Development and evaluation of Indirect Hemagglutination Antibody Test (IHAT) for serological diagnosis and screening of bovine cysticercosis in Ethiopia

The study was conducted to develop and evaluate an Indirect Hemagglutination Antibody Test (IHAT) for the serological diagnosis of Cysticercus bovis in live animals. IHAT was set-up in-house and used to test serum samples of cattle against sheep red blood cell (SRBC) coated with crude extracts of C. bovis cyst. Serum samples for screening were collected from Addis Ababa abattoir (n=522), a dairy farm from the suburbs of Addis Ababa (n=101), and a traditional extensive farm (n=109). Postmortem inspection was conducted on a total of 522 animals slaughtered in Addis Ababa Abattoir, out of which 39 (7.5%) were positive for C. bovis.  Thirty-seven of these had viable C. bovis cysts. IHAT titres were determined from serially diluted sera, with a cut-off value set at a titre of 1:64. Cross reaction with other helminths was either absent or very low.  Sensitivity and specificity of the IHAT were 100% and at least 90%, respectively. Based on this test, 149 cattle (28.5%) from the Abattoir, 33 cattle (30.3%) from the extensive farm and 8 cattle (7.9%) from the dairy farm were positive for C. bovis. The difference in prevalence between the dairy farm and extensive farm was significant (

Modeling trends of health and health related indicators in Ethiopia (1995-2008): a time-series study

<p>Abstract</p> <p>Background</p> <p>The Federal Ministry of Health of Ethiopia has been publishing Health and Health related indicators of the country annually since 1987 E.C. These indicators have been of high importance in indicating the status of health in the country in those years. However, the trends/patterns of these indicators and the factors related to the trends have not yet been investigated in a systematic manner. In addition, there were minimal efforts to develop a model for predicting future values of Health and Health related indicators based on the current trend.</p> <p>Objectives</p> <p>The overall aim of this study was to analyze trends of and develop model for prediction of Health and Health related indicators. More specifically, it described the trends of Health and Health related indicators, identified determinants of mortality and morbidity indicators and developed model for predicting future values of MDG indicators.</p> <p>Methods</p> <p>This study was conducted on Health and Health related indicators of Ethiopia from the year 1987 E.C to 2000 E.C. Key indicators of Mortality and Morbidity, Health service coverage, Health systems resources, Demographic and socio-economic, and Risk factor indicators were extracted and analyzed. The trends in these indicators were established using trend analysis techniques. The determinants of the established trends were identified using ARIMA models in STATA. The trend-line equations were then used to predict future values of the indicators.</p> <p>Results</p> <p>Among the mortality indicators considered in this study, it was only Maternal Mortality Ratio that showed statistically significant decrement within the study period. The trends of Total Fertility Rate, physician per 100,000 population, skilled birth attendance and postnatal care coverage were found to have significant association with Maternal Mortality Ratio trend. There was a reversal of malaria parasite prevalence in 1999 E.C from <it>Plasmodium Falciparum </it>to <it>Plasmodium Vivax</it>. Based on the prediction from the current trend, the Millennium Development Goal target for under-five mortality rate and proportion of people having access to basic sanitation can be achieved.</p> <p>Conclusion</p> <p>The current trend indicates the need to accelerate the progress of the indicators to achieve MDGs at or before 2015, particularly for Maternal Health and access to safe water supply.</p

Cost-effectiveness analysis of clinical specialist outreach as compared to referral system in Ethiopia: an economic evaluation

