BRONCHODILATOR AND ANTI-INFLAMMATORY ACTIVITIES OF ADHATODA SCHIMPERIANA

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Non-communicable diseases in Ethiopia: policy and strategy gaps in the reduction of behavioral risk factors

Introduction: Non-communicable diseases (NCDs) are the leading cause of death worldwide. Over 80% of NCD deaths occur in developing countries. Four modifiable behaviors, namely tobacco use, consumption of unhealthy diet, physical inactivity, and the harmful use of alcohol, contribute to 80% of the NCD burden. Studies show that the vast majority of NCDs can be prevented through behavioral risk-reduction interventions. Properly executed, the interventions could lead to a decrease in the burden of NCDs, ranging from a 30% drop in the prevalence of cancer to a 75% reduction in cardiovascular diseases. This study examined the policy and strategy gaps in the reduction of the modifiable NCD behavioral risk factors in Ethiopia to inform and guide policy-makers and other stakeholders. Methodology: This study used a data triangulation methodology with a sequential, explanatory, mixed-method design conducted in two stages. The authors carried out quantitative analysis on the prevalence and distribution of behavioral risk factors from the Ethiopia NCD STEPwise approach to surveillance (STEPS) survey. Qualitative data on national policies and strategies complemented the analysis of the progress made so far and the existing gaps. Results and Discussion: Ethiopia has made substantial progress in responding to the NCD epidemic by developing a health sector NCD strategic action plan, generating evidence, and setting time-bound national targets on NCD behavioral risk factors. Activities mainly aimed at reducing tobacco use, such as implementation of the ratified WHO Framework Convention on Tobacco Control (FCTC), using evidence of the Global Adult Tobacco Survey (GATS), and the articulation of legislative measures are ongoing. On this paper our analysis reveals policy and strategy gaps, status in law enforcement, social mobilization, and awareness creation to reduce the major behavioral risk factors. Conclusions: NCDs share common risk factors and risk reduction strategies creates an opportunity for an effective response. However, the national response still needs more effort to have a sufficient impact on the prevention of NCDs in Ethiopia. Thus, there is an urgent need for the country to develop and implement targeted strategies for each behavioral risk factor and design functional, multisectoral coordination. There is also a need for establishing sustainable financial mechanisms, such as increasing program budgets and levying ‘sin taxes,’ to support the NCD prevention and control program. Ethiop. J. Health Dev. 2019; 33(4):259-268] Key words: NCDs, behavioral risk factors, policy, strategy, multisectoral coordination, Ethiopi

Non-communicable Diseases in Ethiopia: Disease burden, gaps in health care delivery and strategic directions.

Abstract Introduction: In Ethiopia, non-communicable diseases (NCDs) cause 42% of deaths, of which 27% are premature deaths before 70 years of age. The Disability Adjusted Life Years (DALYs) increased from below 20% in 1990 to 69% in 2015. With no action, Ethiopia will be the first among the most populous nations in Africa to experience dramatic burden of premature deaths and disability from NCDs by 2040. However, the national response to NCDs remains fragmented with the total health spending per capita for NCDs still insignificant. The focus of this paper is highlighting the burden of NCDs in Ethiopia and analyzing one of the two major WHO recommended policy issues; the status of integrated management of NCDs, in Ethiopia. NCDs are complex conditions influenced by a range of individual, social and economic factors, including our perceptions and behavior. Also, NCDs tend to be easily overlooked by individuals and policy makers due to their silent nature. Thus, effectively addressing NCDs requires a fresher look into a range of health system issues, including how health services are organized and delivered.Methods: A mixed method approach with quantitative and qualitative data was used. Quantitative data was obtained through analysis of the global burden of diseases study, WHO-STEPs survey, Ethiopian SARA study and the national essential NCD drug survey. This was supplemented by qualitative data through review of a range of documents, including the national NCD policies and strategies and global and regional commitments.Results and discussion: In 2015, NCDs were the leading causes of age-standardized death rate (causing 711 deaths per 100,000 people (95% UI: 468.8–1036.2) and DALYs. The national estimates of the prevalence of NCD metabolic risk factors showed high rates of raised blood pressure (16%), hyperglycemia (5.9%), hypercholesterolemia (5.6%), overweight (5.2%) and Obesity (1.2%). Prevalence of 3-5 risk factors constituting a metabolic syndrome was 4.4%. Data availability on NCD morbidity and mortality is limited. While there are encouraging actions on NCDs in terms of political commitment, lot of gaps as shown by limited availability of resources for NCDs, NCD prevention and treatment services at the primary health care (PHC) level. Shortage of essential NCD drugs and diagnostic facilities and lack of treatment guidelines are major challenges. There is a need to re-orient the national health system to ensure recognition of the NCD burden and sustain political commitment, allocate sufficient funding and improve organization and delivery of NCD services at PHC level. [Ethiop. J. Health Dev. 2018;32 (3):00-000]Key words: Non-communicable diseases, health-system re-orientation, NCD burden, metabolic risk factors, Service delivery, Primary Health Car

Tobacco use and its predictors among Ethiopian adults: A further analysis of Ethiopian NCD STEPS survey-2015

Background: Consuming any form of tobacco is one of the leading causes of preventable morbidity and mortality. Tobacco smoking has been identified as one of the major risk factors for NCDs, including cardiovascular, chronic respiratory diseases, and different cancers. Although there is national information on magnitude of tobacco use, to date there is limited nationally representative data on factors associated with tobacco use. The aim of this study is to assess the distribution and predicators of tobacco use in Ethiopian adult population between 15 -59.Objectives: The main aim of this study was to assess the prevalence of tobacco use and its predictor in Ethiopia.Methods: A cross-sectional population based study design was employed among population age from 15- 69 years. A stratified, three-stage cluster sampling was used to identify the study subjects. Households in each cluster were selected using simple random sampling method. The sampling frame was based on the population and housing census conducted for Ethiopia in 2007. Data was collected using WHO NCD STEPS questionnaire; current tobacco use of any type was taken as the dependent variable. Five hundred thirteen enumeration areas (EAs) as primary sampling units (PSUs) (404 rural and 109 urban) were selected with probability proportionate to size, followed by selection of households as a secondary sampling units (SSUs). A total of 10,260 households were selected from the 513 EAs (20 households per EA). Eligible individuals were selected from households using Kish method (a pre-assigned table of random numbers to find the person to be interviewed). Descriptive statistics using frequency table, mean, median, interquartile range and standard deviations were computed. Step wise logistic regression was used to analyse the predictors of tobacco use. An Estimator of 95% confidence interval was used both for computing descriptive statistics as well testing associations using logistic regression.Results: The prevalence of tobacco use (all tobacco products) was 4.2%. The mean age (± SD) of starting tobacco use was 21(7) years. The mean frequency of tobacco use was 2 times per day. Hierarchical Logistic regression analysis revealed that participants in age groups 30-44 years, and 60-69 years were less likely to use any tobacco type compared to younger age group of15-29 years. Heavy episodic drinking, AOR 2.46 [95% CI= 1.4 – 4.5], and khat chewing, AOR 4.71[95%= 2.26 – 9.8], were independently associated with tobacco use.Conclusion and recommendations: The overall prevalence of tobacco use was relatively higher in males. Factors associated with tobacco use were heavy episodic drinking and khat chewing. Although tobacco use is an important risk factor for different disease on its own, the additional use of these substances exposes individuals to increased risk of NCDs. The findings warrant the need to implement existing anti-tobacco laws in the country, enhance anti-tobacco awareness raising efforts, and implement interventions to help current tobacco users, focusing attention more on regions with high rates of tobacco use and males. Key words: Ethiopia, NCDs, Predictors, Risk factors, Tobacco use, WHO STEP

Repellent activity of essential oil of the stem of Kleinia squarrosa against mosquitoes

Most commercially available repellents of mosquitoes and other biting arthropods are synthetic and  have a severe toxic effect to human. Moreover, these chemicals cause an irreversible damage to the ecosystem as some of them are non-degradable in nature. Therefore, there is a need to develop safe and effective alternatives to the currently available chemicals used to control vectors. In southern Ethiopia, the smoke obtained from burning the stem of Kleinia squarrosa Cufod. is used as a fumigant to ward off mosquitoes. In the present study hydrodistillation of the powdered stem of K. squarrosa gave a pale yellow oil (0.04%; w/w) with a characteristic pungent odor. A total of twenty-seven compounds have been identified by GC-MS analysis, accounting 48.71% of the total oil. The main constituents of the oil were (E)-iso-γ-bisabolene (9%), α-pinene (5.74%), caryophyllene (5.36%) and sabinene (5.55%). The powdered stem of K. squarrosa was also burned, and the smoke extracted to yield a trace amount brownish oil. Analysis of the oil by GC-MS afforded 36 compounds comprising 94.56% of the total peak area. Terpene-4-ol (18.09%), (E)-iso-γ-bisabolene (14.07%), 5-epi-7-epi-α-eudesmol (12.45%), and caryophyllene (8.35%) figured as major compounds. Mosquito repellent activity of the essential oil was tested on guinea pigs against Anopheles gambiae by a modified Kunming mice technique under laboratory testing conditions. The essential oil exhibited a dose-dependent repellent action in the dose range tested (0.03 - 5%; v/v) with ED50 and ED99.9 values of 1.49% and 4.74% (v/v), respectively. The study further revealed that that the essential oil possesses a 3 h complete protection time. The similarity in the chemical profiles of the essential oil and the oil extracted from the smoke obtained by burning K. squarrosa stem supports the traditional use of the plant as a fumigant to kill mosquitoes.Keywords: Kleinia squarrosa; fumigant; essential oil; mosquito repellent; Anopheles gambia

