Cesarean delivery practices in teaching public and non-government/private MCH hospitals, Addis Ababa

Background: Cesarean section is one of the skilled delivery interventions that have proven to be a life-saving procedure. It should be done under appropriate indications owing to the inherent short and long term complications and high cost. In Ethiopia, a study comparing the practice of cesarean sections in government and non-government hospitals has not been undertaken before.Objective: To describe and compare the practices of cesarean delivery in the teaching public and non-governmental MCH hospitals in Addis Ababa, Ethiopia.Methods: Retrospective cross-sectional study using the cesarean section data of 2011 G.C. from three teaching government and three private-MCH hospitals. The data was analyzed and the mean with standard deviation for continuous variables and proportions for categorical variables were used as descriptive statistics. Chi-square test was used to measure the strength of associations where appropriate, with level of significance set at p-value <0.05.Results: The difference in the proportion of cesarean delivery between the two groups was statistically significant, 31.1% and 48.3% (P<0.05) in the teaching government hospitals and the non-governmental hospitals, respectively. Non-government MCH hospitals contributed to one-third of the total deliveries and 40% of the cesarean sections. Non-reassuring fetal heart rate pattern, previous cesarean section scar, and cephalo-pelvic disproportion account for 51.3% and 59.6% of the indications in the teaching hospitals and non-governmental hospitals, respectively. When individual indications were analyzed between the two groups, previous cesarean section was higher in the non-governmental hospitals, 29.3% vs. 14.6%, (P<0.05), and non-reassuring fetal heart rate pattern frequented more in the teaching hospitals 26.3% vs. 17.8%,(P<0.05), contributed significantly. Maternal request per se contributed to 7.5% of the indication in the non-governmental hospitals compared to none in the teaching hospitals. Of the repeat cesarean sections, 70.3% were done merely for reasons of first cesarean section in non-governmental hospitals compared to 16.8% in the teaching (P<0.05). The proportion of low birth weight, post-term pregnancy and unknown date were seen more in the teaching hospitals compared to non-governmental hospital, (P<0.05). Though three dosing was the most frequently practiced prophylaxis in both study groups, there is a great deal of variability in the choice of antibiotics.Conclusion: The higher proportion of maternal morbidities/mortalities and poor peri-natal outcomes in the setting of higher proportion of emergency cesarean delivery in teaching government hospitals need further study to explore for factors that have contributed so as to improve the quality of care. The high rate of repeat cesarean delivery for one previous cesarean section scar and other non medical indications like maternal request in the non-government MCH hospitals elucidates the need to monitor the appropriateness of these indications. We also recommend standardization of prophylactic antibiotic use and expand use of regional anesthesia for cesarean section

Sero-prevalence of HIV among patients with cervical cancer managed at the Tikur Anbassa Hospital Addis Ababa, Ethiopia

Background: Cervical cancer is the second most common cancer among women in the world. Globally, according to the 2010 report, 493,243 women diagnosed with cervical cancer and 273, 505 of them died from the disease. It is also the commonest gynecologic cancer in the Ethiopian women. Ethiopia is one of the Sub- Saharan African countries with high HIV prevalence. Studies done in different parts of the world demonstrated clear association between HIV and premalignant cervical lesions but studies on HIV prevalence in invasive cervical cancer are few and showed a wide range of variations. Objective: To determine the sero-prevalence of HIV among patients with histologically confirmed cervical cancer in Addis Ababa, Ethiopia. Design: A facility based cross-sectional descriptive study. Setting: Tikur Anbassa hospital, Addis Ababa, the only comprehensive cancer treatment center in Ethiopia. Main variables: Prevalence of HIV, mean age, diagnosis of cervical cancer. Materials and methods: All newly diagnosed, and biopsy proven uterine cervical cancer patients who were managed at Tikur Anbassa hospital records were sought. The records were identified perused and those found to fulfil study entry criteria were evaluated and information collected using structured questionnaire. Data required from each study subject included; socio-demographic, reproductive characteristics and clinical information. Data was then pooled, screened and entered in SPSS. The results were computed and presented in the form of; tables and figures, mean with standard deviation and proportion for quantitative and qualitative statistic respectively. T-test for equality, Chi-square test, and logistic regression were used to measure associations. Significance level was set at P value of 0.05.Result: Of the 255 subjects studied, majority has late clinical stage and squamous cell carcinoma histologically, 64.7% and 92.5% respectively. Similarly,34 out of the 255 were positive for HIV, making the overall sero-prevalence rate of 13.3%. The mean age of the total study population was 46 ±10.55 years. Significant difference was observed in the mean age of cervical cancer occurrence for HIV infected cases compared to the non-infected, 37.01 ± 6.7 and 48.23±10.26 years, respectively (p=000). HIV status and CD4 count were not shown to have any association with clinical stage and histologic variants. Having more than one lifetime sex partner and age less than 40 years were independently shown to have significant association with HIV sero-positivity. Mean CD4 count of the HIV positive subjects was 442.2±251.27. Conclusion and recommendation: In this study HIV infected women with cervical cancer were 8 to 14 years younger than HIV- negative women with cervical cancer. The disease stage and histology were not different in both groups, and without evidence of advanced disease in immune compromised state. It is recommending that further larger scale multicenter study, to explore the reasons for the younger age of occurrence of invasive cervical cancer in patients with HIV/AIDS

Reproductive biology in the medicinal plant, Plumbago zeylanica L.

Plumbago zeylanica L. is an important medicinal plant traditionally used for the treatment of various diseases. Phenology from seed germination via vegetative growth to reproductive development wasstudied under glasshouse and nursery conditions. Seeds rapidly germinated on a mixture of nursery soil and cattle dung in a ratio of 3:1 filled in pots or on cultivated soil under nursery conditions as aprerequisite for vegetative and flowering phenological studies. Hypogeal germination characterizes the emergence of seedlings. Subsequent vegetative and flowering phenology between glass house andnursery field populations showed significant difference (

Assessment of nausea and vomiting of pregnancy on antenatal clients of Addis Ababa

Background: Nausea and vomiting of pregnancy (NVP) are common symptoms experienced during pregnancy. Both mild and severe symptoms can have significant morbidities and socioeconomic impact. Despite its frequency and associated distress, its exact cause is unknown. No study was done addressing this particular important issue in our country and this study will serve as a bench mark for future work on the topic in the Ethiopian context.Objective: To assess nausea and vomiting of pregnancy on ANC (antenatal care) clients of three hospitals of Addis Ababa.Methods: A descriptive facility based cross-sectional study, done in three teaching hospitals of Addis Ababa, the capital city of Ethiopia. Semi-structured questionnaires were administered to random sample of 384 pregnant women. Descriptive statistic was used to summarize data. P-value and χ² test were used to measure associations.Results: The prevalence of nausea and vomiting of pregnancy was 74.5%, with 4.4% being admitted for severe symptoms. It was found out that 91% had symptoms in the 1st trimester, 2.1% after mid pregnancy, and 85% were triggered by smell and taste. Primigravidity, nulliparity, excessive salivation and food aversion were significantly associated with nausea and vomiting connected with pregnancy. Significant associations were also observed between admission for severity and being unmarried, loss to work, affected relationship, more frequent vomiting, and early onset of symptoms. Severe frequency of vomiting was a major factor associated with admission for severity and loss to work.Conclusion and recommendation: Nausea and vomiting of pregnancy found in this study were similar to other studies. Sensory stimuli were major trigger of symptoms and more frequent vomiting was linked with more admission. Importance of supportive measures, rest, counseling and advice on diet and life style modification needs to be underscored and early treatment of vomiting need to be considered

The Impact of Organizational Culture on IS Implementation Success in Ethiopia: the Case of Selected Public and Private Organizations

