Male circumcision and its association with HIV infection and sexually transmitted diseases: evidence from 18 demographic and health surveys in sub-Saharan Africa

The study aimed to assess the association between male circumcision and HIV infection and STDs. The issue is controversial as various studies reported conflicting findings. A cross-sectional comparative study based on the secondary data of 18 Demographic Health Surveys (DHS), carried out in Sub-Saharan Africa starting from 2003, was conducted. From all surveys, information on 70 554 males aged 15 - 59 years was extracted. The association between male circumcision and HIV infection and STD symptoms (genital discharge or genital ulcer/sore) was assessed using binary logistic regression. Adjustment was made for sexual history and basic socio-demographic variables. The weighted prevalence of HIV among men 15 - 59 years was 3.1%. In the bivariate analysis uncircumcised status was significantly associated with risk of HIV, with odds ratio (OR) of 4.12 (95% CI: 3.85 - 4.42). The association was even more significant (4.95 (95% CI: 4.57-5.36)) after adjustment for number of lifetime sexual partners and socio-demographic variables. The risk associated with uncircumcised status is significantly lower among younger men aged 15 - 29 years than those in 30 – 59-year age category. About 5.5% of the study subjects reported either genital discharge or genital sore/ulcer in the preceding 12 months of the surveys. Circumcision status was not significantly associated with either of the symptoms, with adjusted OR of 1.07 (95% CI: 0.99 - 1.15). The study concludes that there is a strong association between uncircumcised status and HIV infection. Hence, male circumcision can be considered as a possible way of reducing the spread of HIV infection in areas where the practice is rare. A comprehensive study to assess the association between circumcision and different types of STDs is recommended.Keywords: Male circumcision, HIV infection, sexually transmitted infections, sub-Saharan Africa, demographic and health survey.L’étude a pour but d’évaluer le degré d’association entre la circoncision, et l’infection à VIH et les maladies sexuellement transmissibles (MST). L’objet de cette étude est controversé car plusieurs études ont révélé des conclusions contradictoires. Une étude transversale comparative basée sur les données de seconde main de 18 enquêtes démographiques et sanitaires (EDS), réalisées en Afrique subsaharienne à partir de 2003, a été menée. Extraites de toutes les enquêtes, des informations sur 70 554 hommes âgés de 15 - 59 ans ont été recueilles. L’association entre la circoncision masculine et, l’infection à VIH et les symptômes de MST (écoulement génital ou ulcère/plaie génitale) a été évaluée en utilisant une régression logistique binaire. L’ajustement a été fait en fonction des variables sociodémographiques basiques et du passé sexuel. La prévalence pondérée du VIH parmi les hommes âgés de 15 - 59 ans était de 3.1%. Dans l’analyse bivariable, le statut de non-circoncis était significativement associé au risque de VIH avec un Odds ratio (OR) de 4.12 (95% IC:3.85 - 4.42). L’association fut même encore plus importante – (4.95 (IC 95%: 4.57 - 5.36) ) après l’ajustement lié aux variables sociodémographiques et celle du nombre de partenaires sexuels au cours d’une vie. Le risque associé au statut de non-circoncis est nettement plus faible chez les hommes plus jeunes, âgés de 15 - 29 ans, que chez ceux de la catégorie d’âge 30 - 59 ans. Environ 5.5% des sujets de l’étude ont fait part d’un écoulement génital ou d’un ulcère/plaie génitale au cours des 12 derniers mois précédant la réalisation des enquêtes. Le statut de circoncis n’a pas été significativement associé à l’un de ces problèmes avec un OR ajusté de 1.07 (IC 95%: 0.99 - 1.15). L’étude conclut qu’il existe un fort lien entre le statut de non-circoncis et l’infection à VIH. Ainsi, la circoncision masculine peut être considérée comme un des moyens possible pour réduire la propagation de l’infection à VIH dans les zones où cette pratique est rare. Une étude approfondie pour évaluer l’association entre la circoncision et les différents types de MST est recommandée

Correlates of anemia among women of reproductive age in Ethiopia: Evidence from Ethiopian DHS 2005

