Background: Road traffic injuries (RTIs) can cause serious physical, psychological, and social consequences, impacting survivors’ quality of life (QoL). This study assessed the QoL and associated factors 1 year after RTIs in Ethiopia. Design and Methods: A cohort study with one-time follow-up phone interview was conducted among 330 adult RTI patients 1 year after discharge from a Trauma Hospital in Ethiopia. Predictors were collected using structured questionnaires, and QoL was assessed using the WHOQOL-BREF tool. Descriptive statistics were used to summarize participant characteristics and QoL scores, while a multivariable linear regression model was employed to identify predictors of QoL. Results: A total of 326 survived, and four deaths occurred in 1 year. Most participants were male ( n = 258, 78.2%), and the median age was 31.5 years (IQR: 25–44). Mean scores for physical health, psychological health, social relationship, and environmental health QoL domains were 56.2, 73.6, 70.5, and 57.8, respectively. More than half (58.0%) reported poor overall QoL. Concussion, amputation and internal injuries (β = −4.39, p = 0.022), history of surgical intervention (β = −5.56, p = 0.037), poor health satisfaction (β = −31.4, p < 0.001), not returning to normal life (β = −17.9, p < 0.001) or work (β = −5.95, p = 0.030), and perceived lack of opportunities (β = −8.98, p = 0.001) were significantly associated with reduced overall QoL. Conclusions: A substantially high number of survivors experience poor QoL. The findings highlight that injury type, health status, and post-injury reintegration status were key determinants. Enhancing post-discharge rehabilitation, psychosocial support, and employment reintegration programs is essential to improve QoL.

Malaria has long been considered a rural disease. However, rapid urbanization, the expansion of urban malaria vectors, and the subsequent, ongoing surge in malaria cases across sub-Saharan Africa, including Ethiopia, underscore the need to address malaria in urban contexts. This study therefore aims to explore the acceptability of insecticide-treated bed nets (ITNs) in an urban setting using the theoretical framework of acceptability. Eight Focus Group Discussions (FGDs), comprising a total of 48 participants, were conducted in the four Kebeles of Batu town, East Shoa, Oromia, Ethiopia. A semi-structured interview guide, developed based on the constructs of the Theoretical Framework of Acceptability (TFA), was used to facilitate the discussions. Data were analyzed using content analysis with a deductive approach, focusing on the seven components of the TFA. All data were managed with Atlas. ti software, version 9. Participants demonstrated a strong understanding of ITNs, expressing positive attitudes and noting a reduction in malaria cases following their introduction. However, concerns regarding the ethicality of ITNs emerged, particularly in relation to sexual assault and the discomfort experienced by pregnant women due to chemical exposure, which was perceived as violating the principle of non-maleficence. Participants also voiced dissatisfaction with the short height of currently available ITNs and expressed mixed feelings about their shapes; women preferred circular shaped nets, while men favored squared ones. In addition, they reported burdens such as adverse skin and respiratory reactions. Female participants, in particular, emphasized the increased household chores associated with handling the ITNs as a part of their morning routine. In conclusion, ITNs can be considered an appropriate intervention in controlling urban malaria. However, practical challenges must be addressed to improve their acceptance and usability.

Abstract Ethiopia has implemented acute flaccid paralysis (AFP) surveillance for nearly three decades as a core polio eradication strategy, yet remains at risk of outbreaks, particularly in pastoralist and conflict-affected areas. As Global Polio Eradication Initiative support declines, understanding factors affecting AFP surveillance and sustainability is critical. This study assessed facilitators, barriers, and adaptive strategies influencing AFP surveillance implementation in Ethiopia. A qualitative study using semi-structured interviews was conducted with 43 participants who had been involved in AFP surveillance for at least 12 months between 1996 and 2018. Guided by the Consolidated Framework for Implementation Research, participants were purposively chosen from the Ministry of Health, regional health bureaus, zonal and district health offices, and included surveillance officers, program managers, and frontline health workers from governmental and partner organizations. Data were analyzed thematically using deductive and inductive approaches in NVivo version 12. AFP surveillance implementation in Ethiopia was influenced by multilevel facilitators and barriers. Strong leadership, organizational structures, and partnerships with global and community actors supported coordination and resource mobilization. Community-based networks, including local volunteers and motivated health workers enhanced case detection and reporting in hard-to-reach areas. However, performance was constrained by high staff turnover, logistical challenges, limited subnational resources, weak supervision, and socio-cultural. Geographic inaccessibility and insecurity further limited implementation. Frontline health workers and volunteers used various adaptive strategies such as community engagement, informal reporting, and context-specific logistical solutions, to sustain surveillance activities. Continued reliance on external support posed a concern for long-term sustainability. Strong organizational systems and community engagement can sustain AFP surveillance in resource-limited settings. However, declining external support is a concern for sustainability. Integrating AFP surveillance into broader health systems, increasing domestic investment, and strengthening community-based approaches are essential for long-term resilience.

Malaria remains a major public health concern in Ethiopia, particularly in endemic settings like Arba Minch Town, where environmental and behavioural factors contribute to persistent malaria epidemic. Despite ongoing control efforts, malaria remains a substantial morbidity, mortality, and socio-economic disruption. The objective of the study was to examine epidemiological investigation of a possible malaria outbreak and risk factors in Arba Minch Town, Gamo Zone, Southern Ethiopia, 2023. A descriptive epidemiological analysis was followed by a 1:1 unmatched community-based case–control study conducted from October 28, 2022, to December 28, 2023. Ninety-four rapid diagnostic test-confirmed cases and 94 neighbourhood controls were selected. Data were collected through structured questionnaires. Data were collected and entered into Epi Info 7.2.6, and then exported to the Statistical Package for the Social Sciences (SPSS) version 26 for statistical analysis. Bivariable logistic regression was conducted, and candidate variables (p-value ≤ 0.25) were selected for multivariable logistic regression analysis. The degree of the association was assessed by computing the adjusted odds ratio (AOR) with a 95

Motorcycle use is rising in low- and middle-income countries, leading to more crashes. Many deaths from these crashes are preventable with correct helmet use. This study examined correct helmet use trends and factors influencing it. A roadside cross-sectional observational study was conducted in 10 randomly selected locations across 10 sub-cities of Addis Ababa from 2015 to 2020 twice a year. Binary logistic regression analysis was performed to identify predictors of correct helmet use. Out of 39,246 drivers and 12,950 passengers observed, 75% of drivers and 26.2% of passengers wore helmets. However, according to the Ethiopian helmet law (which requires the strapped use of any helmet type), only 34.2% of observed drivers (n = 39,246) and 9.1% of observed passengers (n = 12,950) wore helmets correctly. Under the global best-practice standard (strapped use of approved helmets excluding cap helmets) was even lower at 29.6% among drivers and 6.6% among passengers. Correct use declined over six years until the 2019 reinitiation of helmet law enforcement. Among drivers, correct use was linked to full-face helmets (AOR = 1. 90, 95% CI: 1.77–2.04), police enforcement (AOR = 1.08, 95%CI: 1.02–1.14), rain (AOR = 1.26, 95% CI: 1.14–1.40), and riding on arterial roads (AOR = 1.89, 95% CI: 1.78–2.00). For passengers, being female (AOR = 1.55, 95% CI: 1.09–2.19), aged ≥18 (AOR = 2.16, 95% CI: 1.34–3.46), and riding with correctly helmeted drivers (AOR = 3.37, 95% CI: 2.88–3.95) increased correct use. The findings indicate a need for a combination of interventions, including awareness-raising campaigns, sustained enforcement, and preparing helmet standards.

