Background:
According to current estimates, there are 665,723 people in Ethiopia who have human immunodeficiency syndrome. As Ethiopia inches closer to attaining the 95/95/95 targets for treatment ...coverage and reaching epidemic control, however, attrition from anti-retroviral treatment is still one of the key programmatic challenges.
Objective:
To assess the incidence of attrition rate and its predictors among adult HIV patients receiving anti retro viral treatment at Public Health Facility in Adea Berga/Enchini District.
Method:
A 6-year (June 28, 2015 to June 27, 2021) institution-based retrospective cohort study was used to recruit 540 study participants by using simple random sampling. Data were obtained from chart review, coded, entered into Epi Data, and exported to Stata 14.2 software for analysis. At least 1 month missed appointment is considered as attrition and the predictors of attrition were identified using bivariable and multivariable Cox proportional hazard models and an adjusted hazard ratio (AHR). Bivariate and multivariate analyses were conducted to find predictors of attrition, p-value < 0.05 was considered statistically significant.
Results:
From the total 540 study participant, 158 (29.26%) patients were discontinuing from follow up making the incidence rate of attrition 9.50 per 100 person years .Being WHO clinical stage III or IV (AHR = 1.96,), non-practice of Appointment spacing model (AHR = 3.98), poor or fair ART adherence level (AHR = 6.47), age groups (15–24) years (AHR = 1.73) and Others ART linkage pointsindex case testing, tuberculosis clinic and referral from private/public health institutions (AHR = 1.76) were significantly associated.
Conclusions:
The study showed that the incidence of attrition among adults receiving antiretroviral therapy was high. Patient sociodemographic, clinical, and treatment-related factors were significantly associated with patients on ART.
Anemia during pregnancy is a public health problem and is related to negative birth outcomes, especially in developing countries. The main aim of this study was to assess predictors of anemia among ...pregnant women attending antenatal clinics at Hiwot Fana Comprehensive Specialized University Hospital, Eastern Ethiopia.
Unmatched case-control study design was employed among 352 individuals. A face-to-face interview was used to gather data, and each pregnant woman's antenatal care follow-up record cards were reviewed in addition to the interview. EpiData version 3.1 and IBM SPSS version 26 was used for data entry and analysis, respectively. Bivariable and multivariable analyses were conducted to identify predictors of anemia, a p-value of <0.05 was considered a statistically significant association.
The common determinants for anemia in pregnant mothers were: rural residency (AOR = 2.25, 95% CI: 1.14-4.8), no formal education (AOR = 4.4, 95% CI: 1.94-9.9), inter-pregnancy interval (AOR = 2.7, 95% CI: 1.24-5.8), and mid-upper arm circumference (AOR = 5.0, 95% CI: 2.0-12.7).
In this study, the identified determinant factors for anemia were: rural residency, maternal educational status, inter-pregnancy-interval, and mid-upper arm circumference. Therefore, providing health education and promotion for pregnant women regarding anemia by focusing on rural residents and counseling to lengthen their birth spacing is an important task. Moreover, counseling on taking iron supplementation as suggested and consuming a diet rich in iron during antenatal care will be recommended.
Child mortality is high in Ethiopia, but reliable data on the causes of death are scarce. We aimed to gather data for the contributory causes of stillbirth and child deaths in eastern Ethiopia.
In ...this population-based post-mortem study, we established a death-notification system in health facilities and in the community in Kersa (rural), Haramaya (rural) and Harar (urban) in eastern Ethiopia, at a new site of the Child Health and Mortality Prevention Surveillance (CHAMPS) network. We collected ante-mortem data, did verbal autopsies, and collected post-mortem samples via minimally invasive tissue sampling from stillbirths (weighing at least 1000 g or with an estimated gestational age of at least 28 weeks) and children who died younger than 5 years. Children—or their mothers, in the case of stillbirths and deaths in children younger than 6 months—had to have lived in the catchment area for the past 6 months to be included. Molecular, microbiological, and histopathological analyses were done in collected samples. Cause of death was established by an expert panel on the basis of these data and classified as underlying, comorbid, or immediate separately for stillbirths, neonatal deaths (deaths aged 0–27 days), and child deaths (aged 28 days to <5 years).
Between Feb 4, 2019, and Feb 3, 2021, 312 deaths were eligible for inclusion, and the families gave consent in 195 (63%) cases. Cause of death was established in 193 (99%) cases. Among 114 stillbirths, the underlying cause of death was perinatal asphyxia or hypoxia in 60 (53%) and birth defects in 24 (21%). Among 59 neonatal deaths, the most common underlying cause was perinatal asphyxia or hypoxia (17 29%) and the most common immediate cause of death was neonatal sepsis, which occurred in 27 (60%). Among 20 deaths in children aged 28 days to 59 months, malnutrition was the leading underlying cause (15 75%) and infections were common immediate and comorbid causes. Pathogens were identified in 19 (95%) child deaths, most commonly Klebsiella pneumoniae and Streptococcus pneumoniae.
Perinatal asphyxia or hypoxia, infections, and birth defects accounted for most stillbirths and child deaths. Most deaths could have been prevented with feasible interventions, such as improved maternity services, folate supplementation, and improved vaccine uptake.
Bill & Melinda Gates Foundation.
The Oromia regional state is significantly vulnerable to the impacts of drought. The majority of the population of the region is involved in agricultural and pastoral activities for their livelihood. ...Agriculture is predominantly dependent on the right onset, amount, period, and distribution of seasonal rainfall. Though there is abundant water resource in the region, irrigation contributes only 5% to produce agricultural products. This makes the region susceptible to the impacts of climatic extreme events such as drought. Yet, there are only a few studies on the spatial and temporal analysis of droughts over the Oromia regional state. This study examines the spatial and temporal characteristics of drought in the period 1989 to 2019 over the region using Standardized Precipitation and Evapotranspiration (SPEI) and Standardized Precipitation Index (SPI) drought indices. We assess temporal trends of drought over the region using Mann–Kendall trend test. We also assess the role of El Niño-Southern Oscillation (ENSO) in inducing seasonal droughts. Complex spatial and temporal patterns of drought occurrences are observed. The drought incidences at each of the stations have diverse magnitudes and durations. Drought during Belg season is more frequent over the southern and eastern parts of the region, whereas it is less frequent over the western and central parts. The spatial coverage of Belg droughts had increased over the study area since 1997 and decreased in recent years, particularly since 2016. On the other hand, drought during Kiremt season is more frequent over western parts of the region, whereas it is less frequent over southern and eastern parts. The year 2002 was the driest year with significant parts of the region having considerably severe Kiremt droughts. The years 1991, 2000, 2002, 2009, and 2015 were among the major drought years in the region; at least 34% of the region experienced annual droughts. There were 26 stations that showed increasing dry tendencies and 28 stations that showed wetting tendencies. Since a mix of signals in wet and dry tendencies exist in the region, clustering into homogeneous hydroclimatic zones is important in future studies. ENSO and seasonal drought over the region was found to be fairly associated.
Potato virus Y (PVY) is an aphid-borne plant virus that causes substantial yield losses in potato production. Control measures of the viral infection are both limited and expensive. A proper use of ...mixed-cropping strategy can reduce the spread of PVY. In this paper, we formulate and analyze a mathematical model of PVY spread in a mixed-cropping system. Then, we extend the model to an optimal control problem by considering use of mineral oil, insecticide and farmer’s level of field inspection for infected plants. The analytic results show that the basic reproduction number ℜ0, a threshold parameter that decides properties of the dynamics. The disease free equilibrium is stable if ℜ0 < 1 and unstable when ℜ0 > 1. It is found that ℜ0, and hence, the disease dynamics is highly sensitive to the representative parameters of density the non-host plant and its quality in attracting vectors. The model exhibits forward bifurcation at ℜ0 = 1. The study of optimal control problem suggests that mixed-cropping combined with either mineral oil or insecticide is the best to control the disease. Furthermore, simulation results show that mixed-cropping can be used as an alternative strategy and can reduce the need of mineral oil or insecticide.
The electronic community health information system (eCHIS) has been implemented in Ethiopia to support health services delivered by community health workers. Despite the many benefits of digitizing ...community health information systems, the implementation of the eCHIS is challenged by many barriers resulting in low uptake. This study assessed the barriers, facilitators, and motivators of eCHIS use among health workers with focus on health extension workers (HEWs) in Ethiopia.
Phenomenological approach was used to assess the barriers, facilitators and motivators of eCHIS use in Amhara, Harari, Oromia, Sidama, South West Ethiopia and Southern Nation Nationalities and People's regions of Ethiopia. Data were collected from 15-29 May 2022. A total of 54 face-to-face in-depth interviews were conducted among HEWs, HEW supervisors, health information technicians and managers. The interviews were audiotaped using Open Data Kit, transcribed verbatim and translated into English. OpenCode 4.03 software was used for coding and categorizing the data. Thematic analysis was used to analyze the data.
The HEWs and other eCHIS users reported lack of infrastructure and resources; poor quality of training, follow-up, and supervision; parallel recording using the manual and electronic system; and HEWs' workload as barriers hindering eCHIS use. Data quality, retrievability, and traceability; tablet portability; encouragement from supervisors; and positive image in the community resulting from HEWs using tablets in their routine activities were the main facilitators of eCHIS use.
The study identified various barriers that adversely affect the use of eCHIS. An integrated and coordinated approach to eCHIS implementation that encompasses removing the barriers, and reinforcing facilitators is required.
Maize is the second most widely grown cereal and gaining importance as a highly nutritious crop in Ethiopia. However, it is severely destroyed by storage insect pests and needs further research to ...minimize losses. In line with this, research was initiated to evaluate the efficacy of two botanical plant powders (Eucalyptus globulus Labill leaf and Chenopodium ambrosioides L. whole plant) against storage insect pests of maize grains of two maize varieties (BH-661 and Limu) in polypropylene sacks storage conditions at Jimma Zone, Sokoru district. The plant powders were compared with untreated control, and completely randomized design was used in the experiment with three replications for each treatment. Germination capacity, thousand grain weights, percent of insect damage, and weight loss of the stored grains were evaluated and reported in the range of 69.67–94.33%, 318.7–339.3 g, 3.67–50%, and 0.2843–5.22%, respectively, after five months of storage for grains treated with botanicals. However, germination capacity of 10% and 65.33%, percent insect damage of 80.33% and 48%, and weight loss of 23.53% and 5.89% were observed for BH-661 and Limu varieties, respectively, after five months of storage for untreated control. The result indicated that both tested botanicals were effective in protecting the storage insect pests and maintaining the quality of the grains tested in comparison with control and Chenopodium ambrosioides L. whole plant powder is more effective. Although there was significant protective effect compared to untreated control, their effectiveness was decreased drastically after five and three months of storage for Chenopodium ambrosioides L. whole plant powder and Eucalyptus globulus Labill leaf powder, respectively. It is recommended that further research should be done to check if the increasing rate of application increases protection duration of these botanicals and the toxicity of Chenopodium ambrosioides L. should be further studied to use it as a storage insect protectant of maize grains intended for food purpose.
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