Background: Globally, 41.8% of pregnant women and 30.2% of non-pregnant women are anemic. Previous studies which attempted to identify determinants of anemia among women of reproductive age reported conflicting findings. Objective: To assess the correlates of anemia among women of reproductive age in Ethiopia. Methods: A quantitative cross-sectional study carried out based on the secondary data of the Ethiopia Demographic Health Survey (EDHS) 2005. Data of a total of 5963 women of reproductive age were included in the analysis. Data were mainly analyzed using ANOVA and binary logistic regression. Result: The prevalence of anemia was 27.4% (95% CI: 26.3-28.5%). Rural residence, poor educational and economic status, 30-39 years of age and high parity were key factors predisposing women to anemia. Lactating women and those who gave birth in the month of the interview had 1.3 (p = 0.000) and 2.2 (p = 0.012) times higher risk than their counterparts. Those not using contraceptive were 1.4 times (p = 0.02) more likely to develop anemia than current contraceptive users. The average Dietary Diversity Score (DDS) was only 4.01, and not more than 15% of the respondents consumed iron rich foods in the preceding day of the survey. Respondents with low DDS and those who did not consume iron rich foods in the reference period had significantly higher risk of anemia with odds ratio of 1.3 (p = 0.01) and 1.3 (p = 0.002), respectively. Utilizing maternity services, taking iron and vitamin A supplement during pregnancy and postpartum period, respectively, didn’t have a significant effect in reducing the burden of anemia. Recommendation: Family planning, economic and educational empowerment of women have affirmative inputs in combating anemia. A combination of nutrition, educational and livelihood promotion strategies should be instated to enhance dietary diversity. Maternal nutrition interventions should be integrated in a stronger manner into maternity services

Is Income Inequality Endogenous in Regional Growth?

This study focuses on testing the relationship between income inequality and growth within U.S. counties, and the channels through which such effects are observed. The study tests three hypotheses: (1) income inequality has an inverse relationship with growth; (2) regional growth adjustments are the channels through which the inequality and growth are equilibrated; and (3) income inequality is endogenous to regional growth and its adjustment. Results, based on a system of equations estimation, confirm the hypotheses that income inequality has a growth dampening effect; income inequality is endogenous to regional growth and growth adjustment; and the channels through which income inequality determines growth are regional growth adjustments, such as migration and regional adjustment in job and income growth. Results have numerous policy implications: (1) to the extent that income inequality is endogenous, its equilibrium level can be internally determined within a regional growth process; (2) to the extent that traditional income inequality mitigating policies have indirect effect on overall regional growth, they may have unintended indirect effects on income inequality; and (3) to the extent that regional growth adjustment also equilibrates income inequality, such forces can be utilized as policy instruments to mitigate income inequality, and its growth dampening effects hence forth.Income inequality, economic growth, Gini coefficient, growth modeling, population change, per capita income, Community/Rural/Urban Development, Public Economics, I32, J15, O18, P25, R11, R23, R25, R51, R53, R58,

Dietary calcium intake and sunlight exposure among children aged 6-23 months in Dale Woreda, southern Ethiopia

Nutritional rickets can be caused by either or both calcium and vitamin D deficiencies, and can frequently occur in Africa. In Ethiopia, limited evidence exists regarding the calcium intake of children and their sunlight exposure practices. The purpose of this study was to assess information regarding dietary calcium intake and sunlight exposure practice, which are factors related to nutritional rickets. The study was conducted in Dale Woreda, Southern Ethiopia using a community based cross-sectional survey design with both descriptive and analytic components. A total of 170 children were selected using multi-stage sampling technique. A structured questionnaire and an interactive 24-hour dietary assessment method were used to collect data on sociodemographic and economic information and to assess dietary calcium intake of participant children. The Ethiopian food composition table supplemented by world food data were used to convert dietary intake into nutrient content. The mean (SD) age of the study children was 14.4 (+4.7) months. The male to female ratio was 1.24. The mean (± SD) calcium intake of participant children was 407 ± 235 mg/day; 26.5% had low dietary calcium intake compared with their age specific recommended nutrient intake (RNI) value. Regarding sunlight exposure, 41.1% participant mothers exposed their child to sunlight within 1 (one) month of birth and 56.5% of study children were exposed to sunlight for 20 to 30 minutes per day. In conclusion, the risk of dietary calcium inadequacy was prevalent because of low intakes by some children. Even if only 26.5% of participating children had low dietary calcium intake, the children in the study area have some risk of dietary calcium inadequacy due to the high content of phytate in the prevailing complementary foods such as fruits and maize based complementary food, which can inhibit bioavailability of calcium. The participant children were not at risk of inadequate exposure to sunlight because they had good exposure practices and there was no sunlight avoidance practices among the majority of participant children.Key words: Calcium, Children, Ethiopia, Rickets, Sunlight exposure, Vitamin D,Phytate, Complementary food

