Effect of Urea or Urea- Molasses Treated Maize Stover on Body Weight Change and Carcass Parameter on Hararghe Highland Sheep, Eastern Ethiopia

This experiment was conducted to evaluate feed intake, daily body weight gain (ADG) and carcass characteristics of feeding sheep with a basal diet of untreated and treated maize stover (MS) at Haramaya University. The experiment was conducted in a randomized complete block design using 20 intact male Hararghe Highland sheep having a mean initial body weight of 15.4 ± 0.57 kg (mean ± SD). The animals were grouped into five blocks based on initial body weight  and randomly assigned to four treatments; namely, untreated maize stover ad libitum (T1); urea treated maize stover (UTMS) ad libitum (T2); urea-molasses treated maize stover (UMTMS) ad libitum (T3 and T4). T1, T2 and T3 were supplemented with 300g concentrate mix of wheat bran (WB) and noug seed cake (NSC) at the ratio of 2:1. Hundred kg of maize stover (MS) was treated with 4 kg of urea dissolved in 100 liters of water alone or with additional 10% molasses. Water and block salt were available to the animal at all time. The crude protein (CP) content of MS, UTMS, UMTMS, NSC and WB were 5.9, 8, 10, 30.1, and 17.2%, respectively.  Higher (P<0.001) total DM intake was noted for sheep fed T2 (700.7 g/day) and T3 (770.9 g/day) diets than those fed T1 (538.28 g/day) and T4 (481.4 g/day). CP intake was in the same trend as dry matter intake. ADG was 45.1, 65, 69.1, and 20.7 g/day for T1, T2, T3 and T4, respectively, which was significantly higher (P<0.001) for T2 and T3 than T1 and T4. Furthermore, T1, T2 and T3 animals had higher (P<0.001) feed conversion efficiency, dressing percentages (P<0.001) and hot carcass weight (P<0.001) than T4 animals. In general, animals in T2 and T3 had 1.5 and 3.2 times higher average daily gain than those in T1 and T4, respectively. Similarly, animals in T1, T2 and T3 produced about 2.3 kg more carcasses than those in T4. The result revealed that supplementing either urea treated or urea-molasses treated maize stover is a better option to improve both biological and economic performance of sheep. But, no advantage was gained from treating maize stover with a blend of urea and molasses solution if the basal diet is supplemented with concentrate diet

Undernutrition among Pregnant Women in Rural Communities in Southern Ethiopia

Background: Maternal undernutrition rates in Ethiopia are among the highest in the world. In addition, a huge inequity exists within the country, with pregnant women in rural communities being at increased risk. This study assessed the prevalence of undernutrition and its associated factors among pregnant women in a rural community in southern Ethiopia. Methods: A community-based cross-sectional study was conducted among 376 randomly selected pregnant women. Data were collected through face-to-face interview followed by mid-upper arm circumference measurement. Household food insecurity and minimum dietary diversity for women were assessed. Data were entered into EpiData 3.1 and exported to SPSS 20 for analysis. Logistic regression models were fitted to check associations between independent variables and undernutrition. Statistical significance was set at p Results: The prevalence of undernutrition was 41.2% (95% CI 36.3%-46.3%). Unintended pregnancy (AOR 2.06, 95% CI 1.27-3.36) and not participating in Wome's Health Development Army meetings (AOR 3.64, 95% CI 1.51-8.77) were independent predictors of undernutrition. However, minimum dietary diversity for women of five or more food groups (AOR 0.24, 95% CI 0.07-0.82), having at least one antenatal care visit (AOR 0.46, 95% CI 0.27-0.78), age at first pregnancy >= 20 years (AOR 0.39, 95% CI 0.21-0.76), and being from food-secure households (AOR 0.26, 95% CI 0.16-0.43) were independent protective factors against undernutrition. Conclusion: Undernutrition among pregnant women was highly prevalent in the study area. Interventions aiming to reduce undernutrition should focus on discouraging teenage and unintended pregnancy, reducing household food insecurity, and promoting antenatal care visits and encouraging consumption of diversified diets by women. Strengthening the existing network of the Women's Health Development Army seems to be very important

Undernutrition among Institutionalized School-age Orphans in Harari Regional State, Eastern Ethiopia:A Cross-sectional Study

