Active trachoma and community use of sanitation, Ethiopia.

OBJECTIVE: To investigate, in Amhara, Ethiopia, the association between prevalence of active trachoma among children aged 1-9 years and community sanitation usage. METHODS: Between 2011 and 2014, prevalence of trachoma and household pit latrine usage were measured in five population-based cross-sectional surveys. Data on observed indicators of latrine use were aggregated into a measure of community sanitation usage calculated as the proportion of households with a latrine in use. All household members were examined for clinical signs, i.e. trachomatous inflammation, follicular and/or intense, indicative of active trachoma. Multilevel logistic regression was used to estimate prevalence odds ratios (OR) and 95% confidence intervals (CI), adjusting for community, household and individual factors, and to evaluate modification by household latrine use and water access. FINDINGS: In surveyed areas, prevalence of active trachoma among children was estimated to be 29% (95% CI: 28-30) and mean community sanitation usage was 47% (95% CI: 45-48). Despite significant modification (p < 0.0001), no pattern in stratified ORs was detected. Summarizing across strata, community sanitation usage values of 60 to < 80% and ≥ 80% were associated with lower prevalence odds of active trachoma, compared with community sanitation usage of < 20% (OR: 0.76; 95% CI: 0.57-1.03 and OR: 0.67; 95% CI: 0.48-0.95, respectively). CONCLUSION: In Amhara, Ethiopia, a negative correlation was observed between community sanitation usage and prevalence of active trachoma among children, highlighting the need for continued efforts to encourage higher levels of sanitation usage and to support sustained use throughout the community, not simply at the household level

Prediction of Low Community Sanitation Coverage Using Environmental and Sociodemographic Factors in Amhara Region, Ethiopia.

This study developed and validated a model for predicting the probability that communities in Amhara Region, Ethiopia, have low sanitation coverage, based on environmental and sociodemographic conditions. Community sanitation coverage was measured between 2011 and 2014 through trachoma control program evaluation surveys. Information on environmental and sociodemographic conditions was obtained from available data sources and linked with community data using a geographic information system. Logistic regression was used to identify predictors of low community sanitation coverage (< 20% versus ≥ 20%). The selected model was geographically and temporally validated. Model-predicted probabilities of low community sanitation coverage were mapped. Among 1,502 communities, 344 (22.90%) had coverage below 20%. The selected model included measures for high topsoil gravel content, an indicator for low-lying land, population density, altitude, and rainfall and had reasonable predictive discrimination (area under the curve = 0.75, 95% confidence interval = 0.72, 0.78). Measures of soil stability were strongly associated with low community sanitation coverage, controlling for community wealth, and other factors. A model using available environmental and sociodemographic data predicted low community sanitation coverage for areas across Amhara Region with fair discrimination. This approach could assist sanitation programs and trachoma control programs, scaling up or in hyperendemic areas, to target vulnerable areas with additional activities or alternate technologies

Association of community sanitation usage with soil-transmitted helminth infections among school-aged children in Amhara Region, Ethiopia.

BACKGROUND: Globally, in 2010, approximately 1.5 billion people were infected with at least one species of soil-transmitted helminth (STH), Ascaris lumbricoides, Trichuris trichiura, hookworm (Ancylostoma duodenale and Necator americanus). Infection occurs through ingestion or contact (hookworm) with eggs or larvae in the environment from fecal contamination. To control these infections, the World Health Organization recommends periodic mass treatment of at-risk populations with deworming drugs. Prevention of these infections typically relies on improved excreta containment and disposal. Most evidence of the relationship between sanitation and STH has focused on household-level access or usage, rather than community-level sanitation usage. We examined the association between the proportion of households in a community with latrines in use and prevalence of STH infections among school-aged children. METHODS: Data on STH prevalence and household latrine usage were obtained during four population-based, cross-sectional surveys conducted between 2011 and 2014 in Amhara, Ethiopia. Multilevel regression was used to estimate the association between the proportion of households in the community with latrines in use and presence of STH infection, indicated by > 0 eggs in stool samples from children 6-15 years old. RESULTS: Prevalence of STH infection was estimated as 22% (95% CI: 20-24%), 14% (95% CI: 13-16%), and 4% (95% CI: 4-5%) for hookworm, A. lumbricoides, and T. trichiura, respectively. Adjusting for individual, household, and community characteristics, hookworm prevalence was not associated with community sanitation usage. Trichuris trichuria prevalence was higher in communities with sanitation usage ≥ 60% versus sanitation usage < 20%. Association of community sanitation usage with A. lumbricoides prevalence depended on household sanitation. Community sanitation usage was not associated with A. lumbricoides prevalence among households with latrines in use. Among households without latrines in use, A. lumbricoides prevalence was higher comparing communities with sanitation usage ≥ 60% versus < 20%. Households with a latrine in use had lower prevalence of A. lumbricoides compared to households without latrines in use only in communities where sanitation usage was ≥ 80%. CONCLUSIONS: We found no evidence of a protective association between community sanitation usage and STH infection. The relationship between STH infection and community sanitation usage may be complex and requires further study

Factors associated with pastoral community knowledge and occurrence of mycobacterial infections in human-animal interface areas of Nakasongola and Mubende districts, Uganda

<p>Abstract</p> <p>Background</p> <p>Nontuberculous mycobacteria (NTM) are emerging opportunistic pathogens whose role in human and animal disease is increasingly being recognized. Major concerns are their role as opportunistic pathogens in HIV/AIDS infections. The role of open natural water sources as source and livestock/wildlife as reservoirs of infections to man are well documented. This presents a health challenge to the pastoral systems in Africa that rely mostly on open natural water sources to meet livestock and human needs. Recent study in the pastoral areas of Uganda showed infections with same genotypes of NTM in pastoralists and their livestock. The aim of this study was to determine the environmental, animal husbandry and socio-demographic factors associated with occurrence and the pastoral community knowledge of mycobacterial infections at the human-environment-livestock/wildlife interface (HELI) areas in pastoral ecosystems of Uganda.</p> <p>Methods</p> <p>Two hundred and fifty three (253) individuals were subjected to a questionnaire survey across the study districts of Nakasongola and Mubende. Data were analyzed using descriptive statistics and multivariable logistic regression analysis.</p> <p>Results</p> <p>Humans sharing of the water sources with wild animals from the forest compared to savannah ecosystem (OR = 3.3), the tribe of herding pastoral community (OR = 7.9), number of rooms present in household (3-5 vs. 1-2 rooms) (OR = 3.3) were the socio-demographic factors that influenced the level of knowledge on mycobacterial infections among the pastoral communities. Tribe (OR = 6.4), use of spring vs. stream water for domestic use (OR = 4.5), presence of sediments in household water receptacle (OR = 2.32), non separation of water containers for drinking and domestic use (OR = 2.46), sharing of drinking water sources with wild animals (OR = 2.1), duration of involvement of >5 yrs in cattle keeping (OR = 3.7) and distance of household to animal night shelters (>20 meters) (OR = 3.8) were significant socio-demographic factors associated with the risk of occurrence of mycobacterioses among the pastoral communities in Uganda.</p> <p>Conclusion</p> <p>The socio-demographic, environmental and household related factors influence the risk of occurrence as well as pastoralists' knowledge of mycobacterial infections in the pastoral households at the human-environment-livestock/wildlife pastoral interface areas of Uganda.</p

Molecular epidemiology, drug susceptibility and economic aspects of tuberculosis in mubende district, Uganda

<div><p>Background</p><p>Tuberculosis (TB) remains a global public health problem whose effects have major impact in developing countries like Uganda. This study aimed at investigating genotypic characteristics and drug resistance profiles of <i>Mycobacterium tuberculosis</i> isolated from suspected TB patients. Furthermore, risk factors and economic burdens that could affect the current control strategies were studied.</p><p>Methods</p><p>TB suspected patients were examined in a cross-sectional study at the Mubende regional referral hospital between February and July 2011. A questionnaire was administered to each patient to obtain information associated with TB prevalence. Isolates of <i>M. tuberculosis</i> recovered during sampling were examined for drug resistance to first line anti-TB drugs using the BACTEC-MGIT960^TMsystem. All isolates were further characterized using deletion analysis, spoligotyping and MIRU-VNTR analysis. Data were analyzed using different software; MIRU-VNTR <i>plus</i>, SITVITWEB, BioNumerics and multivariable regression models.</p><p>Results</p><p><i>M. tuberculosis</i> was isolated from 74 out of 344 patients, 48 of these were co-infected with HIV. Results from the questionnaire showed that previously treated TB, co-infection with HIV, cigarette smoking, and overcrowding were risk factors associated with TB, while high medical related transport bills were identified as an economic burden. Out of the 67 isolates that gave interpretable results, 23 different spoligopatterns were detected, nine of which were novel patterns. T2 with the sub types Uganda-I and Uganda-II was the most predominant lineage detected. Antibiotic resistance was detected in 19% and multidrug resistance was detected in 3% of the isolates.</p><p>Conclusion</p><p>The study detected <i>M. tuberculosis</i> from 21% of examined TB patients, 62% of whom were also HIV positive. There is a heterogeneous pool of genotypes that circulate in this area, with the T2 lineage being the most predominant. High medical related transport bills and drug resistance could undermine the usefulness of the current TB strategic interventions.</p></div

An Investigation on the Management of Intercultural Conflict among Students from ethnically diverse backgrounds focus at Ambo University

The purpose of this study was to investigate the management of intercultural conflict among students from ethnically diverse backgrounds in higher education institutions in Ethiopia, with a focus on Ambo University. The study's qualitative research design was ethnographic and sampling technique were simple random to students (open-ended questionnaire) and purposive sampling (heterogeneous) for the FGD. The sample size was 60 students who had fully filled out the questionnaire, and of those, 9 students participated in the group discussion and two vices were involved in the in-depth interview. Analysis of the qualitative data started in the field where data presentation was made in narration after thematic analysis. The findings of the study show that the causes of intercultural conflict are ethnocentrism, prejudice, stereotypes, but majorly a student murder at another public university, unethical presentation of the victim in mass media, service termination, naming a block by a rebel group or activist, national crisis, well planned and researched conflict escalation funding by ethnic entrepreneurs. The most widely prevalent types of intercultural conflicts are first interpersonal conflict, then it develops into group and mass, ethnic-based conflict, and structural conflict. Intercultural conflict management styles used by the students are dominating, integrating, physical confrontation, fighting, legal procedures, avoiding, and the most widely practiced is the collaborative approach, with over 90% of conflicts resolved by the peace forum. The university administrators' conflict resolution strategies were both mixed (Jarsuma and Gadda systems, local and federal forces). Although there have been challenges in managing intercultural conflict, such as different communication styles, misinformation on social media, unnecessary measurement by local and federal forces, and some students mocking traditional conflict resolution, conflict entrepreneurs funding students to fuel conflict, and homogeneous leadership. The study recommends that students use collaborative approaches to manage intercultural conflict management styles rather than harsh strategies. The study also recommends naming a block unofficially as it could cause intercultural conflict, so it is better to rename it with positive messages. Homogenous leadership is a hindrance to managing intercultural conflicts, so it should be heterogeneous to be the voice of the whole ethnic group. Finally, concluded with constructive recommendations and conclusions

Effects of different probiotics on the gut microbiome and metabolites in the serum and caecum of weaning piglets

The objective of the study was to determine the effects of antibiotics, yeast culture (YC), and Lactobacillus culture (LC) on the gut microbiome and metabolites in the serum and caecum of weaning piglets. Twenty-four weaning piglets were divided into four treatment groups: control, antibiotic (1% chlortetracycline), 1.8% yeast culture (YC), and 1.6% Lactobacillus culture groups (LC). Each group had six replicated pens with one pig per pen. Feed and water were available ad libitum. Dietary supplementation with antibiotics, YC and LC increased the abundance of phylum, Firmicutes, and decreased the abundance of phylum, Proteobacteria. Beneficial bacteria such as Lactobacillus and Megasphaera in YC and LC groups increased, whereas the proportion of Shigella was decreased. Genera Alloprevotella and Lachnospira were biomarkers in the control and antibiotic groups, respectively. Phylum, Bacteroidetes, and genus, Collinsella, were biomarkers in the YC group, and Mitsuokella, Anaerotruncus, Syntrophococcus and Sharpea were biomarkers in the LC group. Dietary supplementation with different probiotics changed the serum and caecum metabolite profiles too. Antibiotic supplementation increased the levels of D-mannose, D-glucose, and hexadecanoic acid in the serum, and the levels of myo-inositol, D-mannose and benzenepropanoic acid in the caecum. LC increased the concentrations of D-mannose, cis-9-hexadecenoic acid and heptadecanoic acid in caecum compared with the control group. YC and LC supplementation in the weaning diet could improve the abundance of beneficial bacteria by changing the concentrations of some metabolites in the serum and caecum. Therefore, dietary supplementation with YC or LC could be used as additives instead of antibiotics in weaning piglets.Keywords: antibiotic; lactobacillus culture; yeast culture; high-throughput sequencing; gas chromatography mass spectrometr

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Investigating effects of parasite infection on body condition of the Kafue lechwe (Kobus leche kafuensis) in the Kafue basin

<p>Abstract</p> <p>Background</p> <p>The Kafue lechwe (<it>Kobus leche Kafuensis</it>), a medium-sized semi-aquatic antelope, is endemic to the Kafue basin of Zambia. The population of the Kafue lechwe has significantly dropped in the last decades leading to its subsequent inclusion on the red list of endangered species. In order to save the remaining population from extinction, it has become increasingly important that the impact of parasite infection and infestation on the Kafue lechwe is investigated.</p> <p>Findings</p> <p>Endoparasites accounted for the majority of parasites observed from a study of 40 Kafue lechwe occurring in the the Kafue basin. <it>Amphistoma spp. </it>were present in all animals examined, while <it>Fasciola gigantica </it>had a prevalence rate of 0.525 (95% CI: 0.36 to 0.69) and species of <it>Schistosoma </it>0.3 (95% CI: 0.15 to 0.45). Among the ectoparasites, <it>Strobiloestrous vanzyli</it>, had a prevalence rate of 0.15 (95% CI: 0.03 to 0.27), while <it>Rhipicephalus appendiculatus </it>had a prevalence of 0.075 (3/40). Our findings indicate that body condition was not influenced by the parasitic infestation in Kafue lechwe. There was no association between sex and parasitic burden (odds ratio = 0.3, 95% CI: 0.8-1.3). However, an association between age and parasitic burden was observed as older animals above 15 years were more likely to get parasite infections than those aged between 1-5 years (odds ratio = 1.5, 95% CI: 1.1-2.4).</p> <p>Conclusion</p> <p>Overall, there was no evidence that parasitic infections and infestations adversely affected the lechwe population on the Kafue basin. These findings indicate that ecto- and endo-parasite infestation might not play a significant role in reducing the Kafue lechwe population on the Kafue basin.</p