Prevalence of Trachoma from 66 Impact Surveys in 52 Woredas of Southern Nations, Nationalities and Peoples' and Sidama Regions of Ethiopia, 2017-2019.

PURPOSE: Trachoma is endemic in Southern Nations, Nationalities and Peoples' (SNNP) and Sidama regions of Ethiopia. We aimed to measure the prevalence of trachomatous inflammation - follicular (TF) among children aged 1 - 9 years and the prevalence of trachomatous trichiasis (TT) unknown to the health system among people aged ≥15 years following interventions for trachoma in 52 woredas of SNNP and Sidama regions. METHODS: From 2017 - 2019, 66 two-stage cluster sampling cross-sectional population-based surveys were carried out in 52 woredas (third-level administrative divisions) using a standardized World Health Organization-recommended survey methodology. This included one impact survey in 40 woredas, two consecutive impact surveys in 10 woredas and three consecutive impact surveys in two woredas. Water, sanitation and Hygiene (WASH) access was assessed using a modified version of the United Nations Children's Fund/WHO Joint Monitoring Programme questionnaire. RESULTS: By the end of this survey series, 15 (23%) of the woredas had met the active trachoma elimination threshold (TF prevalence <5%) and 12 (18%) had met the TT threshold (TT ≤ 0.2%). Regarding WASH coverage, 20% of households had access to an improved drinking water source within a 30-min journey and 3% had an improved latrine. There was strong evidence that TF was less common in 4 - 6-year-olds and 7 - 9-year-olds than 1 - 3-year-olds. CONCLUSION: Based on the findings, further antibiotic mass drug administration is required in 37 woredas and active TT case finding is needed in 40 woredas. In these surveys, access to WASH facilities was very low; WASH improvements are required

Artificial intelligence (AI): multidisciplinary perspectives on emerging challenges, opportunities, and agenda for research and practice

As far back as the industrial revolution, great leaps in technical innovation succeeded in transforming numerous manual tasks and processes that had been in existence for decades where humans had reached the limits of physical capacity. Artificial Intelligence (AI) offers this same transformative potential for the augmentation and potential replacement of human tasks and activities within a wide range of industrial, intellectual and social applications. The pace of change for this new AI technological age is staggering, with new breakthroughs in algorithmic machine learning and autonomous decision making engendering new opportunities for continued innovation. The impact of AI is significant, with industries ranging from: finance, retail, healthcare, manufacturing, supply chain and logistics all set to be disrupted by the onset of AI technologies. The study brings together the collective insight from a number of leading expert contributors to highlight the significant opportunities, challenges and potential research agenda posed by the rapid emergence of AI within a number of domains: technological, business and management, science and technology, government and public sector. The research offers significant and timely insight to AI technology and its impact on the future of industry and society in general

Maternal Mortality in Rural South Ethiopia: Outcomes of Community-Based Birth Registration by Health Extension Workers

Introduction: Rural communities in low-income countries lack vital registrations to track birth outcomes. We aimed to examine the feasibility of community-based birth registration and measure maternal mortality ratio (MMR) in rural south Ethiopia. Methods: In 2010, health extension workers (HEWs) registered births and maternal deaths among 421,639 people in three districts (Derashe, Bonke, and Arba Minch Zuria). One nurse-supervisor per district provided administrative and technical support to HEWs. The primary outcomes were the feasibility of registration of a high proportion of births and measuring MMR. The secondary outcome was the proportion of skilled birth attendance. We validated the completeness of the registry and the MMR by conducting a house-to-house survey in 15 randomly selected villages in Bonke. Results: We registered 10,987 births (81,4% of expected 13,492 births) with annual crude birth rate of 32 per 1,000 population. The validation study showed that, of 2,401 births occurred in the surveyed households within eight months of the initiation of the registry, 71,6% (1,718) were registered with similar MMRs (474 vs. 439) between the registered and unregistered births. Overall, we recorded 53 maternal deaths; MMR was 489 per 100,000 live births and 83% (44 of 53 maternal deaths) occurred at home. Ninety percent (9,863 births) were at home, 4% (430) at health posts, 2,5% (282) at health centres, and 3,5% (412) in hospitals. MMR increased if: the male partners were illiterate (609 vs. 346; p= 0.051) and the villages had no road access (946 vs. 410; p= 0.039). The validation helped to increase the registration coverage by 10% through feedback discussions. Conclusion: It is possible to obtain a high-coverage birth registration and measure MMR in rural communities where a functional system of community health workers exists. The MMR was high in rural south Ethiopia and most births and maternal deaths occurred at home

The profile of the birth registry.

<p>The profile of the birth registry.</p

The map of the study area within southern Ethiopia.

<p>The map of the study area within southern Ethiopia.</p

Estimates of the maternal mortality ratio per 100,000 live births in the study area compared with national estimates in Ethiopia during the years around 2010.

<p>Note: MMR,</p><p>^β maternal mortality ratio per 100,000 live births, DHS,</p><p>* Demographic and Health Survey, CSA,</p><p>** Central Statistical Agency IHME,</p><p>*** Institute of Health Metrics and Evaluation, Washington University, USA.</p><p>Estimates of the maternal mortality ratio per 100,000 live births in the study area compared with national estimates in Ethiopia during the years around 2010.</p

Socio-demographic data on parents, services, and infrastructures in the birth registry districts of south Ethiopia in 2010.

<p>Note:</p><p>* Education: illiterate are those cannot read/write and had no formal education, literate include those who can read/write and completed higher education,</p><p>** 57% of households with births were within 10 km of health centres (10 km is the government target for access)</p><p>Socio-demographic data on parents, services, and infrastructures in the birth registry districts of south Ethiopia in 2010.</p

Variations in maternal mortality across variables, south Ethiopia, 2010.

<p>Note:</p><p>*maternal mortality ratio per 100,000 live births. Cells with P-value > 0.05 (with no statistical significance) are left empty. MMR in the parenthesis are 95% CIs.</p><p>**Education: illiterate are those who cannot read/write and had no formal education, literate include those who can read/write and more educated up to higher education.</p><p>^§ Compared only all-weather road against no driveable road</p><p>Variations in maternal mortality across variables, south Ethiopia, 2010.</p