Trends of modern contraceptive use among young married women based on the 2000, 2005, and 2011 Ethiopian Demographic and Health Surveys: a multivariate decomposition analysis

Published: January 30, 2015Introduction: Accessing family planning can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is low but it is increasing. This study aimed to analyze the trends and determinants of changes in modern contraceptive use over time among young married women in Ethiopia. Methods: The study used data from the three Demographic Health Surveys conducted in Ethiopia, in 2000, 2005, and 2011. Young married women age 15–24 years with sample sizes of 2,157 in 2000, 1,904 in 2005, and 2,146 in 2011 were included. Logit-based decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 12 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance. Results: Among young married women, modern contraceptive prevalence increased from 6% in 2000 to 16% in 2005 and to 36% in 2011. The decomposition analysis indicated that 34% of the overall change in modern contraceptive use was due to difference in women’s characteristics. Changes in the composition of young women’s characteristics according to age, educational status, religion, couple concordance on family size, and fertility preference were the major sources of this increase. Two-thirds of the increase in modern contraceptive use was due to difference in coefficients. Most importantly, the increase was due to change in contraceptive use behavior among the rural population (33%) and among Orthodox Christians (16%) and Protestants (4%). Conclusions: Modern contraceptive use among young married women has showed a remarkable increase over the last decade in Ethiopia. Programmatic interventions targeting poor, younger (adolescent), illiterate, and Muslim women would help to maintain the increasing trend in modern contraceptive use.Abebaw Gebeyehu Worku, Gizachew Assefa Tessema, Atinkut Alamirrew Zelek

Yam breeding at IITA: achievements, challenges, and prospects

African food system Yam (Dioscorea spp.) is a multispecies, clonally propagated crop cultivated for its starchy tubers. About 10 species are widely cultivated around the world, but only D. rotundata, D. alata, and D. cayenensis are the most widely cultivated species in West Africa, accounting for 93% of the global yam production. Since inception, IITA R4D efforts have focused on developing new varieties of yam with desired agronomic and quality traits and to improve yam-based cropping systems

Prevalence, Reasons, and Perceived Effects of Khat Chewing Among Students of a College in Gondar Town, Northwestern Ethiopia: A Cross‑sectional Study

Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro‑intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution‑based cross‑sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two‑thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.Keywords: College, Effects, Gondar, Khat, Prevalence, Reason

Diabetic and Hypertensive Disorders Following Miscarriage: A Protocol for Systematic Review and Meta-Analysis

(1) Background: Miscarriages occur in approximately 15–25% of all pregnancies. There is limited evidence suggesting an association between history of miscarriage and the development of diabetic and hypertensive disorders in women. This systematic review aims to collate the existing literature and provide up to date epidemiological evidence on the topic. (2) Methods: We will search CINAHL Plus, Ovid/EMBASE, Ovid/MEDLINE, ProQuest, PubMed, Scopus, Web of Science, and Google Scholar, using a combination of medical subject headings, keywords, and search terms, for relevant articles related to the association between miscarriage and the risk of diabetic and hypertensive disorders. Cross-sectional, case–control, nested case–control, case–cohort, and cohort studies published from inception to April 2022 will be included in the search strategy. Three reviewers will independently screen studies and the risk of bias will be assessed using the Joanna Briggs Institute Critical Appraisal tool. Where the data permit, a meta-analysis will be conducted. (3) Results: The results of this systematic review will be submitted to a peer-reviewed journal for publication. (4) Conclusions: The findings of this systematic review will instigate efforts to manage and prevent reproductive, cardiovascular, and metabolic health consequences associated with miscarriages.Damien Foo, Jennifer Dunne, Gavin Pereira, Amanuel Gebremedhin, Bereket Duko, and Gizachew A. Tessem

A manual for large-scale sample collection, preservation, tracking, DNA extraction, and variety identification analysis

Several alternative options have been used for varietal identification. However most of the traditional methods have inherent uncertainty levels and estimates often have wide confidence intervals. In an attempt to circumvent traditional survey-based measurement errors in varietal identification, DNA-based varietal identification has been implemented in the Cassava Monitoring Survey (CMS) of Nigeria — a large adoption study involving 2500 cassava farming households. The DNA fingerprinting technique offers a reliable method to accurately identify varieties grown by farmers and increases accuracy and credibility in the interpretation of adoption rates and associated economic and policy analyses. Unlike phenotype-based methods, DNA is not affected by environmental conditions or plant growth stage and is more abundant than morphological descriptors. However, undertaking a credible DNA-based varietal identification is not a trivial matter because of the logistical challenges involving sample collection and tracking by a large team of field enumerators. This manual presents the detailed steps required for undertaking reliable DNA-fingerprinting-based identification of cassava varieties. In particular, the manual gives detailed information on the establishment of a sample tracking system, preparation of a readily available and cheap sample collection kit, field sample collection methodology, preparation of samples for DNA isolation, and development of a pipeline for variety identification analysis. This manual is part of the outputs of the CMS project funded by the CGIAR Research Program on Roots, Tubers and Bananas (RTB), the Bill & Melinda Gates Foundation, and the International Institute of Tropical Agriculture (IITA)

