Testing the WEAP Hydrologic Model for Awash Basin, Ethiopia “Soil Moisture Module with Watershed Demand Approach”

The research is financed by the Egyptian Government through the Nile Sector bilateral cooperation project Abstract Currently, there are several hydrological simulation models in use worldwide. Prior to adoption of a model to a specific basin, its feasibility and practicality should be tested. This study highlights on the application of Water Evaluation and Planning system (WEAP) model for hydrologic simulation of Awash river basin in Ethiopia. A monthly time step hydrologic model was developed using the soil moisture rainfall-runoff method incorporated in WEAP with an aim to check the suitability of the model for Awash river basin. For this purpose five selected flow gauge stations located at the upper, middle and lower Awash basin were used as control stations. The model is configured taking into account the effects of development and hence the water abstractions, storage, loss rate, etc. are estimated using the data provided through various kinds of research and survey in Ethiopia. Standard methods are also used to prepare the hydro-metrological and landuse input data for each sub-catchment. Based on data availability, the time period 1986-2005 was selected for the hydrologic simulation. The observed data were split for calibration (1986–1995) and validation (1996–2005) purposes. Initially, the model was set up using the default model parameters. Then, manual calibration is performed to reproduce the observed streamflow. The model-simulated values are compared with those obtained from observations using standard statistical tests on monthly and monthly average basis. From the performance test results, it is observed that the coefficient of determination (R2) and the Index of Agreement (IA) show a good fit. Furthermore, the Nash-Sutcliffe Efficiency (NSE) and the Percent Bias (PBIAS) calibration and validation results show good performance for Upper Awash stations and satisfactory results for the middle and lower Awash control stations. As a conclusion, the main modelling constraints were discussed and possible solutions were also suggested in order to improve the performance of water resources simulation models for the Awash basin. Keywords: Awash Basin, Hydrologic Simulation, Calibration, Validation, Model Performance, WEAP DOI: 10.7176/CER/12-3-07 Publication date:March 31st 202

Planning for Environmental Water Allocations: Hydrology - Based Assessment in the Awash River Basin, Ethiopia

The research is financed by the Egyptian Government through the Nile Sector bilateral cooperation project Abstract With expanding water demand due to rapid socio-economic growth and shrinking supplies due to pollution and climate change impact, there is an increasing strain on the water resources of the Awash river basin. Furthermore, flow alterations due to the existing and the ongoing water resources infrastructure projects may adversely impact the natural life cycle of aquatic ecosystems in the river basin. In order to manage these consequences, compensation releases or allocation of environmental flows may be mandatory and calls for the establishment of environmental flows framework in Ethiopia. In this study, the environmental flows at selected five existing and proposed dam sites in the Awash river basin were investigated using six worldwide used hydrology-based methods, viz.: Desktop Reserve Model (DRM), Global Environmental Flow Calculator (GEFC), Tennant, Tessman, 7Q10 and Q95. The environmental flow volumes from the six methods were compared on mean annual, monthly average and monthly basis and it is found that the predictions from the DRM and GEFC are more reliable than the others. Comparative results indicate that minimum annual average flow rates of 4.4 m3/s (15 % of Mean Annual Flow (MAF)), 10.5 m3/s (19 % of MAF), 16.4 m3/s (22 % of MAF), 2.5 m3/s (17 % of MAF) and 24.2 m3/s (26 % of MAF) are required at the immediate downstream reaches of Melka kuntre, Koka, Awash Compensation, Kesem and Tendaho dams respectively. Accordingly, the annual average environmental flow throughout the basin varies from 15-26 % of the natural MAF. Although preliminary, being the first attempt in the Awash river basin, this study is expected to stimulate dialogue among experts and decision makers in Ethiopia. Keywords: EFR, EFA, Tennant, Tessman, Q95, 7Q10, DRM, GEFC Software, Awash DOI: 10.7176/JEES/9-11-08 Publication date: November 30th 201

The Implementation of Social and Behavior Change Communication Intervention to Improve Immunization Demand: A qualitative study in Awabel District, Northwest Ethiopia

AbstractBackground: Immunization coverage in Ethiopia is low, and dropout rates are high. Social Behavior Change Communication (SBCC) interventions were introduced as a means of combating the ‘demand-side’ immunization barriers. However, Little research exists in terms of the efficacy of the SBCC intervention, in terms of promoting uptake, and improving the immunization demands in Ethiopia.Aim: To explore the current implementation status, and perceived effectiveness of SBCC intervention, barriers and facilitators with new strategies aimed at effective implementation of the SBCC intervention in Awabel District, Northwest Ethiopia.Methods: A phenomenological qualitative study was conducted from January 1- October 31, 2020. In-dept interviews were conducted with fifteen key-informants using a piloted semi-structured interview guide. Participants were purposively selected, which comprised of mangers, Expanded Program of Immunization (EPI) focal personnel, Health Extension Workers (HEWs), Women Development Armies (WDAs), mothers and community representatives. Six vaccination sessions were observed. Coding was done to identify patterns. Thematic analysis was performed using Open Code 4. 02.Results: Interpersonal communication, community conversation, social mobilization and family modeling were used as SBCC approaches. HEWs were the key source of information. Religious leaders were among the major stakeholders that encourage immunization. SBCC was perceived as an effective measure to improve immunization demand. There were multiple barriers for implementation of SBCC interventions including limited resources, lack of awareness, geographic barriers, traditional beliefs, lack of incentives, and limited EPI staff and health facility operating hours. Engagement of fathers and religious leaders, strengthening the WDA, and allocation of more resources were listed as possible strategies to tackle barriers.Conclusion: The implementation of SBCC interventions is important to improve immunization demand. Despite its effectiveness, there are several multi-level barriers to its successful implementation. Further, greater investments are required to improve infrastructures, staff employment and capacity building. [Ethiop. J. Health Dev. 2021; 35(SI-3):49-55]Keywords: Immunization, SBCC, Ethiopi

Polymorphism in killer cell immunoglobulin-like receptors and human leukocyte antigen-c and predisposition to preeclampsia in Ethiopian pregnant women population.

INTRODUCTION: Preeclampsia (PE) is a human specific pregnancy-related syndrome of unknown etiology that affects 2-8 % of pregnancies. Polymorphism in maternal Killer Cell Immunoglobulin-like Receptors (KIRs) and the ligand fetal Human Leukocyte Antigen-C (HLA-C) may predispose pregnant mothers for PE due to defective trophoblast invasion into the maternal decidua. Our study aimed to investigate the association between maternal KIR and fetal HLA-C polymorphism and PE in Ethiopian pregnant women. METHODS: We included a total of 288 (157 controls and 131 PE cases) in a case-controls study at Adama Regional Referral Hospital, Ethiopia. The KIR and HLA-C genotyping was done using traditional polymerase chain reaction on genomic DNA extracted form maternal venous and cord blood followed by 2% agarose gel electrophoresis. RESULTS: The statistical associations between variables were evaluated using Pearson's Chi-square test. P < 0.05, with 95 % confidence interval was considered statistically significant. A significant association was observed between the KIR2DS1 and PE, with a higher frequency (60.5 %) of the gene in the control group. Similarly, a significant association was observed between KIR AA genotype and PE, with a higher frequency (38.2 %) of this genotype in the PE group. Ethiopians share the same risk genotype for PE as seen in previous African and European studies, namely homozygosity of a maternal KIR AA genotype. However, Ethiopians differ from other East African populations by sharing the same protective KIR2DS1 gene as Europeans

Clinical and Socio-demographic Profile of the First 33 COVID-19 Cases Treated at Dedicated Treatment Center in Ethiopia

BACKGROUND:Severe respiratory tract infection caused by family of Corona viruses has become world pandemic. The purpose of this study was to describe the first few COVID 19 cases in Ethiopia.METHOD: Descriptive study was conducted on the first 33 consecutive RT-PCR confirmed COVID 19 cases diagnosed and managed at Ekka-Kotebe COVID Treatment Center in Addis Ababa, Ethiopia.RESULT: The median age of the cases was 36 years. Cough, headache and fever were the most frequent symptoms. Diarrhea, sore throats, loss of taste and/or smell sensation were among the rare symptoms. Most (84.8%) had mild to moderate disease, and 15.2%(n=5) were critical at the time of admission. Among the five ICU admissions, four patients required invasive mechanical ventilation. Thirty cases were discharged after two pairs of nasopharyngeal and oropharyngeal samples turned negative for SARS CoV2. Three cases from the ICU died while on mechanical ventilator. The age of the two deaths was 65 years, and one was 60 years. With the exception of three, all cases were either imported from abroad or had contact with confirmed cases.CONCLUSION: Most of our patients were in the younger age group with male predominance and few with comorbidities. Cough was the commonest symptom followed by headache and fever. As it was in the early stage of the pandemic, observation of more cases in the future will reveal further clinical and demographic profiles of COVID-19 cases in Ethiopia

