Healthcare Outcomes and Resource Utilization Associated with Neonatal Hypoglycemia: Analysis of Data from the HCUP Kid’s Inpatient Database

Neonatal hypoglycemia is the most common metabolic abnormality in infants and is associated with neurological damage and death. The risk of developing hypoglycemia among infants born from diabetic mothers is even higher. Although much work has been performed addressing issues for treatment and care, research related to neonatal hypoglycemia has been focused on the clinical or individual level risk factors. Contextual risk factors such as hospital characteristics, neighborhood economic status, and regional variations were not considered in earlier studies. Additionally, although healthcare resources utilization of hypoglycemia has been adequately addressed in the adult population, this topic has not been studied in hypoglycemic neonates. The overarching purpose of this dissertation was to investigate healthcare outcomes and resource utilization related to neonatal hypoglycemia. The first purpose was to conduct a systematic review in order to investigate whether previous studies only focused on clinical risk factors or included a broader health service-related contextual risk factors in assessing the determinants of neonatal hypoglycemia. The second purpose was to identify the key factors associated with increased hospital cost associated with neonatal hypoglycemia in the United States. The third and final purpose of the dissertation was to construct multi-level models that include individual-level and contextual-level characteristics. The systematic review (Project I) determined that previous studies mainly focus on the clinical characteristics of infants and mothers. The systematic review suggested that contextual variables should be included in future research. Project II found that increased cost was observed, when more than five procedures were performed during the same hospitalization, when hospital bed size was between 100 and 300 or ≥ 400, when hospital length of stay exceeded 15 days, in teaching hospitals, in the presence of chronic conditions, comorbidities, prematurity, and death. In project III we found that infant of diabetic mothers had more than 5-fold increased risk of developing neonatal hypoglycemia compared to infants of non-diabetic mothers. Infants born in urban and teaching hospitals also had significantly higher chance of developing neonatal hypoglycemia. Project III also determined that the inclusion of the contextual risk factors improved the final model that was constructed to predict neonatal hypoglycemia

District Level Decentralization and Public Service Delivery in Ethiopia: Cases from Amhara region.

This study assessed how decentralization facilitates public service delivery in Enbse Sarmidir and Dejen Districts of Amhara Region. The assessment was conducted in selected public services: education, health, water supply and rural roads in light of the services delivered before and after the district level decentralization process began.  Both qualitative and quantitative data were collected from primary and secondary sources. Primary data were collected from 18 key sector office and district administration heads through interviews whereas secondary data were collected from planning and performance reports, financial and human power reports and other related sources. The findings indicated that the overall performances of the delivery of services have shown significant improvements after decentralization. However, the improvements were constrained by lack of financial and human resources and problems of coordination and participation. The study also revealed that sustainable and effective decentralized public service delivery does not only depend on institutional and human resources capacity building at local level, but also a functional financial mechanism, clear and appropriate allocation of roles and responsibilities. Keywords: District, Decentralisation, Public Service, Service Deliver

Competition and mobile penetration in sub-Saharan Africa

This paper examines the impact of competition on mobile penetration in 35 Sub-Saharan African (SSA) countries between 2000 and 2006. We examine both the impact of introducing competition and the role of intensity of competition on mobile penetration in these countries. Different specifications with different measures of competition that reflect either the introduction or intensity of competition on the sector have been used in the analysis.Controlling for various sector characteristics and macro-economic indicators, we apply panel data regression analysis with fixed effects. For the most part, the results in this study are consistent with the existing literature, and confirm that the introduction of competition in the mobile market is strongly and positively associated with mobile penetration. Furthermore, the results of this study indicate that promoting effective competition plays a significant role inincreasing mobile penetration

Prevalence and Associated Factors of Hypertension Among Civil Servants Working in Arba Minch Town, South Ethiopia

Despite Hypertension is a global public health challenge and a leading modifiable risk factor for cardiovascular disease and death attention was not given in developing countries. Therefore measuring the prevalence and identifying predictors of Hypertension is very important. Institution based cross sectional study design was employed from March–April, 2016 by taking 319 randomly selected civil servants working in in Arba Minch town. Data was collected using structured questionnaire and standardized instruments for physical examination by 5 trained nurses. SPSS version 20 was used for data analysis. Bi-variable and Multivariate logistic regression was employed for analysis of risk factors. The mean SBP and DBP of study participants were 120.87 + 14.15 mmHg and 80.28 + 8.8 mmHg, respectively. The prevalence of hypertension was found to be 27.8% (95% CI = 22.9-32.7%). Civil servants of age 50 years and above [AOR = 13.3], age 40-49 years [AOR = 5], age 30-39 years [AOR = 3.5], abdominal obesity [AOR=12.2], general obesity [AOR = 4.2], stress status [AOR = 12.3], current alcohol drink [AOR = 3.3], ex-drinker [AOR = 8.9] and family history of hypertension [AOR = 5.6] were found to be significantly associated with hypertension. The prevalence indicates that it is hidden epidemic in this population; therefore for screening and risk reduction program are needed

Evaluation of Funginil (Trichoderma harzianum Formulation) for the Control of Botrytis Corm Rot (Botrytis gladiolorum) on Gladiolus (Gladiolus hybridus) Varieties

