Improving sensitivity of oral fluid testing in IgG prevalence studies: application of mixture models to a rubella antibody survey

A method for the analysis of age-stratified antibody prevalence surveys is applied to a previously reported survey of antibody to rubella virus using oral fluid samples in which the sensitivity of the assay used was shown to be compromised. The age-specific distribution of the quantitative results of antibody tests using oral fluids is modelled as a mixture of strong positive, weak positive and negative components. This yields maximum likelihood estimates of the prevalence at each age and demonstrates that, when used in conjunction with mixture modelling techniques, the results of antibody prevalence studies using oral fluids accurately reflect those obtained using sera

Sero-epidemiology of rubella in the urban population of Addis Ababa Ethiopia

We conducted a community-based cluster sample survey of rubella sero-epidemiology in Addis Ababa, Ethiopia in 1994. Among 4666 individuals for whom complete data were available, rubella antibody prevalence was 91% (95% confidence interval: 90, 92). On multivariable analysis, seroprevalence was lower among individuals who were resident in Addis Ababa for 1 year or less. Approx. 50% seroprevalence was attained by age 4 years, and the estimated average age at infection was 5·2 years. The highest age-specific force of infection was estimated to occur in 5- to 9-year-olds. The early age at infection corresponded with a low estimated incidence of congenital rubella syndrome (CRS) of 0·3 per 1000 live births, equivalent to nine cases of CRS in 1994. The predicted critical level of immunity for elimination of rubella via vaccination was 85–91%, requiring 89–96% coverage with a vaccine of 95% effectiveness. Unless very high coverage of rubella vaccine could be guaranteed, the introduction of childhood vaccination could increase the incidence of CRS in Addis Ababa

X-ray film reject rate analysis at eight selected government hospitals in Addis Ababa, Ethiopia, 2010

Background: Improper practices in radiography that lead to possible repeating of procedures predispose patients for additional cost, more waiting time, and excess dose of ionizing radiation, leading to various dose dependent and dose independent health problems including cancer. In the face of such problems and the scarcity of resources, improvingthe quality and efficiency of radiology services is imperative.Objective: The purpose of this research was to identify the main causes of film faults as well as the pattern and magnitude of film rejection.Methods: Using a prospective cross-sectional hospital based approach; eight public hospitals were selected in Addis Ababa through convenience sampling. Adult and pediatrics radiographs with film faults were reviewed using a standardized checklist of common causes of reject. The collected data were then entered into a database for analysis using descriptive statistics.Results: Reject rate was calculated in eight governmental hospitals across all plain film examinations. The overall reject rate was 374 (3.1 %) in 12,165 x-ray exposures. Total reject rate by hospital showed 10.5% for Zewditu and 1.53% and 1.87% for Tikur Anbessa Specialized Hospital (TASH) and the Police Hospital, respectively.Conclusions: Rejected films were found to have been caused by numerous factors including poor technical judgment, patient motion, and poor supervision of staff. Hence, strategies need to be developed within medical imaging departments to improve the situation.[Ethiop. J. Health Dev. 2012;26(1):54-59

RESULTS OF A FARM AND MARKET SURVEY FOR HMONG SPECIALTY CROP FARMERS IN THE MINNEAPOLIS, ST. PAUL METRO AREA

This report is part of a larger project, "Risk Management Education and Farm Management Development Program for Hmong Specialty Crop Farmers in the Minneapolis, St. Paul Metro Area," funded by the Risk Management Agency, U.S. Department of Agriculture. The project was designed to assist Hmong farmers in the Twin Cities area in improving their production and management practices so they are able to increase their economic viability and reduce their exposure to risk. As part of the overall project, 62 Hmong farmers and 69 customers at farmers markets were surveyed to determine the local specialty crop production and market conditions. The findings of these 2 surveys are contained in the report. The median size of the 62 farms surveyed farms was 3 acres. Forty-two percent of those farmers responding reported total farm product sales between $3,000 and$8,999. Few farmers indicated they were familiar with crop insurance programs. Sixty-eight percent of the 19 farmers responding (or 21% of the 62 surveyed) said they were familiar with multi-peril crop insurance (MPCI). Only 12% of the 50 farmers responding had bought crop insurance in 2002. The most frequently indicated needs for future education programs were production oriented: weed control, insect control, fertilization, and pesticide safety. All of the 69 customers surveyed regularly bought some kind of vegetables or herbs. Over half of the customers bought potatoes, snap beans, peppers, sweet corn, carrots, cucumbers, basil, and winter squash. Eighty-eight percent of customers indicated they typically spend between $10 and$29 on vegetables and herbs during each visit to a farmers' market.Crop Production/Industries,

Pastoralists do plan! Community-led land use planning in the pastoral areas of Ethiopia

