Association of husbands' education status with unintended pregnancy in their wives in southern Ethiopia : a cross-sectional study

Background: Unintended pregnancy rates are substantially higher in developing regions, have significant health consequences, and disproportionately affect subgroups with socio-economic disadvantage. We aimed to examine whether there is an association between husbands’ education status and their wives unintended pregnancy in southern Ethiopia. Methods: The data source for this study was from a cross-sectional study on iron-folate supplementation and compliance in Wolaita, South Ethiopia. Data were collected from October to November 2015 in 627 married pregnant women regarding their husbands’ education status, socio-demographic characteristics, and if they wanted to become pregnant at the time of survey using an interviewer administered questionnaire. Logistic regression was used to estimate Odds Ratios (ORs) with associated z-tests and 95% Confidence Intervals (95% CI) for variables associated with unintended pregnancy. Results: The proportion of unintended pregnancy in this sample was 20.6%. Husbands’ education status, age, residence, and using family planning methods were associated with unintended pregnancy (all P-values < 0.05). Multivariable models consistently showed that being married to a husband with at least some college or university education was associated with a decreased OR for unintended pregnancy after controlling for age and use of family planning at conception period (OR 0.36 [95%CI: 0.17, 0.82]) and age and rural residence (OR 0.40 [95%CI: 0.18, 0.90]). Conclusion: Unintended pregnancy among Ethiopian woman was consistently associated with being married to least educated husbands in southern Ethiopia. Increasing age and living in a rural vs urban area were also independently associated with unintended pregnancy. Strategies for addressing family planning needs of women with poorly educated husbands should be the subject of future research

Hydrological Foundation as a Basis for a Holistic Environmental Flow Assessment of Tropical Highland Rivers in Ethiopia

The sustainable development of water resources includes retaining some amount of the natural flow regime in water bodies to protect and maintain aquatic ecosystem health and the human livelihoods and wellbeing dependent upon them. Although assessment of environmental flows is now occurring globally, limited studies have been carried out in the Ethiopian highlands, especially studies to understand flow-ecological response relationships. This paper establishes a hydrological foundation of Gumara River from an ecological perspective. The data analysis followed three steps: first, determination of the current flow regime flow indices and ecologically relevant flow regime; second, naturalization of the current flow regime looking at how flow regime is changing; and, finally, an initial exploration of flow linkages with ecological processes. Flow data of Gumara River from 1973 to 2018 are used for the analysis. Monthly low flow occurred from December to June; the lowest being in March, with a median flow of 4.0 m(3) s(-1). Monthly high flow occurred from July to November; the highest being in August, with a median flow of 236 m(3) s(-1). 1-Day low flows decreased from 1.55 m(3) s(-1) in 1973 to 0.16 m(3) s(-1) in 2018, and 90-Day (seasonal) low flow decreased from 4.9 m(3) s(-1) in 1973 to 2.04 m(3) s(-1) in 2018. The Mann-Kendall trend test indicated that the decrease in low flow was significant for both durations at alpha = 0.05. A similar trend is indicated for both durations of high flow. The decrease in both low flows and high flows is attributed to the expansion of pump irrigation by 29 km(2) and expansion of plantations, which resulted in an increase of NDVI from 0.25 in 2000 to 0.29 in 2019. In addition, an analysis of environmental flow components revealed that only four "large floods" appeared in the last 46 years; no "large flood" occurred after 1988. Lacking "large floods" which inundate floodplain wetlands has resulted in early disconnection of floodplain wetlands from the river and the lake; which has impacts on breeding and nursery habitat shrinkage for migratory fish species in Lake Tana. On the other hand, the extreme decrease in "low flow" components has impacts on pin smaller pools. These results serve as the hydrological foundation for continued studies in the Gumara catchment, with the eventual goal of quantifying environmental flow requirements.redators, reducing their mobility and ability to access prey concentrate

The performance of mid-upper arm circumference for identifying children and adolescents with overweight and obesity : a systematic review and meta-analysis

