Determinants of Rural Household Food Security in Wolaita Zone: The Case of Humbo Woreda

Among sub-Saharan Africa, Ethiopia remains one of the poorest and most food insecure countries of the world. Therefore, this study attempted to address the determinants of rural household food security in Wolaita zone, the case of Humbo Woreda, South Ethiopia with the objectives of assessing rural households’ food security status and identifying the determinants of rural household food security in the study area. For this study a total of 120 households were selected from five rural kebeles by using systematic random sampling technique. Primary and secondary data sources were collected for this study. The data were analyzed using descriptive statistics and econometric regression models. Multiple linear regression model was applied to identify determinants of rural household food security. The survey result shows that from the total sample respondents 38.3% and 61.7% was food secure and insecure, respectively. The average and squared food insecurity gap among the food insecure households were found as 31.1% and 14.17% respectively. The model result shows out of 13 explanatory variables, about 6 variables had statistically significant relationship with household food security. Family size was negatively related with food security while the other variables (farm size, total livestock owned, and educational status of household head, use of credit and use of inputs) were positively related with household food security. Therefore, more attention should be given to limit the increasing population through awareness creation and provision of education about the use and benefits of family planning to both rural men and women to enhance household food security and also strengthen adult learning programme for those illiterate households. Attention should be given to credit advancing institutions such as microfinance and should make the loan available in time to the farmers and create awareness about repayment and how to use it and more attention should be given to livestock production and their management; strengthen animal health services through extension services. Furthermore, agricultural sector should be given close attention by providing improved agricultural inputs to rural farm households on time. Keywords: Food security, Kilocalorie, Multiple Linear regression models, Humbo

Review on Impact of Small Scale Irrigations in Household Food Security in Ethiopia

Agriculture is the leading sector of Ethiopian economy as well the overall economic growth of the country largely depends on the agricultural sector. However, Ethiopian agriculture remains characterized by small-scale subsistence production systems where crop and livestock yields are very low. In Ethiopia, an estimated 3 million of the country’s people is food insecure and malnourished. Therefore, there is a call for different interventions, irrigation being one of the options, which could help in adapting strategies to cope up with the challenging drought. The country's irrigation potential is estimated at 3.7 million hectare, of which only about recent estimates indicate that the total irrigated area under small-scale irrigation reached to 853,000 ha during the last implementation period of PASDEP(Plan for Accelerated and Sustained Development to End Poverty) – 2009/10. The aim of this paper is to identify the impact of small-scale irrigation on household food security based on review of different literature. Different studies revealed that access to reliable irrigation water can enable farmers to adopt new technologies and intensify cultivation, leading to increased productivity, overall higher production, and greater returns from farming. Access to irrigation enabled the farm households to grow crops more than once a year; to insure increased and stable production, income and consumption and improve their food security status. The review concludes that small-scale irrigation is one of the viable solutions to secure household food needs in the country. However, simply providing irrigation infrastructure to farm households is not a guarantee that rural poverty and food insecurity are being reduced. In addition to that, an enabling socio-economic environment (like access to roads, markets, credit, training and information about innovations) must be provided to the poor farmers to actually make them engage in small scale irrigation farming and ensure to reduce deep rooted food insecurity and poverty. Keywords: Intensify cultivation, Increase productivity, Small scale irrigation, Food security

Parasito-haematological features of acute Plasmodium falciparum and P. vivax malaria patients with and without HIV co-infection at Wonji Sugar Estate, Ethiopia

No Abstract.Ethiopian Journal of Health Development Vol. 19 (2) 2005: 132-13

A geometric morphometric relationship predicts stone flake shape and size variability

