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Article: Caught in the crossfires: the Virchow Prize, its inaugural winner, and the quest to decolonise global health.

Bhopal, Anand / Getnet, Fentabil / Manga, Selene

BMJ global health

2023 Volume 8, Issue 7

Language	English
Publishing date	2023-07-20
Publishing country	England
Document type	Journal Article ; Comment
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2023-013272
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Article ; Online: Burden of hepatitis B virus and syphilis co-infections and its impact on HIV treatment outcome in Ethiopia: nationwide community-based study.

Getaneh, Yimam / Getnet, Fentabil / Amogne, Minilik Demissie / Liao, Lingjie / Yi, Feng / Shao, Yiming

Annals of medicine

2023 Volume 55, Issue 2, Page(s) 2239828

Abstract: Background: Hepatitis B virus (HBV) and syphilis have been the most common co-infections that hinder treatment outcomes and increase early mortality among people living with human immunodeficiency virus (PLHIV). In this study, we aimed to determine the ... ...

Abstract	Background: Hepatitis B virus (HBV) and syphilis have been the most common co-infections that hinder treatment outcomes and increase early mortality among people living with human immunodeficiency virus (PLHIV). In this study, we aimed to determine the burden of HBV and syphilis co-infections and its impact on treatment outcomes among PLHIV in Ethiopia. Methods: We used data from the Ethiopian Population-based HIV Impact Assessment (EPHIA), which was a household-based national survey in 2017/2018. Human immunodeficiency virus (HIV) testing was done among 19,136 participants using the national testing algorithm and 662 participants (3.50%) were HIV positives who were further tested for viral hepatitis and syphilis co-infections using HBV surface antigen and Chembio DPP syphilis assay, respectively. Viral load, CD4 count and high-sensitivity C-reactive protein (hsCRP) were done to measure HIV treatment outcomes. Descriptive statistics were used to determine the burden of co-infections and a logistic regression model to evaluate the determinants of co-infections using STATA V17.0. Results: Overall prevalence of HBV and syphilis co-infection was 5.5% and 2.2%, respectively. HBV and syphilis (double co-infection) was 5.9%. The highest prevalence of HBV co-infection was observed among 10-19 years age group (12.9%) and male participants (7.44%) while the highest syphilis co-infection was among people aged ≥50 years (3.5%) followed by age groups 40-49 (3.3%) and 10-19 years (3.2%). Syphilis co-infection was higher among males (5.2%) compared to females (1.1%). After adjusted regression analysis, HBV co-infected PLHIV had higher odds of virologic failure (AOR (95% confidence interval (CI)) = 6.3 (4.2-14.3)), immunosuppression (CD4 count < 500 cells/mm Conclusions: Burden of HBV and syphilis co-infections is high particularly among male and adolescent PLHIV and these co-infections hinder virologic and immunologic outcome in Ethiopia. Hence, the program shall enhance HBV and syphilis testing and treatment.
MeSH term(s)	Female ; Adolescent ; Male ; Humans ; Child ; Young Adult ; Adult ; Hepatitis B virus ; Syphilis/drug therapy ; Syphilis/epidemiology ; HIV ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Coinfection/epidemiology ; Ethiopia/epidemiology ; C-Reactive Protein ; Hepatitis B/complications ; Hepatitis B/drug therapy ; Hepatitis B/epidemiology ; Treatment Outcome ; Prevalence
Chemical Substances	C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2023-07-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1004226-x
ISSN	1365-2060 ; 1651-2219 ; 0785-3890 ; 1743-1387
ISSN (online)	1365-2060 ; 1651-2219
ISSN	0785-3890 ; 1743-1387
DOI	10.1080/07853890.2023.2239828
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Article: HIV-1 Disease Progression and Drug Resistance Mutations among Children on First-Line Antiretroviral Therapy in Ethiopia.

Getaneh, Yimam / Getnet, Fentabil / Ning, Feng / Rashid, Abdur / Liao, Lingjie / Yi, Feng / Shao, Yiming

Biomedicines

2023 Volume 11, Issue 8

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2023-08-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11082293
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Article ; Online: The spectrum of opportunistic infections and malignancies among women on antiretroviral therapy in Ethiopia.

