Hypospadias Repair in Ethiopia: A Five Year Review

BACKGROUND: Hypospadias repair is one of the problematic issues in pediatric surgery. As a result of the multiple complications following the procedure, a variety of techniques have been used and newer methods continue to emerge. There is still controversy regarding the best method of repair. We aimed to determine the outcome of surgery and factors contributing to unfavorable outcomes in children with hypospadias.MATERIALS AND METHODS: This is a retrospective review undertaken from September 2009 to August 2014. The research was conducted at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. All children who underwent hypospadias repair and had regular follow-up were included in the study.RESULTS: A total of 202 boys aged less than 13 years were assessed. Most surgeries (80.3%) were performed in children older than 18 months. Transverse incised plate urethroplasty (TIP) was frequently performed for distal hypospadias (71.2 %), while transverse ventral preputal flap (TVPF) was the most common procedure done for proximal hypospadias (62.8 %). Overall success rate for first surgery was 55.9 %. There was a high rate of major post-operative complications (44.1%) of which urethrocutaneous fistula (UCF) was the most common (31.2%) followed by meatal stenosis and glans breakdown (7.4 % each). These complications were found to be higher in those who were operated at a later age and those with proximal hypospadias (p=0.03 and p=0.01 respectively). There was also a significant difference among the type of procedures with TIP and TVPF having the least complications (p<0.01).CONCLUSION: From our experience, we found TIP a relatively safe and reliable method of repair for distal hypospadias while TVPF single stage repair was superior in the proximal ones. The high rate of complications in our institution was associated with higher burden of severe hypospadias and older age at surgery.

New Test Day Model for the Genetic Evaluation of mastitis in dairy cattle

In this study, genetic parameters of test-day (TD) somatic cell score (SCS) and lactation average (LA)clinical mastitis (CM) were estimated using a random regression model (RRM) that combine two differentdata models. A multitrait RRM (mt-RRM) was then developed for the genetic evaluation of mastitis.Estimates of breeding values (EBVs) from the mt-RRM were compared to corresponding multitrait LAmodel (biv-LAM) and univariate LA models (univ-LAM). A total of 147500 and about 5.6 million recordsfrom 27500 and 1.4 million Finnish Ayrshire cows were used for estimation of genetic parameters andprediction of breeding values, respectively. Heritabilities of CM1 and CM2 traits: (CM1, -7 to 30 andCM2, 31 to 300 DIM) were 0.026 and 0.016, respectively, while for TD SCS they ranged from 0.06 to0.11. During first lactation, the genetic correlations between TD SCS and CM1 and between TD SCS andCM2 varied from 0.40 to 0.77 and from 0.34 to 0.71, respectively. In genetic evaluation of mastitis, modelcomparisons have showed that mt-RRM has high model predictive ability and high standard deviation ofbreeding values. Moreover, it has added advantages of making efficient use of available TD SCSinformation and offers proofs for bulls and cows. Therefore, mt-RRM can be used as best practical modelin the future evaluation of animals for mastitis resistance

Effect of processing method on the Proximate composition, mineral content and antinutritional factors of Taro (Colocasia esculenta, L.) growth in Ethiopia

Although taro is widely grown in Ethiopia, it is an underutilized crop and little is known about its proximate and micro-element composition and the antinutritional factors of the raw, boiled and fermented products. Boiling and fermentation processing techniques are widely used in the country, especially within the rural community of the Southern region where the crop grows widely. A cultivar of taro grown in the country was analyzed for proximate and mineral composition and antinutritional factors. An investigation was also made on the effects of boiling and fermentation on the nutritional contents. Protein, fat, fiber, total ash and utilizable carbohydrates, respectively were found to be 6.43, 0.47, 2.63, 4.82 and 85.65%, while the Gross Energy was 372.55 Kcal/100g. The contents of the micronutrients namely: Fe, Zn, Mg, Ca, Na, P and Mn were 5.86, 43.08, 7.24, 45.23, 13.81, 7.77 and 3.61 mg/100g, respectively. Phytate for the raw product was 115.43 while oxalate and tannin were 243.06 and 47.69 mg/100g, respectively. Cyanide was not detected in all the samples. There was a significant difference (p < 0.05) in the contents of the proximate and mineral composition and antinutritional factors during boiling and fermentation. The protein content was lower by 9.37% and 8.46%, respectively, in the boiled and fermented products, under the sampling and processing conditions used in the study. The crude fat content was significantly different (p < 0.05) from the crude fat content of the boiled product which was 0.87%. On the other hand, analysis of variance conducted showed that the fiber content of raw sample was significantly different from the fermented samples. Fermentation resulted in a lower level of fiber which was 6.44% and phytates of about 84.75%. Boiling of taro resulted in a higher value of oxalate (70.9%). The data presented in this paper provide an evidence of the potential of Boloso I (which is one variety of taro) to serve as a nutrient dense product for the Ethiopian population provided that the techniques of its processing are optimized.Keywords: Ethiopia, Taro, Oxalates, PhytatesAfrican Journal of Food, Agriculture, Nutrition and Development, Volume 13 No. 2 April 201