BACKGROUND: In countries with scarce specialized Human resource for health, patients are usually referred. The other alternative has been mobilizing specialists, clinical specialist outreach. This study examines whether clinical specialist outreach is a cost effective way of using scarce health expertise to provide specialist care as compared to provision of such services through referral system in Ethiopia. METHODS: A cross-sectional study on four purposively selected regional hospitals and three central referral hospitals was conducted from Feb 4-24, 2009. The perspective of analysis was societal covering analytic horizon and time frame from 1 April 2007 to 31 Dec 2008. Data were collected using interview of specialists, project focal persons, patients and review of records. To ensure the propriety standards of evaluation, Ethical clearance was obtained from Jimma University. RESULTS: It was found that 532 patients were operated at outreach hospitals in 125 specialist days. The unit cost of surgical procedures was found to be ETB 4,499.43. On the other hand, if the 125 clinical specialist days were spent to serve patients referred from zonal and regional hospitals at central referral hospitals, 438 patients could have been served. And the unit cost of surgical procedures through referral would have been ETB 6,523.27 per patient. This makes clinical specialist outreach 1.45 times more cost effective way of using scarce clinical specialists' time as compared to referral system. CONCLUSION: Clinical specialist outreach is a cost effective and cost saving way of spending clinical specialists' time as compared to provision of similar services through referral system

Non-alcoholic fatty liver disease and associated factors among type 2 diabetic patients in southwest Ethiopia

Background: Non-alcoholic Fatty Liver Disease (NAFLD) among type 2 diabetic patients is completely ignored in developing regions like Africa paving the way for public health and economic burden in the region. Therefore, the main objective of this research was to evaluate non-alcoholic fatty liver disease and associatedfactors among type 2 diabetic patients in Southwestern Ethiopia attending Diabetic Clinic of Jimma University Specialized Hospital (JUSH).Methods: Facility based cross-sectional study design was used. Anthropometry, fatty liver (using utrasonography), liver enzymes, and lipid profiles were measured among type 2 diabetic patients who fulfilled the inclusion criteria. Socio-demographic and clinical characteristics were assessed using standard questionnaires.Results: Ninety-six (96) type 2 diabetic patients were enrolled and non-alcoholic fatty liver disease prevalence was 73%. Of nonalcoholic fatty Liver disease documented patients, 35.4%, 31.3% and 6.3% exhibited mild, moderate and severe fatty liver diseases, respectively. Alanine aminotransferase (p ≤0.001), Triacyglycerol (p ≤0.001), total bilirubin (p ≤0.05), direct bilirubin (p ≤0.05) and diabetic duration (p ≤0.01) were significantly associated with nonalcoholic fatty liver disease among type 2 diabetic patients. The Aspartate aminotransferase/ Alanine aminotransferase ratio among non alcoholic fatty liver disease patients was greater than one.Conclusions: The magnitude of non-alcoholic fatty liver disease is high among study groups and it needs urgent action by healthcare systems. Therefore, targeted treatment approach inclusive of non-alcoholic fatty liver disease should be designed.Keywords: Africa, Ethiopia, Nonalcoholic Fatty Liver Disease, Type 2 DM, Liver Enzymes, Lipid Profil

Effect of oral administration of Gnidia Stenophylla Gilg aqueous root extract on food intake and histology of gastrointestinal tract in mice

Background: Aqueous preparations of a medicinal plant, Gnidia stenophylla Gilg (Thymelaeaceae) are commonly used to cure malaria and other ailments in Ethiopia. This study evaluated the safety of the plant extract by determining its effects on food intake and histology of gastrointestinal tract (GIT) after oral administration for 13 weeks in albino mice.Methods: Thirty mice were equally assigned to three groups. Group I served as control and received a vehicle while groups II and III were given 400 and 800 mg/kg body weight/day plant extract respectively, orally, for 13 weeks. At the end of the study, the mice were scarified and postmortem gross and histopathological evaluations were performed on their stomachs and intestines.Results: Chronic oral treatment with the extract for 13 weeks did not induce any sign of illness and death and had no effect on food intake of the mice. Furthermore, extract treatment at both doses did not produce any detectable gross morphological change in GIT. Microscopic evaluation of sections of the stomach, duodenum and jejunum of the mice treated with 400 mg/kg body weight did not show any histopathological change. In the mice treated with 800 mg/kg body weight, however, the GIT sections revealed cytoplasmic vacuolation, hydropic degeneration and excessive erosion of the surface mucosal cells.Conclusion: The results of this study revealed that aqueous root extract of G. stenophylla at effective antimalarial dose is safe even when taken for a longer period in mice. At a higher dose, however, the extract may induce gastrointestinal irritation. Further studies on other vital organs and non-rodent species including humans are recommended.Keywords: Gnidia stenophylla Gilg, aqueous root extract, chronic toxicity, histology, histopathology, gastrointestinal tract, gastrointestinal irritation deficit, Ethiopi

