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Ethiopia - Top 30 Publications

Predictors of adverse drug reaction-related hospitalisation in Southwest Ethiopia: A prospective cross-sectional study.

Adverse drug reactions (ADRs) are important causes of morbidity and mortality in the healthcare system; however, there are no studies reporting on the magnitude and risk factors associated with ADR-related hospitalisation in Ethiopia.

Field based investigation on phytoremediation potentials of Lemna minor and Azolla filiculoides in tropical, semiarid regions: Case of Ethiopia.

This study investigated the concurrent accumulation of eight heavy metals by two floating aquatic macrophytes (Lemna minor and Azolla filiculoides) cultivated in ambient media and blended wastewaters in the semiarid regions of Ethiopia. Both species accumulated heavy metals in varying degrees with a significant concentration gradient within the immediate water media. Highest bioconcentration factor was determined for Mn and Fe in both plants. Results revealed that L. minor was high phytoaccumulator for Fe, Mn, Zn and Co but moderate for Cd, Cu, Ni and Cr. On the other hand, A. filiculoides was a high accumulator for Fe, Mn, Zn and Cu, but its potency was moderate for Co, Cr and Ni, but lower for Cd. Both species exhibited significant difference in accumulating Co, Zn and Mn (p < 0.05). In general, the bioconcentration factors for both plants were comparable within the same treatment. In this study, stronger associations between the heavy metal concentrations in the plant tissues and in the grown water media were observed for A. filiculoides.

Significance of fermentation process on biochemical properties of Phaseolus vulgaris (red beans).

Phaseolus vulgaris L. beans have been characterized as a nearly perfect food in all around the world. It is consider functional in terms of providing nutrients and energy to sustain daily life. Red bean contain high protein, mineral, fibres and chemically diverse micronutrient composition, which can be affected by processing. The main aim of this work is to investigate the effect of open and controlled fermentation on the proximate composition, mineral elements, antinutritional factors and flatulence- causing oligosaccharides of a domesticated bean (Anger, conscope and Loko). Open fermentation was done using endogenous microorganism present in the seed of beans, while controlled fermentation was done on autoclaved beans flour inoculated with thermophilic lactic culture which is a mixed strain culture containing Lactobacillus acidophilus, Bifidobacterium and Streptococcus thermophillus. The result shows that the open and controlled fermentation increased the protein digestibility up to 90% in all samples and 4 days of fermentation time, loko red bean was found to more suitable. The chemical compositions and mineral contain was also high as compared to remaining two verities.

Molluscicidal effect of Achyranthes aspera L. (Amaranthaceae) aqueous extract on adult snails of Biomphalaria pfeifferi and Lymnaea natalensis.

Intestinal schistosomiasis caused by Schistosoma mansoni is a wide spread disease in most parts of Ethiopian highlands. Snail control is one major strategy in schistosomiasis control. The use of molluscicidal plant products is becoming interesting due to their environmental friendliness, accessibility and easy application. This research is aimed to evaluate the molluscicidal effect of Achyranthes aspera on Biomphalaria pfeifferi and Lymnaea natalensis snails, which are of great medical and veterinary importance in Ethiopia.

Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis.

Contemporary data for causes of vision impairment and blindness form an important basis of recommendations in public health policies. Refreshment of the Global Vision Database with recently published data sources permitted modelling of cause of vision loss data from 1990 to 2015, further disaggregation by cause, and forecasts to 2020.

Local, national, and regional viral haemorrhagic fever pandemic potential in Africa: a multistage analysis.

Predicting when and where pathogens will emerge is difficult, yet, as shown by the recent Ebola and Zika epidemics, effective and timely responses are key. It is therefore crucial to transition from reactive to proactive responses for these pathogens. To better identify priorities for outbreak mitigation and prevention, we developed a cohesive framework combining disparate methods and data sources, and assessed subnational pandemic potential for four viral haemorrhagic fevers in Africa, Crimean-Congo haemorrhagic fever, Ebola virus disease, Lassa fever, and Marburg virus disease.

Suidae from Kanapoi.

The whole collection of Suidae from Kanapoi is revised in the context of the systematics and evolution of Nyanzachoerus in the Pliocene of Eastern Africa. It contains only two species, Nyanzachoerus kanamensis and Notochoerus jaegeri. The size and morphology of their premolars overlap, but not those of their m3s. No transitional form between them is known in Kenya, but some populations from Uganda and Ethiopia display intermediate characters, suggesting that No. jaegeri could be descended from a kanamensis-like ancestor. However, the cranial remains of No. jaegeri from Kanapoi are insufficient to formally establish the affinities of the species. On the basis of the dentition, Notochoerus euilus could be descended from No. jaegeri. The noticeable absence of Kolpochoerus at Kanapoi (and in the whole Turkana Basin at that time) remains unexplained. The presence of a species with affinity to Nyanzachoerus tulotos at Ekora raises the possibility that uppermost Miocene sediments occur there.

Use of lectin-magnetic separation (LMS) for detecting Toxoplasma gondii oocysts in environmental water samples.

Proof-of-principle of lectin-magnetic separation (LMS) for isolating Toxoplasma oocysts (pre-treated with 0.5% acidified pepsin (AP)) from water for subsequent detection by microscopy or molecular methods has been shown. However, application of this technique in the routine water-analysis laboratory requires that the method is tested, modified, and optimized. The current study describes attempts to apply the LMS technique on supernatants from water samples previously analyzed for contamination with Cryptosporidium and Giardia using standard methods, and the supernatant following immunomagnetic separation (IMS) retained. Experiments on AP-treatment of Toxoplasma oocysts in situ in such samples demonstrated that overnight incubation at 37 °C was adequate, but excess AP had to be removed before continuing to LMS; neutralization in sodium hydroxide and a single wash step was found to be suitable. Mucilaginous material in post-IMS samples that had been stored at room temperature without washing, which was found to be probably an exudate from bacterial and fungal overgrowth, hampered the isolation of T. gondii oocysts by LMS beads. For detection, microscopy was successful only for clean samples, as debris occluded viewing in dirtier samples. Although qPCR was successful, for some samples non-specific inhibition occurred, as demonstrated by inhibition of an internal amplification control in the qPCR reaction. For some, but not all, samples this could be addressed by dilution. Finally, the optimized methodology was used for a pilot project in which 23 post-IMS water sample concentrates were analyzed. Of these, only 20 provided interpretable results (without qPCR inhibition) of which one sample was positive, and confirmed by sequencing of PCR product, indicating that Toxoplasma oocysts occur in Norwegian drinking water samples. In conclusion, we suggest that post-IMS samples may be suitable for analysis for Toxoplasma oocysts using LMS, only if freshly processed or washed before being refrigerated. In addition, application of AP treatment requires a neutralization step before proceeding to LMS. For detection, qPCR, rather than microscopy, is the most appropriate approach, although some inhibition may still occur, and therefore inclusion of an internal amplification control is important. Our study indicates that, despite some limitations, this approach would be appropriate for further large-scale analysis of samples of raw and treated drinking water.

Safe Surgery for All: Early Lessons from Implementing a National Government-Driven Surgical Plan in Ethiopia.

Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity. As Ethiopia progresses with its commitment to prioritize surgery within its Health Sector Transformation Plan, disseminating the process and outcomes of the SaLTS initiative will inform other countries on successful national implementation strategies. The following article describes the process by which the Ethiopian FMOH established surgical system reform and the preliminary results of implementation across these eight pillars.

Strategies for developing sustainable health research capacity in low and middle-income countries: a prospective, qualitative study investigating the barriers and enablers to locally led clinical trial conduct in Ethiopia, Cameroon and Sri Lanka.

In 2013, the WHO stated that unless low-income and middle-income countries (LMICs) become producers of research, health goals would be hard to achieve. Among the capacities required to build a local evidence base, ability to conduct clinical trials is important. There is no evidence-based guidance for the best ways to develop locally led trial capacity. This research aims to identify the barriers and enablers to locally led clinical trial conduct in LMICs and determine strategies for their sustainable development.

Quality of anthelminthic medicines available in Jimma Ethiopia.

