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

Analysis of Seed Potato Systems in Ethiopia

This study aimed to analyze the seed potato systems in Ethiopia, identify constraints and prioritize improvement options, combining desk research, rapid appraisal and formal surveys, expert elicitation, field observations and local knowledge. In Ethiopia, informal, alternative and formal seed systems co-exist. The informal system, with low quality seed, is dominant. The formal system is too small to contribute significantly to improve that situation. The informal seed system should prioritize improving seed quality by increasing awareness and skills of farmers, improving seed tuber quality of early generations and market access. The alternative and formal seed systems should prioritize improving the production capacity of quality seed by availing new varieties, designing quality control methods and improving farmer’s awareness. To improve overall seed potato supply in Ethiopia, experts postulated co-existence and linkage of the three seed systems and development of self-regulation and selfcertification in the informal, alternative and formal cooperative seed potato systems. Resumen Este estudio tuvo el propósito de analizar los sistemas de producción de papa en Etiopia, identificar limitantes, y priorizar opciones de mejorar, mediante la combinación de investigación de escritorio, apreciaciones rápidas y estudios formales, encuestas a expertos, observaciones de campo y conocimiento local. En Etiopia co-existen sistemas de semilla informal, alternativo y formal. Domina el sistema informal, con baja calidad de semilla. El sistema formal es muy pequeño como para contribuir significativamente al mejoramiento de esa situación. El sistema informal de semilla debería tener como prioridad el mejoramiento en la calidad de la semilla mediante el aumento en la atención y habilidades de los productores, mejorando la calidad de la semilla-tubérculo de las generaciones tempranas y el acceso al mercado. Los sistemas alternativo y formal de semilla deberían priorizar el mejoramiento en la capacidad de producción de semilla de calidad, mediante la validación de nuevas variedades, el diseño de métodos de control de calidad, y mejorando la atención del productor. Para mejorar el suministro general de semilla de papa en Etiopia, los expertos postularon la co-existencia y asociación de los tres sistemas de semillas y el desarrollo de autorregulación y autocertificación en los sistemas cooperativos de semilla de papa informal, alternativo y formal. Keywords Potato . Seed quality . Seed tuber . Seed system . Quality improvement . Expert elicitation . Solanum tuberosum Introductio

Erratum: A large right ventricle and severe hypoxemia. Use of bedside transesophageal echocardiography to assess cardiopulmonary failure (Annals of the American Thoracic Society (2020) 17 (112-115) DOI: 10.1513/AnnalsATS.201904-316CC)

Copyright © 2020 by the American Thoracic Society. The authors would like to make a correction to the legends of Videos 1 and 3 in their article published in the January 2020 issue of AnnalsATS (1). The definition for the abbreviation TEE in these video legends should read transesophageal echocardiogram. For the convenience of our readers, AnnalsATS is replacing the online version of the article with a corrected version; we apologize for the error

Surgically treated acute abdomen at Gondar University Hospital, Ethiopia.

Background: Acute abdomen is an acute onset of abdominal disease entities that require immediate surgical intervention in most of the cases. The numbers of researches done on acute abdomen in general are Very few in Ethiopia. The main objective of this study was to document the burden of acute abdomen in general and the outcome of emergency laparotomyMethods: This was a retrospective study on surgically treated acute abdomen performed at Gondar University Hospital (GUH) from September 1998 to August 2002Results: More than 1 in 10 operations done in GUH were for acute abdomen. Nearly a quarter of the operations performed in the study period were laparotomies, 43.3% of which were on emergency bases. Majority of surgically treated acute abdomen patients were from rural areas (58.2%). The sex composition was significantly different by place of residence (X2= 12.74, p=0.0017). Abdominal pain (100%), Vomiting (90.3%), abdominal distension (58.3%) and constipation (55.3%) were the commonest symptoms in patients with acute abdomen.Conclusion: This study has shown what the commonest symptoms of acute abdomen are and that the outcome of emergency laparotomy may be affected by different factors. Some of these factors were duration of illness, age, presence of peritonitis, Haematocrit level and complication detection time. Since the management is almost the same for almost all causes of surgical acute abdomens, the abovementioned factors should be given due attention in handling such patients. The reasons for low appearance of rural female dwellers to better health care centres need to be investigated

Analysis of Synchronous Machine Excitation Systems: Comparative Study

This paper presents the comparison and performance evaluation of synchronous machine excitation models. The two models, DC1A and AC4A, are among the IEEE standardized model structures for representing the wide variety of synchronous machine excitation systems. The performance evaluation of these models is done using SIMULINK simulation software. The simulation results obtained using transient analysis show that the DC1A excitation system is more reliable and stable than AC4A excitation system

The Relationship between External Financial Flows and Economic Growth in the Southern African Development Community (SADC): The Role of Institutions

The study examined the relationship between external financial flows, domestic savings and economic growth in the SADC region for the period from 1980 to 2009 specifically looking at the role played by institutions. The majority of countries in the SADC region are experiencing low levels of savings, which has led to them relying more on external financial flows to bridge the gap between domestic demand for finance and domestic supply. However the relationship between external finance and economic growth is still a contentious issue. Given this, the study has thus examined the link between growth and external finance in the region, specifically focusing on the impact of the different forms of external financial flows on economic growth in the region incorporating the role played by institutions. The empirical results revealed that three types of external financial flows have a significant impact on economic growth in the SADC region except ODA; however when all the different types of external financial flows were interacted with the measure of institutions, they all become significant and more enhanced in explaining economic growth in the region. This supports the hypothesis that good institutions are necessary in promoting economic growth in developing countries. The empirical results also suggest that foreign capital is another channel through which a crisis in developing countries can be transmitted to the SADC region

THE ROLE OF RISK ASSESSMENT IN MANAGING RISK

Risk and Uncertainty,

On indigenous production, genetic diversity and crop ecology of enset (Ensete ventricosum (Welw.) Cheesman)

Keywords : Enset, staple, indigenous knowledge, genetic diversity, AFLP, characterisation, conservation, Leaf Appearance Rate, Radiation Use Efficiency, yield potential, transplanting, leaf pruning, fermentation, 'kocho', food security The indigenous enset-farming complex of the south and southwestern highlands of Ethiopia has supported a higher population density than any other farming system. Enset ( Ensete ventricosum (Welw.) Cheesman) has been cultivated as (co-)staple food for about 7-10 million people. Since the last three decades, however, because of population pressure, recurrent drought and diseases there has been degradation of natural resources and, thus, the system failed to sustain the population. In the study, described in this thesis, the indigenous enset production methods, farm-based enset biodiversity and the plant characteristics and environmental factors influencing productivity were analysed to identify yield potentials and constraints in Sidama, Wolaita and Hadiya. The ultimate goal was to develop improved agronomic practices and enhance the use of the existing genetic diversity to reduce the gap between the actual yield and yield potential. Some indigenous cultivation methods vary among regions: initiation of suckers, frequency of transplanting, leaf pruning and planting patterns. Morphologically diverse enset clones were identified in Sidama (52), Wolaita (55) and Hadiya (59). Among 146 clones, a total of 180 AFLP fragments was scored of which 104 (58%) appeared polymorphic. The AFLP-based dendrogram showed more duplication groups than the farmers' characterisation method suggesting that farmers overestimate the genetic diversity. The correlation between the two methods was only weak. Yet, the comparison between the AFLP-based and farmers-based characterisation methods showed that some aspects such as absence of clear regional clusters and clustering of clones with various prefixes to a single group corresponded well. Duplications in the clones identified by both methods may be safely removed from a conservation programme. Variation in farmers' skill in discriminating between clones may suggest that the areas where the people's culture is closely associated with the crop, should receive high priority for collecting clones or serving as sites for in situ conservation. Plant height and LAI of different clones increased faster at Awassa or Areka than at Sidama because of a higher leaf appearance rate associated with temperatures being closer to the optimum. This led to higher early interception of photosynthetically active radiation and higher dry matter production. The mean extinction coefficient was between 0.56-0.91 and radiation use efficiency (RUE) ranged from 1.43-2.67 g MJ -1. Yield potential differences between clones existed, mainly because of differences in RUE. The average ratio actual yield : yield potential (0.24) suggest that much can be done to reduce the yield gap. Transplanting suckers directly into permanent field shortens the period until maturity, provides a reasonable yield soon after removing the suckers from the mother corm and reduces the chance of attack by disease or pests. The partitioning of dry matter to the harvestable parts, the harvest indices at different states of processing and the losses caused by scraping or fermentation, however, became more advantageous as a result of repetitive transplanting. At flowering, harvest indices based on fermented enset products of once, twice and three times transplanted suckers were 0.20, 0.35 and 0.25, respectively. Leaf pruning or the interaction between leaf pruning and transplanting did not significantly affect dry matter partitioning, harvest index or processing losses. The maximum fresh weights of kocho after fermentation from enset plants transplanted once, twice and thrice were respectively 25.9, 54.1 and 37.1 kg plant -1. In terms of weight and energy, enset is the most productive crop in the country, sweet potato is second, taro is third and Irish potato is fourth. The cultivation of enset in densely populated areas under low-input conditions can sustain the population better than that of any other crop. Moreover, enset produces various by-products and the prolonged presence of a closed canopy has an ecological advantage similar to that of forest. This study combines indigenous technical knowledge, agronomic, physiological and molecular studies. It has contributed significantly to the understanding of the production methods and the genetic diversity. It has also investigated some strategies to reduce the gap between the actual yield and yield potential. Furthermore, it has underlined the relevance of physiological studies by generating basic physiological parameters. The information gained in this study also helped to underline future research topics

H-NS Regulation of IraD and IraM Antiadaptors for Control of RpoS Degradation

International audienceRpoS, the master sigma factor during stationary phase and under a variety of stress conditions, is regulated at multiple levels, including regulated degradation. Degradation is dependent upon ClpXP and the RssB adaptor protein. H-NS, a nucleoid-associated protein, affects the regulated degradation of RpoS; in the absence of H-NS, RpoS is stable. The mechanisms involved in this regulation were not known. We have found that H-NS inhibits the expression of iraD and iraM, the genes coding for two antiadaptor proteins that stabilize RpoS when overexpressed. The regulation by H-NS of iraM is independent from the previously demonstrated regulation by the PhoP/PhoQ two-component system. Moreover, differences in the behavior of several hns alleles are explained by a role for StpA, an H-NS-like protein, in the regulation of RpoS stability. This finding parallels recent observations for a role of StpA in regulation of RpoS stability in Salmonella