Getaneh, Yimam / Getnet, Fentabil / Rashid, Abdur / Kang, Li / Chu, Qingfei / Li, Sisi / Yi, Feng / Shao, Yiming

Emerging microbes & infections

2023 Volume 12, Issue 2, Page(s) 2271065

Abstract: Abbreviations: AIDS: acquired immune deficiency syndrome; CI: confidence interval; EPHI: Ethiopian Public Health Institute; HAART: highly active antiretroviral therapy; HIV: human immunodeficiency virus; HR: hazard ratio; Mg/dl: milligram per deciliter; ...

Abstract	Abbreviations: AIDS: acquired immune deficiency syndrome; CI: confidence interval; EPHI: Ethiopian Public Health Institute; HAART: highly active antiretroviral therapy; HIV: human immunodeficiency virus; HR: hazard ratio; Mg/dl: milligram per deciliter; TB: tuberculosis; PCP: pneumocystis carinii pneumonia; ZJU: Zhejiang University.
MeSH term(s)	Humans ; Female ; Ethiopia/epidemiology ; AIDS-Related Opportunistic Infections/epidemiology ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Acquired Immunodeficiency Syndrome/drug therapy ; Neoplasms ; Antiretroviral Therapy, Highly Active
Language	English
Publishing date	2023-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2681359-2
ISSN	2222-1751 ; 2222-1751
ISSN (online)	2222-1751
ISSN	2222-1751
DOI	10.1080/22221751.2023.2271065
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Article ; Online: Effects of climatic factors on COVID-19 transmission in Ethiopia.

Endeshaw, Fitsum Bekele / Getnet, Fentabil / Temesgen, Awoke Misganaw / Mirkuzie, Alemnesh H / Olana, Latera Tesfaye / Alene, Kefyalew Addis / Birhanie, Solomon Kibret

Scientific reports

2022 Volume 12, Issue 1, Page(s) 19722

Abstract: Climatic conditions play a key role in the transmission and pathophysiology of respiratory tract infections, either directly or indirectly. However, their impact on the COVID-19 pandemic propagation is yet to be studied. This study aimed to evaluate the ... ...

Abstract	Climatic conditions play a key role in the transmission and pathophysiology of respiratory tract infections, either directly or indirectly. However, their impact on the COVID-19 pandemic propagation is yet to be studied. This study aimed to evaluate the effects of climatic factors such as temperature, rainfall, relative humidity, sunshine duration, and wind speed on the number of daily COVID-19 cases in Addis Ababa, Ethiopia. Data on confirmed COVID-19 cases were obtained from the National Data Management Center at the Ethiopian Public Health Institute for the period 10th March 2020 to 31st October 2021. Data for climatic factors were obtained from the Ethiopia National Meteorology Agency. The correlation between daily confirmed COVID-19 cases and climatic factors was measured using the Spearman rank correlation test. The log-link negative binomial regression model was used to fit the effect of climatic factors on COVID-19 transmission, from lag 0 to lag 14 days. During the study period, a total of 245,101 COVID-19 cases were recorded in Addis Ababa, with a median of 337 new cases per day and a maximum of 1903 instances per day. A significant correlation between COVID-19 cases and humidity was observed with a 1% increase in relative humidity associated with a 1.1% [IRRs (95%CI) 0.989, 95% (0.97-0.99)] and 1.2% [IRRs (95%CI) 0.988, (0.97-0.99)] decrease in COVID-19 cases for 4 and 5 lag days prior to detection, respectively. The highest increase in the effect of wind speed and rainfall on COVID-19 was observed at 14 lag days prior to detection with IRRs of 1.85 (95%CI 1.26-2.74) and 1.078 (95%CI 1.04-1.12), respectively. The lowest IRR was 1.109 (95%CI 0.93-1.31) and 1.007 (95%CI 0.99-1.02) both in lag 0, respectively. The findings revealed that none of the climatic variables influenced the number of COVID-19 cases on the day of case detection (lag 0), and that daily average temperature and sunshine duration were not significantly linked with COVID-19 risk across the full lag period (p > 0.05). Climatic factors such as humidity, rainfall, and wind speed influence the transmission of COVID-19 in Addis Ababa, Ethiopia. COVID-19 cases have shown seasonal variations with the highest number of cases reported during the rainy season and the lowest number of cases reported during the dry season. These findings suggest the need to design strategies for the prevention and control of COVID-19 before the rainy seasons.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Ethiopia/epidemiology ; Pandemics ; Incidence ; Humidity
Language	English
Publishing date	2022-11-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-24024-9
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Article: Longer Delays in Diagnosis and Treatment of Pulmonary Tuberculosis in Pastoralist Setting, Eastern Ethiopia.

