Modeling trends of health and health related indicators in Ethiopia (1995-2008): a time-series study

<p>Abstract</p> <p>Background</p> <p>The Federal Ministry of Health of Ethiopia has been publishing Health and Health related indicators of the country annually since 1987 E.C. These indicators have been of high importance in indicating the status of health in the country in those years. However, the trends/patterns of these indicators and the factors related to the trends have not yet been investigated in a systematic manner. In addition, there were minimal efforts to develop a model for predicting future values of Health and Health related indicators based on the current trend.</p> <p>Objectives</p> <p>The overall aim of this study was to analyze trends of and develop model for prediction of Health and Health related indicators. More specifically, it described the trends of Health and Health related indicators, identified determinants of mortality and morbidity indicators and developed model for predicting future values of MDG indicators.</p> <p>Methods</p> <p>This study was conducted on Health and Health related indicators of Ethiopia from the year 1987 E.C to 2000 E.C. Key indicators of Mortality and Morbidity, Health service coverage, Health systems resources, Demographic and socio-economic, and Risk factor indicators were extracted and analyzed. The trends in these indicators were established using trend analysis techniques. The determinants of the established trends were identified using ARIMA models in STATA. The trend-line equations were then used to predict future values of the indicators.</p> <p>Results</p> <p>Among the mortality indicators considered in this study, it was only Maternal Mortality Ratio that showed statistically significant decrement within the study period. The trends of Total Fertility Rate, physician per 100,000 population, skilled birth attendance and postnatal care coverage were found to have significant association with Maternal Mortality Ratio trend. There was a reversal of malaria parasite prevalence in 1999 E.C from <it>Plasmodium Falciparum </it>to <it>Plasmodium Vivax</it>. Based on the prediction from the current trend, the Millennium Development Goal target for under-five mortality rate and proportion of people having access to basic sanitation can be achieved.</p> <p>Conclusion</p> <p>The current trend indicates the need to accelerate the progress of the indicators to achieve MDGs at or before 2015, particularly for Maternal Health and access to safe water supply.</p

Exploratory analysis of time from HIV diagnosis to ART start, factors and effect on survival: A longitudinal follow up study at seven teaching hospitals in Ethiopia

Background: the HIV care in Ethiopia has reached 79% coverage. The timeliness of the care provided at the different levels in the course of the disease starting from knowing HIV positive status to ART initiation is not well known. This study intends to explore the timing of the care seeking, the care provision and associated factors.Methods: This is a longitudinal follow-up study at seven university hospitals. Patients enrolled in HIV care from September 2005 to December 2013 and aged ≥14 years were studied. Different times in the cascade of HIV care were examined including the duration from date HIV diagnosed to enrollment in HIV care, duration from enrollment to eligibility for ART and time from eligibility to initiation of ART. Ordinal logistic regression was used to investigate their determinants while the effect of these periods on survival of patients was determined using cox-proportional hazards regression.Results: 4159 clients were studied. Time to enrollment after HIV test decreased from 39 days in 2005 to 1 day after 2008. It took longer if baseline CD4 was higher, and eligibility for ART was assessed late. Young adults, lower baseline CD4, HIV diagnosis&lt;2008, late enrollment, and early eligibility assessment were associated with early ART initiation. Male gender, advanced disease stage and lower baseline CD4 were consistent risk factors for mortality.Conclusion and recommendation: Time to enrollment and duration of ART eligibility assessment as well as ART initiation time after eligibility is improving. Further study is required to identify why mortality is slightly increasing after 2010.Key words: HIV, HIV testing, enrollment, eligibility, antiretroviral therapy, mortality, Ethiopia

Nano Fe3O4–graphite paste modified electrochemical sensor for phosphatic pesticide -chlorpyrifos

A sensitive, cost effective and selective electrochemical sensor has been developed by exploiting iron oxide nano-particles as modifier in the paste of graphite powder. Cyclic voltammetric (CV) and differential pulse voltammetric (DPV) working parameters have been standardized and used practically for the determination of chlorpyrifos (O, O-diethyl O-3, 5, 6-trichloropyridin-2-yl phosphorothioate) pesticide from its aqueous solutions. Both techniques were deployed to investigate the electro-chemical interactions between chlorpyrifos and modified carbon paste sensor along with the redox characteristics at analyte/ sensor interface. The significant enhancement in peak current signals and the improved magnitude of the redox peak potential indicated the awe-inspiring facilitation of the electron transfer process by the modifier at the sensor/ analyte interface. The difference in the redox -potential (ΔEp) and peak current ratio (Ipc/Ipa) have revealed a notable surface enhancement characteristic of the modifier that responds the higher concentration gradient of pesticide at the interface. In lower analyte’s concentration range i.e. from 1.0 to 100μM, the peak current varies directly to the pesticide concentration with detection limit of 2.8 x10-6 mol/L. The relative stability of the modified sensor is fine and the reproducibility of the results is up to 98%, even after a gap of two months. The proposed analytical method is quite successful when applied for the quantification of chlorpyrifos from its aqueous samples. The electrochemical sensing/ detection of the pesticide chlorpyrifos is confirmed by its two electrons redox behavior and the same have been explained by suitable reaction scheme as:Keywords: Nano-iron oxide, Chlorpyrifos, Modified graphite paste, Voltammetry, Electrochemical metho

