Risky Sexual Behavior and Associated Factors Among High School Students in Gondar City, Northwest Ethiopia

According to World Health Organization (WHO), youth are young people within 15-24 years old. Studies reported that more than half of all new HIV infections occur among people between the ages of 15 and 24 years. Institution based quantitative cross-sectional study was conducted among high school students in Gondar city. Multistage sampling technique was employed to recruit study participants. Data were collected using pretested structured self-administered questionnaire. Data were entered in Epi Info version 7 and analyzed using SPSS version 21. Descriptive statistics were computed to describe important variables in relation to the outcome variable, Binary and multivariable logistic regressions were used to identify independent predictors of the outcome variable. The overall prevalence of risky sexual behavior was 12.8%. Two out of five sexually active respondents ever had unprotected sexual intercourse. Ever used alcohol ((AOR, 3.53 95% CI (1.73-7.19)), had no parental monitor (AOR, 12.21 95% CI (6.55-22.78), ever watched pornographic film (AOR, 2.24 95% CI (1.15-4.35), had no parental discussion on sexual and reproductive health issues (AOR, 2.57 95% CI (1.36-4.85) and peer pressure (AOR,2.50, 95%CI (1.20-5.21), were factors which significantly increases the odds of risky sexual behavior among youth. Risky sexual behavior among high school students in Gondar city administration was very high and worrisome; so that collaborated effort is needed from parents, schools, health facilities and health policy makers to bring healthy sexual behavior among school youth

Removal of lead(II) ions from aqueous solutions using activated carbon from Militia ferruginea plant leaves

The adsorption of lead(II) on to activated carbon developed from an indigenous Ethiopian medicinal plant leaves namely Birbira (Militia ferruginea) was investigated to assess the possible use of this adsorbent. The influences of contact time, adsorbent dose, Pb(II) concentration, pH and temperature on adsorption were investigated. The maximum adsorption took place at 3 h. at a dose of 4.0 g of adsorbent, and 97.3 % of Pb2+ adsorption at pH of 4.0. The amount of lead ion adsorbed per gram of the adsorbent increased with decreasing concentration of Pb2+. The percentage of adsorption had increased with the increasing temperature. The positive value of ∆H indicated that the adsorption of lead ions on the adsorbent was an endothermic process. The values of free energy (∆G) were negative as expected for a spontaneous process. The decrease in ∆G value with increasing temperature revealed that adsorption of the ion on the adsorbent became favorable at a higher temperature. The calculated value of ∆H was 25.05 kJ mol–1, ∆S was 135.48 JK-1 mol-1 and ∆G was also calculated for each temperature. The two theoretical adsorption isotherms, namely, Langmuir and Freundlich were used to describe the experimental results. The Freundlich adsorption isotherm best fits and adsorption capacity was calculated to be 3.3 mg of Pb(II) per g of adsorbent. The adsorption followed the first order kinetics and was found to be pH dependent being maximum at pH 4.0. The pH effect and desorption studies showed that ion exchange mechanism might be involved in the adsorption process. Reuse of the desorbed bio-adsorbent is possible. The effect of foreign ions on the removal of Pb(II) has been investigated. The removal of Pb(II) from industrial wastewater sample was also tested and showed that more than 97 % removal was possible. The results showed that activated carbon prepared from Birbira (Militia ferruginea) leaves could be used for the removal of Pb(II) from wastewater. KEY WORDS: Industrial wastewater, Lead removal, Adsorbent, Militia ferruginea  Bull. Chem. Soc. Ethiop. 2008, 22(3), 349-360

Disentangling the electronic and phononic glue in a high-Tc superconductor

Unveiling the nature of the bosonic excitations that mediate the formation of Cooper pairs is a key issue for understanding unconventional superconductivity. A fundamen- tal step toward this goal would be to identify the relative weight of the electronic and phononic contributions to the overall frequency (\Omega) dependent bosonic function, \Pi(\Omega). We perform optical spectroscopy on Bi2212 crystals with simultaneous time- and frequency-resolution; this technique allows us to disentangle the electronic and phononic contributions by their different temporal evolution. The strength of the interaction ({\lambda}~1.1) with the electronic excitations and their spectral distribution fully account for the high critical temperature of the superconducting phase transition.Comment: 9 pages, 4 figure

Adjuvant therapy with minocycline for schizophrenia (The MINOS Trial): study protocol for a double-blind randomized placebo-controlled trial

Background: Schizophrenia is understood to be a heterogeneous brain condition with overlapping symptom dimensions. The negative symptom dimension, with its protean cognitive manifestations, responds poorly to treatment, which can be a particular challenge in countries where clozapine therapy is not available. Preliminary data indicate that minocycline may be beneficial adjunct in the treatment of schizophrenia: positive, negative, and cognitive symptoms. In this study we aim to assess the efficacy of adjunctive minocycline to alleviate symptoms of schizophrenia in patients who have failed to respond to a therapeutic trial of antipsychotic medications. Methods: The study is a parallel group, double-blind, randomized, placebo-controlled trial. Participants will be adults (aged 18 years and above) with first episode or relapse episode of schizophrenia of under 5 years’ duration. Patients who failed to show adequate therapeutic response to at least one antipsychotic medication given for a minimum of 4 weeks will be recruited from a psychiatry hospital in Addis Ababa and a psychiatry clinic in Butajira, Ethiopia. A total of 150 participants (75 in each arm) will be required to detect a five-point mean difference between the intervention arms adjusting for baseline symptom severity, at 90% power and 95% confidence. Patients in the intervention arm will receive minocycline (200 mg/day orally) added on to the regular antipsychotic medications participants are already on. Those in the placebo arm will receive an inactive compound identical in physical appearance to minocycline. Intervention will be offered for 12 weeks. Diagnosis will be established using the operational criteria for research (OPCRIT). Primary outcome measure will be a change in symptom severity measured using the positive and the negative syndrome scale for schizophrenia (PANSS). Secondary outcome measures will include changes in severity of negative symptoms, proportion achieving remission, and level of functioning. Whether changes are maintained post intervention will also be measured (PANSS). Key assessment for the primary outcome will be conducted at the end of trial (week 12). One post-intervention assessment will be conducted 4 weeks after the end of intervention (week 16) to determine sustainability of change. Trial registration Clinicaltrials.gov identifier: NCT01809158

