Endoscopic third ventriculostomy versus ventriculoperitoneal shunt placement in children with obstructive hydrocephalus

Background: Uncertainty persists on the best treatment for patients with obstructive hydrocephalus: endoscopic third ventriculostomy (ETV) or ventriculoperitoneal shunt (VPS), particularly in the younger age groups. The author investigated and compared 1-year outcomes for ETV and VPS treatment categories at Zewditu Memorial Hospital (ZMH), Ethiopia.Methods: This was a retrospective, hospital-based study. The study reviewed 259 paediatric patients with hydrocephalus in whom VPS or ETV with or without choroid plexus cauterisation (CPC) was done as a primary treatment, between January 2013 and January 2016 at ZMH. Patients’ medical records, operative notes, and neural tube database records were used to complete a structured questionnaire. The difference in proportions was examined using the chi-square test.Results: Sixty-seven (25.9%) children initially underwent ETV and 192 (74.1%) underwent VPS placements. The median age was 5 months (range 3 days-168 months). Children who underwent VPS placement rather than ETV had a statistically significant higher risk of postoperative infection (27.0% vs 6.1%; P = 0.001), complications (27.0% vs 12.2%; P = 0.025), and a higher but insignificant operative failure rate at 1 year (45.3% vs 38.8%; P = 0.27). Sex and age were not associated with the occurrence of complications, while VPS and myelomeningocele or encephalocele (MMC/EC) were strongly associated. Complication and infection were significantly and negatively associated with complication-free 1-year survival rate (P < 0.001 each), while gender, age, procedure, and cause of hydrocephalus did not show any association with survival. There was a significant reduction of VPS success rate from 76.9% at 6 months postsurgery to 54.7% at 1 year (P < 0.001), while ETV success rate remained constant during the same period (66.7% and 61.2%, respectively). Mortality frequencies for ETV and VPS insertion were 3 (4.5%) and 9 (4.7%), respectively, for a combined total of 12 deaths (4.6%).Conclusions: Sex and age were not associated with complications, while VPS and MMC/EC were strongly associated. Children who underwent VP shunt placement rather than ETV had a higher risk of postoperative infection and complications, but there was no difference in operative failure or success rate and mortality rates between the procedures. ETV failure rate was less likely after 6 months.Keywords: obstructive hydrocephalus; endoscopic third ventriculostomy; ventriculoperitoneal shunt; children; paediatric surgery; neurosurgery; Ethiopi

FOOD-FOR-WORK FOR POVERTY REDUCTION AND THE PROMOTION OF SUSTAINABLE LAND USE: CAN IT WORK?

Food-for-work (FFW) programs are commonly used both for short-term relief and long-term development purposes. In the latter capacity, they are increasingly used for natural resources management projects. Barrett, Holden and Clay (forthcoming) assess the suitability of FFW programs as insurance to cushion the poor against short-term, adverse shocks that could, in the absence of a safety net, have permanent repercussions. In this paper we explore the complementary question of FFW programs' potential to reduce poverty and promote sustainable land use in the longer run through induced changes in investment patterns. FFW programs commonly aim to produce or maintain potentially valuable public goods necessary to stimulate productivity and thus income growth. Among the most common projects are road building, reforestation, and the installation of terracing or irrigation. In the abstract, public goods such as these are unambiguously good. There is a danger, however, that such programs could discourage private soil and water conservation and crowd out private investment. How important are such effects and when are these effects small or large and when and how can they be reduced? How do market characteristics, timing and design of FFW programs affect this? When, where and how can FFW programs more efficiently reduce poverty and promote more sustainable land management? The paper aims to answer these questions. Much recent empirical research has focused on the shorter-term targeting issue of whether FFW and related workfare programs efficiently target the poor (Dev 1995, Von Braun 1995, Webb 1995, Subbarao 1997, Clay et al. 1998, Devereux 1999, Jayne et al. 1999, Ravallion 1999, Teklu and Asefa 1999, Atwood et al. 2000, Gebremedhin and Swinton 2000, Haddad and Adato 2001, Jalan and Ravallion 2001). Much less research has been focused on the longer-term effects of FFW. Yet the large share of hunger worldwide arises due to chronic deprivation and vulnerability, not short-term shocks (Speth 1993, Barrett 2002). Also most of the FFW programs in Ethiopia have long-term development goals and are formally distinguished from the disaster relief FFW programs (Aas and Mellemstrand 2002). It is therefore appropriate to evaluate these programs based on their long-term goals and not only on the basis of short-term targeting. In a case study in Tigray Aas and Mellemstrand (2002) found that the FFW recipients considered the long-term benefits of FFW as more important than the short-term benefits of food provision. FFW programs may produce valuable public goods. For example, Von Braun et al. (1999) report multiplier effects of a FFW-built road in the Ethiopian lowlands. Public provision of public goods may be socially desirable because private investment in soil and water conservation and tree planting may be well below socially optimal levels due to poverty and market imperfections (Holden, Shiferaw and Wik 1998, Holden and Shiferaw 2002, Holden and Yohannes 2002, Pender and Kerr 1998), tenure insecurity (Gebremedhin and Swinton 2000, Holden, Benin, Shiferaw and Pender 2003), lack of technical knowledge and coordination problems across farms (Hagos and Holden 2002). There is, however, also a danger that FFW programs crowd out private investments (Gebremedhin and Swinton 2000). We analyze these issues using multiple methods. First, section II introduces a simple theoretical framework for understanding the analytically ambiguous effects of FFW programs on sustainable land use patterns. We first present the basic intuition in a static framework to illustrate the selection, crowding out and targeting issues, before generalizing it to a dynamic model to illustrate the possible insurance and crowding in effects of FFW. Section III then uses an applied, dynamic bio-economic farm household model applied to a less-favoured area in Ethiopia to investigate via numerical simulation how household welfare and land use patterns vary with changes in environmental and FFW program design parameters. Section IV presents econometric evidence based on survey panel data from northern Ethiopia to assess the relationship between FFW and private investment in conservation. Section V discusses our findings and fleshes them out a bit with further empirical evidence. Section VI concludes.Food Security and Poverty, Q18, O1, Q2, I1,

Trypanosoma equiperdum in the horse : a neglected threat?

Dourine is a contagious disease caused by Trypanosoma equiperdum that is transmitted directly from animal to animal during coitus. Dourine is known as an important disease in many countries, and it threatens equidae worldwide. It is reported to be widespread in South America, Eastern Europe, Russia, Mongolia, Namibia and Ethiopia. The disease can be carried to various parts of the world through the transportation of infected animals and semen. Since knowledge of the prepatent infectiousness of a recently infected animal is lacking, introduction of the disease is in principle an ever-present threat. Definitive diagnosis depends on the identification of the parasite by means of direct microscopy. This is rarely possible in practice and therefore, diagnosis in the field is based on the observation of typical clinical signs, together with serological tests. This paper is an endeavour to review briefly and compile information on the appearance and importance of Dourine in terms of its epidemiological and clinical features, as well as on its diagnosis, treatment and prognosis

Nutritional Status of Adolescent Girls from Rural Communities of Tigray, Northern Ethiopia

Background: Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition. Objective: Assess nutritional status of rural adolescent girls. Design: Cross-sectional. Methods: Anthropometric and socio-demographic information from 211 adolescent girls representing 650 randomly selected households from thirteen communities in Tigray was used in data analysis. Height-for-age and BMI-for-age were compared to the 2007 WHO growth reference. Data were analyzed using SAS, Version 9.1. Results: None of the households reported access to adolescent micronutrient supplementation. The girls were shorter and thinner than the 2007 WHO reference population. The cross-sectional prevalence of stunting and thinness were 26.5% and 58.3%, respectively. Lack of latrine facilities was significantly associated with stunting (p = 0.0033) and thinness (p <0.0001). Age was strong predictor of stunting (r(2) = 0.8838, p <0.0001) and thinness (r(2) = 0.3324, p <0.0001). Conclusion: Undernutrition was prevalent among the girls. Strategies to improve the nutritional status of girls need to go beyond the conventional maternal and child health care programs to reach girls before conception to break the intergenerational cycle of malnutrition. Further, carefully designed longitudinal studies are needed to identify the reasons for poor growth throughout the period of adolescence in this population. [Ethiop. J. Health Dev. 2009; 23(1):5-11

Invitro Antibacterial Screening of Extracts from Selected Ethiopian Medicinal Plants

Indigenous knowledge, literature reports and ethnobotanical records suggest that plants are the basis for medicines. They constitute natural source of antimicrobial drugs that will provide novel or lead compounds for the fight against disease. In this study, the antimicrobial activity of three selected Ethiopian medicinal plants was studied with the objective of  screening their antibacterial activity. The fruits of Measalanceolata, aerial part of Cissus quadrangularis and leaf of Dodonae angustifolia were collected, air dried under shed, powdered and soaked in 80% methanol and extracted. In vitro antibacterial activity of the extracts was tested at different concentrations by using agar disc diffusion method and  measuring the zone of inhibition. The plant extracts showed broad  spectrum activity against gram positive (S. aureus) as well as gram  negative (E. coli) bacteria, except Cissus quadrangularis which did not show any activity against E. coli. Furthermore, the plant extracts had also  concentration dependant zone of inhibition against the tested bacteria. In fact, the highest activity was obtained for Dodonae angustifolia at  1000mg/ml against S. aureus. The activities are attributed to the presence of some secondary metabolites present in the tested plants which have been associated with antibacterial activities. This finding suggests that these medicinal plants can be potential source to isolate antibacterial drugs.Keywords: Antibacterial activity, Disc diffusion, E. coli, Plant extract and S. aureus

