Thoracic empyema: Cause and Treatment Outcome at Gondar University Teaching Hospital, Northwest Ethiopia

Background: Despite improved antimicrobial therapy and multiple options for drainage of infected pleural space, thoracic empyema (TE) continues to cause significant morbidity and mortality. The objectives of this study were to assess the causes and treatment outcome of patients with thoracic empyema.Methods: Patients aged ≥ 13year with TE who were admitted to Gondar University Teaching Hospital, Northwest Ethiopia, from Nov 1999 to Dec 2007 were included. Retrospectively, medical records were reviewed and demographic and clinical data were collected.Results: Records of 81 patients were analyzed; majority (82%) were below the age 50 year. The mean duration of symptoms prior to presentation and hospital stay was 97.4 and 38days, respectively. HIV/AIDS was detected in 60%. Causes of empyema were pulmonary tuberculosis (56%), pneumonia (36%) and lung abscess (7%). Closed chest tube was inserted in 86% of cases and was successful in 93% of them. Case-fatality was 12% and poor outcome occurred in 26%.Conclusions: Early identification of TE and aggressive management with antibiotics or antituberculosis, drainage with chest tube, and surgical treatment when closed tube drainage fails is recommended to improve the high mortality and morbidity

Evaluation of direct colorimetric MTT assay for rapid detection of rifampicin and isoniazid resistance in Mycobacterium tuberculosis

With the spread of multidrug-resistant tuberculosis (MDR-TB) strains there is an increasing need for new accurate and cost-effective methods for a rapid diagnostic and drug susceptibility testing (DST), particularly in low-income countries where tuberculosis is hyperendemic. A colorimetric assay using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) has been suggested as a promising method for DST, especially to rifampicin. In this study, we standardized and evaluated the MTT assay for a rapid direct detection of rifampicin and isoniazid resistant Mycobacterium tuberculosis strains from sputum specimens using Lowenstein-Jensen (LJ) culture medium as a gold standard. The MTT assay sensitivity, specificity, positive and negative predictive values for rifampicin were 100%, 86%, 100%, 99%, respectively. For isoniazid, the MTT assay had a 100% sensitivity, specificity, positive and negative predictive values. Interestingly, the MTT assay gave interpretable results within two weeks for 94% of the samples compared to 7-14 weeks for LJ media. Overall, an excellent agreement was observed between MTT assay and LJ proportion method (Kappa, 0.91 for rifampicin and 1.00 for isoniazid). In conclusion, the direct colorimetric MTT assay simultaneously detects susceptible and resistant strains of M. tuberculosis within three weeks. It significantly shortens the time required to obtain a DST result and could be a reliable alternative method for rapid detection of drug-resistant TB strains in high-TB-burden resource-limited settings

Study of scintillation in natural and synthetic quartz and methacrylate

Samples from different materials typically used as optical windows or light guides in scintillation detectors were studied in a very low background environment, at the Canfranc Underground Laboratory, searching for scintillation. A positive result can be confirmed for natural quartz: two distinct scintillation components have been identified, not being excited by an external gamma source. Although similar effect has not been observed neither for synthetic quartz nor for methacrylate, a fast light emission excited by intense gamma flux is evidenced for all the samples in our measurements. These results could affect the use of these materials in low energy applications of scintillation detectors requiring low radioactive background conditions, as they entail a source of background.Comment: Accepted for publication in Optical Material

Farmer access to irrigation scheduling advice leads to sustainable intensification of high value crops

United States Agency for International Developmen

Direct WIMP identification: Physics performance of a segmented noble-liquid target immersed in a Gd-doped water veto

We evaluate background rejection capabilities and physics performance of a detector composed of two diverse elements: a sensitive target (filled with one or two species of liquefied noble gasses) and an active veto (made of Gd-doped ultra-pure water). A GEANT4 simulation shows that for a direct WIMP search, this device can reduce the neutron background to O(1) event per year per tonne of material. Our calculation shows that an exposure of one tonne $\times$ year will suffice to exclude spin-independent WIMP-nucleon cross sections ranging from $10^{-9}$ pb to $10^{-10}$ pb.Comment: 17 pages, 5 figures. Version accepted for publication in JCA

