treatment adequacy. The RAND (Research and Development)-modified Delphi method was applied to reach expert consensus on best practices for antibiotic prescribing. Additionally, the national standard treatment guideline was used to benchmark prescribing practices. Binary logistic regression was used to identify factors associated with inappropriate prescriptions of antibiotics and analgesics.

The prevalence of inappropriate antibiotics use was 67.5% and 42.2% of patients received inappropriate analgesic prescriptions. Moreover, 51.6% of patients experienced inadequate pain management. Significant factors associated with inappropriate antibiotic prescription included the presence of comorbidities (adjsuted OR (AOR) 3.34, 95% CI 1.88 to 5.92), lack of laboratory tests (AOR 0.26, 95% CI 0.16 to 0.43, higher number of medications (AOR 2.71, 95% CI 1.62 to 4.52) and contaminated wound class (AOR 3.13, 95% CI 1.58 to 6.20). For inappropriate analgesic prescription, pain due to disease (AOR 8.69, 95% CI 1.73 to 4.62), mixed causes of pain (AOR 7.20, 95% CI 1.43 to 6.31), head and facial pain (AOR 0.14, 95% CI 0.05 to 0.39) and an increased number of medications (AOR 2.75, 95% CI 1.72 to 4.41) were significant factors.

The majority of the patients admitted to surgical wards were found to receive inappropriate antibiotic and analgesic medications. Prescribers should pay attention to patients with comorbid diseases, receiving multiple medications. Additionally, routine laboratory tests are essential for guiding antibiotic therapy and improving patient outcomes in surgical wards.

Gestational trophoblastic disease, characterised by abnormal proliferation of trophoblastic tissue in the placenta during pregnancy, contributes to maternal morbidity and mortality. This study aimed to estimate the pooled prevalence and histopathological patterns of gestational trophoblastic disease in Africa, where previous studies have reported inconsistent findings.

Systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.

We searched PubMed, ScienceDirect, Hinari and Google Scholar for studies published between January 2000 and January 2024.

Institution-based observational studies from African countries reporting the prevalence and/or histopathological patterns of gestational trophoblastic disease, using total deliveries as the denominator.

Data were extracted into Excel and analysed using Stata V.17. Pooled estimates were calculated using a random-effects model with Knapp-Hartung adjustment. Heterogeneity was assessed with Cochran’s Q test and the I² statistic, and study quality was evaluated using the Joanna Briggs Institute tool.

Of the 2252 studies identified, 33 were included, comprising 2885 gestational trophoblastic disease cases from eight countries. The pooled prevalence of gestational trophoblastic disease in Africa was 4.35 per 1000 deliveries (95% CI 3.26 to 5.45, I²=99.8%). The pooled prevalence of hydatidiform mole, invasive mole and choriocarcinoma in Africa was 3.49 per 1000 deliveries (95% CI 2.45 to 4.52, I²=99.7%), 0.47 per 1000 deliveries (95% CI 0.14 to 0.79, I²=72.2%) and 0.97 per 1000 deliveries (95% CI 0.54 to 1.40, I²=99.1%), respectively.

This review indicated the prevalence of gestational trophoblastic disease was high. Hydatidiform mole was the predominant histopathological pattern observed. Routine antenatal screening is needed for early detection. Further research should be conducted to identify risk factors and evaluate strategies for the prevention and management of the disease.

CRD42024504268.

This study aims to assess the level of cardiovascular disease (CVD) risk and its associated determinants among hypertensive patients in Jigjiga, Somali Region, Ethiopia using the WHO 10-year CVD risk score.

An institution-based cross-sectional study design was employed.

Hypertensive patients aged 40–74 years in two public hospitals in Jigjiga, Somali Region, Ethiopia, from 20 December 2023 to 20 February 2024.

Randomly selected 344 hypertensive patients aged 40–74 years with a duration of 1 year or more from the time of diagnosis and at least having 6-month follow-up.

10-year CVD risk level was assessed by using WHO 10-year CVD risk score. Risk levels were categorised as low (

Associated factors influencing CVD risk.

The study included 341 hypertensive individuals, with a 99.1% response rate. Of the respondents, 58.9% were men. The overall prevalence of CVD risk within the coming 10 years was 134 (39.3%; 95% CI: 34.1% to 44.5%). Multivariable logistic regression analysis identified age, khat chewing, smoking and comorbid conditions as significant independent predictors of CVD risk. Specifically, individuals aged 60–69 years had an adjusted OR (AOR) of 3.97 (95% CI: 1.94 to 8.16) and those aged 70–74 years had an AOR of 2.99 (95% CI: 1.57 to 5.71). Khat chewers had an AOR of 2.58 (95% CI: 1.22 to 5.46), smokers an AOR of 3.44 (95% CI: 1.59 to 7.48) and individuals with comorbidities an AOR of 2.42 (95% CI: 1.47 to 3.99).

There is a significant increase in 10-year CVD risk among hypertensive patients in the study area. Age, khat chewing, smoking and comorbidities were independent predictors. Regular CVD risk screening for older patients, focused health education to reduce khat and tobacco use and integrated management of comorbidities are essential to lower future cardiovascular risk.