Married women's decision making power on family planning use and associated factors in Mizan-Aman, South Ethiopia : a cross sectional study

Background: Women's use of family planning service is influenced by many factors, especially by their decision making power. A woman's decision-making power, be it individual or decision made in collaboration with a partner, is the most important factor in the use of family planning in a household. The purpose of this study was to assess the impact of women's decision making power on family planning use and its associated factors. Methods: A community-based cross-sectional study was conducted on married women in the child bearing age. The women who were living in Mizan city were selected using the simple random sampling method. Trained nurses collected the data by interview, using a structured and pre-tested questioner. Bivariable and multivariable binary logistic regression analysis was used to identify the associated factors, and the odds ratio with a 95 % CI was computed to assess the strength of the association. Collinearity was also assessed by looking at standard errors in the final fitted model. Result: Overall, more than two-thirds [67.2 %: 95 % CI (63-71 %)] of the married women were found to be more autonomous to decide family planning use. Secondary education [AOR: 9.04, 95 % CI: (4.50, 18.16)], government employment [AOR: 4.84, 95 % CI: (2.03, 11.52)], being wives of government employed spouses [AOR 2.71, 95 % CI: (1.24, 7.97)], having husbands with college or university education [AOR: 11.29, 95 % CI: (4.66, 27.35)], and being in the younger age [AOR: 0.27, 95 % CI :(0.09, 0.75)] were significantly associated with women's decision-making power on family planning. Conclusions: In this study, women had a high decision making power in family planning use. Age category (34-44-years), formal education, and occupational status had effects on women's decision making power. Promoting parental adult education and engaging women in out of house employment is essential to improve their decision making power in using family planning

Mapping and modelling the geographical distribution and environmental limits of podoconiosis in Ethiopia

BACKGROUND Ethiopia is assumed to have the highest burden of podoconiosis globally, but the geographical distribution and environmental limits and correlates are yet to be fully investigated. In this paper we use data from a nationwide survey to address these issues. METHODOLOGY Our analyses are based on data arising from the integrated mapping of podoconiosis and lymphatic filariasis (LF) conducted in 2013, supplemented by data from an earlier mapping of LF in western Ethiopia in 2008-2010. The integrated mapping used woreda (district) health offices' reports of podoconiosis and LF to guide selection of survey sites. A suite of environmental and climatic data and boosted regression tree (BRT) modelling was used to investigate environmental limits and predict the probability of podoconiosis occurrence. PRINCIPAL FINDINGS Data were available for 141,238 individuals from 1,442 communities in 775 districts from all nine regional states and two city administrations of Ethiopia. In 41.9% of surveyed districts no cases of podoconiosis were identified, with all districts in Affar, Dire Dawa, Somali and Gambella regional states lacking the disease. The disease was most common, with lymphoedema positivity rate exceeding 5%, in the central highlands of Ethiopia, in Amhara, Oromia and Southern Nations, Nationalities and Peoples regional states. BRT modelling indicated that the probability of podoconiosis occurrence increased with increasing altitude, precipitation and silt fraction of soil and decreased with population density and clay content. Based on the BRT model, we estimate that in 2010, 34.9 (95% confidence interval [CI]: 20.2-51.7) million people (i.e. 43.8%; 95% CI: 25.3-64.8% of Ethiopia's national population) lived in areas environmentally suitable for the occurrence of podoconiosis. CONCLUSIONS Podoconiosis is more widespread in Ethiopia than previously estimated, but occurs in distinct geographical regions that are tied to identifiable environmental factors. The resultant maps can be used to guide programme planning and implementation and estimate disease burden in Ethiopia. This work provides a framework with which the geographical limits of podoconiosis could be delineated at a continental scale

Determining optimal phosphorus rates and deficit irrigation levels for enhanced soybean productivity in Jawi District, Northwest Ethiopia

