Assessment of alcohol advertising practices in Ethiopia

Background: Alcohol advertising should be prepared with an appropriate sense of responsibility to the consumer public. In Ethiopia, some aspects of alcohol advertising practices contravene with standards.Objectives: To document alcohol advertising practices and explore perceptions about them in Ethiopia.Methods: A qualitative study was carried out in 2010, in the relevant institutions selected purposively from Addis Ababa: private media/advertising agencies, the Federal Ministry of Health (FMOH)/ Food, Medicine and Health Care Administration and Control Authority, Ethiopian Public Health Association (EPHA), Ethiopian Medical Association (EMA), the Ethiopian Youth and Sports Ministry (MYS), Addis Ababa University (AAU), Addis Continental Institute of Public Health (ACIPH), the Ethiopian Broadcast Authority (EBA) and a brewery. Data were generated using indepth, face-to-face interviews with 18 professionals from the nine institutions. Slightly differing interview guides were used according to nature of institutions; thematic analysis of the data on transcribed interviews was performed.Results: Alcohol advertising practices in Ethiopia contravene with fundamental principles of marketing for alcoholic beverages. Advertisers use misleading information about alcoholic drinks, employ people with questionable legal age and use imagery that could be particularly appealing to young audiences. Lack of audience segmenting mechanisms in the media coupled with other forms of promotion such as sponsorships expose, even the very young, to alcohol advertisements.Conclusions: The existing practice of alcohol advertising in the country is against the interest of the public. All concerned stakeholders should be considered in alcohol related policy formulation, implementation and monitoring

Preparing for and executing a randomised controlled trial of podoconiosis treatment in Northern Ethiopia: the utility of rapid ethical assessment

Background Community-based randomized controlled trials are often complex pieces of research with significant challenges around the approach to the community, information provision, and decision-making, all of which are fundamental to the informed consent process. We conducted a rapid ethical assessment to guide the preparation for and conduct of a randomized controlled trial of podoconiosis treatment in northern Ethiopia. Methods A qualitative study was carried out in Aneded woreda, East Gojjam Zone, Amhara Regional State from August to September, 2013. A total of 14 In-depth Interviews (IDIs) with researchers, experts, and leaders, and 8 Focus Group Discussions (FGDs) involving 80 participants (people of both gender, with and without podoconiosis), were conducted. Interviews were carried out in Amharic. Data analysis was started alongside collection. Final data analysis used a thematic approach based on themes identified a priori and those that emerged during the analysis. Results Respondents made a range of specific suggestions, including that sensitisation meetings were called by woreda or kebele leaders or the police; that Health Extension Workers were asked to accompany the research team to patients’ houses; that detailed trial information was explained by someone with deep local knowledge; that analogies from agriculture and local social organisations be used to explain randomisation; that participants in the ‘delayed’ intervention arm be given small incentives to continue in the trial; and that key community members be asked to quell rumours arising in the course of the trial. Conclusion Many of these recommendations were incorporated into the preparatory phases of the trial, or were used during the course of the trial itself. This demonstrates the utility of rapid ethical assessment preceding a complex piece of research in a relatively research-naive setting

Progress with genetic selection for low methane traits in dairy cows

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Stochastic simulation of restoration outcomes for a dry afromontane forest landscape in northern Ethiopia.

Forest and Landscape Restoration (FLR) is carried out with the objective of regaining ecological functions and enhancing human well-being through intervention in degrading ecosystems. However, uncertainties and risks related to FLR make it difficult to predict long-term outcomes and inform investment plans. We applied a Stochastic Impact Evaluation framework (SIE) to simulate returns on investment in the case of FLR interventions in a degraded dry Afromontane forest while accounting for uncertainties. We ran 10,000 iterations of a Monte Carlo simulation that projected FLR outcomes over a period of 25 years. Our simulations show that investments in assisted natural regeneration, enrichment planting, exclosure establishment and soil-water conservation structures all have a greater than 77% chance of positive returns. Sensitivity analysis of these outcomes indicated that the greatest threat to positive cashflows is the time required to achieve the targeted ecological outcomes. Value of Information (VOI) analysis indicated that the biggest priority for further measurement in this case is the maturity age of exclosures at which maximum biomass accumulation is achieved. The SIE framework was effective in providing forecasts of the distribution of outcomes and highlighting critical uncertainties where further measurements can help support decision-making. This approach can be useful for informing the management and planning of similar FLR interventions

Violence against women in relation to literacy and area of residence in Ethiopia

Objective: This study explores violence against women in a low-income setting in relation to residency and literacy. Setting: The study was conducted within the Butajira Rural Health Programme (a Health and Demographic Surveillance Site), which includes rural and semi-urban settings in south-central Ethiopia. Design: This is a community-based cross-sectional study and is part of the WHO Women's Health and Life Events multi-country study. It included 1,994 randomly selected married women. Methods: A standardised WHO questionnaire was used to measure physical violence, residency, literacy of the woman and her spouse, and attitudes of women about gender roles and violence. Analyses present prevalence with 95% confidence intervals and odds ratios derived from bivariate and multivariate logistic regression models. Results: In urban and rural areas of the study area, the women were of varying ages, had varying levels of literacy and had spouses with varying levels of literacy. Women in the overall study area had beliefs and norms favouring violence against women, and women living in rural communities and illiterate women were more likely to accept such attitudes. In general, violence against women was more prevalent in rural communities. In particular, violence against rural literate women and rural women who married a literate spouse was more prevalent. Literate rural women who were married to an illiterate spouse had the highest odds (Adj. OR=3.4; 95% CI: 1.7–6.9) of experiencing physical violence by an intimate partner. Conclusion: Semi-urban lifestyle and literacy promote changes in attitudes and norms against intimate partner violence; however, within the rural lifestyle, literate women married to illiterate husbands were exposed to the highest risks of violence

