Background: Pharmaceuticals are expected to improve human and animal health, but improper management and regulation have led to adverse effects such as reproductive disorders, antibiotic resistance, and biodiversity loss in ecosystems. Their presence in the environment poses significant risks, including a reduction in biodiversity, reproductive issues, and the development of antimicrobial resistance. This review aims to examine the occurrence and sources of pharmaceuticals in the environment and their ecotoxicological and regulatory aspects, with a focus on Ethiopia.Methods: A narrative review of relevant studies conducted in Ethiopia was undertaken. The review included findings on the occurrence, sources, contributing factors, ecotoxicological impacts, and regulatory concerns related to pharmaceutical residues in the environment. Literature was sourced from Google Scholar, Scopus, PubMed, and institutional repositories.Result: The findings revealed the detection of pharmaceutical residues in wastewater treatment facilities, aquatic environments (e.g., lakes and rivers), and commercially available animal products. Aquatic samples also showed significant concentrations, with sulfamethoxazole and fluconazole detected at 0.15 μg/L and 0.012 μg/L, respectively. Antimicrobial resistance genes were identified in wastewater and treatment plant samples, which correlate with the presence of pharmaceutical residues. An ecological risk assessment based on the risk quotient (RQ) revealed ciprofloxacin as a major concern, with an RQ of 8.58, indicating high ecological risk. Sulfonamides exhibited moderate risk, with RQ values ranging from 0.1 to 1.Conclusion: The study highlights the significant presence of pharmaceutical residues in the environment and underscores the inadequacy of regulatory enforcement in addressing this public health issue. Urgent measures are required to prevent environmental contamination and mitigate public health risks, including antimicrobial resistance. Strengthened regulatory measures and proactive interventions by relevant organizations are essential to control and prevent pharmaceutical residues in the environment, offering a critical solution for the country.

Background: Proper disposal of unwanted medicines, in addition to reducing wastage, has a positive impact on the environment and public health. Improper disposal of medications increases the risk of accidental poisonings, particularly among children. This study aimed to assess the level of knowledge, attitudes, and awareness regarding the proper disposal of unused medicines in Gondar city, northwest Ethiopia.Method: From 30 July to 30 August 2023, a community-based cross-sectional study was conducted among the public in Gondar city. The data were gathered using the Kobo toolbox, exported into an Excel sheet, and then analyzed using SPSS version 27. Multivariate and bivariate binary logistic regressions were performed. A p-value of 0.05 with a 95% confidence interval (CI) was used to determine statistical significance.Result: From 786 study participants, the overall knowledge and attitude of the community toward the proper disposal of unused medicines were 42.6 and 42.9%, respectively. Factors identified in this study included ages between 19 and 25 [AOR = 6.91, 95% CI: (3.45, 13.84); education level: secondary [AOR = 11.82, 95% CI: (1.01, 3.29)] and college and above [AOR = 5.68, 95% CI: (2.25, 14.30)]; prior information [AOR = 6.41; 95% CI: (4.02, 10.22)]; and good attitudes [AOR = 2.11; 95% CI: (1.47, 3.02)]] as factors associated with good knowledge toward proper disposal of unused medicines. In addition, receiving information [AOR = 1.86 95% CI: (1.22, 2.86)], taking medication in the past 6 months [AOR = 1.61, 95% CI: (1.09, 2.38)], and being knowledgeable [AOR = 2.07 95% CI: (1.46, 2.94)] were factors contributing to positive attitudes toward the disposal of unused medicines among the general public. Furthermore, approximately 369 participants (46.9%) in our study lacked awareness about the harmful effects of disposing of unused medicine in regular waste.Conclusion: A relatively low level of knowledge and attitudes about the proper disposal of unused medications is present in the community. In this regard, a well-coordinated and methodical public awareness campaign is recommended to disseminate information and promote the appropriate disposal of unused medications.

Background: WHO estimates that 15.8% of substandard or falsified medical products are used to treat non-communicable diseases which account for 80% of the global burden including diabetes. The increased level of use of metformin hydrochloride tablets in clinical practice creates the need to monitor and ascertain the quality of the various brands available in the drug market for quality control assessment and generic substitution. This study aims to assess the pharmaceutical quality of seven brands of metformin tablets circulating in pharmacy outlets in Gondar City, North West Ethiopia. Methods: Official Pharmacopoeia tests such as uniformity of weight, disintegration, assay, and dissolution tests were used to assess the physicochemical quality control parameters of metformin hydrochloride tablet brands. The unofficial tests conducted included crushing strength/hardness and friability. Results: In all seven tests, the tested brands passed the BP official tests for uniformity of weight, friability, disintegration, and dissolution. Each product had a friability of less than 1% with a maximum of 0.385%. In contrast, none of the brands passed the non-official hardness test. Each product disintegrated in seven to twelve minutes, meeting the USP standards. Drug release rates in 45 min ranged from 78.9 to 92.6%, and drug content results were within the USP guidelines (96.55– 102.76%). Conclusion: The current study demonstrated that all seven brands of metformin hydrochloride 500 mg tablets adhered to the quality control parameters specified in the pharmacopeia, except for the hardness test across all brands.

