Medicine, Ethiopia
Medicine, Ethiopia

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Deribew A.,Jimma University | Deribe K.,Jimma University | Reda A.A.,Haromaya University | Tesfaye M.,Jimma University | And 3 more authors.
BMC Public Health | Year: 2013

Background: There is a dearth of literature on the impact of TB/HIV co-infection on quality of life (QoL). We conducted a study to assess the change in QoL over a 6-months period and its predictors among HIV-infected patients with and without TB in Ethiopia. Methods. 465 HIV-infected patients without TB and 124 TB/HIV co-infected patients were enrolled in a prospective study in February, 2009. 455 (98%) HIV-infected and 97 (78%) TB/HIV co-infected patients were followed for 6 months. Data on QoL at baseline and 6§ssup§ th§esup§ month were collected by trained nurses through face to face interviews using the short Amharic version of the World Health Organization Quality of Life Instrument for HIV clients (WHOQOL HIV-Brief). Common Mental Disorder (CMD) was assessed using a validated version of the Kessler-10 scale. Multivariate analysis was conducted using generalized estimating equations (GEE) using STATA to assess change in QoL and its predictors. Results: There was a statistically significant improvement of the physical, psychological, social, environmental and spiritual QoL at the 6§ssup§th§esup§ months follow up compared to the baseline for both groups of patients (P < 0.0001). The change in QoL in all dimension were more marked for TB/HIV co-infected patients compared to HIV-infected patients without TB.A severe form of CMD was strongly associated with poorer physical QoL among TB/HIV co-infected individuals (β = -2.84; P = 0.000) and HIV clients without TB (β = -2.34; P = 0.000). Conclusion: This study reveals that ART and anti-TB treatment significantly improve the QoL particularly among TB/HIV co-infected patients. We recommend that the ministry of health in collaboration with partners shall integrate mental health services into the TB/HIV programs and train health care providers to timely identify and treat CMD to improve QoL. © 2013 Deribew et al.; licensee BioMed Central Ltd.


Deribew A.,Jimma University | Deribe K.,Brighton and Sussex Medical School | Reda A.A.,Haromaya University | Tesfaye M.,Jimma University | Hailmichael Y.,Jimma University
BMC Psychiatry | Year: 2013

Background: The relationship between TB/HIV co-infection and common mental disorders (CMD) is not well investigated. A follow up study was conducted to assess the change in CMD over a 6-months period and its predictors among TB/HIV co-infected and HIV patients without TB in Ethiopia.Methods: A longitudinal study was conducted in 2009. A total of 465 HIV/AIDS patients without TB and 124 TB/HIV co-infected patients from four antiretroviral treatment (ART) centers in Ethiopia were recruited to assess CMD and quality of life (QoL). CMD and QoL were assessed at baseline and at six month using the Kessler-10 scale and the short Amharic version of the World Health Organization Quality of Life Instrument for HIV clients (WHOQOL HIV-Bref) respectively. Multivariate analysis was conducted using generalized estimating equations (GEE) using STATA to assess change in CMD and its predictors.Results: At the 6 month, 540 (97 TB/HIV co-infected and 455 HIV/AIDS patients without TB) patients completed the follow up and 8.6% (21% among TB/HIV co-infected and 2.2% among HIV patients without TB) lost to follow-up.At baseline, 54.4% of TB/HIV co-infected patients had mild to severe mental disorder compared to 41.2% among HIV patients without TB. At the six month follow up, 18.1% of TB/HIV co-infected patients had mild to severe mental disorder compared to 21.8% among HIV patients without TB. The decline of the prevalence of any form of metal disorder was 36.3% among TB/HIV co-infected patients compared to 19.4% among HIV patients without TB (P<0.001).QoL was strongly associated with CMD in TB/HIV co-infected patients and HIV patients without TB (β = -0.04, P<0.001) after controlling the effect of several confounding variables such as sex, income, WHO disease stage, duration on ART, CD4 lymphocyte count, adherence to ART and social support.Conclusion: The prevalence of CMD has significantly reduced particularly among TB/HIV co-infected patients over a 6 months period. Poor QoL is the major independent predictors of CMD. We recommend integration of mental health services in TB/HIV programs. Training of health care providers at TB/HIV clinics could help to screen and treat CMD among TB/HIV co-infected patients. © 2013 Deribew et al.; licensee BioMed Central Ltd.


Abate T.,Hawassa University | Ebro A.,Adami Tulu Agriculture Research Center | Nigatu L.,Haromaya University
Tropical Grasslands | Year: 2010

A study was conducted to examine rangeland resource utilisation practices of pastoralists and rangeland degradation in Rayitu district, southeast Ethiopia. A single-visit survey method was used to gather data through a structured questionnaire (90 households), group discussions and direct observations. Free grazing of communal land (100%), use of enclosures (89%), division of herds based on species and class of animal (59%), migration (79%) and seasonal assessments of the condition of rangeland were the basic traditional rangeland management practices. About 91% of pastoralists indicated that the condition of their rangelands was poor. The most dominant use for woody plants was for construction (91%), followed by browse (68%) and medicinal purposes (25%). More than 86% of the respondents considered that their grazing lands now carried more bushes and shrubs than they did 30 years ago. Feed and water shortages and drought were identified as current challenges for pastoralists, with migration the main coping strategy, in spite of the hardships it entails. Rejuvenating the existing rangelands requires the development of a rangeland management strategy involving pastoralists and other stakeholders, with all participants fully committed to a successful outcome. A reduction in livestock numbers must be an essential component of any future strategy.


Hassen A.,Debre Berhan University | Ebro A.,Adami Tulu Agriculture Research Center | Kurtu M.,Haromaya University | Treydte A.C.,University of Hohenheim
Livestock Research for Rural Development | Year: 2010

A study with the objectives of assessing and documenting the management and utilization practices of different feed resources was carried out in Basona Worana district in the Central highlands of Ethiopia. The study was undertaken using group discussions, structured questionnaire and personal observations. Livestock ownership per household (7.44 Tropical Livestock Unit (TLU) was higher in the high than in the low (4.71 TLU) altitude zone. Native pastures, crop residues, grazing of crop stubbles and fallows lands were the major feed resources in the area. There were private, communal and riverside grazing areas. Although natural pasture and crop residues were produced in large amounts, their full and efficient utilization for livestock feeding has been hindered partly by economic problems and inadequate knowledge of the farmers. The major constraints for not applying different roughage treatment techniques were inadequate knowledge about the methods, lack of finance and accessibility to the methods. Raising the productivity of the pasture land by adopting sound management practices, growing productive and nutritious forages in association with food crops and identifying and correcting the most limiting feed nutrients by using supplements are among the options for resolving animal feed shortages. Training of farmers about feed resource utilization, management and the involvement of the government in improving the financial capabilities of farmers are very important.


Admasu T.,P.A. College | Abule E.,Adami Tulu Agriculture Research Center | Tessema Z.,Haromaya University
Livestock Research for Rural Development | Year: 2010

A survey was conducted in Hamer and Benna-Tsemay districts of the South Omo zone of Ethiopia, with the objectives of assessing the range-livestock management practices and perceptions of the different pastoral groups (Hamer, Benna, and Tsemay) towards rangeland degradation. This information is considered to be vital to future pastoral development planning and interventions. The information was gathered through group discussions, personal observations, and using a structured questionnaire where each household was taken as a unit of analysis. The average family size per household was for Hamer = 7.05 for Benna = 7.93 and for Tsemay = 7 with nearly 98.1% of the respondents without any kind of education. All pastoral groups derived their main income from the sale of animals, which was followed by the sale of honey as in the case of Hamer and Tsemay pastoralists. The average livestock per household was 25.7, 10 and 2.8 tropical livestock unit (TLU) cattle, goat and sheep, respectively. The major livestock production constraints were drought, feed and water shortage and animal health problems. The different pastoral groups have the opinion that the condition of their rangeland is poor, mainly due to overgrazing, drought and increase in human population. Furthermore, there was also a problem of bush encroachment which is an indicator of rangeland degradation. There are no range improvement practices undertaken to improve the condition of the rangelands. Mobility is the first measure taken to solve shortage of livestock feed and water but many of the pastoralists replied that they face many problems during migrations. Because of the unfavorable climatic condition for cultivation, most of the respondents of Hamer and Tsemay pastoralists and about 35% from Benna still prefer communal land tenure, where resources are shared. In conclusion, the indigenous knowledge of the pastoralists about range-livestock management and their environment should be incorporated while planning range-livestock development projects for the study districts.


Terefe A.,P.A. College | Ebro A.,Adami Tulu Agriculture Research Center | Zewedu T.,Haromaya University
Livestock Research for Rural Development | Year: 2010

A study was undertaken in Hamer and Benna-Tsemay districts of the Southern Ethiopia with the objective to determine the condition of the rangelands for grazing animals as influenced by altitude and grazing types. The rangelands in each of the study districts were stratified based on altitude and grazing types. In the study districts, a total of 32, 3, 2, 7 and 29 species of grasses, legumes, sedges, other herbaceous plants and woody species were identified, respectively. The common and/or dominant grass species in the enclosures was Cenchrus ciliaris while in the communal grazing areas they were Cynodon dactylon and Tetrapogon tennulis. In riverside grazing areas, the common and/or dominant grass species was Cynodon dactylon. The total grass biomass of communal, riverside and enclosure areas found in the different altitude categories of the study districts ranged from 398-503; 98-626, and 1,132 - 1,209 kg/ha, respectively. The common and/or dominant woody species in the communal grazing areas were highly palatable species of Acacia tortilis and Grewia bicolor and less palatable Solanum species. In riverside grazing areas, the common and/or dominant woody plants were species of Acacia tortilis, Grewia bicolor, and Solanum species while in the enclosures; Acacia brevispica and Acacia tortilis were found. The woody vegetation density per hectare of communal, riverside and enclosure areas in the different altitude categories of the study districts ranged from 2,501-3,021; 2251-3,021, and 201-700,wd/ha respectively which showed that the communal and riverside grazing areas were bush encroached. The range condition scores ranged from 17.87-20.38 (communal), 22-27 (riverside), 31.05-31.2 (enclosures) which were poor, fair and good condition classes, respectively. Similarly, with regard to the same variable the scored varied from 22-32.87, 19.73-31.43, 17.97-31.44 and 17.87-31.28% in altitudes >1550m, 1250-1550m, 900-1250m, and 550-900m, respectively. The result indicated the need for rangeland improvement measures in communal and riverside grazing areas, in order to attain sustainable livestock production from these areas. Establishment of community based enclosures was found to be one of the ways to improve the condition of the rangelands. The result indicated the need for rangeland improvement measures in communal and riverside grazing areas, in order to attain sustainable livestock production from these areas. Establishment of community based enclosures was found to be one of the ways to improve the condition of the rangelands.


PubMed | Mekele University, Hawassa University, Jimma University, Haromaya University and 5 more.
Type: | Journal: International journal of cardiology | Year: 2016

Auscultation-based surveys in Ethiopia conducted in the late 1990s reported a rural prevalence of 4.6/1000 and an urban prevalence of 6.4/1000 of rheumatic heart disease (RHD). With echo-based screening, we aimed to estimate the national prevalence of RHD in school children by taking school-based samples from six regions across the country using the 2012 World Heart Federation echocardiographic criteria.We conducted a cross-sectional echocardiographic screening of RHD in school children aged 6-18years from 28 randomly selected primary and secondary schools found in six different geographic regions of Ethiopia. We used the standardized WHF echocardiographic criteria.A total of 3238 children (48.5% females) were screened. The mean age was 13.23.2years. Of these, 44 patients (1.4%) met the WHF criteria for definite RHD, while 15 (0.5%) met the criteria for borderline disease, yielding a prevalence of 19 [13.9-23.4, 95% CI] cases per 1000 school children between the ages of 6-18years. The majority of those who tested positive were girls (26/44). The prevalence was lowest in children aged 6-9years and otherwise uniformly distributed across ages 10-18years. Definite RHD involved the mitral valve in 42 subjects, 39 of whom had mitral regurgitation and 3 with mitral stenosis. The aortic valve was affected in 6 children. The ratio of definite to borderline cases was 2.9.This study demonstrated a consistent pattern of high prevalence of asymptomatic RHD with definite disease predominating over borderline involvement across six regions of Ethiopia.