Correlation between caffeine contents of green coffee beans and altitudes of the coffee plants grown in southwest Ethiopia

Caffeine contents of 45 green coffee bean samples collected from coffee plants grown at different altitudes in Southwest Ethiopia was determined by UV-Vis spectrophotometry. The caffeine contents were found in the range of 0.62 - 1.2% (w/w). A moderate negative correlation (R = 0.5463) was found between the caffeine contents of green coffee beans and the altitudes at which the coffee plants were grown. The caffeine contents of 9 of the green coffee bean samples analyzed by high performance liquid chromatography (HPLC) provided comparable results in the range of 0.60−1.1% (w/w). Statistical analysis of data (t-test) indicated absence of significant differences between the caffeine contents obtained by the two methods. Nonetheless, HPLC method is precise, accurate and reliable in determining caffeine content in green coffee bean samples while the UV-Vis spectrophotometry is simple, rapid, precise and more economical. KEY WORDS: Green coffee beans, Caffeine, Correlation between caffeine content and altitude of coffee plant, UV-Vis spectrophotometry, High performance liquid chromatography, Ethiopia Bull. Chem. Soc. Ethiop. 2018, 32(1), 13-25DOI: https://dx.doi.org/10.4314/bcse.v32i1.

Nutritional Status of Adolescent Girls from Rural Communities of Tigray, Northern Ethiopia

Background: Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition.Objective: Assess nutritional status of rural adolescent girls.Design: Cross-sectional.Methods: Anthropometric and socio-demographic information from 211 adolescent girls representing 650 randomly selected households from thirteen communities in Tigray was used in data analysis. Height-for-age and BMI-for-age were compared to the 2007 WHO growth reference. Data were analyzed using SAS, Version 9.1.Results: None of the households reported access to adolescent micronutrient supplementation. The girls were shorter and thinner than the 2007 WHO reference population. The cross-sectional prevalence of stunting and thinness were 26.5% and 58.3%, respectively. Lack of latrine facilities was significantly associated with stunting (p = 0.0033) andthinness (

Federated Learning for Medical Applications: A Taxonomy, Current Trends, Challenges, and Future Research Directions

With the advent of the IoT, AI, ML, and DL algorithms, the landscape of data-driven medical applications has emerged as a promising avenue for designing robust and scalable diagnostic and prognostic models from medical data. This has gained a lot of attention from both academia and industry, leading to significant improvements in healthcare quality. However, the adoption of AI-driven medical applications still faces tough challenges, including meeting security, privacy, and quality of service (QoS) standards. Recent developments in \ac{FL} have made it possible to train complex machine-learned models in a distributed manner and have become an active research domain, particularly processing the medical data at the edge of the network in a decentralized way to preserve privacy and address security concerns. To this end, in this paper, we explore the present and future of FL technology in medical applications where data sharing is a significant challenge. We delve into the current research trends and their outcomes, unravelling the complexities of designing reliable and scalable \ac{FL} models. Our paper outlines the fundamental statistical issues in FL, tackles device-related problems, addresses security challenges, and navigates the complexity of privacy concerns, all while highlighting its transformative potential in the medical field. Our study primarily focuses on medical applications of \ac{FL}, particularly in the context of global cancer diagnosis. We highlight the potential of FL to enable computer-aided diagnosis tools that address this challenge with greater effectiveness than traditional data-driven methods. We hope that this comprehensive review will serve as a checkpoint for the field, summarizing the current state-of-the-art and identifying open problems and future research directions.Comment: Accepted at IEEE Internet of Things Journa

Agricultural technology adoption, seed access constraints and commercialization in Ethiopia

This article examines the driving forces behind farmers’ decisions to adopt agricultural technologies and the causal impact of adoption on farmers’ integration into output market using data obtained from a random cross-section sample of 700 farmers in Ethiopia. We estimate a Double-Hurdle model to analyze the determinants of the intensity of technology adoption conditional on overcoming seed access constraints. We estimate the impact of technology adoption on farmers’ integration into output market by utilizing treatment effect model, regression based on propensity score as well as matching techniques to account for heterogeneity in the adoption decision, and for unobservable characteristics of farmers and their farm. Results show that knowledge of existing varieties, perception about the attributes of improved varieties, household wealth (livestock and land) and availability of active labor force are major determinants for adoption of improved technologies. Our results suggest that the adoption of improved agricultural technologies has a significant positive impact on farmers’ integration into output market and the findings are consistent across the three models suggesting the robustness of the results. This confirms the potential direct role of technology adoption on market participation among rural households, as higher productivity from improved technology translates into higher output market integration