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Addis Ababa, Ethiopia

Woyessa A.,Ethiopian Public Health Institute | Woyessa A.,Addis Ababa Institute of Technology | Deressa W.,Addis Ababa Institute of Technology | Ali A.,Addis Ababa Institute of Technology | Lindtjorn B.,University of Bergen
BMC Public Health

Background: Despite the encroaching of endemic malaria to highland-fringe areas above 2000 meters above sea level in Ethiopia, there is limited information on ownership and use of mosquito nets for malaria prevention. Thus, this study was designed to assess long-lasting insecticidal nets (LLIN) possession and use for malaria prevention in highland-fringe of south-central Ethiopia. Methods. A multi-stage sampling technique was employed to obtain household data from randomly selected households using household head interview in October and November 2008. Household LLIN possession and use was assessed using adjusted Odds Ratio obtained from complex samples logistic regression analysis. Results: Only less than a quarter (23.1%) of 739 households interviewed owned LLINs with more differences between low (54.2%) high (3.5%) altitudes (§ssup§2§esup§ =253, P < 0.001). Higher LLIN ownership was observed in illiterate (adj.OR 35.1 [10.6-116.2]), male-headed (adj.OR 1.7 [1.051-2.89]), owning two or more beds (adj.OR 2.7 [1.6-4.6]), not doing draining/refilling of mosquito breeding sites (adj.OR 3.4 [2.1-5.5]) and absence of rivers or streams (adj.OR 6.4 [3.5-11.8]) of household variables. The presence of ≥2 LLINs hanging (adj.OR 21.0 [5.2-85.1]), owning two or more LLINs (adj.OR 4.8 [1.3-17.5]), not doing draining/refilling of mosquito breeding sites (adj.OR 4.2 [1.3-13.6]), low wealth status (adj.OR 3.55 [1.04-12.14]), and < 1 km distance from absence of rivers or streams (adj.OR 3.9 [1.2-12.1]) of households was associated with more likely use of LLIN. The LLIN ownership was low in the highlands, and most of the highland users bought the bed nets themselves. Conclusions: This study found a low household LLIN ownership and use in the highland-fringe rural area. Therefore, improving the availability and teaching effective use of LLIN combined with removal of temporary mosquito breeding places should be prioritized in highland-fringe areas. © 2014 Woyessa et al.; licensee BioMed Central Ltd. Source

Abeshu M.A.,Inc JSI | Geleta B.,Ethiopian Public Health Institute
Biology and Medicine

Honey is one of nature's wonders. For long, honey has been used as important source of carbohydrates andnatural sweetener. Honey contains sugars, organic acids, minerals, and proteins, enzymes and vitamins in traceamounts. The simple sugars in honey are responsible for its sweetness, hygroscopicity, energy value and otherphysical properties.Honey's use as medicine has been limited due to lack of scientific report. In recent days, however, there isresurgence. Its greatest medicinal potential is its application as topical agent to wounds and skin infections. Honeyhas anti-inflammatory, immune boosting property, and exhibits broad spectrum antibacterial activity, which areattributed both to physical factors: acidity and osmolarity, and chemical factors: hydrogen peroxide, volatiles,beeswax, nectar, pollen and propolis. Its antioxidant activity is attributed to: glucose oxidase, catalase, ascorbic acid,flavonoids, phenolic acids, carotenoid derivatives, organic acids, Maillard reaction products, amino acids, andproteins. Honey prevents and treats gastrointestinal disorders such as peptic ulcers, gastritis and gastroenteritis. Italso poses prebiotic effects and promotes health of gastrointestinal tract.Honey has proven safety for use. Compared to glucose and sucrose, it has lower glycemic and incrementalindices in type I diabetic patients. It's simple sugars are absorbed directly into bloodstream without digestion and canserve as an athletic aid. © 2016 Abeshu MA, et al. Source

Assefa Y.,Ethiopian Public Health Institute | Alebachew A.,Federal HIV AIDS Prevention and Control Office | Lera M.,Federal HIV AIDS Prevention and Control Office | Lynen L.,Institute of Tropical Medicine | And 3 more authors.
Globalization and Health

Background: Antiretroviral treatment (ART) was provided to more than nine million people by the end of 2012. Although ART programs in resource-limited settings have expanded treatment, inadequate retention in care has been a challenge. Ethiopia has been scaling up ART and improving retention (defined as continuous engagement of patients in care) in care. We aimed to analyze the ART program in Ethiopia. Methods: A mix of quantitative and qualitative methods was used. Routine ART program data was used to study ART scale up and patient retention in care. In-depth interviews and focus group discussions were conducted with program managers. Results: The number of people receiving ART in Ethiopia increased from less than 9,000 in 2005 to more than 439, 000 in 2013. Initially, the public health approach, health system strengthening, community mobilization and provision of care and support services allowed scaling up of ART services. While ART was being scaled up, retention was recognized to be insufficient. To improve retention, a second wave of interventions, related to programmatic, structural, socio-cultural, and patient information systems, have been implemented. Retention rate increased from 77% in 2004/5 to 92% in 2012/13. Conclusion: Ethiopia has been able to scale up ART and improve retention in care in spite of its limited resources. This has been possible due to interventions by the ART program, supported by health systems strengthening, community-based organizations and the communities themselves. ART programs in resource-limited settings need to put in place similar measures to scale up ART and retain patients in care. © 2014 Assefa et al.; licensee BioMed Central Ltd. Source

Nega D.,Ethiopian Public Health Institute | Dana D.,Jimma University | Tefera T.,Jimma University | Eshetu T.,Jimma University

Background: In Sub-Saharan African countries, including Ethiopia, malaria in pregnancy is a major public health threat which results in significant morbidities and mortalities among pregnant women and their fetuses. In malaria endemic areas, Plasmodium infections tend to remain asymptomatic yet causing significant problems like maternal anemia, low birth weight, premature births, and still birth. This study was conducted to determine the prevalence and predictors of asymptomatic Plasmodium infection among pregnant women in the rural surroundings of Arba Minch Town, Southern Ethiopia. Methods: A community based cross-sectional study comprising multistage sampling was conducted between April and June, 2013. Socio-demographic data were collected by using a semistructured questionnaire. Plasmodium infection was diagnosed by using Giemsa-stained blood smear microscopy and a rapid diagnostic test (SD BIOLINE Malaria Ag Pf/Pv POCT, standard diagnostics, inc., Korea). Results: Of the total 341 pregnant women participated in this study, 9.1% (31/341) and 9.7% (33/341) were confirmed to be infected with Plasmodium species by microscopy and rapid diagnostic tests (RDTs), respectively. The geometric mean of parasite density was 2392 parasites per microliter (μl); 2275/ μl for P. falciparum and 2032/ μl for P. vivax. Parasitemia was more likely to occur in primigravidae (Adjusted odds ratio (AOR): 9.4, 95% confidence interval (CI): 4.3-60.5), secundigravidae (AOR: 6.3, 95% CI: 2.9-27.3), using insecticide treated bed net (ITN) sometimes (AOR: 3.2, 95% CI: 1.8- 57.9), not using ITN at all (AOR: 4.6, 95% CI: 1.4-14.4) compared to multigravidae and using ITN always, respectively. Conclusion: Asymptomatic malaria in this study is low compared to other studies' findings. Nevertheless, given the high risk of malaria during pregnancy, pregnant women essentially be screened for asymptomatic Plasmodium infection and be treated promptly via the antenatal care (ANC) services. © 2015 Nega et al. Source

Assefa Y.,Ethiopian Public Health Institute | Assefa Y.,Institute of Tropical Medicine | Lynen L.,Institute of Tropical Medicine | Wouters E.,University of Antwerp | And 4 more authors.
BMC Health Services Research

Background: Patient retention, defined as continuous engagement of patients in care, is one of the crucial indicators for monitoring and evaluating the performance of antiretroviral treatment (ART) programs. It has been identified that suboptimal patient retention in care is one of the challenges of ART programs in many settings. ART programs have, therefore, been striving hard to identify and implement interventions that improve their suboptimal levels of retention. The objective of this study was to develop a framework for improving patient retention in care based on interventions implemented in health facilities that have achieved higher levels of retention in care. Methods. A mixed-methods study, based on the positive deviance approach, was conducted in Ethiopia in 2011/12. Quantitative data were collected to estimate and compare the levels of retention in care in nine health facilities. Key informant interviews and focus group discussions were conducted to identify a package of interventions implemented in the health facilities with relatively higher or improving levels of retention. Results: Retention in care in the Ethiopian ART program was found to be variable across health facilities. Among hospitals, the poorest performer had 0.46 (0.35, 0.60) times less retention than the reference; among health centers, the poorest performers had 0.44 (0.28, 0.70) times less retention than the reference. Health facilities with higher and improving patient retention were found to implement a comprehensive package of interventions: (1) retention promoting activities by health facilities, (2) retention promoting activities by community-based organizations, (3) coordination of these activities by case manager(s), and (4) patient information systems by data clerk(s). On the contrary, such interventions were either poorly implemented or did not exist in health facilities with lower retention in care. A framework to improve retention in care was developed based on the evidence found by applying the positive deviance approach. Conclusion: A framework for improving retention in care of patients on ART was developed. We recommend that health facilities implement the framework, monitor and evaluate their levels of retention in care, and, if necessary, adapt the framework to their own contexts. © 2014 Assefa et al.; licensee BioMed Central Ltd. Source

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