This paper consolidates a set of case studies which document how pastoralists plan land and resource use in pastoral and agro-pastoral areas of Ethiopia. These case studies are drawn from the regional states of Afar, Somali, Southern Nations, Nationalities, and Peoples (SNNP), Oromia, and Gambella. They describe not only why, how, and when pastoralists plan, but also the management and governance structures that control planning processes and the later implementation of the plans. By doing this, the paper provides guidance on how best such planning processes can be supported, and how they can be integrated with and/or built on by other planning processes such as those led by government

Mapping the vegetation of the Lake Tana basin, Ethiopia, using Google Earth images

The basin of Lake Tana is one of the most important watersheds in the Nile Basin. It is of great significance to the economy and politics of Ethiopia. In the past, the natural vegetation of the Lake Tana basin was heavily damaged to facilitate the continued expansion of cropland. Vegetation must be conserved and restored to protect the natural environment and maintain the biodiversity of the Lake Tana basin. In this research, we mapped the vegetation of the Lake Tana basin through visual interpretation using high-spatial-resolution images provided by Google Earth and field survey data to provide detailed information of the actual vegetation state for planning conservation and restoration. A total of 33&thinsp;171 polygons were generated to represent the vegetation patches of the Lake Tana basin on the map, and the validation using surveyed vegetation plots indicated that 90&thinsp;% of the patches were correctly identified. The DOI of the dataset used for map production is https://doi.org/10.4121/uuid:48d45053-36f6-411b-96b1-7ae0e22d56d0. We expect that this vegetation map could benefit vegetation conservation and restoration in the Lake Tana basin.</p

A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa

Background Chronic diseases, primarily cardiovascular disease, respiratory disease, diabetes and cancer, are the leading cause of death and disability worldwide. In sub-Saharan Africa (SSA), where communicable disease prevalence still outweighs that of non-communicable disease (NCDs), rates of NCDs are rapidly rising and evidence for primary healthcare approaches for these emerging NCDs is needed. Methods A systematic review and evidence synthesis of primary care approaches for chronic disease in SSA. Quantitative and qualitative primary research studies were included that focused on priority NCDs interventions. The method used was best-fit framework synthesis. Results Three conceptual models of care for NCDs in low- and middle-income countries were identified and used to develop an a priori framework for the synthesis. The literature search for relevant primary research studies generated 3759 unique citations of which 12 satisfied the inclusion criteria. Eleven studies were quantitative and one used mixed methods. Three higher-level themes of screening, prevention and management of disease were derived. This synthesis permitted the development of a new evidence-based conceptual model of care for priority NCDs in SSA. Conclusions For this review there was a near-consensus that passive rather than active case-finding approaches are suitable in resource-poor settings. Modifying risk factors among existing patients through advice on diet and lifestyle was a common element of healthcare approaches. The priorities for disease management in primary care were identified as: availability of essential diagnostic tools and medications at local primary healthcare clinics and the use of standardized protocols for diagnosis, treatment, monitoring and referral to specialist care

Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012

Iqbal S, Maqsood S, Zakar R, Zakria Zakar M, Fischer F. Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012. BMC Health Services Research. 2017;17(1): 189.Background Pakistan, being a developing country, presents the dismal picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal deaths could be avoided if Continuum of Care (CoC) is provided in a structured pathway from pregnancy to birth and to the first week of life of the newborn child. This study aimed to analyse the trends of CoC at all three levels (antenatal care, skilled delivery and postpartum care) and to identify various factors affecting the continuation in receiving CoC in Pakistan during 2006 to 2012. Methods Secondary data analysis was performed on nationally representative data from the last two iterations of Pakistan Demographic and Health Survey (PDHS), conducted during 2006/07 to 2012/13. The analysis is limited to women of the reproductive age group (15–49 years) who gave birth during the last five years preceding both surveys. This leads to a sample size of 5,724 and 7,461 respondents from PDHS 2006/07 and 2012/13 respectively. The association between CoC and several factors, including individual attributes (reproductive status), family influences, community context, as well as cultural and social values was assessed in bivariate analyses in a first step. Furthermore, odds ratios and adjusted odds ratios with 95% confidence intervals using a binary and multivariable logistic regression were calculated. Results Our research presents the trends of a composite measure of CoC including antenatal care, delivery assistance and postpartum care. The largest gap in CoC was observed at antenatal care followed by delivery and postnatal care within 48 h after delivery. Results show that CoC completion rate has increased from 15% to 27% amongst women in Pakistan over time from 2006 to 2012. Women with high age at first birth, having less number of children, with higher education, belonging to richest quintile, living in Sindh province and urban areas, having high autonomy and exposure to mass media were most likely to avail complete CoC. Conclusions The findings show that women in Pakistan still lack the CoC. This calls for attention to develop and implement tailored interventions, focusing on the needs of women in Pakistan to provide CoC in an integrated manner, involving both public and private sectors by appropriately addressing the factors hindering CoC completion rates

Growth inhibition of oral mutans streptococci and candida by commercial probiotic lactobacilli - an in vitro study

<p>Abstract</p> <p>Background</p> <p>Probiotic bacteria are suggested to play a role in the maintenance of oral health. Such health promoting bacteria are added to different commercial probiotic products. The aim of the study was to investigate the ability of a selection of lactobacilli strains, used in commercially available probiotic products, to inhibit growth of oral mutans streptococci and <it>C. albicans in vitro</it>.</p> <p>Methods</p> <p>Eight probiotic lactobacilli strains were tested for growth inhibition on three reference strains and two clinical isolates of mutans streptococci as well as two reference strains and three clinical isolates of <it>Candida albicans </it>with an agar overlay method.</p> <p>Results</p> <p>At concentrations ranging from 10⁹to 10⁵CFU/ml, all lactobacilli strains inhibited the growth of the mutans streptococci completely with the exception of <it>L. acidophilus </it>La5 that executed only a slight inhibition of some strains at concentrations corresponding to 10⁷and 10⁵CFU/ml. At the lowest cell concentration (10³CFU/ml), only <it>L. plantarum </it>299v and <it>L. plantarum </it>931 displayed a total growth inhibition while a slight inhibition was seen for all five mutans streptococci strains by <it>L. rhamnosus </it>LB21, <it>L. paracasei </it>F19, <it>L. reuteri </it>PTA 5289 and <it>L. reuteri </it>ATCC 55730. All the tested lactobacilli strains reduced candida growth but the effect was generally weaker than for mutans streptococci. The two <it>L. plantarum </it>strains and <it>L. reuteri </it>ATCC 55730 displayed the strongest inhibition on <it>Candida albicans</it>. No significant differences were observed between the reference strains and the clinical isolates.</p> <p>Conclusion</p> <p>The selected probiotic strains showed a significant but somewhat varying ability to inhibit growth of oral mutans streptococci and <it>Candida albicans in vitro</it>.</p

In vivo efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria in Central Ethiopia

<p>Abstract</p> <p>Background</p> <p><it>In vivo </it>efficacy assessments of the first-line treatments for <it>Plasmodium falciparum </it>malaria are essential for ensuring effective case management. In Ethiopia, artemether-lumefantrine (AL) has been the first-line treatment for uncomplicated <it>P. falciparum </it>malaria since 2004.</p> <p>Methods</p> <p>Between October and November 2009, we conducted a 42-day, single arm, open label study of AL for <it>P. falciparum </it>in individuals >6 months of age at two sites in Oromia State, Ethiopia. Eligible patients who had documented <it>P. falciparum </it>mono-infection were enrolled and followed according to the standard 2009 World Health Organization <it>in vivo </it>drug efficacy monitoring protocol. The primary and secondary endpoints were PCR uncorrected and corrected cure rates, as measured by adequate clinical and parasitological response on days 28 and 42, respectively.</p> <p>Results</p> <p>Of 4426 patients tested, 120 with confirmed falciparum malaria were enrolled and treated with AL. Follow-up was completed for 112 patients at day 28 and 104 patients at day 42. There was one late parasitological failure, which was classified as undetermined after genotyping. Uncorrected cure rates at both day 28 and 42 for the per protocol analysis were 99.1% (95% CI 95.1-100.0); corrected cure rates at both day 28 and 42 were 100.0%. Uncorrected cure rates at day 28 and 42 for the intention to treat analysis were 93.3% (95% CI 87.2-97.1) and 86.6% (95% CI 79.1-92.1), respectively, while the corrected cure rates at day 28 and 42 were 94.1% (95% CI 88.2-97.6) and 87.3% (95% CI 79.9-92.7), respectively. Using survival analysis, the unadjusted cure rate was 99.1% and 100.0% adjusted by genotyping for day 28 and 42, respectively. Eight <it>P. falciparum </it>patients (6.7%) presented with <it>Plasmodium vivax </it>infection during follow-up and were excluded from the per protocol analysis. Only one patient had persistent parasitaemia at day 3. No serious adverse events were reported, with cough and nausea/vomiting being the most common adverse events.</p> <p>Conclusions</p> <p>AL remains a highly effective and well-tolerated treatment for uncomplicated falciparum malaria in the study setting after several years of universal access to AL. A high rate of parasitaemia with <it>P. vivax </it>possibly from relapse or new infection was observed.</p> <p>Trial Registration</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT01052584">NCT01052584</a></p