Challenges and opportunities for implementing integrated mental health care: a district level situation analysis from five low- and middle-income countries.

BACKGROUND: Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform development and implementation of a comprehensive district plan to integrate mental health into primary care. METHODS: A situation analysis tool was developed for the study, drawing on existing tools and expert consensus. Cross-sectional information obtained was largely in the public domain in all five districts. RESULTS: The PRIME study districts face substantial contextual and health system challenges many of which are common across sites. Reliable information on existing treatment coverage for mental disorders was unavailable. Particularly in the low-income countries, many health service organisational requirements for mental health care were absent, including specialist mental health professionals to support the service and reliable supplies of medication. Across all sites, community mental health literacy was low and there were no models of multi-sectoral working or collaborations with traditional or religious healers. Nonetheless health system opportunities were apparent. In each district there was potential to apply existing models of care for tuberculosis and HIV or non-communicable disorders, which have established mechanisms for detection of drop-out from care, outreach and adherence support. The extensive networks of community-based health workers and volunteers in most districts provide further opportunities to expand mental health care. CONCLUSIONS: The low level of baseline health system preparedness across sites underlines that interventions at the levels of health care organisation, health facility and community will all be essential for sustainable delivery of quality mental health care integrated into primary care

Problematic khat use as a possible risk factor for harmful use of other psychoactive substances: a mixed method study in Ethiopia

Background: Substance use disorders along with neuropsychiatric disorders contributed about 14% of the global burden of disease. Harmful alcohol use, is a known contributor for many harms (accidents, suicide, violence, and complication of other psychiatric and medical disorders). In the Western countries, alcohol and nicotine are gateway drugs to cannabis use, and cannabis use is a risky behavior for other illicit drugs such as cocaine and heroin. Khat use is another psychoactive substance which is common in East African and Arabian Peninsula. But there is a knowledge gap regarding the position of khat use or problematic khat use in sequential progression of different psychoactive substances. Therefore, we aimed to understand and investigate the relationship of problematic khat use and other psychoactive substances in Ethiopia. Methods: Exploratory mixed methods study was employed. Quantitative cross sectional survey was done among 102 khat users, and 4 focus group discussions and 11 in-depth interviews were conducted to understand the pathways between khat use and other psychoactive substances use in 2014. Non random sampling (purposive and snowballing) was employed for both quantitative and qualitative studies. Khat users from khat cafeterias, shops, and from other open markets of khat in Addis Ababa were invited to participate. Result: Currently significant majorities of khat users (86.3%) used at least one other psychoactive substance after they started khat use. The prevalence of harmful drinking was 53.9% among khat users. Problematic khat use was a significant predictor of harmful drinking (p<0.05). About one from ten respondents engaged to risky sexual behavior pushed by the effect of khat after chewing. Conclusion: The proportion of psychoactive substances use especially harmful drinking among khat users was observed higher compared to other cross sectional surveys conducted among general population. In Ethiopia, intervention and policy on harmful alcohol use could consider problematic khat use as one possible risky factor. A rigorous methodology which could test gateway hypothesis

Five-year mortality in a cohort of people with schizophrenia in Ethiopia

<p>Abstract</p> <p>Background</p> <p>Schizophrenia is associated with a two to three fold excess mortality. Both natural and unnatural causes were reported. However, there is dearth of evidence from low and middle income (LAMIC) countries, particularly in Africa. To our knowledge this is the first community based report from Africa.</p> <p>Methods</p> <p>We followed a cohort of 307 (82.1% males) patients with schizophrenia for five years in Butajira, rural Ethiopia. Mortality was recorded using broad rating schedule as well as verbal autopsy. Standardized Mortality Ratio (SMR) was calculated using the mortality in the demographic and surveillance site as a reference.</p> <p>Result</p> <p>Thirty eight (12.4%) patients, 34 men (11.1%) and 4 women (1.3%), died during the five-year follow up period. The mean age (SD) of the deceased for both sexes was 35 (7.35). The difference was not statistically significant (p = 0.69). It was 35.3 (7.4) for men and 32.3 (6.8) for women. The most common cause of death was infection, 18/38 (47.4%) followed by severe malnutrition, 5/38 (13.2%) and suicide 4/38 (10.5%). The overall SMR was 5.98 (95% CI = 4.09 to7.87). Rural residents had lower mortality with adjusted hazard ratio (HR) of 0.30 (95% CI = 0.12-0.69) but insidious onset and antipsychotic treatment for less than 50% of the follow up period were associated with higher mortality, adjusted HR 2.37 (95% CI = 1.04-5. 41) and 2.66(1.054-6.72) respectively.</p> <p>Conclusion</p> <p>The alarmingly high mortality observed in this patient population is of major concern. Most patients died from potentially treatable conditions. Improving medical and psychiatric care as well as provision of basic needs is recommended.</p