Search results for: Berhane Tewelday Weldhiwot

Authors: Berhane Tewelday Weldhiwot

Abstract:

This research investigates the pivotal role of modular forms in modern cryptographic systems, particularly focusing on their applications in secure communications and data integrity. Modular forms, which are complex analytic functions with rich arithmetic properties, have gained prominence due to their connections to number theory and algebraic geometry. This study begins by outlining the fundamental concepts of modular forms and their historical development, followed by a detailed examination of their applications in cryptographic protocols such as elliptic curve cryptography and zero-knowledge proofs. By employing techniques from analytic number theory, the research delves into how modular forms can enhance the efficiency and security of cryptographic algorithms. The findings suggest that leveraging modular forms not only improves computational performance but also fortifies security measures against emerging threats in digital communication. This work aims to contribute to the ongoing discourse on integrating advanced mathematical theories into practical applications, ultimately fostering innovation in cryptographic methodologies.

Keywords: modular forms, cryptography, elliptic curves, applications, mathematical theory

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Authors: Redie Kidane Ghebrehawariat, Betiel Habte Hadgu, Filmon Berhane Kahsay, Rim Berhane Fisehaye, Samuel Haile Kahsay, Saron Yemane Yosief, Selemawit Mosazghi Gilazghi

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A cross-sectional study was conducted from 22 February to 9 April 2022 on small, medium, and large holder dairy farms to determine the bovine mastitis prevalence and associated risk factors in the Anseba region, Eritrea. A total of 34 dairy farms and 193 dairy cows were randomly selected. Dairy cows were physically examined for any change on the udder and milk; a California mastitis test was performed to check sub-clinical mastitis; a closed-ended semi-structured questionnaire composed of 28 variables/risk factors (21 management risk factors and 7 animal-level risk factors) was used to determine the risk factors responsible for clinical and sub-clinical mastitis in the dairy cows. The overall cow-level prevalence of mastitis was 147 (76.2%). The animal level prevalence rate of clinical and sub-clinical mastitis was found to be 22 (11.4%) and 125 (64.8%), respectively, while herd level prevalence both for clinical and subclinical mastitis was found to be 14 (41.2%) and 26 (76.5%) respectively. Based on the already set P-value, which is <0.05, a number of risk factors were found to have a significant relationship with the occurrence of clinical and sub-clinical mastitis. Generally, animal risk factors such as animal age, parity, injury on the udder or teat, and previous history of mastitis presence of injury on the udder and lactation stage were risk factors with a significant relationship with the occurrence of clinical and sub-clinical mastitis. On the other hand, management risk factors with a significant relationship to the occurrence of clinical and sub-clinical mastitis were herd size, failure to milk mastitic cow, at last, educational level, floor type, failure to use a towel, using one towel for more than one cow and failure to practice mastitis test. From a total of 772 quarters, 280 (36.3%) were found positive for sub-clinical mastitis using the California mastitis test; of these, 70 (9%) were weakly positive, 90 (11.7%) were distinct positive, and 120 (15.5%) were strongly positive. Furthermore, 13 (1.7%) quarters were blocked. Quarter level prevalence was right front 80 (41.5%), left front 64 (33.3%), right hind 69 (35.8%) and left hind 67 (34.7%). The study has shown that mastitis is a major problem for dairy farms and the findings suggested that mastitis is one of the limiting factors in increasing milk production. Subclinical mastitis was found to be a devastating problem, and it occurred in all three breeds of lactating dairy cattle. Therefore, farmers should work hard to avoid the above-mentioned risk factors to minimize the infection of their dairy cattle by mastitis and thereby increase their profit. On the other hand, the Ministry of Agriculture, through the extension unit, should work in close contact with the farmers to increase awareness of the economic importance of the disease and associated risk factors.

Keywords: mastitis, prevalence, dairy cattle, Anseba, Eritrea

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Authors: Bedilu A. Ejigu, Eshetu Wencheko, Kiros Berhane

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Anaemia is a condition in which the haemoglobin concentration falls below an established cut-off value due to a decrease in the number and size of red blood cells. The current study aimed to assess the spatial pattern and identify predictors related to anaemia using the third Ethiopian demographic health survey which was conducted in 2010. To achieve this objective, this study took into account the clustered nature of the data. As a result, multilevel modeling has been used in the statistical analysis. For analysis purpose, only complete cases from 15,909 females, and 13,903 males were considered. Among all subjects who agreed for haemoglobin test, 5.49 %males, and 19.86% females were anaemic. In both binary and ordinal outcome modeling approaches, educational level, age, wealth index, BMI and HIV status were identified to be significant predictors for anaemia prevalence. Furthermore, it was noted that pregnant women were more anaemic than non-pregnant women. As revealed by Moran's I test, significant spatial autocorrelation was noted across clusters. The risk of anaemia was found to vary across different regions, and higher prevalence was observed in Somali and Affar region.