Occupational health and safety (OHS) malpractices may increase the risk of occupational injuries and are a significant public health problem in the iron and steel industries, often leading to disability and death. Information on OHS practices related to occupational injuries in the iron and steel industries is limited in many countries. This study aimed to assess OHS practices in relation to occupational injuries among workers in the iron and steel industries in Tanzania. A cross-sectional study was conducted among 321 production line workers. Data were collected through interviews, using a structured OHS questionnaire and the modified International Labour Organization (ILO) injury assessment tool. A total of 209 workers had experienced an occupational injury in the past year. According to univariate regression analyses, the safety practice variables ‘safety inspections’ and ‘use of personal protective equipment’ were significantly associated with occupational injury. However, after adjusting for sociodemographic and organizational factors, including years of work experience, work section, daily working hours, and shift work, these associations were no longer statistically significant. Working in the rolling mill, having less than four years of work experience, working more than 10 h per day, and performing shift work were significant predictors of occupational injuries. These factors attenuated the associations between safety practices and occupational injuries. The severity of injuries was found to be related to the accessibility of PPE. The findings suggest that work experience and organizational characteristics play a critical role in shaping occupational injury risk, highlighting the need for multifaceted interventions that integrate effective safety practices, work experience and organizational measures to improve worker safety in Tanzania’s iron and steel industry.

BACKGROUND:Tobacco advertising and promotion remain major drivers of tobacco use, particularly at points of sale (PoS). Ethiopia has enacted comprehensive tobacco control laws, including bans on TAPS at PoS. However, little is known about how these laws are implemented, monitored, and enforced in practice. This study explored the facilitators and barriers to implementing, monitoring compliance with, and enforcing TAPS laws at PoS in Ethiopia. METHODS:Qualitative interviews with 41 key informants were conducted between December 2022 and January 2023 across 10 purposively selected cities. Participants included policy implementers and stakeholders from government agencies, civil society organizations (CSOs), and international partners. Participants were purposively selected from national and sub-national actors involved in tobacco control, including government agencies (MoH, EFDA, Ministry of Trade, regional health and trade authorities, regulatory bodies, and research institutions) and non-governmental stakeholders (WHO Ethiopia, professional associations, and CSOs). Semi-structured interview guides were developed and administered in local languages. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed thematically using ATLAS.ti software. RESULTS:Key facilitators included strong tobacco control laws (Proclamation No. 1112/2019), federal-level political commitment, and the national tobacco control committee (NTCC). Barriers included the absence of EFDA structures at lower administrative levels, a lack of regionally adapted tobacco control laws, limited dedicated tobacco control departments, unclear enforcement mandates, advertisement of illicit tobacco products, not being a prioritized agenda, low awareness among non-health departments and retailers, tobacco industry interference, and, in some areas, a culture that normalizes tobacco smoking. CONCLUSIONS:Strong legislation banning 100% of TAPS and the presence of a national tobacco control committee support implementation; however, enforcement remains limited by structural, operational, and socio-cultural challenges. Enhancing compliance requires strengthening regional regulations, establishing clear institutional frameworks, raising stakeholder awareness about the tactics of the tobacco industry, and ensuring adequate allocation of human and financial resources, particularly in regions with a high prevalence of illicit tobacco products, to achieve the intended public health impact of TAPS laws in Ethiopia.

