OBJECTIVES:Few randomised trials have been done to assess the impact of hygiene interventions on trachoma even though hygiene improvements feature prominently in the strategy for global elimination of trachoma. This study's aim was to determine if implementing an integrated water, sanitation, and hygiene (WASH) intervention in a hyperendemic region of Ethiopia would reduce clinical signs of trachoma. METHODS:In a parallel-group cluster-randomised trial, 40 Ethiopian communities were randomised in a 1:1 ratio to a WASH intervention or to delayed intervention (i.e., control) (ClinicalTrials.gov NCT02754583). No antibiotic mass drug administration was undertaken. Annual monitoring visits included photography of the superior tarsal conjunctiva. Clinical trachoma-a pre-specified secondary outcome-was assessed from photographs presented in a random order to masked photo-graders. RESULTS:At baseline, conjunctival photographs were taken on 1131 children aged 0-9 years in the WASH arm and 1229 children in the control arm. The mean number of follicles at baseline was 3.8 (95% CI: 3.1, 4.6) in the WASH arm and 3.7 (95% CI: 2.9, 4.4) in the control arm, which increased to a mean of 5.9 (95% CI: 5.1-6.6) in the WASH arm and 5.4 (95% CI: 4.6-6.1) in the control arm after 3 years (0.5 higher in the WASH arm, 95% CI: -0.6 to 1.5, p = 0.66). The mean papillary score increased from 3.3 (95% CI: 3.1-3.5) to 3.7 (95% CI: 3.5-3.9) in the WASH arm and from 3.2 (95% CI: 3.0-3.4) to 3.5 (95% CI: 3.3-3.7) in the control arm (month 36 values 0.2 greater in the WASH arm, 95% CI: -0.1 to 0.4; p = 0.49). No adverse events were reported in either treatment arm. CONCLUSIONS:An integrated WASH intervention delivered in the absence of mass antibiotic distributions did not reduce clinical trachoma outcomes in an area with hyperendemic trachoma.
Background:Quality research is essential to improving maternal, newborn, and child health (MNCH). Although Ethiopia has rapidly expanded academic and research institutions, duplication of studies, gaps in prioritisation and methods, and limited guidance on utilising evidence inhibit a coordinated approach to informing MNCH policy. We aim to address these challenges by characterising and prioritising the needs and opportunities of the MNCH research ecosystem in Ethiopia. Methods:We purposively sampled experts for a three-stage Delphi study. Key informant interviews (KIIs) (n = 18) explored needs and challenges in capacity-strengthening, community engagement in research, operational infrastructure, collaborations, and funding. We thematically coded KII responses to generate 134 statements, which were then rated in an anonymous questionnaire (n = 34) on a Likert scale. We calculated average scores and percentage agreement for each statement. Finally, consensus-building discussions (n = 28) identified top priorities within each topic. Results:Average percentage agreement across statements was 87% (range = 37-100). Highly endorsed priorities included strengthening inclusivity in research agenda-setting, prioritising research addressing key MNCH needs, enhancing research training by emphasising local experiences, cultivating intellectual curiosity, building skills in data analysis and translation, fostering research collaborations with greater multidisciplinary expertise, long-term mentorship, and capacity-building for local institutions, and engaging communities more effectively. Conclusions:Understanding challenges in the existing research environment will enable better-informed activities and stronger research networks that address local priorities. We characterised the MNCH research ecosystem across multiple dimensions, offering actionable opportunities to strengthen research capacities, infrastructure, and innovation design and evaluation through advocacy, organisational and system strengthening efforts, curricula development, and the implementation of principles to guide partnerships and agenda-setting for a variety of stakeholders. Future efforts should prioritise fostering a culture of evidence, collaborative prioritisation of research between policymakers and researchers, and sustained commitment to scaling evidence-based practices to advance MNCH outcomes.
The Joint United Nations Program on HIV/AIDS endorsed a new striving 95–95-95 target to end the AIDS epidemic by the end of 2030. This initiative has been implemented by many countries, including Ethiopia, but achieving it requires paramount effort. The purpose of this study was to determine the pooled virologic failure and its determinants using available evidence in Ethiopia. We searched available evidence on virologic failure from databases PubMed, Hinari, Cochrane, ScienceDirect, Google Scholar, and other search engines until May 30, 2024. Two authors independently searched articles and extracted them using a Microsoft Excel spreadsheet format. The quality of the studies was evaluated using the Newcastle Ottawa Scale. Heterogeneity among included studies was assessed using the Higgins I2 test statistic. The pooled estimates and its determinants were assessed with a random-effects model using Stata/MP version 17. We searched 14,493 relevant records from different databases, and after excluding duplicates, 63 articles were included in this study. The pooled virologic failure was 17.30 (95
BACKGROUND: The Joint United Nations Program on HIV/AIDS endorsed a new striving 95–95-95 target to end the AIDS epidemic by the end of 2030. This initiative has been implemented by many countries, including Ethiopia, but achieving it requires paramount effort. The purpose of this study was to determine the pooled virologic failure and its determinants using available evidence in Ethiopia. METHODS: We searched available evidence on virologic failure from databases PubMed, Hinari, Cochrane, ScienceDirect, Google Scholar, and other search engines until May 30, 2024. Two authors independently searched articles and extracted them using a Microsoft Excel spreadsheet format. The quality of the studies was evaluated using the Newcastle Ottawa Scale. Heterogeneity among included studies was assessed using the Higgins I2 test statistic. The pooled estimates and its determinants were assessed with a random-effects model using Stata/MP version 17. RESULTS: We searched 14,493 relevant records from different databases, and after excluding duplicates, 63 articles were included in this study. The pooled virologic failure was 17.30 (95% CI: 14.57, 20.03, I2 = 99.6). Subgroup analysis indicated that virologic failure prevalence varied by region: it was highest in Southern Ethiopia (26.96%), followed by Oromia region (17.81%). Additional subgroup findings included higher failure in studies conducted after the initiative (18.73%) and among patients under enhanced adherence counseling (43.77%). Poor adherence [OR: 8.10 (95% CI: 4.41, 14.85)], low CD4 count [OR: 2.60 (95% CI: 1.34, 4.99)], advanced WHO clinical staging [OR: 3.99 (95% CI: 2.20, 7.25)], opportunistic infection [OR: 4.91 (95% CI: 2.66, 9.04)], active tuberculosis [OR: 4.54 (95% CI: 1.80, 11.45)], use of cotrimoxazole [OR: 3.13 (95% CI: 1.23, 7.99)], substance use [OR: 4.88 (95% CI: 1.35, 17.62)], and rural residence [OR: 2.88 (95% CI: 1.41, 5.87)] were identified as determinants. CONCLUSIONS: Virologic failure was far away from the third 95% target in Ethiopia, with an expected 86% viral suppression. Despite the escalating viral load testing sites and implementation of different programs, the achievement is unacceptably high nationally. This requires innovative strategies, region-specific interventions, and tremendous efforts to meet the global goal by the end of 2030.
Introduction: The integration of computer technology into healthcare is inevitable, and nurses' involvement is crucial to its practical use. Nursing informatics is a relatively new profession that meaningfully enhances healthcare delivery but is not yet implemented globally, nor consistently within regions of the same country. Objective: To examine nurses' attitudes toward training courses on the use of health technology in health institutions within the Shkodra Municipality. Materials and Methods: A cross-sectional, quantitative study was conducted in February and March 2022. Nurses working in the Shkodra Regional Hospital (63%) and health centers within the municipality (37%) were involved. A focus group format was used to assess nurses' attitudes, preparedness, and willingness to adopt health information technology, herein defined as [insert definition or examples of health information technology]. Descriptive statistics were used to quantify demographic and professional information. Cronbach's α and composite reliability were used to assess internal consistency and construct validity. Results: The questionnaire was completed predominantly by female respondents (63.9%), 61.4% of whom were aged 22–40 years. Most nurses (27.6%) had 1–5 years of work experience. Reliability testing confirmed good convergence validity and internal consistency (Cronbach's α > 0.7). Generally, nurses held positive attitudes toward the use of health technology, with a clear recognition of its potential to significantly enhance healthcare. However, the research also observed that technology applications were formally trained to a lesser extent, and their use in practice remained limited. Conclusion: Shkodra nurses adopt an optimistic approach to the use of health technology in their daily practice, regardless of demographic and professional factors. The study, however, also highlights the urgency of curricular changes and regular professional development courses to bridge gaps in formal education and training.
