Impacts of Private and Public Physical Capital Accumulation on Economic Growth of Ethiopia

The main objective of this research was to examine the impacts of private and public physical capital accumulations on economic growth in Ethiopia for the period ranging from 1974/75- 2017/18 by using Auto Regressive Distributed Lag (ARDL) Approach to Co-integration and Vector Error Correction Model. The result showed that real private capital accumulation had statistically insignificant impact while public capital accumulation had negative and statistically significant impact on economic growth of Ethiopia in the long -run. The result also revealed that human capital and labor force had positive and statistically significant impact while trade openness, macroeconomic instability and foreign aid had negative and statistically significant impact in determining economic growth of Ethiopia in the long- run. In addition, in the short -run private and public capital stocks had negative and statistically significant impact on economic growth of Ethiopia at first lag while human capital, labor force, trade openness, macroeconomic instability and foreign aid had positive and significant impact on economic growth of Ethiopia with lag. Overall, the policy implication of this study is that, given the long -run insignificant impact of private capital and negative significant impact of public capital stocks on economic growth, it is recommendable to reduce public capital investment in different sector investments rather better to encourage private sector participation on economic activities in Ethiopia

Comparison of individual and pooled diagnostic examination strategies during the national mapping of soil-transmitted helminths and Schistosoma mansoni in Ethiopia

Background : Laboratory-based studies have highlighted that pooling stool and urine samples can reduce costs and diagnostic burden without a negative impact on the ability to estimate the intensity of soil-transmitted helminth (STH, Ascaris lumbricoides, Trichuris trichiura and hookworms) and schistosome infections (Schistosoma mansoni and S. haematobium). In this study, we compare individual and pooled stool examination strategies in a programmatic setting. Methods : Stool samples were collected from 2,650 children in 53 primary schools in Amhara Regional State, Ethiopia, during the national mapping of STHs and schistosome infections. Eggs of STHs and S. mansoni were quantified in both individual and pooled samples (pools were made from 10 individual samples) using a single Kato-Katz smear. Principal findings : A pooled diagnostic examination strategy provided comparable estimates of infection intensity with higher fecal egg count (expressed in eggs per gram of stool (EPG)) than those based on individual strategy (Ascaris: 45.1 EPG vs. 93.9, p= 0.03; Trichuris: 1.8 EPG vs. 2.1 EPG, p = 0.95; hookworms: 17.5 EPG vs. 28.5 EPG, p = 0.1a S. mansoni: 1.6 EPG vs. 3.4 EPG, p = 0.02), but had lower sensitivity (Ascaris: 90.0% vs. 55.0%; Trichuris: 91.7% vs. 16.7%; hookworms: 92.6% vs. 61.8%; S. mansoni: 100% vs. 51.7%, p< 0.001). A pooled approach resulted in a similar to 70% reduction in time required for sample testing, but reduced total operational costs by only similar to 11%. Conclusions/Significance : A pooled approach holds promise for the rapid assessment of intensity of helminth infections in a programmatic setting, but it is not major cost-saving strategy. Further investigation is required to determine when and how pooling can be utilized. Such work should also include validation of statistical methods to estimate prevalence based on pooling samples. Finally, the comparison of operational costs across different scenarios of national program management will help determine whether pooling is indeed worthwhile considering

A general framework to support cost-efficient survey design choices for the control of soil-transmitted helminths when deploying Kato-Katz thick smear

Background To monitor and evaluate soil-transmitted helminth (STH) control programs, the World Health Organization (WHO) recommends screening stools from 250 children, deploying Kato-Katz thick smear (KK). However, it remains unclear whether these recommendations are suffi-cient to make adequate decisions about stopping preventive chemotherapy (PC) (preva-lence of infection &lt;2%) or declaring elimination of STHs as a public health problem (prevalence of moderate-to-heavy intensity (MHI) infections &lt;2%). Methodology We developed a simulation framework to determine the effectiveness and cost of survey designs for decision-making in STH control programs, capturing the operational resources to perform surveys, the variation in egg counts across STH species, across schools, between and within individuals, and between repeated smears. Using this framework and a lot quality assurance sampling approach, we determined the most cost-efficient survey designs (number of schools, subjects, stool samples per subject, and smears per stool sam-ple) for decision-making. Principal findings For all species, employing duplicate KK (sampling 4 to 6 schools and 64 to 70 subjects per school) was the most cost-efficient survey design to assess whether prevalence of any infection intensity was above or under 2%. For prevalence of MHI infections, single KK was the most cost-efficient (sampling 11 to 25 schools and 52 to 84 children per school). Conclusions/Significance KK is valuable for monitoring and evaluation of STH control programs, though we recom-mend deploying a duplicate KK on a single stool sample to stop PC, and a single KK to declare the elimination of STHs as a public health problem.</p

Designing and monitoring large-scale deworming programs for soil-transmitted helminthiasis and schistosomiasis in Ethiopia

Neglected tropical diseases (NTDs) are a diverse group of bacterial, parasitic and viral communicable diseases. They are widespread in tropical and subtropical countries where poverty, inadequate sanitation and hygiene are common. A group of these NTDs can be controlled by either innovation or intensified disease management at the level of the individual patient, or through interventions targeting most at-risk populations. Some of the amenable diseases that are targeted at the population level include the soil-transmitted helminthiasis (STH; caused by Ascaris lumbricoides, Trichuris trichiura and the hookworms (Nectator americanus and Ancylostoma duodenale) and schistosomiasis (SCH; caused by Schistsoma mansoni and Schistsoma haematobium). Due to nature of the biology, both diseases affect the same at-risk population, namely children and women of child bearing age. Although historical data highlight that both diseases are prevalent in Ethiopia, a nationwide control program has insufficiently matured

Comparison of coproprevalence and seroprevalence to guide decision-making in national soil-transmitted helminthiasis control programs : Ethiopia as a case study

Background: WHO recommends periodical assessment of the prevalence of any soil-transmitted helminth (STH) infections to adapt the frequency of mass drug administration targeting STHs. Today, detection of eggs in stool smears (Kato-Katz thick smear) remains the diagnostic standard. However, stool examination (coprology) has important operational drawbacks and impedes integrated surveys of multiple neglected tropical diseases. Therefore, the aim of the present study was to assess the potential of applying serology instead of coprology in STH control program decision-making. Methodology: An antibody-ELISA based on extract of Ascaris lung stage larvae (AsLungL3-ELISA) was applied in ongoing monitoring activities of the Ethiopian national control program against schistosomiasis and soil-transmitted helminthiasis. Blood and stool samples were collected from over 6,700 students (median age: 11) from 63 schools in 33 woredas (districts) across the country. Stool samples of two consecutive days were analyzed applying duplicate Kato-Katz thick smear. Principal findings: On woreda level, qualitative (seroprevalence) and quantitative (mean optical density ratio) serology results were highly correlated, and hence seroprevalence was chosen as parameter. For 85% of the woredas, prevalence based on serology was higher than those based on coprology. The results suggested cross-reactivity of the AsLungL3-ELISA with Trichuris. When extrapolating the WHO coproprevalence thresholds, there was a moderate agreement (weighted kappa = 0.43) in program decision-making. Using the same threshold values would predominantly lead to a higher frequency of drug administration. Significance: This is the first time that serology for soil-transmitted helminthiasis is applied on such large scale, thereby embedded in a control program context. The results underscore that serology holds promise as a tool to monitor STH control programs. Further research should focus on the optimization of the diagnostic assay and the refinement of serology-specific program decision-making thresholds

Map of the study area.

<p>Map of the study area.</p

Declining trend of <i>Plasmodium falciparum dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps)</i> mutant alleles after the withdrawal of Sulfadoxine-Pyrimethamine in North Western Ethiopia

<div><p>Antimalarial drug resistance is one of the major challenges in global efforts of malaria control and elimination. In 1998, chloroquine was abandoned and replaced with sulfadoxine/pyrimethamine, which in turn was replaced with artemether/lumefantrine for the treatment of uncomplicated <i>falciparum</i> malaria in 2004. Sulfadoxine/pyrimethamine resistance is associated with mutations in dihydrofolate reductase (<i>Pfdhfr</i>) and dihydropteroate synthase (<i>Pfdhps</i>) genes. The prevalence of mutation in <i>Pfdhfr</i> and <i>Pfdhps</i> genes were evaluated and compared for a total of 159 isolates collected in two different time points, 2005 and 2007/08, from Pawe hospital, in North Western Ethiopia. The frequency of triple <i>Pfdhfr</i> mutation decreased significantly from 50.8% (32/63) to 15.9% (10/63) (<i>P</i><0.001), while <i>Pfdhps</i> double mutation remained high and changed only marginally from 69.2% (45/65) to 55.4% (40/65) (<i>P</i> = 0.08). The combined <i>Pfdhfr/Pfdhps</i> quintuple mutation, which is strongly associated with sulfadoxine/pyrimethamine resistance, was significantly decreased from 40.7% (24/59) to 13.6% (8/59) (<i>P</i><0.0001). On the whole, significant decline in mutant alleles and re-emergence of wild type alleles were observed. The change in the frequency is explained by the reduction of residual drug-resistant parasites caused by the strong drug pressure imposed when sulfadoxine/pyrimethamine was the first-line drug, followed by lower fitness of these resistant parasites in the absence of drug pressure. Despite the decrease in the frequency of mutant alleles, higher percentages of mutation remain prevalent in the study area in 2007/08 in both <i>Pfdhfr</i> and <i>Pfdhps</i> genes. Therefore, further multi-centered studies in different parts of the country will be required to assess the re-emergence of sulfadoxine/pyrimethamine sensitive parasites and to monitor and prevent the establishment of multi drug resistant parasites in this region.</p></div

Temporal changes in the frequency of <i>Pfdhfr</i> and <i>Pfdhps</i> single nucleotide mutations between 2005 and 2007/08.

<p>The asterisk indicates the statistical significance of the difference according to Fisher’s exact test.</p