The Global Polio Eradication Initiative (GPEI) is known to be one of the most successful disease eradication initiatives with massive reductions in polio transmission as well as its contributions to strengthening health systems and capacity building. Existing analyses provide limited insight into how capacity was developed, which forms of capacity were strengthened or neglected, and how these efforts were experienced by implementers. Understanding these factors can be helpful as GPEI accelerates transition and integration into national health systems. This study examines GPEI’s capacity-building efforts from the perspectives of GPEI workers across multiple roles, levels and countries. We conducted a qualitative secondary analysis of semi-structured key informant interviews with global, national, and subnational stakeholders involved in GPEI. Data were coded inductively and deductively analyzed through Capacity Building Pyramid by Potter and Brough 2004. Country-based co-authors reviewed findings for contextual accuracy. We found that GPEI substantially strengthened individual and infrastructure capacity through large-scale training of frontline health workers, development of immunization infrastructure, and establishment of operational. Polio-funded platforms enabled outreach to hard-to-reach populations and were leveraged for other health priorities. Despite substantial investments, capacity building has remained largely individual training and program centric. There was insufficient integration into national systems leading to constrained country ownership and, lack of diverse trainings leading to limited supervisory and management capacity. Lessons of capacity building done under GPEI provide important guidance for future planning, and implementation of large-scale interventions. These findings highlight the need to move beyond predominantly individual-focused training toward deliberate, systems-level capacity strengthening. As polio transition planning accelerates, global health policymakers and planners must prioritize systems-level capacity strengthening, sustainable financing, and national governance to ensure continuity of immunization and public health functions beyond GPEI. Leveraging GPEI assets for broader health system strengthening can accelerate progress toward universal immunization and health care. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by Bill and Melinda Gates Foundation [grant number: OPP1178578]. OA received the award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. https://www.gatesfoundation.org/ ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Johns Hopkins Bloomberg School of Public Health Institutional Review Board and deemed to be “non-human subjects research.” Additional approvals were obtained from: Institutional Review Board of the Ministry of Public Health, Afghanistan, the James P. Grant School of Public Health Ethical Review Committee, the Kinshasa School of Public Health Institutional Review Board, the Institutional Review Board of the College of Health Sciences of Addis Ababa University, the Institutional Review Board for Protection of Human Subjects, IIHMR, the Medical and Health Research Ethics Committee, Gadjah Mada University, and the National Human Research Ethics Committee, Nigeria. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data can be available upon request.

Abstract Purpose Excessive paper dust during paper manufacturing can harm workers’ respiratory health. We aimed to assess inhalable paper dust levels and their determinants among paper mill industry workers. Methods A study was conducted in Ethiopia to measure personal exposure to inhalable paper dust in four paper industries. A total of 150 samples were collected using the IOM sampler attached to Side Kick Casella pumps at a flow rate of 2 L/min. Samples were analysed at Nemko Norlab, Norway. Linear mixed-effect models were used to identify determinants of inhalable paper dust. Results The arithmetic mean of personal inhalable paper dust was 4.5 mg/m3, with 80% of measurements exceeding the Swedish occupational exposure limit (OEL) of 2 mg/m3. The linear mixed-effects model revealed that dust levels were 28% higher when using high-speed compared to low-speed rewinding machines. Additionally, factories with more than four machines per job group had 22% higher exposure than those with fewer machines. Additionally, working in packing and preparation areas was associated with higher dust exposure than other areas. Conclusions Dust exposure levels exceeded the OEL in 80% of samples. The exposure model identified high-speed rewinding machines, a higher number of machines, and work in preparation and packing as factors linked to increased paper dust exposure. These findings suggest that preventive measures, including engineering control, should be implemented in the industry.

Abstract Background Occupational injuries account for more than 395 million cases and almost 3 million deaths globally each year, with the highest burden occurring in low- and middle-income countries. In Ethiopia, occupational injuries contribute substantially to emergency department visits, yet evidence on the magnitude, characteristics, and determinants remain limited. This study aimed to describe the magnitude and characteristics of occupational injuries and identify factors associated with severe injuries among patients presenting to emergency departments. Methods A prospective hospital-based observational study was conducted at three urban public hospitals in Ethiopia. A total of 868 participants aged 18–60 years who visited emergency departments with occupational injuries were consecutively enrolled. Data was collected from October 3, 2024, to March 14, 2025, using structured interviews and clinical chart reviews. Injury severity was classified based on the World Health Organization injury surveillance guideline. Descriptive statistics summarized patient characteristics, work, and injury patterns. Poisson regression with robust variance estimation was used to identify factors associated with severe injury, and adjusted prevalence ratios with 95% confidence intervals were reported. Results Among 5,038 injury patients, 918 (18.2%) had occupational injuries. Of these, 868 (94.6%) participated in the study. The median age was 27 years, and most participants were male (89.5%). The majority were employed in manufacturing (43.9%) and construction (24.0%). Craft and related trades (34.9%) and elementary workers (34.2%) were the most affected. Upper extremity injuries were the most common (57.0%), with lacerations (48.2%) as the leading nature of injury, followed by fractures (28.7%). The primary mechanism of injury was contact with sharp, pointed, or rough elements (43.9%), followed by falls or crashes into objects (16.6%). Among the patients, 175 (20.2%) had severe injuries. Low educational level, fall-related mechanisms, no fixed work area, and accidents due to peers and organizational causes were significantly associated with severe injury in a multivariable regression analysis. Conclusions and recommendations Occupational injuries are a burden on emergency departments, affecting a high proportion of young, male workers in the construction and manufacturing sectors. Severe injuries were related to education, type of work, and injury mechanism. This study underscores the need for targeted workplace safety interventions.

Malaria remains a major public health concern in many low-income nations, including Ethiopia. Monitoring malaria trends through surveillance data is critical for informing control efforts and guiding stakeholders. As a result, we analyzed the five-year trend of malaria morbidity and mortality, distribution of malaria cases by Plasmodium species, demographic characteristics, and geographic areas, and identified potential gaps in malaria control efforts in the former Southern Nations, Nationalities, and Peoples’ Region (SNNPR), Ethiopia, from 2017 to 2021 retrospectively. This study aimed to conduct a retrospective analysis of malaria surveillance data in the former SNNPR, Ethiopia (2017–2021). A retrospective analysis of malaria surveillance data from the former SNNPR was conducted from February 1 to 28, 2022. Data were collected, entered, cleaned, and analyzed using Microsoft Excel 2016. Descriptive analysis was performed, and results were presented using figures and maps. Overall, 6,292,147 suspected malaria cases were tested, with 999,687 (15.89

A cross-sectional study of safety climate and safety performance was performed in Ethiopian construction sites, among 1203 workers from 22 large-scale construction sites. The Nordic Safety Climate Questionnaire was administered using interviews. We developed a model to show the interrelations between safety climate and performance. This model was examined using factor analysis. Low scores for all seven safety climate dimensions were found, with values ranging from 2.33 to 3.08 and a mean of 2.70. Similarly, the mean score of the safety performance construct was 2.95 for safety participation and 3.58 for safety compliance. A strong positive correlation was found between safety climate and safety performance, and safety involvement accounted for 29.2% of the variance, while safety compliance accounted for 28.6% of the variance. The suggested association between self-reported injuries and safety climate was not confirmed. Nonetheless, Pearson correlation analysis demonstrated a statistically significant negative correlation with safety climate. In conclusion, low scores for all safety climate dimensions show that safety on construction sites must be improved. The safety climate positively influences employees’ safety behavior (safety compliance and safety participation) and minimizes occupational injuries.

Background:Road traffic injuries (RTIs) are a leading cause of mortality in low and middle-income countries. The study aimed to assess the magnitude of RTIs, determine the length of stay (LoS) for RTI patients and identify factors associated with prolonged LoS. Methods:A retrospective study was conducted at the Addis Ababa Burn, Emergency and Trauma Hospital in Addis Ababa, Ethiopia. Data were extracted from medical records for the period between 1 April 2021 and 30 March 2022, using a structured data collection form. Descriptive statistics were used to summarize patient and injury characteristics, and Poisson regression model with robust variance was applied to identify factors associated with prolonged LoS in the emergency department (ED). Results:Over the 1 year, 2693 RTI patient records were reviewed, accounting for 38.5% (95% CI 37.4% to 39.7%) of all injury cases. Of these, 2661 patients' data were included in the analysis. The majority of patients were male (n=1932, 72.6%) and 1031 (38.7%) were aged 18-29 years. The most frequently affected body region was the head (n=966, 36.3%), and fracture was the most common injury (n=991, 37.2%). Overall, 59 (2.2%) patients died, and 780 (29.0%; 95% CI 27.6 to 31.0) experienced a LoS exceeding 24 hours. The identified factors associated with prolonged LoS included: residence outside Addis Ababa (adjusted prevalence ratio (APR)=1.41; 95% CI (1.24 to 1.60)), being in the age group of 18-29 years (APR=0.78; 95% CI (0.63 to 0.95), neck injuries (APR: 1.75; 95% CI 1.17 to 2.65), trunk injuries (APR: 1.43; 95% CI 1.09 to 1.89) and outcome of fractures (APR: 4.34; 95% CI 2.66 to 7.00); and contusions and crushing injuries (APR: 3.81; 95% CI 2.33 to 6.21). Conclusions:The magnitude of RTI was substantially high compared with previous studies in Ethiopia. One-third of RTI patients' LoS in the ED exceeded the country's health system standard. The study highlights the need for enhanced road safety and healthcare resource allocation to manage RTIs effectively. Level of evidence:III.

Background: About 15 million people are directly and indirectly involved in Ethiopian coffee production. Coffee workers in Ethiopia may be exposed to workplace noise due to industrial machines, but the extent of their exposure and the prevalence of hearing loss are currently unknown. Objectives: This study aimed to evaluate noise exposure, identify factory and task-related conditions that significantly increase noise levels and assess self-reported hearing loss amongst coffee workers in Ethiopia. Methods: A cross-sectional study was conducted in 12 primary coffee processing factories in three Ethiopia regions. A total of 60 machine room workers were involved in full-shift, personal noise exposure measurements. The results from an observational checklist and statistical analysis of noise measurement data were used to identify the determinants of personal noise exposure. Additionally, 130 randomly selected workers participated in interviews on self-reported hearing loss, yielding a 100% response rate. Results: The average daily noise exposure amongst machine room workers was 96.3 decibels A-weighted (dBA). Ninety-two per cent of the measurements exceeded the occupational exposure limits of 85 dBA, and 40% exceeded 90 dBA. The presence of more than one huller machine was associated with a 4.5 dBA increase in noise exposure. Approximately, 53% of the machine room workers reported at least one symptom of hearing loss. Workers with more than 10 years of experience had nearly three times higher risk of hearing loss symptoms than those with less than 5 years of experience, after adjusting for age and other factors (adjusted prevalence ratio = 2.9, 95% confidence interval: 1.4–5.9). Conclusions: These findings highlight the significant health risk of noise exposure faced by workers in primary coffee factories, with over half of these workers reporting symptoms of hearing loss, and most of them being exposed to noise levels above the recommended limit value. Implementing interventions to reduce noise levels amongst coffee workers is essential to protect their hearing well-being.

BACKGROUND:Ethiopia has made significant strides in adopting comprehensive smoke-free laws aligned with the World Health Organization's Framework Convention on Tobacco Control, which mandates that all public places, including hospitality venues, public transportation, and workplaces, be 100% smoke-free. However, effective implementation across regions remains uneven. This study examines the barriers and facilitators influencing the enforcement of smoke-free legislation in Ethiopia. METHODS:This qualitative study was conducted in 10 major cities in Ethiopia, involving 41 key informant interviews with individuals working on tobacco control. For this study, a framework comprising five key concepts, namely, institutions, agendas, networks, socioeconomic conditions, and ideas, was employed. Semi-structured interview guides were developed in English and then translated into local languages. All audio-recorded interviews were transcribed verbatim and translated into English. Deductive thematic analysis was conducted using ATLAS. Ti Scientific Software. RESULTS:The study identified several key facilitators of compliance with smoke-free laws in Ethiopia, including a well-established legal framework, clear institutional structures, especially in the capital city (Addis Ababa), strong political leadership, stakeholder collaboration, supportive cultural and religious norms, and growing public awareness of the harms associated with tobacco use. However, significant barriers remain, particularly in regional areas. These include the absence of dedicated tobacco control units, lack of region-specific implementation guidelines, competing policy priorities, limited budget and human resources, and insufficient law enforcement engagement. Cultural acceptance of smoking in some communities, economic reliance on tobacco farming, and misconceptions about products like shisha further undermine compliance with smoke-free laws. Additionally, weak coordination across sectors and limited ownership of tobacco control responsibilities among non-health actors hinder effective implementation. CONCLUSION:The study highlights the need for region-specific guidelines, accountable institutions, improved coordination, targeted education, and the addressing of socioeconomic barriers. Leveraging existing strengths and addressing identified challenges will be critical to achieving equitable and effective enforcement of smoke-free laws nationwide.

