Factors affecting willingness to HIV Counseling and Testing among patients presenting with conventional Sexually Transmitted Infections in Addis Ababa

Background: There is ample scientific evidence that a person with an untreated sexually transmitted infection (STI), particularly those inducing ulcers or discharge, is at an increased risk of passing on or acquiring HIV during sexual intercourse. HIV counseling and testing (HIV CT) for STI cases is thus an important tool in the public health response to HIV/AIDS.Objective: To assess factors affecting willingness towards HIV CT among patients with conventional STIs in Addis Ababa.Methods: A cross-sectional study, involving 422 STI cases, was conducted in Addis Ababa from December 2006 to April 2007. STI patients were consecutively selected during an outpatient visit in ten government health centers, which were purposively selected mainly on the basis of their high STI case load. A pre-tested, interviewer administered, structured questionnaire was applied for data collection. The Pearson chi-square test was used to assess statistical significance of associations between willingness towards HIV CT and respondents’ socio-demographic status, knowledge, and behavior. Moreover, bivariate and multivariate logistic regression analyses were done to identify predictors of willingness for HIV CT. For all statistical significance tests, the cut- off value set was p<0.05.Results: Nearly 74% of STI patients said that they would be willing to undergo HIV CT at the time or 3 months after their STI diagnosis. Furthermore, 97.4% and 71.8% of STI patients had heard about HIV/AIDS and STIs, respectively. The majority, 93% of STI patients knew at least one prevention method, and 61.2% identified all the three major methods for preventing HIV/AIDS. Overall, 43.8% of the STI patients had at least one misconception, and 38% had comprehensive knowledge about HIV/AIDS. Ever tested for HIV and being in the age group of 15-34 years were found to be significantly and positively associated with willingness towards HIV CT whereas perceiving small or moderate chance of contracting HIV infection was found to have a significant and negative association.Conclusion: The findings of this study indicated the need for promotion and expansion of sustainable provider initiated HIV CT with subsequent follow up of STI patients as part of a range of services and support, and intensive patient-centered risk reduction counseling for STI patients during the initial visit to health care facilities. [Ethiop. J. Health Dev. 2011;25(2):116-125

Approaches, methods and processes for innovative apiculture development: experiences from Ada'a-Liben Woreda Oromia Regional State, Ethiopia

The Improving Productivity and Marketing Success (IPMS) for Ethiopian Farmers'; Project being implemented by the International Livestock Research Institute (ILRI) commissioned Sap-Tec PLC to study the existing potential and execute apiculture development in Ada';a-Liben woreda, one of the IPMS'; ten Pilot Learning Woredas (PLWs). The main objective of this apiculture intervention was to identify the current beekeeping practices, assess potentials and problems, and provide solutions through the introduction of a participatory market-oriented modern beekeeping practice as an income-generating activity to farmers and others who are interested to complement their income. The activities reported in this paper are based on studies and interventions undertaken to enhance market-oriented apiculture development in Ada';a-Liben woreda between 2005 and 2007. This working paper is divided into a number of sections. The first two sections describe the major strengths and constraints of the bee industry in Ethiopia. Section 3 describes the beekeeping institutes and associations. Sections 4 and 5 analyse the most important opportunities and threats for apiculture development and marketing intervention in Ada';a-Liben woreda. Section 6 presents IPMS intervention strategies and lessons learned in knowledge sharing, capacity building, and commodity development including technology transfer, platforms, input supply, credit facilitation and market linkage. This section also discusses the methods used and the achievements obtained so far. Finally, Section 7 discusses both general and industry specific recommendations, which form the basis for further development of the industry. This working paper is intended to provide preliminary information on lessons drawn in beekeeping interventions in Ada';a-Liben woreda and to share the experiences to those who have already launched or are planning to launch apiary development program as an alternative income generating activity. It also highlights the methodologies applied and the lessons learned from the apiculture interventions of the IPMS project for scaling up to other woredas. The main objective of this apiculture intervention was to identify the current beekeeping practices, assess potentials and problems, and provide solutions through the introduction of a participatory market-oriented modern beekeeping practice as an income-generating activity to farmers and others who are interested to complement their income

Household Fertilizers Use and Soil Fertility Management Practices in Vegetable Crops Production: The Case of Central Rift Valley of Ethiopia

