Characterizing 'health equity' as a national health sector priority for maternal, newborn, and child health in Ethiopia

The study findings point to global pressures in terms of maximizing health investments, and questions how social, political, and economic determinants of health are addressed through broader development agendas. The article characterizes how health (in)equity is represented as a policy issue. Implications for the framing, incentivization, and implementation of health policies follow representations (and misrepresentations). Health inequity is regarded as actionable (can be altered) but not fully resolvable (can never be fully achieved). Operationally, health equity is viewed as a technocratic matter, reflected in the widespread use of metrics to motivate and measure progress.Global Affairs Canada (GAC)Canadian Institutes of Health Research (CIHR

HIV-1 INFECTION AND RELATED RISK FACTORS AMONG FEMALE SEX WORKERS IN URBAN AREAS OF ETHIOPIA

SUMMARY: A total of 6234 female sex workers practicing multi-partner sexual contacts (MPSC) from 23 urban areas of the country were tested for Human Immuno deficiency Virus type 1 (HIV1) infection, in 1988. The sample size ranged from 99 persons in Moyale, to 386 in Asmara. The mean age of the individuals studied was 24.2 years (ranging from 21.5 years to 27.1 years in the different towns). The HIV-1 prevalence rates varied from 1.3% (n=318) in Massawa, to 38.1% (n=312) in Dessie town; the mean for all towns being 17%. The highest prevalence rates were found in the towns along the road from Addis Ababa to Assab, in Bahr-Dar , Dessie and Mekele. The lowest prevalence rates were recorded in three towns of northern Ethiopia. This study indicated that Hiv-1 is widely spread in the urban areas of Ethiopia affecting female sex workers mainly in the 15-29 years age group. Previous episodes of other sexually transmitted diseases, and frequent change of sexual partners were identified as possible risk factors for HIV infection. Frequent mobility of these females may have played a significant role in HIV transmission between the towns

HIV -1 INFECTION AND SOME RELATED RISK FACTORS AMONG FEMALE SEX WORKERS IN ADDIS ABABA

SUMMARY: A sero-epidemiological survey on HIV-l infection was carried out in July 1989, among four groups of female sex workers randomly selected in Addis Ababa. The four groups were comprised of: bar girls, tej (traditional wine) sellers, tella (traditional beer) sellers and females in red light houses. Sera were tested by ELISA and confirmed y western blot. The mean age of the 2617 females studied was 31.2 years, and the prevalence rate for HIV-1 was 24.7%. Persons in the 15-24 age group were affected more frequently. The highest prevalence (43.8%) was found among the females in red light houses. Females with relatively larger number of sexual partners and those who had previous exposure to STDs, had a higher prevalence of the infection. The survey revealed that HIV-1 is highly prevalent among females practicing multi-partner sexual contact (MPSC) in Addis Ababa, and the infection concentrates in the central areas of the city

Genetic and non-genetic parameter estimates for growth traits and Kleiber ratios in Dorper × indigenous sheep

Genetic improvement programme will only be successful when accompanied by a good understanding of the influence of different environmental factors, knowledge of the genetic parameters and the genetic relationships between the traits of interest. This study aimed to evaluate the influence of non-genetic fac- tors on growth traits and Kleiber ratios and to estimate genetic parameters for early growth traits in Dorper indigenous crossbred sheep. The effects of fixed factors were analysed by the general linear model procedure of statistical analysis system, while the genetic parameters were estimated using a WOMBAT computer program fitted animal model. The overall least-square mean for birth weight (BRW), weaning weight (3MW), six-month weight, nine-month weight, and yearling weight were 3.03 ± 0.02, 14.5 ± 0.18, 20.4 ± 0.26, 24.8 ± 0.31, and 28.3 ± 0.40 kg, respectively. The overall least- square mean for Kleiber ratio from birth to weaning (KR1), weaning to six months, six to nine months and nine months to yearling age were 16.8 ± 0.10, 6.41 ± 0.17, 4.55 ± 0.21 and 3.38 ± 0.20 g/kg of meta- bolic weight, respectively. The inclusion of maternal genetic effect had a significant influence on BRW, and it explains 20% of the phenotypic variation. The total heritability estimates for BRW, 3MW, birth to weaning average daily weight gain and KR1 were 0.10, 0.14, 0.16 and 0.12, respectively. The pheno- typic correlation varied from 0.11 ± 0.05 to 0.98 ± 0.02, whereas the direct genetic correlation ranged from 0.32 ± 0.40 to 0.98 ± 0.17. The mean inbreeding coefficient was 0.105% with an annual rate of 0.02%. The heritability estimates for growth traits and Kleiber ratio suggest that slow genetic progress would be expected from the selection. However, the integration of selection with crossbreeding pro- gramme can enhance genetic gain. Therefore, selection should be conducted based on breeding values estimated from multiple information sources to increase the selection response

Effect of co-infection with intestinal parasites on COVID-19 severity: A prospective observational cohort study

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection results in a spectrum of clinical presentations. Evidence from Africa indicates that significantly less COVID-19 patients suffer from serious symptoms than in the industrialized world. We and others previously postulated a partial explanation for this phenomenon, being a different, more activated immune system due to parasite infections. Here, we aimed to test this hypothesis by investigating a potential correlation of co-infection with parasites with COVID-19 severity in an endemic area in Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites, between July 2020 and March 2021. The primary outcome was the proportion of patients with severe COVID-19. Ordinal logistic regression models were used to estimate the association between parasite infection, and COVID-19 severity. Models were adjusted for sex, age, residence, education level, occupation, body mass index, and comorbidities. Findings: 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37.8%) had intestinal parasitic infection. Only 27/255 (10.6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51.8%) non-severe COVID-19 patients were parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (aOR) of 0.23 (95% CI 0.17–0.30; p<0.0001) for all parasites, aOR 0.37 ([95% CI 0.26–0.51]; p<0.0001) for protozoa, and aOR 0.26 ([95% CI 0.19–0.35]; p<0.0001) for helminths. When stratified by species, co-infection with Entamoeba spp., Hymenolepis nana, Schistosoma mansoni, and Trichuris trichiura implied lower probability of developing severe COVID-19. There were 11 deaths (1.5%), and all were among patients without parasites (p = 0.009). Interpretation: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19. Funding: European and Developing Countries Clinical Trials Partnership (EDCTP) – European Union, and Joep Lange Institute (JLI), The Netherlands

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Cropping sequence and nitrogen fertilizer effects on the productivity and quality of malting barley and soil fertility in the Ethiopian highlands

The productivity and quality of malting barley were evaluated using factorial combinations of four preceding crops: faba bean, field pea, rapeseed and barley as main plots, and four nitrogen fertilizer rates (0, 18, 36 and 54 kg N ha-1) as sub-plots with three replications, at two sites on Nitisols of the Ethiopian highlands in 2010 and 2011 cropping seasons. Preceding crops other than barley, and N fertilizer significantly improved yield and quality of malting barley. The highest grain yield, kernel plumpness, protein content and sieve test were obtained for malting barley grown after faba bean, followed by rapeseed and field pea. Nitrogen fertilizer significantly increased yield, protein content and sieve test of malting barley. All protein contents were within the acceptable range for malting quality. Inclusion of legumes in the rotation also improved soil fertility through increases in soil carbon and nitrogen content. We conclude that to maximize yield and quality of malting barley it is critical to consider the preceding crop and soil nitrogen status. Use of appropriate break crops may substitute or reduce the amount of mineral N fertilizer required for the production of malting barley at least for one season without affecting its quality

Combustion Simulation of a Diesel Engine with Split Injections by Lagrangian Conditional Moment Closure Model

The Lagrangian conditional moment closure (CMC) model is applied to combustion simulation of a diesel engine at different load conditions. Calculation is performed by the free open-source computational fluid dynamics (CFD) package, OpenFOAM (Jasak, 1996). In Lagrangian CMC total injected fuel is divided into a given number of fuel groups with each group assumed to have the same residence time, consequently the same conditional flame structure. The Favre mean quantities are obtained by local conditional flame structures weighted by an assumed probability density function (PDF) through the improved beta-PDF integration method. Calculated pressure traces are compared with measurements in five operating conditions involving a single or multiple injections with different fuel mass ratios, rpms, swirl ratios, and exhaust gas recirculation (EGR) rates. The Lagrangian CMC model showed acceptable agreement with measured pressure traces and apparent heat release rates for all test cases. There was no improvement in the results by flame group interaction, which is considered not relevant in the given engine conditions.11sciescopu

Patterns of psychiatric admissions and predictors of patient’s outcome in Jimma University Teaching and Referral Hospital: a retrospective study

Abstract Background Psychiatric morbidity burden accounts 12.45% of the disease admission burden in Ethiopia; only two referral hospitals are found to manage all cases. The aim of this study is to assess the predictors of patient outcomes. Method A 3 years retrospective patients’ cards, charts and medical notes review in psychiatry case admission department of Jimma university teaching and training specialised hospital was conducted. All the admitted cases included in this study. Bivariate and multivariable logistic regression analyses were conducted to identify independent predictors of outcomes. Result Among 402 study participants, the majority of them 301 (74.9%), were improved from their mental illnesses. First to eight grades completed study participants were found to be 1.34 times more likely improved mental illness than not able to read or write [AOR = 1.34, 95% CI (1.18–2.78), P < 0.009)]. The probability of improving from mental illness on married study participants was found 2.81 times more likely than single study participants [AOR = 2.81, CI (1.90–4.50), P < 0.043]. First time admitted cases improved 2.82 times more likely than those having a previous admission history [AOR = 2.82, CI (2.05–3.17), P < 0.05]. Duration of stay from 31 to 44 days showed more likely than from 1 to 20 days on patient improvement, [AOR = 1.88, CI (1.42–2.65), P < 0.034]. However, the hospital stay above 44 days does not show any statistical association with patient’s medical improvement. Conclusion Married, better educated, and the hospital stay of one to one-and-half month predicts better health outcome. Thus, this study suggests, psychiatric case management needs the collaborative care of the family in concurrence with counselling and guidance with enough time to better-off patients’ outcomes. Our findings are useful in designing and improving—patient services for psychiatric patient programs and focused health communication and counselling strategies in relation to psychoactive substances in Ethiopia

Effect of different types and levels of errors in sire pedigree on the accuracy of genetic evaluation in crossbred goats

The effects of different types and levels of errors in sire pedigree on genetic variance, heritability, inbreeding coefficient, estimated breeding value, the accuracy of breeding value and the genetic trend were evaluated. The proportion of interchanged sire (SIC) and progenies without sire (PWS) was varied in four steps from 25 to 100%. These eight pedigree files were compared to a pedigree file with complete pedigree information (CPI). The WOMBAT program fitting animal model was used to determine genetic parameters. The correlations among estimated breeding values (EBV) and between rank of animals resulted from different pedigree files were estimated using using the Pearson correlation and Spearman rank correlation procedure of SAS, respectively. Except for 25–50%PWS, all pedigree files with sire pedigree error overestimated the direct additive genetic variance (σ2a) and direct heritability (h2a) compared to a pedigree file with CPI. The error in sire pedigree underestimated EBV, the accuracy of EBV, and affect the rank of kids. The correlation estimate reduces with an increase of proportion of PWS and was similar for pedigree files with SIC. The magnitude of genetic reduction per year was lower for pedigree files with sire pedigree error compared to pedigree file with CPI. The mean inbreeding coefficient decreased (0.321–0.00%) with increasing the proportion of PWS. Pedigree files with sire pedigree error overestimate the direct heritability, total heritability, EBV, reduce the accuracy of EBV, bias the genetic trend and underestimate the inbreeding level in the flock. However, the genetic parameter estimates derived from the pedigree files with SIC were nears to estimates from the pedigree file with CPI. Improving the recording system and awareness creation about its impact is imperative for a successful genetic improvement program and accurate genetic evaluation