{"id":"https://openalex.org/W4293213090","doi":"https://doi.org/10.1155/2022/9449070","title":"Nonadherence Predictors to Tuberculosis Medications among TB Patients in Gambella Region of Ethiopia","display_name":"Nonadherence Predictors to Tuberculosis Medications among TB Patients in Gambella Region of Ethiopia","publication_year":2022,"publication_date":"2022-08-24","ids":{"openalex":"https://openalex.org/W4293213090","doi":"https://doi.org/10.1155/2022/9449070","pmid":"https://pubmed.ncbi.nlm.nih.gov/36061635","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/9433279"},"language":"en","primary_location":{"id":"doi:10.1155/2022/9449070","doi":"https://doi.org/10.1155/2022/9449070","is_oa":true,"landing_page_url":"https://doi.org/10.1155/2022/9449070","pdf_url":"https://downloads.hindawi.com/journals/cjidmm/2022/9449070.pdf","source":{"id":"https://openalex.org/S165423614","display_name":"Canadian Journal of Infectious Diseases and Medical Microbiology","issn_l":"1180-2332","issn":["1180-2332","1712-9532","1918-1493"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313016","host_organization_name":"Pulsus Group","host_organization_lineage":["https://openalex.org/P4310313016","https://openalex.org/P4310320466"],"host_organization_lineage_names":["Pulsus Group","OMICS Publishing Group"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Canadian Journal of Infectious Diseases and Medical Microbiology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","datacite","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://downloads.hindawi.com/journals/cjidmm/2022/9449070.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5089674267","display_name":"Taye Kebede","orcid":"https://orcid.org/0000-0001-8611-4946","observed_orcids":["https://orcid.org/0000-0001-8611-4946"]},"institutions":[{"id":"https://openalex.org/I1283442259","display_name":"Madda Walabu University","ror":"https://ror.org/04zte5g15","country_code":"ET","type":"education","lineage":["https://openalex.org/I1283442259"]},{"id":"https://openalex.org/I4537092","display_name":"Addis Ababa University","ror":"https://ror.org/038b8e254","country_code":"ET","type":"education","lineage":["https://openalex.org/I4537092"]}],"countries":["ET"],"is_corresponding":true,"raw_author_name":"Taye Kebede","raw_affiliation_strings":["Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia","Department of Biomedical Sciences and Immunology, Natural Sciences College, Madda Walabu University, P.O. Box 247, Bale-Robe, Ethiopia"],"raw_orcid":"https://orcid.org/0000-0001-8611-4946","affiliations":[{"raw_affiliation_string":"Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia","institution_ids":["https://openalex.org/I4537092"]},{"raw_affiliation_string":"Department of Biomedical Sciences and Immunology, Natural Sciences College, Madda Walabu University, P.O. Box 247, Bale-Robe, Ethiopia","institution_ids":["https://openalex.org/I1283442259"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5030699280","display_name":"Wiw Gach Jing","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Wiw Gach Jing","raw_affiliation_strings":["Division of Epidemiology, Gambella Regional Health Bureau, Gambella Region, P.O. Box 408, Gambella, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Epidemiology, Gambella Regional Health Bureau, Gambella Region, P.O. Box 408, Gambella, Ethiopia","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5002228994","display_name":"Abiot Girma","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1443707","display_name":"Jimma University","ror":"https://ror.org/05eer8g02","country_code":"ET","type":"education","lineage":["https://openalex.org/I1443707"]},{"id":"https://openalex.org/I4537092","display_name":"Addis Ababa University","ror":"https://ror.org/038b8e254","country_code":"ET","type":"education","lineage":["https://openalex.org/I4537092"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Abiot Girma","raw_affiliation_strings":["Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia","Department of Public Health, College of Health Sciences and Medicine, Jimma University, P.O. Box 378, Jimma, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia","institution_ids":["https://openalex.org/I4537092"]},{"raw_affiliation_string":"Department of Public Health, College of Health Sciences and Medicine, Jimma University, P.O. Box 