Improving the range of contraceptive choices in rural Ethiopia

Background: Despite the reality of a high unmet need, the utilization of family planning services in Ethiopia could be described as very low. Besides this, the knowledge and practice of family planning is limited merely to the usage of shorter-term contraceptive methods. Therefore, there is a need to expand access to family planning services in rural Ethiopia by making available more choices to family planning clients. Objective: The aim of this study is to examine the pattern of family planning method mix overtime and to assess the impact of combining strategies, such as community and facility based approaches, in improving access to family planning services and choices. Methods: A cross-sectional, descriptive study was conducted in September 2000 in Tehuledere woreda, in South Wollo zone, Amhara Regional State. A census was done on all clients who live in 15 kebeles in the woreda and who used long-term and permanent family planning methods which included IUD, Norplant and male and female sterilization methods and were interviewed. Results: Among the 218 family planning clients interviewed, 11 (5%) were males who had undergone vasectomy. Almost 81% of the clients using long-term and permanent methods were in the age group of 25-44 years. The mean age was 34.2 years with a range of 18-70 years and the mean number of children ever born to the study subjects was 5.6 with a range of 0-14 children. Knowledge of modern family planning methods was found to be over 90%, the majority (73.9%) of the respondents getting information on family planning from the community based reproductive health (CBRH) program. Fifty two percent have undergone voluntary surgical contraception, followed by Norplant (39.0%) and IUD (8.7%). Among the major reasons mentioned for the use of the current family planning methods were limiting family size (45.9%), spacing (27.5%), and side effects of the previous method (12.4%). For most clients (90.8%) the source of information for their current use is the CBRH program. Conclusions: Improving the usage of wide range of contraceptive method mix improves the quality of family planning services rendered to the community and ensures sustainability of the services. A coordinated effort among facility based and community based providers can assist in ensuring client choices and improving the method mix. The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 74-7

Previous utilization of service does not improve timely booking in antenatal care: Cross sectional study on timing of antenatal care booking at public health facilities in Addis Ababa

Background: Antenatal care is more beneficial in preventing adverse pregnancy outcomes when it is sought early in pregnancy. However, existing evidence from developing countries including Ethiopia indicate that few women seek antenatal care at early stage of their pregnancy.Objective: The objective of this study was to assess the timing of ANC booking and impact of previous antenatal care utilization on timing of first antenatal care booking in Addis Ababa governmental health institutions.Methods: A cross sectional study was conducted to collect data from 630 pregnant women who were attending antenatal care service at 10 governmental health centers in Addis Ababa from March 1 to 30, 2008.Results: Past experience on antenatal care service utilization did not come out as a predictor for timely booking of antenatal care (OR=1.40, 95%CI: 0.91, 2.15). Multivariate analysis revealed that respondents who received advice on recommended time of booking, their pregnancy was planned and first pregnancy, were more likely to book timely compared to others (AOR=10.10, 95% CI: 4.54, 22.40; AOR=1.87, 95% CI:1.11, 3.23; (AOR= 1.86, 95% CI: 1.01, 3.44) respectively.Conclusions: Past utilization of antenatal care service did not come as a predictor for timely booking of the service, provided that advice on timely booking is the main factor. In order to improve the situation, strengthening of focused antenatal care, availing of clear service delivery guidelines and training of service providers are important

Utilization of post-abortion care services in three regional states of Ethiopia

Background: In Ethiopia, utilization of post-abortion care service is minimal and it seems that the expanding services are underutilized. The purpose of this study was to assess factors which influence decisions for utilization of abortion related services at community level.Methodology: The study was carried out in six selected districts (woredas) within the three big regions of the country, namely Amhara, Oromiya and SNNPR. The study employed a descriptive cross-sectional design. Both quantitative and qualitative study techniques, including structured interview questionnaires, focus group discussions (FGDs), and in-depth interviews. The study population comprised randomly selected 1,492 women of reproductive age, service providers, and key informants of the sampled districts.Results: Majority of respondents said that they prefer public health facilities. According to the respondents, the reason why women do not visit health facility for PAC services include lack of community support, unavailability of services, services are expensive, facilities are distantly located and lack of means of transportation. From the multivariate analysis it appears that public health facilities are preferred by younger respondents, those with no education, those with no history of unwanted pregnancy and those with better income. The qualitative study indicated that women do not go to health facilities for PAC mainly because of inappropriate treatment by providers at the health facilities. Conclusion: Public health facilities especially health centers are the most preferred but there are barriers that should improve. Introduction of supportive supervision should be considered as a tool for improving quality of care. Amechanism should be in place to obtain community opinion regularly and use it to continuously improve services. To correct some misconceptions and improve community awareness on abortion related issues community providers, including reproductive health agents and health extension workers can teach about availability of services and about abortion related complications. [Ethiop. J. Health Dev. 2010;24 Special Issue 1:123-129

Visceral leishmaniasis patients display altered composition and maturity of neutrophils as well as impaired neutrophil effector functions

Immunologically, active visceral leishmaniasis (VL) is characterised by profound immunosuppression, severe systemic inflammatory responses and an impaired capacity to control parasite replication. Neutrophils are highly versatile cells, which play a crucial role in the induction as well as the resolution of inflammation, the control of pathogen replication and the regulation of immune responses. Neutrophil functions have been investigated in human cutaneous leishmaniasis, however, their role in human visceral leishmaniasis is poorly understood. In the present study we evaluated the activation status and effector functions of neutrophils in patients with active VL and after successful anti-leishmanial treatment. Our results show that neutrophils are highly activated and have degranulated; high levels of arginase, myeloperoxidase and elastase, all contained in neutrophils’ granules, were found in the plasma of VL patients. In addition, we show that a large proportion of these cells are immature. We also analysed effector functions of neutrophils that are essential for pathogen clearance and show that neutrophils have an impaired capacity to release neutrophil extracellular traps, produce reactive oxygen species and phagocytose bacterial particles, but not Leishmania parasites. Our results suggest that impaired effector functions, increased activation and immaturity of neutrophils play a key role in the pathogenesis of VL

Stilbene derivatives promote Ago2-dependent tumour-suppressive microRNA activity

It is well known that natural products are a rich source of compounds for applications in medicine, pharmacy, and biology. However, the exact molecular mechanisms of natural agents in human health have not been clearly defined. Here, we demonstrate for the first time that the polyphenolic phytoalexin resveratrol promotes expression and activity of Argonaute2 (Ago2), a central RNA interference (RNAi) component, which thereby inhibits breast cancer stem-like cell characteristics by increasing the expression of a number of tumour-suppressive miRNAs, including miR-16, -141, -143, and -200c. Most importantly, resveratrol-induced Ago2 resulted in a long-term gene silencing response. We also found that pterostilbene, which is a natural dimethylated resveratrol analogue, is capable of mediating Ago2-dependent anti-cancer activity in a manner mechanistically similar to that of resveratrol. These findings suggest that the dietary intake of natural products contributes to the prevention and treatment of diseases by regulating the RNAi pathway

β-1,3-Glucan-Induced Host Phospholipase D Activation Is Involved in Aspergillus fumigatus Internalization into Type II Human Pneumocyte A549 Cells

The internalization of Aspergillus fumigatus into lung epithelial cells is a process that depends on host cell actin dynamics. The host membrane phosphatidylcholine cleavage driven by phospholipase D (PLD) is closely related to cellular actin dynamics. However, little is known about the impact of PLD on A. fumigatus internalization into lung epithelial cells. Here, we report that once germinated, A. fumigatus conidia were able to stimulate host PLD activity and internalize more efficiently in A549 cells without altering PLD expression. The internalization of A. fumigatus in A549 cells was suppressed by the downregulation of host cell PLD using chemical inhibitors or siRNA interference. The heat-killed swollen conidia, but not the resting conidia, were able to activate host PLD. Further, β-1,3-glucan, the core component of the conidial cell wall, stimulated host PLD activity. This PLD activation and conidia internalization were inhibited by anti-dectin-1 antibody. Indeed, dectin-1, a β-1,3-glucan receptor, was expressed in A549 cells, and its expression profile was not altered by conidial stimulation. Finally, host cell PLD1 and PLD2 accompanied A. fumigatus conidia during internalization. Our data indicate that host cell PLD activity induced by β-1,3-glucan on the surface of germinated conidia is important for the efficient internalization of A. fumigatus into A549 lung epithelial cells

Genomic features and computational identification of human microRNAs under long-range developmental regulation

<p>Abstract</p> <p>Background</p> <p>Recent functional studies have demonstrated that many microRNAs (miRNAs) are expressed by RNA polymerase II in a specific spatiotemporal manner during the development of organisms and play a key role in cell-lineage decisions and morphogenesis. They are therefore functionally related to a number of key protein coding developmental genes, that form genomic regulatory blocks (GRBs) with arrays of highly conserved non-coding elements (HCNEs) functioning as long-range enhancers that collaboratively regulate the expression of their target genes. Given this functional similarity as well as recent zebrafish transgenesis assays showing that the miR-9 family is indeed regulated by HCNEs with enhancer activity, we hypothesized that this type of miRNA regulation is prevalent. In this paper, we therefore systematically investigate the regulatory landscape around conserved self-transcribed miRNAs (ST miRNAs), with their own known or computationally inferred promoters, by analyzing the hallmarks of GRB target genes. These include not only the density of HCNEs in their vicinity but also the presence of large CpG islands (CGIs) and distinct patterns of histone modification marks associated with developmental genes.</p> <p>Results</p> <p>Our results show that a subset of the conserved ST miRNAs we studied shares properties similar to those of protein-coding GRB target genes: they are located in regions of significantly higher HCNE/enhancer binding density and are more likely to be associated with CGIs. Furthermore, their putative promoters have both activating as well as silencing histone modification marks during development and differentiation. Based on these results we used both an elevated HCNE density in the genomic vicinity as well as the presence of a bivalent promoter to identify 29 putative GRB target miRNAs/miRNA clusters, over two-thirds of which are known to play a role during development and differentiation. Furthermore these predictions include miRNAs of the miR-9 family, which are the only experimentally verified GRB target miRNAs.</p> <p>Conclusions</p> <p>A subset of the conserved miRNA loci we investigated exhibits typical characteristics of GRB target genes, which may partially explain their complex expression profiles during development.</p

Track E Implementation Science, Health Systems and Economics

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138412/1/jia218443.pd