Global Diffusion of the Internet X: The Diffusion of Telemedicine in Ethiopia: Potential Benefits, Present Challenges, and Potential Factors

Delivery of healthcare services presents many challenges for governments in most developing countries. Some of these challenges include financial and human resources issues that might affect governments\u27 ability to manage and transform scarce resources to meet healthcare needs. Telemedicine, a healthcare delivery technology where physicians examine patients from distant locations using information technologies, is reported to be increasingly helpful in meeting the needs of the healthcare sector in developing nations such as those in sub-Saharan Africa. This conceptual study reports on the sectoral adoption of telemedicine in Ethiopia, a sub-Saharan African country. We examine the potential benefits of telemedicine diffusion in Ethiopia, addressing the country\u27s healthcare needs, and discussing the obstacles and challenges. Based on previous literature, as well as experiences drawn from other developing nations, we address three potential factors that could influence the diffusion of telemedicine in Ethiopia: active participation of institutions of higher education, Ethiopian foreign alliances, and government involvement. Although the initial successes are relatively small and involve isolated projects, they have been promising and have set the stage for researchers to investigate prevailing projects so as to gain better understanding of the aforementioned factors. Our study does not claim that telemedicine can solve all of Ethiopia\u27s medical challenges; however, we contend that it is a starting point to reach Africans that live in areas with limited medical facilities and personnel. Hence, our study could have far reaching implications as the world looks to help this country, and by extension, other developing countries, to overcome their medical challenges and join the information society

Prevalence and factors associated with trachoma among children aged 1–9 years in Zala district, Gamo Gofa Zone, Southern Ethiopia

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.Background: Trachoma is the leading cause of preventable blindness worldwide. It is common in areas where people are socioeconomically deprived. Globally, approximately 1.2 billion people live in trachoma-endemic areas, in which, 40.6 million individuals have active trachoma and 8.2 million have trichiasis. According to the World Health Organization’s 2007 report, globally close to 1.3 million people are blind due to trachoma, while approximately 84 million suffer from active trachoma. The National Survey (2007) of Ethiopia showed a prevalence of 40.1% active trachoma among children aged 1–9 years. Trachoma is still endemic in most parts of Ethiopia. Objective: To assess prevalence of trachoma and factors associated with it among children aged 1–9 years in Zala district, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples’ Region. Methods: A community-based cross-sectional study was conducted in Zala district from February 28 to March 26, 2014. A total of 611 children were examined for trachoma based on the simplified World Health Organization 1983 classification. A multistage stratified sampling technique with a systematic random sampling technique was used to select study participants. Data were collected by using a semistructured pretested questionnaire and clinical eye examination. The data were entered using EpiData version 3.1 and analyzed using SPSS version 16. Multivariable logistic regression analysis was used to identify independently associated factors. Results: The overall prevalence of active trachoma cases was 224 (36.7%) consisting of 207 (92.4%) trachomatous follicles, eight (3.6%) trachomatous intense, and nine (4.0%) combination of trachomatous follicle and trachomatous intense. Inadequate knowledge of family head about trachoma (adjusted odds ratio [AOR] =2.8 [95% CI: 1.9, 4.2]); #10 m latrine distance (AOR =1.6 [95% confidence interval {CI}: 1.09, 2.4]); presence of above two preschool children (AOR =2.2 [95% CI: 1.3, 3.7]), flies on the face (AOR =6.3 [95% CI: 2.7, 14.7]), and unclean face (AOR =2.4 [95% CI: 1.5, 3.9]) were found to be independently associated with trachoma. Conclusion: Trachoma among children in Zala district is a disease of public health importance. Factors like inadequate knowledge about trachoma by the head of the family, #10 m latrine distance, presence of above two preschool children, flies on the face, and an unclean face were independently associated with trachoma among children. So strengthening of antibiotic use, face washing, and environmental improvement strategy implementation is mandatory

Hospitalization, Recovery, Death, incubation period and Severity of COVID-19: A Systematic Review

AbstractBackground: The novel coronavirus SARS-CoV-2 disease, named “COVID-19" by the WHO, was declared Public Health Emergency Concern globally January 2020. As of 01 February, 2021, the virus already visited more than 200 countries across the globe, with a total of over 103 million confirmed cases, over 2 million deaths and over 76 million recoveries.COVID-19 first appeared in the African continent on 15th February 2020 in Egypt. Back in April 2020, only a few African countries reported 1, 2 or 3 confirmed cases with no death; but as of 07 June the virus visited over 45 African countries already with a total of 183,474 confirmed cases, 81,367 recovered and 5,041 deaths. Moreover, country context evidence is important at least to reduce the impact of COVID 19 in Africa region. Objective: The objective is to get cohesive understanding on hospitalization, recovery, death, incubation period and severity of COVID-19. Methods: Systematic Review was carried out to synthesis cohesive information on hospitalization, recovery, death, incubation period and severity of the disease. This review includes a systematic literature search of PubMed and other sources like Google Scholar and Research Gate. Results: Hospitalization rate for young is as low as 1%, while it ranged from 20.7% to 31.4% for older people. Hospitalization rate was high among patients with obesity (Body Mass Index>40), and heart failure. Recovery rate ranged from 30% in China to over 70% in South Korea. Overall case fatality rate from different studies ranged from 0.1% to 6%. But this value increases to as much as over 45% for those over 75 years old. The median incubation period ranged from 4 days to 5.1 days but showed increment for the older ages. Proportion of critically ill patients ranged from 0.026% to 23%. More severe cases were seen among males than females. Conclusion: This systematic review in-sight the variation in hospitalization, recovery, death, incubation period and severity of COVID-19 pertaining to patients’ characteristics. [Ethiop. J. Health Dev. 2021; 35(SI-1):76-81] Key words: Hospitalization, Recovery, Death, incubation period severity, COVID-19, systematic revie

The Plight of COVID-19 in Ethiopia: Describing Pattern, Predicting Infections, Recoveries and Deaths Using Initial Values from Different Sources

AbstractBackground: On 31rd December 2019, China reported a cluster of cases of pneumonia of unknown etiology in Wuhan city, Hubei province. Eventually, a coronavirus was identified which was called “COVID-19” by World Health Organization (WHO) and was declared as a Public Health Emergency Concern globally.Experts suggested a country context evidence to reduce the impact of COVID-19 in Africa region. To this end, this study aimed to model the course of the outbreak towards understanding the spread of the disease and the effect of integrated intervention. Methods: The SEIR and other relevant models were fitted to determine the effect of integrated intervention towards prevention and control of the virus. Comparative visualization of data was conducted to show the pattern and progress of the disease in Ethiopia in relation with other countries. Results: The overall trend of the virus in Ethiopia showed linear increase since the first case on March 13, 2020, and exponential increase after May 24, 2020. The confirmed cases in Ethiopia reached 5034 within 67 days, while South Africa and Italy reached 22,556 and 205,425 respectively within 67 days after passing 100 cases. The SEIR model considered integrated intervention measures (social distancing, facemask, and hand hygiene) with rho values of 0.7 and 0.5. Without intervention, about 9% of the population can be infected, while the proportion reduced to 5.5% and 2.5% with implementation of 30% and 50% integrated intervention measures, respectively.The Prophet model showed prediction accuracy of 78.3% (95%CI = 74.2% – 82.3%) for confirmed cases. Conclusion: Ethiopia showed the slow progress of COVID-19 compared with South Africa and Italy. The implementation of integrated measures could reduce the proportion of infection significantly. The integrated intervention measures could also extend the peak time to a longer period. The Prophet model showed promising prediction accuracy as it increases when the data increase. [Ethiop. J. Health Dev. 2021; 35(SI-1):82-89] Key Words: COVID-19, patterns, predicting, infections, recovery and deat

Climate change and population growth impacts on surface water supply and demand of Addis Ababa, Ethiopia

Addis Ababa is expected to experience water supply stress as a result of complex interaction of urbanization and climate change. The aim of this study is to investigate water demand and supply prospects for the City of Addis Ababa by applying the Water Evaluation and Planning (WEAP) hydrological model and using scenarios of population growth trends and climate change. The study includes analysis of water consumption, hydrological information and climate data which is statistically downscaled using approach used to generate climate data available at the Worldclim data center. Bias corrected climate model data of NIMR-HadGEM2-AO under a midrange RCP 4.5 scenario and RCP8.5, high emissions scenario was used for the study. The result shows that the projected population of Addis Ababa city using high population growth rate (3.3%) will be about 7 million by the year 2039. The climate change projections result under RCP 4.5 and RCP 8.5 scenarios on surface water supply shows that the level of reservoirs volume both at Legedadi/Dire and Gefersa reservoirs will be reduced in the projected years between the years 2023 and 2039. The result of the RCP 8.5 scenario with low population growth shows that the unmet water demand will be 257.28 million m3 in 2037. The result of the RCP 4.5 scenario with low population growth shows that the unmet water demand will be 314.91 million m3 in 2037. This indicates that the unmet water demand with the dry climate of RCP 4.5 climate change scenario is higher than RCP 8.5 scenario. Under the RCP 4.5 scenario with high population growth (3.3%) the unmet water demand is 87.42 million m3 in 2030, 158.38 million m3 in 2035 and 380.72 million m3 in 2037. This indicates that the unmet water demand in both high population growth and the dry climate of RCP 4.5 climate change scenariowill lead to severe shortage of water in the city. The most effective management options are water tariff increasing, domestic water use technology efficiency improvement and water harvesting which give satisfactory result in mitigating unmet demand of climate change and population growth in the city

A Data Exchange Interoperability Framework for eHealth Applications in Ethiopia

Interoperability between applications is important and creates a bridge between and facilitates data exchange between eHealth applications. In this study, we assess the existing Laboratory Information Systems (LIS) and Electronic Medical Record (EMR) for data exchange interoperability in Ethiopia with the view to proposing and developing a data exchange interoperability framework. We applied a qualitative research method to explore the status of e-Health applications (LIS and EMR) based on functional test done. Using a constructive method, a data exchange interoperability framework on eHealth applications was designed. NVivo-10 software was used for coding the interview and data analysis. The framework is tested by the developers and decision makers. The proposed and designed framework is encouraging for future change

A Theoretical Model for Telemedicine : Social and Value Outcomes in Sub-Saharan Africa

The Sub-Saharan Africa (SSA) region is faced with limited medical personnel and healthcare services to address the many healthcare problems of the region. Poor health indicators reflect the overall decline in socio-economic development. Shortages of access to health services in the region is further complicated by the concentration of health services in urban areas, the region’s multiple medical problems (over 70% of HIV/AIDS cases in the world); and the brain drain phenomenon – it is estimated one-third of African physicians emigrate to North America and Europe. The result is that the SSA region is left with about 10 physicians, and 20 beds, per 100,000 patients. Telemedicine has been found to offer socio-economic benefits, reduce costs, and improve access to healthcare service providers by patients, but previous attempts to move various information technologies from developers in the industrial world to the developing world have failed because of a clear neglect of infrastructural and cultural factors that influence such transfers. The objective of this study is to address key factors that challenge the introduction of telemedicine technology into the health sector in SSA in particular, and by extension, other developing countries with similar socio-economic structures. This research offers a distinctive perspective, focusing on visually-based clinical applications in the SSA region, and considerable attention to the national infrastructure and cultural impact of telemedicine transfer (social and value) outcomes. Two research models and its associated hypotheses are proposed and empirically tested using quantitative data collected from SSA physicians and other health professionals. The study also contributes to the ongoing debate on the potential of telemedicine in improving access and reducing costs. This research can help to understand the socio-economic impact of telemedicine outcomes in a comprehensive way. The finding from the survey shows the rapid advances in telemedicine technology specifically, visual clinical applications may become an essential healthcare tool in the near future within SSA countries

Land Use and Land Cover Change Modulates Hydrological Flows and Water Supply to Gaborone Dam Catchment, Botswana

Identifying the mechanism through which changes in land use and land cover (LULC) modulate hydrological flows is vital for water resource planning and management. To examine the impact of LULC change on the hydrology of the Gaborone Dam catchment within the upper Limpopo basin, where Notwane river is the major river within the catchment, three LULC maps for the years 1997, 2008, and 2017 were established based on a mosaic of Landsat 5 for 1997 and 2008 and Landsat 8 for 2017. The 10 m-resolution Version 200 ESA World Land Cover Map for 2021 is used as a ground truth to train the random forest (RF) classifier to identify land cover classes from Landsat 8 imageries of 2021 using the Google Earth Engine (GEE) Python API. The overall accuracy/kappa coefficient of the RF classifier is 0.99/0.99 for the training and 0.73/0.68 for the validation data sets, which indicate excellent and substantial agreements with the ground truth, respectively. With this confidence in the LULC classification, the impact of LULC change on the hydrological flow within the catchment was estimated by employing the Soil and Water Assessment Tool (SWAT) and indicator of hydrological alteration (IHA). The SWAT model calibration and validation were first performed, and the ability of the model to capture the observed stream flow was found to be good. The LULC maps from Landsat images during the 1997–2017 period show a decrease in forests and shrubland in contrast to an increase in pasture land. The expansion of pasture and cropland and the reduction in forests and shrubland led to a decline in the amount of evapotranspiration and groundwater recharge. Furthermore, the LULC change also caused a reduction in low flow during dry periods and an increase in high flow during the rainy season. The findings clearly demonstrate that LULC changes can affect the water table by altering soil water recharge capacity. The study highlighted the importance of LULC for catchment water resource management through land use planning to regulate the water level in the Gaborone Dam against the impact of climate change and growing water demands by the city of Gaborone due to population growth