In Vivo Antimalarial Activities of Plants Used in Ethiopian Traditional Medicine, Delomenna, Southeast Ethiopia

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Antibacterial activity of extracts from Myrtus communis L. (Ades) and Dodoneae angustifolia L.F. (Kitkita) using bioautography method

The increasing prevalence of antibacterial drug resistant organisms in our globe and high prevalence of infectious diseases in developing countries has led to new efforts in the search of bioactive compounds from complex chemical composition of plant extracts. A bioautographic agar overlay assay using Staphylococcus aureous as the indicator organism for the detection of antimicrobial compounds from ten extracts of Myrtus communis L. and Dodoneae angustifolia L was analyzed. Hexane, dichloromethane, acetone, methanol and water solvents are used as extractant and ethyl acetate: methanol: water, chloroform: ethyl acetate: acetic acid and benzene: ethanol: ammonia solvent systems were used to separate the components from all the extract of Myrtus communis L. and Dodoneae angustifolia L. Our results indicated that the extracts of Myrtus communis L.f. and Dodoneae angustifolia L had bioactive constituents responsible for their antibacterial potentials. Water solvents extracted small number of antibacterial compounds from both plants, followed by hexane extractant; while dichloromethane, acetone and methanol extractant shared similarities in bioactive compounds on bioautograms, and extracted the highest number of antibacterial compounds with variety of polarities. Chloroform: ethyl acetate: acetic acid solvent system separated the largest number of biologically active components in all extractants. As a high number of antibacterially active compounds were found in M. communis and D. angustifolia extracts of dichloromethane, acetone and methanol, we recommend assay guided fractionation, isolation and dosage formulation of these antibacterial compounds from these plants for clinical applications. Keywords/phrases: Antibacterial, Bioactive-compound, Bioautography, Dodonaea angustifolia, Myrtus communisEthiop. J. Biol. Sci., 10(1): 57-72, 201

Prevalence of high bloodpressure, hyperglycemia, dyslipidemia, metabolic syndrome and their determinants in Ethiopia: Evidences from the National NCDs STEPS Survey, 2015

<div><p>The prevalence of diabetes, dyslipidemias, and high blood pressure is increasing worldwide especially in low and middle income countries. World Health Organization has emphasized the importance of the assessment of the magnitude of the specific disease in each country. We determined the prevalence and determinant factors of high blood pressure, hyperglycemia, dyslipidemias and metabolic syndrome in Ethiopia. A community based survey was conducted from -April to June 2015 using WHO NCD STEPS instrument version 3.1. 2008. Multistage stratified systemic random sampling was used to select representative samples from 9 regions of the country. A total of 10,260 people aged 15–69 years participated in the study. Blood pressure (BP) was measured for 9788 individuals. A total of 9141 people underwent metabolic screening. The prevalence of raised blood pressure (SBP ≥140 and/or DBP ≥ 90 mmHg) was 15.8% (16.3% in females and 15.5% in males). The prevalence of diabetes mellitus (FBS ≥ 126 mg /dl) including those on medication was 3.2% (3.5% males and 3.0% females). The prevalence of impaired fasting glucose was 9.1% with ADA criteria and 3.8% with WHO criteria. Hypercholesterolemia was found in 5.2%, hypertriglyceridemia in 21.0%, high LDL cholesterol occurred in 14.1% and low HDL cholesterol occurred in 68.7%. The prevalence of metabolic syndrome using IDF definition was 4.8% (8.6% in females and vs. 1.8% in males). Advanced age, urban residence, lack of physical exercise, raised waist circumference, raised waist hip ratio, overweight or obesity, and total blood cholesterol were significantly associated with raised blood pressure (BP) and diabetes mellitus. Increased waist- hip ratio was an independent predictor of raised blood pressure, hyperglycemia and raised total cholesterol. Our study showed significantly high prevalence of raised blood pressure, hyperglycemia and dyslipidemia in Ethiopia. Community based interventions are recommended to control these risk factors.</p></div

Prevalence of raised blood pressure, hyperglycemia and their determinants, WHO STEPs study, 2015, Ethiopia.

<p>Prevalence of raised blood pressure, hyperglycemia and their determinants, WHO STEPs study, 2015, Ethiopia.</p