Soil-transmitted helminthiasis and schistosomiasis are major public health problems in Ethiopia. Mass deworming of at-risk population using a single dose administration of 400mg albendazole (ABZ) or 500mg mebendazole (MBZ) for treatment of common intestinal worms and 40mg of praziquantel (PZQ) per kg body weight for treatment of schistosomiasis is one of the strategies recommended by World Health Organization (WHO) in order to control the morbidity of soil-transmitted helminthiasis and schistosomiasis. Since storage condition, climate, way of transportation and distribution route could all affect the quality of medicines, regular assessment by surveys is very critical to ensure the therapeutic outcome, to minimize risk of toxicity to the patient and resistance of parasites. Therefore, this study was conducted to assess the pharmaceutical quality of ABZ, MBZ and PZQ tablet brands commonly available in Jimma town (south west Ethiopia). Retail pharmacies (n=10) operating in Jimma town were selected using simple random sampling method. Samples of anthelminthic medicines available in the selected pharmacies were collected. Sample information was recorded and encompassed trade name, active ingredient name, manufacturer's name and full address, labeled medicine strength, dosage form, number of units per container, dosage statement, batch/lot number, manufacturing and expiry dates, storage information and presence of leaflets/package insert. Moreover, a first visual inspection was performed encompassing uniformity of color, uniformity of size, breaks, cracks, splits, embedded surface spots or visual contaminations. Finally, physico-chemical quality attributes investigated encompassed mass uniformity, quantity of active pharmaceutical ingredient (API), disintegration and dissolution, all following Pharmacopoeial test methods The physical characteristics of dosage form, packaging and labeling information of all samples complied with criteria given in the WHO checklists. The mass uniformity of tablets of each brand of ABZ, MBZ and PZQ complied with the pharmacopoeial specification limits, i.e no more than 2 individual masses >5% of average tablet weight, and none deviate by more than 10%. The quantity of APIs in all investigated tablet brands were within the 90-110% label claim (l.c.) limits, ranging between 95.05 and 110.09% l.c. Disintegration times were in line with the pharmacopoeial specification limit for immediate release (IR) tablets, ranging between 0.5 and 13min. However, the dissolution results (mean±SD, n=6) of one ABZ brand (i.e. Wormin(®), Q=59.21±0.99% at 30min) and two PZQ brands (i.e. Bermoxel(®), Q=63.43%±0.7 and Distocide(®), Q=62.43%±1.67, at 75min.) showed poor dissolution, failing the United States Pharmacopoeia (USP) dissolution specification limit.

Association of trace metal elements with lipid profiles in type 2 diabetes mellitus patients: a cross sectional study.

It is well known that dyslipidemia and chronic hyperglycemia increase the onset of diabetes and diabetic complication. The aim of this study is to see the association of trace metals elements and lipid profile among type 2 diabetes mellitus patients.

Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia.

Leprosy reactions are a significant cause of morbidity in leprosy population. Erythema nodosum leprosum (ENL) is an immunological complication affecting approximately 50% of patients with lepromatous leprosy (LL) and 10% of borderline lepromatous (BL) leprosy. ENL is associated with clinical features such as skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. ENL is treated mainly with corticosteroids and corticosteroids are often required for extended periods of time which may lead to serious adverse effects. High mortality rate and increased morbidity associated with corticosteroid treatment of ENL has been reported. For improved and evidence-based treatment of ENL, documenting the systems affected by ENL is important. We report here the clinical features of ENL in a cohort of patients with acute ENL who were recruited for a clinico-pathological study before and after prednisolone treatment.

An Evaluation of the Role of Simulation Training for Teaching Surgical Skills in Sub-Saharan Africa.

An estimated 5 billion people worldwide lack access to any surgical care, whilst surgical conditions account for 11-30% of the global burden of disease. Maximizing the effectiveness of surgical training is imperative to improve access to safe and essential surgical care on a global scale. Innovative methods of surgical training have been used in sub-Saharan Africa to attempt to improve the efficiency of training healthcare workers in surgery. Simulation training may have an important role in up-scaling and improving the efficiency of surgical training and has been widely used in SSA. Though not intended to be a systematic review, the role of simulation for teaching surgical skills in Sub-Saharan Africa was reviewed to assess the evidence for use and outcomes.

Timely initiation of breastfeeding and its association with birth place in Ethiopia: a systematic review and meta-analysis.

Timely initiation of breastfeeding is defined as putting the newborn to the breast within 1 h of birth. In Ethiopia, different studies have been conducted to assess the prevalence of timely initiation of breastfeeding and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of timely initiation of breastfeeding and its association with birth place in Ethiopia using the available studies.

Healthcare spending and health outcomes: evidence from selected East African countries.

Over the last decade, total healthcare expenditures, comprised of both public and private healthcare expenditures, have increased in most East African countries. At the same time, health outcomes such as infant mortality rates, life expectancy at birth and other health outcome indicators have improved.

Prevalence of khat chewing and its effect on academic performance in Sidama zone, Southern Ethiopia.

Khat use is a well-established public health problem in Yemen, Arabian Peninsula, and Ethiopia. Along with its large scale production, the magnitude of khat use is increasing among students.

Proportion and factors associated with low fifth minute Apgar score among singleton newborn babies in Gondar University referral hospital; North West Ethiopia.

New born babies with low Apgar scores are at an increased risk of perinatal morbidity and mortality.

Erratum: Joining smallholder farmers' traditional knowledge with metric traits to select better varieties of Ethiopian wheat.

A correction to this article has been published and is linked from the HTML version of this paper. The error has been fixed in the paper.

Characterizing Active Ingredients of eHealth Interventions Targeting Persons With Poorly Controlled Type 2 Diabetes Mellitus Using the Behavior Change Techniques Taxonomy: Scoping Review.

The behavior change technique taxonomy v1 (BCTTv1; Michie and colleagues, 2013) is a comprehensive tool to characterize active ingredients of interventions and includes 93 labels that are hierarchically clustered into 16 hierarchical clusters.

How Ethiopia achieved Millennium Development Goal 4 through multisectoral interventions: a Countdown to 2015 case study.

3 years before the 2015 deadline, Ethiopia achieved Millennium Development Goal 4. The under-5 mortality decreased 69%, from 205 deaths per 1000 livebirths in 1990 to 64 deaths per 1000 livebirths in 2013. To understand the underlying factors that contributed to the success in achieving MDG4, Ethiopia was selected as a Countdown to 2015 case study.

A new public health order for Africa's health security.

Lessons for the Sustainable Development Goals from Ethiopia's success: the case of under-5 mortality.

Minimum dietary diversity and associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

Dietary diversity has long been recognized as a key element of high quality diets. Minimum Dietary Diversity (MDD) is the consumption of four or more food groups from the seven food groups. Globally, only few children are receiving nutritionally adequate and diversified foods. More than two-thirds of malnutrition related child deaths are associated with inappropriate feeding practice during the first two years of life. In Ethiopia, only 7 % of children age 6-23 months had received the minimum acceptable diet. Therefore, the main aim of this study was to determine the level of minimum dietary diversity practice and identify the associated factors among children aged 6-23 months in Addis Ababa, Ethiopia.

Genetic variation and population structure of maize inbred lines adapted to the mid-altitude sub-humid maize agro-ecology of Ethiopia using single nucleotide polymorphic (SNP) markers.

Molecular characterization is important for efficient utilization of germplasm and development of improved varieties. In the present study, we investigated the genetic purity, relatedness and population structure of 265 maize inbred lines from the Ethiopian Institute of Agricultural Research (EIAR), the International Maize and Wheat Improvement Centre (CIMMYT) and the International Institute of Tropical Agriculture (IITA) using 220,878 single nucleotide polymorphic (SNP) markers obtained using genotyping by sequencing (GBS).

Severe anemia due to pharyngeal leech infestation; a case report from Ethiopia.

Leeches are rare blood-sucking endoparasites. Swimming in streams and ponds as well as drinking contaminated water are the major ways to acquire leeches.

Skin flap vaginal augmentation helps prevent and cure post obstetric fistula repair urine leakage: a critical anatomical analysis.

Our aim was to describe a new surgical method for prophylaxis/cure of post -obstetric fistula repair leakage based on restoring vaginal elasticity with Singapore skin flap. The rationale for this operation was based on the Integral Theory: scarring removes elasticity required for independent function of oppositely-acting urethral closure forces so they become 'tethered, forcibly opening the urethra when give the signal to close. Skin graft restores elasticity and closure. Used prophylactically with Goh type 4 fistula (n=45) 46% were dry against expected 19%. In patients with successful fistula closure, still severe leakage (n=24), 71% were dry against expected 26%. This article is protected by copyright. All rights reserved.

An integrated community-based outpatient therapeutic feeding programme for severe acute malnutrition in rural Southern Ethiopia: Recovery, fatality, and nutritional status after discharge.

A scaled up and integrated outpatient therapeutic feeding programme (OTP) brings the treatment of severely malnourished children closer to the community. This study assessed recovery from severe acute malnutrition (SAM), fatality, and acute malnutrition up to 14 weeks after admission to a programme integrated in the primary health care system. In this cohort study, 1,048 children admitted to 94 OTPs in Southern Ethiopia were followed for 14 weeks. Independent anthropometric measurements and information on treatment outcome were collected at four home visits. Only 32.7% (248/759) of children with SAM on admission fulfilled the programme recovery criteria at the time of discharge (i.e., gained 15% in weight, or oedema, if present at admission, was resolved at discharge). Of all children admitted to the programme for whom nutritional assessment was done 14 weeks later, 34.6% (321/928) were severely malnourished, and 37.5% (348/928) were moderately malnourished; thus, 72.1% were acutely malnourished. Of the children, 27/982 (2.7%) had died by 14 weeks, of whom all but one had SAM on admission. Children with severe oedema on admission had the highest fatality rate (12.0%, 9/75). The median length of admission to the programme was 6.6 weeks (interquartile range: 5.3, 8.4 weeks). Despite children participating for the recommended duration of the programme, many children with SAM were discharged still acutely malnourished and without reaching programme criteria for recovery. For better outcome of OTP, constraints in service provision by the health system as well as challenges of service utilization by the beneficiaries should be identified and addressed.

Physiological and health-related response of broiler chickens fed diets containing raw, full-fat soya bean meal supplemented with microbial protease.

A 2 × 3 factorial study (protease: 0 or 1,5000 PROT/kg and raw full-fat soya bean meal [RSBM] replacing the commercial SBM at 0, 45 and 75 g/kg of diet) was conducted to examine the performance of broilers. Phytase (2000 FYT/kg) was uniformly added to each diet, each also replicated six times, with eight birds per replicate. Birds were raised in climate-controlled rooms using sawdust as the bedding material and offered starter, grower and finisher diets. Feed intake (FI) and body weight gain (BWG) were reduced (p < .05) due to increasing levels of RSBM, but feed conversion ratio (FCR; 0-35 days) was unaffected. Over the first 24 days, neither RSBM nor protease supplementation affected (p > .05) mortality, footpad dermatitis or intestinal lesions in birds. At day 24, the weight, length, width and strength of tibia bone were reduced in chickens that received an elevated level of RSBM (75 g/kg of diet), but this was not significant at day 35. At day 24 (p < .05) and 35 (p < .01), Ca concentration in the litter was reduced when the RSBM level was increased in the diet, but P content was not affected. On days 24 (p < .05) and 35 (p < .01), the N content in litter was also increased with increase in dietary RSBM. Protease supplementation increased (p < .05) the uric acid concentration in the litter (at day 35), but the reverse was the case for ammonia concentration. Overall, the results of this study indicate that there are no major health-related risks, associated with the replacement of commercial SBM with RSBM (≤25%) in broiler diets.

Boundary-spanning actors in complex adaptive governance systems: The case of multisectoral nutrition.

A growing literature highlights complexity of policy implementation and governance in global health and argues that the processes and outcomes of policies could be improved by explicitly taking this complexity into account. Yet there is a paucity of studies exploring how this can be achieved in everyday practice. This study documents the strategies, tactics, and challenges of boundary-spanning actors working in 4 Sub-Saharan Africa countries who supported the implementation of multisectoral nutrition as part of the African Nutrition Security Partnership in Burkina Faso, Mali, Ethiopia, and Uganda. Three action researchers were posted to these countries during the final 2 years of the project to help the government and its partners implement multisectoral nutrition and document the lessons. Prospective data were collected through participant observation, end-line semistructured interviews, and document analysis. All 4 countries made significant progress despite a wide range of challenges at the individual, organizational, and system levels. The boundary-spanning actors and their collaborators deployed a wide range of strategies but faced significant challenges in playing these unconventional roles. The study concludes that, under the right conditions, intentional boundary spanning can be a feasible and acceptable practice within a multisectoral, complex adaptive system in low- and middle-income countries.