Proximate composition, mineral content and antinutritional factors of some capsicum (Capsicum annum) varieties grown in Ethiopia

This study was conducted to generate baseline information on the nutritional composition, mineral content and antinutritional factors of three capsicum varieties (Marako fana, Bako local and Oda haro) grown in Ethiopia. In relation to proximate composition, Marako fana, Bako local and Oda haro contained 9.2, 9.0 and 8.8% moisture; 11.9, 8.8 and 9.2% crude protein; 27.3, 26.0 and 28.6% crude fiber and 11.2, 9.5 and 9.2% fat (oleoresin) on wet weight basis. They also contained 1.7, 1.6 and 1.8 mg/100 g potassium; 27.2, 38.2 and 54.6 mg/100 g calcium and 7.2, 6.9 and 9.6 mg/100 g iron on wet weight basis. Tannin was found to be 0.142, 0.164 and 0.148 mg/100 g, respectively, while phytate was not detected in any of the samples. Analysis of variance and LSD (least significant difference) test revealed that protein and oleoresin of Marako fana were significantly higher (p less than 0.05) than Bako local and Oda haro. Potassium, calcium and iron contents of Oda haro were significantly higher (p less than 0.05). Based on these results Marako fana is preferable for large scale production of oleoresin, while Oda haro is nutritionally preferable because it contains high amounts of potassium, calcium and iron.KEY WORDS: Capsicum, Ethiopia, Composition, Mineral, Antinutrients Bull. Chem. Soc. Ethiop. 2011, 25(3), 451-454

Prevalence and Correlates of Mental Distress Among Working Adults in Ethiopia

Objective: To evaluate the prevalence of mental distress and its correlates among working Ethiopian adults. Methods: This cross-sectional study of 2,180 individuals (1,316 men and 864 women) was conducted among working adults in Addis Ababa, Ethiopia. A structured questionnaire was used to collect information on socio-demographic and lifestyle characteristics of participants. Mental distress was assessed using the self-reporting questionnaire (SRQ). Logistic regression was employed to estimate adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Results: The prevalence of mental distress in the study sample was 17.7% (25.9% in women and 12.4% in men). Younger participants (age ≤24 years) had the highest prevalence of mental distress (35.5% in women and 16.7% in men). The odds of mental distress was 2.47-fold higher among women as compared with men (OR=2.47, 95% CI 1.97-3.09). Participants reporting excellent health status had a 50% reduced odds of mental distress (OR=0.47; 95%CI: 0.38-0.59); and moderate alcohol consumption was associated with a slight increased odds of mental distress (OR=1.26; 95%CI: 1.00-1.67). Conclusion: A high prevalence of mental distress was observed among working adults in Ethiopia. Our findings suggest that the workforce institutions should provide targeted prevention and intervention programs to improve the mental health state of their employees. National mental health policy that clearly outlines and addresses mental distress among working adults is also warranted

Pragmatism in practice: lessons learned during screening and enrollment for a randomised controlled trial in rural northern Ethiopia

Background. We use the example of the Gojjam Lymphoedema Best Practice Trial (GoLBeT), a pragmatic trial in a remote rural setting in northern Ethiopia, to extract lessons relevant to other investigators balancing the demands of practicality and community acceptability with internal and external validity in clinical trials. Methods. We explain in detail the preparation for the trial, its setting in northern Ethiopia, the identification and selection of patients (inclusion and exclusion criterion, identifying and screening of patients at home, enrollment of patients at the health centres and health posts), and randomisation. Results. We describe the challenges met, together with strategies employed to overcome them. Conclusions. Examples given in the previous section are contextualised and general principles extracted where possible. We conclude that it is possible to conduct a trial that balances approaches that support internal validity (e.g. careful design of proformas, accurate case identification, control over data quality and high retention rates) with those that favour generalisability (e.g. ‘real world’ setting and low rates of exclusion). Strategies, such as Rapid Ethical Assessment, that increase researchers’ understanding of the study setting and inclusion of hard-to-reach participants are likely to have resource and time implications, but are vital in achieving an appropriate balance

