Microbiological assessment of indoor air of teaching hospital wards: A case of Jimma University Specialized Hospital

BACKGROUND: Hospital environment represents a congenial situation where microorganisms and susceptible patients are indoors together. Thus, the objective of this study is to provide fundamental data related to the microbial quality of indoor air of Jimma University Specialized Hospital wards, to estimate the health hazard and to create standards for indoor air quality control.METHODS: The microbial quality of indoor air of seven wards of Jimma University Specialized Hospital was determined. Passive air sampling technique, using open Petri-dishes containing different culture media, was employed to collect sample twice daily.RESULTS: The concentrations of bacteria and fungi aerosols in the indoor environment of the wards ranged between 2123 – 9733 CFU/m3. The statistical analysis showed that the concentrations of bacteria that were measured in all studied wards were significantly different from each other (p-value=0.017), whereas the concentrations of fungi that were measured in all sampled wards were not significantly different from each other (p-value=0.850). Moreover, the concentrations of bacteria that were measured at different sampling time (morning and afternoon) were significantly different (p-value =0.001).CONCLUSION: All wards that were included in the study were heavily contaminated with bacteria and fungi. Thus, immediate interventions are needed to control those environmental factors which favor the growth and multiplication of microbes, and it is vital to control visitors and students in and out the wards. Moreover, it is advisable that strict measures be put in place to check the increasing microbial load in the hospital environment.KEYWORDS: Indoor air, Microbiological assessment, Sedimentation technique, Open-plate technique, Hospital environment, Bacteria, Fung

Nutritional and antinutritional evaluation of indigenous Ethiopian Okra (Abelmoschus esculentus) seed accessions

Okra, of high nutritional potential, is one of the underutilized indigenous vegetables in Ethiopia. A food based-intervention specifically dietary diversification is an affordable and sustainable strategy to meet the demand of adequate food supply and population growth. One way of ensuring dietary diversity is to search and promote underutilized indigenous plant species such as okra. Therefore, the objective of this study was to determine nutritional and anti-nutritional factors content of the seeds of eight okra accessions (OPA#1, OPA#2, OPA#3, OPA#4, OPA#5, OPA#6, OPA#7 and OPA#8) grown at Assosa Agricultural Research Center in Benishangul Gumuz region, Ethiopia. Molar ratios of the seeds were also calculated and  compared to the critical values to predict the mineral bioavailability. All the analyses were conducted using official standard procedures and grade standard reagents. The results of this study revealed that the proximate composition (g/100 g) of the seed accessions varied significantly (P<0.05) and had respective ranges for moisture content 9.27-12.70, crude protein 22.51-38.09, crude fat 18.64-36.84, crude fibre 1.94-5.96, crude ash 4.53-6.05, utilizable carbohydrate 18.69-37.77 and metabolisable energy  324.88-423.84 kcal/100g. The mineral composition (mg/100g) also varied significantly (P<0.05) with range of calcium 66.37 to 103.66, iron 8.33 to 20.29, potassium 90.00 to 187.92, zinc 3.92 to 6.42, phosphorus 16.94 to 1497.23 and sodium 15.06 to 27.81. The seeds of accession of OPA#6 contained high amounts of crude protein and fat, whereas OPA#8 was high in calcium, iron and potassium. The range of phytate, tannin and oxalate content (mg/100g) of the seed of okra accessions ranged from 0.39 to 0.46, 0.71 to 3.78, 0.74 to 0.75, respectively. The calculated molar ratios of  phytate:calcium, phytate:iron, phytate:zinc, oxalate:calcium and  phytate*calcium/zinc were 0.0025 to 0.0037, 0.0017 to 0.0041, 0.0063 to 0.106, 0.0020 to 0.0051 and 0.0140 to 0.0175, respectively, below the critical value, indicating high bioavailability of calcium, iron and zinc in all accessions. The results of this study revealed that seeds of okra contain appreciable amounts of essential nutrients and are low in  anti-nutrient content implying high mineral bioavailability. Hence, increasing the production and consumption of these nutrient rich  underutilized okra seeds could help in food fortification, dietary diversification and alleviation of problems associated with malnutrition in the country.Key words: Okra, Seed, Accession, Proximate composition, Minerals,  Anti-nutritional factor

Physiological Rances and Virulence Diversity of Puccinia graminis f. sp. tritici on Wheat in Ethiopia

The physiologic races of the rust fungus Puccinia graminis f. sp. tritici in the main wheat-growing regions of Ethiopia were determined on seedlings of the standard wheat stem rust differentials following the international system of nomenclature. Forty-four races were identified among the 75 isolates studied over a period of four years. The 16 isolates collected in 2001 all belonged to different race groups. The 33 isolates collected in 2002 belonged to 23 race groups, and, the 17 and nine rust isolates collected in 2003 and 2004 respectively belonged to eight and three race groups. Most of the rust samples collected from individual wheat fields belonged to different groups with only a few belonging to the same race group. The physiologic race breakdown differed greatly from year to year. TTR was the only race identified in all cropping seasons. Races such as TTT, TTR, PTT, PTR and TTQ showed relatively wider virulence spectra. Races such as TTR and TTT showed a relatively wider spatial distribution. Generally, P. graminis populations in Ethiopia appear to be highly variable, and this should be an important consideration when devising a breeding programme for this country

Challenges and opportunities to improve autism services in low-income countries: lessons from a situational analysis in Ethiopia

Background. Little has been reported about service provision for children with autism in low-income countries. This study explored the current service provision for children with autism and their families in Ethiopia, the existing challenges and urgent needs, and stakeholders’ views on the best approaches to further develop services. Methods. A situational analysis was conducted based on i) qualitative interviews with existing service providers; ii) consultation with a wider group of stakeholders through two stakeholder workshops; and iii) information available in the public domain. Findings were triangulated where possible. Results. Existing diagnostic and educational services for children with autism are scarce and largely confined to Ethiopia’s capital city, with little provision in rural areas. Families of children with autism experience practical and psychosocial challenges, including severe stigma. Informants further raised the lack of culturally and contextually appropriate autism instruments as an important problem to be addressed. The study informants and local stakeholders provided several approaches for future service provision expansion, including service decentralisation, mental health training and awareness raising initiatives. Conclusions. Services for children with autism in Ethiopia are extremely limited; appropriate care for these children is further impeded by stigma and lack of awareness. Ethiopia’s plans to scale up mental healthcare integrated in primary healthcare provides an opportunity to expand services for children with autism and other developmental disorders. These plans and additional strategies outlined in this paper can help to address the current service provision gaps and may also inform service enhancement approaches in other low-income countries

Modulation of neuro-dopamine homeostasis in juvenile female Atlantic cod (Gadus morhua) exposed to polycyclic aromatic hydrocarbons and perfluoroalkyl substances

The dopaminergic effect of PAH and PFAS mixtures, prepared according to environmentally relevant concentrations, has been studied in juvenile female Atlantic cod (Gadus morhua). Benzo[a]pyrene, dibenzothiophene, fluorene, naphthalene, phenanthrene, and pyrene were used to prepare a PAH mixture, while PFNA, PFOA, PFOS, and PFTrA were used to prepare a PFAS mixture. Cod were injected intraperitoneally twice, with either a low (1×) or high (20×) dose of each compound mixture or their combinations. After 2 weeks of exposure, levels of plasma 17β-estradiol (E2) were significantly elevated in high PAH/high PFAS treated group. Brain dopamine/metabolite ratios (DOPAC/dopamine and HVA+DOPAC/dopamine) changed with E2 plasma levels, except for high PAH/low PFAS and low PAH/high PFAS treated groups. On the transcript levels, th mRNA inversely correlated with dopamine/metabolite ratios and gnrh2 mRNA levels. Respective decreases and increases of drd1 and drd2a after exposure to the high PAH dose were observed. Specifically, high PFAS exposure decreased both drds, leading to high plasma E2 concentrations. Other studied end points suggest that these compounds, at different doses and combinations, have different toxicity threshold and modes of action. These effects indicate potential alterations in the feedback signaling processes within the dopaminergic pathway by these contaminant mixtures.acceptedVersio

Suicidal ideation and behaviour among community and health care seeking populations in five low- and middle-income countries: a cross-sectional study.

: Aims Suicidal behaviour is an under-reported and hidden cause of death in most low- and middle-income countries (LMIC) due to lack of national systematic reporting for cause-specific mortality, high levels of stigma and religious or cultural sanctions. The lack of information on non-fatal suicidal behaviour (ideation, plans and attempts) in LMIC is a major barrier to design and implementation of prevention strategies. This study aims to determine the prevalence of non-fatal suicidal behaviour within community- and health facility-based populations in LMIC. : Twelve-month prevalence of suicidal ideation, plans and attempts were established through community samples (n = 6689) and primary care attendees (n = 6470) from districts in Ethiopia, Uganda, South Africa, India and Nepal using the Composite International Diagnostic Interview suicidality module. Participants were also screened for depression and alcohol use disorder. : We found that one out of ten persons (10.3%) presenting at primary care facilities reported suicidal ideation within the past year, and 1 out of 45 (2.2%) reported attempting suicide in the same period. The range of suicidal ideation was 3.5-11.1% in community samples and 5.0-14.8% in health facility samples. A higher proportion of facility attendees reported suicidal ideation than community residents (10.3 and 8.1%, respectively). Adults in the South African facilities were most likely to endorse suicidal ideation (14.8%), planning (9.5%) and attempts (7.4%). Risk profiles associated with suicidal behaviour (i.e. being female, younger age, current mental disorders and lower educational and economic status) were highly consistent across countries. : The high prevalence of suicidal ideation in primary care points towards important opportunities to implement suicide risk reduction initiatives. Evidence-supported strategies including screening and treatment of depression in primary care can be implemented through the World Health Organization's mental health Global Action Programme suicide prevention and depression treatment guidelines. Suicidal ideation and behaviours in the community sample will require detection strategies to identify at risks persons not presenting to health facilities.<br/

Systematic review and meta-analysis: prevalence of alcohol use among young people in eastern Africa.

OBJECTIVE: Systematic review and meta-analysis of published studies of alcohol use among young people (age 15-24 years) in eastern Africa to estimate prevalence of alcohol use and determine the extent of use of standardised screening questionnaires in alcohol studies. METHODS: Five databases (MEDLINE, EMBASE, Global Health, Africa-wide, and PsycINFO) were searched for publications until 30th June 2013. Results were summarised using the guidelines on preferred reporting items for systematic reviews and meta-analyses (PRISMA) and on quality assessment using the modified quality assessment tool for systematic reviews of observational studies (QATSO). Heterogeneity was assessed using the I(2) statistic (DerSimonian-Laird). RESULTS: We identified 2785 potentially relevant studies, of which 56 were eligible for inclusion. Only two studies (4%) used the standardised Alcohol Use Disorder Identification Test (AUDIT) questionnaire, and six studies (13%) used the Cut down, Annoyed, Guilt, Eye opener (CAGE) questionnaire. The reported median prevalence of alcohol use was ever-use 52% [interquartile range (IQR): 20-58%], use in the last month 28% (IQR: 17-37%), use in the last year 26% (IQR: 22-32%), and problem drinking as defined by CAGE or AUDIT 15% (IQR: 3-36%). We observed high heterogeneity between studies, with the highest prevalence of ever use of alcohol among university students (82%; 95%CI: 79-85%) and female sex workers (66%; 95%CI: 58-74%). Current use was most prevalent among male sex workers (69%; 95%CI: 63-75%). CONCLUSIONS: Reported alcohol use and problem drinking were common among diverse groups of young people in eastern Africa, indicating the urgent need for alcohol-focused interventions in this population. Few studies have used standardised alcohol screening questionnaires. Epidemiological research to investigate alcohol-focused interventions in young people should aim to apply such questionnaires that should be validated for use in this population

Readiness of primary health care facilities in Jimma zone to provide diabetic services for diabetic clients, Jimma zone, southwest Ethiopia, March 2013

Published date: Oct 12, 2016Background: Diabetes is one of the commonest non-communicable diseases of the 21st century. Global burden of diabetes in 2010 was estimated at 285 million and projected to increase to 438 million by the year 2030, if no interventions are put in place. The primary health care facilities are the first level of contact for such rising cases of diabetes, despite of this fact there is no study done on the capabilities of primary health care facilities to accommodate diabetic services. Hence, the objective of this study is to assess the readiness of selected primary public hospitals and health centers to accommodate diabetic care in Jimma zone south west Ethiopia. Methods: Health facility based cross-sectional study design using quantitative and qualitative method of data collection was conducted from Feb 1-March 1, 2013. After checking the completeness, and coding of questionnaires, the quantitative data were entered into computer software and analyzed using SPSS version 20.0. Results: All of the facilities have at least some of the drugs and medical supplies and other resources required for the diagnosis and management of diabetes never the less there was no specific plan to deal with diabetic management at health facilities. Majority of patients were first diagnosed in other health facilities and referred to the current health institutions for follow up and there is no routine screening for diabetics in adult outpatient department in some health facilities. Conclusion and recommendation: Required drugs and medical supplies are not regularly fulfilled, health facilities have no plan for diabetic management, and health workers did not get training on management of diabetics. No routine screening at adult patients at outpatient departments. Hence the Woreda and the zone have to work on the capacity of the health workers and health facilities to handle diabetic care at health center level.Fikru Tafese, Elias Teferi, Beyene Wondafirash, Sintayehu Fekadu, Garumma Tolu and Gugsa Nemarr

Long-term fire resilience of the Ericaceous Belt, Bale Mountains, Ethiopia

Fire is the most frequent disturbance in the Ericaceous Belt (ca 3000- 4300 m.a.s.l.), one of the most important plant communities of tropical African mountains. Through resprouting after fire, Erica establishes a positive fire feedback under certain burning regimes. However, present-day human activity in the Bale Mountains of Ethiopia includes fire and grazing systems that may have a negative impact on the resilience of the ericaceous ecosystem. Current knowledge of Erica-fire relationships is based on studies of modern vegetation, lacking a longer time perspective that can shed light on baseline conditions for the fire feedback. We hypothesize that fire has influenced Erica communities in the Bale Mountains at millennial timescales. To test this, we (1) identify the fire history of the Bale Mountains through a pollen and charcoal record from Garba Guracha, a lake at 3950 m.a.s.l., and (2) describe the long-term bidirectional feedback between wildfire and Erica, which may control the ecosystem's resilience. Our results support fire occurrence in the area since ca 14 000 years ago, with particularly intense burning during the early Holocene, 10.8-6.0 cal ka BP. We show that a positive feedback between Erica abundance and fire occurrence was in operation throughout the Lateglacial and Holocene, and interpret the Ericaceous Belt of the Ethiopian mountains as a long-term fire resilient ecosystem. We propose that controlled burning should be an integral part of landscape management in the Bale Mountains National Park

The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

Background: Neglected tropical diseases (NTDs) are a group of chronic parasitic diseases and related conditions that are the most common diseases among the 2·7 billion people globally living on less than US$2 per day. In response to the growing challenge of NTDs, Ethiopia is preparing to launch a NTD Master Plan. The purpose of this review is to underscore the burden of NTDs in Ethiopia, highlight the state of current interventions, and suggest ways forward. Results: This review indicates that NTDs are significant public health problems in Ethiopia. From the analysis reported here, Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo. Ethiopia is estimated to have the highest burden of trachoma, podoconiosis and cutaneous leishmaniasis in sub-Saharan Africa (SSA), the second highest burden in terms of ascariasis, leprosy and visceral leishmaniasis, and the third highest burden of hookworm. Infections such as schistosomiasis, trichuriasis, lymphatic filariasis and rabies are also common. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. However, despite these high burdens of infection, the control of most NTDs in Ethiopia is in its infancy. In terms of NTD control achievements, Ethiopia reached the leprosy elimination target of 1 case/10,000 population in 1999. No cases of human African trypanosomiasis have been reported since 1984. Guinea worm eradication is in its final phase. The Onchocerciasis Control Program has been making steady progress since 2001. A national blindness survey was conducted in 2006 and the trachoma program has kicked off in some regions. Lymphatic Filariasis, podoconiosis and rabies mapping are underway. Conclusion: Ethiopia bears a significant burden of NTDs compared to other SSA countries. To achieve success in integrated control of NTDs, integrated mapping, rapid scale up of interventions and operational research into co implementation of intervention packages will be crucial