Keywords: anaemia, Moran's I test, multilevel models, spatial pattern

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Authors: Demisash, Abate Getnet, Gudisa, Ababo Geleta, Daba, Berhane Olani

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As consumption trends of fish are rising in Ethiopia, assessment of the environmental performance of Fisheries becomes vital. Hence, Cleaner Production Assessment was conducted on Lake Tana No.1 Fish Supply Association. This paper focuses on determining the characteristics, quantity, and setting up cleaner production options for the site with the experimental investigation. The survey analysis showed that illegal waste dumping in Lake Tana is common practice in the area, and some of the main reasons raised were they have no option than doing this for dis-charging fish wastes. Quantifying a fish waste by examination of records at the point of generation resulted in a generation rate of 72,822.61 kg per year, which is a significant amount of waste and needs management system. The result of the proximate analysis showed high free fat content of about 12.33%, and this was a good candidate for the production of biodiesel that has been set as an option for fish waste utilization. Among the different waste management options, waste reduction by product optimization, which involves biodiesel production, was chosen as a potential method. Laboratory scale experiments were performed to produce a renewable energy source from the wastes. The resulting biodiesel was characterized and found to have a density of 0.756kg/L, viscosity 0.24p, and 153°C flashpoints, which shows the product has values in compliance with the American Society for Testing and Materials (ASTM) standards.

Keywords: biodiesel, cleaner production, renewable energy, waste management

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Authors: Berhane Gebreslassie

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Conventional commericial buildings are among the highest unwisely consumes enormous amount of energy and as consequence produce significant amount Carbon Dioxide (CO2). Traditional/conventional buildings have been built for years without consideration being given to their impact on the global warming issues as well as their CO2 contributions. Since 1973, simulation of Green Building (GB) for Energy Efficiency started and many countries in particular the US showed a positive response to minimize the usage of energy in respect to reducing the CO2 emission. As a consequence many software companies developed their own unique building energy efficiency simulation software, interfacing interoperability with Building Information Modeling (BIM). The last decade has witnessed very rapid growing number of researches on GB energy efficiency system. However, the study also indicates that the results of current GB simulation are not yet satisfactory to meet the objectives of GB. In addition most of these previous studies are unlikely excluded the studies of ultimate building energy efficiencies simulation. The aim of this project is to meet the objectives of GB by design, modeling and simulation of building ultimate energy efficiencies system. This research project presents multi-level, L-shape office building in which every particular part of the building materials has been tested for energy efficiency. An overall of 78.62% energy is saved, approaching to NetZero energy saving. Furthermore, the building is implements with distributed energy resources like renewable energies and integrating with Smart Building Automation System (SBAS) for controlling and monitoring energy usage.

Keywords: ultimate energy saving, optimum energy saving, green building, sustainable materials and renewable energy

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Authors: Habtamu Fufa, Yemane Berhane

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Child under nutrition has long-term consequences for intellectual ability, economic productivity, reproductive performance and susceptibility to metabolic and cardiovascular disease. The unacceptably high prevalence of malnutrition in young children of the region has not changed much over the last decades, which could make the achievement of the corresponding Millennium Development Goals very unlikely. Despite the well-documented problems of child malnutrition in Sub-Saharan Africa, there is few systematic review of evidences on determinants of child malnutrition in the region. The current available evidence on determinants of child under nutrition in Sub-Saharan Africa is systematically reviewed. The method used in searching relevant literature was using bio medical databases PUBMED, Google scholar and the website of the World Health Organization on nutrition using the following key words: "Determinants “, "Child Malnutrition", and "Sub- Saharan Africa". The search was limited to articles published in and after 1995 up to date. In all the reviewed articles, the data were analyzed using multivariate regression analysis and or odds ratios for significance of determinants in child malnutrition. Synthesis of 40 published articles from various countries of the region is done and noted that household economic status, maternal education, disease, breastfeeding practices, age and sex of a child, birth interval and residential areas were found to be determinants of child under nutrition. Poverty remains the main factor of malnutrition in Sub-Saharan Africa and poor education of parents aggravates the malnutrition through perpetuation of poor nutrition practices. Male children under five years are the most affected ones. Understanding of these determinants of poor nutritional attainment would provide insights in designing interventions for reducing the high levels of child malnutrition in this region. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child nutritional & health status in Sub-Saharan Africa.

Keywords: child malnutrition, determinants, Sub-Saharan Africa, health status

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Authors: G. Berhane, F. Kebede

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A feeding trial was conducted to enhance the utilization of locally produced full-fat soybean by the broiler industry. The study had three phases such as starter (1-14d), grower (15–28d), and finisher (29–49d) phases. A completely randomized design (CRD) was used in the starter phase with three treatments (commercial soybean meal (SBM) was replaced by raw full-fat soybean (RFSB) at 0, 10, or 20%), and each was replicated eight times. A total of 408 unsexed one-day-old Cobb-500 broiler chicks were randomly allocated to replicates. A 2 x 3 factorial arrangement was used in both second (grower) and third (finisher) phase trials, which had six experimental diets. These six treatments were formed by dividing the original three diets (containing 0, 10, or 20% of RFSB into two and then by pelleting anyone from each respective group and leaving the other as mash. Every treatment had four replications and 17 birds in each. Chemical compositions of feed ingredients were analyzed, and data on the initial body weight of chicks, feed offered, feed leftover, body weight (BW) of chickens, and mortality were collected. At the end of the experiment, two birds (one male and one female) per replicate were randomly selected and humanly slaughtered. Weights of dressed, eviscerated, cut parts of the carcass and visceral organs were weighed and recorded. Results indicated that feed intake (FI), body weight gain (BWG), BW, and feed conversion ratio (FCR) of broilers were not significantly affected (P=0.05) by supplementation of a leveled RFSB on diets at starter, grower, and finisher phases. The FI at the finisher stage was also significantly (P=0.05) influenced by the feed forms. However, weights of dressed, eviscerated, cut parts of the carcass and visceral organs were not significantly (P=0.05) affected by both RFSB supplementation, up to 20%, and feed forms. It is concluded that commercial SBM can be replaced by locally produced RFSB up to 20% without pelleting the diets.

Keywords: broilers, carcass characteristics, raw full-fat soybean, weight gain

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Authors: Samuel Abraham Berhane, Lingbing Bu

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This paper presents the spatiotemporal variability of aerosols, clouds, and precipitation within the major cities in Eritrea and it investigates the relationship between aerosols, clouds, and precipitation concerning the presence of aerosols over the study region. In Eritrea, inadequate water supplies will have both direct and indirect adverse impacts on sustainable development in areas such as health, agriculture, energy, communication, and transport. Besides, there exists a gap in the knowledge on suitable and potential areas for cloud seeding. Further, the inadequate understanding of aerosol-cloud-precipitation (ACP) interactions limits the success of weather modification aimed at improving freshwater sources, storage, and recycling. Spatiotemporal variability of aerosols, clouds, and precipitation involve spatial and time series analysis based on trend and anomaly analysis. To find the relationship between aerosols and clouds, a correlation coefficient is used. The spatiotemporal analysis showed larger variations of aerosols within the last two decades, especially in Assab, indicating that aerosol optical depth (AOD) has increased over the surrounding Red Sea region. Rainfall was significantly low but AOD was significantly high during the 2011 monsoon season. Precipitation was high during 2007 over most parts of Eritrea. The correlation coefficient between AOD and rainfall was negative over Asmara and Nakfa. Cloud effective radius (CER) and cloud optical thickness (COT) exhibited a negative correlation with AOD over Nakfa within the June–July–August (JJA) season. The hybrid single-particle Lagrangian integrated trajectory (HYSPLIT) model that is used to find the path and origin of the air mass of the study region showed that the majority of aerosols made their way to the study region via the westerly and the southwesterly winds.