SOME ASPECTS OF MALARIA PREVALENCE, VECTOR INFECTIVITY AND D DT RESIST AN CE STUDIES IN GAMBELIA REGION, SOUTHERN WESTERN ETHIOPIA

ABSTRACT: Prevalence of Plasmodium falciparum and Plasmodium vivax in thehuman population, infectivity and DDT resistance of Anopheles mosquitoes were studied on samples collected during the peak malaria season of 1990 from Gambella, South West Ethiopia. Mosquito vectors collected were assorted into species and their infectivity with malaria parasites was determined by the enzyme-linked immunosorbent assay (ELISA). In the human population out of a total of 821 individuals examined from nine villages, 4.1% (34) were found to be positive for malaria parasites. Of the 34 positive individuals 5.9% (2) were positive for Plasmodium vivax and 94.1 (32) for Plasmodium falciparum. Although relatively high positivity rates for malaria were observed in 1-4 and 5-14 age groups, the difference in the rates of positivity was not statistically significant for the whole population (P = 0.5077). However, a significant difference in parasite prevalence was detected between the nine localities (P &lt; 0.05). Compared to that of 1989, the overall malaria prevalence rate in the human population significantly decreased in 1990 (P &lt; 0.05). Insecticide susceptibility studies revealed the presence of DDT resistant Anopheles gambiae s.l. mosquitos in Itang. Furthermore, a strong evidence would suspect the vectorial status of A. pharoensis was obtained by detecting salivary gland sporozoite antigens of P. vivax in the head region of two mosquitos. Sporozoite rates of 0.76% (P. falciparum) for A. gambiae s.l. and 0.47% (P. vivax) for A. pharoensis were determined. [Ethiop. J. Health Dev. 1994;8(1):1-8

Hydrological Foundation as a Basis for a Holistic Environmental Flow Assessment of Tropical Highland Rivers in Ethiopia

The sustainable development of water resources includes retaining some amount of the natural flow regime in water bodies to protect and maintain aquatic ecosystem health and the human livelihoods and wellbeing dependent upon them. Although assessment of environmental flows is now occurring globally, limited studies have been carried out in the Ethiopian highlands, especially studies to understand flow-ecological response relationships. This paper establishes a hydrological foundation of Gumara River from an ecological perspective. The data analysis followed three steps: first, determination of the current flow regime flow indices and ecologically relevant flow regime; second, naturalization of the current flow regime looking at how flow regime is changing; and, finally, an initial exploration of flow linkages with ecological processes. Flow data of Gumara River from 1973 to 2018 are used for the analysis. Monthly low flow occurred from December to June; the lowest being in March, with a median flow of 4.0 m(3) s(-1). Monthly high flow occurred from July to November; the highest being in August, with a median flow of 236 m(3) s(-1). 1-Day low flows decreased from 1.55 m(3) s(-1) in 1973 to 0.16 m(3) s(-1) in 2018, and 90-Day (seasonal) low flow decreased from 4.9 m(3) s(-1) in 1973 to 2.04 m(3) s(-1) in 2018. The Mann-Kendall trend test indicated that the decrease in low flow was significant for both durations at alpha = 0.05. A similar trend is indicated for both durations of high flow. The decrease in both low flows and high flows is attributed to the expansion of pump irrigation by 29 km(2) and expansion of plantations, which resulted in an increase of NDVI from 0.25 in 2000 to 0.29 in 2019. In addition, an analysis of environmental flow components revealed that only four "large floods" appeared in the last 46 years; no "large flood" occurred after 1988. Lacking "large floods" which inundate floodplain wetlands has resulted in early disconnection of floodplain wetlands from the river and the lake; which has impacts on breeding and nursery habitat shrinkage for migratory fish species in Lake Tana. On the other hand, the extreme decrease in "low flow" components has impacts on pin smaller pools. These results serve as the hydrological foundation for continued studies in the Gumara catchment, with the eventual goal of quantifying environmental flow requirements.redators, reducing their mobility and ability to access prey concentrate

