FLOWER BUD REMOVAL AND EARTHING UP TIME INCREASED GROWTH AND TUBER YIELD OF POTATO AT EASTERN TIGRAY, ETHIOPIA

In Ethiopia, potato is a staple food crop and source of cash income for smallholder farmers, but the national average yield in farmers’ field is lower than experimental yields due to poor agronomic activities. The study aimed to determine the effects of flower removal and earthing up time on growth and tuber yield of potato. The experiment comprised of three flower removal stage and five earthing up time treatments, which were laid out in a randomized complete block design of 3x5 factorial arrangements with three replications. Results indicated that plant height, stem number, tuber length and tuber diameter were shown significantly affected (p < 0.05) by the main effect of flower removal and earthing up time but not by their interaction. Fresh shoot biomass and physiological maturity were recorded significantly affected (p < 0.05) by earthing up time, but not by flower removal stage and its interaction with earthing up time. Total fresh biomass, marketable and unmarketable tuber yield, as well as total tuber yield were significantly affected (p < 0.05) by main factors and their interaction effects. The results clearly indicated that the highest total tuber yield (30.96 ton ha-1) was recorded from flower bud removed potato earthed up at 15 days after complete emergence. Therefore, flower bud removed potato earthed up at 15 days after full emergence was better in terms of all yield contributing characters and tuber yield

ASSESSMENT OF DRUG USE AND EFFECT IN PREGNANT WOMEN ATTENDING ANTENATAL CARE IN HOSPITALS OF MEKELLE, TIGRAY, ETHIOPIA

Objectives: To assess the extent and nature of drug utilization among pregnant women attending antenatal care in hospitals of Mekelle, Tigray, Ethiopia. Methods: Institution-based cross sectional study was conducted by reviewing the antenatal care follow up cards and interviewing pregnant women using semi-structured questionnaire by nurses working in the four hospitals. Details of drugs self utilized and prescribed during the current pregnancy were investigated and categorized according to the United States Food and Drug Administration fetal risk classification. Data was analyzed using SPSS version 20.0. Result: Of the 400 participants, majority 199 (49.8%) were in age group of 26-36years. 38 (9.5%) and 8 (2%) have self utilized modern and herbal drugs, respectively. Majority 26 (59.1%) were analgesics. Most 32 (84.2%) of the self medicated modern drugs were from category C, followed by category B. Illiterates and secondary school complete participants have practiced self medication 3.7 times (AOR 3.65 (1.31, 10.20), p=0.014) and 4.03 times (AOR 4.03 (1.09, 14.96), p=0.038) more than the tertiary complete participants, respectively. Self medication use was 3.7 times more among non government employees than governmental employees (AOR 3.68 (1.11, 12.17), p=0.033). Forty one (10.2%) of the participants had chronic diseases where most 26 (39.4%) were from category C, followed by category D 17 (25.8%). Of all the participants, 249 (62.2%) consumed one or more prescription drugs, with 1.86±0.94 average number of drugs prescribed per pregnant women. Majority 190 (76.3%) were from category B, followed by category C 94 (37.8%), category A 53 (21.3%), category C/D 23 (9.2%), category D 22 (8.8%), category B/C 7 (2.8%), category A/C 3 (1.2%) and category X 1 (0.4%).  One hundred one (40.6%) of the drugs were prescribed in Ayder referral hospital, followed by Mekelle 93 (37.3%), kalkidan 31 (12.4%) and Meskerem 24 (9.6%) hospitals. Majority of the drugs prescribed in each hospital were from category B (80 (32.1%), 71 (28.5%), 21 (8.4%) and 18 (7.2%), respectively. Antibacterial drugs were the most commonly prescribed 146 (38.7%). Conclusion: Majority consumed one or more prescription drugs. Most of them were from category B. Keywords: pregnancy, self medications, prescription drugs, US FDA fetal risk classification, Hospitals of Mekelle

ASSESSMENT ON KNOWLEDGE OF DIABETIC PATIENTS ON THEIR DISEASE AND THERAPEUTIC GOAL AT AYDER REFERRAL HOSPITAL, MEKELLE, ETHIOPA

Diabetes mellitus is a chronic illness that requires continuing medical care and patient self-management education to prevent acute and long term complications. The aim of this study was to assess diabetic patients’ knowledge of their disease and therapeutic goals at Ayder referral Hospital. A descriptive cross sectional study was conducted on139 diabetic patients, who attended outpatient Diabetes clinic of Ayder Referral Hospital. Data was collected through face-to-face interview using a pre-tested structured questionnaire. SPSS version 16 was used to analyze the data. The result showed that out of 139 patients, Seventy six (54.7%) of them were men. Overall the general knowledge of patients was found as; 41(29.5%) scored good, 32(23%) scored moderate and 66(47.5%) scored poor. From all the patients, 38 (27.3%) had good knowledge, 30(21.6%) had moderate and 71(51.1%) scored poor on disease related questions and 38 (27.3%) scored good, 49(35.3%) moderate and 52(37.4%) scored poor on therapeutic goal related question types. In this study patients had Knowledge deficit about their disease, which limits their involvement in the management of their disease. This study emphasizes the need for diabetes education at all levels to tackle diabetes-related complications. Key words: Knowledge, disease, diabetes, self-management, therapeutic goal Ayder Referral Hospita