Background: Although orphans are at increased risk of undernutrition, studies assessing prevalence of undernutrition are limited to orphans residing with their relatives or on street. This study was conducted to assess magnitude of undernutrition and its associated factors among institutionalized school-age orphans in Harari Regional State, eastern Ethiopia. Methods: An institution based cross-sectional study was conducted among all school-age (6-12 years) orphans living in all orphan centers in Harari Regional State, eastern Ethiopia. Data were collected by using a structured pretested questionnaire supplemented with anthropometric measurements. Data were entered using EpiData 3.1 and analyzed using SPSS 22. Logistic regression models were fitted to identify factors associated with undernutrition. Statistical significance was declared at P-value Results: A total of 265 orphans residing in all orphan centers in the region were included. The prevalence of stunting, wasting, and underweight were 15.8% (95% CI: 11.9, 20.7), 10.9% (95% CI: 7.7, 15.3), and 8.7% (95% CI: 4.3, 10.5), respectively. Staying in orphan center for 6 to 10 years (AOR = 6.2; 95% CI: 2.6, 15.10), having recent illness (AOR = 3.9; 95% CI: 1.4, 10.4), and being aged 10 to 12 years (AOR = 11.2; 95% CI: 3.5, 35.4) were significantly associated with stunting whereas having recent illness (AOR = 4.3; 95% CI: 1.4, 7.3) and being aged 6 to 7 years (AOR: 10.4; 95% CI: 3.2, 33.6) were significantly associated with wasting. Underweight was more likely (AOR: 8.9; 95% CI: 2.7, 29.5) among children with recent illness. Conclusions: Almost 1 in 6, 1 in 9, and 1 in 11 institutionalized school-age orphans in Harari Regional State were stunted, wasted, and underweight respectively. Younger children and those with recent illness were more likely to be undernourished. Underlying reasons for undernutrition among orphans being cared in orphan centers should be further explored

Integrated geophysical imaging of the Aluto-Langano geothermal field (Ethiopia)

The Aluto-Langano geothermal system is located in the central part of the Main Ethiopian Rift, one of the world\u2019s most tectonically active areas, where continental rifting has been occurring since several Ma and has yielded widespread volcanism and enhanced geothermal gradient. The geothermal system is associated to the Mt Aluto Volcanic Complex, located along the eastern margin of the rift and related to the Wonji Fault Belt, constituted by Quaternary NNE-SSW en-echelon faults. These structures are younger than the NE-SW border faults of the central Main Ethiopian Rift and were originated by a stress field oblique to the rift direction. This peculiar tectonism yielded local intense rock fracturing that may favour the development of geothermal reservoirs. In this paper, we present the results of an integrated geophysical survey carried out in 2015 over an area of about 200 km2 covering the Mt Aluto Volcanic Complex. The geophysical campaign included 162 coincident magnetotelluric and time domain electromagnetic soundings, and 207 gravity stations, partially located in the sedimentary plain surrounding the volcanic complex. Three-dimensional inversion of the full MT static-corrected tensor and geomagnetic tipper was performed in the 338-0.001 Hz band. Gravity data processing comprised digital enhancement of the residual Bouguer anomaly and 2D-3D inverse modelling. The geophysical results were compared to direct observations of stratigraphy, rock alteration and temperature available from the several deep wells drilled in the area. The magnetotelluric results imaged a low-resistivity layer which appears well correlated with the mixed alteration layer found in the wells and can be interpreted as a low-temperature clay cap. The clay-cap bottom depth is well corresponds to a change of thermal gradient. The clay cap is discontinuous, and in the central area of the volcanic complex is characterised by a dome-shape structure likely related to isotherm rising. The propilitic alteration layer, pinpointed as the 80-Ohm-m isosurface, shows two dome-shape highs. The first is NNE-trending, and may be interpreted as an upflow zone along a fault of the Wonji belt. Two productive wells are located along the borders of this area, as well as the alignements of fumaroles and altered grounds. The second is linked to a wide resistive area, located at shallow depth, where no clay cap was detected. It could be interpreted as a fossil high-temperature alteration zone reaching shallow depths, and it is associated to several fumaroles. Modeling of 2D/3D gravity data shows that the anomalies are due to shallow density variations likely related to lithology. The deep lateral variations due to structural lineaments inferred from well stratigraphy have no detectable signature. However, the trend analysis performed on the residual Bouguer anomaly (via horizontal and tilt derivative computations), allowed to identify five lineaments. Three of them exhibit NNE-SSW strike, corresponding to the Wonji Fault Belt Trend, whereas two have NNW-SSE strike, corresponding to the Red Sea Rift trend, which in this area is of minor evidence. The signature of shallow structures is then indicative of major regional structures. One of the lineaments marks the presence of a major fumarolic zone

Protocol for the evaluation of a complex intervention aiming at increased utilisation of primary child health services in Ethiopia: a before and after study in intervention and comparison areas.