Prescriptions come with extensive instructions on taking medicines but provide little information about the burden of unused medicines. This issue centers around the vast quantities of unused medications accumulated in households. The study aimed to assess the prevalence of unused medicines and associated factors in Gondar City. The study was conducted through a community-based cross-sectional survey in Gondar City from July 30 to August 30, 2023. The data was collected using the Kobo toolbox, exported into an Excel sheet, and then analyzed using SPSS version 27 software. Both multivariate and bivariate binary logistic regressions were performed in the data analysis. A p-value of 0.05 with a 95% confidence interval was used to determine statistical significance. The study interviewed 786 participants, with a 92.8% response rate. 55% of the 786 households surveyed kept unused medications at home, most commonly antibiotics (37%), antipyretics (17.6%), and analgesics (15%). Factors associated with having unused medicines at home included not receiving medication information (AOR = 2.327, 95% CI: 1.535, 3.527), having a chronic disease (AOR = 5.897, 95% CI: 3.667, 9.484), having health insurance coverage (AOR = 1.456, 95% CI: 1.036, 2.047), self-medicating with NSAIDs (AOR = 2.018, 95% CI: 1.396, 2.919), and poor disposal practices (AOR = 3.613, 95% CI: 2.546, 5.127). The study found a considerable high prevalence of unused medications in Gondar City due to factors like lack of medication education, chronic conditions, insurance coverage, self-medication, and poor disposal practices. To address this, public education programs and safe disposal guidelines should be implemented to promote safer practices.

Background: Malaria is a major public health issue in East Africa, leading to widespread illness and fatalities, especially among vulnerable populations such as children under 5 years of age and pregnant women. Artemisinin‐based combination therapies (ACTs) are the primary treatment modality; however, their efficacy is undermined by the prevalence of substandard ACTs and the increasing risk of resistance. Therefore, it is crucial to improve evidence on quality, therapeutic efficacy, and regulatory performance to promote malaria control efforts in the region. Methods: This systematic review followed PRISMA 2020 guidelines, with the protocol registered in PROSPERO (CRD420251135109). Literature was searched in PubMed and Google Scholar databases from July to September 2025. Methodological quality was appraised using MEDQUARG and STROBE. Two reviewers independently extracted data, resolving discrepancies by consensus. The extracted findings were synthesised narratively to identify key trends. Results: A systematic review of 40 articles from Ethiopia, Kenya, Tanzania, and Uganda revealed considerable variation in the quality of Artemisinin‐based combination therapies (ACTs). Across the four East African countries, a total of 3363 ACT samples were tested, of which 375 failed to comply with specification limits set for at least one physicochemical quality parameter. This corresponds to an overall failure rate of 11.2% (375/3363). Country‐specific failure rates reflect the highest rate in Uganda (33.3% [16/48]), followed by Kenya (14.1% [10/71]), Tanzania (11.6% [333/2859]), and Ethiopia (4.2% [16/385]). This considerable variation could be attributed to the differences in prevalence, the number of studies conducted, study design, and sampling methodology. The reported poor quality of ACTs, major treatment options in managing malaria cases, could pose a public health threat. Though the studies conducted so far may not give a real picture of the magnitude of poor quality ACTs medicines and their impact on the treatment outcomes, the reports indicated that ACTs remain highly efficacious, with most therapeutic trials reporting polymerase chain reaction‐corrected cure rates of ≥ 90%. As indicated in the literature, Artemether‐lumefantrine consistently demonstrated strong treatment outcomes, while dihydroartemisinin‐piperaquine provided extended prophylactic effects. However, emerging Plasmodium falciparum resistance, particularly K13 mutations associated with delayed parasite clearance, poses an ongoing threat to ACT effectiveness. Conclusion: The findings of this study revealed that 11.2% of ACTs samples were found to be poor quality. The clinical data reflects that in East Africa, ACTs remain effective despite the prevalence of substandard and falsified ACTs and emerging resistance threatening long‐term gains. Thus, strengthening regional regulatory harmonization, pharmacovigilance, molecular surveillance, and local manufacturing capacity is essential to combat resistance of ACT and ensure equitable access to quality‐assured therapies.

Background: Since the beginning of the pandemic, scientists and researchers are highly engaged in the discovery and production of vaccines and specific treatments for COVID-19. In China, the National Health Commission has declared the use of herbal medicine combined with Western medicine as a treatment for COVID-19 and has issued many guidelines on herbal medicine-related therapies. Ethiopians have a variety of medicinal herbs to treat various viral diseases. Hence, this study aimed to assess the perception of the respondent towards COVID-19 related symptoms and traditional medicine practice for their management. Methods: A hospital-based cross-sectional study was done among 423 patients and patient attendants at the University of Gondar Comprehensive Specialized Hospital from August 6 to 27, 2021. Data were collected using a structured questionnaire, and the data were entered into Epi Info 7 and then analyzed with SPSS 20. The association between the independent and dependent variables was explained using chi-square test. Results: A total of 423 respondents participated in the study; 414 (97.9%) participants heard about COVID-19 and responded correctly to the chief clinical symptoms. Fever is the most perceived symptom, reported by 378 (91.3) respondents, and the least reported symptom was loss of taste and smell by 30 (7.2%) respondents. This study showed that home remedies were practiced by 323 of the total respondents, and herbal medicines were the second most and practiced by 316 respondents. Monthly income and perceived knowledge about chief symptoms were statistically significantly associated (p < 0.05) with the use of complementary and alternative medicine for the management of COVID-19 related symptoms. Conclusion: This study found that most of the respondents have knowledge about the signs and symptoms of COVID-19 and the traditional medicine is being practiced by most of the study participants as a management for COVID-19 and related symptoms.