E-Health: The Benefits & The Potential Risk for a Violation of Patient Information Privacy

The Internet drives the hottest stocks on Wall Street, shapes technological innovation, and fills the pages of the world\u27s presses. What does this mean for society, government, commerce, and especially for healthcare organizations who are using the virtual world as a vehicle to deliver patient care services through e-Health system. This proposal compares and contrasts the level advantages and the potential risks involved in providing health care services using e-Health system. The methods used to measure the benefits vs. potential risk on e-Health are the Oakland medical center will be the focus area with the selected groups being patients who are identified and diagnosed with chronic diabetic disease. The study method requires for each selected sample (patient) to respond to nine questions relevant to healthcare services and products provided to the group through the Internet. The collected data will be analyzed to determine benefits vs. potential risk on e-Health

Sustainable EcoSan - Fossa alterna: the case of Menge, Ethiopia

This study is a cross-sectional community-based study aimed at identifying factors affecting sustainability of Fossa alterna adoption among rural households in Menge Woreda in Benishangul-Gumuz Region, Ethiopia. A sample of 216 was considered from 547 households that use Fossa alterna latrines, since they were introduced by WaterAid in Ethiopia project. The study used both qualitative and quantitative research to capture data. The study in the area has found that Ecological Sanitation (EcoSan) type-Fossa alterna technology has not been adopted as a way to sustainably manage human excreta in rural communities. Out of the sample of 216 households who had previously constructed Fossa alterna latrines only 25% are currently functional, 45% have replaced them with traditional pit latrines and very few households started linking Fossa alterna latrines with farming. There were several major technical design problems that hindered sustainability of household Fossa alterna in the study area. During the design, the family size and their water use practices were not considered and partition of pits and basements were not made of waterproof materials. Other factors included lack of awareness about operation and management, capital costs, the high management burden on women and girls, absence of coordinated effort among stakeholders, and lack of attention to sanitation by local community-based organisations

Impact assessment in schools: impact of WASH provision in teaching-learning process, Benishangul Gumuz, Assosa Zone, Menge Woreda

Most of schools in Menge woreda had no safe water supply for the school community. To address this problem, WaterAid Ethiopia constructed water supply schemes and sanitation facilities in the schools’ vicinity. To assess the impact of facilities on the teachinglearning process, data was collected for five months that is the study period (from 01 Nov. 07 to 31 March 08) using questionnaires. The study found that the major reason for absence or tardiness is the sum result of household workloads, such as fetching water; followed by lack of hygiene awareness and resulting health problems. Majority of health problems are due to WASHrelated diseases. Yet, the students’ reasons for poor hygiene are not related to a lack of awareness. Recommendations are provided for action. These include establishing effective school sanitation clubs, raising parent awareness through education, strengthening sector collaboration and advocacy on relationship between education and WASH

Modeling and Forecasting Rainfall in Ethiopia

Ethiopian economy is extremely dependent on agricultural sector, which contributes 45% to the Gross Domestic Product (GDP), 85% foreign earnings and provides livelihood to 80% of the population. Ethiopian agriculture is highly dependent on natural rainfall, with irrigation agriculture accounting for less than 1% of the country’s total cultivated land. Therefore, modeling and forecasting the rainfall dynamics of the country has a great importance. This paper aims at examining the rainfall dynamics and fit appropriate model for forecasting Ethiopian rainfall. In this research, we apply Box-Jenkins approach, Seasonal Autoregressive Integrated Moving Average (SARIMA) model in order to forecast monthly rainfall of Ethiopia for the period of twelve months ahead. Monthly rainfall data from 1901 to 2015 were used from world bank group (climate change portal). Appropriate SARIMA model has been identified based on an Akaike information criteria (AIC) and Bayesian information criteria (BIC) for forecasting the amount of monthly average rainfall. Farmers, in general agricultural sectors, policy makers, tourists, and investors engaged in the construction industry are some of the sectors benefited from this result

Risk Factors for Anemia in Patients with Chronic Renal Failure: A Systematic Review and Meta-Analysis

BACKGROUND፡ Anemia in patients with chronic kidney disease presents significant impacts on patients, the health-care system and financial resources. There is a significant variation in the primary studies on risk factors of anemia in this patient population across the globe.Therefore, this study aimed to identify the risk factors of anemia among chronic kidney disease patients at the global level.METHODS: PubMed, Scopus, African Journals Online, Web of Science and Google Scholar were searched and complemented by manual searches. A Funnel plot and Egger’s regression test were used to determine publication bias. DerSimonian and Laird random-effects modes were applied to estimate pooled effect sizes, odds ratios, and 95% confidence interval across studies. Analysis was performed using STATA™ Version 14 software.RESULT: A total of 28 studies with 24,008 study participants were included in this study. Female sex (AOR= 1.36; 95% CI 1.11, 1.67), stage 5 CKD (AOR = 13.66; 95% CI: 5.19, 35.92), body mass index ≥ 30 kg/m2 (AOR = 0.51; 95% CI: 0.29, 0.91), comorbidities (AOR = 2.90; 95% CI: 1.68, 5.0), proteinuria 3+(AOR = 3.57; 95% CI: 1.03, 12.93), hypocalcemia (AOR=3.61, 95%CI: 1.56–8.36), and iron therapy (AOR: 0.59; 95% CI:0.31, 0.98) were significantly associated with anemia of chronic kidney disease.CONCLUSION: Female sex, stage 5 CKD, body mass index ≥ 30 kg/m2, comorbidity, and hypocalcemia were found to be significantly associated with anemia of chronic kidney disease. Therefore, situation-based interventions and country contextspecific preventive strategies should be developed to reduce the risk factors of anemia in patients with chronic renal failure

The combined impacts of land use change and climate change on soil organic carbon stocks in the Ethiopian highlands

Land Use Change (LUC), especially deforestation in tropical regions, significantly contributes to global anthro-pogenic greenhouse gas (GHG) emissions. Here, we address potential combined impacts of LUC and Climate Change (CC) on Soil Organic Carbon (SOC) stocks in the Ethiopian highlands. The soil model Q was employed to predict SOC stocks for various combinations of LUC and CC scenarios until the year 2100. Four reference sce-narios (cropland, bushland, natural forest, and Eucalyptus plantations under contemporary climatic conditions) were evaluated against reported measurements of SOC stocks. We studied impacts of six common LUC scenarios, including deforestation and planting Eucalyptus, on SOC stocks under contemporary and future climates. To assess the impact of CC, effects of elevated temperature (mean annual temperature + 2.6 degrees C) together with three litterfall scenarios (no change in litterfall, a 5% reduction and 22% increase, designated CC0, CCd, and CCi, respectively) were considered to test potential vegetation responses to increases in temperature and atmospheric CO2 concentrations. Most of the tested combinations of LUC and CC led to losses of SOC stocks. Losses were most severe, both relatively and absolutely, in the deforestation scenarios: up to 30% was lost if natural forest was converted to cropland and temperature increased (under the CC0 scenario). Gains in SOC stocks of 4-19% were modelled when sparse vegetation was converted to more dense vegetation like Eucalyptus plantation with sub-stantially increased litterfall (the CCi scenario). Elevated temperature accelerated decomposition rates, leading to circa 8% losses of SOC stocks.We conclude that effects of LUC and CC on SOC stocks are additive and changes in litterfall caused by LUC determine which has the largest impact. Hence, deforestation is the biggest threat to SOC stocks in the Ethiopian highlands, and stocks in sparse vegetation systems like cropland and bushland are more sensitive to CC0 than LUC. We recommend conservation of natural forests and longer rotation periods for Eucalyptus plantations to preserve SOC stocks.Finally, we suggest that use of the Q model is a viable option for national reporting changes in SOC stocks at Tier 3 within the LULUCF sector to the United Nations Framework Convention on Climate Change (UNFCCC) as it is widely applicable and robust, although it only requires input data on a few generally available variables

Preterm Neonatal Mortality and its predictors in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study

BACKGROUND፡ Preterm neonatal death is a global problem. In Ethiopia, it is still high, and the trend in reduction is slower as compared to child mortality. Preterm neonatal birth is the leading cause. The magnitude and associated factors are also not well documented. Therefore, this study aimed to estimate the incidence of mortality and its predictors among preterm neonates in Tikur Anbesa Specialized Hospital (TASH).METHODS: An institution-based retrospective cohort study was conducted among 604 preterm neonates admitted to Tikur Anbesa Specialized Hospital. Data were collected by reviewing patient charts using systematic sampling with a checklist. The data entry was done using EpiData version 4.2, and analysis was done using Stata Version 14.1. Kaplan-Meier and log-rank tests were used to estimate the survival time and to compare it. Cox proportional hazard was also fitted to identify major predictors. Hazard Ratios (HRs) with 95% Confidence Intervals (CI) were used to assess the relationship between factors associated with the occurrence of death. Finally, statistical significance was declared at p-value < 0.05.RESULTS: In this study, a total of 604 patient charts were reviewed; of these, 571 met the inclusion criteria and were recruited to the study. A total of 170(29.7%) preterm neonates died during the follow-up period. The median follow-up time of preterm neonate under the cohort was 21 days (IQR: 4, 27). The incidence rate was 39.1 per 1000-person day. Rural residency (AHR: 1.45 (95% CI: 1.1,4.8)), Maternal diabetic Mellitus (AHR:2.29 (95%CI: 1.43,3.65), neonatal sepsis (AHR:1.62 (95% CI: 1.11,2.37), respiratory distress (AHR:1.54 (95% CI:1.03,2.31), extreme prematurity (AHR:2.87 (95% CI:1.61, 5.11), and low APGAR score (AHR:3.11 (95% CI:1.79, 5.05) was found to be predictors .CONCLUSION: The rate of preterm neonatal mortality is still an important problem. Having maternal gestational Diabetic Mellitus, neonatal sepsis, respiratory distress, and low Apgar score were major predictors for preterm neonatal mortality. Therefore, efforts have to be made to reduce the incidence of death and for timely management of mothers with Diabetic Mellitus. Healthcare professionals should also work on early diagnosis and treatment of preterm neonate with sepsis, respiratory distress, and low Apgar score

Agreement between direct fluorescent microscopy and Ziehl-Neelsen concentration techniques in detection of pulmonary tuberculosis in northwest Ethiopia

Background: The sensitivity of smear microscopy for diagnosis of tuberculosis might be improved through treatment of sputum with sodium hypochlorite and application of fluorescent microscopy. This study aimed to determine the agreement between direct Fluorescent Microscopy and Ziehl-Neelsen concentration technique by their ability of detecting acid fast bacilli in resource poor settings.Methods: A cross sectional study was conducted at Gondar University Referral Hospital, Northwest Ethiopia. Three sputum specimens were collected from consecutive TB suspects. Direct and concentrated sputum smears were air-dried, heat-fixed and stained by auramine O and Ziehl-Neelsen staining techniques respectively. The stained slides were examined for acid fast bacilli using direct Fluorescent Microscopy and Ziehl-Neelsen concentration techniques.Results: Of 293 specimens, 4.4% and 2.4 % were AFB positive by direct fluorescent microscopy and Ziehl-Neelsen bleach concentrated techniques respectively. There was high percentage of tuberculosis positivity from early morning sputum samples (2.4%) compared to first spot (1.4%) and second spot (1.7%) sputum samples when using Ziehl-Neelsen sodium hypochlorite concentration technique. A moderate agreement was seen between the two methods (Kappa=0.484, P value<0.001).Conclusion: Direct fluorescent microscopy has shown high positivity rate compared to Ziehl-Neelsen concentration technique. A moderate agreement was seen between the two methods. Thus, Ziehl-Neelsen bleach sedimentation technique is recommended for detection of pulmonary tuberculosis at peripheral health service level when Fluorescent Microscopy is not availableKeywords: Agreement, Direct Fluorescent Microscopy, Ziehl-Neelsen concentration, Tuberculosis, Ethiopi

The Magnitude of Neonatal Mortality and Its Predictors in Ethiopia:A Systematic Review and Meta-Analysis

Background. Although neonatal death is a global burden, it is the highest in sub-Saharan African countries such as Ethiopia. Moreover, there is disparity in the prevalence and associated factors of studies. Therefore, this study was aimed at providing pooled national prevalence and predictors of neonatal mortality in Ethiopia. Methods. The following databases were systematically explored to search for articles: Boolean operator, Cochrane Library, PubMed, EMBASE, Hinari, and Google Scholar. Selection, screening, reviewing, and data extraction were done by two reviewers independently using Microsoft Excel spreadsheet. The modified Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute Prevalence Critical Appraisal tools were used to assess the quality of evidence. All studies conducted in Ethiopia and reporting the prevalence and predictors of neonatal mortality were included. Data were extracted using Microsoft Excel spreadsheet software and imported into Stata version 14s for further analysis. Publication bias was checked using funnel plots and Egger's and Begg's tests. Heterogeneity was also checked by Higgins's method. A random effects meta-analysis model with 95% confidence interval was computed to estimate the pooled effect size (i.e., prevalence and odds ratio). Moreover, subgroup analysis based on region, sample size, and study design was done. Results. After reviewing 88 studies, 12 studies fulfilled the inclusion criteria and were included in the meta-analysis. Pooled national prevalence of neonatal mortality in Ethiopia was 16.3% (95% CI: 12.1, 20.6, I2=98.8%). The subgroup analysis indicated that the highest prevalence was observed in the Amhara region, 20.3% (95% CI: 9.6, 31.1), followed by Oromia, 18.8% (95% CI: 11.9, 49.4). Gestational age [AOR: 1.32 (95% CI: 1.07, 1.58)], neonatal sepsis [AOR: 1.23 (95% CI: 1.05, 1.4)], respiratory distress syndromes (RDS) [AOR: 1.18 (95% CI: 0.87, 1.49)], and place of residency [AOR: 1.93 (95% CI: 1.13, 2.73)] were the most important predictors. Conclusions. Neonatal mortality in Ethiopia was significantly decreased. There was evidence that neonatal sepsis, gestational age, and place of residency were the significant predictors. RDS were also a main predictor of mortality even if not statistically significant. We strongly recommended that health care workers should give a priority for preterm neonates with diagnosis with sepsis and RDS

Incidence of respiratory distress and its predictors among neonates admitted to the neonatal intensive care unit, Black Lion Specialized Hospital, Addis Ababa, Ethiopia

Background Although respiratory distress is one of the major causes of neonatal morbidity and mortality throughout the globe, it is a particularly serious concern for nations like Ethiopia that have significant resource limitations. Additionally, few studies have looked at neonatal respiratory distress and its predictors in developing countries, and thus we sought to investigate this issue in neonates who were admitted to the Neonatal Intensive Care Unit at Black Lion Specialized Hospital, Ethiopia. Methods An institution-based retrospective follow-up study was conducted with 571 neonates from January 2013 to March 2018. Data were collected by reviewing patients’ charts using a systematic sampling technique with a pretested checklist. The data was then entered using Epidata 4.2 and analyzed with STATA 14. Median time, Kaplan-Meier survival estimation curves, and log-rank tests were then computed. Bivariable and multivariable Gompertz parametric hazard models were fitted to detect the determinants of respiratory distress. The hazard ratio with a 95% confidence interval was subsequently calculated. Variables with reported p-values < 0.05 were considered statistically significant. Results The proportion of neonates with respiratory distress among those admitted to the Black Lion Specialized Hospital neonatal intensive care unit was 42.9% (95%CI: 39.3–46.1%) The incidence rate was 8.1/100 (95%CI: 7.3, 8.9). Significant predictors of respiratory distress in neonates included being male [Adjusted hazard ratio (HR): 2.4 (95%CI: 1.1, 3.1)], born via caesarean section [AHR: 1.9 (95%CI: 1.6, 2.3)], home delivery [AHR: 2.9 (95%CI: 1.5, 5,2)], maternal diabetes mellitus (AHR: 2.3 (95%CI: 1.4, 3.6)), preterm birth [AHR: 2.9 (95%CI: 1.6, 5.1)], and having an Apgar score of less than 7 [AHR: 3.1 (95%CI: 1.8, 5.0)]. Conclusions In this study, the proportion of respiratory distress (RD) was high. Preterm birth, delivery by caesarean section, Apgar score < 7, sepsis, maternal diabetes mellitus, and home delivery were all significant predictors of this condition. Based on our findings this would likely include encouraging more hospital births, better control of diabetes in pregnancy, improved neonatal resuscitation and addressing ways to decrease the need for frequent caesarean sections