Mitiku H.,Haromaya University | Legesse M.,Addis Ababa Institute of Technology | Teklemariam Z.,Haromaya University | Erko B.,Addis Ababa Institute of Technology
Ethiopian Journal of Health Development | Year: 2010

Background: Although the epidemiology of schistosomiasis is well established and the disease distribution has also been mapped in Ethiopia, discovery of new foci has continuously been reported. Objectives: The objective of this study was to assess the establishment of transmission of schistosomiasis mansoni in Tikur Wuha area, southern Ethiopia. Methods: A cross-sectional epidemiological study involving 375 school children in Tikur Wuha Elementary School was conducted in December 2007 and January 2008. Stool specimens were collected and microscopically examined using Kato-Katz method. Snail survey was also conducted using scoop in Tikur Wuha River and littoral zone of Lake Awassa on the side of Tikur Wuha Kebele (administrative unit). The snails collected were checked for trematode infection by shedding. Laboratory-bred mice were exposed to schistosome cercariae and definite identification of the schistosome was made using eggs and adult worm morphology. Results: The prevalence and intensity of schistosomiasis mansoni was 12% and 69 eggs per gram (epg) of stool, respectively. Biomphalaria sudanica collected in Tikur Wuha River shed schistosome cercariae. Adult S. mansoni worms were harvested from laboratory-bred mice after 6 weeks of laboratory maintenance. Conclusion: The prevalence and intensity of schistosomiasis mansoni among school children was low and the area represents low-risk community. The finding of S. mansoni infected young children, the collection of B. sudanica infected with schistosome cercariae, and the establishment of infection in lab-bred mice all confirmed the transmission of schistosomiasis mansoni in Tikur Wuha area. Appropriate intervention measures need to be in place to reduce morbidity and transmission of intestinal schistosomiasis in the area.


Dubiwak R.,Haromaya University | Seme A.,Addis Ababa Institute of Technology
Ethiopian Medical Journal | Year: 2014

Background: Contraceptive method mix and choice is not uniform across all countries. Literatures have shown that a significant variation exists in contraceptive method mix among regions and countries. In Africa most mothers rely on short-term contraceptives such as pills and injectables or traditional methods while in Asia and Latin America permanent methods mainly male and female sterilizations are commonly used. Though long term methods of contraception are recommended for its effectiveness and efficiencies in countries like Ethiopia where high fertility rate is a concern, its choice and utilization remains low. Objective: The main objective of the study was to assess factors influencing contraceptive method choice and use among married women of reproductive age in rural Districts of East Harerge Zone of Oromia Region. Methods: A community-based cross-sectional study using both quantitative and qualitative methods was conducted among 473 married women of reproductive age in two rural districts of East Harerge Zone. A systematic random sampling method was used to select the study participants from the list of all married women who have been using contraceptives in the project sites. Data was collected using structured and pretested questionnaires. Data entry and analysis was done using EPI Info version 6.04d and SPSS for Windows version 15, respectively. Frequencies and proportions were used for description while odds ratio with 95% CI was used to determine the strength and significance of association between independent and outcome variables. Multiple logistic regression analysis was used to control confounding variables. Results: A total of 473 currently married women who were using modern contraceptives were interviewed for the survey. About 6 in ten (58.8%) were in the age range of 25-34 years with the mean (±SD) age of 29.5 (±5.7)years. About three-fourth (74%) were short-term contraceptive method users while only 26% were long-term contraceptive method users. Duration of family planning use, reasons for contraceptive use and provider's choice of the method were positively associated with long-term contraceptive use by married women of reproductive age in the study area. Qualitative finding showed that religious and cultural perceptions about contraceptives and values the society, particularly men, gives to large family size has negatively influenced contraceptive use. Conclusions: Long-term contraceptive method use is influenced by duration and reason for use of the methods and provider's choice in the study area. Misconceptions about fertility regulations and the value the society gives to large family size do also affect contraceptive use. Beside availing contraceptives of choice, reproductive health/ family planning awareness creation targeting religious leaders as well as interventions aimed at respecting women's right of accessing family planning method of their choice has to be strengthened in the study area.


Hagos F.,Basin Water | Mamo K.,Haromaya University
Water Resources and Economics | Year: 2014

This paper examines the economics of groundwater irrigation and its impact on livelihood of smallholder farmers in Eastern Ethiopia. The results indicate that groundwater technologies are financially viable at 8, 12.25 and 16.5 percent discount rates. The net present value of these technologies is still viable under partial and full cost recovery regimes. Small-scale groundwater irrigation with boreholes provides a good option for poor households, bringing about significant positive impact in consumption expenditure. Groundwater, if adequately harvested, has a significant positive impact on the improvement of livelihoods of smallholding farmers; it is advantageous for the society if government and nongovernmental agencies are engaged in the expansion of deep groundwater wells on a sustainable basis. It is also vital to think of institutionalizing a cost recovery scheme to ensure water use efficiency and to sustain the future investments in irrigation, especially in developing groundwater resources. © 2014 .

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