Rapid Ethical Appraisal: A tool to design a contextualized consent process for a genetic study of podoconiosis in Ethiopia

Background: Obtaining genuine informed consent from research participants in developing countries can be difficult, partly due to poor knowledge about research process and research ethics. The situation is complicated when conducting genomic research on a disease considered familial and a reason for stigmatisation. Methods: We used a Rapid Ethical Appraisal tool to assess local factors that were barriers to getting genuine informed consent prior to conducting a genetic study of podoconiosis (non-filarial elephantiasis) in two Zones of Ethiopia. The tool included in-depth interviews and focus group discussions with patients, healthy community members, field workers, researchers/Institutional Review Board (IRB) members, elders, religious leaders, and podoconiosis administrators who work closely with patients. Results: Most patients and healthy community members did not differentiate research from routine clinical diagnosis. Participants felt comfortable when approached in the presence of trusted community members. Field workers and podoconiosis administrators preferred verbal consent, whereas the majority of patients and healthy community members prefer both verbal and written consent. Participants better understood genetic susceptibility concepts when analogies drawn from their day-to-day experience were used. The type of biological sample sought and gender were the two most important factors affecting the recruitment process. Most researchers and IRB members indicated that reporting incidental findings to participants is not a priority in an Ethiopian context. Conclusions: Understanding the concerns of local people in areas where research is to be conducted facilitates the design of contextualized consent processes appropriate for all parties and will ultimately result in getting genuine consent

Leadership in strategic information (LSI) building skilled public health capacity in Ethiopia

<p>Abstract</p> <p>Background</p> <p>In many developing countries, including Ethiopia, few have the skills to use data for effective decision making in public health. To address this need, the U.S. Centers for Disease Control and Prevention (CDC), in collaboration with two local Ethiopian organizations, developed a year long Leadership in Strategic Information (LSI) course to train government employees working in HIV to use data from strategic information sources. A process evaluation of the LSI course examined the impact of the training on trainees' skills and the strengths and weaknesses of the course. The evaluation consisted of surveys and focus groups.</p> <p>Findings</p> <p>Trainees' skill sets increased in descriptive and analytic epidemiology, surveillance, and monitoring and evaluation (M and E). Data from the evaluation indicated that the course structure and the M and E module required revision in order to improve outcomes. Additionally, the first cohort had a high attrition rate. Overall, trainees and key stakeholders viewed LSI as important in building skilled capacity in public health in Ethiopia.</p> <p>Conclusion</p> <p>The evaluation provided constructive insight in modifying the course to improve retention and better address trainees' learning needs. Subsequent course attrition rates decreased as a result of changes made based on evaluation findings.</p

Characterisation of silent and active genes for a variable large protein of Borrelia recurrentis

BACKGROUND: We report the characterisation of the variable large protein (vlp) gene expressed by clinical isolate A1 of Borrelia recurrentis; the agent of the life-threatening disease louse-borne relapsing fever. METHODS: The major vlp protein of this isolate was characterised and a DNA probe created. Use of this together with standard molecular methods was used to determine the location of the vlp1(B. recurrentis A1) gene in both this and other isolates. RESULTS: This isolate was found to carry silent and expressed copies of the vlp1(B. recurrentis A1) gene on plasmids of 54 kbp and 24 kbp respectively, whereas a different isolate, A17, had only the silent vlp1(B. recurrentis A17) on a 54 kbp plasmid. Silent and expressed vlp1 have identical mature protein coding regions but have different 5' regions, both containing different potential lipoprotein leader sequences. Only one form of vlp1 is transcribed in the A1 isolate of B. recurrentis, yet both 5' upstream sequences of this vlp1 gene possess features of bacterial promoters. CONCLUSION: Taken together these results suggest that antigenic variation in B. recurrentis may result from recombination of variable large and small protein genes at the junction between lipoprotein leader sequence and mature protein coding region. However, this hypothetical model needs to be validated by further identification of expressed and silent variant protein genes in other B. recurrentis isolates

Traumatic physical health consequences of intimate partner violence against women: what is the role of community-level factors?

<p>Abstract</p> <p>Background</p> <p>Intimate partner violence (IPV) against women is a serious public health issue with recognizable direct health consequences. This study assessed the association between IPV and traumatic physical health consequences on women in Nigeria, given that communities exert significant influence on the individuals that are embedded within them, with the nature of influence varying between communities.</p> <p>Methods</p> <p>Cross-sectional nationally-representative data of women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey was used in this study. Multilevel logistic regression analysis was used to assess the association between IPV and several forms of physical health consequences.</p> <p>Results</p> <p>Bruises were the most common form of traumatic physical health consequences. In the adjusted models, the likelihood of sustaining bruises (OR = 1.91, 95% CI = 1.05 - 3.46), wounds (OR = 2.54, 95% CI = 1.31 - 4.95), and severe burns (OR = 3.20, 95% CI = 1.63 - 6.28) was significantly higher for women exposed to IPV compared to those not exposed to IPV. However, after adjusting for individual- and community-level factors, women with husbands/partners with controlling behavior, those with primary or no education, and those resident in communities with high tolerance for wife beating had a higher likelihood of experiencing IPV, whilst mean community-level education and women 24 years or younger were at lower likelihood of experiencing IPV.</p> <p>Conclusions</p> <p>Evidence from this study shows that exposure to IPV is associated with increased likelihood of traumatic physical consequences for women in Nigeria. Education and justification of wife beating were significant community-level factors associated with traumatic physical consequences, suggesting the importance of increasing women's levels of education and changing community norms that justify controlling behavior and IPV.</p