Review of Maternal Death in Jimma University specialized Hospital

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Pre-Extension Demonstration of Improved Bread Wheat Varieties with Their Production Packages in High land Area of Eastern Amhara Region, Ethiopia

The study was basically focused on demonstration of bread wheat technologies for wider demand-driven technology diffusion in major wheat growing area in high land of eastern Amhara. The objectives were in order to evaluate and demonstrate improved bread wheat variety with their production package to the farming community and assess farmers and extension workers reaction towards improved bread wheat technology. The activity was conducted in main season 2019/2020 at Jama and Meket districts. The fact that wheat production and productivity in the region as well as in the particular study area low because farmers are using low yielding, disease and pest resistant local varieties. The improved bread wheat variety was demonstrated along with the local variety at 12 farmers' fields. Yield data, economic data, farmers’ perception and preferences were collected throughout the demonstration stages and data were analyzed by using ANOVA, partial budget analysis and preference ranking. The results of ANOVA showed that yield and yield related parameters statistically significant at the probability level of  0.01% and 0.05% among treatments. The highest mean yield was recorded from "Hibist" with improved management 2.49 ton/ha and 1.42 ton/ha at Jama and Meket districts respectively followed by local with improved management and the lowest was from local with farmers practices. Furthermore, the result of partial budget analysis show that the use of improved and local variety with recommended package more profitable with the MRR of 1.96 and 0.81 than farmer practices at Jama district and 74.26 and 9.26 at Meket district respectively. Farmer preference analysis improved & local variety with improved management ranks 1st and 2nd at Jama respectively while reverse at Meket and lastly ranks farmer practices at both districts. Generally, improved bread wheat with recommended package has higher yield advantage, financial feasibility and social acceptance than control and farmer practices, it is recommended to be scale out for further dissemination

Participatory Evaluation of Early Maturing Sorghum Technologies in Eastern Amhara Region of Ethiopia

The low or non-adoption of improved agricultural technologies might be resulted from inadequate participation of farmers at all stages of the process of benefiting farmers. The current study was conducted in the representative sorghum producing areas of Wollo i.e. Raya kobo, Kalu and Dawa chefa with the objective of assessing farmers’ preference towards improved sorghum varieties and providing a menu of sorghum technologies. The study was conducted in 2019 cropping season having one year duration. Both inferential and descriptive statistics were used to analyze the collected data. Farmers’ perception was assessed using preference ranking and narration. Moreover, Agricultural events such as field days and experience sharing were prepared to capture farmers’ perception about the technologies.  GenStat v.18th was used to analyze the data. Analysis of variance was employed to test the mean difference of yield among varieties. The result of ANOVA showed that improved sorghum varieties Dekeba and ESH1 gave the highest grain yield at respective sites. In kalu and Dawa chefa, farmers preferred Argiti whereas in Raya Kobo, Melkam was the variety preferred by the farmers. From the analysis of Spearman’s rank correlation, there was evidence on coincidence of farmers’ preference and the actual data. Therefore, based on the analysis of farmers’ preference and yield data, improved sorghum technologies Melkam and Argiti can be promoted in the respective districts of the study area

Enhancing Faba Bean Production through Promoting Integrated Faba Bean Gall Management Practices in Eastern Amhara Region of Ethiopia

In Ethiopia, a great variety of diseases affects faba bean production. However, gall forming faba bean new disease has become a very serious disease that seriously affected faba beans producing areas of Wollo. This prescalling up of integrated faba bean gall technology has been conducted at Meket and Wadla woredas of north Wollo in 2017/18 to create wider demand on the management of gall disease and to enhance integrated gall disease management  technology dissemination. The study areas were selected purposively due to high infestation of the disease. A total of 32 farmers were selected based on a voluntary base. Adjacent farms of 5.7 ha at Wadla and 3 ha at Meket was selected and clustered accordingly. Integrated disease management i.e seed dressing with 300 gm Baylaton/100Kg seed, improved varieties and hand weeding were applied as a package for the control of the disease. Dosha with chemical gave an average gain yield of 2.2 tons/ha at Meket whereas Wolki with chemical gave an average grain yield of 2.5 tons/ha at Wadla woreda. However, the local variety with farmers’ practice gave an average grain yield of 100 kg/ha and 900 kg/ha at Wadla and Meket woredas respectively. The result of economic analysis also indicate that the technology is by far advantageous than the local variety and practice. So, the technology should be further disseminated to other hot spot areas of faba bean gall diseases

Predictors of Time to First Line Antiretroviral Treatment Failure among Adult Patients Living with HIV in Public Health Facilities of Arba Minch Town, Southern Ethiopia

BACKGROUND: Antiretroviral therapy is a proven medication given for Human Immunodeficiency Virus positive individuals. However, first-line antiretroviral treatment failure becomes a public health issue and early detection of treatment failure is crucial for timely actions. Therefore, this study aimed to identify the predictors of time to first-line antiretroviral treatment failure among adult patients living with HIV in public health facilities of Arba Minch Town.METHODS: Institution-based retrospective cohort study was employed among 396 adult patients that were selected using simple random sampling. The data on relevant variables were extracted from patient medical cards. Bi-variable and multi-variable Cox proportional hazard regression analyses were used to identify predictors.RESULTS: The median survival time was 21 months. Substance use (AHR=2.94, 95% CI=1.62 to 5.32), disclosure status (AHR=1.98, 95% CI=1.03 to 3.79), time since HIV diagnosis (AHR=2.19 95% CI=1.01 to 4.79), WHO clinical stage (AHR=2.02, 95% CI=1.02 to 4.00), opportunistic infection (AHR=2.27, 95% CI=1.23 to 4.19), nutritional status (AHR=3.78, 95% CI=1.99 to 7.17), functional status (AHR=2.71 95% CI=1.33 to 5.51), CD4 count (AHR=1.99, 95% CI=1.05 to 3.75), and adherence level (AHR=1.99, 95% CI=1.05 to 3.76) were independent predictors of time to first line ART treatment failure.CONCLUSION: History of substance use, lack of disclosure status, time since HIV diagnosis, advanced WHO clinical staging, low CD4 counts, opportunistic infection, functional status, poor adherence to ART and under-nutrition affect the time to first-line treatment failure among adult patients living with HIV. Therefore, preventive interventions, and information and counseling focusing on high risk groups of HIV infected adult are very important

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Determinants of Anemia among Pregnant Women Attending Antenatal Clinic in Public Health Facilities at Durame Town: Unmatched Case Control Study

Background. Anemia among pregnant women is one of the most common public health problems in developing country. World health organization (WHO) estimate shows nearly half of pregnant women were affected by anemia. High burden of anemia is observed in Africa particularly in Ethiopia. However, the factors that contribute to the occurrence of anemia were not exhaustively studied. Therefore, the aim of this study was to identify determinant factors of anemia among pregnant women in Durame Town, southern Ethiopia. Method. An institutional based unmatched case control study was conducted among 111 cases and 222 controls in Durame Town from 16th February to 8th May 2017 using interviewer administered questionnaires. Controls were pregnant women whose hemoglobin level was 11 g/dl and above at their first antenatal care clinics and cases were pregnant women whose hemoglobin level was less than 11 g/dl. Bivariate and multivariate logistic regression model was used to see the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value were used to identify the significant association. Result. A total of 333 women (111 cases and 222 controls) participated in the study. The major determinant factors were parasitic infection (AOR: 3.67, 95% CI: 1.72-7.86), not taking additional diet during pregnancy (AOR: 2.49, 95% CI: 1.22-5.08), consuming tea/coffee immediately after food (AOR: 3.58, 95% CI: 1.72-7.42), not eating meat (AOR: 2.07, 95% CI: 1.03-4.15), previous heavy menstrual blood flow (AOR: 2.62, 95% CI: 1.18-5.84), and being housewife (AOR: 2.38, 95% CI: 1.02-5.57). Conclusion. Parasitic infection, additional diet during pregnancy, consuming tea/coffee immediately after food, meat consumption, previous heavy menstrual blood flow, and occupational status of women were significant factors associated with anemia among pregnant women. Therefore, anemia prevention strategy should include promotion of counseling on additional diet during pregnancy, preventing parasitic infection, and increasing employment opportunities for women

Bacterial resistance to fluoroquinolones and contributing factors in Addis Ababa, Ethiopia: a mixed methods study

Fluoroquinolones are widely used globally and there is a growing trend of resistance to these agents. However, there is scanty information in Ethiopia and this study aimed to assess the level of bacterial resistance to fluoroquinolones and identify contributing factors in Addis Ababa, Ethiopia. Concurrent mixed methods study design was used. Records (January 2013 to December 2016) of the Microbiology Laboratory of International Clinical Laboratories were retrospectively reviewed. In addition, qualitative interviews were conducted with purposively selected 20 prescribers’ and dispensers’ to explore perceived contributing factors to resistance. Descriptive statistics was used to summarize the data and possible association was explored using multivariable logistic regression. Qualitative data was analyzed using thematic analysis. A total of 7,889 bacterial isolates were identified from 4,310 patients. The overall resistance of bacterial isolates to fluoroquinolones was 42.5% and the highest resistance was to nalidixic acid (63.3%). Enterococci and Escherichia coli developed high level of resistance to ciprofloxacin and norfloxacin; while Enterococci had higher resistant to nalidixic acid (77.8%). Resistance to fluoroquinolones was 5-times more likely in patients aged ≥ 60 years than those < 15 years old (AOR = 5.63, 95% CI: 4.71, 6.73). Resistance to fluoroquinolones increased from 40.4% in 2013 to 49.0% in 2015 but declined to 46.3% in 2016. Respondents of the qualitative interviews suggested that injudicious prescribing due to lack of institutional antibiogram and inadequate knowledge, nonprescription sales of antibiotics and/or patient hording and sharing practices contributed for the high level of fluoroquinolone resistance. The study showed a high level of bacterial resistance to fluoroquinolones. Patients’ age and year of testing were significantly associated with resistance. Moreover, inappropriate prescribing practice, illegal over-the-counter sales as well as their unreasonable use by patients were key drivers to the problem. This calls for the strict regulation of non-prescription sales of antibiotics, public awareness creation and development of local antibiogram to guide prescribing. Keywords: fluoroquinolones, bacterial resistance, qualitative interview, enterococci, Escherichia col

Podoconiosis in Ethiopia: from neglect to priority public health problem

Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated master plan for NTDs. An integrated lymphoedema management guideline has been developed. Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this