Antimicrobial Prescription Practices in the Veterinary Clinics of Addis Ababa, Ethiopia

The objectives of this study were to assess the adherence of animal health workers to rational antimicrobial prescription guidelines. Data were collected from personnel working in 25 clinics by using structured  questionnaires. The data included the methods of diagnosis and drug selection, the frequently prescribed antimicrobials, methods of prescription and the availability of drug information sources. The study showed that diagnosis was established on a presumptive basis; pen-strep and oxytetracycline were the frequently prescribed drugs and verbal instruction was a common form of prescription. Adherence to the rational guidelines was substantially low and the prescription practices favor the selection of drug resistant pathogens. Educational programs are needed to ensure the perceived benefit of animals and reduce the rates of emergence of drug resistant pathogens of animal origin in Ethiopia.Keywords: Addis Ababa, Animals, Antimicrobials, Health workers, Prescription

Improving probabilistic flooding using topological indexes

Unstructured networks are characterized by constrained resources and require protocols that efficiently utilize bandwidth and battery power. Probabilistic flooding, allows nodes to rebroadcast RREQ packets with some probability p, thus reducing the overhead. The key issue in of this algorithm consists of determining p. The techniques proposed so far either use a fixed p determined by a priori considerations, or a p variable from one node to the other - set, for instance based on node degree or distance between source and destination - or even a dynamic p based on the number of redundant messages received by the nodes. In order to make the computation of forwarding probability p works optimally regardless of changing of topology, we propose to set p based on the node role within the message dissemination process. Specifically, we propose to identify such role based on the nodes' clustering coefficients (the lower the coefficient, the higher the forwarding probability). The performance of the algorithm is evaluated in terms of routing overhead, packet delivery ratio, and end-to-end delay. The algorithm pays a price in terms of computation time for discovering the clustering coefficient, however reduces unnecessary and redundant control messages and achieves a significant improvements in both dense and sparse networks in terms of packet delivery ratio. We compare by simulation the performance of this algorithm with the one of the most representative competing algorithms

Effect of Soil and Water Conservation on Rehabilitation of Degraded Lands and Crop Productivity in Maego Watershed, North Ethiopia

Many soil and water conservation (SWC) measures were undertaken to decrease land degradation in Ethiopia. However, evaluation of their performance is essential to understand their success or failure and readjusting accordingly in the future planning. Therefore, the objective of this study was to evaluate effectiveness of SWC measures in rehabilitation of degraded watershed and increase crop productivity in Maego watershed, Ethiopia. Seventy six sample plots were randomly taken from treated and untreated sub-watersheds for woody species and soil sampling. Crops yield was measured on top side, middle zone and below side of SWC structures. There were significantly higher woody species density and diversity, total nitrogen (TN), soil organic matter (SOM) and soil moisture in the treated uncultivated land than the untreated one. The highest tree and sapling species density and diversity, TN and SOM were recorded on the exclosure part of the treated sub-watershed. Landscape position affected soil fertility, but has no effect on woody species density and diversity. The highest barley and wheat yield was measured on top side of SWC structures. Therefore, physical SWC structures should be integrated with exclosure to enhance rehabilitation of degraded watersheds/landscapes. Integration of biological SWC measures that improve soil fertility are essential on the cultivated land of the watershed. Most of the existing SWC structures, especially the old ones are filled with accumulated sediment, so maintenance is needed

Client and facility level determinants of quality of care in family planning services in Ethiopia: multilevel modelling

Over the last two decades, while contraceptive use has improved in Ethiopia, the contraceptive prevalence rate remains low. In addition to socio-demographic and cultural factors, the quality of care in Family Planning (FP) services is an important determining factor of FP utilization. However, little research exists on the determinants of quality of care in FP services in Ethiopia. This study aims to identify the client and facility level determinants of quality of care in FP services in Ethiopia.This study was based on the first Ethiopian Services Provision Assessment Plus (ESPA+) survey conducted in 2014. A total of 1247 clients nested in 374 health facilities were included in the analysis. Multilevel mixed-effects logistic regression modelling was conducted. The outcome variable, client satisfaction, was created using polychoric principal component analysis using eleven facets that reflect client satisfaction.The results showed that both client-level and facility-level factors were associated with quality of care in FP services in Ethiopia. At the client-level; provision of information on potential side effects of contraceptive method (AOR = 5.22, 95% CI: 2.13-12.80), and number of history and physical assessments (AOR = 1.19, 95% CI: 1.03-1.34) were positively associated with client satisfaction, whereas waiting times of 30 minutes to two hours (AOR = 0.11, 95% CI: 0.03-0.33) was negatively associated with client satisfaction. At the facility-level; urban location (AOR = 4.61, 95% CI: 1.04-20.58), and availability of FP guidelines/protocols for providers (AOR = 4.90, 95% CI: 1.19-20.19) had positive significant effect on client satisfaction.Quality improvement programs in FP services in Ethiopia should focus on shortening waiting times and provision of information about the potential side effects of contraceptive methods. It is also important to improve health providers' skills in thorough client history taking and physical assessment. Further distribution and implementation of best practice guidelines for providers working in the FP services must be a priority.Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Yibeltal Assefa, Theodros Getachew Zemedu, Mengistu Kifle, Caroline O. Laurenc

Editorial

NCD Risk Factors on the Rise in Ethiopia: A call for Action

Characterizing the strength of wood truss joints

Probability density functions (normal, lognormal, and three-parameter Weibull) were used to characterize strength data for three different types of metal-plate-connected wood truss joints (web at the bottom chord, tension splice, and heel). Modulus of elasticity (MOE) of the lumber used to fabricate the joints was also characterized. A probability-plot technique, in conjunction with Kolmogorov-Smirnov and chi-square statistics, was used to determine which distribution best fit the data. Lumber MOE was best described by a lognormal distribution. No single distributional form fit the strength data for all three joint types with equal accuracy. Lumber MOE and joint strength were unrelated. Strength data for the web at the bottom chord and heel joints were best described by normal distributions; however, none of the distributions considered fit the data for the tension splice joints. The probability-plot technique provided a better visual inspection of fit than did a density function superimposed over a histogram. Fitted distributions are easy to work with and can be used in reliability analyses to simulate strength values of joints. The results presented here are for particular joint types and plates and should not be extrapolated to other truss joints

Bovine Tuberculosis at the Wildlife-Livestock-Human Interface in Hamer Woreda, South Omo, Southern Ethiopia

Bovine tuberculosis (BTB) is endemic in cattle in the Ethiopian Highlands but no studies have been done so far in pastoralists in South Omo. This study assessed the prevalence of bovine tuberculosis (BTB) at an intensive interface of livestock, wildlife and pastoralists in Hamer Woreda (South Omo), Ethiopia. A cross-sectional survey including a comparative intradermal skin testing (CIDT) was conducted in 499 zebu cattle and 186 goats in 12 settlements. Sputum samples from 26 symptomatic livestock owners were cultured for TB. Fifty-one wildlife samples from 13 different species were also collected in the same area and tested with serological (lateral flow assay) and bacteriological (culture of lymph nodes) techniques. Individual BTB prevalence in cattle was 0.8% (CI: 0.3%–2%) with the >4 mm cut-off and 3.4% (CI: 2.1%–5.4%) with the >2 mm cut-off. Herd prevalence was 33.3% and 83% when using the >4 and the >2 mm cut-off respectively. There was no correlation between age, sex, body condition and positive reactors upon univariate analysis. None of the goats were reactors for BTB. Acid fast bacilli (AFB) were detected in 50% of the wildlife cultures, 79.2% of which were identified as Mycobacterium terrae complex. No M. bovis was detected. Twenty-seven percent of tested wildlife were sero-positive. Four sputum cultures (15.4%) yielded AFB positive colonies among which one was M. tuberculosis and 3 non-tuberculous mycobacteria (NTM). The prevalence of M. avium-complex (MAC) was 4.2% in wildlife, 2.5% in cattle and 0.5% in goats. In conclusion, individual BTB prevalence was low, but herd prevalence high in cattle and BTB was not detected in goats, wildlife and humans despite an intensive contact interface. On the contrary, NTMs were highly prevalent and some Mycobacterium spp were more prevalent in specific species. The role of NTMs in livestock and co-infection with BTB need further research

Disclosure experience and associated factors among HIV positive men and women clinical service users in southwest Ethiopia

BACKGROUND: Disclosing HIV test results to one's sexual partner allows the partner to engage in preventive behaviors as well as the access of necessary support for coping with serostatus or illness. It may motivate partners to seek testing or change behavior, and ultimately decrease the transmission of HIV. The present study was undertaken to determine the rate, outcomes and factors associated with HIV positive status disclosure in Southwest Ethiopia among HIV positive service users. METHODS: A cross-sectional study was carried out from January 15, 2007 to March 15, 2007 in Jimma University Specialized Hospital. Data were collected using a pre-tested interviewer-administered structured questionnaire. RESULTS: A total of 705 people (353 women and 352 men), participated in the study of which 71.6% were taking ART. The vast majority (94.5%) disclosed their result to at least one person and 90.8% disclosed to their current main partner. However, 14.2% of disclosure was delayed and 20.6% did not know their partner's HIV status. Among those who did not disclose, 54% stated their reason as fear of negative reaction from their partner. Among those disclosures however, only 5% reported any negative reaction from the partner. Most (80.3%) reported that their partners reacted supportively to disclosure of HIV status. Disclosure of HIV results to a sexual partner was associated with knowing the partner's HIV status, advanced disease stage, low negative self-image, residing in the same house with partner, and discussion about HIV testing prior to seeking services. CONCLUSION: Although the majority of participants disclosed their test results, lack of disclosure by a minority resulted in a limited ability to engage in preventive behaviors and to access support. In addition, a considerable proportion of the participants did not know their partner's HIV status. Programmatic and counseling efforts should focus on mutual disclosure of HIV test results, by encouraging individuals to ask their partner's HIV status in addition to disclosing their own

Barriers and facilitators of maternal health care services use among pastoralist women in Ethiopia: Systems thinking perspective

We explored the barriers and facilitators of maternal health care service use among women in the pastoralist region of Ethiopia. We used a mixed methods design—focus group discussions, key informant interviews, review of the literature and Participatory Ethnographic Evaluation Research (PEER) methods followed by a household survey among randomly chosen pastoralist women of reproductive age (n = 1,499). We used multi-variable regression analyses, and a p value ≤ 0.05 was set to determine statistical significance. In addition, we analysed qualitative data thematically and developed a causal loop diagram using dynamic synthesis methodology to analyse non-linearity, intricate relationships of the variable of interests. In this study, 20.6% of women used modern contraceptive methods, 44.6% had four or more antenatal visits and 38.4% of sampled women received skilled delivery services. We observed multiple individual and community related factors such as education, income and women’s and their partner’s knowledge, perceptions, husband approval, social norms and value-expectations and providers’ gender preferences and health systems factors such as access to health facilities, place of living, provider's cultural competency skills, supplies, delivery positions, economic and political stability, and provider's attitude were linked to maternal health care services utilization among women in pastoralist regions. Approaches towards pastoralists’ health care delivery systems should be responsive to their cultural and political ecology and human agency