In search of Insights from Community of Practice and Use of Telemedicine in Low income Countries: The case of Ethiopia

The use of ICT for exchange of medical records in provision of health care services appears to be a viable option for enhancing the capacity of low income developing countries struggling with shortage of qualified medical personnel. This study seeks to gain a preliminary assessment of whether health professionals who work in the health facilities covered by the Ethio-Indian Telemedicine program have adopted and used the Telemedicine technology to enhance health care services. Among other things, the study also aims to understand the extent to which health professionals in the study area consider Telemedicine as a viable option for delivery of health care services. Survey will be conducted to gather information from users in the study area. The study is primarily informed by literature on Community of Practice, Unified Theory of Acceptance and Use of Technology, and Case Study Research

Psychological distress and its predictors in AIDS orphan adolescents in Addis Ababa city: A comparative survey

Back ground: In developing countries the number of children orphaned by AIDS is growing rapidly. Consequently, the psychological well-being of these children has become a serious concern.Objectives: To assess the psychological distress of AIDS orphans as compared to non-AIDS orphan adolescents and factors related to it, in Addis Ababa.Methods: Comparative cross-sectional design combining both quantitative and qualitative methods was used. An equal number of 438 subjects were included in this study with each group of AIDS and non-AIDS orphan adolescents between 11-18 age groups. Structured interviewer administered questionnaire and scales including HAD, Rosenberg’s and MPSS scales were used to measure the orphans’ level of depression, anxiety, self-esteem and their perceived social support.Result: Among the study participants, 279 (34.7%) orphan adolescents where 157 (39.1%) of AIDS and 122 (30.3 %) of non-AIDS orphan adolescents were depressed in the week before the survey. Moreover, 301(37.4%) orphan adolescents where 164 (40.8%) of AIDS and 137 (34.1%) of non-AID once were anxious. However, the difference observed in depression and anxiety [OR (95% CI) =1.164(0.733, 1.754) & 0.88(0.57, 1.33)] was not statistically significant. The main predicator variables of depression and anxiety in both study groups were their perceived social support and self-esteem. Factors such as discrimination, school enrollment, physical abuse, child labor were also identified as predicators.Conclusion : A large proportion of orphan adolescents are having psychological problems that can affect their present and future life. Thus, a more focused and concerted effort is needed to improve their mental health. [Ethiop. J. Health Dev. 2011;25(2):135-142

Factors affecting fertility decisions of married men and women living with HIV in South Wollo Zone, Northeast Ethiopia

Background: In a setting with high HIV prevalence and high fertility rates, addressing fertility issues of People Living with HIV/AIDS (PLWHA) is crucial. However, understanding of the factors associated with fertility decisions of PLWHA in Ethiopia is remarkably low.Objective: The study was conducted to assess factors associated with fertility decisions of PLWHA in South Wollo Zone, Northeast Ethiopia.Methods: The study was conducted from February 1 to March 30, 2008 using cross-sectional design. Quantitative data were collected from a sample of 458 men and 458 women using structured questionnaire. Qualitative data were also collected from six health care providers. Logistic regression was used to analyze the quantitative data.Results: The study showed that 18.3% of currently married PLWHA have decided to have a child. The factors found to be independently associated with current decision to have a child were higher family income [OR (95% CI) = 2.29 (1.23, 4.26)], partner’s decision to have a child [OR (95% CI) = 36.4 (17.0, 77.5)], having knowledge on PMTCT [OR (95% CI) = 2.26 (1.44, 3.54)] and having partner with negative HIV test result [OR (95% CI) = 0.408 (0.219, 0.759)]. During in-depth interview the health care providers indicated the fertility related counseling service to be low.Conclusion: In spite of the fact that significant proportion of married PLWHA had decided to have a child, the fertility related counseling service is low. Improving fertility related counseling services to enable clients make informed fertility decision is mandatory. The factors identified to be associated with fertility decision could be of major importance and as such should be investigated further

Genotype x environment interaction and stability analysis for yield and yield related traits of Kabuli-type Chickpea (Cicer arietinum L.) in Ethiopia

Chickpea is the major pulse crop cultivated in Ethiopia. However, its production is constrained due to genotype instability and environmental variability. This research was carried out to examine the magnitude of environmental effect on yield of chickpea genotypes and to investigate the stability and adaptability of genotypes under different agro-ecologies. Seventeen (17) genotypes were evaluated in randomized complete block design (RCBD) with four replications in five locations. Various stability indices were used to assess stability and genotype by environment performances. Combined analysis of variance (ANOVA) for yield and yield components revealed highly significant (P≤0.01) differences for genotypes, environments and their interaction. The significant interaction showed genotypes respond differently across environments. At Akaki, Chefe Donsa, Debre Zeit, Dembia and Haramaya, top performing genotype were DZ-2012-CK-0001 (2933 kg/ha), Arerti (3219 kg/ha), Arerti (3560 kg/ha) DZ-2012-CK-0013 (2675 kg/ha) and Arerti (2019 kg/ha), respectively. The first two PCs explained 74.45% of the variance. Based on ASV value, DZ-2012-CK-0002 were most stable genotypes. As per AMMI biplot, Arerti and DZ-10-4 were most widely adapted genotypes. Dembia and Haramaya were most discriminative environments for genotypes. Debre Zeit and Chefe Donsa were favorable environment for genotype. Genotypes DZ-2012-CK-0004, DZ-2012-CK-0010, DZ-2012-CK-0013, DZ-2012-CK-0007 and DZ-10-4 are recommendable to Akaki, Chefe Donsa, Debre Zeit, Dembia and Haramya, respectively.Keywords: AMMI, ASV, clustering, phenologic traits, Kabuli, univariate statistics.Abbreviation: E, Environments; G, genotypes; RCBD, randomized complete block design.

Assessment of Ethiopian Health Facilities Readiness for Implementation of Telemedicine

Ethiopiahas one of the lowest ratios of health professionals to population in the world. The few medical specialists who are available work mainly in the capital city and in a few regional cities. The use of telemedicine in public health facilities can mitigate the shortage of medical personnel. We conducted a survey of selected public health facilities located inAddis Ababa,Ethiopia. The study could be modified and extended to other countries in Sub-SaharanAfrica. In this study, we adapted Bakry’s e-government assessment model, STOPE (Strategy, Technology, Organizational, People, and Environment) to assess telemedicine readiness. Validity and reliability tests were conducted using the Smart PLS software package. The survey data was analyzed using SPSS version 16, and descriptive and analytical statistical reports were generated. The color-coded feature of the McConnell International analysis tool was used to display the results. All factors in STOPE indicated amber color, which implies the need for substantial improvements at the health facilities in order to adopt Telemedicine. The STOPE model results from this study show that the degree of readiness for telemedicine implementation varies from a weak rating for Technology readiness to strong rating for Organization readiness

Amino-substituted naphthalene sulfonic acid/graphene composite as metal -free catalysts for oxygen reduction reactions

Composites of reduced graphene oxide (rGO) and conducting polymers synthesized from 8-amino-2-naphthalene sulfonic acid (8-ANSA), 5-amino-1-naphthalene sulfonic acid (5-ANSA), 2-amino-1-naphthalene sulfonic acid (2-ANSA), and 4-amino-1-naphthalene sulfonic (4-ANSA) were prepared for use as an electrocatalyst in oxygen reduction reaction (ORR). The electrocatalytic activities were examined in oxygen saturated 0.1 M KOH solution using cyclic and linear sweep voltammetry. The best performing polymer composite was found to be GC/poly(8-ANSA)/rGO, with an enhanced electrocatalytic activity over the rGO only and poly(8-ANSA) only films. More than 100 mV positive shift in the onset potential and 1.6 times increase in current density were observed. The catalytic activity of 2-ANSA, 4-ANSA, 5-ANSA, and 8-ANSA was also validated by density functional theory (DFT). Our calculations predict a much better catalytic activity for 8-ANSA than that of 2-ANSA, 4-ANSA, and 5-ANSA.               KEY WORDS: Poly(amino naphthalene sulfonic acid), Reduced graphene oxide, Oxygen reduction reaction, Electrocatalyst Bull. Chem. Soc. Ethiop. 2019, 33(2), 359-372.DOI: https://dx.doi.org/10.4314/bcse.v33i2.1

Improving cattle disease reporting and surveillance in Ethiopia using smartphone-based application

This study explores the use of a smartphone-based application to increase the accuracy and completeness of cattle disease reporting and surveillance in three regions of Ethiopia. We compared the performance of a smartphone-based application with traditional (paper-based) cattle diagnosis and reporting, in terms of demographics and disease information, level of detail and delay in time to transmit information to higher levels. A total of 547 and 678 clinical cattle cases were diagnosed in veterinary clinics visited by two groups of final-year veterinary students using the VetAfrica-Ethiopia (VAE) smartphone app and manual approach respectively. The group using the VAE application diagnosed over 90% cases as diseases of a specific name, while in reports from the manual system almost 50% of cases were diagnosed as non-specific diseases or ‘syndromes’. Furthermore, the mean duration of time required for smartphone data to be received by zonal- and federal- level veterinary services through a Cloud-based server were estimated to be two days (95% CI: 1.6–2.3), five days (95% CI: 3.8–5.4), and 13 days (95% CI: 12–14.9) in the Central, Eastern and Southern regions. The traditional reporting system adopted a batch reporting approach and only around two thirds of all cases reach the federal veterinary service by the end of a month. Despite the fact that such smartphone technology-assisted reporting and surveillance involves considerable start-up challenges and may be affected by intermittent mobile internet network coverage, they offer significant benefits in terms of improving data integrity, timeliness and reduced costs in the long run

Docosahexaenoic acid reduces microglia phagocytic activity via miR-124 and induces neuroprotection in rodent models of spinal cord contusion injury

Microglia are activated after spinal cord injury (SCI), but their phagocytic mechanisms and link to neuroprotection remain incompletely characterized. Docosahexaenoic acid (DHA) has been shown to have significant neuroprotective effects after hemisection and compression SCI and can directly affect microglia in these injury models. In rodent contusion SCI, we demonstrate that DHA (500 nmol/kg) administered acutely post-injury confers neuroprotection and enhances locomotor recovery, and also exerts a complex modulation of the microglial response to injury. In rodents, at 7 days after SCI, the level of phagocytosed myelin within Iba1-positive or P2Y12-positive cells was significantly lower after DHA treatment, and this occurred in parallel with an increase in intracellular miR-124 expression. Furthermore, intraspinal administration of a miR-124 inhibitor significantly reduced the DHA-induced decrease in myelin phagocytosis in mice at 7 days post-SCI. In rat spinal primary microglia cultures, DHA reduced the phagocytic response to myelin, which was associated with an increase in miR-124, but not miR-155. A similar response was observed in a microglia cell line (BV2) treated with DHA, and the effect was blocked by a miR-124 inhibitor. Furthermore, the phagocytic response of BV2 cells to stressed neurones was also reduced in the presence of DHA. In peripheral monocyte-derived macrophages, the expression of the M1, but not the M0 or M2 phenotype, was reduced by DHA, but the phagocytic activation was not altered. These findings show that DHA induces neuroprotection in contusion injury. Furthermore, the improved outcome is via a miR-124-dependent reduction in the phagocytic response of microglia.US Department of Defence CDMRP/SCIRP award (W81XWH-10-1-1040 to P.K.Y., T.B. and A.M.T.); The Barts and London Charity (to P.K.Y. and A.M.T.); Rod Flower Vacation Scholarship (to A.L.B.); International Spinal Research Trust (to J.H. and P.G.P.); Ray W. Poppleton Endowment (to P.G.P.); Chang Gung Memorial Hospital, Taiwan (CMRPG3A1051–1054 to Z.-H.L.). M.A.B. is funded by the Spanish Ministry of Economy and Competitivity (Programa Ramón y Cajal: RYC-2017-21804)

Importance of Ethnicity, CYP2B6 and ABCB1 Genotype for Efavirenz Pharmacokinetics and Treatment Outcomes: A Parallel-group Prospective Cohort Study in two sub-Saharan Africa Populations.

We evaluated the importance of ethnicity and pharmacogenetic variations in determining efavirenz pharmacokinetics, auto-induction and immunological outcomes in two African populations. ART naïve HIV patients from Ethiopia (n = 285) and Tanzania (n = 209) were prospectively enrolled in parallel to start efavirenz based HAART. CD4+ cell counts were determined at baseline, 12, 24 and 48 weeks. Plasma and intracellular efavirenz and 8-hydroxyefvairenz concentrations were determined at week 4 and 16. Genotyping for common functional CYP2B6, CYP3A5, ABCB1, UGT2B7 and SLCO1B1 variant alleles were done. Patient country, CYP2B6*6 and ABCB1 c.4036A>G (rs3842A>G) genotype were significant predictors of plasma and intracellular efavirenz concentration. CYP2B6*6 and ABCB1 c.4036A>G (rs3842) genotype were significantly associated with higher plasma efavirenz concentration and their allele frequencies were significantly higher in Tanzanians than Ethiopians. Tanzanians displayed significantly higher efavirenz plasma concentration at week 4 (p<0.0002) and week 16 (p = 0.006) compared to Ethiopians. Efavirenz plasma concentrations remained significantly higher in Tanzanians even after controlling for the effect of CYP2B6*6 and ABCB1 c.4036A>G genotype. Within country analyses indicated a significant decrease in the mean plasma efavirenz concentration by week 16 compared to week 4 in Tanzanians (p = 0.006), whereas no significant differences in plasma concentration over time was observed in Ethiopians (p = 0.84). Intracellular efavirenz concentration and patient country were significant predictors of CD4 gain during HAART. We report substantial differences in efavirenz pharmacokinetics, extent of auto-induction and immunologic recovery between Ethiopian and Tanzanian HIV patients, partly but not solely, due to pharmacogenetic variations. The observed inter-ethnic variations in efavirenz plasma exposure may possibly result in varying clinical treatment outcome or adverse event profiles between populations