IntroductionAlthough tuberculosis (TB) is one of the significant public health challenges in severely malnourished children throughout the globe, it is a severe issue for countries such as Ethiopia, with significant resource limitations. Few studies have examined the incidence of tuberculosis and its predictors among children under five years of age with severe acute malnutrition in developing countries, and there is a paucity of data. This study aimed to estimate the incidence of tuberculosis and its predictors among under-five children with severe acute malnutrition (SAM) in North Shoa, Amhara region, Ethiopia.MethodsAn institution-based retrospective follow-up study was conducted between January 20, 2017, and June 20, 2019. The sample size was calculated using STATA, which yields a total of 345 charts that were selected with systematic random sampling. Data entry was performed using Epi-data version 4.2 and analyzed with STATA 14. Kaplan-Meier survival curves were computed. Cox proportional hazard models were fitted to detect the determinants of tuberculosis. The hazard ratio with a 95% confidence interval was subsequently calculated. Variables with p-values < 0.05 were considered statistically significant.ResultsThe incidence rate of tuberculosis among children under five years of age with SAM was 4.6 per 100 person-day observations (95% CI: 3.29, 8.9). Predictors of TB were a history of contact with known TB cases [AHR: 1.4 (95% CI: 1.00, 2.8], HIV/AIDS [AHR: 3.71 (95% CI: 2.10, 8.71)], baseline pneumonia [AHR: 2.10 (1.76,12)], not supplying zinc at baseline [AHR: 3.1 (1.91, 4.70)], and failed appetite taste at the diagnosis of SAM [AHR: 2.4 (1.35, 3.82)].ConclusionsIn this study, the incidence rate of TB was high. Not supplying zinc at baseline, failed appetite taste at the diagnosis of SAM, history of contact with known TB cases, and baseline pneumonia were significant predictors of TB. Prioritizing regular TB screenings, nutritional support, and zinc supplementation for under-five children with SAM should be implemented to reduce the risk of TB.

Background Globally, child mortality is remaining high, especially in sub-Saharan African countries like Ethiopia. Mortality which happens within 24 hours of admission is preventable. However, in Ethiopia little is known regarding pediatric emergency mortality. Therefore, this study was aimed to identify determinants of pediatric emergency mortality at compressive specialized hospitals found in South Nation Nationalities and people region, Southern Ethiopia. Methods A facility-based unmatched case-control study was conducted on 344 children (115 cases and 229 controls) at comprehensive specialized hospitals of South Nation Nationalities and people region, Ethiopia. The data collection checklist was checked for its consistency. Data were entered and cleaned for missed values by using Epi Data3.1, then exported to Stata version 14.1 for analysis. Logistic regression was done to identify the significant determinants for pediatric emergency mortality. Finally, AORs at 95% CI and P-value < 0.05 were used to declare statistical significance. Result A total of 344 charts were reviewed, of which 333 (97%) (112 cases and 221 controls) charts fulfilled the inclusion criteria.. In multivariable analysis, delayed diagnosis and treatment [AOR = 2.088, 95% of CI (1.128, 3.864)], acute respiratory distress syndrome [AOR = 2.804, 95% of CI (1.487, 5.250)], dehydration [AOR = 3.323, 95% of CI (1.260, 8.761)], meningitis [AOR = 5.282, 95% of CI (2.707, 10.310)], sepsis [AOR = 4.224, 95% of CI (2.220, 8.040)], accidental injury [AOR = 3.603, 95% of CI (1.877, 6.916)] and duration of sign/symptoms [AOR = 5.481, 95% of CI (2.457, 12.230)] were significantly associated with pediatric emergency mortality. Conclusion In the current study, delayed diagnosis and treatment, acute respiratory distress syndrome, dehydration, sepsis, meningitis, accidental injury and duration of signs/symptoms were significantly associated with pediatric emergency mortality. Healthcare professionals should identify and treat patients early at an emergency department and provide attention to patients with the above diseases. Furthermore, quality care should be provided.

BackgroundContinuum of care (CoC) is the continuity of care from the beginning of pregnancy to the postnatal period to improve maternal, neonatal, and child health. Dropout from the maternal CoC remains a public health challenge in Ethiopia. There are limited studies on women who dropped out of the CoC. The available studies have focused on the time dimension of the CoC, and there is a paucity of data on the place dimension of the CoC. Thus, this study aimed to determine the prevalence of dropout from the maternal CoC and its associated factors in Debre Berhan town, northeast Ethiopia.MethodsA community-based cross-sectional study design was conducted among 842 mothers from September to October 2020. A cluster sampling technique was applied, and data were collected through face-to-face interviews using a structured and pre-tested questionnaire. Data were cleaned and entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics, and bivariable and multivariable logistic regression analyses were performed to summarize the findings, and a p-value of &lt;0.05 was considered statistically significant.ResultThe overall prevalence of dropout from the maternity continuum of care was 69.1% [95% CI (66.0–72.3)]. The prevalence of dropout from ANC, skilled birth attendant, and PNC visits was 45.4, 0.5, and 48.7%, respectively. Rural residents, partners' level of education, monthly income, the timing of the first ANC visit, antenatal counseling about a continuum of care, and the level of satisfaction with the service delivery were significantly associated with ANC dropout. Maternal age and occupation, partners' age, media exposure, parity, the timing of the first ANC visit, the place of ANC visit, and the time spent for an ANC visit were significantly associated with dropout from PNC visits. Husbands' occupation, monthly income, number of alive children, the timing of the first ANC visit, and the time spent for an ANC visit had a statistically significant association with dropout from the maternity CoC.ConclusionDropout from the CoC in the study area was high. Socioeconomic development, partner involvement, antenatal counseling, efficient service delivery, and media exposure are vital to improving the high dropout rate from the maternal continuum of care.

The research on complex networks is a hot topic in many fields, among which community detection is a complex and meaningful process, which plays an important role in researching the characteristics of complex networks. Community structure is a common feature in the network. Given a graph, the process of uncovering its community structure is called community detection. Many community detection algorithms from different perspectives have been proposed. Achieving stable and accurate community division is still a non-trivial task due to the difficulty of setting specific parameters, high randomness and lack of ground-truth information. In this paper, we explore a new decision-making method through real-life communication and propose a preferential decision model based on dynamic relationships applied to dynamic systems. We apply this model to the label propagation algorithm and present a Community Detection based on Preferential Decision Model, called CDPD. This model intuitively aims to reveal the topological structure and the hierarchical structure between networks. By analyzing the structural characteristics of complex networks and mining the tightness between nodes, the priority of neighbor nodes is chosen to perform the required preferential decision, and finally the information in the system reaches a stable state. In the experiments, through the comparison of eight comparison algorithms, we verified the performance of CDPD in real-world networks and synthetic networks. The results show that CDPD not only has better performance than most recent algorithms on most datasets, but it is also more suitable for many community networks with ambiguous structure, especially sparse networks.

IntroductionChronic liver disease imposed substantial health and economic burden causing 1.75 million deaths and increased hospital admission rates. However, it is a neglected health issue in resource-limited countries like Ethiopia, with the paucity of data on the determinants of chronic liver disease. Besides, available studies considered single or limited factors. Thus, the aim of this study was to assess the determinant factors of chronic liver disease among patients who were attending at the gastroenterology units.MethodsAn unmatched case-control study was conducted on 281 (94 cases and 187 controls) systematically selected subjects at tertiary hospitals in Northern Ethiopia from November 2018 to June 2019. Data were collected using an interviewer-administered questionnaire and checklists, entered to Epi data version 4.4.2, and analyzed using SPSS version 25. Bi-variable and multivariate analyses were done using binary logistic regression. Variables with p< 0.25 in the bi-variable analysis were fitted to the final model. An adjusted odds ratio with 95% CI was used to declare significance and associations.ResultsAn overall 281 (94 cases and 187 controls) patients attending at the gastroenterology units had been included with a response rate of 100%. Being chronic alcohol consumer (AOR=2.8; 95% CI: 1.1-7.0), having a history of herbal medication use (AOR=14; 95% CI: 5.2-42), history of injectable drug use (AOR=8.7; 95% CI: 3-24.8), and hepatitis B infection (AOR=12; 95% CI: 3.0-49) were found to have an independent association with chronic liver disease.ConclusionAlcohol consumption, history of herbal medication use, hepatitis B infection, and history of parenteral medication use were found to be determinant factors of chronic liver disease. Strengthening viral hepatitis screening activities, interventions focused on behavioral change, and linking traditional healers to the healthcare system is crucial.What is known about the subject?Chronic liver disease (CLD) causes substantial health and economic burden where more than 1 million deaths occurred due to CLD complications annually. Studies reported that CLD causes 1.8-10% of all deaths and responsible for increased hospital admission rates. From 1980 to 2010, chronic liver disease-related deaths doubled in sub-Saharan African countries. Despite measures have been designed and on implementation to decrease this burden, the access to these interventions is limited, and the number of patients increased dramatically.What does this study add?Different behavioral, socio-cultural, and clinical factors had a statistically significant association with chronic liver disease.Alcohol consumption, history of herbal medication use, hepatitis B infection (HBV+), and history of parenteral medication use were found to be determinant factors of chronic liver disease (CLD).Strength and limitations of the studyDespite this study presented important findings that could input for the scientific world in the area of CLD, the study had its own limitations.Since almost all participants did not have documented medical checkups, it was challenging to extract previous history of chronic viral hepatitis. Hence, the effect of this pertinent variable was left unevaluated in this study.