Sodium Stibogluconate (SSG) & Paromomycin Combination Compared to SSG for Visceral Leishmaniasis in East Africa: A Randomised Controlled Trial

Visceral leishmaniasis (VL) is a parasitic disease with about 500,000 new cases each year and is fatal if untreated. The current standard therapy involves long courses, has toxicity and there is evidence of increasing resistance. New and better treatment options are urgently needed. Recently, the antibiotic paromomycin (PM) was tested and registered in India to treat this disease, but the same dose of PM monotherapy evaluated and registered in India was not efficacious in Sudan. This article reports the results of a clinical trial to test the effectiveness of injectable PM either alone (in a higher dose) or in combination with sodium stibogluconate (SSG) against the standard SSG monotherapy treatment in four East African countries—Sudan, Kenya, Ethiopia and Uganda. The study showed that the combination of SSG &PM was as efficacious and safe as the standard SSG treatment, with the advantages of being cheaper and requiring only 17 days rather than 30 days of treatment. In March 2010, a WHO Expert Committee recommended the use of the SSG & PM combination as a first line treatment for VL in East Africa

Geographical Variation in the Response of Visceral Leishmaniasis to Paromomycin in East Africa: A Multicentre, Open-Label, Randomized Trial

Visceral leishmaniasis (VL) is a fatal parasitic disease with 500,000 new cases each year according to WHO estimates. New and better treatment options are urgently needed in disease endemic areas due to the long courses, toxicity and development of resistance to current treatments. Recently, the antibiotic paromomycin was tested and registered in India to treat this disease. The current study describes a clinical trial to test the effectiveness of injectable paromomycin, either alone or in combination with the standard drug sodium stibogluconate in three East African countries—Sudan, Kenya and Ethiopia. The study showed that at the same paromomycin dose that was successfully used and registered in India, a far poorer outcome was obtained, particularly in Sudan, suggesting that there are either differences in the patients ability to respond to the drug or in the susceptibility of parasites in East Africa compared with those in India. However, no major safety concerns were noted with the treatment. Further research was initiated to see if a higher dose of paromomycin would perform better, especially in Sudan. The results of this and the performance of the combination arm will be reported later. Our study highlights the importance of considering geographical differences to treatment responses

Safety and efficacy of single dose versus multiple doses of AmBisome for treatment of visceral leishmaniasis in eastern Africa: a randomised trial.

BACKGROUND: Anti-leishmanial drug regimens that include a single dose AmBisome could be suitable for eastern African patients with symptomatic visceral leishmaniasis (VL) but the appropriate single dose is unknown. METHODOLOGY: A multi-centre, open-label, non-inferiority, randomized controlled trial with an adaptive design, was conducted to compare the efficacy and safety of a single dose and multiple doses of AmBisome for the treatment of VL in eastern Africa. The primary efficacy endpoint was definitive cure (DC) at 6 months. Symptomatic patients with parasitologically-confirmed, non-severe VL, received a single dose of AmBisome 7.5 mg/kg body weight or multiple doses, 7 times 3 mg/kg on days 1-5, 14, and 21. If interim analyses, evaluated 30 days after the start of treatment following 40 or 80 patients, showed the single dose gave significantly poorer parasite clearance than multiple doses at the 5% significance level, the single dose was increased by 2·5 mg/kg. In a sub-set of patients, parasite clearance was measured by quantitative reverse transcriptase (qRT) PCR. PRINCIPAL FINDINGS: The trial was terminated after the third interim analysis because of low efficacy of both regimens. Based on the intention-to-treat population, DC was 85% (95%CI 73-93%), 40% (95%CI 19-64%), and 58% (95%CI 41-73%) in patients treated with multiple doses (n = 63), and single doses of 7·5 (n = 21) or 10 mg/kg (n = 40), respectively. qRT-PCR suggested superior parasite clearance with multiple doses as early as day 3. Safety data accorded with the drug label. CONCLUSIONS: The tested AmBisome regimens would not be suitable for VL treatment across eastern Africa. An optimal single dose regimen was not identified. TRIALS REGISTRATION: www.clinicaltrials.govNCT00832208