Objective: This study aimed to synthesise the existing evidence on the performance of mid-upper arm circumference (MUAC) to identify children and adolescents with overweight and obesity. Design: Systematic review and meta-analysis. Setting: We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, CINAHL and Google scholar databases from their inception to December 10, 2021, for relevant studies. There were no restrictions regarding the language of publication. Studies reporting measures for the diagnostic performance of MUAC compared with a reference standard for diagnosing overweight and obesity in children and adolescents aged 2–19 years were included. Participants: A total of 54 381 children and adolescents from twenty-one studies were reviewed; ten studies contributed to meta-analyses. Results: In boys, MUAC showed a pooled AUC of 0·92 (95 % CI 0·89, 0·94), sensitivity of 84·4 (95 % CI 84·6, 90·8) and a specificity of 86·0 (95 % CI 79·2, 90·8), when compared against BMI z-score, defined overweight and obesity. As for girls, MUAC showed a pooled AUC of 0·93 (95 % CI 0·90, 0·95), sensitivity of 86·4 (95 % CI 79·8, 91·0), specificity of 86·6 (95 % CI 82·2, 90·1) when compared against overweight and obesity defined using BMI z-scores. Conclusion: In comparison with BMI, MUAC has an excellent performance to identify overweight and obesity in children and adolescents. However, no sufficient evidence on the performance of MUAC compared with gold standard measures of adiposity. Future research should compare performance of MUAC to the ‘golden standard’ measure of excess adiposity

Potential of Water Hyacinth Infestation on Lake Tana, Ethiopia: A Prediction Using a GIS-Based Multi-Criteria Technique

Water hyacinth is a well-known invasive weed in lakes across the world and harms the aquatic environment. Since 2011, the weed has invaded Lake Tana substantially posing a challenge to the ecosystem services of the lake. The major factors which affect the growth of the weed are phosphorus, nitrogen, temperature, pH, salinity, and lake depth. Understanding and investigating the hotspot areas is vital to predict the areas for proper planning of interventions. The main objective of this study is therefore to predict the hotspot areas of the water hyacinth over the surface of the lake using the geographical information system (GIS)-based multi-criteria evaluation (MCE) technique. The main parameters used in the multi-criteria analysis were total phosphorus (\u3e0.08 mg L−1), total nitrogen (\u3e1.1 mg L−1), temperature (\u3c26.2 °C), pH (\u3c8.6), salinity (\u3c0.011%), and depth (\u3c6 m). These parameters were collected from 143 sampling sites on the lake in August, December (2016), and March (2017). Fuzzy overlay spatial analysis was used to overlay the different parameters to obtain the final prediction map of water hyacinth infestation areas. The results indicated that 24,969 ha (8.1%), 21,568.7 ha (7.1%), and 24,036 ha (7.9%) of the lake are susceptible to invasion by the water hyacinth in August, December, and March, respectively. At the maximum historical lake level, 30,728.4 ha will be the potential susceptible area for water hyacinth growth and expansion at the end of the rainy season in August. According to the result of this study, the north and northeastern parts of the lake are highly susceptible for invasion. Hence, water hyacinth management and control plans shall mainly focus on the north and northeastern part of Lake Tana and upstream contributing watersheds

Advances in water resources research in the Upper Blue Nile basin and the way forward: A review

The Upper Blue Nile basin is considered as the lifeline for ∼250 million people and contributes ∼50 Gm3/year of water to the Nile River. Poor land management practices in the Ethiopian highlands have caused a significant amount of soil erosion, thereby threatening the productivity of the Ethiopian agricultural system, degrading the health of the aquatic ecosystem, and shortening the life of downstream reservoirs. The Upper Blue Nile basin, because of limited research and availability of data, has been considered as the “great unknown.” In the recent past, however, more research has been published. Nonetheless, there is no state-of-the-art review that presents research achievements, gaps and future directions. Hence, this paper aims to bridge this gap by reviewing the advances in water resources research in the basin while highlighting research needs and future directions. We report that there have been several research projects that try to understand the biogeochemical processes by collecting information on runoff, groundwater recharge, sediment transport, and tracers. Different types of hydrological models have been applied. Most of the earlier research used simple conceptual and statistical approaches for trend analysis and water balance estimations, mainly using rainfall and evapotranspiration data. More recent research has been using advanced semi-physically/physically based distributed hydrological models using high-resolution temporal and spatial data for diverse applications. We identified several research gaps and provided recommendations to address them. While we have witnessed advances in water resources research in the basin, we also foresee opportunities for further advancement. Incorporating the research findings into policy and practice will significantly benefit the development and transformation agenda of the Ethiopian government

Linkages between GRACE water storage, hydrologic extremes, and climate teleconnections in major African aquifers