ANTI-TUBERCULOSIS DRUG RESISTANCE IN ETHIOPIA: A MATA- ANALYSIS

Tuberculosis is one of the most dangers of health in the world. Ethiopia ranked seventh from the 22 high burden counties in the world. The main problem is development of resistance to the major anti-tuberculosis drugs actually increasing in Ethiopia. The aim was to review studies done on anti-tuberculosis drug resistance in Ethiopia. Literatures were searched for published articles on anti-tuberculosis drug resistance using the combination of terms; resistance, anti-tuberculosis and Ethiopia. Fifteen studies done in different parts of Ethiopia from 1978-2005 G.C were retrieved without restriction of place & design of study. The primary resistance of the fifteen studies done in various parts of Ethiopia (Addis Ababa, Harar, Bahir Dar, Sidamo, Arsi, and Hosanna) from1978-2005 G.C showed: Isoniazid (H) 1.9%-21.4%, Streptomycin (S) 1.9%-26%, Rifampicin (R) 0%-1.9%, Ethambutol (E) 0%-6.3%, Thiacetazone (T) 2.2%-6.3%, H+S 1.9%-26%, H+T 0%-4.4%, S+T 0%-1.8%, H+R 0%-1.1%, S+R 0%-0.7%, R+T 0%-0.4%, H+E 0%-0.9%, S+E 0%-0.6% ,H+S+T 0%-2.4%, H+S+R 0%-1.1%, H+T+R 0%-0.4%, H+S+E 0%-1.7%, R+H+T+S 0%-0.6% and Multi Drug Resistance 0%-1.3%.Acquired drug resistance: H 5.3%-66.7%, S 1.2%-46%, R 0%-12%, E 0%-5.6%, T0%-29%, H+T 0%-20%, H+S 4.8%- 28%, R+H 0%-8%, R+S 0%-3.5%, S+T 0%-2.3%, H+E 0%-3.6%, R+E 0%-5.6%, S+E 0%- 11.2%, H+S+T 0%-16%, R+S+T 0%-2.3% , R+S+H 0%-4%, H+S+E 0%-3.6%, H+R+E 0%- 3.6%, H+R+S+E 0%-14.3% and Multi Drug Resistance 0%-26.3%. It can be concluded that resistance to the anti-tuberculosis drugs is increasing. National level drug resistance survey is recommended to design policies and strategies to prevent increase of drug resistance. Key words: Resistance, tuberculosis, anti-tuberculosis drugs and Ethiopia

The COVID-19 pandemic and healthcare systems in Africa:A scoping review of preparedness, impact and response

BACKGROUND: The COVID-19 pandemic has overwhelmed health systems in both developed and developing nations alike. Africa has one of the weakest health systems globally, but there is limited evidence on how the region is prepared for, impacted by and responded to the pandemic. METHODS: We conducted a scoping review of PubMed, Scopus, CINAHL to search peer-reviewed articles and Google, Google Scholar and preprint sites for grey literature. The scoping review captured studies on either preparedness or impacts or responses associated with COVID-19 or covering one or more of the three topics and guided by Arksey and O’Malley’s methodological framework. The extracted information was documented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension checklist for scoping reviews. Finally, the resulting data were thematically analysed. RESULTS: Twenty-two eligible studies, of which 6 reported on health system preparedness, 19 described the impacts of COVID-19 on access to general and essential health services and 7 focused on responses taken by the healthcare systems were included. The main setbacks in health system preparation included lack of available health services needed for the pandemic, inadequate resources and equipment, and limited testing ability and surge capacity for COVID-19. Reduced flow of patients and missing scheduled appointments were among the most common impacts of the COVID-19 pandemic. Health system responses identified in this review included the availability of telephone consultations, re-purposing of available services and establishment of isolation centres, and provisions of COVID-19 guidelines in some settings. CONCLUSIONS: The health systems in Africa were inadequately prepared for the pandemic, and its impact was substantial. Responses were slow and did not match the magnitude of the problem. Interventions that will improve and strengthen health system resilience and financing through local, national and global engagement should be prioritised

The COVID-19 pandemic and healthcare systems in Africa : a scoping review of preparedness, impact and response

Funding Information: Funding GAT was supported with funding from the Australia National Health and Medical Research Council (NHMRC) Investigator Grant #1195716.Peer reviewedPublisher PD

The superior effect of nature based solutions in land management for enhancing ecosystem services