NbSe3: Effect of Uniaxial Stress on the Threshold Field and Fermiology

We have measured the effect of uniaxial stress on the threshold field ET for the motion of the upper CDW in NbSe3. ET exhibits a critical behavior, ET ~ (1 - e/ec)^g, wher e is the strain, and ec is about 2.6% and g ~ 1.2. This ecpression remains valid over more than two decades of ET, up to the highest fields of about 1.5keV/m. Neither g nor ec is very sensitive to the impurity concentraction. The CDW transition temperature Tp decreases linearly with e at a rate dTp/de = -10K/%, and it does not show any anomaly near ec. Shubnikov de-Haas measurements show that the extremal area of the Fermi surface decreases with increasing strain. The results suggest that there is an intimate relationship between pinning of the upper CDW and the Fermiology of NbSe3.Comment: 4 pages, 5 figure

A robust SNP barcode for typing Mycobacterium tuberculosis complex strains

Strain-specific genomic diversity in the Mycobacterium tuberculosis complex (MTBC) is an important factor in pathogenesis that may affect virulence, transmissibility, host response and emergence of drug resistance. Several systems have been proposed to classify MTBC strains into distinct lineages and families. Here, we investigate single-nucleotide polymorphisms (SNPs) as robust (stable) markers of genetic variation for phylogenetic analysis. We identify ~92k SNP across a global collection of 1,601 genomes. The SNP-based phylogeny is consistent with the gold-standard regions of difference (RD) classification system. Of the ~7k strain-specific SNPs identified, 62 markers are proposed to discriminate known circulating strains. This SNP-based barcode is the first to cover all main lineages, and classifies a greater number of sublineages than current alternatives. It may be used to classify clinical isolates to evaluate tools to control the disease, including therapeutics and vaccines whose effectiveness may vary by strain type

Differential Epigenetic Regulation of TOX Subfamily High Mobility Group Box Genes in Lung and Breast Cancers

Aberrant cytosine methylation affects regulation of hundreds of genes during cancer development. In this study, a novel aberrantly hypermethylated CpG island in cancer was discovered within the TOX2 promoter. TOX2 was unmethylated in normal cells but 28% lung (n = 190) and 23% breast (n = 80) tumors were methylated. Expression of two novel TOX2 transcripts identified was significantly reduced in primary lung tumors than distant normal lung (p<0.05). These transcripts were silenced in methylated lung and breast cancer cells and 5-Aza-2-deoxycytidine treatment re-expressed both. Extension of these assays to TOX, TOX3, and TOX4 genes that share similar genomic structure and protein homology with TOX2 revealed distinct methylation profiles by smoking status, histology, and cancer type. TOX was almost exclusively methylated in breast (43%) than lung (5%) cancer, whereas TOX3 was frequently methylated in lung (58%) than breast (30%) tumors. TOX4 was unmethylated in all samples and showed the highest expression in normal lung. Compared to TOX4, expression of TOX, TOX2 and TOX3 in normal lung was 25, 44, and 88% lower, respectively, supporting the premise that reduced promoter activity confers increased susceptibility to methylation during lung carcinogenesis. Genome-wide assays revealed that siRNA-mediated TOX2 knockdown modulated multiple pathways while TOX3 inactivation targeted neuronal development and function. Although these knockdowns did not result in further phenotypic changes of lung cancer cells in vitro, the impact on tissue remodeling, inflammatory response, and cell differentiation pathways suggest a potential role for TOX2 in modulating tumor microenvironment

Health gains and fi nancial risk protection aff orded by public fi nancing of selected interventions in Ethiopia: an extended cost-eff ectiveness analysis

Background The way in which a government chooses to fi nance a health intervention can aff ect the uptake of health interventions and consequently the extent of health gains. In addition to health gains, some policies such as public fi nance can insure against catastrophic health expenditures. We aimed to evaluate the health and fi nancial risk protection benefi ts of selected interventions that could be publicly fi nanced by the government of Ethiopia. Methods We used extended cost-eff ectiveness analysis to assess the health gains (deaths averted) and fi nancial risk protection aff orded (cases of poverty averted) by a bundle of nine (among many other) interventions that the Government of Ethiopia aims to make universally available. These nine interventions were measles vaccination, rotavirus vaccination, pneumococcal conjugate vaccination, diarrhoea treatment, malaria treatment, pneumonia treatment, caesarean section surgery, hypertension treatment, and tuberculosis treatment. Findings Our analysis shows that, per dollar spent by the Ethiopian Government, the interventions that avert the most deaths are measles vaccination (367 deaths averted per $100 000 spent), pneumococcal conjugate vaccination (170 deaths averted per$100 000 spent), and caesarean section surgery (141 deaths averted per $100 000 spent). The interventions that avert the most cases of poverty are caesarean section surgery (98 cases averted per$100 000 spent), tuberculosis treatment (96 cases averted per $100 000 spent), and hypertension treatment (84 cases averted per$100 000 spent). Interpretation Our approach incorporates fi nancial risk protection into the economic evaluation of health interventions and therefore provides information about the effi ciency of attainment of both major objectives of a health system: improved health and fi nancial risk protection. One intervention might rank higher on one or both metrics than another, which shows how intervention choice—the selection of a pathway to universal health coverage—might involve weighing up of sometimes competing objectives. This understanding can help policy makers to select interventions to target specifi c policy goals (ie, improved health or fi nancial risk protection). It is especially relevant for the design and sequencing of universal health coverage to meet the needs of poor populations