Assessing communication on sexual and reproductive health issues among high school students with their parents, Bullen Woreda, Benishangul Gumuz Region, North West Ethiopia

Background: “Adolescents "and "young people “are defined by WHO as the age group 10-19 years and 10-24 years, respectively. Young people make up over one –quarter of the world’s population. Neglecting this population has a major implication on sexual and reproductive behaviors as they develop into adults. The health threats for adolescents today are predominantly behavioral rather than biomedical and more of today's adolescents are involved in health behaviors with potential for serious consequences. Hence, it is important to understand the exposure of school students to sexual and reproductive health knowledge and skills at different places including home.Objective: To assess the level and factors influencing communication between school students and parents on sexual and RH issues.Methods: A cross-sectional survey using self-administered questionnaire and supplemented by focus group discussion was conducted in January 2006 at Bullen Woreda preparatory and high schools in northwest Ethiopia.Results: A total of 412 young people participated in the study. Of these, 284(68.9%) were males and the rest 29.1% females About 13% of the respondents were sexually active. School was mentioned as the most common source of information for sexual and reproductive health issues followed by friends. Three hundred sixty two (88%) respondents believed that it is important to discuss sexual and reproductive health issues/matters with parents. However, only 119 (28.9%) of them discussed on two or more SRH topics with their parents. A high proportion of both male (78%) and female (72%) students preferred to discuss sexual and reproductive health issues with peers compared to less than 27% who prefer to discuss with parents. Conclusions: Although the majority of the students think discussion on sexual and reproductive health issues is important, they prefer to discuss with peers as this makes them more comfortable. Thus, it is essential to improve the sexual and Reproductive Health knowledge of school students to enhance peer influence positively and improve parent student communications through targeted family life education activities among students and parents. [Ethiop. J. Health Dev. 2010;24(2):89-95

In what ways can Community Integrated Management of Neonatal and Childhood Illnesses (C-IMNCI) improve child health?

Background: In addition to access to quality health services, family child care practices play a major role in improving child health and achieving reduction in childhood mortality.Objective: To assess the effect of community integrated management of neonatal and childhood illness interventions on family practices for child care.Methods: A comparative cross-sectional survey was conducted in Dabat District, northwest Ethiopia. A total of 800 mothers or caretakers of children of under two years form the Community Integrated Management of Childhood Illnesses intervention and non-intervention areas were selected using a multistage sampling procedure and interviewed in November 2007.Result: Three hundred thirty seven (84.3%) of the mothers from the intervention area and 358 (89.5%) from nonintervention area were illiterate. Thre vast majority (99.5%) of the fathers in each of the areas were farmers. Mothers/care takers from community IMNCI intervention areas reported better child care practices in terms of time of breastfeeding initiation (OR=9.10, 95% CI=5.45, 12.43), avoiding prelacteal feeding (OR=11.01, 95% CI=7.98, 15.43), initiation of supplementary feeding (OR=3.63, 95% CI=2.23, 5.93) compared to mothers/care takers form non intervention areas. Regarding water, personal hygiene and environmental sanitation, statistical significant differences were observed in using a safe drinking source of water (OR=6.36, 95% CI=4.49, 9.01) and availability of pit latrines (OR=43.52, 95% CI=25.46, 67.89) between the intervention and non-intervention areas. The likelihood of seeking care for diarrhea was about five times and that of fever is three times higher in the intervention areas compared to the non-intervention one.Conclusion: Community IMNCI has positive effects on child feeding, disease prevention, health care seeking practices and these practices are expected to improve child health and survival. Thus the program needs to be scaled up in other areas. Further studies may assess the actual effect of the intervention on child morbidity and mortality. [Ethiop. J. Health Dev. 2011;25(2):143-149

Fertility Desire and Reproductive Health Care Needs of Men and Women Living with HIV/AIDS in Nekemte, East Wollega, Ethiopia

Understanding fertility desire and reproductive health care needs of HIV positive men and women in the era of better access to antiretroviral therapy and improved health status is important in planning and  organizing appropriate health services. To assess the fertility desire and reproductive health care needs of men and women living with HIV/AIDS inNekemte town, East Wollega, Ethiopia. A facility based comparative cross-sectional study was conducted among PLHIV both men and women from February to March 2010 on a total sample of 592 respondents in Nekemte town using structured questionnaires complimented by an in-depth  interview. Men had higher desire to have a child than women (40.5% versus 30.7%). Men and women who were sexually active in the six months prior to survey were 78.4% and 61.8% respectively. Being male (AOR: 1.7, 95% CI: 1.1-2.8), having no living child (AOR: 13.1, 95%CI: 5.3-32.3), or having less than three living children (AOR: 4.2, 95%CI: 2.2-8.0), having partner desiring child (AOR: 15.4, 95%CI: 9.2-25.8), CD4 count .200 (AOR: 2.0, 95%CI: 1.2-3.5) were significantly associated with fertility desire. Health care delivery should consider the desire for childrenby men and women living with HIV/AIDS in order to avert preventable untoward health and related consequences

Unintended pregnancy and induced abortion in a town with accessible family planning services: The case of Harar in eastern Ethiopia

Introduction: It is a universally accepted fact that unintended pregnancy and births could have negative consequences for women, children, families and societies at large. Methods: A cross-sectional study was conducted in Harrar town in southeast Ethiopia where family planning services are relatively easily accessible. The study was carried out in nine kebeles (smallest administrative units), selected from three woredas (districts). A multistage sampling technique was used to select females in the reproductive age group 15-49 years for interview. A structured questionnaire was used to collect data. Results: A total of 983 females aged 15-49 years were interviewed out of whom, 225 (33.3%) sexually active women reported that their most recent pregnancies were unintended. The prevalence of unintended childbirth among sexually active women constituted about 14.3% of the total while induced abortion was found to be 14.4 %. In multivariate analysis, teenagers (OR 4.2 95% CI 1.4,10, 5), those married at the age of less than 20 years (OR 2.1 95%CI 1.9, 4.7), and currently unmarried (OR 1.7 95% CI 1.2, 2.5) had a higher chance of experiencing unwanted pregnancy. Literate women were found to have a significantly higher chance of having induced abortion (OR 2.8, 95% CI 1.4, 6.4). Conclusions: Unintended pregnancy was found to be a major reproductive health problem in the study area showing the high unmet need for family planning and thus deserves priority attention. Expanding access to family planning without regard for the provision of effective IEC, counseling and quality care may not have the expected benefits in this context. The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 79-8

A new approach for product cost estimation using data envelopment analysis

Cost estimation of new products has always been difficult as only few design, manufacturing and operational features will be known. In these situations, parametric or non-parametric methods are commonly used to estimate the cost of a product given the corresponding cost drivers. The parametric models use priori determined cost function where the parameters of the function are evaluated from historical data. Non-parametric methods, on the other hand, attempt to fit curves to the historic data without predetermined function. In both methods, it is assumed that the historic data used in the analysis is a true representation of the relation between the cost drivers and the corresponding costs. However, because of efficiency variations of the manufacturers and suppliers, changes in supplier selections, market fluctuations, and several other reasons, certain costs in the historic data may be too high whereas other costs may represent better deals for their corresponding cost drivers. Thus, it may be important to rank the historic data and identify benchmarks and estimate the target costs of the product based on these benchmarks. In this paper, a novel adaptation of cost drivers and cost data is introduced in order to use data envelopment analysis for the purpose of ranking cost data and identify benchmarks, and then estimate the target costs of a new product based on these benchmarks. An illustrative case study has been presented for the cost estimation of landing gears of an aircraft manufactured by an aerospace company located in Montreal, CANADA

A case study to estimate costs using Neural Networks and regression based models

Bombardier Aerospace’s high performance aircrafts and services set the utmost standard for the Aerospace industry. A case study in collaboration with Bombardier Aerospace is conducted in order to estimate the target cost of a landing gear. More precisely, the study uses both parametric model and neural network models to estimate the cost of main landing gears, a major aircraft commodity. A comparative analysis between the parametric based model and those upon neural networks model will be considered in order to determine the most accurate method to predict the cost of a main landing gear. Several trials are presented for the design and use of the neural network model. The analysis for the case under study shows the flexibility in the design of the neural network model. Furthermore, the performance of the neural network model is deemed superior to the parametric models for this case study

Vulnerability to episodes of extreme weather: Butajira, Ethiopia, 1998–1999

BACKGROUND: During 1999-2000, great parts of Ethiopia experienced a period of famine which was recognised internationally. The aim of this paper is to characterise the epidemiology of mortality of the period, making use of individual, longitudinal population-based data from the Butajira demographic surveillance site and rainfall data from a local site. METHODS: Vital statistics and household data were routinely collected in a cluster sample of 10 sub-communities in the Butajira district in central Ethiopia. These were supplemented by rainfall and agricultural data from the national reporting systems. RESULTS: Rainfall was high in 1998 and well below average in 1999 and 2000. In 1998, heavy rains continued from April into October, in 1999 the small rains failed and the big rains lasted into the harvesting period. For the years 1998-1999, the mortality rate was 24.5 per 1,000 person-years, compared with 10.2 in the remainder of the period 1997-2001. Mortality peaks reflect epidemics of malaria and diarrhoeal disease. During these peaks, mortality was significantly higher among the poorer. CONCLUSIONS: The analyses reveal a serious humanitarian crisis with the Butajira population during 1998-1999, which met the CDC guideline crisis definition of more than one death per 10,000 per day. No substantial humanitarian relief efforts were triggered, though from the results it seems likely that the poorest in the farming communities are as vulnerable as the pastoralists in the North and East of Ethiopia. Food insecurity and reliance on subsistence agriculture continue to be major issues in this and similar rural communities. Epidemics of traditional infectious diseases can still be devastating, given opportunities in nutritionally challenged populations with little access to health care

Mycobacterium tuberculosis Affects Protein and Lipid Content of Circulating Exosomes in Infected Patients Depending on Tuberculosis Disease State

Tuberculosis (TB), which is caused by the bacterium Mycobacterium tuberculosis (Mtb), is still one of the deadliest infectious diseases. Understanding how the host and pathogen interact in active TB will have a significant impact on global TB control efforts. Exosomes are increasingly recognized as a means of cell-to-cell contact and exchange of soluble mediators. In the case of TB, exosomes are released from the bacillus and infected cells. In the present study, a comprehensive lipidomics and proteomics analysis of size exclusion chromatography-isolated plasma-derived exosomes from patients with TB lymphadenitis (TBL) and treated as well as untreated pulmonary TB (PTB) was performed to elucidate the possibility to utilize exosomes in diagnostics and knowledge building. According to our findings, exosome-derived lipids and proteins originate from both the host and Mtb in the plasma of active TB patients. Exosomes from all patients are mostly composed of sphingomyelins (SM), phosphatidylcholines, phosphatidylinositols, free fatty acids, triacylglycerols (TAG), and cholesterylesters. Relative proportions of, e.g., SMs and TAGs, vary depending on the disease or treatment state and could be linked to Mtb pathogenesis and dormancy. We identified three proteins of Mtb origin: DNA-directed RNA polymerase subunit beta (RpoC), Diacyglycerol O-acyltransferase (Rv2285), and Formate hydrogenase (HycE), the latter of which was discovered to be differently expressed in TBL patients. Furthermore, we discovered that Mtb infection alters the host protein composition of circulating exosomes, significantly affecting a total of 37 proteins. All TB patients had low levels of apolipoproteins, as well as the antibacterial proteins cathelicidin, Scavenger Receptor Cysteine Rich Family Member (SSC5D), and Ficolin 3 (FCN3). When compared to healthy controls, the protein profiles of PTB and TBL were substantially linked, with 14 proteins being coregulated. However, adhesion proteins (integrins, Intercellular adhesion molecule 2 (ICAM2), CD151, Proteoglycan 4 (PRG4)) were shown to be more prevalent in PTB patients, while immunoglobulins, Complement component 1r (C1R), and Glutamate receptor-interacting protein 1 (GRIP1) were found to be more abundant in TBL patients, respectively. This study could confirm findings from previous reports and uncover novel molecular profiles not previously in focus of TB research. However, we applied a minimally invasive sampling and analysis of circulating exosomes in TB patients. Based on the findings given here, future studies into host–pathogen interactions could pave the way for the development of new vaccines and therapies

Malaria-related mortality based on verbal autopsy in an area of low endemicity in a predominantly rural population in Ethiopia

<p>Abstract</p> <p>Background</p> <p>Although malaria is one of the most important causes of death in Ethiopia, measuring the magnitude of malaria-attributed deaths at community level poses a considerable difficulty. Nevertheless, despite its low sensitivity and specificity, verbal autopsy (VA) has been the most important technique to determine malaria-specific cause of death for community-based studies. The present study was undertaken to assess the magnitude of malaria mortality in a predominantly rural population of Ethiopia using VA technique at Butajira Rural Health Programme (BRHP) Demographic Surveillance Site (DSS).</p> <p>Methods</p> <p>A verbal autopsy was carried out for a year from August 2003 to July 2004 for all deaths identified at BRPH-DSS. Two trained physicians independently reviewed each VA questionnaire and indicated the most likely causes of death. Finally, all malaria related deaths were identified and used for analysis.</p> <p>Results</p> <p>A verbal autopsy study was successfully conducted in 325 deaths, of which 42 (13%) were attributed to malaria. The majority of malaria deaths (47.6%) were from the rural lowlands compared to those that occurred in the rural highlands (31%) and urban (21.4%) areas. The proportional mortality attributable to malaria was not statistically significant among the specific age groups and ecological zones. Mortality from malaria was reckoned to be seasonal; 57% occurred during a three-month period at the end of the rainy season between September and November. About 71% of the deceased received some form of treatment before death, while 12 (28.6%) of those who died neither sought care from a traditional healer nor were taken to a conventional health facility before death. Of those who sought treatment, 53.3% were first taken to a private clinic, 40% sought care from public health facilities, and the remaining two (6.7%) received traditional medicine. Only 11.9% of the total malaria-related deaths received some sort of treatment within 24h after the onset of illness.</p> <p>Conclusion</p> <p>The results of this study suggest that malaria plays a considerable role as a cause of death in the study area. Further data on malaria mortality with a relatively large sample size for at least two years will be needed to substantially describe the burden of malaria mortality in the study area.</p