Getnet, Fentabil / Demissie, Meaza / Worku, Alemayehu / Gobena, Tesfaye / Tschopp, Rea / Seyoum, Berhanu

Risk management and healthcare policy

2020 Volume 13, Page(s) 583–594

Abstract: Purpose: This study aimed to assess the extent of patient, health system and total delays in diagnosis and treatment of pulmonary tuberculosis (TB) in Somali pastoralist setting, Ethiopia.: Patients and methods: A cross-sectional study among 444 ... ...

Abstract	Purpose: This study aimed to assess the extent of patient, health system and total delays in diagnosis and treatment of pulmonary tuberculosis (TB) in Somali pastoralist setting, Ethiopia. Patients and methods: A cross-sectional study among 444 confirmed new pulmonary TB patients aged ≥15 years in 5 TB care units was conducted between December 2017 and October 2018. Data were collected using a structured questionnaire and record review. We measured delays from symptom onset to provider visit, provider visit to diagnosis and diagnosis to treatment initiation. Delays were summarized using median days. Mann-Whitney and Kruskal-Wallis tests were used to compare delays between categories of explanatory variables. The Log-binomial regression model was used to reveal factors associated with health system delay ≥15 days, presented in adjusted prevalence ratio (APR) with 95% confidence interval (CI). Results: The median age of patients was 30 years, ranged from 15 to 82. The majority (62.4%) were male, and nearly half (46.4%) were pastoralists. The median patient, health system and total delays were 30 (19-48.5), 14 (4.5-29.5) and 50 (35-73.5) days, respectively. The median patient delay (35.5 days) and total delay (58.5 days) among pastoralists were substantially higher than the equivalent delays among non-pastoralists [p<0.001]. Of all, 3.8% of patients (16 of 18 were pastoralists) delayed longer than 6 months without initiating treatment. Factors associated with health system delay ≥15 days were mild symptoms [APR (95% CI) = 1.4 (1.1-1.7)], smear-negativity [APR (95% CI) = 1.2 (1.01-1.5)], first visit to health centers [APR (95% CI) = 1.6 (1.3-2.0)] and multiple provider contacts [APR (95% CI) = 5.8 (3.5-9.6)]. Conclusion: Delay in diagnosis and treatment remains a major challenge of tuberculosis control targets in pastoralist settings of Ethiopia. Efforts to expand services tailored to transhumance patterns and diagnostic capacity of primary healthcare units need to be prioritized.
Language	English
Publishing date	2020-06-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2495128-6
ISSN	1179-1594
ISSN	1179-1594
DOI	10.2147/RMHP.S258186
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Article ; Online: Neglected burden of injuries in Ethiopia, from 1990 to 2019: a systematic analysis of the global burden of diseases study 2019.

Berheto, Tezera Moshago / Sengoelge, Mathilde / Tadesse, Sebsibe / Workie, Shimelash Bitew / Tessema, Gizachew / Memirie, Solomon Tessema / Mohammed, Shikur / Getnet, Fentabil / Walker, Ally / Naghavi, Mohsen / Misganaw, Awoke

Frontiers in public health

2023 Volume 11, Page(s) 1149966

Abstract: Background: The 2030 agenda for sustainable development goals has given injury prevention new attention, including halving road traffic injuries. This study compiled the best available evidence on injury from the global burden of diseases study for ... ...

