Simple learning tools to improve clinical laboratory practical skills training

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Factors associated with compliance of prenatal iron folate supplementation among women in Mecha district, Western Amhara: A cross-sectional study

Introduction: Iron and folate supplementation can effectively control and prevent anaemia in pregnancy. In Ethiopia, all pregnant women are prescribed iron folate during their ANC visit. However, limited adherence is thought to be a major reason for the low effectiveness of iron supplementation programs. Therefore this study was done to investigate factors associated with compliance of prenatal iron folate supplementation among women who gave birth in the last 12 months before the survey in Mecha district.Methods: Community based cross sectional study design was employed in Mecha district from June 25 - July 15/2013. A sample of 634 women who gave birth 12 months before the survey was included in the study. Study participants were selected by systematic random sampling technique after allocating the total sample to each kebele proportionally. Data were  collected using a pre-tested structured Amharic questionnaire. Collected data were edited, coded and entered to Epi info version 3.1 and exported to` SPSS version 16. Bivariate and multivariable analysis was computed. Results: A total of 628 women who gave birth twelve months before the survey were enrolled. In this study only 20.4% of participants were  compliant with iron foliate supplementation. In multivariable analysis, age of the mother, educational status of the mother, knowledge of anaemia and iron folate tablets, and history of anaemia during pregnancy were  significantly associated with compliance to iron folate supplementation (P < .05). Belief that too many tablets would harm the baby and fear of side effects were the major reasons given for noncompliance.Conclusion: Compliance to iron folate supplementation is very low in the study area. Increasing female education and increasing knowledge of women about anaemia and iron folate tablets are recommended to  increase compliance to iron folate supplementation

Assessment of laboratory logistics management information system practice for HIV/AIDS and tuberculosis laboratory commodities in selected public health facilities in Addis Ababa, Ethiopia

Introduction: Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods: A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results: There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion: Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures were recommended.Key words: Logistics management information system, stock outs, laboratory commoditie

Automated EKG Annotation with Neural Networks

We have developed two automated systems using 11,810 physician-annotated single lead EKG signals. A focused tap delay line multilayer neural network followed by a threshold detection module is used to develop the QRS detection system. Approximately, a miss rate of 5.6%, false detection rate of 5.5%, error rate of 0.049%, and relative error rate of 10.6% is observed with a precision of 10 ms. With this same precision, the Pan and Tompkins QRS detection algorithm is tested on these sequences and encountered 20.3% of false detection rate, 19.8% of miss rate, 0.2\% error rate, and 33.4% of relative error rate. For a precision of 167 ms, the neural network has only 55% of the error made by the Pan and Tompkins QRS detection algorithm. The beat classification system uses the correctly detected beats along with the physician indication of normal and abnormal for the beat as an input for the multilayer neural network. The training and validation error for this system is 24.7% error rate, 24% false detection rate and miss rate. The inconsistency in the physician annotation has a significant effect on these systems. Sixty percent of the error in the QRS detection system is due to the inconsistency. About 41.4% of the false negative and 30.5% of the false positive errors of the beat classification system are also due to this inconsistency. A more accurate data set will augment the performance of these systems.Electrical Engineerin

Magnitude and determinants of stunting in children underfive years of age in food surplus region of Ethiopia: The case of West Gojam Zone

Background: Child malnutrition is a major public health problem in Ethiopia. Surprisingly, the highest level of stunting is found in food surplus areas of the country. Objective: To identify the determinants of stunting in food surplus areas of West Gojam Zone. Method: A community based cross-sectional survey was conducted on 622 mother-child pairs of 0-59 month old children in Mecha and Wenberma Woredas of West Gojam Zone, Northern Ethiopia between May and June 2006. The study investigated the differential impact of demographic and socio-economic factors, health related factors and dietary factors on stunting among under-five children. Both bivariate analysis and multivariate analysis (logistic regression model) were used to identify the determinants of under-five stunting. Results: The analyses revealed that 43.2 (12.0-17.6) 95% CI percent of the children under age five were suffering from chronic malnutrition, 14.8 (39.3-47.1) 95% CI percent were acutely malnourished and 49.2 (45.3-53.1) 95% CI percent were found to be under-weight. The main contributing factors for under-five stunting were found to be sex of the child, child’s age, diarrhea episode, deprivation of colostrum, duration of breastfeeding, pre-lacteal feeds, type of food, age of introduction of complementary feeding and method of feeding. Conclusion: The findings of this study led to the realization that inappropriate feeding practice is the principal risk factor which brought about nutritional deprivation among under-five children in food surplus areas of Ethiopia. Thus, the importance of appropriate feeding during infancy and childhood cannot be overstated even in food surplus areas. The high prevalence of malnutrition in the study area points out the need to revisit the impression held by many people that malnutrition is not a problem in food surplus areas. Development and implementation of preventive policies aimed at addressing child malnutrition should also consider food surplus areas of the country. [Ethiop. J. Health Dev. 2009;23(2):98-106

Oral health awareness, practices and status of patients with diabetes attending a tertiary health institution in Nigeria

Background: Despite the reported increasing prevalence of diabetes mellitus, very few studies have documented report on oral health awareness and oral health conditions of individuals with diabetes mellitus from our environment. Thus this study aimed at assessing the oral health awareness, practices and status of individuals with diabetes mellitus attending a tertiary health facility in Nigeria.Methods: A cross sectional survey of 143 patients with diabetes attending the medical outpatients' clinic of the hospital. Information was obtained from participants using pretested structured questionnaires and oral examination. Tests of associations were determined using Chi-square and student t test.Results: One-fifth (20.3%) of the respondents were aware of good oral health preventing oral diseases in diabetes. Thirty-five (24.5%) knew that diabetes could worsen oral health condition and only 3 (2.1%) could correctly explain the association between diabetes and oral health conditions. Forty-three (30.1%) had participated in an oral health education program focused on diabetes and oral health. The majority (88.6%) had calculus accumulation while none had a healthy periodontium.Conclusion: Oral health awareness, practices and status of patients with diabetes were poor in our environment. Thus, these individuals need to be better informed of the relationship between oral health and diabetes.Keywords: Oral disease; diabetes; awareness; oral health educatio

Salivary Secretion and Composition in Malaria: A Case-control Study

Summary: No previous studies have documented changes in salivary secretion in patients with malaria. This study aimed to compare salivary secretion and composition in malaria positive and malaria negative individuals. Ninety participants composed of 40 malaria parasite positive and 50 malaria parasite negative individuals (age and gender matched) were included. Malaria diagnosis was achieved by microscopic examination of Giemsa stained thick and thin film of blood smears. A self-administered questionnaire was used to assess presence or absence of oral symptoms in the malaria parasite positive individuals. Whole saliva samples were collected and analyzed for flow rate, pH, total protein and concentrations of electrolytes (K+, Na+, Ca2+, Cl-, PO42- and HCO32-). Data were analysed using Independent-Samples t-test and Spearman’s correlation test. The salivary flow rate was significantly reduced in malaria parasite positive individuals (P = 0.001). Oral symptoms were present in 82.5% of the malaria parasite positive individuals. There was no significant difference in the salivary pH, total protein and electrolyte ion concentrations between the two groups. Also, Spearman’s correlation test showed no significant relationship between the presence of oral symptom and the salivary parameters. Salivary flow rates are reduced in the individuals with malaria. However, presence of oral symptoms in these individuals may not be attributed to the reduced salivary flow rate. Further studies are needed to validate our findings and elucidate mechanisms involved.Keywords: Saliva, Malaria, Salivary flow rate, Salivary electrolytes, Salivary pH, Salivary total protein

The Grand Ethiopian Renaissance Dam: Source of Cooperation or Contention?

This paper discusses the challenges and benefits of the Grand Ethiopian Renaissance Dam (GERD), which is under construction and expected to be operational on the Blue Nile River in Ethiopia in a few years. Like many large-scale projects on transboundary rivers, the GERD has been criticized for potentially jeopardizing downstream water security and livelihoods through upstream unilateral decision making. In spite of the contentious nature of the project, the authors argue that this project can provide substantial benefits for regional development. The GERD, like any major river infrastructure project, will undeniably bring about social, environmental, and economic change, and in this unique case has, on balance, the potential to achieve success on all fronts. It must be stressed, however, that strong partnerships between riparian countries are essential. National success is contingent on regional cooperation

Larvicidal effects of Jatropha curcas L. against Anopheles arabiensis (Diptera: Culicidea)

Crude and column chromatographic fractions of methanol leaf extract of Jatropha curcas were tested for their larvicidal activities against laboratory reared late third instar larvae of Anopheles arabiensis. Crude methanol leaf extract of J .curcas had similar larvicidal activity to 0.5 ppm Temephos (positive control) at test concentrations ranging from 125 -1000 ppm while column chromatographic fractions (F1 and F2 ) of the crude methanol leaf extract of J.curcas showed similar larvicidal activities to 0.5 ppm Temephos at 62.5 and 125 ppm test concentrations. Column chromatographic fraction three (F3) showed similar larvicidal activity to 0.5 ppm Temephos at 125 ppm test concentration. The LC50 and LC90 values of crude methanol leaf extract of J.curcas were found to be 92.09 and 241.09 ppm, respectively. Toxic activities of column chromatographic fraction one (F1) (LC50=28.65 ppm; LC90 = 49.20 ppm) were nearly equal to that of column chromatographic fraction two [F2] (LC50= 30.40 ppm; LC90 = 49.80 ppm). Least toxicity on the test larvae was observed by column chromatographic fraction three [F3] (LC50 = 80.70 ppm; LC90 = 123.70 ppm). Thus, the larvicidal activity of crude methanol leaf extract was not due to the synergistic effects of its fractions. Further studies are recommended to identify larvicidal active ingredients from the active column chromatographic fractions of crude methanol leaf extract of J. curcas. Key words: Malaria vector control, Anopheles arabiensis, Botanical larvicides J. curca