Organizational Culture in firms or institutions is widely believed to affect organizational performance and the success of the information system (IS) implementation. This work in progress study investigates the relationships between organizational/corporate culture and management support with IS implementation success in selected organizations. Based on the organizational culture construct by Hofstede et al (1990) and the IS implementation success framework by Sharma and Yetton (2003), a structured questionnaire is developed and will be self administered to selected participants in the selected organizations. Specifically, the objective of the study is to examine the impact of organizational or corporate culture on IS implementation success in selected public and private organizations in Ethiopia. Relationship between management support and IS implementation success in organizations, which will be moderated by task interdependence, will also be examined. Thus the work in progress and future study of this paper contributes to the existing literature by providing a framework for IS implementation success in low-income countries like Ethiopia

Mechanisms of Management Support and its Effect on Successful IS Implementation: The Case of Ethiopian Customs Authority

The successful implementation of information systems innovations remains a theoretical as well as a managerial challenge. In particular, the role of management support has been identified as a critical factor. Sharma and Yetton (2003) have stated that the absence of a main effect of management support on implementation success raises important research questions regarding the mechanisms through which management support contribute to implementation success. This work in progress research is a continuation of Sharma and Yetton’s recommendation. This study will extend the stream of research model by Sharma and Yetton identifying the role of an important moderator—mechanism of management support—for the successful implementation of IS innovations. The research question for this study is: What is the impact of mechanisms of support on management to successfully implement information systems in an organization? We evaluate this research question in a global context using the successful IS implementation at the Ethiopian Customs Authority

Acceptance of WoredaNet E-Government Services in Ethiopia: Applying the UTAUT Model

WoredaNet is a Wide Area Network intended to link all woreda1 administrative units in Ethiopia. The technology presentsunique opportunities to facilitate the application of e-Government packages in the country. This study is a work in progressthat utilizes the Unified Theory of Acceptance and Use of Technology (UTAUT) for the understanding of acceptance andadoption of Information Technology in Ethiopian context. The study tries to further validate the model and assess acceptanceof the e-Government services put in place in the WoredaNet infrastructure in the country. The government of Ethiopia, whileutilizing the technology, is still in the process of extending it throughout the country. The study, thus, contributes to thesuccess of Services implementation in the WoredaNet by examining acceptance and utilization issues amongst the users sinceusers’ acceptance of the technology is crucial for its ultimate success

The Impact of Transactional and Transformational Leader on Organizational Performance - The Case of Selected Ethiopian Companies

In the literature, there are various approaches of leadership (also called styles or theories) identified as distinct ones. The two most referred ones are transformational and transactional leadership approaches. This research compares and contrasts the two theories of leadership in terms of their impact on IT supported organizational performance. The main objective of the study is to assess the extent they are practiced and their impact on performance. A survey will be made on selected companies to assess how subordinates will evaluate their leaders in terms of the attributes of the two styles of leadership. Questionnaires based on the Likert scale will be used to gather relevant data for the study. A model which has been developed based on the framework of Thite will be used to test the hypotheses forwarded. The research will contribute significantly by providing new insight into how a leader’s style will influence organizational performance in an Ethiopian context

Genomic and phenotypic analysis of Vavilov's historic landraces reveals the impact of environment and genomic islands of agronomic traits.

The Vavilov Institute of Plant Genetic Resources (VIR), in St. Petersburg, Russia, houses a unique genebank, with historical collections of landraces. When they were collected, the geographical distribution and genetic diversity of most crops closely reflected their historical patterns of cultivation established over the preceding millennia. We employed a combination of genomics, computational biology and phenotyping to characterize VIR's 147 chickpea accessions from Turkey and Ethiopia, representing chickpea's center of origin and a major location of secondary diversity. Genotyping by sequencing identified 14,059 segregating polymorphisms and genome-wide association studies revealed 28 GWAS hits in potential candidate genes likely to affect traits of agricultural importance. The proportion of polymorphisms shared among accessions is a strong predictor of phenotypic resemblance, and of environmental similarity between historical sampling sites. We found that 20 out of 28 polymorphisms, associated with multiple traits, including days to maturity, plant phenology, and yield-related traits such as pod number, localized to chromosome 4. We hypothesize that selection and introgression via inadvertent hybridization between more and less advanced morphotypes might have resulted in agricultural improvement genes being aggregated to genomic 'agro islands', and in genotype-to-phenotype relationships resembling widespread pleiotropy