Heading towards commercialization? The case of live animal marketing in Ethiopia

The current levels of contributions of the livestock subsector in Ethiopia, at either the macro or micro level, is below potential. Policy, technological, organizational and institutional interventions to improve the contributions of livestock to the national economy need to be based on an understanding of the constraints and opportunities available based on sound theoretical and empirical analysis. This rapid marketing appraisal study is aimed at assessing the supply chains of live cattle and live shoats in the four Ethiopian regional states of Tigray, Amhara, Oromia and the Southern Nations, Nationalities and Peoples region (SNNPR). Livestock production in Ethiopia is based on traditional technology and practices, and is subsistence oriented. Although efforts are being made to introduce and promote market oriented livestock production, with or without fattening, these efforts are miniscule compared with the size of the livestock population and the number of household who rear them. Hence, it is important to build on these efforts, evaluate them to learn lessons, and strengthen the extension service to promote the market orientation among the wider farming population. In most of the study areas, feed shortage was identifi ed as the most important constraint to livestock production. In some of the study areas, livestock diseases were identified as most important constraint, followed by feed shortage. Potential solutions to the feed problem vary depending on the resource bases of a particular intervention area. The relative bias of the extension service in favour of crop production has left the livestock extension service too limited. This calls for the need to invigorate the livestock extension service throughout the country. Especially, the development of market oriented livestock extension service deserves serious attention. Livestock credit supply falls short of demand in many of the study areas and some farmers complained about the periodic repayment schedule of the livestock credit. On average, there are four livestock market places per woreda. The primary markets in some of the Pilot Learning Woredas (PLWs) are fenced in which the respective municipalities charge buyers and sellers tax for sold animals upon exit. Farmers and traders in all of the study sites reported no or very little access to formal livestock marketing information. Farmers in all PLWs depend on actual market day information for prices and selling decisions. Livestock traders are almost exclusively male. Key informants indicated that there are no farmer associations or cooperatives involved in livestock marketing in the woredas, except in some areas where export abattoirs have established livestock marketing cooperatives and unions. The reasons for selling livestock, as reported by farmers, include the need to cover incidental cash expenses to fill household food defi cit gaps, buy clothing, cover school and medical fees, cover expenses for social events, down payment for credit and credit repayments, payment for labour for agricultural activities, buy other animals, and to purchase crop inputs. Forced sales due to shortage of feed and water during the dry period were also widely mentioned. The sale of male shoats dominates the sale of females. The age of shoats supplied to the markets in the eight PLWs ranges from 1 to 2 years. The most common weight of shoats offered for sale ranges between 15 to 25 kg live weight. In almost all PLWs livestock are transported mainly by trekking. Farmers and traders indicated a number of problems affecting marketing of shoats and cattle. The major ones include inadequate market places, lack of adequate supply of good condition animals, lack of holding (concentration) places, feed shortage, shortage of stock supply for fattening/reproduction, lack of market information and low price due to poor body conditions

Dairy production, processing and marketing systems of Shashemene-Dilla area, South Ethiopia

Two hundred forty dairy producers, both rural and urban producers in the four major towns representing the Shashemene-Dilla area in southern Ethiopia, were selected using a multi-stage sampling techniques, with the objective of characterizing dairy production, processing/handling, marketing systems as well as to prioritize constraints and opportunities for dairy development in the area. To characterize dairy marketing systems in the study area, a Rapid Market Appraisal (RMA) technique was employed. Dairy marketing systems were studied with the help of topical guidelines. Dairy producers were interviewed using a pre-tested and structured formal questionnaire. Two major dairy production systems, namely the urban and mixed crop-livestock systems were identified, and again classified into two categories based on the major crops grown as a cereal crop producing and enset-coffee producing areas. The average family size of urban and rural dairy producers was 7.19 ± 0.26 and 7.58 ± 0.23 persons, respectively. Dairy contributed about half of the income of urban producers but it made up only 1.6% of the total income of families in the mixed crop-livestock production system. Average farm size of households in the mixed system was 1.14 ± 0.99 ha, while more than 97% of the urban producers use their own residence compound for dairying, which is only 200-400 square meters. Average herd size per household in the cereal based mixed system (3.8 ± 0.42) was higher than in the enset-coffee based systems (2.3 ± 0.36). Out of the total herds of urban producers, 32% of cattle were local cows while 19% were crossbred. Husbandry practices like feeding, watering, housing, breeding, milking, calf rearing, waste management, and record keeping were also different between the two productions systems. An estimated total of 9,645,020 litres of milk was produced annually from 4463 small and medium farms in the four towns. The majority of producers (61.7%) in the mixed crop-livestock system process milk at home, while the majority of urban producers (79.2%) produced milk for sale. An informal dairy marketing system was the only marketing system in the area. Different market channels and market outlets were identified for different dairy commodities, butter being the one having the longest channel. Prices of dairy commodities were influenced by different factors like season, access to market/distance from towns, fasting and non-fasting days, festivals and holidays, level of supply vs. purchasing ability of the urban dwellers, and quality of dairy products. Constraints for dairy development in the area included: availability and costs of feeds, shortage of farm land, discouraging marketing system, waste disposal problems, genotype improvement problem, poor extension and animal health services, and knowledge gap regarding improved dairy production systems. The rapid urbanization, subsequent increase in human population and standard of living of the urban dwellers especially the regional town Awassa as well as the rest three zonal towns can be considered as a good prospect for the development of dairy in the area. Dairying in the studied areas can be improved by solving major problems of smallholder dairy producers through services related to feed supply, access to land, good marketing systems, allocating place for waste handling and management and through provisions of veterinary, artificial insemination (AI), credit, extension, and training services at reasonable time and cost. Moreover, as market is the deriving force to the production and productivity of dairying, encouraging private investors to establish dairy processing plants in the area may be an option as a permanent market outlet for both rural and urban dairy producers through an organized milk collection schemes

How Much Margin Is Left for Degrading Agricultural Soils? The Coming Soil Crises

Agricultural soils are in peril. Multiple lines of observational and empirical evidence suggest that we are losing the world’s fertile soils at an alarming rate, worsening the on-going global food crisis. It is increasingly clear that the risk of soil crises driven by erratic precipitation, warming air, and farming mismanagement is coming sooner rather than later. At this critical time, society cannot avoid looking for ways to curb soil crises. We argue that now is the right time for science-based mitigation strategies and new insights to protect soils. We offer four research priority areas that society needs to address. Arresting and reversing the ongoing soil degradation are tantamount to safeguarding humanity and the environment. To the extent that we continue to treat soil crises as a problem for farmers only—not as a global challenge—we only escalate the scale to which the problem will grow in time and complexity

Assessment of vitamin A supplementation coverage and its association with childhood illness in Boloso Sore Woreda, Welayta Zone, SNNP Region, Ethiopia

Background: Vitamin A plays vital role in the physiology of vision and immunity. Globally quarters of a billion children are Vitamin A deficient. Vitamin A supplementation of children and mothers during postpartum period is a key strategy to avert the deficiency. However the effect of Vitamin A supplementation on incidence of childhood illnesses is controversial. Objective: To assess the effect of Vitamin A supplementation on the reduction of common childhood illnesses, and to measure the coverage of vitamin A supplementation among children aged 6-59 months and mothers during postpartum period. Methods: A retrospective cohort study which involves comparison between Vitamin A supplemented and nonsupplemented children was conducted in Feb 2008 in Boloso Sore Woreda, Wolayta Zone, SNNPR. A total of 1601 children aged 6-59 months were selected using Probability Proportional to Size (PPS) sampling technique. Results: Vitamin A supplementation coverage among children (6-59 months) was 83.1% and among women (in postpartum period) who had given birth in the preceding 12 months of the survey was 13.2%. In comparison with the corresponding level in 2005, the coverage in the area has increased significantly (

Maize and livestock: their inter-linked roles in meeting human needs in Ethiopia

This study was conducted to understand the roles and interactions of maize and livestock in meeting livelihoods requirement of Ethiopian households in the maize belt. Emphasis was given to the factors that determine the use patterns of maize in order to identify options for improving the use of maize as livestock feed. The specific objectives were to characterize the maize-livestock production system; to assess the availability and use of livestock feed in the system; to analyse the role of maize as food and feed; and to analyse the factors that affect the use of maize as livestock feed. The report is organized as follows. The first section is introduction. The following section presents methods of study. Section three describes the study area. Section four presents crop production in the maize belt area. Sections five and six deal with maize and livestock production in the maize belt, respectively. Section seven presents the multiple roles of maize, while section eight describes the feed marketing situation in the study area. Section nine concludes the paper and draws implications