Abstract	Background: The 2030 agenda for sustainable development goals has given injury prevention new attention, including halving road traffic injuries. This study compiled the best available evidence on injury from the global burden of diseases study for Ethiopia from 1990 to 2019. Methods: Injury data on incidence, prevalence, mortality, disability-adjusted life years lost, years lived with disability, and years of life lost were extracted from the 2019 global burden of diseases study for regions and chartered cities in Ethiopia from 1990 to 2019. Rates were estimated per 100,000 population. Results: In 2019, the age-standardized rate of incidence was 7,118 (95% UI: 6,621-7,678), prevalence was 21,735 (95% UI: 19,251-26,302), death was 72 (95% UI: 61-83), disability-adjusted life years lost was 3,265 (95% UI: 2,826-3,783), years of live lost was 2,417 (95% UI: 2,043-2,860), and years lived with disability was 848 [95% UI: (620-1,153)]. Since 1990, there has been a reduction in the age-standardized rate of incidence by 76% (95% UI: 74-78), death by 70% (95% UI: 65-75), and prevalence by 13% (95% UI: 3-18), with noticeable inter-regional variations. Transport injuries, conflict and terrorism, interpersonal violence, self-harm, falls, poisoning, and exposure to mechanical forces were the leading causes of injury-related deaths and long-term disabilities. Since 1990, there has been a decline in the prevalence of transport injuries by 32% (95% UI: 31-33), exposure to mechanical forces by 12% (95% UI: 10-14), and interpersonal violence by 7.4% (95% UI: 5-10). However, there was an increment in falls by 8.4% (95% UI: 7-11) and conflict and terrorism by 1.5% (95% UI: 38-27). Conclusion: Even though the burden of injuries has steadily decreased at national and sub-national levels in Ethiopia over the past 30 years, it still remains to be an area of public health priority. Therefore, injury prevention and control strategies should consider regional disparities in the burden of injuries, promoting transportation safety, developing democratic culture and negotiation skills to solve disputes, using early security-interventions when conflict arises, ensuring workplace safety and improving psychological wellbeing of citizens.
MeSH term(s)	Global Burden of Disease ; Quality-Adjusted Life Years ; Ethiopia/epidemiology ; Prevalence ; Incidence
Language	English
Publishing date	2023-05-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1149966
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Article ; Online: Estimated travel time and staffing constraints to accessing the Ethiopian health care system: A two-step floating catchment area analysis.

Hendrix, Nathaniel / Warkaye, Samson / Tesfaye, Latera / Woldekidan, Mesfin Agachew / Arja, Asrat / Sato, Ryoko / Memirie, Solomon Tessema / Mirkuzie, Alemnesh H / Getnet, Fentabil / Verguet, Stéphane

Journal of global health

2023 Volume 13, Page(s) 4008

Abstract: Background: Despite large investments in the public health care system, disparities in health outcomes persist between lower- and upper-income individuals, as well as rural vs urban dwellers in Ethiopia. Evidence from Ethiopia and other low- and middle- ... ...

Abstract	Background: Despite large investments in the public health care system, disparities in health outcomes persist between lower- and upper-income individuals, as well as rural vs urban dwellers in Ethiopia. Evidence from Ethiopia and other low- and middle-income countries suggests that challenges in health care access may contribute to poverty in these settings. Methods: We employed a two-step floating catchment area to estimate variations in spatial access to health care and in staffing levels at health care facilities. We estimated the average travel time from the population centers of administrative areas and adjusted them with provider-to-population ratios. To test hypotheses about the role of travel time vs staffing, we applied Spearman's rank tests to these two variables against the access score to assess the significance of observed variations. Results: Among Ethiopia's 11 first-level administrative units, Addis Ababa, Dire Dawa, and Harari had the best access scores. Regions with the lowest access scores were generally poorer and more rural/pastoral. Approximately 18% of the country did not have access to a public health care facility within a two-hour walk. Our results suggest that spatial access and staffing issues both contribute to access challenges. Conclusion: Investments both in new health facilities and staffing in existing facilities will be necessary to improve health care access within Ethiopia. Because rural and low-income areas are more likely to have poor access, future strategies for expanding and strengthening the health care system should strongly emphasize equity and the role of improved access in reducing poverty.
MeSH term(s)	Humans ; Ethiopia/epidemiology ; Health Services Accessibility ; Health Facilities ; Rural Population ; Catchment Area, Health
Language	English
Publishing date	2023-01-27
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2741629-X
ISSN	2047-2986 ; 2047-2986
ISSN (online)	2047-2986
ISSN	2047-2986
DOI	10.7189/jogh.13.04008
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Article ; Online: Out-of-pocket expenditures and financial risks associated with treatment of vaccine-preventable diseases in Ethiopia: A cross-sectional costing analysis.

Memirie, Solomon Tessema / Tolla, Mieraf Taddesse / Rumpler, Eva / Sato, Ryoko / Bolongaita, Sarah / Tefera, Yohannes Lakew / Tesfaye, Latera / Tadesse, Meseret Zelalem / Getnet, Fentabil / Mengistu, Tewodaj / Verguet, Stéphane

PLoS medicine

2023 Volume 20, Issue 3, Page(s) e1004198

Abstract: Background: Vaccine-preventable diseases (VPDs) remain major causes of morbidity and mortality in low- and middle-income countries (LMICs). Universal access to vaccination, besides improved health outcomes, would substantially reduce VPD-related out-of- ... ...

