Objective This study assessed the magnitude of risky sexual practices and associated factors among adult people living with HIV (PLHIV) attending antiretroviral clinics in public hospitals in Kembata Tembaro Zone, southern Ethiopia. Design A cross-sectional study was conducted. Setting A hospital-based study was conducted among adult PLHIV in the Kambata Tambaro Zone, southern Ethiopia. Participants 300 men and women aged 15 years and older who had been receiving HIV/AIDS care and support in four public hospitals participated in this study. Study outcome Risky sexual practice was the study outcome. It was defined based on responses to four items: multiple sexual partnerships, casual sex, consistent condom use and sex under the influence of alcohol. Risky sexual practice was defined based on a ‘yes’ response to any of the four items. Results Of the adult PLHIV who were sexually active in the 6 months preceding the survey, 75.7% (95% CI: 70.5% to 80.2%) engaged in at least one risky sexual practice, with 3.3% (95% CI: 1.8% to 6.1%) engaged in three or more. A positive attitude towards condom use and being on antiretroviral therapy for over 10 years were correlated with low odds of risky sexual practices. There was a higher likelihood of risky sexual behaviour among those who kept their HIV status secret and did not bring up using a condom before sexual contact. Whereas, those with a positive attitude towards condom use had a reduced risk of engaging in risky sexual practices. Conclusion A considerable proportion of adult PLHIV engage in risky sexual practices. Efforts directed at removing barriers to disclosing HIV status to partners and promoting condom use discussion among sexual partners could reduce the burden of risky sexual practices and the onward transmission of HIV.

Introduction: Ethiopia has been implementing measles elimination strategies since 2003, including periodic supplemental immunisation activities every 2-3 years, and the introduction of a second dose measles vaccine in 2018. At national level, the coverage for first and second dose measles vaccine is 61% and 53% respectively. In the past decade, populations displacements and service disruptions due to natural and man-made disasters, exacerbated by the impact of the COVID-19 pandemic on the sub-optimally functioning immunisation system, have contributed to multiple measles outbreaks in the country. Methods: between July and August of 2024, a total of 44 woredas conducted a measles outbreak response vaccination campaign. Among these, 11 woredas were selected purposively to implement an outbreak root cause analysis exercise. Analysis of data and document reviews were done at woreda and health facility levels, along with interview of immunization program officers at different administrative levels, and interviews of care givers of confirmed measles cases. Results: in 2024, a total of 4664 confirmed measles cases and 24 deaths were reported to the national level from the 11 woredas. Despite reported high administrative vaccine coverage at the woreda level, only 56% of the measles cases had received at least one dose of measles vaccine, as seen during household visits. More than half (55%) of the 11 woredas do not have any facility that offers daily vaccination services, due to staff shortage (36%), concerns of vaccine wastage (36%), and lack of operational funding (18%). Twelve (44%) out of the 27 health posts and one third (8 of 24) of the health centers do not give measles vaccines in every vaccination session. Cancellations of vaccination sessions were reported from 24 health centers and 27 health posts in 4 woredas due to various reasons including staff shortage, vaccine stockout, lack of means of transportation for field trips and electric power interruption. Non vaccination due to a combination of these multiple factors was identified as the root cause of the measles outbreaks. Conclusion: there are cross-cutting systemic factors that contributed to the measles outbreaks in various woredas, alongside contextual factors which differ from one health facility to another and between woredas. It is important that these findings are used to develop tailored efforts to strengthen routine immunisation services within the service catchment areas. Root cause analysis should be implemented as part of every outbreak investigation and response efforts.

Background: Anthrax is a serious infectious disease affecting animals and humans and remains a public health issue in developing countries. Aim: This study assessed the overall anthrax outbreak response and identified strengths, challenges, and best practices during surveillance, preparedness, and response in Ethiopia from May 2022 to July 2022. Setting: Conducted in Arba Minch Town, Gamo Zone, Southern Ethiopia. Methods: An after-action review (AAR) using qualitative methods was performed. Experts included clinicians, public health professionals, and government officials were involved in the outbreak response. Data were collected via focus group discussions, key informant interviews, and observations, recorded digitally. Thematic analysis was used. Results: Strong stakeholder engagement and coordination were evident, with mass vaccinations aiding control. However, gaps included unprepared logistics, poor communication, and insufficient training. Despite anthrax being immediately notifiable, weaknesses in surveillance detection and reporting were found. Coordination was effective with intersectoral collaboration and commitment, leading to a commendable, lifesaving response once initiated. Conclusion: The study revealed effective engagement and coordination but identified gaps in preparedness and communication. Addressing these through capacity-building and stronger preparedness is crucial for future outbreak management. Contribution: This study provides valuable evidence-based insights to improve health preparedness and response in the African context.