Water resources management is a critical issue in Africa where many regions are subjected to sequential droughts and floods. The objective of our work was to assess spatiotemporal variability in water storage and related controls (climate, human intervention) in major African aquifers and consider approaches toward more sustainable development. Different approaches were used to track water storage, including GRACE/GRACE Follow On satellites for Total Water Storage (TWS); satellite altimetry for reservoir storage, MODIS satellites for vegetation indices, and limited ground-based monitoring. Results show that declining trends in TWS (60–73 km3 over the 18 yr GRACE record) were restricted to aquifers in northern Africa, controlled primarily by irrigation water use in the Nubian and NW Saharan aquifers. Rising TWS trends were found in aquifers in western Africa (23–49 km3), attributed to increased recharge from land use change and cropland expansion. Interannual variability dominated TWS variability in eastern and southern Africa, controlled primarily by climate extremes. Climate teleconnections, particularly El Nino Southern Oscillation and Indian Ocean Dipole, strongly controlled droughts and floods in eastern and southern Africa. Huge aquifer storage in northern Africa suggests that the recent decadal storage declines should not impact the regional aquifers but may affect local conditions. Increasing groundwater levels in western Africa will need to be managed because of locally rising groundwater flooding. More climate resilient water management can be accomplished in eastern and southern Africa by storing water from wet to dry climate cycles. Accessing the natural water storage provided by aquifers in Africa is the obvious way to manage the variability between droughts and floods

Breast cancer in Ethiopia: evidence for geographic difference in the distribution of molecular subtypes in Africa

Abstract Background Breast cancer is a heterogeneous disease with several morphological and molecular subtypes. Widely accepted molecular classification system uses assessment of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and proliferation marker Ki67. Few studies have been conducted on the incidence and molecular types of breast cancer in Sub-Saharan Africa. Previous studies mainly from Western and Central Africa, showed breast cancer to occur at younger ages and to present with aggressive features, such as high-grade, advanced stage and triple-negative phenotype (negative for ER, PR and HER2). Limited data from East Africa including Ethiopia however shows hormone receptor negative tumors to account for a lower proportion of all breast cancers than has been reported from elsewhere in Africa. Methods In this study from Tikur Anbessa Specialized Hospital, 114 breast cancer patients diagnosed between 2012 and 2015 were enrolled. ER, PR, Ki67 and HER2 receptor status were assessed using immunohistochemistry from tissue microarrays. FISH was used for assessment of gene amplification in all equivocal tumor samples and for confirmation in HER2-enriched cases. Results The distribution of molecular subtypes was: Luminal A: 40%; Luminal B: 26%; HER2-enriched: 10%; TNBC: 23%. ER were positive in 65% of all tumors and 43% the cases were positive for PR. There was statistically significant difference in median age at diagnosis between the molecular subtypes (P < 0.05). There was a bimodal distribution of molecular subtypes in different age ranges with Luminal B subtype being more common at younger ages (median = 36) and Luminal A subtype more prevalent at older ages (median = 42). There were no statistically significant differences in tumor grade, histology, and stage between the molecular subtypes of breast cancer. Conclusion The present study detected Luminal A breast cancer to be the most common subtype and reveals a relatively low rate of hormone receptor negative and TNBC. Our findings and results from other East African studies suggest geographic variability in the distribution of the molecular subtypes of breast cancer in Africa and hence have important clinical and policy implications for breast cancer control and treatment in Ethiopia.https://deepblue.lib.umich.edu/bitstream/2027.42/142374/1/12905_2018_Article_531.pd

Southern theories in ICT4D

This paper suggests that the dominance of northern research paradigms in ICT4D may be viewed as a continuation of colonial sway over the endeavors of the global South. The notion of Southern Theory - as introduced in the work of Raewyn Connell, the Comaroffs, and others - may be a route by which re-searchers in the global South can reclaim the intellectual territory of ICT4D, with indigenous and regional research paradigms and theories rather than those simply absorbed from the global North

Cost-effectiveness of an ambulance-based referral system for emergency obstetrical and neonatal care in rural Ethiopia

Background: To estimate the cost-effectiveness of an ambulance-based referral system an dedicated to emergency obstetrics and neonatal care (EmONC) in remote sub-Saharan settings. Methods: In this prospective study performed in Oromiya Region (Ethiopia), all obstetrical cases referred to the hospital with the ambulance were consecutively evaluated during a three-months period. The health professionals who managed the referred cases were requested to identify those that could be considered as undoubtedly effective. Pre and post-referral costs included those required to run the ambulance service and the additional costs necessary for the assistance in the hospital. Local life expectancy tables were used to calculate the number of year saved. Results: A total of 111 ambulance referrals were recorded. The ambulance was undoubtedly effective for 9 women and 4 newborns, corresponding to 336 years saved. The total cost of the intervention was 8299 US dollars. The cost per year life saved was 24.7 US dollars which is below the benchmarks of 150 and 30 US dollars that define attractive and very attractive interventions. Sensitivity analyses on the rate of effective referrals, on the costs of the ambulance and on the discount rate confirmed the robustness of the result. Conclusions: An ambulance-based referral system for EmONC in remote sub-Saharan areas appears highly cost-effective