Introduction: Ethiopia is a global hotspot for child malnutrition, with an estimated 1.2 million children under five affected by severe acute malnutrition (SAM) in 2022. In response, the country has integrated SAM into its broader disease surveillance system. In January 2022, the Dubti District Health Office in the Afar Region detected an unusual surge in SAM cases through its surveillance system. This study aimed to assess the extent of the outbreak and identify the associated risk factors.Methods: We conducted an unmatched case–control study involving 258 mother–child dyads from five affected kebeles in the Dubti District of the Afar Region Ethiopia. The descriptive study included all 442 SAM cases from the line list, while 86 cases and 168 controls were selected using a simple random sampling method for the analytic study. The data were entered into EpiData software (version 3.1) and analyzed using SPSS software (version 25.0). Binary logistic regression (LR) analysis was performed to identify risk factors for SAM. Statistically, the results were summarized using an adjusted odds ratio (AOR), 95% confidence intervals (CIs), and a p-value of <0.05.Results: The median age of the cases was 22 months, with an interquartile range of 12–34 months. A total of 39 deaths were reported, with a case fatality rate (CFR) of 8.82%. The identified SAM risk factors included households with more than five members (AOR = 3.341, 95% CI: 1.475–7.563), more than five under-five children (AOR = 4.442, 95% CI: 2.000–9.866), lack of vaccination (AOR = 3.641, 95% CI: 1.618–8.198), pneumonia (AOR = 5.61, 95% CI: 2.488–12.651), diarrhea (AOR = 4.68, 95% CI: 2.169–10.097), lack of access to sanitation and hygiene (AOR = 3.18, 95% CI: 1.462–6.934), and household food insecurity (AOR = 9.46, 95% CI: 2.095–42.712).Conclusion: The study revealed a significant outbreak of SAM, with a CFR of 8.82%. The outbreak was associated with factors such as large family sizes, having multiple under-five children, a lack of vaccination, pneumonia, and diarrhea. These findings emphasize the urgent need to safeguard essential child health services, water supply, sanitation and hygiene, and household food security.

Background: In response to the increasing incidence and prevalence of hypertension, Ethiopia has been piloting hypertension control at the primary health care level in selected sentinel sites. However, no evaluation has been conducted and its success and failures have not been ascertained. Objective: This study aimed to evaluate on whether sentinel hypertension surveillance system in Mojo City were operating efficiently and effectively. Methods: A concurrently embedded mixed design (quantitative or qualitative) study was conducted in 2 sentinel health centers in Mojo city, Oromia region of Ethiopia. The usefulness and 9 system attributes were assessed via key informant interviews, observations, and record reviews. The qualitative data were analyzed manually via thematic analysis, whereas quantitative data were analyzed via SPSS Software version 25.0 (IBM Corp). Results: The study invited 14 key informants, and all were willing to participate in the interview. The completeness and timeliness of reports were 98% and 100%, respectively. The sensitivity, positive predictive value, and representativeness were 45.3%, 92.6%, and 22%, respectively. Nearly three-fourths (10/14, 71%) of key informants perceived the system as flexible, while half thought it as unstable due to factors such as inadequate training and lack of supportive supervision and feedback system. Health facilities did not conduct routine data analysis and interpretation, nor did they use for action. Conclusions: The surveillance system in Mojo city was simple, flexible, acceptable, and predictive but less sensitive, unrepresentative, and unstable. There is a need for implementing routine data analysis and use for action, adequate training, and feedback system for optimizing the system’s performance and to ensure its sustainability.

BACKGROUND Hypertension is one of the rising non-communicable diseases in Ethiopia. To achieve optimal hypertension control, and reduce the risk of cardiovascular complications, Ethiopia had initiated a hypertension program in primary healthcare settings whose effectiveness has not yet been ascertained OBJECTIVE This study aimed to determine the effectiveness of a pilot hypertension program in the Amhara region of Ethiopia METHODS A parallel evaluation design guided by the CDC’s Framework of evaluating public health programs was conducted at four pilot and four non-pilot health facilities in the Amhara region of Ethiopia. Data were collected using checklist with a structured questionnaire from face-to face interviews, record reviews and observations. Data were analyzed using SPSS version 25.0. Statistical comparisons were made using chi-square tests, t-tests, 95% confidence intervals, and p < 0.05 RESULTS Opportunistic blood pressure (BP) screening was significantly higher in pilot facilities (91%, 95% CI: 87.8–93.5%) than in non-pilot facilities (74.4%, 95% CI: 71.2–79.7%). Hypertension detection rate was significantly higher in pilot facilities (19.9%, 95% CI: 16.2–24.0%) compared to non-pilot facilities (14.9%, 95% CI: 11.7–18.6%). Half (51.8%) of the hypertensive patients in the pilot facilities and 42.4% in the non-pilot facilities had controlled BP, with a statistically significant difference in BP control rates between facilities (chi-square, X2=0.823; p < 0.001). Overall, pilot facilities showed better performance in the hypertension prevention (72.8% vs 43.6%), treatment (85.3% vs 55.0%) and control domains (49.8% vs 42.4%). The mean performance across the three domains was higher in pilot facilities (76.1%) compared to non-pilot facilities (51.2%) (t = 2.125; p = 0.042) CONCLUSIONS The pilot program in the Amhara region showed promising results in hypertension prevention, treatment, and control. These results support the scale-up of pilot components into nationwide program such as structured approaches in hypertension management, protocol adherence and integration into community level care

The timeframe from drug initiation to blood pressure (BP) control is an important yet underutilized measure of hypertension management. While numerous studies have explored BP control rates, data on the time to BP control are limited. This study aimed to estimate time to BP control and identify its predictors in the Afar region of Ethiopia. A facility-based retrospective cohort study was conducted among at five public hospitals. Data were collected using a structured questionnaire from cohort registers and patient charts and analyzed using Stata version 14.2. Kaplan–Meier survival analysis was used to estimate the time to BP control. Cox regression analysis was performed to identify predictors of time to BP control. The median age of the participants was 56 years (interquartile range: 47–64 years).The median time to BP control was 13 months (95% CI: 11–15). Factors associated with faster BP control included the use of combination therapy (AHR = 1.85, 95% CI: 1.28–2.68) and the absence of comorbidities (AHR = 1.86, 95% CI: 1.28–2.68). In contrast, factors associated with delayed BP control were age ≥ 60 years (AHR = 0.38, 95% CI: 0.24–0.61), severe hypertension (AHR = 0.63, 95% CI: 0.47–0.84), serum creatinine ≥1.5 mg/dL (AHR = 0.37, 95% CI: 0.17–0.8), and fasting blood sugar (FBS) ≥126 mg/dL (AHR = 0.34, 95% CI: 0.15–0.74). The median time to BP control in the present study exceeded the indications from clinical trials and previous estimates. Combination therapy and the absence of comorbidities were associated with a shorter time to BP control, whereas older age, higher baseline BP levels, and elevated creatinine and FBS levels were associated with delayed BP control. These findings highlight the need for enhanced patient education and counseling, comprehensive management of comorbidities, regular end-organ evaluation, and the use of combination therapies to achieve timely BP control.