Assessment of antiretroviral treatment outcome in public hospitals, South Nations Nationalities and Peoples Region, Ethiopia

Background: The outcome of antiretroviral treatment, survival patterns and associated determining factors in public hospitals are not well known. Thus a longitudinal study is vital to understand the pattern of survival and treatment outcome.Objective: To assess the outcome of antiretroviral treatment in rural public hospitals in South Nations, Nationalities and Peoples Region, Ethiopia.Method: A historical retrospective cohort study design was used for patients visiting hospitals from January 1, 2005 to January 31, 2009. A total of 5,664 patient records were examined from eight randomly selected public hospitals. Kaplan-Meier models were used to estimate mortality and Cox proportional hazards models to identify predictors of mortality.Results: The median age was 30 years and 73.6% were in the age group 25-40 while the higher HIV risk age group 14-24 covered only 12.8%. The proportion of females was 56.3%. The cumulative proportions of survivals were 92%, 90%, 88% and 86% at months 6, 12, 24 and 36 respectively. The hazard of death was higher in male (AHR: 1.632, CI: 1.309-2.034) and those who had a baseline CD4 cell count < 50 cells /ml compared to these with a count of above 200 (AHR: 3.176, CI: 2.304- 4.434). Patients with WHO stage IV at baseline had a higher risk of death compared to these with a WHO stage I (AHR: 5.603, CI: 1.753-17.905).Conclusions: There is an indication of improvement of survival in the patient population. An advanced disease stage, Low CD4 cell count, gender and timing of ARV regimen combinations had significant contribution in determining a longer survival time. Priority should thus be given to identify HIV-infected individuals and start ART earlier in the course of their illness. [Ethiop. J. Health Dev. 2011;25(2):102-109

Spatiotemporal analysis of droughts using self-calibrating Palmer’s Drought Severity Index in the central region of South Africa

Published ArticleThe loss of life and property from drought events has forced society to focus on the development of reliable early warning systems which may enable farmers and other stakeholders to correctly and timely adapt to the expected impacts of climatic hazard. However, a scientific approach to a reliable early warning system for a region requires, among others, characterisation of drought events in the region in terms of duration, magnitude, intensity and frequency using standard drought indices. Therefore, the objective of this study was to identify and characterise drought events in the Modder River basin, central region of South Africa, using a self-calibrated Palmer’s Drought Severity Index (sc-PDSI). Attempts were also made to establish a relationship between meteorological and hydrological drought events in the region. During the period of analysis, the total number of drought episodes identified in the study area ranged between eight and sixteen. It was found that the most severe drought episodes occurred during the period 1992–1995 followed by the period 1982–1987. Results of analysis of seasonal drought events in one of the quaternary catchments (C52A) revealed that peak drought events during the three summer months (November, December and January) occurred in the area in 1993. However, in terms of event magnitude and intensity, the worst drought events were recorded during the period December 1982–July 1987, followed by the event that ensued during December 1989–September 1995. Results of analysis of decadal variation of drought events showed that the number of extreme and moderate drought events recorded in the catchment showed statistically significant increasing trends during the five decades at 5 % significance level. Moreover, spectral analysis of sc-PDSI time series in the region identified periodicities in the time series ranging from 6 years (C52E) to 16 years (C52K). In terms of the spatial extent of extreme drought events, the maximum areal coverage (91 %) was recorded in November 1998, followed by December 1998 and December–January 1999 (43 %). Analysis of the relative frequency of droughts of varying categories revealed that extreme drought events were most prevalent in the C52E (2.72 %) quaternary catchment, followed by C52C (2.21 %). The study also found an average lag time of 10 months between the onsets of meteorological and hydrological drought events in the region

Quadrature Rules on Triangles and Tetrahedra for Multidimensional Summation-By-Parts Operators

Multidimensional diagonal-norm summation-by-parts (SBP) operators with collocated volume and facet nodes, known as diagonal-$\mathsf{E}$ operators, are attractive for entropy-stable discretizations from an efficiency standpoint. However, there is a limited number of such operators, and those currently in existence often have a relatively high node count for a given polynomial order due to a scarcity of suitable quadrature rules. We present several new symmetric positive-weight quadrature rules on triangles and tetrahedra that are suitable for construction of diagonal-$\mathsf{E}$ SBP operators. For triangles, quadrature rules of degree one through twenty with facet nodes that correspond to the Legendre-Gauss-Lobatto (LGL) and Legendre-Gauss (LG) quadrature rules are derived. For tetrahedra, quadrature rules of degree one through ten are presented along with the corresponding facet quadrature rules. All of the quadrature rules are provided in a supplementary data repository. The quadrature rules are used to construct novel SBP diagonal-$\mathsf{E}$ operators, whose accuracy and maximum timestep restrictions are studied numerically.Comment: 11 pages, 1 figur

Oat-field pea intercropping for sustainable oat production: effect on yield, nutritive value and environmental impact

