Prevalence and Correlates of Mental Distress Among Working Adults in Ethiopia

Objective: To evaluate the prevalence of mental distress and its correlates among working Ethiopian adults. Methods: This cross-sectional study of 2,180 individuals (1,316 men and 864 women) was conducted among working adults in Addis Ababa, Ethiopia. A structured questionnaire was used to collect information on socio-demographic and lifestyle characteristics of participants. Mental distress was assessed using the self-reporting questionnaire (SRQ). Logistic regression was employed to estimate adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Results: The prevalence of mental distress in the study sample was 17.7% (25.9% in women and 12.4% in men). Younger participants (age ≤24 years) had the highest prevalence of mental distress (35.5% in women and 16.7% in men). The odds of mental distress was 2.47-fold higher among women as compared with men (OR=2.47, 95% CI 1.97-3.09). Participants reporting excellent health status had a 50% reduced odds of mental distress (OR=0.47; 95%CI: 0.38-0.59); and moderate alcohol consumption was associated with a slight increased odds of mental distress (OR=1.26; 95%CI: 1.00-1.67). Conclusion: A high prevalence of mental distress was observed among working adults in Ethiopia. Our findings suggest that the workforce institutions should provide targeted prevention and intervention programs to improve the mental health state of their employees. National mental health policy that clearly outlines and addresses mental distress among working adults is also warranted

Preparing for and executing a randomised controlled trial of podoconiosis treatment in Northern Ethiopia: the utility of rapid ethical assessment

Background Community-based randomized controlled trials are often complex pieces of research with significant challenges around the approach to the community, information provision, and decision-making, all of which are fundamental to the informed consent process. We conducted a rapid ethical assessment to guide the preparation for and conduct of a randomized controlled trial of podoconiosis treatment in northern Ethiopia. Methods A qualitative study was carried out in Aneded woreda, East Gojjam Zone, Amhara Regional State from August to September, 2013. A total of 14 In-depth Interviews (IDIs) with researchers, experts, and leaders, and 8 Focus Group Discussions (FGDs) involving 80 participants (people of both gender, with and without podoconiosis), were conducted. Interviews were carried out in Amharic. Data analysis was started alongside collection. Final data analysis used a thematic approach based on themes identified a priori and those that emerged during the analysis. Results Respondents made a range of specific suggestions, including that sensitisation meetings were called by woreda or kebele leaders or the police; that Health Extension Workers were asked to accompany the research team to patients’ houses; that detailed trial information was explained by someone with deep local knowledge; that analogies from agriculture and local social organisations be used to explain randomisation; that participants in the ‘delayed’ intervention arm be given small incentives to continue in the trial; and that key community members be asked to quell rumours arising in the course of the trial. Conclusion Many of these recommendations were incorporated into the preparatory phases of the trial, or were used during the course of the trial itself. This demonstrates the utility of rapid ethical assessment preceding a complex piece of research in a relatively research-naive setting

Hypospadias Repair in Ethiopia: A Five Year Review

BACKGROUND: Hypospadias repair is one of the problematic issues in pediatric surgery. As a result of the multiple complications following the procedure, a variety of techniques have been used and newer methods continue to emerge. There is still controversy regarding the best method of repair. We aimed to determine the outcome of surgery and factors contributing to unfavorable outcomes in children with hypospadias.MATERIALS AND METHODS: This is a retrospective review undertaken from September 2009 to August 2014. The research was conducted at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. All children who underwent hypospadias repair and had regular follow-up were included in the study.RESULTS: A total of 202 boys aged less than 13 years were assessed. Most surgeries (80.3%) were performed in children older than 18 months. Transverse incised plate urethroplasty (TIP) was frequently performed for distal hypospadias (71.2 %), while transverse ventral preputal flap (TVPF) was the most common procedure done for proximal hypospadias (62.8 %). Overall success rate for first surgery was 55.9 %. There was a high rate of major post-operative complications (44.1%) of which urethrocutaneous fistula (UCF) was the most common (31.2%) followed by meatal stenosis and glans breakdown (7.4 % each). These complications were found to be higher in those who were operated at a later age and those with proximal hypospadias (p=0.03 and p=0.01 respectively). There was also a significant difference among the type of procedures with TIP and TVPF having the least complications (p<0.01).CONCLUSION: From our experience, we found TIP a relatively safe and reliable method of repair for distal hypospadias while TVPF single stage repair was superior in the proximal ones. The high rate of complications in our institution was associated with higher burden of severe hypospadias and older age at surgery.

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

BACKGROUND: 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. METHODS: We used a set of complementary methods to analyse progress in child health in Ethiopia between 1990 and 2014. We used Demographic Health Surveys to analyse trends in coverage and equity of key reproductive, maternal health, and child health indicators. Standardised tools developed by the Countdown Health Systems and Policies working group were used to understand the timing and content of health and non-health policies. We assessed longitudinal trends in health-system investment through a financial analysis of National Health Accounts, and we used the Lives Saved Tool (LiST) to assess the contribution of interventions towards reducing under-5 mortality. FINDINGS: The annual rate of reduction in under-5 mortality increased from 3·3% in 1990-2005 to 7·8% in 2005-13. The prevalence of stunting decreased from 60% in 2000 to 40% in 2014. Overall levels of coverage of reproductive, maternal health, and child health indicators remained low, with disparities between the lowest and highest wealth quintiles despite improvement in coverage for essential health interventions. Coverage of child immunisation increased the most (21% of children in 2000 vs 80% of children in 2014), followed by coverage of satisfied demand for family planning by women of reproductive age (19% vs 63%). Provision of antenatal care increased from 10% of women in 2000 to 32% of women in 2014, but only 15% of women delivered with a skilled birth attendant by 2014. A large upturn occurred after 2005, bolstered by a rapid increase in health funding that facilitated the accelerated expansion of health infrastructure and workforce through an innovative community-based delivery system. The LiST model could explain almost 50% of the observed reduction in child mortality between 2000 and 2011; and changes in nutritional status were responsible for about 50% of the 469?000 lives saved between 2000 and 2011. These developments occurred within a multisectoral policy platform, integrating child survival and stunting goals within macro-level policies and programmes for reducing poverty and improving agricultural productivity, food security, water supply, and sanitation. INTERPRETATION: The reduction of under-5 mortality in Ethiopia was the result of combined activities in health, nutrition, and non-health sectors. However, Ethiopia still has high neonatal and maternal morbidity and mortality from preventable causes and an unfinished agenda in reducing inequalities, improving coverage of effective interventions, and strengthening multisectoral partnerships for further progress. FUNDING: Bill & Melinda Gates Foundation and Government of Canada

New Test Day Model for the Genetic Evaluation of mastitis in dairy cattle

In this study, genetic parameters of test-day (TD) somatic cell score (SCS) and lactation average (LA)clinical mastitis (CM) were estimated using a random regression model (RRM) that combine two differentdata models. A multitrait RRM (mt-RRM) was then developed for the genetic evaluation of mastitis.Estimates of breeding values (EBVs) from the mt-RRM were compared to corresponding multitrait LAmodel (biv-LAM) and univariate LA models (univ-LAM). A total of 147500 and about 5.6 million recordsfrom 27500 and 1.4 million Finnish Ayrshire cows were used for estimation of genetic parameters andprediction of breeding values, respectively. Heritabilities of CM1 and CM2 traits: (CM1, -7 to 30 andCM2, 31 to 300 DIM) were 0.026 and 0.016, respectively, while for TD SCS they ranged from 0.06 to0.11. During first lactation, the genetic correlations between TD SCS and CM1 and between TD SCS andCM2 varied from 0.40 to 0.77 and from 0.34 to 0.71, respectively. In genetic evaluation of mastitis, modelcomparisons have showed that mt-RRM has high model predictive ability and high standard deviation ofbreeding values. Moreover, it has added advantages of making efficient use of available TD SCSinformation and offers proofs for bulls and cows. Therefore, mt-RRM can be used as best practical modelin the future evaluation of animals for mastitis resistance

Effect of processing method on the Proximate composition, mineral content and antinutritional factors of Taro (Colocasia esculenta, L.) growth in Ethiopia

Although taro is widely grown in Ethiopia, it is an underutilized crop and little is known about its proximate and micro-element composition and the antinutritional factors of the raw, boiled and fermented products. Boiling and fermentation processing techniques are widely used in the country, especially within the rural community of the Southern region where the crop grows widely. A cultivar of taro grown in the country was analyzed for proximate and mineral composition and antinutritional factors. An investigation was also made on the effects of boiling and fermentation on the nutritional contents. Protein, fat, fiber, total ash and utilizable carbohydrates, respectively were found to be 6.43, 0.47, 2.63, 4.82 and 85.65%, while the Gross Energy was 372.55 Kcal/100g. The contents of the micronutrients namely: Fe, Zn, Mg, Ca, Na, P and Mn were 5.86, 43.08, 7.24, 45.23, 13.81, 7.77 and 3.61 mg/100g, respectively. Phytate for the raw product was 115.43 while oxalate and tannin were 243.06 and 47.69 mg/100g, respectively. Cyanide was not detected in all the samples. There was a significant difference (p < 0.05) in the contents of the proximate and mineral composition and antinutritional factors during boiling and fermentation. The protein content was lower by 9.37% and 8.46%, respectively, in the boiled and fermented products, under the sampling and processing conditions used in the study. The crude fat content was significantly different (p < 0.05) from the crude fat content of the boiled product which was 0.87%. On the other hand, analysis of variance conducted showed that the fiber content of raw sample was significantly different from the fermented samples. Fermentation resulted in a lower level of fiber which was 6.44% and phytates of about 84.75%. Boiling of taro resulted in a higher value of oxalate (70.9%). The data presented in this paper provide an evidence of the potential of Boloso I (which is one variety of taro) to serve as a nutrient dense product for the Ethiopian population provided that the techniques of its processing are optimized.Keywords: Ethiopia, Taro, Oxalates, PhytatesAfrican Journal of Food, Agriculture, Nutrition and Development, Volume 13 No. 2 April 201

Rapid Ethical Appraisal: A tool to design a contextualized consent process for a genetic study of podoconiosis in Ethiopia

Background: Obtaining genuine informed consent from research participants in developing countries can be difficult, partly due to poor knowledge about research process and research ethics. The situation is complicated when conducting genomic research on a disease considered familial and a reason for stigmatisation. Methods: We used a Rapid Ethical Appraisal tool to assess local factors that were barriers to getting genuine informed consent prior to conducting a genetic study of podoconiosis (non-filarial elephantiasis) in two Zones of Ethiopia. The tool included in-depth interviews and focus group discussions with patients, healthy community members, field workers, researchers/Institutional Review Board (IRB) members, elders, religious leaders, and podoconiosis administrators who work closely with patients. Results: Most patients and healthy community members did not differentiate research from routine clinical diagnosis. Participants felt comfortable when approached in the presence of trusted community members. Field workers and podoconiosis administrators preferred verbal consent, whereas the majority of patients and healthy community members prefer both verbal and written consent. Participants better understood genetic susceptibility concepts when analogies drawn from their day-to-day experience were used. The type of biological sample sought and gender were the two most important factors affecting the recruitment process. Most researchers and IRB members indicated that reporting incidental findings to participants is not a priority in an Ethiopian context. Conclusions: Understanding the concerns of local people in areas where research is to be conducted facilitates the design of contextualized consent processes appropriate for all parties and will ultimately result in getting genuine consent

Rapid ethical assessment on informed consent content and procedure in Hintalo-Wajirat, Northern Ethiopia: a qualitative study

Background Informed consent is a key component of bio-medical research involving human participants. However, obtaining informed consent is challenging in low literacy and resource limited settings. Rapid Ethical Assessment (REA) can be used to contextualize and simplify consent information within a given study community. The current study aimed to explore the effects of social, cultural, and religious factors during informed consent process on a proposed HPV-serotype prevalence study. Methodology A qualitative community-based REA was conducted in Adigudom and Mynebri Kebeles, Northern Ethiopia, from July to August 2013. Data were collected by a multi-disciplinary team using open ended questions concerning informed consent components in relation to the parent study. The team conducted one-to-one In-Depth Interviews (IDI) and Focus Group Discussions (FGDs) with key informants and community members to collect data based on the themes of the study. Tape recorded data were transcribed in Tigrigna and then translated into English. Data were categorized and thematically analyzed using open coding and content analysis based on pre-defined themes. Results The REA study revealed a number of socio-cultural issues relevant to the proposed study. Low community awareness about health research, participant rights and cervical cancer were documented. Giving a vaginal sample for testing was considered to be highly embarrassing, whereas giving a blood sample made participants worry that they might be given a result without the possibility of treatment. Verbal consent was preferred to written consent for the proposed study. Conclusion This rapid ethical assessment disclosed important socio-cultural issues which might act as barriers to informed decision making. The findings were important for contextual modification of the Information Sheet, and to guide the best consent process for the proposed study. Both are likely to have enabled participants to understand the informed consent better and consequently to comply with the study

Proximate composition, mineral content and antinutritional factors of some capsicum (Capsicum annum) varieties grown in Ethiopia

This study was conducted to generate baseline information on the nutritional composition, mineral content and antinutritional factors of three capsicum varieties (Marako fana, Bako local and Oda haro) grown in Ethiopia. In relation to proximate composition, Marako fana, Bako local and Oda haro contained 9.2, 9.0 and 8.8% moisture; 11.9, 8.8 and 9.2% crude protein; 27.3, 26.0 and 28.6% crude fiber and 11.2, 9.5 and 9.2% fat (oleoresin) on wet weight basis. They also contained 1.7, 1.6 and 1.8 mg/100 g potassium; 27.2, 38.2 and 54.6 mg/100 g calcium and 7.2, 6.9 and 9.6 mg/100 g iron on wet weight basis. Tannin was found to be 0.142, 0.164 and 0.148 mg/100 g, respectively, while phytate was not detected in any of the samples. Analysis of variance and LSD (least significant difference) test revealed that protein and oleoresin of Marako fana were significantly higher (p less than 0.05) than Bako local and Oda haro. Potassium, calcium and iron contents of Oda haro were significantly higher (p less than 0.05). Based on these results Marako fana is preferable for large scale production of oleoresin, while Oda haro is nutritionally preferable because it contains high amounts of potassium, calcium and iron.KEY WORDS: Capsicum, Ethiopia, Composition, Mineral, Antinutrients Bull. Chem. Soc. Ethiop. 2011, 25(3), 451-454