Precipitation Extremes in Dynamically Downscaled Climate Scenarios over the Greater Horn of Africa

This study first assesses the performance of regional climate models in the Coordinated Regional Climate Downscaling Experiment (CORDEX) in reproducing observed extreme precipitation indices over the Greater Horn of Africa (GHA) region during 1989–2005. The study then assesses projected changes in these extremes during 2069–2098 compared to 1976–2005. The Regional Climate Model (RCM) simulations are made using two RCMs, with large-scale forcing from four CMIP5 Global limate Models(GCMs) under two Representative Concentration Pathways (RCP4.5 and RCP8.5). We found that RCM simulations have reasonably captured observed patterns of moderate precipitation extreme indices (MPEI). Pattern correlation coefficients between simulated and observed MPEI exceed 0.5 for all except the Simple Daily Intensity Index (SDII). However, significant overestimations or underestimations exist over localized areas in the region. Projected changes in Total annual Precipitation (PRCPTOT) and the annual number of heavy (\u3e10 mm) and very heavy (\u3e20 mm) precipitation days by 2069–2098 show a general north-south pattern, with decreases over the southern half and increases over the northern half of the GHA. These changes are often greatest over parts of Somalia, Eritrea, the Ethiopian highlands and southern Tanzania. Maximum one- and five-day precipitation totals over a year and SDII (ratio of PRCPTOT to rainy days) are projected to increase over a majority of the GHA, including areas where PRCPTOT is projected to decrease, suggesting fewer, but heavier rainy days in the future. Changes in the annual sum of daily precipitation above the 95th and 99th percentiles are statistically significant over a few locations, with the largest projected decrease/increase over Eritrea and northwestern Sudan/Somalia. Projected changes in Consecutive Dry Days (CDD) suggest longer periods of dryness over the majority of the GHA, except the central portions covering northern Uganda, southern South Sudan, southeastern Ethiopia and Somalia. Substantial increases in CDD are located over southern Tanzania and the Ethiopian highlands. The magnitude and the spatial extent of statistically-significant changes in all MPEI increase from RCP4.5 to RCP8.5, and the separation between positive and negative changes becomes clearer under RCP8.5

Low-cost wearable multichannel surface EMG acquisition for prosthetic hand control

Prosthetic hand control based on the acquisition and processing of surface electromyography signals (sEMG) is a well-established method that makes use of the electric potentials evoked by the physiological contraction processes of one or more muscles. Furthermore intelligent mobile medical devices are on the brink of introducing safe and highly sophisticated systems to help a broad patient community to regain a considerable amount of life quality. The major challenges which are inherent in such integrated system’s design are mainly to be found in obtaining a compact system with a long mobile autonomy, capable of delivering the required signal requirements for EMG based prosthetic control with up to 32 simultaneous acquisition channels and – with an eye on a possible future exploitation as a medical device – a proper perspective on a low priced system. Therefore, according to these requirements we present a wireless, mobile platform for acquisition and communication of sEMG signals embedded into a complete mobile control system structure. This environment further includes a portable device such as a laptop providing the necessary computational power for the control and a commercially available robotic handprosthesis. Means of communication among those devices are based on the Bluetooth standard. We show, that the developed low cost mobile device can be used for proper prosthesis control and that the device can rely on a continuous operation for the usual daily life usage of a patient

Precipitation Extremes in Dynamically Downscaled Climate Scenarios over the Greater Horn of Africa

This study first assesses the performance of regional climate models in the Coordinated Regional Climate Downscaling Experiment (CORDEX) in reproducing observed extreme precipitation indices over the Greater Horn of Africa (GHA) region during 1989–2005. The study then assesses projected changes in these extremes during 2069–2098 compared to 1976–2005. The Regional Climate Model (RCM) simulations are made using two RCMs, with large-scale forcing from four CMIP5 Global limate Models(GCMs) under two Representative Concentration Pathways (RCP4.5 and RCP8.5). We found that RCM simulations have reasonably captured observed patterns of moderate precipitation extreme indices (MPEI). Pattern correlation coefficients between simulated and observed MPEI exceed 0.5 for all except the Simple Daily Intensity Index (SDII). However, significant overestimations or underestimations exist over localized areas in the region. Projected changes in Total annual Precipitation (PRCPTOT) and the annual number of heavy (\u3e10 mm) and very heavy (\u3e20 mm) precipitation days by 2069–2098 show a general north-south pattern, with decreases over the southern half and increases over the northern half of the GHA. These changes are often greatest over parts of Somalia, Eritrea, the Ethiopian highlands and southern Tanzania. Maximum one- and five-day precipitation totals over a year and SDII (ratio of PRCPTOT to rainy days) are projected to increase over a majority of the GHA, including areas where PRCPTOT is projected to decrease, suggesting fewer, but heavier rainy days in the future. Changes in the annual sum of daily precipitation above the 95th and 99th percentiles are statistically significant over a few locations, with the largest projected decrease/increase over Eritrea and northwestern Sudan/Somalia. Projected changes in Consecutive Dry Days (CDD) suggest longer periods of dryness over the majority of the GHA, except the central portions covering northern Uganda, southern South Sudan, southeastern Ethiopia and Somalia. Substantial increases in CDD are located over southern Tanzania and the Ethiopian highlands. The magnitude and the spatial extent of statistically-significant changes in all MPEI increase from RCP4.5 to RCP8.5, and the separation between positive and negative changes becomes clearer under RCP8.5