Evaluation of the effect of dipping of corms of gladiolus (Gladiolus hybridus) in three concentrations (0.5; 1.0 and 1.5%) of Funginil (Trichoderma harzianum formulation) against Botrytis gladiolorum isolate BG-4 on the growth and yield parameters of White Enchantress and Sheherzade varieties were carried out in pot culture and under field experiments, respectively. The result of the pot experiment on White Enchantress revealed that there was a highly significant reduction in disease incidence in treatment of Funginil over both the inoculated and uninoculated controls. As the rate of Funginil increased the percentage of sprouting also increased whereas the disease incidence decreased significantly. In the field trial, the maximum plant height, number of leaves, number of spikes, rachis length, and number of floret, length of floret and diameter of first floret were obtained with the application of 1.5% Funginil. The height decreased with the increasing number of the leaves, spikes, floret, length of floret and floret diameters as well as rachis length increased with increasing rates of Funginil. These results suggest that Funginil can be used as biocontrol agent against corm rot (B. gladiolorum) of Gladiolus (Gladiolus hybridus) varieties

Incidence of Opportunistic Infections Among Adult HIV Positive People Receiving Co-trimoxazole Prophylaxis

In Ethiopia, Co-trimoxazole prophylaxis therapy (CPT) used to prevent opportunistic infections among people living with HIV is the standard of practice; however incidence of opportunistic infection and their predictors are rarely documented in the country. This was a retrospective follow up study to describe the incidence and predictors of opportunistic infections among 244 adults receiving CPT. Participants were followed for a median time of 72 weeks. During a study period a total of 53opportunistic infections were recorded; making the overall incidence rate 23.9/100 person-years. High incidence of opportunistic infections is likely to occur if: the clients were married (adjusted hazard ratio (AHR) 1.965;(95% CI: 1.109, 3.451), had history of tuberculosis treatment (AHR: 2.34(95% CI:1.05, 5.24)), patients who are indicated for CPT because of both clinical and WHO clinical staging criteria(AHR 2.418 (95% CI:1.02, 5.72 ),and had poor adherence to CPT (AHR, 2.11 (95% CI: 1.19-3.72)). Eventhough adherence is non-substitutable strategy to prevent opportunistic infection, the cohort of HIV patients failed to adhere to CPT, which in turn resulthigh incidence of opportunistic infections among them, therefore improving adherence as guideline should be a priority to prevent OIs among people living with HIV in the study region

Evaluation of disease incidence and severity and yield loss of finger millet varieties and mycelial growth inhibition of Pyricularia grisea isolates using biological antagonists and fungicides in vitro condition.

Objective: The aim of this study was to conduct a survey on the disease incidence and severity at 5 agroecological zones of Ethiopia. Moreover, the study was also designed to carry out pathogenicity test, estimate yield losses caused by test pathogen and in vitro evaluation of fungicides and biocontrol agents against finger millet blast isolates. Methodology and Results: The incidence of finger millet blast was assessed as the percentage of plants with visible symptoms in a field and greenhouse. Blast severity was also evaluated as the percentage of leaf area with symptoms. From the surveyed areas, maximum disease incidence and severity were recorded in west Wollega zone with 63.03 and 34.60%, and lowest disease incidence and severity was recorded in Awi zone with 46.7 and 15.7%, respectively. A total of 42 isolates of P. grisea were collected and isolated from infected finger millet plants and wild relatives from five agro-ecological zones of Ethiopia. The pathogenicity test conducted in greenhouse on three finger millet varieties also indicated that among P. grisea isolates, Pg.11, Pg.41 and Pg.40 showed the highest disease incidence on all the three varieties with 74.8, 69.5 and 66.5%, respectively. Moreover, the highest disease severity with 27.7 and 27.8% were observed by isolates Pg.11 and Pg.41, respectively. In vitro evaluation and testing of Trichoderma viride have showed maximum mycelial growth inhibition with 77.1% and 74.1% by isolates Pg.41 and Pg.22, respectively; while Pseudomonas fluorescens showed maximum mycelial growth inhibition by isolates Pg.40 (57.2%), followed by Pg.26 (56.1%). The efficacy tests of four fungicides evaluated for their antifungal activity showed Sancozeb (85.50- 88.40%) as the most effective fungicide to inhibit mycelial growth of P. grisea.Conclusion and application of findings: The highest percent of mycelial growth inhibition of P. grisea isolates was observed by T.harzianum and T. viride and followed by Pseudomonas fluorescens. Sancozeb was the most effective fungicide and also showed the highest mycelial growth inhibition on the isolate of P. grisea and followed by ridomil, bayleton, and curzate. From in vitro evaluation of the effectiveness of biological agents and fungicides against the mycelia growth of P.grisea isolates, fungicides were most effective for the control of blast disease of finger millet than biological agents.Keywords: Biocontrol, Blast disease, Eleusine coracana, Fungicide, Pyricularia grisea

Evidence on the effect of gender of new-born, antenatal care and postnatal care on breastfeeding practices in Ethiopia:a meta-analysis and meta-regression analysis of observational studies (vol 9, e023956, 2019)

The following amendments were considered to the original version of this article. Reference 35: Gultie T, Sebsibie G. Determinants of suboptimal breastfeeding practice in Debre Berhan town, Ethiopia: a cross sectional study. Int Breastfeed J 2016;11 has been excluded from the published article. Authors have found in their meta-analysis, 1 that this study in reference 352 was retracted from the International Breastfeeding Journal in 2018 (online: 07 March 2018) because of significant overlap of both text and data with the Master's Thesis of Hilina Ketma, "Assessment of prevalence and determinants of suboptimal breastfeeding among mothers of children aged less than two years in Dire Dawa City Administration, Ethiopia, June 2013", which was defended at the School of Graduate Studies, Addis Ababa University, Addis Ababa, Ethiopia in June 2013.3 Therefore, authors have performed reanalysis by excluding Gultie and Sebsibie study (reference 35), and revised figure 3 and figure 5. In conclusion, despite having excluded Gultie and Sebsibie study, the results show that antenatal care significantly associated with timely initiation of breastfeeding and exclusive breastfeeding. Therefore, the central findings of the original article remain unaffected. Please, find the revised figures. (Figure Presented)