Background: Coordinating outbreak investigations requires effective interagency communication. Important tasks include making the initial notifications, establishing roles and responsibilities for each jurisdiction, providing updates on the progress of the investigations, revising priorities for the investigation, and establishing the next steps. The major goal of surveillance activities is to identify and eliminate preventable causes of morbidity and mortality. Outbreak response basically entails preparedness which helps to establish arrangements in advance to enable timely, effective and appropriate responses to specific potential hazardous events or emerging disaster situations that might threaten society/environment Objective: To review lessons learned from the October 2018 Wolayta Zone yellow fever outbreak management in SNNPR, Ethiopia. Methods: Qualitative research approach, with Thematic Analysis. Purposive sampling method was used. Data were collected through FGDs, in-depth interviews, observation and document reviews Results : Among the main findings of the review is the weakness of the surveillance to detect case; the surveillance system was not that much effective for early detection of viral hemorrhagic fevers and there was knowledge gap to detect in the existing. The Review found out further that preparedness plan was weak, failing to consider the outbreak for VRAM. However, it is worth-noting that the Review showed that despite late detection, a rapid response team was set up and was able to save the lives of many during the outbreak. The findings further showed there was good coordination among various stakeholders at different levels and with satisfying sharing of roles and responsibilities. Conclusion: Based on the major findings, it may be concluded that the surveillance system was weak to detect yellow fever outbreak occurrence in Wolaita Zone. A major gap is therefore the inability to include the case to the IDSR weekly report. Once the case was confirmed, the response to the crisis was fairly commendable. Even though there was a confusion on identifying the first case, after the confirmation of the first case, the case management went as per the standard guideline and SOPs, helping save so many lives through availing the service free of charge Key terms: After Action Review; Outbreak Response; Yellow Fever, Surveillance, Coordination,

: In the past 15 years, there has been a dramatic increase in the global incidence of dengue and its severe manifestations, such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Epidemics in endemic countries are occurring more frequently with increasing magnitude. A well-managed front-line response not only reduces the number of unnecessary hospital admissions but also saves the lives of dengue patients. The objective of this study was to review the Dengue fever outbreak management in Dire Dawa City Administration Ethiopia, March 17_27,2021. The study employed a qualitative research approach, with thematic analysis. A purposive sampling method was used. Data were collected through FGDs, in-depth interviews, and document reviews. The results show there were qualified, experienced, and dedicated professionals for the management of the outbreak. In addition, the engagement of laboratory professionals to decrease the extent of outbreaks and to interrupt the rate of transmission was very interesting. However, the regional dengue fever laboratory investigation was limited to differential diagnosis because of the unavailability of diagnostic methods and essential laboratory equipment.

Introduction: suspected cases of type 2 circulating poliovirus were reported from the Somali, Sidama, and Southern Nations, Nationalities, and Peoples' (SNNP) regions of Ethiopia. A surveillance and laboratory investigation team were deployed to Bokh Woreda, Dollo Zone, Somali Region, for a prompt investigation of the polio outbreak. Four cases, including the index case, tested positive for type 2 circulating poliovirus. The objective of this study was to review the overall polio outbreak response in Ethiopia, validate existing capacity, document best practices, and identify areas for improvement to further strengthen emergency preparedness, surveillance, and future response efforts. Methods: the study employed a qualitative research approach with thematic analysis and used purposive sampling. Results: the study reveals that coordination among various levels of government and non-governmental organizations played a critical role in managing the outbreak. As noted by a key informant, “for the polio coordination, we had revitalized the existing task forces that were previously established for the Measles outbreak campaign” [KII SNNPR Zonal EPI focal, 2020]. The Emergency Operation Center was central in guiding and directing the response, with its five key functions ensuring coordination, logistics, command, planning, and finance [KII Somali Region PHI Director, 202]. Conclusion: effective coordination and preparedness are vital in managing public health emergencies such as the poliomyelitis outbreak in Ethiopia. While the revitalization of existing task forces and the leadership of the Emergency Operation Center facilitated a coordinated response with strong stakeholder engagement, challenges in surveillance and case detection remained significant barriers to optimal outbreak management.