Sources of variation for indoor nitrogen dioxide in rural residences of Ethiopia

<p>Abstract</p> <p>Background</p> <p>Unprocessed biomass fuel is the primary source of indoor air pollution (IAP) in developing countries. The use of biomass fuel has been linked with acute respiratory infections. This study assesses sources of variations associated with the level of indoor nitrogen dioxide (NO₂).</p> <p>Materials and methods</p> <p>This study examines household factors affecting the level of indoor pollution by measuring NO₂. Repeated measurements of NO₂were made using a passive diffusive sampler. A <it>Saltzman </it>colorimetric method using a spectrometer calibrated at 540 nm was employed to analyze the mass of NO₂on the collection filter that was then subjected to a mass transfer equation to calculate the level of NO₂for the 24 hours of sampling duration. Structured questionnaire was used to collect data on fuel use characteristics. Data entry and cleaning was done in EPI INFO version 6.04, while data was analyzed using SPSS version 15.0. Analysis of variance, multiple linear regression and linear mixed model were used to isolate determining factors contributing to the variation of NO₂concentration.</p> <p>Results</p> <p>A total of 17,215 air samples were fully analyzed during the study period. Wood and crop were principal source of household energy. Biomass fuel characteristics were strongly related to indoor NO₂concentration in one-way analysis of variance. There was variation in repeated measurements of indoor NO₂over time. In a linear mixed model regression analysis, highland setting, wet season, cooking, use of fire events at least twice a day, frequency of cooked food items, and interaction between ecology and season were predictors of indoor NO₂concentration. The volume of the housing unit and the presence of kitchen showed little relevance in the level of NO₂concentration.</p> <p>Conclusion</p> <p>Agro-ecology, season, purpose of fire events, frequency of fire activities, frequency of cooking and physical conditions of housing are predictors of NO₂concentration. Improved kitchen conditions and ventilation are highly recommended.</p

Suicide and suicide attempts in people with severe mental disorders in Butajira, Ethiopia:10 year follow-up of a population-based cohort

Background: People with severe mental disorders (SMD) are at higher risk of suicide. However, research into suicide attempts and completed suicide in people with SMD in low-and middle-income countries is mostly limited to patients attending psychiatric facilities where selection bias is likely to be high. Methods: A population-based cohort of 919 people with SMD from rural Ethiopia (who received standardized clinician diagnoses of schizophrenia (n = 358) major depressive disorder (n = 216) and bipolar I disorder (n = 345)) were followed up annually for an average of 10 years. The Longitudinal Interval Follow-up Evaluation chart was administered by psychiatrists and used to evaluate systematically suicidal behavior and risk factors, which may be amenable to intervention. Results: Over the follow-up period, the cumulative risk of suicide attempt was 26.3% for major depression, 23.8% for bipolar I disorder and 13.1% for schizophrenia, (p &lt; 0.001). The overall incidence of completed suicide was 200.2/100,000 person-years (CI = 120.6, 312.5). Hanging was the most frequent method used (71.5%) for both attempters and completers. Most people who completed suicide were successful on the first attempt (84.2%), but the case-fatality rate for suicide attempt was 9.7%. In the adjusted logistic regression model, being currently married (Adjusted OR) =2.17, 95% CI = 1.21, 3.91), and having a diagnosis of bipolar I disorder (Adjusted OR = 2.59, 95% CI = 1.57, 4.26) or major depression (Adjusted OR = 2.71, 95% CI = 1.60, 4.58) were associated significantly with increased risk of suicide attempts. Conclusion: In this sample of people with SMD from a rural setting, the rate of suicide was high. Initiatives to integrate mental health service into primary care need to focus on limiting access to suicide methods in people with SMD in addition to expanding access to mental health care