Determining the optimal phosphorus rates and deficit irrigation levels is key to enhancing soybean productivity in the Jawi District, Northwest Ethiopia. Soybean is a vital cash crop in Jawi District, Northwest Ethiopia, and improving its productivity is crucial for food security and community socioeconomic status. The optimal phosphorus and deficit irrigation rates in this region remain unresolved. The aim of this study was to optimize soybean productivity in this region by determining the optimal phosphorus rates and deficit irrigation levels. The experiment was conducted during irrigation seasons 2021/22 and 2022/23 using a split-plot design with an RCBD arrangement. The results showed that combining P rates of 10, 20, 30, and 40 kg ha-1 with 100% ETc. significantly increased soybean grain production. Similarly, soybean grain yield increased at P rates of 0, 10, 20, 30, and 40 kg ha-1 P with 75% ETc. The highest water productivity recorded was 0.29 kg m-3 at 50% ETc. This study suggests that combining P rates of 10, 20, 30, and 40 kg ha-1 P with 100% ETc. and P rates of 0, 10, 20, 30, and 40 kg ha-1 P with 75% ETc. could significantly enhance soybean productivity. Implementing these strategies could lead to more sustainable and efficient agricultural practices in Jawi District, thereby improving crop yields and overall profitability

Clinical, experimental and pathophysiological effects of Yaq-001: a non-absorbable, gut-restricted adsorbent in models and patients with cirrhosis

Objective: Targeting bacterial translocation in cirrhosis is limited to antibiotics with risk of antimicrobial resistance. This study explored the therapeutic potential of a non-absorbable, gut-restricted, engineered carbon bead adsorbent, Yaq-001 in models of cirrhosis and acute-on-chronic liver failure (ACLF) and, its safety and tolerability in a clinical trial in cirrhosis. // Design: Performance of Yaq-001 was evaluated in vitro. Two-rat models of cirrhosis and ACLF, (4 weeks, bile duct ligation with or without lipopolysaccharide), receiving Yaq-001 for 2 weeks; and two-mouse models of cirrhosis (6-week and 12-week carbon tetrachloride (CCl4)) receiving Yaq-001 for 6 weeks were studied. Organ and immune function, gut permeability, transcriptomics, microbiome composition and metabolomics were analysed. The effect of faecal water on gut permeability from animal models was evaluated on intestinal organoids. A multicentre, double-blind, randomised, placebo-controlled clinical trial in 28 patients with cirrhosis, administered 4 gr/day Yaq-001 for 3 months was performed. // Results: Yaq-001 exhibited rapid adsorption kinetics for endotoxin. In vivo, Yaq-001 reduced liver injury, progression of fibrosis, portal hypertension, renal dysfunction and mortality of ACLF animals significantly. Significant impact on severity of endotoxaemia, hyperammonaemia, liver cell death, systemic inflammation and organ transcriptomics with variable modulation of inflammation, cell death and senescence in the liver, kidneys, brain and colon was observed. Yaq-001 reduced gut permeability in the organoids and impacted positively on the microbiome composition and metabolism. Yaq-001 regulated as a device met its primary endpoint of safety and tolerability in the clinical trial. // Conclusions: This study provides strong preclinical rationale and safety in patients with cirrhosis to allow clinical translation. // Trial registration number: NCT03202498

Methotrexate and prednisolone study in erythema nodosum leprosum (MaPs in ENL) protocol: a double-blind randomised clinical trial.

INTRODUCTION: Erythema nodosum leprosum (ENL) is an immunological complication of leprosy. ENL results in morbidity and disability and if it is not treated can lead to death. The current treatment consists of thalidomide or high doses of oral corticosteroids for prolonged periods. Thalidomide is not available in many leprosy endemic countries. The use of corticosteroids is associated with morbidity and mortality. Identifying treatment regimens that reduce the use of corticosteroids in ENL is essential. Methotrexate (MTX) is used to treat many inflammatory diseases and has been used successfully to treat patients with ENL not controlled by other drugs, including prednisolone and thalidomide. We present the protocol of the 'MTX and prednisolone study in ENL' (MaPs in ENL) a randomised controlled trial (RCT) designed to test the efficacy of MTX in the management of ENL. METHODS AND ANALYSIS: MaPs in ENL is an international multicentre RCT, which will be conducted in leprosy referral centres in Bangladesh, Brazil, Ethiopia, India, Indonesia and Nepal. Patients diagnosed with ENL who consent to participate will be randomly allocated to receive 48 weeks of weekly oral MTX plus 20 weeks of prednisolone or 48 weeks of placebo plus 20 weeks of prednisolone. Participants will be stratified by type of ENL into those with acute ENL and those with chronic and recurrent ENL. The primary objective is to determine whether MTX reduces the requirement for additional prednisolone. Patients' reported outcome measures will be used to assess the efficacy of MTX. Participants will be closely monitored for adverse events. ETHICS AND DISSEMINATION: Results will be submitted for publication in peer-reviewed journals. Ethical approval was obtained from the Observational/Interventions Research Ethics Committee of the London School of Hygiene & Tropical Medicine (15762); The Leprosy Mission International Bangladesh Institutional Research Board (in process); AHRI-ALERT Ethical Review Committee, Ethiopia; Ethics Committee of the Managing Committee of the Bombay Leprosy Project; and The Leprosy Mission Trust India Ethics Committee; the Nepal Health and Research Council and Health Research Ethics Committee Dr. Soetomo, Indonesia. This study is registered at www.clinicaltrials.gov. This is the first RCT of MTX for ENL and will contribute to the evidence for the management of ENL.Trial registration numberNCT 03775460

Prevalence of ocular pseudoexfoliation in Baso and Worena District, central Ethiopia

Background: Pseudoexfoliation syndrome is an accumulation of fibrillary extracellular material in the anterior segment of the eye. It is the most common identifiable cause of glaucoma. Objective: To assess the prevalence of pseudoexfoliation syndrome and its association with high intraocular pressure and glaucoma in Baso and Worena District, central Ethiopia. Methods and subjects: A community-based cross-sectional study was conducted in Baso and Worena District, central Ethiopia, from 09 January to 08 February 2018. After a systematic random selection of participants, a questionnaire was administered. Study participants were then examined to assess the anterior segment of their eyes (using a portable slit lamp), measure intraocular pressure (using a Tono-pen AVIA®), and assess the dilated fund us of each eye (using a direct ophthalmoscope). Results: A total of 682 people above 40 years of age were examined. The study participants’ ages ranged from 40 to 89 years. The prevalence of pseudoexfoliation syndrome was found to be 13.2% for patients ≥40 years old (90/682), 17.6% for those ≥50 years old (85/483), 23.1% for those ≥60 years old (74/320), 34.1% for those ≥70 years old (42/123), and 27.8% for those ≥80 years old (5/18). Seventy one (78.9%) of the 90 participants who were found to have pseudoexfoliation syndrome had bilateral involvement and 19 (21.1%) had unilateral involvement. Prevalence increased with age and was highest for those aged 70 to 79. In twenty nine (32.2%) of the 90 cases, pseudoexfoliation syndrome was associated with high intraocular pressure, and 13 (14.4%) had high intraocular pressure and pseudoexfoliative glaucoma. Conclusions and recommendations: Pseudoexfoliation syndrome is common in Baso and Worena District, central Ethiopia. It represents one of the major risk factors for glaucoma. [Ethiop. J. Health Dev. 2020; 34(1):54-58] Key words: Pseudoexfoliation syndrome, glaucoma, intraocular pressur

Men's knowledge, attitudes, and associated factors toward obstetric danger signs: A community-based cross-sectional study in Debre Tabor North West, Ethiopia

Introduction: Maternal mortality remains a public health challenge worldwide, particularly in developing countries. Men should be informed about these danger signs to be better equipped to act if they occur. Studies on the topic have been limited in the area. The study aimed to assess men's knowledge, attitudes, and related factors about obstetrics danger signs in Debre Tabor, Ethiopia. Materials and Methods: A study was conducted in Debre Tabor Town with 609 participants using a pre-tested questionnaire. The data were analyzed using EpiData version 4.6 and SPSS version 25. Variables with P values ≤0.2 were analyzed with multi-variable logistic regression. A statistically significant association was determined using an adjusted odds ratio with a 95% confidence interval (CI) and a P value <0.05. Results: In this study, 609 men were interviewed, with a response rate of 96.9%. Men's knowledge of obstetric danger signs was 44.8%, while their attitudes were 35.6%. Wives' education level (AOR = 7.27, 2.13–8.83), history of obstetric danger signs (AOR = 5.34, 3.49–8.16), receiving antenatal care (AOR = 2.44, 1.29–4.64), giving birth in a hospital (AOR = 4.38, 1.69–11.31), and having a health development army leader (AOR = 3.86, 1.38–10.75) were all associated with knowledge at 95% CI. Having a higher wealth index (AOR = 6.30, 3.44–11.53) and having two or more children (AOR = 2.80, 1.51–5.25) at 95% CI were associated with attitude. Conclusions: Men's awareness and attitudes concerning obstetric danger signs were low. The husband's education, place of birth, and prenatal care are all important factors in increasing men's understanding and attitudes. As a result, the government and stakeholders must prioritize education, attitude reform, and health education for men