THE PREVALENCE OF LEPROSY AMONG DIFFERENT ETHNIC GROUPS IN THE BLUE NILE VALLEY OF WESTERN ETHIOPIA

ABSTRACT: An epidemiological study of leprosy among different ethnic groups in the Blue Nile valley of western Ethiopia was conducted to obtain baseline data on disease prevalence. A total of 1430 people in three villages were examined for clinical signs and symptoms of leprosy. History, physical examination and skin smears were done. The prevalence rate of leprosy was found to be the highest (53/1000) among the Nilotic people on the southern banks of the Blue Nile River, while the prevalence for Oromo people of the highest altitudes was near zero. For the Nilotic people of Dalati (altitude 1,200 m) the prevalence rate was 18/1000. Although it constitutes a major health problem in the lowlands, leprosy seems to be comparatively less prevalent in the highlands. Possible socio-cultural explanations for this epidemiological pattern of leprosy in Mendi District are discussed and suggestions for further investigation and control measures are given

THE PREVALENCE OF LEPROSY AMONG DIFFERENT ETHNIC GROUPS IN THE BLUE NILE VALLEY OF WESTERN ETHIOPIA

ABSTRACT: An epidemiological study of leprosy among different ethnic groups in the Blue Nile valley of western Ethiopia was conducted to obtain baseline data on disease prevalence. A total of 1430 people in three villages were examined for clinical signs and symptoms of leprosy. History, physical examination and skin smears were done. The prevalence rate of leprosy was found to be the highest (53/1000) among the Nilotic people on the southern banks of the Blue Nile River, while the prevalence for Oromo people of the highest altitudes was near zero. For the Nilotic people of Dalati (altitude 1,200 m) the prevalence rate was 18/1000. Although it constitutes a major health problem in the lowlands, leprosy seems to be comparatively less prevalent in the highlands. Possible socio-cultural explanations for this epidemiological pattern of leprosy in Mendi District are discussed and suggestions for further investigation and control measures are given

Prevalence of pulmonary TB and spoligotype pattern of Mycobacterium tuberculosis among TB suspects in a rural community in Southwest Ethiopia

<p>Abstract</p> <p>Background</p> <p>In Ethiopia where there is no strong surveillance system and state of the art diagnostic facilities are limited, the real burden of tuberculosis (TB) is not well known. We conducted a community based survey to estimate the prevalence of pulmonary TB and spoligotype pattern of the <it>Mycobacterium tuberculosis </it>isolates in Southwest Ethiopia.</p> <p>Methods</p> <p>A total of 30040 adults in 10882 households were screened for pulmonary TB in Gilgel Gibe field research centre in Southwest Ethiopia. A total of 482 TB suspects were identified and smear microscopy and culture was done for 428 TB suspects. Counseling and testing for HIV/AIDS was done for all TB suspects. Spoligotyping was done to characterize the <it>Mycobacterium tuberculosis </it>isolates.</p> <p>Results</p> <p>Majority of the TB suspects were females (60.7%) and non-literates (83.6%). Using smear microscopy, a total of 5 new and 4 old cases of pulmonary TB cases were identified making the prevalence of TB 30 per 100,000. However, using the culture method, we identified 17 new cases with a prevalence of 76.1 per 100,000. There were 4.3 undiagnosed pulmonary TB cases for every TB case who was diagnosed through the passive case detection mechanism in the health facility. Eleven isolates (64.7%) belonged to the six previously known spoligotypes: T, Haarlem and Central-Asian (CAS). Six new spoligotype patterns of <it>Mycobacterium tuberculosis</it>, not present in the international database (SpolDB4) were identified. None of the rural residents was HIV infected and only 5 (5.5%) of the urban TB suspects were positive for HIV.</p> <p>Conclusion</p> <p>The prevalence of TB in the rural community of Southwest Ethiopia is low. There are large numbers of undiagnosed TB cases in the community. However, the number of sputum smear-positive cases was very low and therefore the risk of transmitting the infection to others may be limited. Active case finding through health extension workers in the community can improve the low case detection rate in Ethiopia. A large scale study on the genotyping of <it>Mycobacterium tuberculosis </it>in Ethiopia is crucial to understand transmission dynamics, identification of drug resistant strains and design preventive strategies.</p

Prejudice and misconceptions about tuberculosis and HIV in rural and urban communities in Ethiopia: a challenge for the TB/HIV control program

<p>Abstract</p> <p>Background</p> <p>In Ethiopia, where HIV and tuberculosis (TB) are very common, little is known about the prejudice and misconceptions of rural communities towards People living with HIV/AIDS (PLHA) and TB.</p> <p>Methods</p> <p>We conducted a cross sectional study in Gilgel Gibe Field Research area (GGFRA) in southwest Ethiopia to assess the prejudice and misconceptions of rural and urban communities towards PLHA and TB. The study population consisted of 862 randomly selected adults in GGFRA. Data were collected by trained personnel using a pretested structured questionnaire. To triangulate the findings, 8 focus group discussions among women and men were done.</p> <p>Results</p> <p>Of the 862 selected study participants, 750(87%) accepted to be interviewed. The mean age of the respondents was 31.2 (SD ± 11.0). Of the total interviewed individuals, 58% of them were females. More than half of the respondents did not know the possibility of transmission of HIV from a mother to a child or by breast feeding. For fear of contagion of HIV, most people do not want to eat, drink, and share utensils or clothes with a person living with HIV/AIDS. A higher proportion of females [OR = 1.5, (95% CI: 1.0, 2.2)], non-literate individuals [OR = 2.3, (95%CI: 1.4, 3.6)], rural residents [OR = 3.8, (95%CI: 2.2, 6.6)], and individuals who had poor knowledge of HIV/AIDS [OR = 2.8, (95%CI: 1.8, 2.2)] were more likely to have high prejudice towards PLHA than respectively males, literates, urban residents and individuals with good knowledge. Exposure to cold air was implicated as a major cause of TB. Literates had a much better knowledge about the cause and methods of transmission and prevention of TB than non-literates. More than half of the individuals (56%) had high prejudice towards a patient with TB. A larger proportion of females [OR = 1.3, (95% CI: 1.0, 1.9)] and non-literate individuals [OR = 1.4, (95% CI: 1.1, 2.0)] had high prejudice towards patients with TB than males and literate individuals.</p> <p>Conclusion</p> <p>TB/HIV control programs in collaboration with other partners should invest more in social mobilization and education of the communities to rectify the widespread prejudice and misconceptions.</p

Determinants of Antenatal Care Utilization in Jimma Town, Southwest Ethiopia

No abstract - Available on PD

Assessment of quality of care in family planning services in Jimma Zone, Southwest Ethiopia

Background: Providing quality of care in family planning services is an important task for care providers so as to increase service utilization and coverage; however, little is known about the existing quality of care in such services. Objective: To assess quality of care in family planning services in Jimma Zone, southwest Ethiopia. Methods: A cross-sectional survey was conducted from January 20-24,2003 in eight service delivery points in Jimma zone. Three modules consisting six elements of quality in accordance with Bruce-Jain framework were used; observation was made during 687 clients interacting with their providers (the number of providers was 17), exit interview was made with 635 clients, and facility audit was also carried out. Results: More than 80% of unmarried clients were getting the service from non-governmental clinic. Sixty-nine (10.9%) and 14(8.1% of those who reported problem) clients expressed dissatisfaction with waiting time and solutions given by the provider respectively. Method unavailability was the reason in most service delivery points for providing methods different from clients' choices. Most clients were not told method specific and other relevant information. Provider's special training and the time of the training have shown statistically significant difference on six and two quality of care indicators respectively. Majority of the service delivery points did not have copy of guideline and mechanism to make programmatic change based on clients' feedback; all were not supervised in the last three months prior to data collection. Conclusion: Several constraints in the provision of the service are identified and recommendations are forwarded accordingly. [Ethiop.J.Health Dev. 2003;18(1):8-18

Tuberculosis lymphadenitis in Southwest Ethiopia: a community based cross-sectional study

Abstract Background In Ethiopia where there is no strong surveillance system and diagnostic facilities are limited, the real burden of tuberculosis (TB) lymphadenitis is not well known. Therefore, we conducted a study to estimate the prevalence of TB lymphadenitis in Southwest Ethiopia. Methods A community based cross-sectional study was conducted from February to March 2009 in the Gilgel Gibe field research area. A total of 30,040 individuals 15 years or older in 10,882 households were screened for TB lymphadenitis. Any individual 15 years or older with lumps in the neck, armpits or groin up on interview were considered TB lymphadenitis suspect. The diagnosis of TB lymphadenitis was established when acid fast bacilli (AFB) smear microscopy of fine needle aspiration (FNA) sample, culture or cytology suggested TB. HIV counseling and testing was offered to all TB lymphadenitis suspects. Descriptive and bivariate analysis was done using SPSS version 15. Results Complete data were available for 27,597 individuals. A total of 87 TB lymphadenitis suspects were identified. Most of the TB lymphadenitis suspects were females (72.4%). Sixteen cases of TB lymphadenitis were confirmed. The prevalence of TB lymphadenitis was thus 58.0 per 100,000 people (16/27,597) (95% CI 35.7-94.2). Individuals who had a contact history with chronic coughers (OR 5.58, 95% CI 1.23-25.43) were more likely to have TB lymphadenitis. Lymph nodes with caseous FNA were more likely to be positive for TB lymphadenitis (OR 5.46, 95% CI 1.69-17.61). Conclusion The prevalence of TB lymphadenitis in Gilgel Gibe is similar with the WHO estimates for Ethiopia. Screening of TB lymphadenitis particularly for family members who have contact with chronic coughers is recommended. Health extension workers could be trained to screen and refer TB lymphadenitis suspects using simple methods.</p

Factors associated with knowledge about the cause of TB among TB suspects (n = 395) in the Gilgel Gibe field research area, south west Ethiopia, March 2009.

<p>*Significant (<i>p</i><0.05),</p>†<p>Adjusted for marital status, sex and literacy status.</p

Factors associated with stigma towards TB among TB suspects (n = 389) in the Gilgel Gibe field research area, south west Ethiopia, March 2009.

<p>*High = total stigma score greater than or equal to the mean score of the study population, low =  total stigma score less than the mean score of the study population.</p