BACKGROUND: By expanding primary health care services, Ethiopia has reduced under-five mor4tality. Utilisation of these services is still low, and concerted efforts are needed for continued improvements in newborn and child survival. "Optimizing the Health Extension Program" is a complex intervention based on a logic framework developed from an analysis of barriers to the utilisation of primary child health services. This intervention includes innovative components to engage the community, strengthen the capacity of primary health care workers, and reinforce the local ownership and accountability of the primary child health services. This paper presents a protocol for the process and outcome evaluation, using a pragmatic trial design including before-and-after assessments in both intervention and comparison areas across four Ethiopian regions. The study has an integrated research capacity building initiative, including ten Ph.D. students recruited from Ethiopian Regional Health Bureaus and universities. METHODS: Baseline and endline surveys 2 years apart include household, facility, health worker, and district health office modules in intervention and comparison areas across Amhara, Southern Nations Nationalities and Peoples, Oromia, and Tigray regions. The effectiveness of the intervention on the seeking and receiving of appropriate care will be estimated by difference-in-differences analysis, adjusting for clustering and for relevant confounders. The process evaluation follows the guidelines of the UK Medical Research Council. The implementation is monitored using data that we anticipate will be used to describe the fidelity, reach, dose, contextual factors and cost. The participating Ph.D. students plan to perform in-depth analyses on different topics including equity, referral, newborn care practices, quality-of-care, geographic differences, and other process evaluation components. DISCUSSION: This protocol describes an evaluation of a complex intervention that aims at increased utilisation of primary and child health services. This unique collaborative effort includes key stakeholders from the Ethiopian health system, the implementing non-governmental organisations and universities, and combines state-of-the art effectiveness estimates and process evaluation with capacity building. The lessons learned from the project will inform efforts to engage communities and increase utilisation of care for children in other parts of Ethiopia and beyond. TRIAL REGISTRATION: Current Controlled Trials ISRCTN12040912, retrospectively registered on 19 December, 2017

Multidisciplinary exploration of the Tendaho Graben geothermal fields

The NW-SE trending Tendaho Graben is the major extensional feature of the Afar, Ethiopia. Rifting and volcanic activity within the graben occurred mostly between 1.8 and 0.6 Ma, but extended to at least 0.2 Ma. Very recent (0.22\u2013 0.03 Ma) activity is focused along the southern part of the younger and active Manda Hararo Rift, which is included in the north-western part of the graben. Extension gave rise to about 1600 m of vertical displacement (verified by drilling) of the basaltic Afar Stratoid sequence, over a crust with a mean thickness of about 23 km. The infill of graben, overlying the Stratoids, consists of volcanic and sedimentary deposits that have been drilled by six exploratory wells. Within the graben, two main geothermal fields have been explored by intensive geological, geochemical and geo- physical surveys over an area that approximately covers a square sector of 40x40 km. Both new and existing data sets have been integrated. The Dubti-Ayrobera system is located along the central axis of the graben. Available data, acquired in the last three decades, comprise more than two thousands gravity and magnetic stations, 229 magnetotelluric stations and structural-geological and geochemical observations. The Alalobeda system is located along the SW flank of the graben, at about 25 km from the Dubti-Ayrobera system and has been very recently stud- ied by means of gravimetric (300 stations), magnetotelluric and TDEM (140 stations) geological and geochemical surveys. The new residual magnetic anomaly map has been used to map the younger normal polarity basalt distribution and infer the location of the unknown main rift axis. The bedrock surface resulting by the 3D inversion of the new residual Bouguer anomaly enlightens the main normal faults hindered by sediments and the secondary structures represented by horsts and grabens. The three-dimensional resistivity models allow mapping the sedimentary infill of the graben, fracture zones in the Afar Stradoids bedrock and the dome-shape structure of the clay cap layer. The 2D and 3D gravimetric, magnetic and resistivity models have been integrated with the structural, geological and geochemical outcomings in order to get an updated conceptual model of the geothermal systems

Does a complex intervention targeting communities, health facilities and district health managers increase the utilisation of community-based child health services? A before and after study in intervention and comparison areas of Ethiopia.

INTRODUCTION: Ethiopia successfully reduced mortality in children below 5 years of age during the past few decades, but the utilisation of child health services was still low. Optimising the Health Extension Programme was a 2-year intervention in 26 districts, focusing on community engagement, capacity strengthening of primary care workers and reinforcement of district accountability of child health services. We report the intervention's effectiveness on care utilisation for common childhood illnesses. METHODS: We included a representative sample of 5773 households with 2874 under-five children at baseline (December 2016 to February 2017) and 10 788 households and 5639 under-five children at endline surveys (December 2018 to February 2019) in intervention and comparison areas. Health facilities were also included. We assessed the effect of the intervention using difference-in-differences analyses. RESULTS: There were 31 intervention activities; many were one-off and implemented late. In eight districts, activities were interrupted for 4 months. Care-seeking for any illness in the 2 weeks before the survey for children aged 2-59 months at baseline was 58% (95% CI 47 to 68) in intervention and 49% (95% CI 39 to 60) in comparison areas. At end-line it was 39% (95% CI 32 to 45) in intervention and 34% (95% CI 27 to 41) in comparison areas (difference-in-differences -4 percentage points, adjusted OR 0.49, 95% CI 0.12 to 1.95). The intervention neither had an effect on care-seeking among sick neonates, nor on household participation in community engagement forums, supportive supervision of primary care workers, nor on indicators of district accountability for child health services. CONCLUSION: We found no evidence to suggest that the intervention increased the utilisation of care for sick children. The lack of effect could partly be attributed to the short implementation period of a complex intervention and implementation interruption. Future funding schemes should take into consideration that complex interventions that include behaviour change may need an extended implementation period. TRIAL REGISTRATION NUMBER: ISRCTN12040912

Antenatal care utilization and nutrition counseling are strongly associated with infant and young child feeding knowledge among rural/semi-urban women in Harari region, Eastern Ethiopia

There is a gap in evidence linking antenatal care (ANC) utilization, nutrition counseling, and knowledge of pregnant women about infant and young child feeding (IYCF), particularly in low-income settings. Therefore, this study aimed to identify the association between ANC follow-up and nutrition counseling with IYCF knowledge. A cross-sectional study was conducted among 390 pregnant women in the rural kebeles of the Harari region from January to June 2019. Data were collected using face-to-face interviews on tablet computers. Bivariate and multivariate logistic regression were employed. An adjusted odds ratio (with 95% CI) was used to determine the strength of association between IYCF knowledge with ANC follow-up and nutrition counseling by adjusting for educational status, occupation, gravida, and distance to the nearest health center. Overall, 54.4% [95% CI 49.2, 59.2] of currently pregnant women were knowledgeable about IYCF of which only 20% started ANC follow-up and 24.4% received nutrition counseling. Out of 288 multigravida women, only 51.4% had ANC follow-up during their last pregnancy. In the adjusted model, ANC follow-up during the current pregnancy (AOR 1.85, 95% CI 1.07–3.22), those who received nutrition counseling (AOR 1.92, 95% CI 1.09–3.38), literate in education (AOR 1.71, 95% CI 1.07–2.73), multigravida (AOR 1.96, 95% CI 1.12–3.43), and far from the nearest health center (AOR 0.95, 95% CI 0.93–0.97) were significantly associated with the mothers IYCF knowledge. Thus, health care providers should encourage mothers to attend ANC during pregnancy and provide nutrition counseling about the IYCF

Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021

Background Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. Methods We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures—borrowing strength from predictive covariates and across age, time, and geography—and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). Findings Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1–16·5), to 515 000 (425 000–614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3–44·9), from 5·46 million (4·62–6·45) in 2000 to 7·74 million (6·51–9·2) in 2021. We estimated 34 400 (25 000–45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000–467 000). In children younger than 5 years, there were 81 100 (58 800–108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. Interpretation Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease.publishedVersio

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe