Assessments of Alfalfa (Medicago sativa) and Rhodes grass (Chloris gayana) at Soddo and Kedidagamila districts of southern Ethiopia

Assessments of Rhodes grass (Chloris gayana) and Alfalfas (Medicago sativa) was carried out on 36 farmers fields in soddo and kedidagamila districts of Southern Ethiopia during 2010/2011 cropping season in order to test the adaptability of grass and legume forages, create awareness to the farmers and evaluate the yield performance of the technologies by farmers evaluation criteria. The range and mean performance of annual grass and legume forages have showed considerable amount of variability among the traits. For instance, fresh biomass yield of rhodes grass varied from 31.9-98.0 and 27.8-39.3 tones/ha for soddo and Kedidagamila districts respectively. The plant height and number of branch/plant of rhodes grass also varied from 128.9-172.9cm and 4.0-16.0 for soddo and 110.8- 129.5 cm and 7.0-16.0 for Kedidagamila. Moreover, the fresh biomass yield of alfalfa in soddo is varied from 21.9-44.1 and 22.1-34.30 t/ha and dry matter 8.26-23.26 and 10.6-17.6 t/ha for soddo and Kedidagamila districts respectively. Based on farmers evaluation, both alfalfa and Rhodes grass are the most vigorous, persistent and highly adapted species, and thus can be safely suggested for the soddo district. Furthermore, the growth performance of Rhodes grass in kedidagamila also good but, productivity of alfalfa was poor and this probably resulting from unfavorable climatic conditions. The over all mean of the result, 90.26% and 69.43% of soddo farmers were selected rhodes grass and alfalfa. In kedidagamila, 88.88 % of the farmers were preferred Rhodes grass over 40.25 % of alfalfa. Key words: Assessments, adaptation,  Evaluation Medicago sativa, Chloris gayan

Assessments of Alfalfa (Medicago sativa) and Rhodes grass (Chloris gayana) at Soddo and Kedidagamila districts of southern Ethiopia

Assessments of Rhodes grass (Chloris gayana) and Alfalfas (Medicago sativa) was carried out on 36 farmers fields in soddo and kedidagamila districts of Southern Ethiopia during 2010/2011 cropping season in order to test the adaptability of grass and legume forages, create awareness to the farmers and evaluate the yield performance of the technologies by farmers evaluation criteria. The range and mean performance of annual grass and legume forages have showed considerable amount of variability among the traits. For instance, fresh biomass yield of rhodes grass varied from 31.9-98.0 and 27.8-39.3 tones/ha for soddo and Kedidagamila districts respectively. The plant height and number of branch/plant of rhodes grass also varied from 128.9-172.9cm and 4.0-16.0 for soddo and 110.8- 129.5 cm and 7.0-16.0 for Kedidagamila. Moreover, the fresh biomass yield of alfalfa in soddo is varied from 21.9-44.1 and 22.1-34.30 t/ha and dry matter 8.26-23.26 and 10.6-17.6 t/ha for soddo and Kedidagamila districts respectively. Based on farmers evaluation, both alfalfa and Rhodes grass are the most vigorous, persistent and highly adapted species, and thus can be safely suggested for the soddo district. Furthermore, the growth performance of Rhodes grass in kedidagamila also good but, productivity of alfalfa was poor and this probably resulting from unfavorable climatic conditions. The over all mean of the result, 90.26% and 69.43% of soddo farmers were selected rhodes grass and alfalfa. In kedidagamila, 88.88 % of the farmers were preferred Rhodes grass over 40.25 % of alfalfa. Key words: Assessments, adaptation,  Evaluation Medicago sativa, Chloris gayan

Pragmatism in practice: lessons learned during screening and enrollment for a randomised controlled trial in rural northern Ethiopia

Background. We use the example of the Gojjam Lymphoedema Best Practice Trial (GoLBeT), a pragmatic trial in a remote rural setting in northern Ethiopia, to extract lessons relevant to other investigators balancing the demands of practicality and community acceptability with internal and external validity in clinical trials. Methods. We explain in detail the preparation for the trial, its setting in northern Ethiopia, the identification and selection of patients (inclusion and exclusion criterion, identifying and screening of patients at home, enrollment of patients at the health centres and health posts), and randomisation. Results. We describe the challenges met, together with strategies employed to overcome them. Conclusions. Examples given in the previous section are contextualised and general principles extracted where possible. We conclude that it is possible to conduct a trial that balances approaches that support internal validity (e.g. careful design of proformas, accurate case identification, control over data quality and high retention rates) with those that favour generalisability (e.g. ‘real world’ setting and low rates of exclusion). Strategies, such as Rapid Ethical Assessment, that increase researchers’ understanding of the study setting and inclusion of hard-to-reach participants are likely to have resource and time implications, but are vital in achieving an appropriate balance