BACKGROUND:The 2019 Ethiopia's comprehensive tobacco control proclamation mandates 100% smoke-free public places and workplaces. Despite the proclamation, compliance remains uncertain, particularly at hospitality venues (HVs). The aim of this study was to evaluate the extent of compliance with smoke-free laws in HVs and to also understand the factors associated with non-compliance. METHODS:This cross-sectional observational study was conducted in 10 cities in Ethiopia-Addis Ababa, Adama, Assosa, Bahir Dar, Dire Dawa, Gambella, Harar, Hawassa, Jigjiga, and Semera-Logia -between December 5th and 28th, 2022. Data were collected electronically using smartphones, utilizing a pre-tested, standardized checklist and covert observation. The subjects were selected through multi-stage cluster sampling. A total of 1,370 HVs (hotels, restaurants, bars, bars and restaurants, café and restaurants, butcher houses and restaurants, groceries, and nightclubs/ lounges) were observed. Specific and composite compliance indicators were computed for indoor and outdoor spaces. Poisson regression analyses identified factors associated with indoor active smoking and non-compliance. Statistical significance was set at P<0.05. Data were analyzed using SPSS version 26. RESULTS:Among the 1,370 HVs included in this study, 1,368 had indoor spaces, 327 had both indoor and outdoor spaces, and two had only outdoor spaces. Active smoking was observed in 32.2% (95% CI:30-35) of indoor HVs, with the highest rates in nightclubs/lounges (68.6%) and bars (65.7%). Semera-Logia reported the highest prevalence of active smoking (70.4%). Adherence with 'no smoking' signage was low (35.2%), while ashtrays, lighters, and designated smoking areas (DSAs) were rarely present. Outdoor active smoking was observed in 46.5% (95% CI:41-52) of HVs. Only 12.8% of indoor spaces were fully adherent to the smoke-free law requirements. Venues in Semera-Logia were over twice as likely to have active smoking (adjusted prevalence ratio [aPR]: 2.71; 95% CI: 2.00-3.66) compared to Addis Ababa. Bars and nightclubs/lounges had significantly higher prevalence of active smoking than cafés/restaurants. 'No smoking' signs were associated with reduced prevalence of indoor active smoking (aPR: 0.77; 95% CI: 0.67-0.89), while smoking within a 10-meter range (aPR: 2.67; 95% CI: 2.13-3.32), the presence of lighters (aPR: 1.69; 95% CI: 1.41-2.02), and the sale of tobacco products (aPR: 1.58; 95% CI: 1.34-1.86) were all associated with higher prevalence of indoor active smoking. CONCLUSION:Compliance with 'no active smoking' and adherence to smoke-free laws in HVs remain low, particularly in bars, nightclubs/lounges, and Semera-Logia, with high rates of active smoking both indoors and outdoors. Enhanced enforcement and targeted are needed to educate the public and HV owners about the risks of SHS and the importance of tobacco control laws.

Loss to follow-up (LTFU) remains a major challenge in HIV care, particularly in resource-limited settings. While several studies have identified its predictors, many have neglected the competing risks of transfer out and death, as well as the dynamic influence of these predictors over time. A retrospective cohort study was conducted among adult HIV patients who initiated antiretroviral therapy (ART) between 2019 and 2024. LTFU was a primary outcome, whereas transfer out and death were competing risks. A Fine‒Gray subdistribution hazard ratio (SHR) regression analysis identified LTFU predictors within a competing risk framework. An extended SHR model with a time‒covariate interaction term was used to examine the predictors’ time‒varying effects on LTFU risk. Data analysis was performed via STATA 17 and Python 3.9. In a cohort of 4,135 HIV patients (8,521.54 person-years of follow-up), the overall incidence of LTFU was 13.10 per 100 person-years (95% CI: 12.35–13.89), with cumulative risks of 15%, 25%, and 35% at 1, 3, and 5 years post-ART, respectively. The predictors of LTFU included younger age (15–24 years: aSHR = 1.51), male sex (aSHR = 1.24), incomplete address details (aSHR = 1.72), noninitiation/noncompletion of TPT (aSHR = 2.16), poor adherence (aSHR = 2.54), and undernutrition (aSHR = 2.03). While younger age (e.g., 15–24 years) was associated with an increased risk of LTFU at baseline (baseline aSHR = 1.36, p = 0.014), this association diminished over time (interaction aSHR = 0.54, p = 0.001). Undernutrition consistently predicted LTFU (baseline aSHR = 1.64, p < 0.001), with no significant time-dependent effect (interaction aSHR = 1.01, p = 0.903). In conclusion, this study highlights the high incidence of LTFU among HIV patients and its key predictors. Notably, age has a significant time-dependent effect, with its influence on the risk of LTFU being most pronounced during the early stage of ART initiation, whereas nutritional status remains a consistent predictor of LTFU over time.

The construction industry is widely acknowledged as one of the most hazardous sectors for workers. This study examined the associations between safety climate and safety behaviour on self-reported injuries in large-scale construction sites in Ethiopia. A cross-sectional study was conducted from January to May 2023 among 1203 workers from 22 large-scale construction sites. Study participants from each site were selected using a proportional-to-the-size approach. The Nordic Safety Climate Questionnaire (NOSAQ-50) was administered using interviews. Binary logistic regression analysis was performed to identify the relationship between safety climate, safety behaviour, and other factors of self-reported injuries. The prevalence of self-reported injuries in the last twelve months was 35.7

Despite the global commitment to ending AIDS by 2030, the loss of follow-up (LTFU) in HIV care remains a significant challenge. To address this issue, a data-driven clinical decision tool is crucial for identifying patients at greater risk of LTFU and facilitating personalized and proactive interventions. This study aimed to develop a prediction model to assess the future risk of LTFU in HIV care in Ethiopia. The study used a retrospective design in which machine learning (ML) methods were applied to the electronic medical records (EMRs) data of adult HIV-positive individuals who were newly enrolled in antiretroviral therapy between July 2019 and April 2024. The data were collected across eight randomly selected high-volume healthcare facilities. Six supervised ML classifiers—J48 decision tree, random forest, K-nearest neighbors, support vector machine, logistic regression, and naïve Bayes—were utilized for training via Weka 3.8.6 software. The performance of each algorithm was evaluated through a 10-fold cross-validation approach. Algorithm performance was compared via the corrected resampled t test (p < 0.05), and decision curve analysis (DCA) was used to assess the model’s clinical utility. A total of 3,720 individuals’ EMR data were analyzed, with 2,575 (69.2

Background: In Tanzania, iron and steel manufacturing industries are based on manual work with minor automation, as workers segregate scrap metals and add them to furnaces for melting. The workers here are exposed to hazardous conditions, posing a risk to their health. Objective: To determine the prevalence of occupational injuries and possible predictors for injuries among workers in the iron and steel industries in Tanzania. Methods: The cross-sectional study was conducted in 2022 in Tanzania. Workers from the production lines in four iron and steel factories participated in the study. The data were collected by interviews, using a structured questionnaire modified from the International Labour Organization (ILO) manual on occupational injury statistics from household surveys and establishment surveys. Chi-squared tests and regression analyses were used. Results: Out of 381 invited workers, 321 participated in the study (response rate: 84). Of the respondents, 209 had experienced at least one injury that restricted them from work at least one day in the past year, giving an overall prevalence of occupational injuries of 65.1% peryear. Out of the injured respondents, 135 (64.6%) reported being hospitalized or lying on the bed at home due to the injury. Working years, working hours per day, working 12-hour shifts, and their section at the workplace (rolling mill or furnace) were factors significantly associated with occupational injuries in univariate regression analyses. Working hours of more than 10 hours per day, adjusted for all other factors, gave an odds ratio of 2.54 for experiencing injuries at work, with a 95% confidence interval (1.46-4.41), while no other factors showed significant association with injuries after adjustment. Conclusion: The prevalence of occupational injuries in the Tanzanian iron and steel industries was 65.1%. Working for more than 10 hours per day was a significant predictor of occupational injuries.