Individual correlates of podoconiosis in areas of varying endemicity: a case-control study

BACKGROUND Podoconiosis is a non-filarial form of elephantiasis resulting in lymphedema of the lower legs. Previous studies have suggested that podoconiosis arises from the interplay of individual and environmental factors. Here, our aim was to understand the individual-level correlates of podoconiosis by comparing 460 podoconiosis-affected individuals and 707 unaffected controls. METHODS/PRINCIPAL FINDINGS This was a case-control study carried out in six kebeles (the lowest governmental administrative unit) in northern Ethiopia. Each kebele was classified into one of three endemicity levels: 'low' (prevalence 5%). A total of 142 (30.7%) households had two or more cases of podoconiosis. Compared to controls, the majority of the cases, especially women, were less educated (OR = 1.7, 95% CI = 1.3 to 2.2), were unmarried (OR = 3.4, 95% CI = 2.6-4.6) and had lower income (t = -4.4, p<0.0001). On average, cases started wearing shoes ten years later than controls. Among cases, age of first wearing shoes was positively correlated with age of onset of podoconiosis (r = 0.6, t = 12.5, p<0.0001). Among all study participants average duration of shoe wearing was less than 30 years. Between both cases and controls, people in 'high' and 'medium' endemicity kebeles were less likely than people in 'low' endemicity areas to 'ever' have owned shoes (OR = 0.5, 95% CI = 0.4-0.7). CONCLUSIONS Late use of shoes, usually after the onset of podoconiosis, and inequalities in education, income and marriage were found among cases, particularly among females. There were clustering of cases within households, thus interventions against podoconiosis will benefit from household-targeted case tracing. Most importantly, we identified a secular increase in shoe-wearing over recent years, which may give opportunities to promote shoe-wearing without increasing stigma among those at high risk of podoconiosis

Determinants of mortality among under-five children admitted with severe acute malnutrition in Addis Ababa, Ethiopia.

BACKGROUND: Management of severe acute malnutrition (SAM) has been a program priority in Ethiopia, but it remains the leading cause of mortality in under-five children. Hence, this study aimed to identify the incidence density rate of mortality and determinants among under-five children with severe acute malnutrition in St. Paul's Hospital Millennium Medical College, 2012 to 2019. METHODS: A retrospective cohort study was conducted and data were collected using a structured checklist from 673 charts, of which 610 charts were included in the final analysis. The Kaplan-Meier survival curve with Log-rank test was used to estimate the survival time. Bi-variable and multi-variable Cox proportional hazard regression models were fitted to identify determinants of death. Schoenfeld residuals test was used to check a proportional hazard assumption. Goodness of fit of the final model was checked using Nelson Aalen cumulative hazard function against Cox-Snell residual. RESULTS: In this study, 61 (10%) children died making the incidence density rate of death 5.6 (95% CI: 4.4, 7.2) per 1000 child-days. Shock (Adjusted Hazard Ratio) [AHR] =3.2; 95% CI: 1.6, 6.3)), IV fluid infusion (AHR = 5.2; 95% CI: 2.4, 10.4), supplementing F100 (AHR = 0.12; 95%CI: 0.06, 0.23) and zinc (AHR = 0.45; 95% CI: 0.22, 0.93) were determinants of death. CONCLUSION: The overall proportion of deaths was within the range put forth by the Sphere standard and the national SAM management protocol. Shock and IV fluid infusion increased the hazard of death, whereas F100 & zinc were found to decrease the likelihood death. Children with SAM presented with shock should be handled carefully and IV fluids should be given with precautions

Seroepidemiology of measles in Addis Ababa, Ethiopia: implications for control through vaccination.

We undertook a representative survey of measles antibodies in Addis Ababa, Ethiopia 1994, to characterize immunity and transmission. Specific-antibody levels (IU/l) were determined by ELISA for 4654 sera from individuals aged 0-49 years (1805 < 15 years) collected by stratified household-cluster sampling. The proportion seronegative (< 100 IU/l) was 20% (95% CI: 16-25) in children 9-59 months old, declining to 9% (7-12) in 5-9 year olds, 5% (4-7) in 10-14 year olds, and < 1% in adults. The proportion of children (< 15 years old) with low-level antibody (100-255 IU/l) was 8% (7-10). Vaccination and an absence of a history of measles illness were strongly associated with low-level antibody. History of measles vaccination in 9 months to 14-year-old children was approximately 80%. We estimate a primary vaccine failure rate of 21% (12-34) and continued high measles incidence of 22 per 100 susceptibles (19-24) per annum. Our data support the introduction of campaign vaccination in the city in 1998, although higher routine vaccine coverage is required to sustain the impact. The implications of a high prevalence of low-level antibody are discussed

Capacity Gaps in Post Disaster Waste Management: Case Study in Sri Lanka

Disaster waste is one of the major consequences aftermath of any disaster, impacts on public and environment, rescue and emergency services, provision of lifeline support and socio-economic recovery of affected areas. Thus, management of wastes created by disasters has become an increasingly important issue to be addressed in responding to a disaster. This chapter intends to present the prevailing gaps in disaster waste management and approaches to minimize the impacts on disaster management at developing countries with special emphasis to Sri Lankan context. Findings revealed that, unavailability of single point responsibility and provisions for disaster waste in existing policies and capacity constraints of the prevailing peace time solid waste management practices as major capacity gaps. Establishment of a regulatory body and enforceable rules and regulations with necessary levels of capacities were identified with seven areas for capacity building for post disaster waste management. The research enabled to attain sustainable post disaster waste management for future resilience

Lower Crustal Earthquakes in the March 2018 Sequence Along the Western Margin of Afar

During the evolution of continental rift systems, extension is thought to progressively focus in-rift to the future breakup boundary while faults along the rift margins progressively deactivate. However, observational constraints on how strain is partitioned between rift axis and rift margins are still lacking. The Afar rift records the latest stages of rifting and incipient continental breakup. Here, we analyzed the recent MW 5.2 earthquake on the Western Afar Margin on March 24, 2018 and the associated seismic sequence of &gt;500 earthquakes using 24 temporary seismic stations deployed during 2017–2018. We show seismicity occurring at lower crustal depths, from ∼15 to ∼30&nbsp;km, with focal mechanisms and relocated earthquakes highlighting both west-dipping and east-dipping normal faults. We tested earthquake depth using InSAR by processing six independent interferograms using Sentinel-1 data acquired from both ascending and descending tracks. None of them shows evidence of surface deformation. We tested possible ranges of depth by producing forward models for a fault located at progressively increasing depths. Models show that surface deformation is not significant for fault slip at depths greater than 15&nbsp;km, in agreement with the hypocentral depth of 19&nbsp;km derived from seismic data for the largest earthquake. Due to the localized nature of deep earthquakes near hot springs coupled with subsurface evidence for magmatism, we favor an interpretation of seismicity induced by migrating fluids such as magma or CO2. We suggest that deep fluid migration can occur at the rifted-margin influencing seismicity during incipient continental rupture

Lower Crustal Earthquakes in the March 2018 Sequence Along the Western Margin of Afar

During the evolution of continental rift systems, extension is thought to progressively focus in-rift to the future breakup boundary while faults along the rift margins progressively deactivate. However, observational constraints on how strain is partitioned between rift axis and rift margins are still lacking. The Afar rift records the latest stages of rifting and incipient continental breakup. Here, we analyzed the recent M W 5.2 earthquake on the Western Afar Margin on March 24, 2018 and the associated seismic sequence of &gt;500 earthquakes using 24 temporary seismic stations deployed during 2017–2018. We show seismicity occurring at lower crustal depths, from ∼15 to ∼30 km, with focal mechanisms and relocated earthquakes highlighting both west-dipping and east-dipping normal faults. We tested earthquake depth using InSAR by processing six independent interferograms using Sentinel-1 data acquired from both ascending and descending tracks. None of them shows evidence of surface deformation. We tested possible ranges of depth by producing forward models for a fault located at progressively increasing depths. Models show that surface deformation is not significant for fault slip at depths greater than 15 km, in agreement with the hypocentral depth of 19 km derived from seismic data for the largest earthquake. Due to the localized nature of deep earthquakes near hot springs coupled with subsurface evidence for magmatism, we favor an interpretation of seismicity induced by migrating fluids such as magma or CO 2. We suggest that deep fluid migration can occur at the rifted-margin influencing seismicity during incipient continental rupture. </p

Seismicity and crustal structure of the southern main Ethiopian rift: new evidence from Lake Abaya

The Main Ethiopian Rift (MER) has developed during the 18 Ma-Recent separation of the Nubian and Somalian plates. Extension in its central and northern sectors is associated with seismic activity and active magma intrusion, primarily within the rift, where shallow (urn:x-wiley:15252027:media:ggge22586:ggge22586-math-00015 km) seismicity along magmatic centers is commonly caused by fluid flow through open fractures in hydrothermal systems. However, the extent to which similar magmatic rifting persists into the southern MER is unknown. Using data from a temporary network of five seismograph stations, we analyze patterns of seismicity and crustal structure in the Abaya region of the southern MER. Magnitudes range from 0.9 to 4.0; earthquake depths are 0–30 km. urn:x-wiley:15252027:media:ggge22586:ggge22586-math-0002 ratios of urn:x-wiley:15252027:media:ggge22586:ggge22586-math-00031.69, estimated from Wadati diagram analysis, corroborate bulk-crustal urn:x-wiley:15252027:media:ggge22586:ggge22586-math-0004 ratios determined via teleseismic P-to-S receiver function H-urn:x-wiley:15252027:media:ggge22586:ggge22586-math-0005 stacking and reveal a relative lack of mafic intrusion compared to the MER rift sectors to the north. There is a clear association of seismicity with the western border fault system of the MER everywhere in our study area, but earthquake depths are shallow near Duguna volcano, implying a shallowed geothermal gradient associated with rift valley silicic magmatism. This part of the MER is thus interpreted best as a young magmatic system that locally impacts the geothermal gradient but that has not yet significantly modified continental crustal composition via rift-axial magmatic rifting