Background Ethiopia has set a goal to eliminate malaria by 2030; Artemether–lumefantrine (AL) is put as one of the cornerstone strategies for uncomplicated plasmodium falciparum malaria treatment. However, only focusing on prescribing of the treatment without assessing patients’ adherence could lead to the resistance of the drug. In Ethiopia, there is limited evidence about patients’ adherence to AL and its influencing factors. Therefore, this study aimed at addressing this information gap. Methods A health facility based cross-sectional study was employed. Participants were selected using simple random sampling technique from registration books of the public health facilities in AsgedeTsimbla. Data were collected from March 24th to April 30th, 2018. We interviewed participants using a pre-tested structured questionnaire, and the blister pack was also inspected at their homes on day 4. Data were entered into Epi-Info and analyzed using SPSS 21. Odds ratios with 95% Confidence Intervals were estimated and the level of significance was declared at p-value ≤ 0.05. Results A total of 384 study participants were interviewed with a response rate of 95.5%. The overall AL adherence was 53.6% (95% CI 48.4–58.3%). Children aged < 5 years [AOR: 0.4, 95% CI (0.2–0.8)], and being treated in health post [AOR: 0.3, 95% CI (0.1–0.5)] were more likely to show AL adherence whereas illiteracy [AOR: 9.4, 95% CI (4.2–21.3)], didn’t know the consequence of discontinued AL [AOR: 4.0, 95% CI (2.1–7.6)], had concomitant drugs [AOR: 2.5, 95% CI (1.4–4.5)], and stopped/saved drug when improved before tablet got finished [AOR: 3.2, 95% CI (1.7–5.9)] were factors less likely to be associated with AL adherence. Conclusion AL adherence was low. Children aged < 5 years, and being treated in health post were determinants of AL adherence whereas illiteracy, didn’t know the consequence of discontinued the drug, had concomitant drugs, and stopped/saved drug when improved before tablet got finished were factors that hindered the AL adherence. Stakeholders should emphasize designing appropriate strategies including educational interventions to increase the AL adherence and prevent drug resistance. Further research should be conducted to evaluate AL resistance.

BackgroundHepatic venous-occlusive disease is blockage of microscopic veins in the liver causing 20–50% mortality. Ingestion of pyrrolizidine alkaloid plant, radiation therapy, and post-bone-marrow-transplant reactions are the commonest causes. In Ethiopia, a venous-occlusive disease outbreak was identified in 2002 in Tahtay Koraro district, Tigray. Suspected due to ingestion of the toxic pyrrolizidine alkaloid plant Ageratum conyzoids, found throughout the district. We aimed to describe the surveillance data of venous-occlusive disease from September 2006 to August 2016 in Tahtay koraro district, Ethiopia, 2017.MethodologyWe defined a possible Hepatic venous-occlusive disease case as any patient with abdominal pain for at least 2 weeks, abdominal distention, and hepato-splenomegaly during September 2006-August 2016. We reviewed previous district line lists, weekly reports, and clinical records to identify and describe cases. Agricultural interventions were obtained from the agricultural offices of the district.ResultWe identified 179 possible cases with 83 deaths with a case-fatality rate of 46.3%. Among cases, 110 (61.5%) were males and 113 (63%) were >15 years. In total, 164 (91.6%) cases were from one village (Kelakil). The pick number of cases of VOD in this village was during 2008/09 which was 1076. The highest incidence (86/100,000) occurred in 2008. During the study period, 2,746 years of potential life were lost due to Hepatic venous-occlusive disease. Mechanical removal of the Ageratum started in 2011.ConclusionHepatic venous-occlusive disease was an ongoing problem in Tahtay Koraro; However, the problem has largely been alleviated by displacing people from the affected area and removing the causative weed. More research is needed to understand why Kelakil village was more affected despite the widespread presence of the weed. Chemical and mechanical removal of the Ageratum could strengthen intervention activities.