378, Jimma, Ethiopia","institution_ids":["https://openalex.org/I1443707"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5109337998","display_name":"Kifle Woldemichael","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1443707","display_name":"Jimma University","ror":"https://ror.org/05eer8g02","country_code":"ET","type":"education","lineage":["https://openalex.org/I1443707"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Kifle Woldemichael","raw_affiliation_strings":["Department of Epidemiology, College of Health Sciences and Medicine, Jimma University, P.O. Box 378, Jimma, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Epidemiology, College of Health Sciences and Medicine, Jimma University, P.O. Box 378, Jimma, Ethiopia","institution_ids":["https://openalex.org/I1443707"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5089674267"],"corresponding_institution_ids":["https://openalex.org/I1283442259","https://openalex.org/I4537092"],"apc_list":{"value":2160,"currency":"USD","value_usd":2160},"apc_paid":{"value":2160,"currency":"USD","value_usd":2160},"fwci":0.5047,"has_fulltext":true,"cited_by_count":7,"citation_normalized_percentile":{"value":0.60118239,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":97},"biblio":{"volume":"2022","issue":null,"first_page":"1","last_page":"16"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10038","display_name":"Tuberculosis Research and Epidemiology","score":0.9643999934196472,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10038","display_name":"Tuberculosis Research and Epidemiology","score":0.9643999934196472,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11620","display_name":"Medication Adherence and Compliance","score":0.03200000151991844,"subfield":{"id":"https://openalex.org/subfields/2714","display_name":"Family Practice"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10082","display_name":"HIV/AIDS Research and Interventions","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/tuberculosis","display_name":"tuberculosis","score":0.9599999785423279},{"id":"https://openalex.org/keywords/medication-non-adherence","display_name":"medication non-adherence","score":0.8379999995231628},{"id":"https://openalex.org/keywords/antituberculosis-drugs","display_name":"antitubercular agents","score":0.8569999933242798},{"id":"https://openalex.org/keywords/treatment-completion","display_name":"treatment completion","score":0.5509999990463257},{"id":"https://openalex.org/keywords/stigma","display_name":"stigma","score":0.5649999976158142},{"id":"https://openalex.org/keywords/patient-counseling","display_name":"patient counseling","score":0.6359999775886536},{"id":"https://openalex.org/keywords/gambella-region","display_name":"Gambella","score":0.6000000238418579}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7804056406021118},{"id":"https://openalex.org/C2781069245","wikidata":"https://www.wikidata.org/wiki/Q12204","display_name":"Tuberculosis","level":2,"score":0.7781839370727539},{"id":"https://openalex.org/C3019056677","wikidata":"https://www.wikidata.org/wiki/Q1189184","display_name":"Tb treatment","level":3,"score":0.5186333060264587},{"id":"https://openalex.org/C556039675","wikidata":"https://www.wikidata.org/wiki/Q771035","display_name":"Traditional medicine","level":1,"score":0.404675155878067},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3614614009857178},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3206002712249756},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.10059326887130737}],"mesh":[],"locations_count":6,"locations":[{"id":"doi:10.1155/2022/9449070","doi":"https://doi.org/10.1155/2022/9449070","is_oa":true,"landing_page_url":"https://doi.org/10.1155/2022/9449070","pdf_url":"https://downloads.hindawi.com/journals/cjidmm/2022/9449070.pdf","source":{"id":"https://openalex.org/S165423614","display_name":"Canadian Journal of Infectious Diseases and Medical Microbiology","issn_l":"1180-2332","issn":["1180-2332","1712-9532","1918-1493"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313016","host_organization_name":"Pulsus Group","host_organization_lineage":["https://openalex.org/P4310313016","https://openalex.org/P4310320466"],"host_organization_lineage_names":["Pulsus Group","OMICS Publishing Group"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Canadian