People’s Awareness and Perception Level on the Risks of Climate Change and Constraints of Their Adaptation Strategies in Mekelle City, Tigray Regional State, Ethiopia

All over the world Climate change is creating significant environmental, ecological, social and economic threats mainly to the cities of the developing nations. Likely, in Ethiopia, climate change induced risks such as drought, flooding and hot temperature are rapidly increasing and causing adverse effects. Adequate level of community’s awareness and perception about the cause, indicators and impacts of climate change and its adaptation measures to effectively cope climate change related impact is essential. Therefore, the main objective of this journal article was to evaluate the level of people’s awareness and perception on the risks of climate change and the challenges of their adaptation strategies in Mekelle city.  In order to realize this objective, the study employed descriptive type, survey method and mixed approach of research. Primary data were collected using questionnaire, interview, focused group discussion and observation.  The study also used secondary data using literature and document review from secondary sources. Moreover, the data analysis methods utilized in this study were SPSS and Excels through graphs, line graphs, cross tabs, chi-square and simple linear regression to show the trends of temperature and rainfall. Finally the study has identified lower level of awareness and perception on climate change; increased daily temperature; reduced amount and duration of rainfall, increased incidence of disease; drying of wetlands and rivers and fluctuation of rainy season as the major findings. Consequently, the communities confronted with water shortage, heath problem, fuel wood shortage, loss of assets and shortage of food supply. The most common adaptation strategies were planting of seedlings, efficient use of fuel stove and water, agro-forestry practice awareness raising and soil and water conservation. Nevertheless, lack of up-to-date climate change related information, limited adaptation technologies, poverty and financial shortage can be considered as the major constraints of adaptation strategies of the people

Establishment of two lines of Ethiopian isolates of Plasmodium falciparum in vitro

Abstract: An attempt was made to establish Ethiopian isolates of Plasmodium falciparum in tissue culture flasks. Two lines, FCA-1 and FCA-2, were derived from two patients infected with falciparum malaria in North and South Shewa, Ethiopia, respectively. Parasites were initiated into culture in tissue culture flasks. Both lines grew very slowly for the first four weeks but increased their multiplication rates and became established between the 5th and 7th weeks in culture. Both lines produced gametocytes. Infected red blood cells cryopreserved after five weeks were easily recovered. Sufficient parasite materials have been preserved in liquid nitrogen for later use and/or for supply to researchers in other laboratories. [Ethiop. J. Health Dev. 1997;11(3):235-239

Impacts of urban safety net on income, food expenditure and intake capacity of poor households in Addis Ababa city, Ethiopia, 2021

Although measures taken to address food insecurity and income inequality showed notable outcomes, they have continued to be major global issues mainly in urban areas of developing countries. To relieve these problems, Ethiopia started an urban safety net program in Addis Ababa city in 2017. The purpose of this study was to investigate the impacts and progress of the urban safety net program, mainly its cash transfers (CTs) on income, consumption, and food security of poor households using indicators based on elements of a theory of change and Engel's coefficient. It assessed whether the program was significant (or not) to program beneficiaries compared to situations before the start of the program, non-beneficiaries, and beneficiaries' sex. A total of 560 sample households were selected through a multi-stage sampling for household surveys. Comparative approaches, paired and independent t-tests, and linear regression were used to analyze the data. Results revealed that the CTs had a satisfactory targeting accuracy of the poor and produced positive effects on monthly income, savings, food expenditures and intake, and seed money for a business start. Since financial transfers account for a larger proportion of the income of households, current income becomes significantly bigger compared to income during the pre-program periods and non-beneficiary households. Food access, expenditure, and savings capacities of beneficiaries in post-CT became better than in pre-CT along with better food access and diet intake two to three a day than non-beneficiaries. Besides, coverage and benefits were statistically significant for women compared to men. The implementation of the urban safety net program is good in its positive impacts and progress toward nutrition and food security of poor households as a result of an increase in their income, food expenditure, intake, and access. This implies policymakers could potentially expect to see improvements in nutrition and food security, especially when targeting urban poor and female-headed households. However, delays in payments and work equipment, declining size and value of payments, and weak supplementary services are the program's shortcomings. Policy implications to improve the size of transfers, emergency aids, timely payments and equipment provisions, and interventions like regular business training, supervision, and guidance are recommended

How the driving behaviors and customer handling of public transportation operators have been impacted by the COVID-19 pandemic in Addis Ababa, Ethiopia: the perspective of protection motivation theory?

The COVID-19 pandemic has had an impact on every aspect of human life and economic sectors such as transportation operations around the world. This paper tries to investigate how COVID-19 pandemic factors influenced the driving and customer handling behaviors of urban public transportation operators in Addis Ababa city, Ethiopia. To that end, a framework of mixed research, pre/post study design, and protection motivation theory (PMT) was used to guide the development, quantification, and analysis of the causal relationships of pandemic-related constructs on driving and customer handling behaviors. The examined driving behavior variables included harsh speeding, harsh braking, and drink-drive events concerning the time period before and during the COVID-19 pandemic outbreak. Customer handling was also operationalized in terms of the level of friendly handling and care provided to customers. As a result, primary data were collected through transport surveys on 143 randomly selected public transit operators, including city buses, midsize buses, minibuses, bajajs, and light rail transits. Furthermore, contingency indexes, likert scales, and binary logistic regression models were used to estimate and predict the most significant factors that affected driving and customer handling behavior. Findings showed that the new COVID-19 pandemic and response measure-related factors were the most significant factors impacting driving behavior during the pandemic. Driving frequencies and intentions, as well as driving decisions or choices, were significantly influenced and reduced. Due to the pandemic-related factors, harsh driving behaviors such as harsh speeding and braking became more frequent during the pandemic compared to the pre-COVID period. Additionally, the correlation between harsh driving behavior and other factors, mainly trip distance traveled, driving during risky nighttime hours, and driving requests, was significant. Furthermore, due to the impacts of COVID-19, government measures, and changes in driving behavior, customer handling and care behaviors were predominantly unfriendly. Findings revealed that the performance of PMT was relevant, and it could inform and guide studies to understand such an impact analysis. Thus, policymakers must learn from the harsh lessons of COVID-19 and make bold investments in preparedness, prevention, and response, including pandemic-sensitive strategies and customer-oriented strategies

Paracheck-PF® test Versus Microscopy in the Diagnosis of Falciparum Malaria in Arbaminch

Background: Malaria is a major cause of morbidity and mortality in Ethiopia. Rapid diagnostic tests such as Paracheck Pf are the major tools for falciparum malaria diagnosis as an alternative to microscopy in peripheral health facilities. The objective of this study was to evaluate the sensitivity and specificity of Paracheck Pf against microscopy for diagnosis of P.falciparum infection and observe the persistence of the antigen for an elongated period.Methods: Cross sectional study was undertaken in Arbaminch Zuria at Shele health center from October 2008 to January 2009. Paracheck-Pf versus microscopy comparison was done in conjunction with an artemisinin-based combination therapy efficacy monitoring for a period of 28 days. Standard microscopic procedures were done by experienced laboratory technicians and paracheck-Pf was performed in accordance with the manufacturer’s instruction.Results: out of 1293 examined blood films, 400(31%) were found to be malaria positive. Considering microscopy as the gold standard, paracheck-pf showed sensitivity of 94.1 %( 95%CI: 89.9-98.3%) and specificity of 80.0% (95%CI: 67.6-92.4%). The positive and negative predictive values were 93.3 %( 95%CI: 88.8-97.8%) and 82.1% (95%CI: 70-94.1%), respectively. Comparing microscopy results 98.7 % (79/80), 60% (48/80), 48.1% (37/77), and 44.6 %( 33/74) were also found to be positive by paracheck-pf at days7, 14, 21, and 28, respectively. Conclusion: Paracheck Pf® has a comparable diagnostic performance in detecting P. falciparum infections through the persistence of frequent false positivity is a limitation. Thus, this diagnostic test is not appropriate for monitoring of treatment effect. Keywords: P. falciparum, Paracheck-Pf®, RDT, microscopy.Ethiop J Health Sci. Vol. 22, No. 2 July 201

Therapeutic efficacy of mefloquine and sulfadoxine/pyrimethamine for the treatment of uncomplicated pasmodium falciparum malaria in children, Metehara town, Southeast Ethiopia

Background: The development of resistance by P. falciparum to most drugs used in prophylaxis and therapeutics underscores the need to investigate the sensitivity of local parasite isolates to the currently available standard antimalarial drugs. Objective: To assess parasitological resistance and therapeutic efficacy of mefloquine (MQ) and sulfadoxine/pyrimethamine (SP) in children with uncomplicated falciparum malaria in Metehara town, southeast Ethiopia. Methods: The therapeutic responses to MQ and SP were examined using the World Health Organization 14-day in vivo test protocol. A total of 119 children that fulfilled the inclusion criteria were assigned to the MQ (n=59) or SP (n=50) treatment group. The patients were followed up for 14 days, and clinical and parasitological outcomes were assessed. Results: The 14-day clinical and parasitological cure rates in children treated with MQ were found to be 100% (55/55) with no recrudescence until day 14. In the SP group, the clinical cure and failure rates were found to be 78.9 % (45/57) and 12% (7/57) respectively. Out of the patients with clinical failure in the SP group, one child was classified as early treatment failure and six had late treatment failure. The incidence of parasitological resistance was 21.1 % (8 patients with RI and, 4 patients with RII). MQ was faster in fever and parasite clearance rate by day 2 (76.4%) and day 3 (98.2%) than in the SP group (64.9% day 2 and 91.2% day 3). Gametocyte carrier rate following therapy was significantly lower in those treated with MQ than in those receiving SP; 1.8% with MQ had gametocytes by day 14 compared to 50.9 % with SP (P

Therapeutic efficacy of Artemether/Lumefantrine (Coartem®) against Plasmodium falciparum in Kersa, South West Ethiopia

<p>Abstract</p> <p>Background</p> <p>Artemether/Lumefantrine (Coartem^®) has been used as a first-line treatment for uncomplicated <it>Plasmodium falciparum </it>infection since 2004 in Ethiopia. In the present study the therapeutic efficacy of artemether/lumefantrine for the treatment of uncomplicated <it>P. falciparum </it>infection at Kersa, Jima zone, South-west Ethiopia, has been assessed.</p> <p>Methods</p> <p>A 28 day therapeutic efficacy study was conducted between November 2007 and January 2008, in accordance with the 2003 WHO guidelines. Outcomes were classified as early treatment failure (ETF), late clinical failure (LCF), late parasitological failure (LPF) and adequate clinical and parasitological response (ACPR).</p> <p>Results</p> <p>90 patients were enrolled and completed the 28 day follow-up period after treatment with artemether/lumefantrine. Cure rate was very high, 96.3%, with 95% CI of 0.897-0.992 (PCR uncorrected). Age-stratified data showed adequate clinical and parasitological response (ACPR) to be 100% for children under 5 and 97.4% and 87.3% for children aged 5-14, and adults, respectively. There was no early treatment failure (ETF) in all age groups. Fever was significantly cleared on day 3 (P < 0.05) and 98% of parasites where cleared on day 1 and almost all parasites were cleared on day 3. 72.5% of gametocytes were cleared on day 1, the remaining 27.5% of gametocytes were maintained up to day 3 and total clearance was observed on day 7. Hemoglobin concentration showed a slight increase with parasitic clearance (P > 0.05). No major side effect was observed in the study except the occurrence of mouth ulcers in 7% of the patients.</p> <p>Conclusions</p> <p>The current study proved the excellent therapeutic efficacy of artemether/lumefantrine in the study area and the value of using it. However, the proper dispensing and absorption of the drug need to be emphasized in order to utilize the drug for a longer period of time. This study recommends further study on the toxicity of the drug with particular emphasis on the development of oral ulcers in children.</p

In Vivo Efficacy of Artemether-Lumefantrine and Chloroquine against Plasmodium vivax: A Randomized Open Label Trial in Central Ethiopia

Background In vivo efficacy assessments of antimalarials are essential for ensuring effective case management. In Ethiopia, chloroquine (CQ) without primaquine is the first-line treatment for Plasmodium vivax in malarious areas, but artemether-lumefantrine (AL) is also commonly used. Methods and Findings In 2009, we conducted a 42-day efficacy study of AL or CQ for P. vivax in Oromia Regional State, Ethiopia. Individuals with P. vivax monoinfection were enrolled. Primary endpoint was day 28 cure rate. In patients with recurrent parasitemia, drug level and genotyping using microsatellite markers were assessed. Using survival analysis, uncorrected patient cure rates at day 28 were 75.7% (95% confidence interval (CI) 66.8–82.5) for AL and 90.8% (95% CI 83.6–94.9) for CQ. During the 42 days of follow-up, 41.6% (47/113) of patients in the AL arm and 31.8% (34/107) in the CQ arm presented with recurrent P. vivax infection, with the median number of days to recurrence of 28 compared to 35 days in the AL and CQ arm, respectively. Using microsatellite markers to reclassify recurrent parasitemias with a different genotype as non-treatment failures, day 28 cure rates were genotype adjusted to 91.1% (95% CI 84.1–95.1) for AL and to 97.2% (91.6–99.1) for CQ. Three patients (2.8%) with recurrent parasitemia by day 28 in the CQ arm were noted to have drug levels above 100 ng/ml. Conclusions In the short term, both AL and CQ were effective and well-tolerated for P. vivax malaria, but high rates of recurrent parasitemia were noted with both drugs. CQ provided longer post-treatment prophylaxis than AL, resulting in delayed recurrence of parasitemia. Although the current policy of species-specific treatment can be maintained for Ethiopia, the co-administration of primaquine for treatment of P. vivax malaria needs to be urgently considered to prevent relapse infections. Trial Registration ClinicalTrials.gov NCT0105258

Comparison of artemether-lumefantrine and chloroquine with and without primaquine for the treatment of Plasmodium vivax infection in Ethiopia: A randomized controlled trial

Background: Recent efforts in malaria control have resulted in great gains in reducing the burden of Plasmodium falciparum, but P. vivax has been more refractory. Its ability to form dormant liver stages confounds control and elimination efforts. To compare the efficacy and safety of primaquine regimens for radical cure, we undertook a randomized controlled trial in Ethiopia. Methods and findings: Patients with normal glucose-6-phosphate dehydrogenase status with symptomatic P. vivax mono-infection were enrolled and randomly assigned to receive either chloroquine (CQ) or artemether-lumefantrine (AL), alone or in combination with 14 d of semi-supervised primaquine (PQ) (3.5 mg/kg total). A total of 398 patients (n = 104 in the CQ arm, n = 100 in the AL arm, n = 102 in the CQ+PQ arm, and n = 92 in the AL+PQ arm) were followed for 1 y, and recurrent episodes were treated with the same treatment allocated at enrolment. The primary endpoints were the risk of P. vivax recurrence at day 28 and at day 42. The risk of recurrent P. vivax infection at day 28 was 4.0% (95% CI 1.5%–10.4%) after CQ treatment and 0% (95% CI 0%–4.0%) after CQ+PQ. The corresponding risks were 12.0% (95% CI 6.8%–20.6%) following AL alone and 2.3% (95% CI 0.6%–9.0%) following AL+PQ. On day 42, the risk was 18.7% (95% CI 12.2%–28.0%) after CQ, 1.2% (95% CI 0.2%–8.0%) after CQ+PQ, 29.9% (95% CI 21.6%–40.5%) after AL, and 5.9% (95% CI 2.4%–13.5%) after AL+PQ (overall p < 0.001). In those not prescribed PQ, the risk of recurrence by day 42 appeared greater following AL treatment than CQ treatment (HR = 1.8 [95% CI 1.0–3.2]; p = 0.059). At the end of follow-up, the incidence rate of P. vivax was 2.2 episodes/person-year for patients treated with CQ compared to 0.4 for patients treated with CQ+PQ (rate ratio: 5.1 [95% CI 2.9–9.1]; p < 0.001) and 2.3 episodes/person-year for AL compared to 0.5 for AL+PQ (rate ratio: 6.4 [95% CI 3.6–11.3]; p < 0.001). There was no difference in the occurrence of adverse events between treatment arms. The main limitations of the study were the early termination of the trial and the omission of haemoglobin measurement after day 42, resulting in an inability to estimate the cumulative risk of anaemia. Conclusions: Despite evidence of CQ-resistant P. vivax, the risk of recurrence in this study was greater following treatment with AL unless it was combined with a supervised course of PQ. PQ combined with either CQ or AL was well tolerated and reduced recurrence of vivax malaria by 5-fold at 1 y

In vivo efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria in Central Ethiopia

<p>Abstract</p> <p>Background</p> <p><it>In vivo </it>efficacy assessments of the first-line treatments for <it>Plasmodium falciparum </it>malaria are essential for ensuring effective case management. In Ethiopia, artemether-lumefantrine (AL) has been the first-line treatment for uncomplicated <it>P. falciparum </it>malaria since 2004.</p> <p>Methods</p> <p>Between October and November 2009, we conducted a 42-day, single arm, open label study of AL for <it>P. falciparum </it>in individuals >6 months of age at two sites in Oromia State, Ethiopia. Eligible patients who had documented <it>P. falciparum </it>mono-infection were enrolled and followed according to the standard 2009 World Health Organization <it>in vivo </it>drug efficacy monitoring protocol. The primary and secondary endpoints were PCR uncorrected and corrected cure rates, as measured by adequate clinical and parasitological response on days 28 and 42, respectively.</p> <p>Results</p> <p>Of 4426 patients tested, 120 with confirmed falciparum malaria were enrolled and treated with AL. Follow-up was completed for 112 patients at day 28 and 104 patients at day 42. There was one late parasitological failure, which was classified as undetermined after genotyping. Uncorrected cure rates at both day 28 and 42 for the per protocol analysis were 99.1% (95% CI 95.1-100.0); corrected cure rates at both day 28 and 42 were 100.0%. Uncorrected cure rates at day 28 and 42 for the intention to treat analysis were 93.3% (95% CI 87.2-97.1) and 86.6% (95% CI 79.1-92.1), respectively, while the corrected cure rates at day 28 and 42 were 94.1% (95% CI 88.2-97.6) and 87.3% (95% CI 79.9-92.7), respectively. Using survival analysis, the unadjusted cure rate was 99.1% and 100.0% adjusted by genotyping for day 28 and 42, respectively. Eight <it>P. falciparum </it>patients (6.7%) presented with <it>Plasmodium vivax </it>infection during follow-up and were excluded from the per protocol analysis. Only one patient had persistent parasitaemia at day 3. No serious adverse events were reported, with cough and nausea/vomiting being the most common adverse events.</p> <p>Conclusions</p> <p>AL remains a highly effective and well-tolerated treatment for uncomplicated falciparum malaria in the study setting after several years of universal access to AL. A high rate of parasitaemia with <it>P. vivax </it>possibly from relapse or new infection was observed.</p> <p>Trial Registration</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT01052584">NCT01052584</a></p