The prevalence and antimicrobial responses of Shigella isolates in HIV-1 infected and uninfected adult diarrhoea patients in north west Ethiopia

Background: Shigella is one of the diarrhoea causing organisms found in HIV positive patients. But so far, the pattern of diarrhoeal agents caused by Shigella in AIDS patients has not been determined. Objective: This study is thus aimed at determining the prevalence, antimicrobial susceptibility and resistance of Shigella isolates in HIV positive subjects. Methods: All stool samples taken from the subjects of this study were plated on the MacConkey agar and incubated at 35-37oC for 24 or 48 hrs. Biochemical and antimicrobial sensitivity testing were carried out by using the standard methods. Results: Out of the 391 subjects included in the study, 199(63.8%) HIV seropositive and 113 seronegative patients had acute and chronic diarrhoea while 79 were HIV seropositive without diarrhoea. Of the 27 (8.7) Shigella isolates taken from the diarrhea patients, 11 (3.5%) were from HIV positive subjects. All Shigella isolates were found to be sensitive against norfloxacin (100%), gentamicin (97%), polymyxin B (97%) and kanamycin (93%). The most frequent resistance observed was to chloramphenicol (62%), tetracycline (86%) and ampicillin (100%). The frequency of resistance of Amp, Sex, Ch, TTc was found to be very high when compared with other patterns of resistance. Conclusion: The high proportion of HIV seropositive patients who had diarrhea in the absence of identified Shigella strains strongly indicates the existence of other diarrhoeagenic agents or mechanisms. Detailed investigation is important to get comprehensive information for better treatment of diarrhoea in HIV /AIDS patients. According to this finding, norfloxacin, gentamicin, polymyxin B, kanamycin and nalidixic acid might be used as drugs of choice for empirical treatment. On the other hand, amplicilin, tetracycline and chloramphenicol may not be used as the drugs of choice for the treatment of Shigella infection unless culture and sensitivity tests are done prior to treatment. The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 99-10

Brief communication: Low prevalence of HIV infection, and knowledge, attitude and practice on HIV/AIDS among high school students in Gondar, Northwest Ethiopia

HIV/AIDS is a major public health problem in Ethiopia. Therefore, a school based cross-sectional study was conducted in Gondar; Northwest Ethiopia to determine the seroprevalence of HIV infection and to assess Knowledge, attitude and practice related to HIV/AIDS. A total of 565 students were included in the study. The seroprevalence of HIV infection was 1.1%. Sexual contact with commercial sex worker or non-regular partner was reported by 16.7% of the students. Only 58.5% of those who practice sex used condoms. History of sexually transmitted diseases was reported by 10.7% of the sexually active students. The majority (96.6%) reported unprotected sex, unsafe blood transfusion, contaminated needles and mother to child transmissions as common ways of HIV transmission. Abstinence, faithfulness to one\'s partner and use of condom as means to prevent transmission of HIV was responded by 84.1%, 60.4% and 41.8% of the students, respectively. Over 82% demanded screening for HIV as a precondition for marriage and 97.2% agreed to have a VCT service. The findings of the study indicate that the prevalence of HIV infection is low among high school students in Gondar. The students had adequate knowledge about HIV/AIDS and VCT despite the risky practices. Continued health education is needed to bring behavioral changes.The Ethiopian Journal of Health Development Vol. 21 (2) 2007: pp. 179-18

Co-morbid mental health conditions in people with epilepsy and association with quality of life in low- and middle-income countries:a systematic review and meta-analysis