The rehabilitation and restoration of land is a key strategy to recover services -goods and resources- ecosystems offer to the humankind. This paper reviews key examples to understand the superior effect of nature based solutions to enhance the sustainability of catchment systems by promoting desirable soil and landscape functions. The use of concepts such as connectivity and the theory of system thinking framework allowed to review coastal and river management as a guide to evaluate other strategies to achieve sustainability. In landmanagement NBSs are not mainstream management. Through a set of case studies: organic farming in Spain; rewilding in Slovenia; land restoration in Iceland, sediment trapping in Ethiopia and wetland construction in Sweden, we showthe potential of Nature based solutions (NBSs) as a cost-effective long term solution for hydrological risks and land degradation. NBSs can be divided into two main groups of strategies: soil solutions and landscape solutions. Soil solutions aimto enhance the soil health and soil functions throughwhich local eco-systemserviceswill bemaintained or restored. Landscape solutions mainly focus on the concept of connectivity. Making the landscape less connected, facilitating less rainfall to be transformed into runoff and therefore reducing flood risk, increasing soilmoisture and reducing droughts and soil erosionwe can achieve the sustainability. The enhanced eco-system services directly feed into the realization of the Sustainable Development Goals of the United Nations

Global, regional, and national burden of tuberculosis, 1990–2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

Background Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. Methods We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. Findings Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9·02 million (95% uncertainty interval [UI] 8·05–10·16) and the number of tuberculosis deaths was 1·21 million (1·16–1·27). Among HIV-positive individuals, the number of incident cases was 1·40 million (1·01–1·89) and the number of tuberculosis deaths was 0·24 million (0·16–0·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (–1·3% [–1·5 to −1·2]) than mortality did (–4·5% [–5·0 to −4·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was −4·0% (–4·5 to −3·7) and mortality was −8·9% (–9·5 to −8·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13·7 for incidence and 14·9 for mortality), and the lowest ratios were in high-income North America (0·4 for incidence) and Oceania (0·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67·3 for incidence and 73·0 for mortality), and high-income North America had the lowest ratios (0·4 for incidence and 0·5 for mortality). Interpretation If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV

Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Previous attempts to characterise the burden of chronic respiratory diseases have focused only on specific disease conditions, such as chronic obstructive pulmonary disease (COPD) or asthma. In this study, we aimed to characterise the burden of chronic respiratory diseases globally, providing a comprehensive and up-to-date analysis on geographical and time trends from 1990 to 2017. Methods Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, we estimated the prevalence, morbidity, and mortality attributable to chronic respiratory diseases through an analysis of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLL) by GBD super-region, from 1990 to 2017, stratified by age and sex. Specific diseases analysed included asthma, COPD, interstitial lung disease and pulmonary sarcoidosis, pneumoconiosis, and other chronic respiratory diseases. We also assessed the contribution of risk factors (smoking, second-hand smoke, ambient particulate matter and ozone pollution, household air pollution from solid fuels, and occupational risks) to chronic respiratory disease-attributable DALYs. Findings In 2017, 544.9 million people (95% uncertainty interval [UI] 506.9- 584.8) worldwide had a chronic respiratory disease, representing an increase of 39.8% compared with 1990. Chronic respiratory disease prevalence showed wide variability across GBD super-regions, with the highest prevalence among both males and females in high-income regions, and the lowest prevalence in sub-Saharan Africa and south Asia. The age-sex- specific prevalence of each chronic respiratory disease in 2017 was also highly variable geographically. Chronic respiratory diseases were the third leading cause of death in 2017 (7.0% [95% UI 6.8-7 .2] of all deaths), behind cardiovascular diseases and neoplasms. Deaths due to chronic respiratory diseases numbered 3 914 196 (95% UI 3 790 578-4 044 819) in 2017, an increase of 18.0% since 1990, while total DALYs increased by 13.3%. However, when accounting for ageing and population growth, declines were observed in age-standardised prevalence (14.3% decrease), agestandardised death rates (42.6%), and age-standardised DALY rates (38.2%). In males and females, most chronic respiratory disease-attributable deaths and DALYs were due to COPD. In regional analyses, mortality rates from chronic respiratory diseases were greatest in south Asia and lowest in sub-Saharan Africa, also across both sexes. Notably, although absolute prevalence was lower in south Asia than in most other super-regions, YLLs due to chronic respiratory diseases across the subcontinent were the highest in the world. Death rates due to interstitial lung disease and pulmonary sarcoidosis were greater than those due to pneumoconiosis in all super-regions. Smoking was the leading risk factor for chronic respiratory disease-related disability across all regions for men. Among women, household air pollution from solid fuels was the predominant risk factor for chronic respiratory diseases in south Asia and sub-Saharan Africa, while ambient particulate matter represented the leading risk factor in southeast Asia, east Asia, and Oceania, and in the Middle East and north Africa super-region. Interpretation Our study shows that chronic respiratory diseases remain a leading cause of death and disability worldwide, with growth in absolute numbers but sharp declines in several age-standardised estimators since 1990. Premature mortality from chronic respiratory diseases seems to be highest in regions with less-resourced health systems on a per-capita basis

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe