Health and Poverty: The Issue of Health Inequalities in Ethiopia

The objectives of this study are to provide a comprehensive assessment of inequalities in infant and under-five years¿ child survival, access to and utilisations of child health services among different socio-economic groups in Ethiopia; and identify issues for policies and programmes at national and sub-national levels. This thesis examines the effect of parental socioeconomic status, maternal and delivery care services, mothers¿ bio-demographic and background characteristics on the level of differences in infant and under-five years¿ child survival and access to and utilisation of child health services. Descriptive and multivariate analyses were carried out for selected variables in the literature which were consider as the major determinants of infant mortality rate (IMR) and under-five years¿ child mortality rate (U5MR); access to and utilisations of child health services based on data from Ethiopian demographic and health survey (EDHS), covering the years 2000-2005. In the multivariate analysis a logit regression model was used to estimates inequalities in infant and under-five years¿ child survival, and inequalities in access to and utilisation of child health services. In Ethiopia, little was known about inequalities in IMR and U5MR, and inequalities in access to and utilisation of child health services. Besides, there is no systematic analysis of health inequalities and into its determinants using logistic regression. According to the available literature, this is the first comprehensive and systematic analysis of inequality of health in Ethiopia. The findings show that compared to under-five years¿ children of mothers¿ partners¿ with no work, mothers¿ partners¿ in professional, technical and managerial occupations had 13 times more chance of under-five years¿ child survival for 2000 weighted observations. In addition, compared to infants of mothers who were gave birth to one child in last 5 years preceding the survey, infants of mothers who were gave birth to 2 children in last 5 years preceding the survey had 70% less chance of infant survival while infants of mothers who were gave birth to 3 or more children had 89% less chance of infant survival for 2000 weighted observations. Moreover, this study finding also indicates that inequalities increased significantly in the five years period between 2000 and 2005 among mothers with different birth interval. Most of the relations between birth interval and receiving childhood immunisation for vaccine-preventable diseases were statistically significant. Moreover compared to non-educated mothers, mothers who completed secondary and higher education were nearly 10 times more likely to receive DPT3 immunisation for their young children. This study concludes that policy measures that tackle health inequalities will have a positive impact in the implementation of health sector strategy of Ethiopia. Health inequalities studies in Ethiopia and Sub-Saharan Africa (SSA) countries should focus on systematic analysis of different socio-economic groups. The finding of this study support investing in the Ethiopia¿s health extension package (HEP) is a necessary but not sufficient condition for addressing rural poor health problem. HEP is successful in increasing primary health care coverage in rural Ethiopia to 89.6% (FMOH, 2009) but unable to reduce Ethiopia¿s higher level of IMR and U5MR. HEP is one of the success stories that address the rural poor health problem and can also be adapted to developing countries of SSA. The finding also shows that the success stories such as health insurance programs like Rwanda (World Bank, 2008a) and Ethiopia (FMOH, 2009/10) will play a key role in achieving country¿s health care financing goal of universal coverage. This can also be replicated in the developing SSA countries

Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis.

BackgroundUterine rupture has a significant public health importance, contributing to 13% of maternal mortality and 74%-92% of perinatal mortality in Sub-Saharan Africa, and 36% of maternal mortality in Ethiopia. The prevalence and predictors of uterine rupture were highly variable and inconclusive across studies in the country. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence and predictor of uterine rupture in Ethiopia.MethodsThis systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist. PubMed, Cochrane Library, Google Scholar, and African Journals Online databases were searched. The Newcastle- Ottawa quality assessment tool was used for critical appraisal. I2 statistic and Egger's tests were used to assess the heterogeneity and publication bias, respectively. The random-effects model was used to estimate the pooled prevalence and odds ratios with a 95% confidence interval.ResultsSixteen studies were included, with a total of 91,784 women in the meta-analysis. The pooled prevalence of uterine rupture was 2% (95% CI: 1.99, 3.01). The highest prevalence was observed in the Amhara regional state (5%) and the lowest was in Tigray region (1%). Previous cesarean delivery (OR = 9.95, 95% CI: 3.09, 32.0), lack of antenatal care visit (OR = 8.40, 95% CI: 4.5, 15.7), rural residence (OR = 4.75, 95% CI: 1.17, 19.3), grand multiparity (OR = 4.49, 95% CI: 2.83, 7.11) and obstructed labor (OR = 6.75, 95%CI: 1.92, 23.8) were predictors of uterine rupture.ConclusionUterine rupture is still high in Ethiopia. Therefore, proper auditing on the appropriateness of cesarean section and proper labor monitoring, improving antenatal care visit, and birth preparedness and complication readiness plan are needed. Moreover, early referral and family planning utilization are the recommended interventions to reduce the burden of uterine rupture among Ethiopia women

A nonstandard Volterra difference equation for the SIS epidemiological model

By considering the contact rate as a function of infective individuals and by using a general distribution of the infective period, the SIS-model extends to a Volterra integral equation that exhibits complex behaviour such as the backward bifurcation phenomenon.We design a nonstandard finite difference (NSFD) scheme, which is reliable in replicating this complex dynamics. It is shown that the NSFD scheme has no spurious fixed-points compared to the equilibria of the continuous model. Furthermore, there exist two threshold parameters Rc 0 andRm0 , Rc 0 ≤ 1 ≤ Rm0 , such that the disease-free fixed-point is globally asymptotically stable (GAS) for R0, the basic reproduction number, less than Rc 0 and unstable for R0 > 1, while it is locally asymptotically stable (LAS) and coexists with a LAS endemic fixed-point forRc 0 Rm0 andRm0 < ∞. Numerical experiments that support the theory are provided.DST/NRF SARChI Chair in Mathematical Models and Methods in Bioengineering and Biosciences.http://www.thelancet.com/2016-09-30hb201

Analysis and dynamically consistent nonstandard discretization for a rabies model in humans and dogs

Rabies is a fatal disease in dogs as well as in humans. A possible model to represent rabies transmission dynamics in human and dog populations is presented. The next generation matrix operator is used to determine the threshold parameter R0, that is the average number of new infective individuals produced by one infective individual intro- duced into a completely susceptible population. If R0 < 1, the disease-free equilibrium is globally asymptotically stable, while it is unstable and there exists a locally asymptot- ically stable endemic equilibrium when R0 > 1. A nonstandard nite di erence scheme that replicates the dynamics of the continuous model is proposed. Numerical tests to support the theoretical analysis are provided.DST/NRF SARChI Chair in Mathematics Models and Methods in Bioengineering and Biosciences.http://link.springer.com/journal/133982017-09-30hb2016Mathematics and Applied Mathematic

Prevalence and Associated Factors of Sensorineural Hearing Impairment Among Patients with T2DM in Amhara Region, Northwest Ethiopia, 2022: A Multi-Centered Cross-Sectional Study

Dereje Esubalew,1 Mihret Melese,2 Melese Belete,3 Adugnaw Ambelu,2 Bezawit Mulat,2 Tadegew Adane,4 Wubet Tazeb Wondie,5 Mengistie Diress2 1Department of Human Physiology, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia; 2Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Human Physiology, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 4Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia; 5Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Ambo University, Ambo, EthiopiaCorrespondence: Dereje Esubalew, Tel +251942868674, Email [email protected]: Generally, people with type 2 diabetes mellitus in various countries experience a significant rate of sensorineural hearing impairment. Nonetheless, there is scant evidence of sensorineural hearing impairment among type 2 diabetes mellitus patients in Northwest Ethiopian. Therefore, the objective of this study was to evaluate the occurrence rate and contributing factors of sensorineural hearing impairment in type 2 diabetics at comprehensive and specialized referral hospitals in Northwest Ethiopia.Methods: A facility-based cross-sectional study design was carried out from May 3, 2022, to June 14, 2022, on 846 study participants in Ethiopia, with a response rate of 99.65%. The research subjects were chosen by simple random sampling techniques. Data was gathered by using audiometric measurements and structured interview-administered questionnaires and then entered into EPI data version 4.6. Finally, it was exported to STATA 14 for analysis. Binary logistic regression, chi-square test, and odds ratio were done to verify the assumptions and degree of association. Ultimately, factors exhibiting a p-value < 0.05 with a 95% CI were regarded as significant predictors of hearing impairment.Results: The magnitude of sensorineural hearing impairment in this investigation was 50.49% (95% CI: 45.67%, 55.26%). Factors significantly associated with sensorineural hearing impairment were age (AOR=1.10, 95% CI: 1.07, 1.14), hyperlipidemia (AOR=2.86, 95% CI: 1.05, 7.82), duration of diabetes (AOR=2.26, 95% CI: 1.26, 4.06), hypertension (AOR=1.94, 95% CI: 1.02, 3.69) and regular physical exercise (AOR=0.25, 95% CI: 0.09, 0.68).Conclusions and Recommendations: In this study, relatively high rates of sensorineural hearing impairment were observed. Stakeholders should establish routine hearing screening, and participants will advise to incorporate regular physical exercise into their routines.Keywords: hearing loss, impairment, audiometer, diabetes, Ethiopi

NIKA 2: next-generation continuum/polarized camera at the IRAM 30 m telescope and its prototype

NIKA 2 (New Instrument of Kids Array) is a next generation continuum and polarized instrument successfully installed in October 2015 at the IRAM 30 m telescope on Pico-Veleta (Granada, Spain). NIKA 2 is a high resolution dual-band camera, operating with frequency multiplexed LEKIDs (Lumped Element Kinetic Inductance Detectors) cooled at 100 mK. Dual color images are obtained thanks to the simultaneous readout of a 1020 pixels array at 2 mm and 1140 x 2 pixels arrays at 1.15 mm with a final resolution of 18 and 12 arcsec respectively, and 6.5 arcmin of Field of View (FoV). The two arrays at 1.15 mm allow us to measure the linear polarization of the incoming light. This will place NIKA 2 as an instrument of choice to study the role of magnetic fields in the star formation process. The NIKA experiment, a prototype for NIKA 2 with a reduced number of detectors (about 400 LEKIDs) and FoV (1.8 arcmin), has been successfully operated at the IRAM 30 telescope in several open observational campaigns. The performance of the NIKA 2 polarization setup has been successfully validated with the NIKA prototype.Comment: 5 pages, 4 figures, proceeding for the conference: Extragalactic radio surveys 201

The NIKA instrument: results and perspectives towards a permanent KID based camera for the Pico Veleta observatory

The New IRAM KIDs Array (NIKA) is a pathfinder instrument devoted to millimetric astronomy. In 2009 it was the first multiplexed KID camera on the sky; currently it is installed at the focal plane of the IRAM 30-meters telescope at Pico Veleta (Spain). We present preliminary data from the last observational run and the ongoing developments devoted to the next NIKA-2 kilopixels camera, to be commissioned in 2015. We also report on the latest laboratory measurements, and recent improvements in detector cosmetics and read-out electronics. Furthermore, we describe a new acquisition strategy allowing us to improve the photometric accuracy, and the related automatic tuning procedure.Comment: 24th International Symposium on Space Terahertz Technology, ISSTT 2013, April 8 to 10, 2013, Groningen, the Netherland

High angular resolution Sunyaev-Zel'dovich observations of MACS J1423.8+2404 with NIKA: Multiwavelength analysis

The prototype of the NIKA2 camera, NIKA, is an instrument operating at the IRAM 30-m telescope, which can observe simultaneously at 150 and 260GHz. One of the main goals of NIKA2 is to measure the pressure distribution in galaxy clusters at high resolution using the thermal SZ (tSZ) effect. Such observations have already proved to be an excellent probe of cluster pressure distributions even at high redshifts. However, an important fraction of clusters host submm and/or radio point sources, which can significantly affect the reconstructed signal. Here we report on <20" resolution observations at 150 and 260GHz of the cluster MACSJ1424, which hosts both radio and submm point sources. We examine the morphology of the tSZ signal and compare it to other datasets. The NIKA data are combined with Herschel satellite data to study the SED of the submm point source contaminants. We then perform a joint reconstruction of the intracluster medium (ICM) electronic pressure and density by combining NIKA, Planck, XMM-Newton, and Chandra data, focusing on the impact of the radio and submm sources on the reconstructed pressure profile. We find that large-scale pressure distribution is unaffected by the point sources because of the resolved nature of the NIKA observations. The reconstructed pressure in the inner region is slightly higher when the contribution of point sources are removed. We show that it is not possible to set strong constraints on the central pressure distribution without accurately removing these contaminants. The comparison with X-ray only data shows good agreement for the pressure, temperature, and entropy profiles, which all indicate that MACSJ1424 is a dynamically relaxed cool core system. The present observations illustrate the possibility of measuring these quantities with a relatively small integration time, even at high redshift and without X-ray spectroscopy.Comment: 15 pages, 17 figures, submitted to A&

The NIKA2 instrument, a dual-band kilopixel KID array for millimetric astronomy

NIKA2 (New IRAM KID Array 2) is a camera dedicated to millimeter wave astronomy based upon kilopixel arrays of Kinetic Inductance Detectors (KID). The pathfinder instrument, NIKA, has already shown state-of-the-art detector performance. NIKA2 builds upon this experience but goes one step further, increasing the total pixel count by a factor $\sim$10 while maintaining the same per pixel performance. For the next decade, this camera will be the resident photometric instrument of the Institut de Radio Astronomie Millimetrique (IRAM) 30m telescope in Sierra Nevada (Spain). In this paper we give an overview of the main components of NIKA2, and describe the achieved detector performance. The camera has been permanently installed at the IRAM 30m telescope in October 2015. It will be made accessible to the scientific community at the end of 2016, after a one-year commissioning period. When this happens, NIKA2 will become a fundamental tool for astronomers worldwide.Comment: Proceedings of the 16th Low Temperature Detectors workshop. To be published in the Journal of Low Temperature Physics. 8 pages, 4 figures, 1 tabl

High-resolution tSZ cartography of clusters of galaxies with NIKA at the IRAM 30-m telescope

The thermal Sunyaev-Zeldovich effect (tSZ) is a powerful probe to study clusters of galaxies and is complementary with respect to X-ray, lensing or optical observations. Previous arcmin resolution tSZ observations ({\it e.g.} SPT, ACT and Planck) only enabled detailed studies of the intra-cluster medium morphology for low redshift clusters ($z < 0.2$). Thus, the development of precision cosmology with clusters requires high angular resolution observations to extend the understanding of galaxy cluster towards high redshift. NIKA2 is a wide-field (6.5 arcmin field of view) dual-band camera, operated at $100 \ {\rm mK}$ and containing $\sim 3300$ KID (Kinetic Inductance Detectors), designed to observe the millimeter sky at 150 and 260 GHz, with an angular resolution of 18 and 12 arcsec respectively. The NIKA2 camera has been installed on the IRAM 30-m telescope (Pico Veleta, Spain) in September 2015. The NIKA2 tSZ observation program will allow us to observe a large sample of clusters (50) at redshift ranging between 0.5 and 1. As a pathfinder for NIKA2, several clusters of galaxies have been observed at the IRAM 30-m telescope with the NIKA prototype to cover the various configurations and observation conditions expected for NIKA2.Comment: Proceedings of the 28th Texas Symposium on Relativistic Astrophysics, Geneva, Switzerland, December 13-18, 201