BackgroundEvaluation of a surveillance system should be conducted on regular bases to ensure that the system is working as envisioned or not. Therefore, we evaluated Dangila district’s public health surveillance system performance in line with its objectives.MethodsIn August 2017, a concurrent embedded mixed quantitative/qualitative, facility-based cross-sectional study was conducted in Dangila district among 12 health facilities/sites. The qualitative part involved 12 purposively selected key stakeholders interview. A semi-structured questionnaire adapted from updated CDC guideline for evaluating public health surveillance system was used for data collection through face to face interview and record review. The major qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings. The quantitative findings were analyzed using Microsoft Excel 2007.ResultsAll necessary surveillance guidelines, registers and reporting formats were distributed adequately to health facilities. Only the district health office has Emergency Preparedness and Response Plan (EPRP), but not supported by the budget required to respond in case an emergency occurred. There were no regular data analysis and interpretations in terms of time, place and person. Weekly report completeness and timeliness were 100 and 94.6% respectively. The information collected was considered relevant by its users to detect outbreaks early with high acceptability. All stakeholders agreed that the system is simple, easy to understand, representative and can accommodate modifications. Written feedbacks were not obtained in all health facilities. The supervision checklist obtained in the district was not adequate to assess surveillance activities in detail. The calculated positive predictive value for malaria was 11%.ConclusionsThe surveillance system was simple, useful, flexible, acceptable and representative. Report completeness and timelines were above the national and international targets. However, the overall implementation of the system in the district was not satisfactory to achieve the intended objective of surveillance for public health action due to the lack of regular data analysis and feedback dissemination. To create a well-performing surveillance system, regular supervision and epidemiologically analyzed and interpreted feedback system is mandatory.

Background Human papillomavirus (HPV) infection is considered as the major risk factor for the development of cervical cancer, second most frequent cancer in Ethiopia. However, the magnitude of the problem and the associated factors remain unrevealed in the Amhara region. This study aimed to determine the prevalence of HPV infection and factors contributing to the progression of HPV infection to cervical cancer. Methods Facility-based cross-sectional study design was employed among women aged 21 to 49 years of age who came for routine cervical cancer screening to 4 randomly selected hospitals (2 general and 2 referral) of Amhara region from May to October, 2019. The sample size was calculated by using the single population proportion formula, proportionated to hospitals, and women were recruited consecutively. Socio demographic and clinical data were collected using a pretested questionnaire and detection of HPV infection was done using HPV test (OncoE6TM Cervical Test) specific to HPV16/18 in cervical swabs. Visual inspection with acetic acid (VIA) was used to determine cervical lesions (precancerous and cancerous). Descriptive statistics and bivariate and multivariate logistic regression were used to describe HR-HPV and cervical lesions burden and association between HR-HPV, and cervical lesions and potential risk factors. Results Among 337 women 21 to 49 years (median age of 35 years ±SD = 7.1 years) of age enrolled in the study, The overall prevalence of oncogenic HPVs (HPV16/18) and the VIA-positivity rate, possible an indicative of cervical lesions, were 7.1% and 13.1%, respectively. Logistic regression analysis showed a significant association between early age of first sexual intercourse (COR = 2.26; 95% CI: 1.0–5.05) and level of education (COR = 0.31; 95% CI: 0.12–0.78) with cervical lesions. Higher odds of HPV positivity (COR = 1.56; 95% CI: 0.59–4.11, p = 0.36) and VIA positivity (COR = 1.39; 95% CI: 0.64–3.00, p = 0.39) were observed among participants who had a history of sexually transmitted illnesses (STIs). Conclusions There was a relatively low prevalence of oncogenic HPV 16/18 and VIA-positivity in women attending four hospitals in the Amhara Region. Early age sexual contact, high parity, and being uneducated/low level of education were independently associated factors with HR-HPV infection and development of cervical lesions, highlighting the importance of prioritizing the limited HPV testing to those risk groups.

Objective Ethiopia is among the 30 high tuberculosis (TB) burden countries with annual estimated TB incidence of 164/100,000 population and death rate of 28/100,000 population for 2017. We analyzed the trend in magnitude of tuberculosis in Awi Zone from July 08/2011 up to June 27/2016. Results Tuberculosis surveillance data (2012 to 2016) was extracted from Awi Zonal Health Department Health Management Information System database and TB program unit and analyzed by Microsoft Excel 2007 ® . Epi-Info 7 software was used for tuberculosis trend analysis using Chi square for trends. A total of 8193 new TB cases were included in the analysis, of which 18.7% were smear positive PTB cases, 28.5% smear negative PTB (PTB−) cases and 52.7% were extra pulmonary TB (EPTB) cases. All form TB prevalence rate was 213/100,000 population in 2012 and significantly decreased to 189 in 2016 (Trend χ 2 = 11.97; P = 0.00054). Similarly, all form TB incidence rate was 167/100,000 population in 2012 and decreased to 122 in 2016 (Trend χ 2 = 37.6; P = 0.000). Overall, the magnitude of tuberculosis had decreased over the periods reviewed. The proportion of EPTB is high. We recommend culture and chest X-ray diagnostic services expansion to capture EPTB and PTB− cases.

Background Sufficient knowledge and favorable attitude are among the key determinants for people’s adherence to coronavirus disease (COVID-19) precaution measures. Hence, this study assessed Dessie city resident’s knowledge, attitude, and practice on COVID-19. Methods We used a facility-based cross-sectional study among 424 Dessie city residents from 17 to 21/05/2020. We dichotomized knowledge, attitude and practice scores based on the mean value. We entered the data into EpiData manager software 4.2 and exported to SPSS-20 for data analysis. We run three independent logistic regression analyses to determine factors associated with sufficient knowledge, a favorable attitude, and adequate practice. We defined significant association at a p-value of <0.05. Results Among 424 participants, 92.7% have sufficient knowledge about COVID-19, while 96% have a favorable attitude to prevent and control the pandemic. However, the practice was adequate only in 44.6% of the participants. Increasing educational status (AOR: 6.5, 95% CI: 2–21.4), availability of television (AOR: 3.8, 95% CI: 1.4–10.5), having a telephone (AOR: 3.4, 95% CI: 1.3–9.1) and radio (AOR: 4.2, 95% CI: 1.1–15.5) are the factors associated with sufficient knowledge, while sufficient knowledge (AOR: 5.4, 95% CI: 1.7–17.2), is the only predictor identified for favorable attitude. Similarly, being a farmer (AOR: 0.14, 95% CI: 0.047–0.4), availability of telephone (AOR: 3.1, 95% CI: 1.2–8.2), and sufficient knowledge (AOR: 15.2, 95% CI: 1.9–118) are the predictors of adequate practice. Conclusion In the study area, the participant’s knowledge and attitude are found to be sufficient to halt coronavirus transmission. However, practice in the vast majority is not adequate to stop coronavirus transmission. Educational status, television, telephone, radio, occupation and knowledge are the significant factors for successful prevention and control of coronavirus. Despite escalating public knowledge, our finding suggests the government to follow some compulsory regulations for uniform implementation of preventive measures.

BackgroundDistinguishing a recent from long-standing HIV infection is a critical step to reduce new infections in 2030. Therefore, this analysis determines the proportion of recent HIV infections among newly diagnosed cases and associated factors in the Amhara regional state between 2019 and 2021.MethodsWe got the HIV case-based surveillance dataset (July 2019 up to August 12/2021) from the Amhara Public Health Institute. Recent infection is an infection gained within the last 12 months as identified by Asante recency test kits. Logistic regression was carried out to identify factors associated with recent infection. Adjusted odd with 95% CI and a p-value of &lt; 0.05 was considered to declare significant associations.ResultsOut of 5,689 eligible cases, 3,129 (55%) recency tests had been performed. The proportion of recent HIV infection is 443 (14.2%, 95% CI: 13, 15.4%). High proportion of recent infections is reported from Bahir Dar city (23.3%), Central Gondar (17.7%), West Gojjam (16.5%), North Shewa (16.5%) and South Gondar zones (15.7%). Besides, the proportion of recent infection is high among clients aged ≥ 51 years (32.4%), illicit drug users (30.6 %), homelessness (28.5%), current commercial sex workers (27.9%), prisoners (21.1%), and among clients with invasive medical procedures (22.2%). Recent infection is significantly associated with females (AOR: 1.9, 95% CI: 1.2–3.1), secondary and above education (AOR: 2.1, 95% CI: 1.3–3.4), commercial sex workers (AOR: 1.8, 95% CI: 1.2–2.7), having contact with index case (AOR: 0.5, 95% CI: 0.3–0.8) and illicit drug utilization (AOR: 3.6, 95% CI: 1.1–12.4).ConclusionIn the Amhara region, the proportion of recent HIV infection is high with marked variation across sociodemographic characteristics. We identified the risk or preventive factors associated with a recent infection. Therefore, all HIV responders should target their prevention efforts toward hot spot areas and sub-populations to stop further transmission.