Multimorbidity from chronic conditions among adults in urban slums : the AWI-Gen Nairobi site study findings

Background: In the era of double burden of infectious and non-communicable diseases in sub-Saharan Africa, the burden of multimorbidity is likely to be common. However, there is limited evidence on the burden and its associated factors in the sub-Saharan African context. Objective: The aim of this study was to determine the levels and identify determinants of multimorbidity from chronic conditions in two urban slums in Nairobi. Methods: Data collected from 2003 study participants aged 40–60 years in two urban slums of the Nairobi Urban Health and Demographic Surveillance System in 2015 were used. Using self-report, anthropometry and key biomarkers, data on 16 conditions including chronic diseases, behavioral disorders and metabolic abnormalities were gathered. Lifetime multimorbidity defined by the occurrence of at least two chronic conditions in an individual at any time during their life course was computed. Factors associated with lifetime multimorbidity were identified using multiple logistic regression. Findings: A total of 2,081 chronic conditions were identified among 1,302 individuals. While 701 (35.0%) had no chronic condition, single morbidity was reported in 726 (36.2%) of the study population. The overall prevalence of lifetime multimorbidity was 28.7%. The prevalence of dyads and triads of simultaneous occurrences of conditions (episodic multimorbidity) was 20.8% and 6.1%, respectively. Single morbidity was positively associated with gender and alcohol consumption; and negatively associated with employment. Women, older people, the unemployed, current smokers and current alcohol consumers had higher levels of lifetime multimorbidity in the study population. Interpretation: The findings of this study indicate that a considerable proportion of adults living in urban slums experience multimorbidity from chronic conditions. Further studies with a better rigor to establish temporal associations between socio-demographic factors and the occurrence of chronic conditions are needed to explore the impacts and implications on health status and health system

Barriers, facilitators and motivators of electronic community health information system use among health workers in Ethiopia

BackgroundThe electronic community health information system (eCHIS) has been implemented in Ethiopia to support health services delivered by community health workers. Despite the many benefits of digitizing community health information systems, the implementation of the eCHIS is challenged by many barriers resulting in low uptake. This study assessed the barriers, facilitators, and motivators of eCHIS use among health workers with focus on health extension workers (HEWs) in Ethiopia.MethodsPhenomenological approach was used to assess the barriers, facilitators and motivators of eCHIS use in Amhara, Harari, Oromia, Sidama, South West Ethiopia and Southern Nation Nationalities and People's regions of Ethiopia. Data were collected from 15–29 May 2022. A total of 54 face-to-face in-depth interviews were conducted among HEWs, HEW supervisors, health information technicians and managers. The interviews were audiotaped using Open Data Kit, transcribed verbatim and translated into English. OpenCode 4.03 software was used for coding and categorizing the data. Thematic analysis was used to analyze the data.ResultsThe HEWs and other eCHIS users reported lack of infrastructure and resources; poor quality of training, follow-up, and supervision; parallel recording using the manual and electronic system; and HEWs' workload as barriers hindering eCHIS use. Data quality, retrievability, and traceability; tablet portability; encouragement from supervisors; and positive image in the community resulting from HEWs using tablets in their routine activities were the main facilitators of eCHIS use.ConclusionThe study identified various barriers that adversely affect the use of eCHIS. An integrated and coordinated approach to eCHIS implementation that encompasses removing the barriers, and reinforcing facilitators is required

Prevalence of human papillomavirus and Helicobacter pylori in esophageal and gastroesophageal junction cancer biopsies from a case-control study in Ethiopia

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