Journal of Infectious Diseases and Medical Microbiology","raw_type":"journal-article"},{"id":"pmid:36061635","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/36061635","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:9433279","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9433279/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Can J Infect Dis Med Microbiol","raw_type":"Text"},{"id":"pmh:oai:doaj.org/article:26530b1ef5184db4840253d23b81e417","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/26530b1ef5184db4840253d23b81e417","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Canadian Journal of Infectious Diseases and Medical Microbiology, Vol 2022 (2022)","raw_type":"article"},{"id":"doi:10.60692/1kvxe-8bx87","doi":"https://doi.org/10.60692/1kvxe-8bx87","is_oa":true,"landing_page_url":"https://doi.org/10.60692/1kvxe-8bx87","pdf_url":null,"source":{"id":"https://openalex.org/S7407051682","display_name":"Greater South Information System","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article-journal"},{"id":"doi:10.60692/vpdb3-2t107","doi":"https://doi.org/10.60692/vpdb3-2t107","is_oa":true,"landing_page_url":"https://doi.org/10.60692/vpdb3-2t107","pdf_url":null,"source":{"id":"https://openalex.org/S7407051682","display_name":"Greater South Information System","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article-journal"}],"best_oa_location":{"id":"doi:10.1155/2022/9449070","doi":"https://doi.org/10.1155/2022/9449070","is_oa":true,"landing_page_url":"https://doi.org/10.1155/2022/9449070","pdf_url":"https://downloads.hindawi.com/journals/cjidmm/2022/9449070.pdf","source":{"id":"https://openalex.org/S165423614","display_name":"Canadian Journal of Infectious Diseases and Medical Microbiology","issn_l":"1180-2332","issn":["1180-2332","1712-9532","1918-1493"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","jufo-1","ki-jl-1","norway-1","poland-70","russia-white-list-2"],"host_organization":"https://openalex.org/P4310313016","host_organization_name":"Pulsus Group","host_organization_lineage":["https://openalex.org/P4310313016","https://openalex.org/P4310320466"],"host_organization_lineage_names":["Pulsus Group","OMICS Publishing Group"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Canadian Journal of Infectious Diseases and Medical Microbiology","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320316452","display_name":"Armauer Hansen Research Institute","ror":"https://ror.org/05mfff588"},{"id":"https://openalex.org/F4320323098","display_name":"Jimma University","ror":"https://ror.org/05eer8g02"},{"id":"https://openalex.org/F4320331136","display_name":"Madda Walabu University","ror":"https://ror.org/04zte5g15"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4293213090.pdf","grobid_xml":"https://content.openalex.org/works/W4293213090.grobid-xml"},"referenced_works_count":47,"referenced_works":["https://openalex.org/W197737186","https://openalex.org/W1926244529","https://openalex.org/W1991426693","https://openalex.org/W2002306802","https://openalex.org/W2006094917","https://openalex.org/W2008389680","https://openalex.org/W2012600468","https://openalex.org/W2022650284","https://openalex.org/W2066488874","https://openalex.org/W2067970576","https://openalex.org/W2072932749","https://openalex.org/W2088580357","https://openalex.org/W2095618448","https://openalex.org/W2107340859","https://openalex.org/W2125168028","https://openalex.org/W2132302715","https://openalex.org/W2133824626","https://openalex.org/W2472320328","https://openalex.org/W2498119267","https://openalex.org/W2515684719","https://openalex.org/W2520962153","https://openalex.org/W2529595675","https://openalex.org/W2565103424","https://openalex.org/W2574877663","https://openalex.org/W2692780334","https://openalex.org/W2734777287","https://openalex.org/W2760780347","https://openalex.org/W2775086596","https://openalex.org/W2887480480","https://openalex.org/W2943788676","https://openalex.org/W2947134490","https://openalex.org/W2952973864","https://openalex.org/W2957437912","https://openalex.org/W3009705041","https://openalex.org/W3017301554","https://openalex.org/W3036573352","https://openalex.org/W3044462873","https://openalex.org/W3047578780","https://openalex.org/W3047804275","https://openalex.org/W3093583398","https://openalex.org/W3106832146","https://openalex.org/W3138784179","https://openalex.org/W3148012559","https://openalex.org/W3161316134","https://openalex.org/W3165517670","https://openalex.org/W4213388422","https://openalex.org/W7094442314"],"related_works":["https://openalex.org/W6957913247","https://openalex.org/W2079580836","https://openalex.org/W7097105322","https://openalex.org/W2600676035","https://openalex.org/W4392613033","https://openalex.org/W6989376494","https://openalex.org/W4385975178","https://openalex.org/W2908949990","https://openalex.org/W2788342018","https://openalex.org/W2133824626"],"abstract_inverted_index":{"Background.":[0],"Global":[1],"tuberculosis":[2],"(TB)":[3],"disease":[4,245],"deaths":[5],"rise":[6],"comparable":[7],"to":[8,72,78,113,186,208,268,277],"the":[9,26,30,58,61,66,74,156,191,284,288,292,303,312,339],"one":[10],"seen":[11],"in":[12,18,40,55,84,107,283,311,353],"2015":[13],"(by":[14,20],"200,000)":[15],"or":[16,165,262],"even":[17],"2012":[19],"400,000)":[21],"as":[22,246],"a":[23,134],"result":[24],"of":[25,29,42,68,76,88,98,119,137,155,275,294,305,309,314],"potential":[27],"impact":[28],"COVID-19":[31],"pandemic.":[32],"Ethiopia\u2019s":[33],"Gambella":[34,85,108,285],"region":[35,286],"is":[36],"leading":[37],"for":[38,330,349],"years":[39],"terms":[41],"TB":[43,49,99,150,169,224,244,281,306,328,351],"cases":[44,129,143],"and":[45,130,144,241,297,317,324,342],"its":[46],"comorbidities.":[47],"The":[48,121,273],"control":[50,352],"program":[51],"effectiveness":[52],"depends":[53],"on":[54,57,96],"large":[56],"patients":[59,83,100,127,151,205,242,282],"completing":[60],"appropriate":[62],"treatment":[63,81,192,211,279],"regimen.":[64],"Hence,":[65],"objective":[67],"this":[69],"study":[70,93,289],"was":[71,94,125],"determine":[73],"determinants":[75,274],"nonadherence":[77,267,276],"anti-TB":[79,269,278],"drug":[80],"among":[82,280],"regional":[86],"state":[87],"Ethiopia.":[89],"Methods.":[90],"A":[91],"case-control":[92],"conducted":[95],"cohorts":[97],"sampled":[101],"from":[102,110],"four":[103],"public":[104],"health":[105,344],"facilities":[106],"Region":[109],"January":[111],"2019":[112],"2020,":[114],"followed":[115],"by":[116,337],"18":[117],"months":[118],"follow-up.":[120],"total":[122],"sample":[123],"size":[124],"296":[126],"(74":[128],"222":[131],"controls)":[132],"with":[133,181,201,219,237,256,266],"response":[135],"rate":[136],"97.3%":[138],"(288":[139],":":[140],"72":[141],"nonadhered":[142],"216":[145],"controls).":[146],"Cases":[147],"(nonadhered)":[148],"were":[149,160,260,291],"who":[152,162,171,206],"missed":[153],"10%":[154],"doses":[157],"while":[158],"controls":[159],"patients,":[161,170],"completed":[163],"90%":[164],"more":[166],"doses.":[167],"Results.":[168],"perceived":[172,318,335],"stigma":[173,336],"[AOR":[174,194,212,230,249],"=":[175,195,213,231,250],"2.7":[176],"at":[177,197,215,233,252,326],"95%":[178,198,216,234,253],"CI":[179,199,217,235,254],"(1.1\u20136.6)":[180],"P":[182,202,220,238,257],"value":[183,203,221,239,258],"<0.05],":[184,240],"failed":[185],"receive":[187],"any":[188],"counseling":[189,332],"during":[190,210,287],"course":[193],"65.24":[196],"(11.69\u2013363.95)":[200],"<0.01],":[204,222],"used":[207],"smoking":[209],"15.4":[214],"(7.7\u201330)":[218],"taking":[223],"medications":[225],"regularly":[226],"has":[227,346],"no":[228],"benefits":[229],"6.8":[232],"(1.8\u201324.9)":[236],"believing":[243],"not":[247],"severe":[248],"8.38":[251],"(2.0\u201334.6)":[255],"<0.05]":[259],"significantly":[261,264],"highly":[263],"associated":[265],"drugs":[270],"medications.":[271],"Conclusion.":[272],"period":[290],"absence":[293],"counselling":[295],"services,":[296],"patients\u2019":[298],"behavior":[299],"(smoking":[300],"habits,":[301],"undermining":[302],"severity":[304],"disease,":[307],"lack":[308],"trust":[310],"outcomes":[313],"regular":[315],"medications,":[316],"stigmatization).":[319],"Accordingly,":[320],"capacitating":[321],"healthcare":[322],"providers":[323],"workers":[325],"all":[327],"clinics":[329],"effective":[331,350],",":[333],"preventing":[334],"protecting":[338],"patient\u2019s":[340],"secrecy,":[341],"routine":[343],"education":[345],"paramount":[347],"importance":[348],"Gambella.":[354]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":3},{"year":2023,"cited_by_count":1}],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2022-08-27T00:00:00"}