Abstract	Background: Vaccine-preventable diseases (VPDs) remain major causes of morbidity and mortality in low- and middle-income countries (LMICs). Universal access to vaccination, besides improved health outcomes, would substantially reduce VPD-related out-of-pocket (OOP) expenditures and associated financial risks. This paper aims to estimate the extent of OOP expenditures and the magnitude of the associated catastrophic health expenditures (CHEs) for selected VPDs in Ethiopia. Methods and findings: We conducted a cross-sectional costing analysis, from the household (patient) perspective, of care-seeking for VPDs in children aged under 5 years for pneumonia, diarrhea, measles, and pertussis, and in children aged under 15 years for meningitis. Data on OOP direct medical and nonmedical expenditures (2021 USD) and household consumption expenditures were collected from 995 households (1 child per household) in 54 health facilities nationwide between May 1 and July 31, 2021. We used descriptive statistics to measure the main outcomes: magnitude of OOP expenditures, along with the associated CHE within households. Drivers of CHE were assessed using a logistic regression model. The mean OOP expenditures per disease episode for outpatient care for diarrhea, pneumonia, pertussis, and measles were $5·6 (95% confidence interval (CI): $4·3, 6·8), $7·8 ($5·3, 10·3), $9·0 ($6·4, 11·6), and $7·4 ($3·0, 11·9), respectively. The mean OOP expenditures were higher for inpatient care, ranging from $40·6 (95% CI: $12·9, 68·3) for severe measles to $101·7 ($88·5, 114·8) for meningitis. Direct medical expenditures, particularly drug and supply expenses, were the major cost drivers. Among those who sought inpatient care (345 households), about 13·3% suffered CHE, at a 10% threshold of annual consumption expenditures. The type of facility visited, receiving inpatient care, and wealth were significant predictors of CHE (p-value < 0·001) while adjusting for area of residence (urban/rural), diagnosis, age of respondent, and household family size. Limitations include inadequate number of measles and pertussis cases. Conclusions: The OOP expenditures induced by VPDs are substantial in Ethiopia and disproportionately impact those with low income and those requiring inpatient care. Expanding equitable access to vaccines cannot be overemphasized, for both health and economic reasons. Such realization requires the government's commitment toward increasing and sustaining vaccine financing in Ethiopia.
MeSH term(s)	Child ; Humans ; Health Expenditures ; Cross-Sectional Studies ; Ethiopia ; Vaccine-Preventable Diseases ; Whooping Cough ; Catastrophic Illness
Language	English
Publishing date	2023-03-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2185925-5
ISSN	1549-1676 ; 1549-1277
ISSN (online)	1549-1676
ISSN	1549-1277
DOI	10.1371/journal.pmed.1004198
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Article ; Online: The Global Cohort of Doctoral Students: Building Shared Global Health Research Capacity in High-Income and Low- and Middle-Income Countries.

Abdelmenan, Semira / Andersen, Christopher T / Getnet, Fentabil / Iyer, Hari S / Molebatsi, Kesaobaka / Passarelli, Simone / Sauer, Sara M / Semakula, Muhammed

Annals of global health

2021 Volume 87, Issue 1, Page(s) 10

Abstract: Doctoral students in high- and low-income countries pursuing careers in global health face gaps in their training that could be readily filled through structured peer-learning activities with students based at partnering institutions in complimentary ... ...

Abstract	Doctoral students in high- and low-income countries pursuing careers in global health face gaps in their training that could be readily filled through structured peer-learning activities with students based at partnering institutions in complimentary settings. We share lessons learned from the Global Cohort of Doctoral Students, a community of doctoral students based at the Harvard T. H. Chan School of Public Health, Haramaya University, University of Gondar, University of Botswana, and University of Rwanda College of Medicine and Health Sciences. Students in the Global Cohort program engage in collaborative research, forums for constructive feedback, and professional development activities. We describe the motivation for the program, core activities, and early successes.
MeSH term(s)	Biomedical Research ; Capacity Building ; Developing Countries ; Education, Graduate ; Global Health/education ; Health Personnel/education ; Health Workforce ; Humans ; Income ; Students
Language	English
Publishing date	2021-01-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2821756-1
ISSN	2214-9996 ; 2214-9996
ISSN (online)	2214-9996
ISSN	2214-9996
DOI	10.5334/aogh.3160
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