Social capital and maternal and child health services uptake in low- and middle-income countries: mixed methods systematic review

Background: Social capital has become an important concept in the field of public health, and is associated with improved health services uptake. This study aimed to systematically review the available literature on the role of social capital on the utilization of maternal and child health services in low- and middle-income countries (LMICs). Methods: Mixed-methods research review and synthesis using three databases PubMed, Scopus, and Science Direct for peer-reviewed literature and Google Scholar and Google search engines for gray literature were performed. Both quantitative and qualitative studies conducted in LMICs, published in English and in grey literature were considered. Prior to inclusion in the review methodological quality was assessed using a standardized critical appraisal instrument. Results: A total of 1,545 studies were identified, of which 13 records were included after exclusions of studies due to duplicates, reading titles, abstracts, and full-text reviews. Of these eligible studies, six studies were included for quantitative synthesis, and seven were included for qualitative synthesis. Of the six quantitative studies, five of them addressed the association between social capital and health facility delivery. Women who lived in communities with higher membership in groups that helps to form intergroup bridging ties had higher odds of using antenatal care services. Synthesized qualitative findings revealed that women received some form of emotional, informational, and instrumental support from their network members. Receiving health information from trusted people and socio-cultural factors influenced the use of maternal and child health services. Conclusions: Social capital has a great contribution to improve maternal and child health services. Countries aiming at improving maternal and child health services can be benefited from adapting existing context-specific social networks in the community. This review identified limited available evidence examining the role of social capital on maternal and child health services uptake and future studies may be required for an in-depth understanding of how social capital could improve maternal and child health services.Endalkachew Worku Mengesha, Getu Degu Alene, Desalegne Amare, Yibeltal Assefa, and Gizachew A Tessem

The burden of HIV/AIDS in Ethiopia from 1990 to 2016: evidence from the Global Burden of Diseases 2016 Study

BACKGROUND: The burden of HIV/AIDS in Ethiopia has not been comprehensively assessed over the last two decades. In this study, we used the 2016 Global Burden of Diseases, Injuries and Risk factors (GBD) data to analyze the incidence, prevalence, mortality and Disability-adjusted Life Years Lost (DALY) rates of Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) in Ethiopia over the last 26 years. METHODS: The GBD 2016 used a wide range of data source for Ethiopia such as verbal autopsy (VA), surveys, reports of the Federal Ministry of Health and the United Nations (UN) and published scientific articles. The modified United Nations Programme on HIV/AIDS (UNAIDS) Spectrum model was used to estimate the incidence and mortality rates for HIV/AIDS. RESULTS: In 2016, an estimated 36,990 new HIV infections (95% uncertainty interval [UI]: 8775-80262), 670,906 prevalent HIV cases (95% UI: 568,268-798,970) and 19,999 HIV deaths (95% UI: 16426-24412) occurred in Ethiopia. The HIV/AIDS incidence rate peaked in 1995 and declined by 6.3% annually for both sexes with a total reduction of 77% between 1990 and 2016. The annualized HIV/AIDS mortality rate reduction during 1990 to 2016 for both sexes was 0.4%

Roles and Responsibilities in Newborn Care in four African Sites.

To explore roles and responsibilities in newborn care in the intra- and postpartum period in Nigeria, Tanzania and Ethiopia. Qualitative data were collected using in-depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses. We found that birth attendants were the main decision-makers and care takers in the intrapartum period. Birth attendants varied across sites and included female relatives (Ethiopia and Nigeria), traditional birth attendants (Tanzania and Nigeria), spiritual birth attendants (Nigeria) and health workers (Tanzania and Nigeria). In the early newborn period, when the mother is deemed to be resting, female family members assumed this role. The mothers themselves only took full responsibility for newborn care after a few days or weeks. The early newborn period was protracted for first-time mothers, who were perceived as needing training on caring for the baby. Clear gender roles were described, with newborn care being considered a woman's domain. Fathers had little physical contact with the newborn, but played an important role in financing newborn care, and were considered the ultimate decision-maker in the family. Interventions should move beyond a focus on the mother-child dyad, to include other carers who perform and decide on newborn care practices. Given this power dynamic, interventions that involve men have the potential to result in behaviour change