DETERMINANTS OF PRE-ECLAMPSIA AND GESTATIONAL HYPERTENSION

ABSTRACT: To examine the determinant factors for pre- eclampsia and gestational hypertension, a total of 567 pregnant women were randomly selected from 13 urban subdistricts and 13 rural villages from a central region in Ethiopia and included in the study. Albuminuria was detected in 11.5% and abnormal diastolic blood pressure in 12.2%. 2.9% and 9.2% were classified as pre-eclamptic and gestational hypertensive, respectively. Younger educated women, in a higher income category, and in their first pregnancy were found to be at a higher risk of pre- eclampsia and gestational hypertension. Strenuous physical exertion and low dietary protein intake during the early months of pregnancy also increased the risk of both pre-eclampsia and gestational hypertension. A high dietary calcium intake during the early months of pregnancy increased the risk of pre-eclampsia but not gestational hypertension

MEDICAL STUDENTS' ATTITUDES TOWARDS COMMUNITY HEALTH

ABSTRACT: Attitudes of medical students are important because as members and leaders of the health team in the national health system, they are potentially influential in affecting the opinions of others, particularly of their peers, other health workers, the public and public officials after graduation. This study was undertaken to describe the magnitude of, and social and demographic factors associated with, negative attitudes towards community health activities among medical students in Addis Abeba, Ethiopia. The study population consisted of all premedical, preclinical 1, preclinical 2, clinical 1 and clinical 2 students of the Faculty in the 1985/86 academic year. A cohort of students consisting of all premedical and preclinical 1 students also completed the same questionnaire for a second time in the second half of the 1988/89 academic year (ie, after a three year interval). A total of 434 out of 523 students (83%) completed the questionnaires in the academic year 1985/86. For the academic year 1988/89 the corresponding figure was 219 out of 262 (83.6%). It is shown that medical students in Addis Abeba, Ethiopia are predominantly young, males, christians, Amhara, from major urban centers and mid- or upper- income families. It is also shown that negative attitudes towards community health activities increased during the course of medical school and that this negative attitude was positively associated with type of high school attended (non-government) and with parental income (mid- or upper-level) in this population of medical students

Evaluation of an Amharic version of the Composite International Diagnostic Interview (CIDI) in Ethiopia

Abstract: The feasibility, reliability , and acceptance of the Amharic version of the CIDI (Composite International Diagnostic Interview) was tested in a patient-population of a psychiatric hospital and an inner-city community sample in Addis Ababa. In the hospital-based study, the CIDI was judged to be acceptable by most clinician and non clinician interviewers. Concerns about it included the length of the interview and difficulties with a few of the items. For specific diagnoses made with frequency of five or more time, percent agreement and kappa ranged from 92.5%-100% and 0.78-1.00, respectively. In the community-based study, a total of 502 individuals selected from Arada district by systematic random sampling were interviewed. Estimates of prevalence for specific diagnoses are comparable with earlier prevalence estimates from Ethiopia. It is concluded that the Amharic version of CIDI is reliable, acceptable, and feasible for use in. mental health studies in Ethiopia. Further studies of parts of the CIDI (especially the sections of organic brain syndrome and use of drug) are recommended. [Ethiop. I. Health Dev. 1996;10(2):69-77

The Attitudes of students, parents and teachers towards the promotion and provision of condoms for adolescents in Addis Ababa

Abstract: A cross-sectional descriptive survey through a self-administered, anonymous and structured questionnaire was conductd from September to December, 1993, in ten high schools in Addis Ababa to determine the sexual behaviour of adolescents, their knowledge about AIDS, attitudes and practices regarding condoms, their attitudes towards the promotion and distribution of condoms in schools, and towards the incorporation of health and sex education into the regular teaching curricula and into the teachers’ training curricula. A total of 910 parents, 755 students and 232 teachers participated in the survey. The results showed that, of the 755 students, 39.8% of the boys and 5.6% of the girls have had sexual experience. Peer pressure (35.2%) and force (21.6%) were the most important factors that precipitated the first sexual encounter. Ten percent of the students had coital contact with a commercial sex worker. Only 42.2% of the sexually active students used condoms on their first sexual encounter, and only 27.7% used condoms continuously on their subsequent sexual encounters. An overwhelming majority in each of the three categories, (92.6% of the students, 98.7% of the parents and 96.1% of the teachers), approved the incorporation of health education into the regular teaching curricula. The idea of sex education in schools was also approved by 80.1% of the students, 90.9% of the parents and 96.1% of the teachers. This study, based upon the findings, recommends that education and health policy makers make relentless effort to commence health and sex education by incorporating them into the regular curricula; the implementation of subsequent surveys to identify the most effective and acceptable routes of condom distribution in school; and implementation of similar surveys in the rural settings to assess the attitudes in a different setting and acquire a more general overview for the whole country. [Ethiop. J. Health Dev. 1997;11(1):7-16

Pneumonia and malaria in under-five children of southern Ethiopia

Abstract: An observational and experimental study was conducted to see the proportion of overlap between the clinical and laboratory diagnosis of pneumonia and malaria and the therapeutic effectiveness of cotrimoxazole. Children under five years who presented to the clinic with fever and/or cough or difficulty in breathing were enrolled in the study. Blood smears were done for all enrolled children while chest x-rays were obtained only for those children with parasitaemia or who met the clinical case definition for pneumonia. There were 736 children who met the clinical case definition of malaria, while 731 met the clinical case definition of pneumonia. Of these two groups, 456 (61.9%) of children with clinical malaria and 62.3% of those with clinical pneumonia represent the overlap of children who met both clinical definitions. Specific clinical definition did not differentiate pneumonia and malaria. A single treatment of both diseases by cotrimoxazole is showed to be as effective as a combination of treatment with chloroquine and procaine penicillin. Parasite clearance was better in the cotrimoxazole group than the chloroquine-penicillin group, however the cotrimoxazole group had a higher rate of recurdescences with two out of 41 patients smear positive at day 14. A significant proportion of overlap in the clinical and laboratory diagnosis of pneumonia and malaria is shown and that a three days cotrimoxazole therapy is equally effective in treating both diseases as a combination of chloroquine and procaine penicillin is. [Ethiop. J. Health Dev. 1997;11(1):43-50

Tuberculosis and HIV infection in southern Ethiopia

Abstract: A health institution-based cross-sectional study was carried out in Shashemene town, southern Ethiopia, between September, 1993 and January, 1994 to determine the sero-prevalence and the clinical impact of HIV among newly diagnosed tuberculosis patients. The HIV-antibody was determined using the two ELISA procedures (Wellcozyme, Wellcome Diagnostics, Dartford Kent England, and Du-pont assay, Singapore). A total of 450 tuberculosis patients aged 15 years and above were enrolled in the study. The overall HIV-seroprevalence rate was 44.4%. The highest rate was observed in the age group 20-39 years. A slightly higher HIV-infection rate was found in males (46%) than in females (41%). Those divorced and widowed patients had higher proportion of HIV sero-positivity. The HIV positivity rate was higher for extra-pulmonary than pulmonary form of tuberculosis (OR = 3.80; 95% CI: 1.49, 9.7 ). Higher proportions of sputum positive patients were HIV-positive compared to the sputum negative pulmonary tuberculosis patients (OR=1.09; 95% CI: 0.64,1.85) though they manifested typical radiographic features (OR = 7.87; 95% CI: 4.39, 14.21). Significant differences were noted among HIV positives than HIV negatives in manifesting herpes zoster, lymphadenopathy, oral candidiasis, peripheral paraesthesia and chronic diarrhoea. An alternative diagnostic approach is required to avoid missing HIV-related tuberculosis which is communicable to the general population. Other findings are discussed and recommendations made. [Ethiop. J. Health Dev. 1997;11(1):51-59

CARE GIVERS KNOWLEDGE, BELIEFS, ATTITUDES AND PRACTICES ON CASE MANAGEMENT OF ACUTE RESPIRATORY ILLNESSES IN A RURAL DISTRICT IN ETIHIOPIA

ABSTRACT: A survey was conducted in three randomly selected farmers' associations in Sululta District, around Chancho town out of which, 540 households were selected randomly. Mothers and other care givers of children under-five were interviewed regarding their knowledge, beliefs, attitudes and practices in case management of acute respiratory illnesses. The study showed that 406(75% ) of the care givers have favorable practice, whereas 483(89.4%),497(92.0%) and 334(61.9%) of the care givers have unfavorable attitudes, knowledge and beliefs, respectively. Care givers' age is significantly associated with practice, attitudes and beliefs. Care givers' economic status is also significantly associated with their practice, attitudes and knowledge whereas care givers' education and presence of grand parents in the neighborhood affected significantly their attitude, knowledge and belief. [Ethiop. i. Health Dev. 1994;8(2): 103-108

Breastfeeding In Addis Ababa, Ethiopia: Results of a focus group study

Abstract: A large shift has been observed from breastfeeding to bottle feeding in the urban areas of developing countries. Non-optimal breastfeeding patterns are contributing to the diarrhoeal diseases and malnutrition problems in such areas. To examine the existent of non-optimal breastfeeding, to identify the segment of the population in which these practices exist, and to ultimately carry out well targeted interventions, a situation analysis study on the breastfeeding patterns of infants was undertaken in the capital city of Ethiopia, Addis Ababa. In-depth interviews and focus group discussion were used in this study. The in-depth interviews revealed out that there was no policy 9! the Ministry of Health concerning breastfeeding and supplementation and there was a delay in the rooming-in of babies delivered at health facilities during evening and night hours. Newborns were also given non-nutritive fluids in the first three days of life. Working mothers were allowed to have a 45-day paid maternity leave. The focus group discussions undertaken wi!h mothers and grandmothers revealed that most newborns were given water just after birth. Itwas generally found out that women from low socio-economic status (SES) had negative attitude while those from middle and high socio-economic status and grandmothers had positive attitude towards breastfeeding regardless of their ethnicity. Recommendations are made based on the results obtained in the study. [Ethiop. J. Health Dev. 1996;10(3):133-143

DESCRIPTION OF MENINGITIS EPIDEMIC IN HAIKOCH NA BUTAJIRA DISTRICT

ABSTRACT: A retrospective review of a recent meningitis epidemic in Haikoch na Butajira District for the months of February and March 1989 was conducted. The epidemic is described in terms of person, place and time. The relationship of the epidemic with weather changes (rainfall and temperature) is assessed. There were a total of 6968 reported cases of meningitis with 203 deaths. The case fatality rate was 2.9%. The male to female ratio was 1.05 to 1. The peak of the epidemic was found to be during the second half of the month of February. There were 864 cases from urban, 3321 from villagized and 2783 from non villagized areas giving period prevalence rates of 6%, 8% and 2%, respectively, during the two months. Based on this study, surveillance and control recommendations are made