Scaling Preservice Training in Comprehensive Contraception and Abortion Care and Research across Ethiopia

This retrospective case study examines a five-year project scaling preservice training of comprehensive contraception and abortion care across nine Ethiopian schools of medicine and midwifery beginning in July 2014. It captures lessons learned from implementing the framework and share them with other schools and health ministries planning to strengthen contraception and abortion preservice training and research. The case study is based on semi-structured interviews conducted in July–December 2018 with 19 individuals who held faculty roles in the partner schools or staff roles with the Center for International Reproductive Health Training team in Ethiopia or Michigan. It also draws from document analysis of internal project files from across the full project period and participant observation by the case study authors, who were each involved in various stages of implementation. The case study is also available at http://hdl.handle.net/2027/spo.mpub11627346. This case study is shared under a Creative Commons Attribution Noncommercial No-Derivatives License: http://creativecommons.org/licenses/by-nc-nd/4.0/.https://deepblue.lib.umich.edu/bitstream/2027.42/150691/1/2019-scaling-preservice-training-in-comprehensive-contraception.pdfDescription of 2019-scaling-preservice-training-in-comprehensive-contraception.pdf : Case Stud

Prevalence of human papillomavirus and Helicobacter pylori in esophageal and gastroesophageal junction cancer biopsies from a case-control study in Ethiopia

peer reviewe

Estimated Yield Loss Assessment of Bread Wheat (Triticumaestivum L.) due to Septoria Leaf Blotch Septariatritici (Roberge in Desmaz) on Wheat in Holeta Agricultural Research Center, West Shewa, Ethiopia

Abstract Septoria leaf blotch is one of the most important yield limiting diseases of wheat world wide. Yield loss assessment was conducted in Randomized Complete Block Design (RCBD) in pair treatment (sprayed versus unsprayed), with four replications at Holeta Agricultural Research Center experimental field during the main cropping season of 2014. A susceptible bread wheat variety 'Huluka' and systemic fungicide Propicanazole, (Tilt-250 E.C), at the rate of 0.5 l/ha was used under natural infections. Evaluation was started from the onset of the disease 62 days after planting (DAP). The initial incidence and severity of disease treated and untreated plots were similar with incidence of 22.5 and 20and Severity of 6.6 % and 5.6 % respectively. However at 110 DAP, the incidence and severity of treated plots were 25and 4.3, while that of untreated plots were 100 and 95% respectively. The effects of Septoria leaf blotch on grain yield was significant (P<0.05) when the treated (5626.kg/ha) was compared with the un treated plots (3324.3 kg/ha). Yield loss in grain yield was estimated to be 41%. Disease parameters like disease incidence, severity and the area under disease progress curves (AUDPC) were negatively correlated with yield and yield components, whereas, yield components were positively correlated with yield. Data on cost benefit analysis showed that, the highest net return benefit was obtained from fungicide treated plots with mean value of 46018.80 Ethiopian birr/ha -1 . While the least net return was obtained from untreated plots with a value of 26280.85birr/ha. The marginal value also indicated that, the highest marginal rate of return (926%) was obtained from treated plots when compared with untreated plots. There is a need to assess further pathogen variability's and subsequently to screen resistant varieties against the Septoria leaf blotch. In absence of other options yet farming communities need to be advised on timely application of efficient fungicides against the pathogen that may lead to utilization of integrated diseases management

Amoebic liver abscess: A 20-year retrospective analysis at Tikur Anbessa Hospital, Ethiopia

No Abstract Available Ethiop.J.Health Dev. Vol.18(3) 2004: 199-20

Prevalence of Helicobacter pylori vacA and cagA genotypes in Ethiopian dyspeptic patients

A total of 300 gastric biopsy samples and 50 Helicobacter pylori isolates were collected from Ethiopian adult dyspeptic patients. The vacA and cagA genes were detected in 90 and 79% of biopsy specimens, respectively, and in 100 and 87% of clinical isolates, respectively. Both genes were detected in 84% of the gastric biopsy samples and in 87% of the clinical isolates. Among vacA genotypes, the s1/m1 genotype was the most common in gastric biopsy samples (48%). The vacA and cagA positive H. pylori strains were detected to a higher degree in patients with chronic active gastritis (71%) than patients with other histopathological findings (29%) (P < 0.05)

Pooled prevalence and associated factors of pregnancy termination among youth aged 15-24 year women in East Africa: Multilevel level analysis.

BackgroundMost of unwanted pregnancies among adolescent girls and young women (AGYW) in Africa result in pregnancy termination. Despite attempts to enhance maternal health care service utilization, unsafe abortion remains the leading cause of maternal death in Sub-Saharan Africa (SSA), there is still a study gap, notably in East Africa, where community-level issues are not studied. Therefore, this study aimed to assess pooled prevalence pregnancy termination and associated factors among youth (15-24 year-old) women in the East Africa.MethodsThe study was conducted based on the most recent Demographic and Health Surveys (DHS) in the 12 East African countries. A total weighted sample of 44,846 youth (15-24) age group women was included in this study. To detect the existence of a substantial clustering effect, the Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR)-test were used. Furthermore, because the models were nested, deviance (-2LLR) was used for model comparison. In the multilevel logistic model, significant factors related to pregnancy termination were declared using Adjusted Odds Ratios (AOR) with a 95%Confidence Interval (CI) and p-value of 0.05.ResultThe pooled prevalence of pregnancy termination in East African countries was 7.79% (95% CI: 7.54, 8.04) with the highest prevalence in Uganda 12.51% (95% CI: 11.56, 13.41) and lowest was observed in Zambia 5.64% ((95% CI: 4.86, 6.41). In multilevel multivariable logistic regression result, age 20-24 [AOR = 1.93; 95% CI: 1.71, 2.16], media exposure [AOR = 1.22; 95% CI: 1.12, 1.34], married [AOR = 1.32, 95% CI: 1.21, 1.43], had working [AOR = 1.13; 95% CI: 1.04, 1.23],no education[AOR = 3.98, 95% CI: 2.32, 6.81], primary education [AOR = 4.05, 95% CI: 2.38, 6.88], secondary education [AOR = 2.96, 95% CI: 1.74, 5.03], multiparous [AOR = 0.85; 95%CI: 0.79, 0.93], sexual initiation greater or equal to 15 [AOR = 0.82; 95%CI: 0.74, 0.99] were significantly associated with pregnancy termination.ConclusionThe pooled prevalence of pregnancy termination in East Africa was high in this study. Maternal age, marital status, education status, parity, age at first sex, media exposure, working status and living countries were significantly associated with pregnancy termination. The finding provides critical information for developing health interventions to decrease unplanned pregnancies and illegal pregnancy termination

DataSheet_2_Inflammatory immune profiles associated with disease severity in pulmonary tuberculosis patients with moderate to severe clinical TB or anemia.xlsx

BackgroundImmune control of Mycobacterium tuberculosis (Mtb) infection is largely influenced by the extensive disease heterogeneity that is typical for tuberculosis (TB). In this study, the peripheral inflammatory immune profile of different sub-groups of pulmonary TB patients was explored based on clinical disease severity, anemia of chronic disease, or the radiological extent of lung disease.MethodsPlasma samples were obtained from n=107 patients with active pulmonary TB at the time of diagnosis and after start of standard chemotherapy. A composite clinical TB symptoms score, blood hemoglobin status and chest X-ray imaging were used to sub-group TB patients into 1.) mild and moderate-severe clinical TB, 2.) anemic and non-anemic TB, or 3.) limited and extensive lung involvement. Plasma levels of biomarkers associated with inflammation pathways were assessed using a Bio-Plex Magpix 37-multiplex assay. In parallel, Th1/Th2 cytokines were quantified with a 27-multiplex in matched plasma and cell culture supernatants from whole blood stimulated with M. tuberculosis-antigens using the QuantiFERON-TB Gold assay.ResultsClinical TB disease severity correlated with low blood hemoglobin levels and anemia but not with radiological findings in this study cohort. Multiplex protein analyses revealed that distinct clusters of inflammation markers and cytokines separated the different TB disease sub-groups with variable efficacy. Several top-ranked markers overlapped, while other markers were unique with regards to their importance to differentiate the TB disease severity groups. A distinct immune response profile defined by elevated levels of BAFF, LIGHT, sTNF-R1 and 2, IP-10, osteopontin, chitinase-3-like protein 1, and IFNα2 and IL-8, were most effective in separating TB patients with different clinical disease severity and were also promising candidates for treatment monitoring. TB patients with mild disease displayed immune polarization towards mixed Th1/Th2 responses, while pro-inflammatory and B cell stimulating cytokines as well as immunomodulatory mediators predominated in moderate-severe TB disease and anemia of TB.ConclusionsOur data demonstrated that clinical disease severity in TB is associated with anemia and distinct inflammatory immune profiles. These results contribute to the understanding of immunopathology in pulmonary TB and define top-ranked inflammatory mediators as biomarkers of disease severity and treatment prognosis.</p

Vitamin D and Phenylbutyrate Supplementation Does Not Modulate Gut Derived Immune Activation in HIV-1

Dysbiosis and a dysregulated gut immune barrier function contributes to chronic immune activation in HIV-1 infection. We investigated if nutritional supplementation with vitamin D and phenylbutyrate could improve gut-derived inflammation, selected microbial metabolites, and composition of the gut microbiota. Treatment-na&iuml;ve HIV-1-infected individuals (n = 167) were included from a double-blind, randomized, and placebo-controlled trial of daily 5000 IU vitamin D and 500 mg phenylbutyrate for 16 weeks (Clinicaltrials.gov NCT01702974). Baseline and per-protocol plasma samples at week 16 were analysed for soluble CD14, the antimicrobial peptide LL-37, kynurenine/tryptophan-ratio, TMAO, choline, and betaine. Assessment of the gut microbiota involved 16S rRNA gene sequencing of colonic biopsies. Vitamin D + phenylbutyrate treatment significantly increased 25-hydroxyvitamin D levels (p &lt; 0.001) but had no effects on sCD14, the kynurenine/tryptophan-ratio, TMAO, or choline levels. Subgroup-analyses of vitamin D insufficient subjects demonstrated a significant increase of LL-37 in the treatment group (p = 0.02), whereas treatment failed to significantly impact LL-37-levels in multiple regression analysis. Further, no effects on the microbiota was found in number of operational taxonomic units (p = 0.71), Shannon microbial diversity index (p = 0.82), or in principal component analyses (p = 0.83). Nutritional supplementation with vitamin D + phenylbutyrate did not modulate gut-derived inflammatory markers or microbial composition in treatment-na&iuml;ve HIV-1 individuals with active viral replication

DataSheet_1_Inflammatory immune profiles associated with disease severity in pulmonary tuberculosis patients with moderate to severe clinical TB or anemia.docx

BackgroundImmune control of Mycobacterium tuberculosis (Mtb) infection is largely influenced by the extensive disease heterogeneity that is typical for tuberculosis (TB). In this study, the peripheral inflammatory immune profile of different sub-groups of pulmonary TB patients was explored based on clinical disease severity, anemia of chronic disease, or the radiological extent of lung disease.MethodsPlasma samples were obtained from n=107 patients with active pulmonary TB at the time of diagnosis and after start of standard chemotherapy. A composite clinical TB symptoms score, blood hemoglobin status and chest X-ray imaging were used to sub-group TB patients into 1.) mild and moderate-severe clinical TB, 2.) anemic and non-anemic TB, or 3.) limited and extensive lung involvement. Plasma levels of biomarkers associated with inflammation pathways were assessed using a Bio-Plex Magpix 37-multiplex assay. In parallel, Th1/Th2 cytokines were quantified with a 27-multiplex in matched plasma and cell culture supernatants from whole blood stimulated with M. tuberculosis-antigens using the QuantiFERON-TB Gold assay.ResultsClinical TB disease severity correlated with low blood hemoglobin levels and anemia but not with radiological findings in this study cohort. Multiplex protein analyses revealed that distinct clusters of inflammation markers and cytokines separated the different TB disease sub-groups with variable efficacy. Several top-ranked markers overlapped, while other markers were unique with regards to their importance to differentiate the TB disease severity groups. A distinct immune response profile defined by elevated levels of BAFF, LIGHT, sTNF-R1 and 2, IP-10, osteopontin, chitinase-3-like protein 1, and IFNα2 and IL-8, were most effective in separating TB patients with different clinical disease severity and were also promising candidates for treatment monitoring. TB patients with mild disease displayed immune polarization towards mixed Th1/Th2 responses, while pro-inflammatory and B cell stimulating cytokines as well as immunomodulatory mediators predominated in moderate-severe TB disease and anemia of TB.ConclusionsOur data demonstrated that clinical disease severity in TB is associated with anemia and distinct inflammatory immune profiles. These results contribute to the understanding of immunopathology in pulmonary TB and define top-ranked inflammatory mediators as biomarkers of disease severity and treatment prognosis.</p