Background: Comorbid mental health conditions are common in people with epilepsy and have a significant negative impact on important epilepsy outcomes, although the evidence is mostly from high-income countries. This systematic review aimed to synthesise evidence on the association between comorbid mental health conditions and quality of life and functioning among people with epilepsy living in low- and middle income countries (LMICs). Methods: We searched PubMed, EMBASE, CINAHL, Global Index medicus (GID) and PsycINFO databases from their dates of inception to January 2022. Only quantiative observational studies were included. Meta-analysis was conducted for studies that reported the same kind of quality of life and functioning outcome. Cohen’s d was calculated from the mean difference in quality-of-life score between people with epilepsy who did and did not have a comorbid depression or anxiety condition. The protocol was registered with PROSPERO: CRD42020161487. Results: The search strategy identified a total of 2,101 articles, from which 33 full text articles were included. Depression was the most common comorbid mental health condition (33 studies), followed by anxiety (16 studies). Meta-analysis was conducted on 19 studies reporting quality of life measured with the same instrument. A large standardized mean effect size (ES) in quality of life score was found (pooled ES = −1.16, 95% confidence interval (CI) − 1.70, − 0.63) between those participants with comorbid depression compared to non-depressed participants. There was significant heterogeneity between studies (I 2 = 97.6%, p < 0.001). The median ES (IQR) was − 1.20 (− 1.40, (− 0.64)). An intermediate standard effect size for anxiety on quality of life was also observed (pooled ES = −0.64, 95% CI − 1.14, − 0.13). There was only one study reporting on functioning in relation to comorbid mental health conditions. Conclusion: Comorbid depression in people with epilepsy in LMICs is associated with poor quality of life although this evidence is based on highly heterogeneous studies. These findings support calls to integrate mental health care into services for people with epilepsy in LMICs. Future studies should use prospective designs in which the change in quality of life in relation to mental health or public health interventions across time can be measured

Risk factors for brucellosis and knowledge-attitude practice among pastoralists in Afar and Somali regions of Ethiopia

BACKGROUND: Brucellosis is a neglected bacterial zoonotic disease with substantial economic impact on households. Pastoral communities are a potential risk group due to their way of life being closely interlinked with their large livestock herds. METHODOLOGY: A semi-structured questionnaire survey was conducted in households in the pastoral Afar and Somali (SRS) regions. All households had people and animals serologically tested for brucellosis. Questions were related to husbandry, consumption habits, and knowledge-attitude-practice towards the disease and zoonoses. Descriptive statistics and logistic analysis were performed to assess potential risk factors for having households with positive humans and/or animals. RESULT: 647 households were included in the survey. Herd brucellosis prevalence was 40.3 % (15.9-86.3 % in Afar; 4-72.2 % in SRS). Over half (56.3 %) of the households in Afar and 41.8 % in SRS had at least one human reactor. Nearly a quarter of the households (22.8 %), recalled abortions in goats in the last 12 months, whereas 52.5 % and 50.3 % recalled stillborn in all species and membrane retentions respectively. All respondents drank raw milk and discarded animal afterbirths in the direct surroundings with minimal protection. Risk factors for animal reactors were goat herd size, and goat abortion. There was no identified risk factor for having human reactors in households. None of the households knew about brucellosis. CONCLUSION: Although being endemic in Afar and SRS, Brucellosis is not known by the pastoralists. Brucellosis control programs will have to be tailored to the pastoral context, accounting for their mobility, large, multi-species herds and habits

Integrated human-animal sero-surveillance of Brucellosis in the pastoral Afar and Somali regions of Ethiopia

BACKGROUND: Brucellosis is widespread in Ethiopia with variable reported prevalence depending on the geographical area, husbandry practices and animal species. However, there is limited information on the disease prevalence amongst pastoral communities, whose life is intricately linked with their livestock. METHODOLOGY: We conducted an integrated human-animal brucellosis sero-surveillance study in two adjacent pastoral regions, Afar and Somali region (SRS). This cross-sectional study included 13 woredas (districts) and 650 households. Blood samples were collected from people and livestock species (cattle, camel, goats and sheep). Sera were analyzed with C-ELISA for camels and shoats (sheep and goats), with I-ELISA for cattle and IgG ELISA for humans. Descriptive and inferential statistics analyses were performed. RESULTS: A total of 5469 sera were tested by ELISA. Prevalence of livestock was 9.0% in Afar and 8.6% in SRS (ranging from 0.6 to 20.2% at woreda level). In humans, prevalence was 48.3% in Afar and 34.9% in SRS (ranging from 0.0 to 74.5% at woreda level). 68.4% of all households in Afar and 57.5% of households in SRS had at least one animal reactor. Overall, 4.1% of animals had a history of abortion. The proportion of animals with abortion history was higher in seropositive animals than in seronegative animals. Risk factor analysis showed that female animals were significantly at higher risk of being reactors (p = 0.013). Among the species, cattle had the least risk of being reactors (p = 0.014). In humans, there was a clear regional association of disease prevalence (p = 0.002). The older the people, the highest the odds of being seropositive. CONCLUSION: Brucellosis is widespread in humans and animals in pastoral communities of Afar and SRS with the existence of geographical hotspots. No clear association was seen between human and particular livestock species prevalence, hence there was no indication as whether B. abortus or B. melitensis are circulating in these areas, which warrants further molecular research prior to embarking on a national control programs. Such programs will need to be tailored to the pastoral context

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI