Comparative milk production and prevalence study of parasites and sub clinical mastitis on indigenous lactating cows under different feeding regimes in central highlands of Ethiopia

Comparative study on prevalence of gastrointestinal parasites, ticks and subclinical mastitis as well as milk yield was conducted on local zebu lactating dairy cows exposed to different feeding regimes in dry seasons at Sululta and Mukaturi districts of North Shewa zone, central Ethiopia. A total of 15 households at each district having at least two lactating local zebu dairy cows were selected; 15 cows of one group at each district were maintained as farmers own feeding practice (control diet, T0), and the others 15 at each district were supplemented (intervention diet, T1). Prior to the experiment, all animals were checked for any gastrointestinal parasite infection, tick infestation and mastitis, through clinical and laboratory diagnosis. All animals with positive results were effectively treated and rechecked before the commencement of the study and those with negative results were followed until the end. The study showed that there was no statistical significant difference (p>0.05) in the prevalence rate of gastrointestinal parasites, external parasites (ticks) and sub clinical mastitis among the treatment and control groups at each district and among districts where the overall prevalence rate was (63.3%, 60% and 33.3%, respectively) for Sululta district and (80%, 56.7% and 40% respectively) for Mukaturi district. The prevalence rate of gastrointestinal parasites, external parasites (ticks) and sub clinical mastitis were 60%, 46.7% and 33.3%, respectively for the treatment group and 66.7%, 73.3% and 33.3%, respectively for the control group at Sululta district, while prevalence of 87.5%, 56.3% and 43.8%, respectively for the treatment group and 71.4%, 57.1% and 35.7%, respectively for the control was observed at Mukaturi district. Also, no statistical significant difference(p>0.05) was found in the mean EPG value among the two districts. The main tick genera encountered were Boophilus, Amblyomma, Rhipicephalus and a mixed infestation by two or more than two of these ticks in both districts. Furthermore, the possible observational limiting factors encountered in the study were those related with general management and lack in utilization of different disease prevention and control options. The study also showed that cows maintained on the intervention diet at both districts produced considerably higher (P<0.05) milk per day compared to those cows which were receiving the control diet. Moreover the financial returns in terms of net profits gained per cow per day were observed to be higher for experimental cows receiving the intervention diets at both districtsKeywords: dairy cattle, feeding, season, mastitis, prevalence, parasites, milkyiel

Lessons from the evolution of human resources for health in Ethiopia: 1941-2010

Human resources for health (HRH) policy and planning is highly challenging in any setting but the more so in underdeveloped countries. Ethiopia has relatively vast and distinctive experience in accelerated training, use of substitute categories/task-shifting… from which important lessons could be drawn.Based on thorough analysis of documents (official, unofficial, government and others) and 1st hand experience of the authors, the paper explores the major issues in HRH development between 1941 – end of the Italian Occupation - and 2010 – end of the Health Sector Development Program (HSDP) III.The socio-cultural and economic context; development in education, higher education in particular and the general human resources development policy, strategy and plans in the successive periods are assessed briefly.Major developments of• Reconstruction and Basic Health Services Period (1941-1974): the successive five-year plans; the training of orderlies/dressers, the 1st nursing schools, training abroad…; the Gondar Public Health College and the Gondar Team; the beginnings of medical education …• Primary Health Care Period (1974-1991) the Ten Years Perspective Health Plan; the training of Community Health Workers - Community Health Agents and Trained Traditional Birth Attendants -, nurse practitioners, health assistants; discontinuation of the health officers (HO) training, the initiation of Jimma College of Health Sciences and of post-graduate training in medicine at the Faculty of Medicine Addis Ababa University…• Sector-Wide Approach Period (1991-2010) the Health Sector Development Programs I-III, the reintroduction of Health Officers training, the accelerated training/‘Flooding Strategy’, Health Extension Workers, retention/‘Brain-Drain’ of health workers…are explored in some depth and lessons drawn for future HRH development in the country.The conclusions underscore the laudable efforts in all periods but difficulties of learning from the past; the continued very low workforce density and the highly skewed distribution; the recurring challenges of sustained human resources development – quality, motivation, retention… - of the task-shifting and accelerated training attempts and the need to develop specific HRH policy and strategy

Pathways between objective and perceived neighborhood factors among Black breast cancer survivors

Background Mounting evidence supports associations between objective neighborhood disorder, perceived neighborhood disorder, and health, yet alternative explanations involving socioeconomic and neighborhood social cohesion have been understudied. We tested pathways between objective and perceived neighborhood disorder, perceived neighborhood social cohesion, and socioeconomic factors within a longitudinal cohort. Methods Demographic and socioeconomic information before diagnosis was obtained at interviews conducted approximately 10 months post-diagnosis from participants in the Women’s Circle of Health Follow-up Study – a cohort of breast cancer survivors self-identifying as African American or Black women (n = 310). Neighborhood perceptions were obtained during follow-up interviews conducted approximately 24 months after diagnosis. Objective neighborhood disorder was from 9 items audited across 23,276 locations using Google Street View and scored to estimate disorder values at each participant’s residential address at diagnosis. Census tract socioeconomic and demographic composition covariates were from the 2010 U.S. Census and American Community Survey. Pathways to perceived neighborhood disorder were built using structural equation modelling. Model fit was assessed from the comparative fit index and root mean square error approximation and associations were reported as standardized coefficients and 95% confidence intervals. Results Higher perceived neighborhood disorder was associated with higher objective neighborhood disorder (β = 0.20, 95% CI: 0.06, 0.33), lower neighborhood social cohesion, and lower individual-level socioeconomic factors (final model root mean square error approximation 0.043 (90% CI: 0.013, 0.068)). Perceived neighborhood social cohesion was associated with individual-level socioeconomic factors and objective neighborhood disorder (β = − 0.11, 95% CI: − 0.24, 0.02). Conclusion Objective neighborhood disorder might be related to perceived disorder directly and indirectly through perceptions of neighborhood social cohesion

A parsimonious explanation for intersecting perinatal mortality curves: understanding the effect of plurality and of parity

BACKGROUND: Birth weight- and gestational age-specific perinatal mortality curves intersect when compared across categories of maternal smoking, plurality, race and other factors. No simple explanation exists for this paradoxical observation. METHODS: We used data on all live births, stillbirths and infant deaths in Canada (1991–1997) to compare perinatal mortality rates among singleton and twin births, and among singleton births to nulliparous and parous women. Birth weight- and gestational age-specific perinatal mortality rates were first calculated by dividing the number of perinatal deaths at any given birth weight or gestational age by the number of total births at that birth weight or gestational age (conventional calculation). Gestational age-specific perinatal mortality rates were also calculated using the number of fetuses at risk of perinatal death at any given gestational age. RESULTS: Conventional perinatal mortality rates among twin births were lower than those among singletons at lower birth weights and earlier gestation ages, while the reverse was true at higher birth weights and later gestational ages. When perinatal mortality rates were based on fetuses at risk, however, twin births had consistently higher mortality rates than singletons at all gestational ages. A similar pattern emerged in contrasts of gestational age-specific perinatal mortality among singleton births to nulliparous and parous women. Increases in gestational age-specific rates of growth-restriction with advancing gestational age presaged rising rates of gestational age-specific perinatal mortality in both contrasts. CONCLUSIONS: The proper conceptualization of perinatal risk eliminates the mortality crossover paradox and provides new insights into perinatal health issues

Effect of Travel Distance and Time to Radiotherapy on Likelihood of Receiving Mastectomy

© 2014, Society of Surgical Oncology. Background: Breast-conserving surgery (BCS) followed by adjuvant radiation therapy (RT) is the standard of care for women with early-stage breast cancer as an alternative to mastectomy. The purpose of this study was to examine the relationship between receipt of mastectomy and travel distance and time to RT facility in New Jersey (NJ). Methods: Data were collected from a cohort of 634 NJ women diagnosed with early-stage breast cancer. In patients receiving RT, the precise RT facility was used, whereas in patients not receiving RT, surgeons were contacted to determine the location of RT referral. Travel distance and time to RT facility from the patients’ residential address were modeled separately using multiple binomial regression to examine their association with choice of surgery while adjusting for clinical and sociodemographic factors. Results: Overall, 58.5 % patients underwent BCS with median travel distance to the radiation facility of 4.8 miles (vs. 6.6 miles for mastectomy) and median travel time of 12.0 min (vs. 15.0 min for mastectomy). Patients residing \u3e9.2 miles compared with ≤9.2 miles from radiation facility were 44 % more likely to receive mastectomy. Additionally, patients requiring \u3e19 min compared with ≤19 min of travel time were 36 % more likely to receive mastectomy. Conclusions: These data found that travel distance and time from RT facility act as barriers to undergoing BCS in women with early-stage breast cancer. Despite being in an urban region, a significant number of women in NJ with early-stage breast cancer did not receive BCS

Study of the Working Conditions of Health Extension Workers in Ethiopia

Background: Ethiopia is well placed as a potential candidate for the Millennium Development Goals (MDGs) fasttracking but the current 0.2/1000 human resource for health (HRH) clearly indicates the challenges ahead. However, there are also opportunities as the country has now launched an “Accelerated Expansion of Primary Health Care Coverage: 2005-2009” of which “The Health Extension Program (HEP)” is a major component”. Objective: The study focuses on the first batch of Health Extension Workers (HEWs) with the overall objective of assessing the working conditions of HEWs and their job satisfaction. Methods: An in-depth field study was carried out on 60 HEW in 50 health posts (HP) from six regions, 23 zones and 27 woredas. Results: There are challenges in harmonizing the staffing pattern at the HP level, guiding time-use, work schedule and relationship with the community. There are no clear guidelines on relationship with other health workers at the community level, on career structure, transfer, and leave of absences. Reporting and health management information system in general is weak. Conclusion: Placing HEW at community level is a commendable undertaking but fulfilling favorable working conditions is an important challenge which is compounded by long distances and poor transportation and communication facilities. These issues are elaborated and possible responses discussed.Ethiopian Journal of Health Development Vol. 21 (3) 2007: pp. 246-25