The aim of the study is to evaluate the effect of Oat–field pea intercropping on the yield, nutritive value, and environmental impact of oat grown under a reduced level of nitrogen fertilisation. The trial was laid out in a randomized complete block design with the following treatments: oat-0 (oat (Avena sativa L., SRCP X 80 Ab 2291 variety) without N fertilization (urea)), oat-23 (oat fertilised with 23 kg N/ha), oat-46 (oat fertilised with 46 kg N/ha), O1P1 (oat intercropped with field pea (Pisum sativum L., local variety) a ratio of 1:1), O1P2 (oat intercropped with field pea a ratio of 1:2), and O2P1 (oat intercropped with field pea at a ratio of 2:1). All of the experimental plots received standard husbandry practices except for nitrogen fertilisation. Soil pH, organic matter, total nitrogen, available phosphorus, and organic carbon were determined before and after planting. The effect of nitrogen fertilization and intercropping of oat with field pea on carbon footprint, acidification footprint, eutrophication footprint, and human toxicity footprint was calculated for each plot. Oat-0 significantly reduced the total nitrogen content of the soil, while there was no significant effect of the other treatments. O2P1 significantly out-yielded all control groups; however, it was not significantly different from fertilisation treatments. Intercropping with field pea did not significantly increase the cost of production of dry matter, crude protein, or dry matter digestibility compared to control groups. Intercropping with field pea significantly reduced the carbon footprint, acidification, eutrophication, and human toxicity footprint compared to the control groups. Therefore, oat–field pea intercrops are recommended for the production of high-quality forage at low N input with reduced environmental impact

Knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital, southwest Ethiopia

<p>Abstract</p> <p>Background</p> <p>In Ethiopia maternal mortality rate is very high more than one in five women die from pregnancy or pregnancy related causes. The use of contraceptives to prevent unwanted pregnancies and unsafe abortion is an important strategy to minimize maternal mortality rate. Among various forms of contraception, emergency contraceptives are the only one that can be used after sexual intercourse offering chance to prevent unwanted pregnancy. The aim of this study was to assess the knowledge, attitude and practice of emergency contraceptive among women who seek abortion care at Jimma University specialized hospital (JUSH).</p> <p>Methods</p> <p>Institution base cross-sectional study on knowledge, attitude and practice of emergency contraceptive was conducted at JUSH from April to June, 2011Data was collected using structured questionnaire and analyzed using SPSS version 17.0.</p> <p>Results</p> <p>In this study 89 women were interviewed. More than half of them (48) were from urban area and 41 were from rural area.46 (51.7%) of them were single. Of all the respondents only nine women had awareness about emergency contraceptive. Seven of the women mentioned pills as emergency contraception and only two of them mentioned both pills and injectable as emergency contraception. All of them have positive attitude towards emergency contraception but none of them have ever used emergency contraceptives.</p> <p>Conclusion and recommendation</p> <p>The finding revealed pregnancy among women of 15-19 years was very common. The knowledge and practice of emergency contraception is very low. But there is high positive attitude towards emergency contraceptives. Since there is much deficit on knowledge of women on emergency contraceptives, in addition to making them accessible; programs targeted at promotion and education of emergency contraceptives is helpful to prevent unwanted pregnancy.</p

‘Kangaroo mother care’ to prevent neonatal deaths due to preterm birth complications

Background ‘Kangaroo mother care’ (KMC) includes thermal care through continuous skin-to-skin contact, support for exclusive breastfeeding or other appropriate feeding, and early recognition/response to illness. Whilst increasingly accepted in both high- and low-income countries, a Cochrane review (2003) did not find evidence of KMC’s mortality benefit, and did not report neonatal-specific data

Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia

Background: As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia. Methods: To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale. Results: Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25, p < 0.05), taking aspirin (β = 0.76, p < 0.05), and having a history of hospitalization (β = 0.91, p < 0.05). Conclusions: We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management

Outcome of preterm twins compared to preterm singleton neonates, a multicenter prospective observational study in Ethiopia

Background: In recent decades there has been a major increase in multiple birth rates, and the rate of twining vary from 6-9 per thousand life births to 20 per thousand live births across differ-ent areas of the world. Many studies have demonstrated higher neonatal and perinatal mortality and morbidity rates in twin deliveries compared to singleton births. This study was aimed to com-pare the outcomes of preterm twins and preterm singletons.Methods: A prospective, observational multicenter study was conducted from July 2016 to May 2018 in five tertiary hospitals in Ethiopia. All preterm, liveborn infants born at or transferred at less than 7 days of life to one of the study hospitals with an estimated gestational age below 37 weeks were included.Results: A total of 3,703 preterm neonates admitted to participating neonatal intensive care units were included in the study, of which 1171(31.6%) were twins. After adjusting for birth weight and gestational age, the mortality rate for preterm singletons of 31.0% was higher than the mortality rate for preterm twins of 24.8%, which was statistically significant (p-value = 0.001), OR of 1.37 (95% CI: 1.15 to 1.64). The study also identified an inverse relationship between birth weight and gestational age, and mortality. Male singletons were more likely to die than male twins (440 (32.4%) vs. 141 (23.4%); AOR 1.56 (95% CI: 1.22, 1.99); p=0.001)Conclusion: Our study showed that the mortality of a singleton preterm infant was significantly higher than the mortality of a preterm twin infan

African <em>Moringa stenopetala</em> Plant: An Emerging Source of Novel Ingredients for Plant-Based Foods

Moringa stenopetala is a multi-purpose tropical plant native to East Africa. The plant is exceptionally rich in nutrients and health-promoting bioactive compounds. It is among the top plants that could potentially feed the world and alleviate nutritional deficiencies. Moringa stenopetala is a versatile plant because its various parts, including leaves, seeds, flowers, pods, bark, and roots are useful to humans. Especially, the leaves and seeds are high in protein with all the essential amino acids. Based on the FAO database, M. stenopetala seed protein with its essential amino acid content stands highest among all commercial plant protein sources. Though it is a high-value plant and extensively used for food and traditional medicine by the local people in its native place, it is underutilized elsewhere. This chapter reviews recent research efforts that aim to unlock the potential of the plant as a source of ingredients for food, cosmetic and nutraceutical industries