Keywords: aerosol-cloud-precipitation, aerosol optical depth, cloud effective radius, cloud optical thickness, HYSPLIT

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Authors: Teklay Tesfay, Gebreyesus Brhane Tesfahunegn, Abadi Berhane, Selemawit Girmay

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Adjusting the proper sowing date of a crop at a particular location with a changing climate is an essential management option to maximize crop yield. However, determining the optimum sowing date for rainfed maize production through field experimentation requires repeated trials for many years in different weather conditions and crop management. To avoid such long-term experimentation to determine the optimum sowing date, crop models such as AquaCrop are useful. Therefore, the overall objective of this study was to evaluate the performance of AquaCrop model in simulating maize productivity under varying sowing dates. A field experiment was conducted for two consecutive cropping seasons by deploying four maize seed sowing dates in a randomized complete block design with three replications. Input data required to run this model are stored as climate, crop, soil, and management files in the AquaCrop database and adjusted through the user interface. Observed data from separate field experiments was used to calibrate and validate the model. AquaCrop model was validated for its performance in simulating the green canopy and aboveground biomass of maize for the varying sowing dates based on the calibrated parameters. Results of the present study showed that there was a good agreement (an overall R2 =, Ef= d= RMSE =) between measured and simulated values of the canopy cover and biomass yields. Considering the overall values of the statistical test indicators, the performance of the model to predict maize growth and biomass yield was successful, and so this is a valuable tool help for decision-making. Hence, this calibrated and validated model is suggested to use for determining optimum maize crop sowing date for similar climate and soil conditions to the study area, instead of conducting long-term experimentation.

Keywords: AquaCrop model, calibration, validation, simulation

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Authors: Hanna Gulema, Meaza Demissie, Alemayehu Worku, Tesfaye Assebe Yadeta, Yemane Berhane

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Background: In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA). Method: We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study’s outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the Mixed effect logistic regression model was used to examine the effect of the intervention. Result: The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06–4.09]) after controlling selected covariates, p-value 0.033. Conclusions: The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.

Keywords: family eating practice, social norm intervention, adolescence girls, caregiver

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Authors: Abadi Berhane, Walelign Worku, Berhanu Abrha, Gebre Hadgu, Tigray

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Sesame is an important oilseed crop in Ethiopia; which is the second most exported agricultural commodity next to coffee. However, there is poor soil fertility management and a research-led farming system for the crop. The AquaCrop model was applied as a decision-support tool; which performs a semi-quantitative approach to simulate the yield of crops under different soil fertility levels. The objective of this experiment was to calibrate and validated the AquaCrop model for simulating the growth and yield of sesame under different nitrogen fertilizer levels and to test the performance of the model as a decision-support tool for improved sesame cultivation in the study area. The experiment was laid out as a randomized complete block design (RCBD) in a factorial arrangement in the 2016, 2017, and 2018 main cropping seasons. In this experiment, four nitrogen fertilizer rates; 0, 23, 46, and 69 Kg/ha nitrogen, and three improved varieties (Setit-1, Setit-2, and Humera-1). In the meantime, growth, yield, and yield components of sesame were collected from each treatment. Coefficient of determination (R2), Root mean square error (RMSE), Normalized root mean square error (N-RMSE), Model efficiency (E), and Degree of agreement (D) were used to test the performance of the model. The results indicated that the AquaCrop model successfully simulated soil water content with R2 varying from 0.92 to 0.98, RMSE 6.5 to 13.9 mm, E 0.78 to 0.94, and D 0.95 to 0.99; and the corresponding values for AB also varied from 0.92 to 0.98, 0.33 to 0.54 tons/ha, 0.74 to 0.93, and 0.9 to 0.98, respectively. The results on the canopy cover of sesame also showed that the model acceptably simulated canopy cover with R2 varying from 0.95 to 0.99, and a RMSE of 5.3 to 8.6%. The AquaCrop model was appropriately calibrated to simulate soil water content, canopy cover, aboveground biomass, and sesame yield; the results indicated that the model adequately simulated the growth and yield of sesame under the different nitrogen fertilizer levels. The AquaCrop model might be an important tool for improved soil fertility management and yield enhancement strategies of sesame. Hence, the model might be applied as a decision-support tool in soil fertility management in sesame production.

Keywords: aquacrop model, sesame, normalized water productivity, nitrogen fertilizer

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Authors: Abadi Berhane, Walelign Worku, Berhanu Abrha, Gebre Hadgu

Abstract:

Sesame is an important oilseed crop in Ethiopia, which is the second most exported agricultural commodity next to coffee. However, there is poor soil fertility management and a research-led farming system for the crop. The AquaCrop model was applied as a decision-support tool, which performs a semi-quantitative approach to simulate the yield of crops under different soil fertility levels. The objective of this experiment was to calibrate and validate the AquaCrop model for simulating the growth and yield of sesame under different nitrogen fertilizer levels and to test the performance of the model as a decision-support tool for improved sesame cultivation in the study area. The experiment was laid out as a randomized complete block design (RCBD) in a factorial arrangement in the 2016, 2017, and 2018 main cropping seasons. In this experiment, four nitrogen fertilizer rates, 0, 23, 46, and 69 Kg/ha nitrogen, and three improved varieties (Setit-1, Setit-2, and Humera-1). In the meantime, growth, yield, and yield components of sesame were collected from each treatment. Coefficient of determination (R2), Root mean square error (RMSE), Normalized root mean square error (N-RMSE), Model efficiency (E), and Degree of agreement (D) were used to test the performance of the model. The results indicated that the AquaCrop model successfully simulated soil water content with R2 varying from 0.92 to 0.98, RMSE 6.5 to 13.9 mm, E 0.78 to 0.94, and D 0.95 to 0.99, and the corresponding values for AB also varied from 0.92 to 0.98, 0.33 to 0.54 tons/ha, 0.74 to 0.93, and 0.9 to 0.98, respectively. The results on the canopy cover of sesame also showed that the model acceptably simulated canopy cover with R2 varying from 0.95 to 0.99 and a RMSE of 5.3 to 8.6%. The AquaCrop model was appropriately calibrated to simulate soil water content, canopy cover, aboveground biomass, and sesame yield; the results indicated that the model adequately simulated the growth and yield of sesame under the different nitrogen fertilizer levels. The AquaCrop model might be an important tool for improved soil fertility management and yield enhancement strategies of sesame. Hence, the model might be applied as a decision-support tool in soil fertility management in sesame production.

Keywords: aquacrop model, normalized water productivity, nitrogen fertilizer, canopy cover, sesame

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Authors: Anteneh Berhane Yeyi, Tefera Belachew

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Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.

Keywords: NTDs, IFAS, WRA, Ethiopia

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Authors: Henok Biruk Alemayehu, Kalkidan Berhane Tsegaye, Fozia Seid Ali, Nebiyat Feleke Adimassu, Getasew Alemu Mersha

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Background: Strabismus is a visual disorder where the eyes are misaligned and point in different directions. Untreated strabismus can lead to amblyopia, loss of binocular vision, and social stigma due to its appearance. Since it is assumed that knowledge is pertinent for early screening and prevention of strabismus, the main objective of this study was to assess knowledge and attitudes toward strabismus in Woreta town, Northwest Ethiopia. Providing data in this area is important for planning health policies. Methods: A community-based cross-sectional study was done in Woreta town from April–May 2020. The sample size was determined using a single population proportion formula by taking a 50% proportion of good knowledge, 95% confidence level, 5% margin of errors, and 10% non- response rate. Accordingly, the final computed sample size was 424. All four kebeles were included in the study. There were 42,595 people in total, with 39,684 adults and 9229 house holds. A sample fraction ’’k’’ was obtained by dividing the number of the household by the calculated sample size of 424. Systematic random sampling with proportional allocation was used to select the participating households with a sampling fraction (K) of 21 i.e. each household was approached in every 21 households included in the study. One individual was selected ran- domly from each household with more than one adult, using the lottery method to obtain a final sample size. The data was collected through a face-to-face interview with a pretested and semi-structured questionnaire which was translated from English to Amharic and back to English to maintain its consistency. Data were entered using epi-data version 3.1, then processed and analyzed via SPSS version- 20. Descriptive and analytical statistics were employed to summarize the data. A p-value of less than 0.05 was used to declare statistical significance. Result: A total of 401 individuals aged over 18 years participated, with a response rate of 94.5%. Of those who responded, 56.6% were males. Of all the participants, 36.9% were illiterate. The proportion of people with poor knowledge of strabismus was 45.1%. It was shown that 53.9% of the respondents had a favorable attitude. Older age, higher educational level, having a history of eye examination, and a having a family history of strabismus were significantly associated with good knowledge of strabismus. A higher educational level, older age, and hearing about strabismus were significantly associated with a favorable attitude toward strabismus. Conclusion and recommendation: The proportion of good knowledge and favorable attitude towards strabismus were lower than previously reported in Gondar City, Northwest Ethiopia. There is a need to provide health education and promotion campaigns on strabismus to the community: what strabismus is, its’ possible treatments and the need to bring children to the eye care center for early diagnosis and treatment. it advocate for prospective research endeavors to employ qualitative study design.Additionally, it suggest the exploration of studies that investigate causal-effect relationship.

Keywords: strabismus, knowledge, attitude, Woreta

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