Central obesity and its associated factors among cancer patients at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

PurposeObesity, especially the hidden type of obesity (central obesity), has been believed to be the major risk factor for developing and progressing non-communicable diseases, including cancers. However, there are limited studies regarding the issue in Ethiopia and the study area. Therefore, this study aimed to evaluate the magnitude of central obesity and its associated factors among cancer patients visited the oncology unit of the University of Gondar Comprehensive Specialized Hospital.MethodsAn institutional-based cross-sectional study was conducted from January 10 to March 10, 2021. A total of 384 study participants were enrolled using a systematic sampling technique. The data were collected using a semi-structured interviewer-administered questionnaire and were pretested to address the quality of assurance. The weight of the participants was assessed using body mass index (BMI) and central obesity. Both bivariate and multivariate logistic regressions were conducted to identify the factors associated with central obesity, and p-values less than 0.05 with multivariate were considered statistically significant associations.ResultMost respondents (60.16%) were stage I cancer patients. The study found that about 19.27% of the participants were prevalent central obesity, and none of them were obese by body mass index (BMI) categorization criteria. However, about 12.24% and 7.03% of the participants were found to be underweight and overweight, respectively. The variables associated with central obesity were sex (AOR=14.40; 95% CI: 5.26 - 39.50), occupation (AOR=4.32; 95%CI: 1.10 - 17.01), and residency (AOR=0.30; 95% CI: 0.13 - 0.70).ConclusionA significant number of the respondents (19.27%) were centrally obese. Being female, urban residency and having an occupation other than a farmer, merchant, and governmental were the factors associated with central obesity. Hence, cancer patients may be centrally obese with average body weight

Willingness to pay for social health insurance among public civil servants: A cross-sectional study in Dessie City Administration, North-East Ethiopia

BackgroundThe readiness to pay for health insurance has an impact on universal health care. This study investigated the willingness of public civil servants in Dessie City Administration, North-East Ethiopia, to pay for social health insurance and associated factors.MethodsFrom April to May 2021, a cross-sectional study was undertaken. The sectors from which the samples were proportionately allocated were chosen using a multistage sampling procedure. Using their payroll list as a sampling frame, simple random sampling was done to recruit them. A semi-structured self-administered questionnaire was used to collect data. Epi Data version 3.1 was used to enter, code, and clean the data, which was then exported to SPSS version 23 for analysis. To determine relationships, bi-variable and multivariable analyses were utilized. Candidates for multivariable analysis were variables with a p-value ≤ 0.3 in bi-variable analysis. AOR with a 95% CI was used to determine the strength and direction of association. Statistical significance was defined at p-value < 0.05.ResultsA total of 796 employees took part in the study, with a 94.42% response rate. Overall, 29.60% of them were willing to pay for the scheme (95% CI: 26.4, 33%). The decision to pay was influenced by favorable perception (AOR = 2.43, 95% CI: 1.72, 3.44), household income < Birr 5,000 (AOR = 0.26, 95% CI: 0.14, 0.48), acute illness (AOR = 0.48, 95% CI: 0.32, 0.72), bachelor level education (AOR = 0.44, 95% CI: 0.28, 0.70), master and above level education (AOR = 0.26, 95% CI: 0.14, 0.49), and age 25–29 years (AOR = 1.97, 95 % CI: 1.08, 3.57).ConclusionThe willingness of the civil servants to pay for social health insurance was low, and it was influenced by their attitudes toward the scheme, the occurrence of severe illness, income level, educational status, and age

COVID-19 lockdown and natural resources: a global assessment on the challenges, opportunities, and the way forward

Background: The Coronavirus (COVID-19) is a global pandemic caused by SARS-CoV-2, which has an enormous effect on human lives and the global environment. This review aimed to assess the global scientific evidence on the impact of COVID-19 lockdown on natural resources using international databases and search engines. Thus, the unprecedented anthropause due to COVID-19 has positive and negative effects on natural resources. Main body This review showed that the unprecedented pandemic lockdown events brought a negative impact on the physical environment, including pollution associated with a drastic increase in person protective equipment, deforestation, illegal poaching and logging, overfishing, disruption of the conservation program and projects. It is noted that the spread of pandemic diseases could be aggravated by environmental pollution and a rapid increase in the global population. Despite these negative impacts of COVID-19, the anthropause appear to have also several positive effects on natural resources such as short term reduction of indoor and outdoor environmental pollutants (PM2.5, PM10, NO2, SO2, CO, and CO2), reduction in noise pollutions from ships, boats, vehicles, and planes which have positive effects on aquatic ecosystems, water quality, birds behaviour, wildlife biodiversity, and ecosystem restoration. Conclusion Therefore, governments and scientific communities across the globe have called for a green recovery to COVID-19 and implement multi-actor interventions and environmentally friendly technologies to improve and safeguard sustainable environmental and biodiversity management and halt the next pandemic

Setting up a pragmatic clinical trial in a lowresource setting: a qualitative assessment of GoLBeT, a trial of podoconiosis management in Northern Ethiopia

Background Clinical trials are often perceived as being expensive, difficult and beyond the capacity of healthcare workers in low-resource settings. However, in order to improve healthcare coverage, the World Health Organization (WHO) World Health Report 2013 stated that all countries need to become generators as well as recipients of data. This study is a methodological examination of the steps and processes involved in setting up the Gojjam Lymphoedema Best Practice Trial (GoLBeT; ISRCTN67805210), a highly pragmatic clinical trial conducted in northern Ethiopia. Challenges to the trial and strategies used to deal with them were explored, together with the reasons for delays. Methodology and principal findings Qualitative research methods were used to analyse emails and reports from the period between trial inception and recruitment. This analysis was complemented by interviews with key informants from the trial operational team. The Global Health Research Process Map was used as a framework against which to compare the steps involved in setting up the trial. A mini-group discussion was conducted with the trial operational team after study completion for reflection and further recommendations. This study showed that the key areas of difficulty in setting up and planning this trial were: the study design, that is, deciding on the study endpoint, where and how best to measure it, and assuring statistical power; recruitment and appropriate training of staff; planning for data quality; and gaining regulatory approvals. Collaboration, for example with statisticians, the trial steering committee, the study monitors, and members of the local community was essential to successfully setting up the trial. Conclusions and significance Lessons learnt from this trial might guide others planning pragmatic trials in settings where research is not common, allowing them to anticipate possible challenges and address them through trial design, planning and operational delivery. We also hope that this example might encourage similar pragmatic studies to be undertaken. Such studies are rarely undertaken or locally led, but are an accessible and efficient way to drive improved outcomes in public health

Lymphoedema management to prevent acute dermatolymphangioadenitis in podoconiosis northern Ethiopia (GoLBeT): a pragmatic randomised controlled trial in

Background Podoconiosis (endemic, non-filarial elephantiasis) affects ~4 million subsistence farmers in tropical Africa. Limited awareness of the condition and lack of evidence for treatment mean that no endemic-country government yet offers lymphoedema management for podoconiosis patients. Among patients with filarial lymphoedema, trials suggest that limb care is effective in reducing the most disabling sequelae: acute dermatolymphangioadenitis (ADLA) episodes. Methods We conducted a pragmatic randomised controlled trial to test the hypothesis that a simple, inexpensive lymphoedema management package would reduce the incidence of ADLA in adult podoconiosis patients in northern Ethiopia. Patients were individually randomised to a package comprising instruction in foot hygiene, skin care, bandaging, exercises, use of socks and shoes, with support by lay Community Podoconiosis Agents at monthly meetings; or no intervention. The primary outcome was incidence of ADLA, measured using a validated patient-held pictorial diary. Assignment was not masked, but those performing the primary analysis were. The trial was registered at the International Standard Randomised Controlled Trials Number Register, number ISRCTN67805210. Findings A total of 350 patients were randomised to the intervention and 346 to the control group, with 93.4% follow-up at one year. During the 12 months of follow up, 16,550 new episodes of ADLA occurred during 765.2 person years observed. The incidence of ADLA was 19.4 (95% CI 18.9 to 19.9) and 23.9 (95% CI 23.4 to 24.4) episodes per person year in the intervention and control groups respectively; incidence rate ratio 0.81 (95% CI 0.69 to 0.96, p=0.02), rate difference -4.5 (95% CI -5.1 to -3.8) episodes per person year. No important adverse events related to the intervention were reported. Interpretation A simple, inexpensive package of lymphoedema self-care is effective in reducing frequency and duration of ADLA. We recommend its implementation by endemic-country governments

Cost-effectiveness and social outcomes of a community-based treatment for podoconiosis lymphoedema in the East Gojjam zone, Ethiopia

Background Podoconiosis is a disease of the lymphatic vessels of the lower extremities that is caused by chronic exposure to irritant soils. It results in leg swelling, commonly complicated by acute dermatolymphangioadenitis (ADLA), characterised by severe pain, fever and disability. Methods We conducted cost-effectiveness and social outcome analyses of a pragmatic, randomised controlled trial of a hygiene and foot-care intervention for people with podoconiosis in the East Gojjam zone of northern Ethiopia. Participants were allocated to the immediate intervention group or the delayed intervention group (control). The 12-month intervention included training in foot hygiene, skin care, bandaging, exercises, and use of socks and shoes, and was supported by lay community assistants. The cost-effectiveness analysis was conducted using the cost of productivity loss due to acute dermatolymphangioadenitis. Household costs were not included. Health outcomes in the cost-effectiveness analysis were: the incidence of ADLA episodes, health-related quality of life captured using the Dermatology Life Quality Index (DLQI), and disability scores measured using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Results The cost of the foot hygiene and lymphoedema management supplies was 529 ETB (69 I$, international dollars) per person per year. The cost of delivery of the intervention as part of the trial, including transportation, storage, training of lay community assistants and administering the intervention was 1,890 ETB (246 I$) per person. The intervention was effective in reducing the incidence of acute dermatolymphangioadenitis episodes and improving DLQI scores, while there were no significant improvements in the disability scores measured using WHODAS 2.0. In 75% of estimations, the intervention was less costly than the control. This was due to improved work productivity. Subgroup analyses based on income group showed that the intervention was cost-effective (both less costly and more effective) in reducing the number of acute dermatolymphangioadenitis episodes and improving health-related quality of life in families with monthly income <1,000 ETB (130 I$). For the subgroup with family income ≥1,000 ETB, the intervention was more effective but more costly than the control. Conclusions Whilst there is evident benefit of the intervention for all, the economic impact would be greatest for the poorest

Podoconiosis treatment in northern Ethiopia (GoLBet): study protocol for a randomised controlled trial

BACKGROUND Podoconiosis is one of the forgotten types of leg swelling (elephantiasis) in the tropics. Unlike the other, better-known types of leg swelling, podoconiosis is not caused by any parasite, virus or bacterium, but by an abnormal reaction to minerals found in the clay soils of some tropical highland areas. Non-governmental Organizations (NGOs) have been responsible for the development of simple treatment methods without systematic evaluation of its effectiveness. It is essential that a large scale, fully controlled, pragmatic trial of the intervention is conducted. We aim to test the hypothesis that community-based treatment of podoconiosis lymphoedema reduces the frequency of acute dermatolymphangioadenitis episodes ('acute attacks') and improves other clinical, social and economic outcomes. METHODS/DESIGN This is a pragmatic, individually randomised controlled trial. We plan to randomly allocate 680 podoconiosis patients from the East Gojjam Zone in northern Ethiopia to one of two groups: 'Standard Treatment' or 'Delayed Treatment'. Those randomised to standard treatment will receive the hygiene and foot-care intervention from May 2015 for one year, whereas those in the control arm will be followed through 2015 and be offered the intervention in 2016. The trial will be preceded by an economic context survey and a Rapid Ethical Assessment to identify optimal methods of conveying information about the trial and the approaches to obtaining informed consent preferred by the community. The primary outcome will be measured by recording patient recall and using a simple, patient-held diary that will be developed to record episodes of acute attacks. Adherence to treatment, clinical stage of disease, quality of life, disability and stigma will be considered secondary outcome measures. Other outcomes will include adverse events and economic productivity. Assessments will be made at baseline and at 3, 6, 9 and 12 months thereafter. DISCUSSION The evidence is highly likely to inform implementation of the new master plan for integrated control of Neglected Tropical Diseases (NTDs), in which podoconiosis is identified as one of eight NTDs prioritised for control. Potentially, an estimated 3 million patients in Ethiopia will therefore benefit from the results of this trial. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number. REGISTRATION NUMBER ISRCTN67805210 . Date of registration: 24 January 2013