Background Syphilis is a highly contagious sexually transmitted infection posing a significant public health challenge, especially in developing countries, including sub-Saharan Africa. Female sex workers are exposed to sexually transmitted infections, including syphilis, because of their sexual behavior and limited access to health services. However, data on national syphilis prevalence estimates and the associated factors are scarce in Ethiopia. This, as well as our limited knowledge about the extent of clustering among female sex workers in the country, is a critical gap in information we aimed to fill through this analysis. Methods The study was a cross-sectional, bio-behavioral survey conducted among female sex workers in six cities and ten major towns in Ethiopia. Participants were selected using a respondent-driven sampling method. Survey participants provided blood samples for syphilis, HIV, and hepatitis serological testing. Survey data were collected via an interviewer-administered questionnaire. In this analysis, we employed descriptive statistics to summarize data on the study variables. In addition, we used multilevel bivariable and multivariable logistic regression models to examine the association between independent variables and the dependent variable (syphilis prevalence) while accounting for the clustering effect. Result A total of 6085 female sex workers participated in the survey. Their median age [Interquartile Range (IQR) was 25 (8)] years, and a majority (96.1%) were in the 20–24-year-old age group. The prevalence of syphilis among female sex workers in Ethiopia’s six cities and ten major towns was 6.2%. Being in the age group of 30–34 (AOR = 2.64; 95% CI = 1.40, 4.98) and 35–59 (AOR = 4.7; 95% CI = 2.5, 8.86), being divorced/widowed (AOR = 1.37; 95% CI = 1.03, 1.82), having no formal education (AOR = 3.38; 95% CI = 2.34, 5.11), primary 1st cycle (grades 1–4) education (AOR = 2.77; 95% CI = 1.79, 4.30), and having primary 2nd cycle (grades 5–8) education (AOR = 1.80; 95% CI = 1.21, 2.69) were significantly associated with syphilis among female sex workers. Conclusion The prevalence of syphilis among female sex workers was high. Being divorced/widowed or in the older age group and having a low level of education were significantly associated with an increased risk of syphilis. The high prevalence and associated factors identified need to be considered in planning comprehensive interventions to control syphilis among female sex workers in Ethiopia.

Background Hepatitis B and C virus infections are endemic diseases in sub-Saharan Africa, the region with the highest prevalence of these infections in the world. Female sex workers are exposed to sexually transmitted infections, including hepatitis B and C, because of their high-risk sexual behavior and limited access to health services. There are no large-scale data on the prevalence of hepatitis B and C virus infections among female sex workers in Ethiopia, a critical gap in information this study aimed to fill. Methods This was a cross-sectional, biobehavioral survey conducted from December 2019—April 2020 among 6085 female sex workers aged ≥15 years and residing in sixteen (16) regional capital cities and selected major towns of Ethiopia. Blood samples were collected from the participants for hepatitis B and C virus serological testing. The data were collected using an open data kits (ODK) software and imported into STATA version16 for analysis. Descriptive statistics (frequencies and proportions) were used to summarize data on the study variables. Bivariable and multivariable logistic regression analyses were conducted to determine the strength of association between independent variables (risk factors) and the outcome (hepatitis B and C virus infection). Adjusted Odd ratio (AOR) was used to determine independent associations, 95% confidence interval to assess precision of the estimates, and a P value ≤ 0.05 to determine statistically significant. Results The prevalence of hepatitis B and C infections among the 6085 female sex workers was 2.6% [(95% CI (2.2,2.8)] and 0.5% [(95% CI (0.4,0.7)], respectively. Female sex workers who had 61–90 and ≥91 paying clients in the past six months [(AOR = 1.66; 95% CI, (0.99, 2.79); P = 0.054] and [(AOR = 1.66 95% CI, (1.11, 2.49); P = 0.013], respectively, age at first sex selling of 20–24 and >25 years [(AOR = 1.67; 95% CI, (1.14, 2.44); P = 0.009)] and [(AOR = 1.56; 95% CI (1.004, 2.43); P = 0.048)], respectively, known HIV positive status [(AOR = 1.64; 95% CI (1.03, 2.62); P = 0.036] were significantly associated with the prevalence of hepatitis B virus infection. Similarly, hepatitis C was significantly associated with, age at first sex ≤15 years and age 16–20 years [(AOR = 0.21; 95%CI (0.07,0.61); P = 0.005)] and [(AOR = 0.18; 95% CI (0.061, 0.53); P = 0.002)], respectively, known HIV positive status [(AOR = 2.85; 95%CI (1.10,7.37); P = 0.031)] and testing positive for syphilis [(AOR = 4.38; 95% CI (1.73,11.11); P = 0.002)], respectively. Conclusion This analysis reveals an intermediate prevalence of hepatitis B and a low prevalence of hepatitis C infection among female sex workers in Ethiopia. It also suggests that population groups like female sex workers are highly vulnerable to hepatitis B, hepatitis C, and other sexually transmitted infections. There is a need for strengthening treatment and prevention interventions, including immunization services for hepatitis B vaccination, increasing HCV testing, and provision of treatment services.

Background: Syphilis is a highly contagious Sexually Transmitted Infection posing a significant public health challenge, especially in developing countries including those in sub-Saharan Africa. Female sex workers are exposed to sexually transmitted infections, including syphilis, because of their sexual behavior and limited access to health services. There is scarce data on national syphilis prevalence estimate and the associated factors in Ethiopia. This along with our limited knowledge extent of clustering among female sex workers across towns in the country, a critical gap in information we aimed to fill through this analysis. Methods: The study was a community based cross-sectional, bio-behavioral survey conducted among FSWs in 16 cities and major towns in Ethiopia by using a Respondent Driven Sampling method. Survey data were collected through an interviewer administered questionnaire and blood samples were collected for syphilis, HIV, and hepatitis serological testing from 6085 participants. In this analysis, we employed descriptive statistics to summarize data on the study variables. We used multilevel bivariable and multivariable logistic regression models to examine the association between independent variables and the outcome (syphilis prevalence), while also accounting for the clustering effect. Result: Of the 6085 female sex workers included in the study, a majority (96.1%) were in the 20-24 years age group. The overall prevalence of syphilis among female sex workers in the 16 cities and major towns of Ethiopia was 6.2%. Being in the age group of 30-34 (AOR=2.64; 95% CI=1.40, 4.98), and 35-59 (AOR=4.7; 95% CI=2.5, 8.86), being divorced/widowed (AOR=1.37; 95% CI=1.03, 1.82), having no formal education (AOR=3.38; 95% CI=2.34, 5.11), primary 1st cycle (grades 1-4) education (AOR=2.77; 95% CI=1.79, 4.30), and having primary 2nd cycle (grades 5-8) education (AOR=1.80; 95% CI=1.21, 2.69) were significantly associated with syphilis infection among female sex workers. Conclusion: The prevalence of syphilis was high among female sex workers in Ethiopia. Being divorced/widowed or in the older age group, and having low level of education were significantly associated with increased risk of syphilis. The high prevalence and the determinant identified in the study need to be considered in the planning of comprehensive interventions to control syphilis infection among female sex workers in Ethiopia.

BackgroundHepatitis B and C virus infections are endemic diseases in sub-Saharan Africa, the region with the highest prevalence of these infections in the world. Female sex workers are exposed to sexually transmitted infections, including hepatitis B and C, because of their high-risk sexual behavior and limited access to health services. There is no data on national prevalence estimate on hepatitis B and C virus infections among female sex workers in Ethiopia, a critical gap in information this study aimed to fill.MethodsThis was a cross-sectional, biobehavioral, national study conducted from December 2019 - April 2020 among 6085 commercial female sex workers aged ≥15 years and residing in sixteen (n=16) regional capital cities and selected towns of Ethiopia. Blood samples were collected for hepatitis B and C virus serological testing from the participants. The data were collected using an open data kits (ODK) software and imported into STATA version16 for analysis. Descriptive statistics (frequencies and proportions) were used to summarize data on the study variables. Bivariate and multivariate logistic regression analyses were conducted to determine the strength of association between independent variables (risk factors) and the outcome (hepatitis B and C virus infection). Adjusted Odd ratio (AOR) was used to determine independent associations, 95% confidence interval to assess precision of the estimates, and a P value ≤ 0.05 was considered statistically significant.ResultsThe prevalence of hepatitis B and C infections among the 6085 female sex workers was 2.6% [(95% CI (2.2,2.8)] and 0.5% [(95% CI (0.4,0.7)], respectively. Female sex workers who had 61-90 and ≥91 paying clients in the past six months [(AOR=1.66; 95% CI, (0.99, 2.79); P=0.054] and [(AOR=1.66 95% CI, (1.11, 2.49); P=0.013], respectively, age at first sex selling of 20-24 and >25 years [(AOR=1.67; 95% CI, (1.14, 2.44); P=0.009)] and [(AOR=1.56; 95% CI (1.004, 2.43); P=0.048)], respectively, known HIV positive status [(AOR=1.64; 95% CI (1.03, 2.62); P=0.036] were significantly associated with the prevalence of hepatitis B virus infection. Similarly, hepatitis C was significantly associated with, age at first sex ≤15 years and age 16-20 years [(AOR=0.21; 95%CI (0.07,0.61); P=0.005)] and [(AOR=0.18; 95% CI (0.061, 0.53); P=0.002)], respectively, known HIV positive status [(AOR=2.85; 95%CI (1.10,7.37); P=0.031)] and testing positive for syphilis [(AOR=4.38; 95% CI (1.73,11.11); P=0.002)], respectively.ConclusionThis analysis reveals an intermediate prevalence of hepatitis B and a low prevalence of hepatitis C infection among female sex workers in Ethiopia. It also suggests that population groups with like female sex workers are highly vulnerable to hepatitis B, hepatitis C, and other sexually transmitted infections. There is a need for strengthening treatment and prevention interventions, including immunization services.

Introduction: Level of knowledge, Attitude and Practice (KAP) of the community towards corona virus disease 2019 (COVID-19) is important to prevent and control the disease . In Ethiopia there are some studies that assess the KAP’s of different segments of the community and reported different results. However, there is limited review evidence that pooled the proportion of KAP of the community to wards COVID-19 prevention and control of the disease in Ethiopia. The aim of this systematic review and meta-analysis was to summarize and pool the proportion of KAP towards COVID-19 prevention and control in general community. Methods: A systematic review and meta-analysis study was conducted to estimate the pooled proportion of Knowledge, Attitude and Practice towards COVID-19 prevention and control in general community. Electronic databases such as PubMed, Google Scholar and Science Direct were searched for studies reported in English language without restricting publication year. The search strategy was used by combining the keywords: “Knowledge”, “Attitude”, “Practice”, “COVID-19”, and “Ethiopia” both in Medical Subject Heading (MeSH) and free text terms. Data was analyzed using STATA version 14. Random effects model meta-analysis was employed to estimate pooled proportion of KAP’s towards COVID-19 in general community Results: Data on 12391 participants which retrived from 26 studies included into this review .The study was pooled to estimate the pooled proportion of knowledge, attitude and practice towards COVID-19 prevention and control in the community. Our meta-analysis revealed that the pooled proportion of good knowledge was 62% (95% CI: 54%-71%), while favorable attitude 64 %( 95% CI: 58%-71%) and prevention practice 44% (95% CI: 32%-56%). Conclusion: Our review indicated that the knowledge, attitude and practice towards COVID-19 prevention and control in general community were considerably insufficient. There are several different factors that affects the level of practice towards COVID-19 prevention. Therefore, collaborative efforts should be made by the government, partners and the media to improve the knowledge,attitude and practice of the general community towards COVID-19 preventive practices.