Outcome Evaluation of the work of the CGIAR Research Program on Water, Land and Ecosystems (WLE) on soil and water management in Ethiopia

In 2019, the CGIAR Research Program on Water, Land and Ecosystems (WLE) Leadership chose to evaluate WLE’s work in Ethiopia as one of its countries where it has had most success. The objectives of the evaluation are: To determine how and in what ways WLE contributed to the achievement of intended/unintended outcomes; Based on the findings of the evaluation, make recommendations of how WLE (and its partners) can become more effective in supporting soil and water management in Ethiopia; To serve as a participatory learning experience for WLE and its partners. This report describes the evaluation process, findings, conclusions and recommendations

High-repetition-rate and high-photon-flux 70 eV high-harmonic source for coincidence ion imaging of gas-phase molecules

Unraveling and controlling chemical dynamics requires techniques to image structural changes of molecules with femtosecond temporal and picometer spatial resolution. Ultrashort-pulse x-ray free-electron lasers have significantly advanced the field by enabling advanced pump-probe schemes. There is an increasing interest in using table-top photon sources enabled by high-harmonic generation of ultrashort-pulse lasers for such studies. We present a novel high-harmonic source driven by a 100 kHz fiber laser system, which delivers 10$^{11}$ photons/s in a single 1.3 eV bandwidth harmonic at 68.6 eV. The combination of record-high photon flux and high repetition rate paves the way for time-resolved studies of the dissociation dynamics of inner-shell ionized molecules in a coincidence detection scheme. First coincidence measurements on CH$_3$I are shown and it is outlined how the anticipated advancement of fiber laser technology and improved sample delivery will, in the next step, allow pump-probe studies of ultrafast molecular dynamics with table-top XUV-photon sources. These table-top sources can provide significantly higher repetition rates than the currently operating free-electron lasers and they offer very high temporal resolution due to the intrinsically small timing jitter between pump and probe pulses

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Children with Moderate Acute Malnutrition with No Access to Supplementary Feeding Programmes Experience High Rates of Deterioration and No Improvement: Results from a Prospective Cohort Study in Rural Ethiopia

Background: Children with moderate acute malnutrition (MAM) have an increased risk of mortality, infections and impaired physical and cognitive development compared to well-nourished children. In parts of Ethiopia not considered chronically food insecure there are no supplementary feeding programmes (SFPs) for treating MAM. The short-term outcomes of children who have MAM in such areas are not currently described, and there remains an urgent need for evidence-based policy recommendations. Methods: We defined MAM as mid-upper arm circumference (MUAC) of ≥11.0cm and <12.5cm with no bilateral pitting oedema to include Ethiopian government and World Health Organisation cut-offs. We prospectively surveyed 884 children aged 6–59 months living with MAM in a rural area of Ethiopia not eligible for a supplementary feeding programme. Weekly home visits were made for seven months (28 weeks), covering the end of peak malnutrition through to the post-harvest period (the most food secure window), collecting anthropometric, socio-demographic and food security data. Results: By the end of the study follow up, 32.5% (287/884) remained with MAM, 9.3% (82/884) experienced at least one episode of SAM (MUAC <11cm and/or bilateral pitting oedema), and 0.9% (8/884) died. Only 54.2% of the children recovered with no episode of SAM by the end of the study. Of those who developed SAM half still had MAM at the end of the follow up period. The median (interquartile range) time to recovery was 9 (4–15) weeks. Children with the lowest MUAC at enrolment had a significantly higher risk of remaining with MAM and a lower chance of recovering. Conclusions: Children with MAM during the post-harvest season in an area not eligible for SFP experience an extremely high incidence of SAM and a low recovery rate. Not having a targeted nutrition-specific intervention to address MAM in this context places children with MAM at excessive risk of adverse outcomes. Further preventive and curative approaches should urgently be considered

Knowledge and attitude of health extension workers regarding mental health problems in Jimma Zone, Ethiopia: a cross-sectional study.

OBJECTIVE: Health extension workers' (HEWs') knowledge and attitude regarding mental health problems are vital for integrating mental healthcare into primary healthcare services. However, information in this context is scarce in Ethiopia. So, this study aimed to assess HEWs' knowledge and attitude towards mental health problems in Jimma, Ethiopia. DESIGN: A cross-sectional study. SETTING: Five districts in Jimma Zone, Ethiopia, 2020. PARTICIPANTS: A total of 259 HEWs working in selected five districts were included in the study. OUTCOME: The knowledge and attitude status of HEWs towards mental health problems. RESULTS: Nearly half of the respondents had inadequate knowledge (122,47.1%) and an unfavourable attitude (125, 48.3%). Most (139, 53.7%) described mental illness as due to evil spirits' possession. Almost all (240, 92.7%) of the respondents reported talking or laughing alone as a manifestation of mental illness. Almost two-thirds (157, 60.6%) of the respondents reported people with mental illness are dangerous. About a quarter (63, 24.3%) of the participants stated witch doctors should manage mental illnesses. CONCLUSIONS: A significant proportion of the study respondents had poor knowledge and attitude towards mental health problems. Short-term and long-term mental health training is needed to improve their perception level and to provide effective community mental health services

Network analysis of dairy cattle movement and associations with bovine tuberculosis spread and control in emerging dairy belts of Ethiopia

Abstract: Background: Dairy cattle movement could be a major risk factor for the spread of bovine tuberculosis (BTB) in emerging dairy belts of Ethiopia. Dairy cattle may be moved between farms over long distances, and hence understanding the route and frequency of the movements is essential to establish the pattern of spread of BTB between farms, which could ultimately help to inform policy makers to design cost effective control strategies. The objective of this study was, therefore, to investigate the network structure of dairy cattle movement and its influence on the transmission and prevalence of BTB in three emerging areas among the Ethiopian dairy belts, namely the cities of Hawassa, Gondar and Mekelle. Methods: A questionnaire survey was conducted in 278 farms to collect data on the pattern of dairy cattle movement for the last 5 years (September 2013 to August 2018). Visualization of the network structure and analysis of the relationship between the network patterns and the prevalence of BTB in these regions were made using social network analysis. Results: The cattle movement network structure display both scale free and small world properties implying local clustering with fewer farms being highly connected, at higher risk of infection, with the potential to act as super spreaders of BTB if infected. Farms having a history of cattle movements onto the herds were more likely to be affected by BTB (OR: 2.2) compared to farms not having a link history. Euclidean distance between farms and the batch size of animals moved on were positively correlated with prevalence of BTB. On the other hand, farms having one or more outgoing cattle showed a decrease on the likelihood of BTB infection (OR = 0.57) compared to farms which maintained their cattle. Conclusion: This study showed that the patterns of cattle movement and size of animal moved between farms contributed to the potential for BTB transmission. The few farms with the bulk of transmission potential could be efficiently targeted by control measures aimed at reducing the spread of BTB. The network structure described can also provide the starting point to build and estimate dynamic transmission models for BTB, and other infectious diseases

Scaling-up water management interventions for rainfed agriculture in the Ethiopian Highlands: status, issues, and opportunities

Ethiopia is the second most populous country in Africa with more than 110 million people. The capacity to feed its rapidly growing population largely depends on rainfed agricultural production systems, in a range of agro climatic regions from arid and semiarid lowlands to temperate highlands. Agriculture is undermined by both severe land degradation and high inter- and intra-seasonal rainfall variability. As a result, the current average productivity of rainfed farming remains low (1.7 t ha-1 for pulses and 2.7 t ha-1 for cereals). This is despite a slow yield increase (e.g. about 1.5 t ha-1 for cereals and 1 t ha-1 for pulses) due to the introduction of new crop cultivars, fertilizers and management practices. Recognising the large yield gap in rainfed systems, the Ethiopian government has, since 1970, initiated a number of public welfare programs. These have involved various natural resource management programs with a special focus on agricultural water management (AWM) in Sustainable Land Management Projects (SLMP). SLMPs, centered around rainfed production systems, have been implemented to address land degradation, enhance crop and livestock productivity, and improve household incomes. Integrated resource management approaches have helped local communities obtain tangible benefits from AWM, and strengthened a number of ecosystem services, when compared to a sectoral approach. In the last 15 years, through SLMP 1 and 2, more than 2% of agricultural fields, and communal rainfed land, in Ethiopia, has been subject to AWM and sustainable land management. This has benefitted around 1.4 million households and supported environmental sustainability. Over 430,000 people have also benefited from related income generating activities. However, systematic data on various aspects of AWM is required to obtain a clear understanding of the overall impact of these interventions. This study proposes following a landscape approach, in order to realize the full potential of diverse AWM interventions, and a consortium approach to capacity building to achieve large scale, system level outcomes

Clinical Profile of Neonates Admitted with Sepsis to Neonatal Intensive Care Unit of Jimma Medical Center, A Tertiary Hospital in Ethiopia

BACKGROUND፡ Globally, over 3 million newborn die each year, one million of these attributed to infections. The objective of this study was to determine the etiologies and clinical characteristics of sepsis in neonates admitted to intensive care unit of a tertiary hospital in Ethiopia.METHODS: A longitudinal hospital based cohort study was conducted from April 1 to October 31, 2018 at the neonatal intensive care unit of Jimma Medical Center, southwest Ethiopia. Diagnosis of sepsis was established using the World Health Organization’s case definition. Structured questionnaires and case specific recording formats were used to capture the relevant data. Venous blood and cerebrospinal fluid from neonates suspected to have sepsis were collected.RESULTS: Out of 304 neonates enrolled in the study, 195 (64.1%) had clinical evidence for sepsis, majority (84.1%;164/195) of them having early onset neonatal sepsis. The three most frequent presenting signs and symptoms were fast breathing (64.6%; 122/195), fever (48.1%; 91/195) and altered feeding (39.0%; 76/195). Etiologic agents were detected from the blood culture of 61.2% (115/195) neonates. Bacterial pathogens contributed for 94.8% (109/115); the rest being fungal etiologies. Coagulase negative staphylococci (25.7%; 28/109), Staphylococcus aureus (22.1%; 24/109) and Klebsiella species (16.5%; 18/109) were the most commonly isolated bacteria.CONCLUSION: Majority of the neonates had early onset neonatal sepsis. The major etiologies isolated in our study markedly deviate from the usual organisms causing neonatal sepsis. Multicentre study and continuous surveillance are essential to tackle the current challenge to reduce neonatal mortality due to sepsis in Ethiopia

Ecosystem-based interventions and farm household welfare in degraded areas: Comparative evidence from Ethiopia

Agricultural productivity and farm household welfare in areas of severe land degradation can be improved through ecosystem-based interventions. Decisions on the possible types of practices and investments can be informed using evidence of potential benefits. Using farm household data together with a farm level stochastic simulation model provides an initial quantification of farm income and nutrition outcomes that can be generated over a five year period from manure and compost based organic amendment of crop lands. Simulated results show positive income and nutrition impacts. Mean farm income increases by 13% over the planning period, from US$32,833 under the business as usual situation (application of 50 kg DAP and 25 kg urea ha− 1 yr− 1) to US$37,172 under application of 10 t ha− 1 yr− 1 farm yard manure during the first three years and 5 t ha− 1 yr− 1 during the last two years. As a result of organic soil amendment, there is an associated increase in the available calorie, protein, fat, calcium, and iron per adult equivalent, giving the improvement in farm household nutrition. The evidence is substantive enough to suggest the promotion and adoption at scale, in degraded ecosystems, of low cost organic soil amendment practices to improve agricultural productivity and subsequent changes in farm household welfare

Assessing potential locations for flood-based farming using satellite imagery: a case study of Afar region, Ethiopia

The dry lowlands of Ethiopia are seasonally affected by long periods of low rainfall and, coinciding with rainfall in the Amhara highlands, flood waters which flow onto the lowlands resulting in damage to landscapes and settlements. In an attempt to convert water from storm generated floods into productive use, this study proposes a methodology using remote sensing data and geographical information system tools to identify potential sites where flood spreading weirs may be installed and farming systems developed which produce food and fodder for poor rural communities. First, land use land cover maps for the study area were developed using Landsat-8 and MODIS temporal data. Sentinel-1 data at 10 and 20m resolution on a 12-day basis were then used to determine flood prone areas. Slope and drainage maps were derived from Shuttle RADAR Topography Mission Digital Elevation Model at 90m spatial resolution. Accuracy assessment using ground survey data showed that overall accuracies (correctness) of the land use/land cover classes were 86% with kappa 0.82. Coinciding with rainfall in the uplands, March and April are the months with flood events in the short growing season (belg) and June, July and August have flood events during the major (meher) season. In the Afar region, there is potentially >0.55m ha land available for development using seasonal flood waters from belg or meher seasons. During the 4 years of monitoring (2015–2018), a minimum of 142,000 and 172,000 ha of land were flooded in the belg and meher seasons, respectively. The dominant flooded areas were found in slope classes of <2% with spatial coverage varying across the districts. We concluded that Afar has a huge potential for flood-based technology implementation and recommend further investigation into the investments needed to support new socio-economic opportunities and implications for the local agro-pastoral communities