Large areas of farms are covered by variety of vegetable crops in the Central Rift Valley of Ethiopia. With a view to improve current vegetable production fertilizer use efficiency, survey has been conducted through collections of baseline information to describe household fertilizer uses and soil fertility management in vegetable production system using descriptive statistics. Multistage samplings were made to select  representative growers in the six districts of East Showa zone. Based on field observations and group discussions, vegetable growers grouped their farm land into four local categories. The survey revealed that tomato growers apply variable rates of urea and DAP fertilizers for tomato cultivation. Survey results indicated that highest 43.61% of onion growers apply 200 kg of DAP fertilizer on their onion field, while 30.85% of growers apply 300 kg DAP per ha, another 39.35% apply, 400 kg and above DAPfertilizer, still 8.5% of onion growers apply 600 kg DAP fertilizer on their onion farm. This survey indicated that fertilizers were not wisely used in the vegetable crops production systems and the applications are in excess rate, which could leads to pollution of the environment from over dose application and from runoff in to the water bodies and leaching in to the ground water with economic loss. Most of the tomato and onion growers use three splits application of UREA and DAP mainly at transplanting, at first and second cultivation for both crops as top-dressing. The survey results indicated that 54.44% of onion growers apply an average of 230.35 kg ha-1 DAP at transplanting, while 46.53% apply an average of 188.29kg ha-1 DAP at second split application, and finally 17.82% apply an  average of 119.44 kg ha-1 DAP at last third split applications. This is the first document come across that vegetable growers in the CRV area apply DAP fertilizer as much as three splits. This indicates that there are no  systems of updating of frontline development workers; poor extension services with shallow development workers knowledge made the growers totally depend on their own innovations for vegetable production

Irrigation Water Management Practices in Smallholder Vegetable Crops Production: The Case of the Central Rift Valley of Ethiopia

Smallholder irrigated vegetable production in the Central Rift Valley region of Ethiopia is instrumental in ensuring the year-round availability of fresh vegetables in the local market in the country. However, a number of  problems constrain irrigated vegetable production in the region. Therefore, asurvey was conducted with the objectives of assessing smallholder  irrigated vegetable production practices and identifying factors associated with problems of irrigation water management. The survey was conducted in December 2011. A multistage purposive sampling procedure was  employed to select sample districts, peasant associations, and sample respondents that grew vegetables using small-scale irrigation. Key  informants were interviewed and group discussions were conducted with smallholder vegetable farmers. Data were collected on household irrigation knowledge, experiences, skills, irrigation water sources as well as on  irrigation water management practices such as methods, time, depth and frequency of irrigation. Data were also collected on supplemental irrigation practices under rain-fed vegetable production. In addition, household perceptions on the environmental impacts of irrigation, on-farm irrigation water related challenges, and related information were also recorded. About 16.5% of the respondents indicated that their knowledge and skills on irrigation water management practices were mainly drawn from experiences of trial and error.About 38.1% of the respondents indicated that they  irrigated their vegetable fields both in the morning and the afternoon  whereas 35.1% replied that they irrigated only in the afternoon. A large number of the respondents (89.6%) replied that they determined irrigation intervals based on specific crop needs. About 90.9% of the respondents replied that they applied enough irrigation water up to the point where the water level reached the furrow basin head. The survey result also indicated that 51.7% of the respondents practiced supplemental irrigation when shortage of moisture occurred in the soil during the rainy season as well at the end of the rainy season. One hundred percent of the respondents replied that they faced problems commonly related with the use of  irrigation, namely, soil salinity, waterlogging, soil erosion and degradation, sedimentation, and build-up of pests and diseases. In conclusion, the survey results revealed that extension services on irrigation water  management were almost non-existent, and the smallholder vegetable farmers managed irrigation water merely by intuition.Therefore,  participatory on-farm irrigation research and extension on irrigation water management practices should be formulated to generate appropriate technologies for enhanced and sustainable irrigated vegetable production in the region

Prevalence and risk factors for anemia severity and type in Malawian men and women: urban and rural differences.

BACKGROUND: The global burden of anemia is large especially in sub-Saharan Africa, where HIV is common and lifestyles are changing rapidly with urbanization. The effects of these changes are unknown. Studies of anemia usually focus on pregnant women or children, among whom the burden is greatest. We describe prevalence and risk factors for anemia among rural and urban men and women of all ages in Malawi. METHODS: We analyzed data from a population-wide cross-sectional survey of adults conducted in two sites, Karonga (rural) and Lilongwe (urban), commencing in May 2013. We used multinomial logistic regression models, stratified by sex to identify risk factors for mild and moderate-to-severe anemia. RESULTS: Anemia prevalence was assessed among 8,926 men (age range 18-100 years) and 14,978 women (age range: 18-103 years). Weighted prevalence levels for all, mild, and moderate-to-severe anemia were 8.2, 6.7 and 1.2% in rural men; 19.4, 12.0 and 7.4% in rural women; 5.9, 5.1 and 0.8% in urban men; and 23.4, 13.6 and 10.1% in urban women. Among women, the odds of anemia were higher among urban residents and those with higher socioeconomic status. Increasing age was associated with higher anemia prevalence in men. Among both men and women, HIV infection was a consistent risk factor for severity of anemia, though its relative effect was stronger on moderate-to-severe anemia. CONCLUSIONS: The drivers of anemia in this population are complex, include both socioeconomic and biological factors and are affecting men and women differently. The associations with urban lifestyle and HIV indicate opportunities for targeted intervention

KRAS Ubiquitination at Lysine 104 Retains Exchange Factor Regulation by Dynamically Modulating the Conformation of the Interface

RAS proteins function as highly regulated molecular switches that control cellular growth. In addition to regulatory proteins, RAS undergoes a number of posttranslational modifications (PTMs) that regulate its activity. Lysine 104, a hot spot for multiple PTMs, is a highly conserved residue that forms key interactions that stabilize the RAS helix-2(H2)/helix-3(H3) interface. Mutation at 104 attenuates interaction with guanine nucleotide exchange factors (GEFs), whereas ubiquitination at lysine 104 retains GEF regulation. To elucidate how ubiquitination modulates RAS function, we generated monoubiquitinated KRAS at 104 using chemical biology approaches and conducted biochemical, NMR, and computational analyses. We find that ubiquitination promotes a new dynamic interaction network and alters RAS conformational dynamics to retain GEF function. These findings reveal a mechanism by which ubiquitination can regulate protein function

Prevalence of and Risk Factors for Trachoma in Southern Nations, Nationalities, and Peoples' Region, Ethiopia: Results of 40 Population-Based Prevalence Surveys Carried Out with the Global Trachoma Mapping Project.

PURPOSE: We sought to estimate the prevalence of trachoma at sufficiently fine resolution to allow elimination interventions to begin, where required, in the Southern Nations, Nationalities, and Peoples' Region (SNNPR) of Ethiopia. METHODS: We carried out cross-sectional population-based surveys in 14 rural zones. A 2-stage cluster randomized sampling technique was used. A total of 40 evaluation units (EUs) covering 110 districts ("woredas") were surveyed from February 2013 to May 2014 as part of the Global Trachoma Mapping Project (GTMP), using the standardized GTMP training package and methodology. RESULTS: A total of 30,187 households were visited in 1047 kebeles (clusters). A total of 131,926 people were enumerated, with 121,397 (92.0%) consenting to examination. Of these, 65,903 (54.3%) were female. In 38 EUs (108 woredas), TF prevalence was above the 10% threshold at which the World Health Organization recommends mass drug administration with azithromycin annually for at least 3 years. The region-level age- and sex-adjusted trichiasis prevalence was 1.5%, with the highest prevalence of 6.1% found in Cheha woreda in Gurage zone. The region-level age-adjusted TF prevalence was 25.9%. The highest TF prevalence found was 48.5% in Amaro and Burji woredas. In children aged 1-9 years, TF was associated with being a younger child, living at an altitude 15°C, and the use of open defecation by household members. CONCLUSION: Active trachoma and trichiasis are significant public health problems in SNNPR, requiring full implementation of the SAFE strategy (surgery, antibiotics, facial cleanliness, and environmental improvement)

Improving the screening and treatment of hypertension in people living with HIV: An evidence-based policy brief by Malawi’s Knowledge Translation Platform

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Pseudomonas aeruginosa Adaptation to Lungs of Cystic Fibrosis Patients Leads to Lowered Resistance to Phage and Protist Enemies

Pathogenic life styles can lead to highly specialized interactions with host species, potentially resulting in fitness trade-offs in other ecological contexts. Here we studied how adaptation of the environmentally transmitted bacterial pathogen, Pseudomonas aeruginosa, to cystic fibrosis (CF) patients affects its survival in the presence of natural phage (14/1, ΦKZ, PNM and PT7) and protist (Tetrahymena thermophila and Acanthamoebae polyphaga) enemies. We found that most of the bacteria isolated from relatively recently intermittently colonised patients (1-25 months), were innately phage-resistant and highly toxic for protists. In contrast, bacteria isolated from long time chronically infected patients (2-23 years), were less efficient in both resisting phages and killing protists. Moreover, chronic isolates showed reduced killing of wax moth larvae (Galleria mellonella) probably due to weaker in vitro growth and protease expression. These results suggest that P. aeruginosa long-term adaptation to CF-lungs could trade off with its survival in aquatic environmental reservoirs in the presence of microbial enemies, while lowered virulence could reduce pathogen opportunities to infect insect vectors; factors that are both likely to result in poorer environmental transmission. From an applied perspective, phage therapy could be useful against chronic P. aeruginosa lung infections that are often characterized by multidrug resistance: chronic isolates were least resistant to phages and their poor growth will likely slow down the emergence of beneficial resistance mutations