PERCEPTIONS OF TEACHERS AND STUDENTS ON THE PRACTICES OF EDUCATIONAL QUALITY ENHANCEMENT IN DILLA UNIVERSITY: A DIFFERENTIAL STUDY

Despite the rapid enrolment expansion during the last few years, higher education participation rate in Sub‐Saharan African region has remained among the lowest in the world (6%). At present, the major challenge facing many Sub‐Saharan African nations is, on the one hand, of addressing the unmet demand for access through rapid expansion of their higher education and on the other, of improving quality of their education in the context of the prevailing socio‐economic, fiscal and political constraints. Under these circumstances, a descriptive survey was conducted using both qualitative and quantitative approaches to data collection and analysis to seek out and investigate the perception of teachers and students on the practices of educational quality enhancement in Dilla University besides exploring and justifying the current practices of educational issues.  Article visualizations

PERCEPTIONS OF TEACHERS AND STUDENTS ON THE PRACTICES OF EDUCATIONAL QUALITY ENHANCEMENT IN DILLA UNIVERSITY: A CORRELATION STUDY

The development and practices of enhancing quality in higher education is one of the areas of the ongoing debate. Quality of education and its enhancement come at the forefront of all crucial issues in the context of increasing recognition of the role of higher education for national development. Universities in general, become complex in terms of expanding access and study programs and they depend on government for their full financial resources. These trends raise a concern about quality of education and thus lead to demand for accountability on the part of university. The study, being a descriptive survey, used both qualitative and quantitative approaches to data collection with a view to investigate the perception of teachers and students on the practices of educational quality enhancement in Dilla University. The use of the qualitative approach substantiated the investigators to develop an understanding of individuals and events in their natural settings.  Article visualizations

Determinants of delay in seeking treatment among malaria patients in Dera district, NorthWest Ethiopia: a case control study

Background: Prompt and effective treatment of malaria is critical because delays increase the risk for serious illness, disability and death.Objective: To assess determinants of delay in seeking treatment among malaria patients at Dera district, NorthWest Ethiopia. Methods: A case control study was conducted from September 01 to October 15, 2014. A total of 318 malaria patients diagnosed using microscopy or rapid diagnostic test, and who sought treatment in health centers were interviewed. Multivariable logistic regression was done to identify determinants of delay.Results: Delay was high when a patient earned less than 25.0 USD [AOR=15.7, 95% CI: 4.8 - 51.2] and 9.6 times higher if he/she was not a member of community based health insurance [AOR= 9.6, 95% CI: 4.4 - 21.3]. Respondents who travelled for more than 30 minutes to get to a health facility [AOR= 4.4, 95% CI: 1.2 - 15.9] were more likely to be late in seeking treatment for malaria. Conclusion: Income, community based health insurance, previous history of malaria infection, decision making and distance were determinants of delay in seeking treatment for malaria. To reduce the delay, interventions should focus on outreach malaria services and increase enrollment to community based health insurance.Keywords: Malaria, treatment seeking, Ethiopia

Prevalence of Anemia and Associated Factors among PHIVs Attendants Antiretroviral Therapy Clinics in Public Health Institutions in Dire Dawa Town, East Ethiopia

Background: Anemia is one of the most commonly observed hematological abnormalities and an independent prognostic marker of Human Immunodeficiency virus (HIV) disease progression in people living with HIV. However, there is limited evidence on the magnitude and its correlates among attendants of Antiretroviral Therapy (ART) in low-income countries including Ethiopia. Objective: The aim this study was to determine Prevalence of anemia and associated factors among PHIVs attendants Antiretroviral Therapy clinics in public health institutions in Dire Dawa Town, East Ethiopia Methods: An institution based cross - sectional study design was used from mid January to mid February 2014.The study participants were selected by using simple random sampling technique. A pre- tested structured questionnaire was used to collect data. Both bivariate and multivariable logistic regressions were used to identify associated factors. Hematological and immunological data were collected by using blood samples. Odds ratio along with 95% confidence interval was estimated to identify factors associated with anemia among the study population using a multivariable logistic regression. Results: The prevalence of anemia was 41.2%, 95% CI (36.7%, 45.9%). In multivariable logistic regression analysis, being female[AOR=1.95, 95% CI (1.22, 3.11)], use of different types of  zidovudine (AZT) based Highly Active Antiretroviral Therapy (HAART) : 1c:AZT+3TC+ neverapine [ AOR=2.56 , 95% CI (1.28,5.12) ] , and 1d: AZT+3TC + Evaferenz [ AOR=2.99 , 95% CI(1.27,7.03)] , overall ART category: zidovudine - based HAART  [ AOR=2.98, 95% CI (1.27,6.99)] ,  WHO’s HIV  clinical  stage III [AOR=2.49, 95% CI: (1.24, 5.01)] and stage IV [AOR= 5.92, 95% CI (1.26, 27.8)] , and lower CD4 count [AOR=2.34, 95% CI (1.10,4.98)]  were  independently associated with anemia .Conclusion: Macrocytic anemia was common among patients taking Antiretroviral Therapy. The likelihood of developing anemia increases with disease progression associated decreased immunological state and use of zidovudin-based HAART. Therefore, those factors associated with anemia among PHIVs would be emphatically considered comprehensive care and treatment for PHIVs by including anemia treatment and prevention strategies by police makers in collaboration with others responsible bodies. Keywords: Anemia, Antiretroviral Therapy, Ethiopia, Dire Dawa , Macrocytosis, Zidovudin