The archaeological record represents a window onto the complex relationship between stone artefact variance and hominin behaviour. Differences in the shapes and sizes of stone flakes-the most abundant remains of past behaviours for much of human evolutionary history-may be underpinned by variation in a range of different environmental and behavioural factors. Controlled flake production experiments have drawn inferences between flake platform preparation behaviours, which have thus far been approximated by linear measurements, and different aspects of overall stone flake variability (Dibble and Rezek J Archaeol Sci 36:1945-1954, 2009; Lin et al. Am Antiq 724-745, 2013; Magnani et al. J Archaeol Sci 46:37-49, 2014; Rezek et al. J Archaeol Sci 38:1346-1359, 2011). However, when the results are applied to archaeological assemblages, there remains a substantial amount of unexplained variability. It is unclear whether this disparity between explanatory models and archaeological data is a result of measurement error on certain key variables, whether traditional analyses are somehow a general limiting factor, or whether there are additional flake shape and size drivers that remain unaccounted for. To try and circumvent these issues, here, we describe a shape analysis approach to assessing stone flake variability including a newly developed three-dimensional geometric morphometric method (\u273DGM\u27). We use 3DGM to demonstrate that a relationship between platform and flake body governs flake shape and size variability. Contingently, we show that by using this 3DGM approach, we can use flake platform attributes to both (1) make fairly accurate stone flake size predictions and (2) make relatively detailed predictions of stone flake shape. Whether conscious or instinctive, an understanding of this geometric relationship would have been critical to past knappers effectively controlling the production of desired stone flakes. However, despite being able to holistically and accurately incorporate three-dimensional flake variance into our analyses, the behavioural drivers of this variance remain elusive

A Framework for Bundling Climate-Smart Agriculture (CSA) and Climate Information Services (CIS) in Ethiopia

Ethiopia is increasingly impacted by climate change and variability because of its greater reliance on climate-sensitive economic sectors such as agriculture. The impacts of climate change and variability are greater on a poor section of the rural community in particular because of their weak adaptive capacities. In recent years, there has been an increasing focus on promoting climate-smart agriculture (CSA) and climate information services (CIS) to improve climate risk management and adaptation of smallholders to climate change in Ethiopia. However, CSA and CIS are rarely provided to farmers in an integrated manner. Therefore, considering the current agricultural technology development and dissemination landscape and the growing digital climate agro-advisory services in the country, a CSA and CIS budling framework is developed for Ethiopia. Bundling of CSA and CIS is expected to empower farmers to make appropriate decisions on a seasonal and intra-seasonal basis, minimize 'technology failure' due to climate variability and enhance adoption of new or existing CSA technologies/practices, reduce yield loss due to climate variability, and farm costs, and increase household income and food security and enhances resilience. Moreover, the bundling framework creates an opportunity for a platform to integrate tools, technologies, and services provided by different institutions and actors. The framework is validated through stakeholder feedback, and it is expected to guide the scaling of bundled services to smallholders

Does a complex intervention targeting communities, health facilities and district health managers increase the utilisation of community-based child health services? A before and after study in intervention and comparison areas of Ethiopia.

INTRODUCTION: Ethiopia successfully reduced mortality in children below 5 years of age during the past few decades, but the utilisation of child health services was still low. Optimising the Health Extension Programme was a 2-year intervention in 26 districts, focusing on community engagement, capacity strengthening of primary care workers and reinforcement of district accountability of child health services. We report the intervention's effectiveness on care utilisation for common childhood illnesses. METHODS: We included a representative sample of 5773 households with 2874 under-five children at baseline (December 2016 to February 2017) and 10 788 households and 5639 under-five children at endline surveys (December 2018 to February 2019) in intervention and comparison areas. Health facilities were also included. We assessed the effect of the intervention using difference-in-differences analyses. RESULTS: There were 31 intervention activities; many were one-off and implemented late. In eight districts, activities were interrupted for 4 months. Care-seeking for any illness in the 2 weeks before the survey for children aged 2-59 months at baseline was 58% (95% CI 47 to 68) in intervention and 49% (95% CI 39 to 60) in comparison areas. At end-line it was 39% (95% CI 32 to 45) in intervention and 34% (95% CI 27 to 41) in comparison areas (difference-in-differences -4 percentage points, adjusted OR 0.49, 95% CI 0.12 to 1.95). The intervention neither had an effect on care-seeking among sick neonates, nor on household participation in community engagement forums, supportive supervision of primary care workers, nor on indicators of district accountability for child health services. CONCLUSION: We found no evidence to suggest that the intervention increased the utilisation of care for sick children. The lack of effect could partly be attributed to the short implementation period of a complex intervention and implementation interruption. Future funding schemes should take into consideration that complex interventions that include behaviour change may need an extended implementation period. TRIAL REGISTRATION NUMBER: ISRCTN12040912

Prognostic Value of C-Reactive Protein in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Northern Ethiopia

Purpose To evaluate the role of C-reactive protein (CRP) in predicting severe COVID-19 patients. Methods A prospective observational cohort study was conducted from July 15 to October 28, 2020, at Kuyha COVID-19 isolation and treatment center hospital, Mekelle City, Northern Ethiopia. A total of 670 blood samples were collected serially. SARS-CoV-2 infection was confirmed by RT-PCR from nasopharyngeal swabs and CRP concentration was determined using Cobas Integra 400 Plus (Roche). Data were analyzed using STATA version 14. P-value < 0.05 was considered statistically significant. Results Overall, COVID-19 patients had significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0– 127.8) mg/L vs 0.9 (IQR: 0.5– 1.9) mg/L; p=0.0004)]. Those with severe COVID-19 clinical presentation had significantly higher median CRP levels compared to those with non-severe cases [166.1 (IQR: 48.6– 332.5) mg/L vs 2.4 (IQR: 1.2– 7.6) mg/L; p< 0.00001)]. Moreover, COVID-19 patients exhibited higher median CRP levels at baseline [58 (IQR: 2.0– 127.8) mg/L] that decreased significantly to 2.4 (IQR: 1.4– 3.9) mg/L after 40 days after symptom onset (p< 0.0001). Performance of CRP levels determined using ROC analysis distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73– 0.91; p=0.001; 77.4% sensitivity and 89.4% specificity). In multivariable analysis, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 for those who have higher ages and comorbidities (ARR 3.99, 95% CI: 1.35– 11.82; p=0.013). Conclusion CRP was found to be an independent determinant factor for severe COVID-19 patients. Therefore, CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes

Longitudinal profile of antibody response to SARS-CoV-2 in patients with COVID-19 in a setting from Sub-Saharan Africa: A prospective longitudinal study.

BACKGROUND Serological testing for SARS-CoV-2 plays an important role for epidemiological studies, in aiding the diagnosis of COVID-19, and assess vaccine responses. Little is known on dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia. METHODS In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune-assays (LFIAs), and an electrochemiluminescent immunoassay. We determined longitudinal antibody response to SARS-CoV-2 as well as seroconversion dynamics. RESULTS Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-97%. Agreement between different assays ranged between 84%-92%. The estimated positive predictive value (PPV) for IgM or IgG in a scenario with seroprevalence at 5% varies from 33% to 58%. Nonetheless, when the population seroprevalence increases to 25% and 50%, there is a corresponding increases in the estimated PPVs. The estimated negative-predictive value (NPV) in a low seroprevalence scenario (5%) is high (>99%). However, the estimated NPV in a high seroprevalence scenario (50%) for IgM or IgG is reduced significantly to 80% to 85%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested, within a median time of 11 (IQR: 9-15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6-11) vs. 15 (IQR: 13-21) days; p = 0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, of the remaining 74 COVID-19 patients included in the cohort, 64 (62.8%) were positive for antibody at the time of enrollment, and 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during follow-up. CONCLUSIONS Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of seroassays before implementation. Factors associated with failure to seroconvert needs further research

Effect of co-infection with intestinal parasites on COVID-19 severity: A prospective observational cohort study

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection results in a spectrum of clinical presentations. Evidence from Africa indicates that significantly less COVID-19 patients suffer from serious symptoms than in the industrialized world. We and others previously postulated a partial explanation for this phenomenon, being a different, more activated immune system due to parasite infections. Here, we aimed to test this hypothesis by investigating a potential correlation of co-infection with parasites with COVID-19 severity in an endemic area in Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites, between July 2020 and March 2021. The primary outcome was the proportion of patients with severe COVID-19. Ordinal logistic regression models were used to estimate the association between parasite infection, and COVID-19 severity. Models were adjusted for sex, age, residence, education level, occupation, body mass index, and comorbidities. Findings: 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37.8%) had intestinal parasitic infection. Only 27/255 (10.6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51.8%) non-severe COVID-19 patients were parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (aOR) of 0.23 (95% CI 0.17–0.30; p<0.0001) for all parasites, aOR 0.37 ([95% CI 0.26–0.51]; p<0.0001) for protozoa, and aOR 0.26 ([95% CI 0.19–0.35]; p<0.0001) for helminths. When stratified by species, co-infection with Entamoeba spp., Hymenolepis nana, Schistosoma mansoni, and Trichuris trichiura implied lower probability of developing severe COVID-19. There were 11 deaths (1.5%), and all were among patients without parasites (p = 0.009). Interpretation: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19. Funding: European and Developing Countries Clinical Trials Partnership (EDCTP) – European Union, and Joep Lange Institute (JLI), The Netherlands

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic