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Terefe B.,University of Gondar | Birhanu A.,Addis Ababa Institute of Technology | Nigussie P.,Ethiopian Health and Nutrition Research Institute EHNRI | Tsegaye A.,Addis Ababa Institute of Technology
Anemia | Year: 2015

Iron deficiency anemia among pregnant women is a widespread problem in developing countries including Ethiopia, though its influence on neonatal iron status was inconsistently reported in literature. This cross-sectional study was conducted to compare hematologic profiles and iron status of newborns from mothers with different anemia status and determine correlation between maternal and neonatal hematologic profiles and iron status in Ethiopian context. We included 89 mothers and their respective newborns and performed complete blood count and assessed serum ferritin and C-reactive protein levels from blood samples collected from study participants. Maternal median hemoglobin and serum ferritin levels were 12.2 g/dL and 47.0 ng/mL, respectively. The median hemoglobin and serum ferritin levels for the newborns were 16.2 g/dL and 187.6 ng/mL, respectively. The mothers were classified into two groups based on hemoglobin and serum ferritin levels as iron deficient anemic (IDA) and nonanemic (NA) and newborns of IDA mothers had significantly lower levels of serum ferritin (P = 0.017) and hemoglobin concentration (P = 0.024). Besides, newborns' ferritin and hemoglobin levels showed significant correlation with maternal hemoglobin (P = 0.018; P = 0.039) and ferritin (P = 0.000; P = 0.008) levels. We concluded that maternal IDA may have an effect on the iron stores of newborns. © 2015 Betelihem Terefe et al. Source

Misgena D.K.,Ethiopian Health and Nutrition Research Institute EHNRI
Ethiopian Journal of Health Development | Year: 2011

Background: Since the advent of HAART, there is a significant reduction in opportunistic Infections (OIs), morbidity, mortality and HIV transmission. However, the low antiretroviral Therapy (ART) coverage in resource-limited countries (42%) and the presence of globally 500-800 thousand patients on first-line having to required switch to second-line drugs in 2010 are some concerns. Other challenges related to HAART include: lifelong therapy, failed treatment response, optimal time to start treatment and switching regimens, drug interaction, toxicity, cardiovascular risks, drug resistance, lost to follow-up, immune reconstitution inflammatory syndrome (IRIS), early mortality, and lack of restoration of solid immunity against HIV. To achieve the goals of ART, national ART programmes focus on the vital patient monitoring systems including clinical, immunologic, virologic, adherence, lost to follow-up and mortality. Objectives: This review is aimed at addressing the profile of immunovirological responses to HAART and the factors associated with, with a special emphasis on the drawbacks of immunologic assessment to diagnose virologic failures. Main findings: WHO recommends clinical and immunological assessments as surrogates of plasma viral load (VL) to identify first-line treatment failures in resource-poor settings. However, immunological tools have poor sensitivity (20-30%) and specificity (86-90%) to identify virologic failures that may lead to continue with failed regimen or to unnecessary switch of regimen which could result in a more complex profile of resistance. There are three main types of immunovirologic responders in clinical practice: concordant responders (40-60%), concordant non-responders (12-27.3%), and discordant responders that include lack of CD4+ increases despite viral suppression (7-48%), and optimal CD4+ responses in the absence of viral suppression (5-23.8%), whereby the risk of morbidity and mortality is higher in the concordant non-responders and discordant responders. Conclusions: ART benefits a substantial number of HIV patients even in resource-poor settings. Since clinico-immunological assessments have lower performance in diagnosing virologic failures, moving towards the availability of VL testing to confirm treatment failures, if not pre-HAART resistance testing, is a logical and timely approach for resource limited countries like Ethiopia where the long-term effect of the roll-out ART is not well investigated. However, the high cost and technical demand of VL testing, lack of experience of health professionals, weak infrastructure and health care system, the unavailability and high costs of second-line drugs could be the major challenges during expansion of VL testing. Moreover, longitudinal studies on long-term effects of HAART, and surveys focused on transmitted or acquired HIV drug resistance, and Early Warning Indicators are highly pertinent. Source

Akalu G.,Ethiopian Health and Nutrition Research Institute EHNRI | Taffesse S.,Ethiopian Health and Nutrition Research Institute EHNRI | Gunaratna N.S.,Nevin Scrimshaw International Nutrition Foundation | De Groote H.,International Maize and Wheat Improvement Center
Food and Nutrition Bulletin | Year: 2010

Background. Undernutrition is a persistent problem in Africa, especially in rural areas where the poor largely depend on staples and have limited access to a diverse diet. Quality protein maize (QPM) consists of maize varieties biofortified with increased lysine and tryptophan levels. Several studies in controlled settings have indicated the positive impact of QPM on the nutritional status of children. Objective. Two 1-year, randomized, controlled studies were undertaken to measure the effect of QPM on the nutritional status of children consuming typical maize-based diets when QPM was cultivated by their households in the western Ethiopian highlands. Methods. The first study used a cluster-randomized design with 151 children aged 5 to 29 months; the second study used a completely randomized design with 211 children aged 7 to 56 months. In both studies, half of the households were provided with QPM seed and the other half with seed of an improved conventional maize variety. Results. Undernutrition was pervasive, and maize was the dominant food in the children's complementary diets. In the first study, a positive effect of QPM was observed for weight but not height, with children in the QPM group recovering from a drop in weight-for-height. In the second study, children consuming conventional maize progressively faltered in their growth, whereas children consuming QPM did not change significantly in height-for-age and had a marginal increase in weight-for-age. Conclusions. These studies indicate that in major maize-producing and -consuming areas of Africa, home cultivation and use of QPM in children's diets could reduce or prevent growth faltering and may in some cases support catch-up growth in weight. © 2010, The United Nations University. Source

Tegegne D.,Health Science University | Desta K.,Addis Ababa Institute of Technology | Tegbaru B.,Ethiopian Health and Nutrition Research Institute EHNRI | Tilahun T.,Ethiopian Health and Nutrition Research Institute EHNRI
BMC Research Notes | Year: 2014

Background: Hepatitis B Virus is a major public health problem worldwide. In 2012 alone, over 350 million chronic carriers and 1. 2 million annual deaths were occurred. Hepatitis B Virus causes 60 to 80% of the world's primary liver cancer and nearly 90% infants infected due to vertical transmission are at higher risk of developing chronic liver disease and cancer. Hence determining the burden of maternal and neonatal Hepatitis B Virus infection is a priority. Methods. A cross sectional study was conducted from July - September 2012 at St. Paul's Hospital Millennium Medical College and Selam Health Center, Addis Ababa, Ethiopia. Blood samples from delivering mothers (n = 265) and their corresponding cords (n = 265) were collected. A pretested questionnaire was used to collect data. Hepatitis B Virus surface antigen was detected using Enzyme Linked Immunosorbent Assay. Frequency analysis and logistic regression test was used to identify the potential risk factors associated with Hepatitis B Virus positivity using SPSS Version -15. Results: A total of 265 delivering women with the mean age of 25.8 years were enrolled in the study. Of these delivering women, 8 (3.0%) of mothers were positive for Hepatitis B Virus surface antigen, whereas 6 (2.3%) of cord bloods were positives with 75% concordance rate of exposed infants with sero-positive mothers. However, only one maternal positive case was observed for Hepatitis B e Ag test. Only 11% of the mothers know their Hepatitis B Virus status. Of the total mothers assessed for possible risk factors, 69 (26%) had only one type, while 161 (60.8%) had multiple exposure factors such as ear pricing, history of tribal marks, abortion, multiple-sexual partner and history of surgical procedures experienced from high to low frequency. The remaining 35 (13.2%) of the participants had not experienced possible risk factors. Conclusion: Though the maternal positivity rate was low, the rate of positivity in cord bloods was almost equal to those infected mothers. Therefore, screening of pregnant mothers and vaccination of infants could help to reduce the transmission. To minimize the higher overall risk exposure status of mothers, increasing awareness and intensive public health education is also recommended. © 2014 Tegegne et al.; licensee BioMed Central Ltd. Source

Baye K.,Addis Ababa Institute of Technology | Retta N.,Addis Ababa Institute of Technology | Abuye C.,Ethiopian Health and Nutrition Research Institute EHNRI
Food and Nutrition Bulletin | Year: 2014

Background. In light of the continuing rise in food prices during and after the 2008 world food crisis, whether food and cash transfers are equally effective in improving food security and diet quality is debatable. Objective. To compare the effects of conditional food and cash transfers of the Ethiopian Productive Safety Net Program (PSNP) on household food security and dietary diversity. Methods. Data on household dietary diversity, child anthropometry, food security, and preference of transfer modalities (food, cash, or mixed) were generated from a cross-sectional survey of 195 PSNP beneficiary households (67 receiving food and 128 receiving cash) in Hawella Tulla District, Sidama, southern Ethiopia. Results. Most beneficiaries (96%) reported food shortages, and 47% reported food shortages that exceeded 3 months. Households receiving cash had better household dietary diversity scores (p =.02) and higher consumption of oils and fats (p =.003) and vitamin A-rich foods (p =.002). Compared with households receiving food, households receiving cash were more affected by increases in food prices that forced them to reduce their number of daily meals (p <.001) and spend less on nonstaples (p <.001). While most households receiving food (82%) preferred to continue receiving food, households receiving cash (56%) preferred a mix of food and cash. Conclusions. Households receiving cash had better household dietary diversity than households receiving food, a result suggesting that cash transfers may be more effective. However, the continuing rise in food prices may offset these benefits unless cash transfers are index-linked to food price fluctuations. © 2014, The Nevin Scrimshaw International Nutrition Foundation. Source

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