Survey of ethno-veterinary medicinal plants at selected districts of Harari Regional State, Eastern Ethiopia

The survey of ethno-veterinary medicinal plants was conducted from November,2014 to April, 2015 at selected districts of Harari Regional State, eastern Ethiopia.The aim of the study was to identify and document medicinal plants and the associated ethno-medicinal knowledge of the local community. Semi-structured interview, guided field observation, group discussion and market survey were used to collect the required data. Informant consensus method and group discussion wereconducted for crosschecking and verification of the information. Both descriptivestatistics and quantitative methods were used for data analysis. About 46 plantspecies belonging to 33 families were identified and documented based on the localclaims of the plants. Majority plant taxa were collected from the wild (54.4%) followed by domestic once (24%). Among these plant families, Fabaceae, Solanaeceae and Euphorbiaceae were commonly used to treat Equine colic, retained placenta and Black leg respectively. The most frequently used plant parts were reported to be the leaves (37%) and then the roots (30.4%). The condition of preparation was in the fresh form (82.5%) and fresh/dry form (17.5%). Oral  administration (65.3%) was the most common route of administration. In  conclusion, the participants have a wealth of indigenous knowledge about plant medicines for treating their livestock but, agricultural expansion was the major threats to medicinal plants in the study area. Thus, awareness creation should be done in order to conserve and document the plants. Keywords: Ethno-veterinary, Medicinal plants, Indigenous knowledge, HarariRegional Stat

Determinants of delay in seeking treatment among malaria patients in Dera district, NorthWest Ethiopia: a case control study

Background: Prompt and effective treatment of malaria is critical because delays increase the risk for serious illness, disability and death. Objective: To assess determinants of delay in seeking treatment among malaria patients at Dera district, NorthWest Ethiopia. Methods: A case control study was conducted from September 01 to October 15, 2014. A total of 318 malaria patients diagnosed using microscopy or rapid diagnostic test, and who sought treatment in health centers were interviewed. Multivariable logistic regression was done to identify determinants of delay. Results: Delay was high when a patient earned less than 25.0 USD [AOR=15.7, 95% CI: 4.8 - 51.2] and 9.6 times higher if he/she was not a member of community based health insurance [AOR= 9.6, 95% CI: 4.4 - 21.3]. Respondents who travelled for more than 30 minutes to get to a health facility [AOR= 4.4, 95% CI: 1.2 - 15.9] were more likely to be late in seeking treatment for malaria. Conclusion: Income, community based health insurance, previous history of malaria infection, decision making and distance were determinants of delay in seeking treatment for malaria. To reduce the delay, interventions should focus on outreach malaria services and increase enrollment to community based health insurance

Serological evidence for a decline in malaria transmission following major scale-up of control efforts in a setting selected for Plasmodium vivax and Plasmodium falciparum malaria elimination in Babile district, Oromia, Ethiopia.

BACKGROUND: Following successful malaria control during the last decade, Ethiopia instituted a stepwise malaria elimination strategy in selected low-transmission areas. METHODS: Cross-sectional surveys were conducted in Babile district, Oromia, Ethiopia from July to November 2017 to evaluate malaria infection status using microscopy and nested polymerase chain reaction (nPCR) and serological markers of exposure targeting Plasmodium falciparum and Plasmodium vivax apical membrane antigen-1 (AMA-1). RESULTS: Parasite prevalence was 1.2% (14/1135) and 5.1% (58/1143) for P. falciparum and 0.4% (5/1135) and 3.6% (41/1143) for P. vivax by microscopy and nPCR, respectively. Antibody prevalence was associated with current infection by nPCR for both P. falciparum (p<0.001) and P. vivax (p=0.014) and showed an age-dependent increase (p<0.001, for both species). Seroconversion curves indicated a decline in malaria exposure 15 y prior to sampling for P. falciparum and 11.5 y prior to sampling for P. vivax, broadly following malaria incidence data from district health offices, with higher antibody titres in adults than children for both species. CONCLUSIONS: Malaria transmission declined substantially in the region with continuing heterogeneous but measurable local transmission, arguing in favour of continued and tailored control efforts to accelerate the progress towards elimination efforts

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation