Is lathyrism still endemic in northern Ethiopia? – The case of Legambo Woreda (district) in the South Wollo Zone, Amhara National Regional State

Background: Lathyrism is a neurotoxic disorder caused by over consumption of grass pea (lathyrism sativus). It is endemic in Ethiopia, India and Bangladesh. The fact that grass pea usually tends to replace the staple serial based diet of rural north and central Ethiopia during times of acute food shortages, makes the disease particularly important in the Ethiopian context. Objective: This study is aimed at investigating on whether lathyrism is still endemic in northern Ethiopia based on the March 26, 2004 report that appeared on the Amharic daily Addis Zemen, which indicated the occurrence of an epidemic where 400 people have been paralyzed in Legambo Woreda, south Wollo, Zone of ANRS. Methods: A house-to-house survey of 3,440 households was undertaken in Legambo Woreda, south Wollo Zone of the Amhara National Regional State, using pre-tested questionnaires. The study subjects were identified as persons with walking difficulties due to weaknesses of the legs.Results: The study identified 424 cases of lathyrism which occurred over many years in the woreda which has a population of 171,976, which gives a prevalence of 2.5/1000. Specifically the survey revealed that there were 48 cases with onset occuring in 1997, 54 in 1998, 55 in 1999, 38 in 2000 and 37 in 2001. The study further revealed that there is ongoing endemicity of lathyrism in this typical highland woreda of north Ethiopia.Conclusion: It important that lathyrism gets the attention of relevant governmental agencies that should ensure the existence of early waring systems to deal with food shortages promptly so that the rural population does not resort to consuming large amounts of grass pea. Lathyrism has to also be a reportable disease within the Ministry of Health system in those areas of northern Ethiopia when grass pea is cultivated. Ethiopian Journal of Health Development Vol. 19(3) 2005: 230-23

Prevalence and burden of primary headache in Akaki textile mill workers, Ethiopia

Headache disorders are the most common complaints worldwide. Migraine, tension-type and cluster headaches account for majority of primary headaches and impose a substantial burden on the individual, family or society at large. The burden is immense on workers, women and children in terms of missing work and school days. There are few studies that show relatively lower prevalence of primary headaches in Africa as compared to Europe and America. There might be many reasons for this lower prevalence. The objective of this study is to determine the prevalence and burden of primary headaches among the Akaki textile factory workers, which may provide data for the local and international level toward the campaign of lifting the burden of headache worldwide. The overall 1-year prevalence of all types of primary headaches was found to be 16.4%, and that of migraine was 6.2%. The prevalence of migraine in females was 10.1% while it was 3.7% in males. The prevalence of tension-type headaches was found to be 9.8%. This was 16.3 % in females as compared to 5.7% in males. The burden of the primary headaches in terms of lost workdays, gross under recognition and absence of effective treatment is tremendous. In conclusion, the prevalence of primary headaches in the Akaki textile mill workers is significant, particularly in females, and the burden is massive, in a place of poverty and ignorance. We recommend the availability and administration of specific therapy to the factory workers with primary headaches, and community based well-designed study for the whole nation’s rural and urban population

修书、刻图与观礼:明代地方社会的家礼传播

家礼“庶民化“是明代礼学的一大特色。此种情况的出现,除了“以礼化民“和“以礼造族“等社会因素之推动,尤有赖于地方社会多渠道、多层级的家礼传播:既有官方倡导,也有民间自为;既有礼书、礼图等文本形式,亦有士人示范、指导等非文本形式。本文利用现存的一些明代家礼礼书,结合明代地方志和文集资料,围绕礼书、礼图和演礼观习等家礼传播途径,揭示了家礼知识是如何“下渗“民间的。这一复杂的历史进程是以士人为主导、以学校为中心、以执礼为目标、以民间为指向的具有创造性精神的社会礼仪化过程。教育部人文社会科学基金项目“现存明代私修礼书的整理与研究”(项目编号:06JA770009)的成果之

Fluoride Exposure from Groundwater as Reflected by Urinary Fluoride and Children’s Dental Fluorosis in the Main Ethiopian Rift Valley

This cross-sectional study explores the relationships between children’s F− exposure from drinking groundwater and urinary F− concentrations, combined with dental fluorosis (DF) in the Main Ethiopian Rift (MER) Valley. We examined the DF prevalence and severity among 491 children (10 to 15 This cross-sectional study explores the relationships between children’s F− exposure from drinking groundwater and urinary F− concentrations, combined with dental fluorosis (DF) in the Main Ethiopian Rift (MER) Valley. We examined the DF prevalence and severity among 491 children (10 to 15 years old) who are lifelong residents of 33 rural communities in which groundwater concentrations of F− cover a wide range. A subset of 156 children was selected for urinary F− measurements. Our results showed that the mean F− concentrations in groundwater were 8.5 ± 4.1 mg/L (range: 1.1–18 mg/L), while those in urine were 12.1 ± 7.3 mg/L (range: 1.1–39.8 mg/L). The prevalence of mild, moderate, and severe DF in children’s teeth was 17%, 29%, and 45%, respectively, and the majority (90%; n = 140) of the children had urinary F− concentrations above 3 mg/L. Below this level most of the teeth showed mild forms of DF. The exposure-response relationship between F− and DF was positive and nonlinear, with DF severity tending to level off above a F− threshold of ~6 mg/L, most likely due to the fact that at ~6 mg/L the enamel is damaged as much as it can be clinically observed in most children. We also observed differential prevalence (and severity) of DF and urinary concentration across children exposed to similar F− concentrations in water, which highlights the importance of individual-specific factors in addition to the F− levels in drinking water. Finally, we investigated urinary F− in children from communities where defluoridation remediation was taking place. The lower F− concentration measured in urine of this population demonstrates the capacity of the urinary F−method as an effective monitoring and evaluation tool for assessing the outcome of successful F− mitigation strategy in a relatively short time (months) in areas affected with severe fluorosis

The methodology of population surveys of headache prevalence, burden and cost: Principles and recommendations from the Global Campaign against Headache

The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against Headache to improve and standardize methods in use for cross-sectional studies, the most important is the production of consensus-based methodological guidelines. This report describes the development of detailed principles and recommendations. For this purpose we brought together an expert consensus group to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most of all, these recommendations seek to encourage collaborations between specialists in headache disorders and epidemiologists. The focus is on migraine, tension-type headache and medication-overuse headache, but they are not intended to be exclusive to these. The burdens arising from secondary headaches are, in the majority of cases, more correctly attributed to the underlying disorders. Nevertheless, the principles outlined here are relevant for epidemiological studies on secondary headaches, provided that adequate definitions can be not only given but also applied in questionnaires or other survey instruments