Current status of intestinal Schistosomiasis and soiltransmitted helminthiasis among primary school children in Adwa Town, Northern Ethiopia

Background: Epidemiological baseline information on the prevalence and intensity of parasitic infections in a given locality is a prerequisite for development and evaluation of sound control strategies.Objective: To determine the current status of schistosomiasis and soil-transmitted helminthiasis among primary school children in Adwa Town, northern Ethiopia.Methods: A cross-sectional epidemiological study was carried out in eight primary schools in Adwa Town between October and November 2007. Fecal samples of 386 school children in the age group 7-18 were collected andmicroscopically examined using the Kato-Katz and formol-ether concentration methods. A questionnaire was used to identify determinants for Schistosoma mansoni and soil-transmitted helminth infections.Results: The most prevalent intestinal parasitic infection among primary school children in Adwa Town as determined by Kato-Katz (58.7%) and formol ether concentration (60.6%) methods was intestinal schistosomiasis, with an overall intensity of 95.8 eggs per gram of stool. The prevalence of S. mansoni infection was higher in males (70.7%) than in females (57%), as determined by both methods. Less common parasites observed included Ascaris lumbricoides, hookworm species, Hymenolepis nana, Strongyloides stercoralis, and Entamoeba histolytica/dispar.Conclusion: The residents of Adwa Town represent a high-risk community with respect to intestinal schistosomiasis. Hence, mass praziquantel administration to school-age children and all adults considered to be at risk is required once a year until the level of infection falls below the level of public health importance. There is also a need to supplement chemotherapy with other measures such as environmental sanitation and health education to make the impact of chemotherapy sustainable

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

Joint spatiotemporal modelling of tuberculosis and human immunodeficiency virus in Ethiopia using a Bayesian hierarchical approach

Abstract Background The aim of this paper was to evaluate the distribution of HIV and TB in Ethiopia during four years (2015-2018) at the district level, considering both spatial and temporal patterns. Methods Consolidated data on the count of TB case notifications and the number of patients with HIV for four years, 2015-2018, were provided by the Ethiopian Federal Ministry of Health. The data was analyzed using the Bayesian hierarchical approach, employing joint spatiotemporal modelling. The integrated nested Laplace approximation available in the R-INLA package was used to fit six models, each with different priors, for the precision parameters of the random effects variances. The best-fitting model with the best predictive capacity was selected using the Deviance Information Criterion and the negative sum of cross-validatory predictive log-likelihood. Results According to the findings of the selected model, about 53% of the variability in TB and HIV incidences in the study period was explained by the shared temporal component, disease-specific spatial effect of HIV, and space-time interaction effect. The shared temporal trend and disease-specific temporal trend of HIV risk showed a slight upward trend between 2015 and 2017, followed by a slight decrease in 2018. However, the disease-specific temporal trend of TB risk had almost constant trend with minimal variation over the study period. The distribution of the shared relative risks was similar to the distribution of disease-specific TB relative risk, whereas that of HIV had more districts as high-risk areas. Conclusions The study showed the spatial similarity in the distribution of HIV and TB case notifications in specific districts within various provinces. Moreover, the shared relative risks exhibit a temporal pattern and spatial distribution that closely resemble those of the relative risks specific to HIV illness. The existence of districts with shared relative risks implies the need for collaborative surveillance of HIV and TB, as well as integrated interventions to control the two diseases jointly

Podoconiosis treatment in northern Ethiopia (GoLBet): study protocol for a randomised controlled trial

BACKGROUND Podoconiosis is one of the forgotten types of leg swelling (elephantiasis) in the tropics. Unlike the other, better-known types of leg swelling, podoconiosis is not caused by any parasite, virus or bacterium, but by an abnormal reaction to minerals found in the clay soils of some tropical highland areas. Non-governmental Organizations (NGOs) have been responsible for the development of simple treatment methods without systematic evaluation of its effectiveness. It is essential that a large scale, fully controlled, pragmatic trial of the intervention is conducted. We aim to test the hypothesis that community-based treatment of podoconiosis lymphoedema reduces the frequency of acute dermatolymphangioadenitis episodes ('acute attacks') and improves other clinical, social and economic outcomes. METHODS/DESIGN This is a pragmatic, individually randomised controlled trial. We plan to randomly allocate 680 podoconiosis patients from the East Gojjam Zone in northern Ethiopia to one of two groups: 'Standard Treatment' or 'Delayed Treatment'. Those randomised to standard treatment will receive the hygiene and foot-care intervention from May 2015 for one year, whereas those in the control arm will be followed through 2015 and be offered the intervention in 2016. The trial will be preceded by an economic context survey and a Rapid Ethical Assessment to identify optimal methods of conveying information about the trial and the approaches to obtaining informed consent preferred by the community. The primary outcome will be measured by recording patient recall and using a simple, patient-held diary that will be developed to record episodes of acute attacks. Adherence to treatment, clinical stage of disease, quality of life, disability and stigma will be considered secondary outcome measures. Other outcomes will include adverse events and economic productivity. Assessments will be made at baseline and at 3, 6, 9 and 12 months thereafter. DISCUSSION The evidence is highly likely to inform implementation of the new master plan for integrated control of Neglected Tropical Diseases (NTDs), in which podoconiosis is identified as one of eight NTDs prioritised for control. Potentially, an estimated 3 million patients in Ethiopia will therefore benefit from the results of this trial. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number. REGISTRATION NUMBER ISRCTN67805210 . Date of registration: 24 January 2013

Landscape positions dictating crop fertilizer responses in wheat-based farming systems of East African Highlands

Improving fertilizer use efficiency has remained a challenge, particularly for small-scale farming in undulating ‘abnormal’ landscapes of East Africa. Milne's 1930s concept on ‘Catena’ was considered as a breakthrough in understanding soil variability and its implication on productivity in East African highlands. However, there is limited information on how the ‘Catena’ features could be used for fine tuning fertilizer recommendations. We initiated multiple on-farm replicated experiments in three wheat-growing districts (Endamohoni, Lemo and Worreilu) in the Ethiopian highlands in 2014, 2015 and 2016 to assess landscape positions affecting crop-nutrient responses, identify yield limiting nutrients across the ‘Catena’ (N, P, K, S and Zn) and quantify effects of landscape positions on resources use efficiency. We clustered farmlands across the ‘Catena’ (Hillslopes, Midslopes and Footslopes) based on land scape positions in the respective locations. Wheat yield was more strongly and significantly affected by landscape positions (P N92 P46) while differences between landscape positions diminish at lower rates. Yield benefits due to application of K was significant only in the dry years (P < 0.05), while there was hardly any yield benefit from the application of zinc and sulfur. The crop nitrogen recovery fraction and crop water productivity decreased with an increasing slope regardless of nutrient combinations. The results indicated that the landscape position could be considered as a proxy indicator for targeted fertilizer application, particularly in farms with undulating topographic features. Hillslopes are better served by the application of organic fertilizers along with conservation measures as applying higher rates of mineral fertilizer in hillslopes would rather increase the risk of downstream nutrient movement

Existence Of Three Positive Solutions For Second Order Undammed Three Point Boundary Value Problems In Cone Banach Space

This thesis is concerned with second-order three-point undamped non-linear boundary value problems. It also focused on constructing Green’s function for corresponding homogeneous boundary value problems by using Green’s function properties. Under the suitable conditions, we established the existence of three positive solution by applying Avery and Peterson fixed point theorem. To illustrate the result examples are provided. This study was mostly dependent on secondary source of data such as journals and books which related to our study area

Land use and land cover changes and Soil erosion in Yezat Watershed, North Western Ethiopia

Soil erosion affects land qualities and water resources. This problem is severe in Ethiopia due to its topographic features. The present research was aimed to estimate spatiotemporal changes in land-use/land-cover pattern and soil erosion in the Yezat watershed in Ethiopia. This study was carried out by using landsat imageries of 2001, 2010 and 2015. Images were classified into categories using supervised classification by maximum likelihood algorithm. They were also classified into different biomass levels by using Normalized Difference Vegetation Index (NDVI) analysis. Revised Universal Soil Loss Equation modeling was applied in a GIS environment to quantify the potential soil erosion risk. The area under grassland, woodland and homesteads have increased by 610.69 (4%), 101.69 (0.67%) and 126.6 ha (0.83%) during 2001–2015. The extent of cultivated land and shrub/bushland was reduced by 323.43(0.02%) and 515.44 ha (3.41%), respectively, during the same period. The vegetation cover in the watershed decreased by 91% during 2001–2010, and increased by 88% during 2010–2015. Increase of NDVI values indicates better ground cover due to implementation of integrated watershed development program in the region. The estimated annual soil losses were 7.2 t ha−1 yr−1 in 2001, 7.7 t ha−1 yr−1in 2010 and 4.8 t ha−1 yr−1in 2015. Management interventions are necessary to improve the status and utilization of watershed resources in response to sustainable land management practices for sustainable livelihood of the local people

Global, regional, and national burden of tuberculosis, 1990–2016: results from the Global Burden of Diseases, Injuries, and Risk Factors 2016 Study

Background Although a preventable and treatable disease, tuberculosis causes more than a million deaths each year. As countries work towards achieving the Sustainable Development Goal (SDG) target to end the tuberculosis epidemic by 2030, robust assessments of the levels and trends of the burden of tuberculosis are crucial to inform policy and programme decision making. We assessed the levels and trends in the fatal and non-fatal burden of tuberculosis by drug resistance and HIV status for 195 countries and territories from 1990 to 2016. Methods We analysed 15 943 site-years of vital registration data, 1710 site-years of verbal autopsy data, 764 site-years of sample-based vital registration data, and 361 site-years of mortality surveillance data to estimate mortality due to tuberculosis using the Cause of Death Ensemble model. We analysed all available data sources, including annual case notifications, prevalence surveys, population-based tuberculin surveys, and estimated tuberculosis cause-specific mortality to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how the burden of tuberculosis differed from the burden predicted by the Socio-demographic Index (SDI), a composite indicator of income per capita, average years of schooling, and total fertility rate. Findings Globally in 2016, among HIV-negative individuals, the number of incident cases of tuberculosis was 9·02 million (95% uncertainty interval [UI] 8·05–10·16) and the number of tuberculosis deaths was 1·21 million (1·16–1·27). Among HIV-positive individuals, the number of incident cases was 1·40 million (1·01–1·89) and the number of tuberculosis deaths was 0·24 million (0·16–0·31). Globally, among HIV-negative individuals the age-standardised incidence of tuberculosis decreased annually at a slower rate (–1·3% [–1·5 to −1·2]) than mortality did (–4·5% [–5·0 to −4·1]) from 2006 to 2016. Among HIV-positive individuals during the same period, the rate of change in annualised age-standardised incidence was −4·0% (–4·5 to −3·7) and mortality was −8·9% (–9·5 to −8·4). Several regions had higher rates of age-standardised incidence and mortality than expected on the basis of their SDI levels in 2016. For drug-susceptible tuberculosis, the highest observed-to-expected ratios were in southern sub-Saharan Africa (13·7 for incidence and 14·9 for mortality), and the lowest ratios were in high-income North America (0·4 for incidence) and Oceania (0·3 for mortality). For multidrug-resistant tuberculosis, eastern Europe had the highest observed-to-expected ratios (67·3 for incidence and 73·0 for mortality), and high-income North America had the lowest ratios (0·4 for incidence and 0·5 for mortality). Interpretation If current trends in tuberculosis incidence continue, few countries are likely to meet the SDG target to end the tuberculosis epidemic by 2030. Progress needs to be accelerated by improving the quality of and access to tuberculosis diagnosis and care, by developing new tools, scaling up interventions to prevent risk factors for tuberculosis, and integrating control programmes for tuberculosis and HIV