Preparing for and executing a randomised controlled trial of podoconiosis treatment in Northern Ethiopia: the utility of rapid ethical assessment

Background Community-based randomized controlled trials are often complex pieces of research with significant challenges around the approach to the community, information provision, and decision-making, all of which are fundamental to the informed consent process. We conducted a rapid ethical assessment to guide the preparation for and conduct of a randomized controlled trial of podoconiosis treatment in northern Ethiopia. Methods A qualitative study was carried out in Aneded woreda, East Gojjam Zone, Amhara Regional State from August to September, 2013. A total of 14 In-depth Interviews (IDIs) with researchers, experts, and leaders, and 8 Focus Group Discussions (FGDs) involving 80 participants (people of both gender, with and without podoconiosis), were conducted. Interviews were carried out in Amharic. Data analysis was started alongside collection. Final data analysis used a thematic approach based on themes identified a priori and those that emerged during the analysis. Results Respondents made a range of specific suggestions, including that sensitisation meetings were called by woreda or kebele leaders or the police; that Health Extension Workers were asked to accompany the research team to patients’ houses; that detailed trial information was explained by someone with deep local knowledge; that analogies from agriculture and local social organisations be used to explain randomisation; that participants in the ‘delayed’ intervention arm be given small incentives to continue in the trial; and that key community members be asked to quell rumours arising in the course of the trial. Conclusion Many of these recommendations were incorporated into the preparatory phases of the trial, or were used during the course of the trial itself. This demonstrates the utility of rapid ethical assessment preceding a complex piece of research in a relatively research-naive setting

Genetic parameters for cow-specific digestibility predicted by near infrared reflectance spectroscopy

Digestibility traits included in this study were dry matter digestibility (DMD, g/kg), which was calculated based on the indigestible neutral detergent fibre (iNDF, g/kg of dry matter) content in faeces (iNDFf) and in diet (iNDFd), and iNDFf predicted directly from faecal samples by near infrared reflectance spectroscopy (NIRS). The data set was collected at three research herds in Finland and one in Norway including in total 931 records from 328 lactating Nordic Red Cattle and Holstein cows. Observations were associated with different accuracy, due to the differences in sampling protocols used for collecting faecal samples. Heritability estimates varied between different sampling protocols and ranged from 0.14 ± 0.06 to 0.51 ± 0.24 for DMD and from 0.13 ± 0.05 to 0.48 ± 0.18 for iNDFf. Estimated genetic standard deviations were 10.5 g/kg and 6.2 g/kg dry matter for DMD and iNDFf, respectively. Results of our study indicated that recording only the iNDF content in the faeces is sufficient to determine genetic variation in cows’ ability to digest feed. The coefficient of genetic variation for DMD was rather small (1.7%), but could be utilized if it is supported by a positive analysis of benefits over costs.Peer reviewe

Awake prone positioning for COVID-19 patients at Eka Kotebe General Hospital, Addis Ababa, Ethiopia: A prospective cohort study

Objectives: The objectives of the study were to evaluate the benefit of awake prone positioning in COVID-19 patients hospitalized at Eka Kotebe General Hospital, Addis Ababa, Ethiopia.Materials and Methods: Consecutive patients with COVID-19 who require supplemental oxygen to maintain oxygen saturation of ≥90% during the month of October 2020 were enrolled. Structured questionnaires were employed to collect data. Admission oxygen saturation was recorded for each patient before and after their first proning session. Analysis of descriptive and comparison statistics was done using SPSS version 25.Results: A total of 61 patients were included in the study. The mean age (+SD) for the cohort was 55.4 (+16.9) years. The average duration of proning was 5+2.5 h/session and 8+6 h/day. The average oxygen saturation before proning was 89% (SD 5.2) and 93% (SD 2.8) 1 h after proning (P < 0.001); supplemental oxygen requirements significantly decreased with prone ventilation, before proning: FiO2 0.33 (+0.14) versus 1 h after prone ventilation: FiO2 0.31 (+0.13) (P < 0.001). Oxygen improvement with prone ventilation was not associated with duration of illness or total prone position hours. When assessed at 28 days after admission, 55.7% (n = 34) had been discharged home, 1.6% (n = 1) had died, and 42.6 (n = 26) were still hospitalized.Conclusion: Awake prone positioning demonstrated improved oxygen saturation in our oxygen requiring COVID-19 patients. Even though further studies are needed to support causality and determine the effect of proning on disease severity and mortality, early institution of prone ventilation in appropriate oxygen requiring COVID-19 patients should be encouraged