In Vitro Micropropagation of Aloe adigratana Reynolds Using Offshoot Cuttings

This study aimed at developing a suitable and reproducible protocol for in vitro micropropagation of Aloe adigratana Reynolds using explants from offshoots with the help of the most commonly used plant growth regulators (PGRs). Explants were initiated in full-strength Murashige and Skoog (MS) media enriched with 0.2 mg/L benzylaminopurine (BAP) + 0.2 mg/L naphthaleneacetic acid (NAA). Shooting experiment was conducted in full-strength MS media enriched with 0/0, 0.5/0.5, 1.0/0.5, 1.5/0.5, and 2.0/0.5 mg/L BAP/NAA. Likewise, rooting experiment was carried out in half-strength MS media enriched with NAA at 0.5, 1.0, and 1.5 mg/L and indol-3-butyric acid (IBA) at 0.5, 1.0, and 1.5 mg/L. Finally, acclimatization study was conducted in greenhouse, nursery, and open field. The shooting response of the plant was best in MS media enriched with 1.0 mg/L BAP + 0.5 mg/L NAA. This media formulation resulted in the shortest mean number of days to shooting (14.00 ± 2.30 days), the highest mean shoot number (4.00 ± 3.40), and the second highest mean shoot length (8.60 ± 2.10 cm). IBA enhanced rooting at higher concentrations (1.0 and 1.5 mg/L), but NAA did the same at lower concentrations (0.5 and 1.0 mg/L). All plantlets (n = 62) survived primary acclimatization. Secondary acclimatization in composted and matured soil media under nursery and open field (sun light) condition produced 88 to 93% survival rate. The death of plantlets in the secondary acclimatization is accounted to mechanical damage. This study demonstrated that the tested PGRs were useful in enhancing the in vitro micropropagation of the plant. Future studies need to focus on optimizing the protocol for large-scale, commercial micropropagation

Content of major, minor and toxic elements of different edible mushrooms grown in Mekelle, Tigray, Northern Ethiopia

Major, minor and toxic elements were determined by flame atomic absorption spectrometry and flame photometry in edible canned, wild and cultivated oyster mushrooms grown in cotton waste, wheat straw and wood waste substrates in Mekelle, Tigray, Ethiopia. Dry ashing using mixtures of HNO3:H2SO4:H2O2 (1:1:1 ratio) was used for digestion. The mean concentrations (mg/kg) of the studied elements in the mushroom samples were ranged from 964.66 to 4180.33, 2652.66 to 19918.66, 22.00 to 34.64, 16.00 to 30.38, 34.13 to 621.06, 40.25 to 120.91, 8.40 to 34.33, 4.22 to 30.63, 1.94 to 2.52 and 1.53 to 2.17 for Na, K, Ca, Mg, Fe, Zn, Cu, Mn, Cd and Pb, respectively. There were significant differences (p < 0.05) in the K, Fe, Zn and Mn levels of the mushroom samples which may be attributed to substrate variations. Moreover, significantly high correlations were observed between Na-K, Ca-Cd, Fe-Mn, Zn-Cu, Zn-Pb, Cu-Pb and Cd-Pb. Most of the results of this study were in good agreement with WHO recommended limits. However, the concentrations of Na and Cd in canned mushroom and all elements grown in wood substrate were recorded above the WHO recommended limits. The results of this study showed that, with the exception of canned and wood waste grown, the mushrooms can be used for human diets because of their acceptable content of many essential and minor elements and low content of toxic metals

Determinants of Uterine Rupture and Its Management Outcomes among Mothers Who Gave Birth at Public Hospitals of Tigrai, North Ethiopia: An Unmatched Case Control Study

Introduction. Uterine rupture is a leading cause of maternal death in Ethiopia. Despite strengthening the health care system and providing basic and comprehensive emergency obstetric care closer to the communities, uterine rupture continues to produce devastating maternal and fetal outcomes. Although risk factors of uterine rupture are context specific, there is lack of clarity in our context towards the contributing factors and untoward outcomes of uterine rupture. This study was conducted to identify the risk factors of uterine rupture and its impacts in public hospitals of Tigrai. Objective. This study would identify determinant factors of uterine rupture and its management outcomes among mothers who gave birth in public hospitals in Tigrai region, North Ethiopia. Method. A retrospective hospital-based unmatched case control study design was implemented with 135 cases of women with uterine rupture and 270 controls of women without uterine rupture. Cases were enrolled consecutively from case notes of women who gave birth from 1/9/2015 to 30/6/2019, while charts (case note) of women without uterine rupture found following the cases were selected randomly and enrolled. Bivariate and multivariate logistic regression with 95% confidence interval was used to identify the determinants of uterine rupture. Result. Mothers referred from remote health institutions (AOR 7.29 (95% CI: 2.7, 19.68)), mothers who visited once for antenatal care (AOR 2.85 (95% CI: 1.02, 7.94)), those experiencing obstructed labor (AOR 13.33 (95% CI: 4.23, 42.05)), and birth weight of a newborn greater than four kilograms (AOR 5.68 (95% CI: 1.39, 23.2)) were significantly associated with uterine rupture. From 135 mothers who develop uterine rupture, 13 (9.6%) mothers died and 101 (74.8%) fetuses were stillborn. Obstetrical complications like abdominal hysterectomy in 75 (55.6%) of mothers and excessive blood loss in 84 (57.8%) were additional untoward outcomes of uterine rupture. Conclusion. Referrals from remote health institutions, once-visited antenatal care, obstructed labor, and birth weight of newborns greater than four kilograms were significant determinants of uterine rupture. Maternal death, stillbirth, hysterectomy, and hemorrhage were adverse outcomes. The findings of this study suggest early identification of factors that expose to uterine rupture during antenatal care, labor, and delivery must be attended to and further prospective studies are needed to explore predictors of untoward outcomes. Knowing the determinants of uterine rupture helps prevent the occurrence of a problem in pregnant women, which reduces maternal morbidity and mortality, and would have a tremendous help in identifying the best optional strategies in our current practices. This assertion was added to the abstract concluding session