Hawassa, Ethiopia
Hawassa, Ethiopia

Hawassa University is a public university in the Southern Nations, Nationalities, and People's Region of Ethiopia established as a body of Debub University on 22 December 1999. The main Campus and several Faculties located in Hawassa city, 270 km south of the capital Addis Ababa. Wikipedia.

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Berhan A.,Hawassa University | Berhan Y.,Hawassa University
BMC Endocrine Disorders | Year: 2013

Background: Alogliptin is a new dipeptidyl peptidase (DPP-4) inhibitor, which is under investigation for treatment of type 2 diabetes either alone or in combination with other antidiabetic drugs. The aim of this meta-analysis was to assess the efficacy and tolerability of alogliptin in patients with type 2 diabetes.Methods: Computer based search was performed in MEDLINE, Cochrane library, and HINARI (Health InterNetwork Access to Research Initiative) databases. Meta-analysis was carried out by incorporating double-blind randomized controlled studies done on the efficacy of alogliptin in patients with type 2 diabetes. The efficacy and tolerability of alogliptin was determined by standardized mean differences (SMDs) and Mantel-Haenszel odds ratio. Heterogeneity was assessed by the chi-squared test (Cochran Q test) and I2 statistics.Results: The pooled SMDs demonstrated a significant reduction in HbA1c in patients treated with alogliptin 12.5 mg (SMD = -0.81; 95% CI, -1.11 to -0.51) or alogliptin 25 mg (SMD= -0.98; 95%CI= -1.30 to -0.66) as compared with controls. The SMD for reduction in fasting plasma glucose level (FPG) from baseline was also statistically significant among alogliptin treated patients. However, the effect of alogliptin on body weight change was inconclusive. The proportion of patients who discontinued alogliptin due to adverse events was not different from controls. Similarly, the meta-analyses of specific adverse events did not demonstrate statistically significant differences.Conclusions: Alogliptin alone or in combination with other antidiabetic drug has shown a significant reduction in HbA1c and FPG level in patients with type 2 diabetes. However, its consistent efficacy for longer duration of therapy needs further investigation. © 2013 Berhan and Berhan; licensee BioMed Central Ltd.

Regassa N.,Hawassa University
African Health Sciences | Year: 2011

Background: Access to antenatal care (ANC) and postnatal care (PNC) services has a great deal of impacts on major causes of infant death and significantly affects trends of mortality in a population. Antenatal care may play an indirect role in reducing maternal mortality by encouraging women to deliver with assistance of a skilled birth attendant or in a health facility. In most rural settings of Ethiopia, there are challenges in increasing such health care service utilization mainly due to the fact that the decisions that lead women to use the services seem to occur within the context of their marriage, household and family setting. Objective: Examining the prevalence and factors associated with antenatal Care (ANC) and Postnatal Care (PNC) service utilizations. Methods: This was a cross-sectional population based study undertaken in 10 rural villages of the Sidama zone, southern Ethiopia. The data were collected from a representative sample of 1,094 households drawn from the study population using a combination of simple random and multistage sampling techniques. Two dependent variables were used in the analysis: The ANC, measured by whether a woman got the service (at least once) from a health professional or not during her last pregnancy and PNC which was approximated by whether the last born child completed the required immunization or not. Household and women's characteristics were used as explanatory variables for both dependent variables. Results: The study revealed that the level of ANC and PNC service utilizations is 77.4 % and 37.2% respectively. The predicted probabilities, using logistic regression, showed that women who are literate, have exposure to media, and women with low parity are more likely to use both ANC and PNC services. Conclusion: Antenatal care service utilization was generally good while the postnatal care given to new born children was very low compared to other population groups in the region. Promoting women's education and behavioral change communication at grass root level, provision of the services at both home and health facilities, and improving the quality and capacity of the health providers are some of the recommendations forwarded.

This meta-analysis was conducted to determine the efficacy, safety and tolerability of tofacitinib in the treatment of rheumatoid arthritis in patients with an inadequate response or intolerance to at least one of the nonbiologic or biologic disease-modifying antirheumatic drugs (DMARDs). Electronic based literature search was conducted in the databases of HINARI (Health InterNetwork Access to Research Initiative), MEDLINE and Cochrane library. The studies included in the meta-analysis were double-blind randomized clinical trials that were conducted in treatment-refractory or intolerant patients with rheumatoid arthritis. The odds ratios (OR), standardized mean differences (SMD) and the 95% confidence intervals (95% CI) were determined by using the random effects model. Heterogeneity among the included studies was evaluated by I2 statistics. The odds of tofacitinib treated patients who met the criteria for an at least a 20% improvement in the American College of Rheumatology scale (ACR 20) was more than 4 times higher than placebo treated patients (overall OR = 4.15; 95% CI, 3.23 to 5.32). Even though the discontinuation rate due to adverse events was not different from placebo groups, tofacitinib was associated with infections (overall SMD = 1.96, 95% CI = 1.428 to 2.676), reduction in neutrophil counts (overall SMD = -0.34, 95% CI = -0.450 to -0.223) and elevated levels of LDL cholesterol and liver enzymes. Tofacitinib was effective in the treatment of active rheumatoid arthritis in patients with an inadequate response or intolerance to at least one DMARDs. However, treatment with tofacitinib was associated with infections and laboratory abnormalities.

Background: The discovery of sodium-glucose co-transporter 2 (SGLT2) inhibitors, with a novel mechanism independent of insulin secretion or sensitization, bring about a new therapeutic approach to the management of type 2 diabetes mellitus. The aim of this meta-analysis was to evaluate the safety and efficacy of SGLT2 inhibitors at different doses in randomized double blind clinical trials.Methods: This meta-analysis was conducted by including randomized double-blind controlled trials of SGLT2 inhibitors in patients with type 2 diabetes irrespective of their antidiabetic drug exposure history but with an inadequate glycemic control. All the effect sizes were computed using the random effects model. Standardized mean differences (SMDs) and odds ratios (OR) were computed for continuous and dichotomous variables, respectively. Additional analyses like sensitivity analysis, subgroup analysis and meta-regression were also performed.Results: The pooled analyses demonstrated a significant reduction in mean changes in Hemoglobin A1c (HbA1c) (SMD = -0.78%, 95% CI, -0.87 to -0.69), fasting plasma glucose (FPG) (SMD = -0.70 mg/dl, 95% CI, -0.79 to -0.61), body weight (overall SMD = -0.59 kg, 95% CI, -0.65 to -0.52) and blood pressure from baseline with SGLT2 inhibitors based therapy. Consistently a significant number of patients treated with SGLT2 inhibitors achieved HbA1c < 7% (OR = 2.09, 95% CI, 1.77 to 2.46). SGLT2 inhibitors based therapy was associated with adverse events like genital and urinary tract infections.Conclusion: All studied doses of SGLT2 inhibitors, either as monotherapy or in combination with other antidiabetic agents, consistently improved glycemic control in patients with type 2 diabetes. However, a small percentage of patients suffer from genital and urinary tract infections. © 2013 Berhan and Barker; licensee BioMed Central Ltd.

Background: Vortioxetine is a novel multimodal compound that has recently been approved by the FDA for the treatment of major depressive disorder (MDD). It is a selective serotonin (5-HT) 3A and 5-HT7 receptor antagonist, 5-HT1B receptor partial agonist, 5-HT1A receptor agonist and inhibitor of serotonin transporters. The objective of this meta-analysis was to evaluate the efficacy and safety of vortioxetine in adults with MDD.Methods: A literature search was conducted in the databases of PubMed, EMBASE, Cochrane library and HINARI. The meta-analysis was conducted by including randomized controlled trials that assessed the efficacy and safety of vortioxetine in adult patients with MDD. Using the random effects model, which assumes individual studies are estimating different treatment effects, the efficacy and safety of vortioxetine was determined by weighted mean differences (WMDs) and odds ratios (ORs). The findings were considered as statistically significant when the 95% CI of WMDs and ORs did not include 0 and 1, respectively. Heterogeneity testing, meta-regression and sensitivity analysis were also performed.Results: During the initial literature search about 151 publications were identified. Based on the predetermined inclusion criteria, 7 randomized controlled trials were included. The pooled analysis demonstrated a statistically significant reduction in the Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline among patients who were on vortioxetine (WMD = -3.92; 95% CI, -5.258 to -2.581). Furthermore, a statistically significant number of patients with MDD who were on vortioxetine have achieved a greater than or equal to 50% reduction in depression symptoms from baseline. However, a significant number of patients who were on vortioxetine therapy reported more adverse events than patients who were on placebo (overall OR = 1.21; 95% CI, 1.06 to 1.38).Conclusions: Therapy with vortioxetine was significantly associated with reduction in depression symptoms from baseline compared to placebo. Nevertheless, a significant number of patients who were on vortioxetine therapy have reported more adverse events. © 2014 Berhan and Barker; licensee BioMed Central Ltd.

Background: Vitamin A deficiency can cause anemia as the nutrient is essential for hematopoiesis, mobilization of iron store and immunity. Nevertheless, clinical trials endeavored to evaluate the effect of Vitamin A Supplementation (VAS) on hemoglobin concluded inconsistently. Accordingly, the objective of the current study is to assess the effect of single high dose VAS on the hemoglobin status of children aged 6-59 months.Methods: The study was conducted based on the data of Ethiopian Demographic Health Survey 2011. The data from 2397 children aged 6-59 months who received a single dose of 30 or 60 mg of VAS (depending on age) in the preceding 6 months were matched with similar number children who did not receive the supplement in the reference period. The matching was based on propensity scores generated from potential confounders. Distributions of hemoglobin concentration and risks of anemia were compared between the groups using paired t-test, matched Relative Risk (RR) and standardized mean difference.Result: The supplemented and non-supplemented groups were homogeneous in pertinent socio-demographic variables. Compared to propensity score matched non-supplemented children, those who received vitamin A had a 1.50 (95% CI: 0.30-2.70) g/l higher hemoglobin concentration (P = 0.014). In the supplemented and non-supplemented groups, the prevalences of anemia were 46.4% and 53.9%, respectively. VAS was associated with a 9% reduction in the risk of anemia (RR = 0.91 (95% CI: 0.86-0.96)). Stratified analysis based on household wealth status indicated that the association between VAS and hemoglobin status was restricted to children from the poor households (RR = 0.74 (95% CI: 0.61-0.90)). Effect size estimates among all children (Cohen's d = 0.07) and children from poor households (d = 2.0) were modest.Conclusion: Single high dose VAS among Ethiopian children 6-59 months of age was associated with a modest increase in hemoglobin and decrease in risk of anemia. Household wealth status may modify the apparent association between VAS and hemoglobin status. © 2014 Gebremedhin; licensee BioMed Central Ltd.

Biazin B.,Hawassa University | Sterk G.,University Utrecht
Agriculture, Ecosystems and Environment | Year: 2013

The Ethiopian Rift Valley is a dry land zone where for a long time pastoral communities have made their living from acacia-based woodlands. But many pastoralists have changed from a pastoral way of life to mixed farming over time. The aim of this study was to evaluate land-use and land cover (LULC) changes in the Central Rift Valley dry lands of Ethiopia, and determine the role of drought vulnerability as a driver. A combination of GIS/remote sensing techniques, drought vulnerability analyses, field observation and surveying were employed. Because drought vulnerability is linked more closely to the types of land-uses and social contexts rather than only climatological events, it was examined based on locally perceived criteria of drought. Accordingly, the pastoral way of life was vulnerable to severe drought during 25% of the last 28. years while the mixed farming (livestock and maize farming combined) system was vulnerable to severe drought only during 4% of the years. Over the last 5 decades, cultivated lands increased to threefold while the dense acacia coverage declined from 42% in 1965 to 9% in 2010. The observed LULC changes were driven by the interplay of recurrent drought, socioeconomic and institutional dynamics, access to markets and improved technologies such as early-maturing maize cultivars and better land management. Proper policy and technological interventions are required to develop appropriate drought adaptation strategies and avert the increasing degradation of woodlands in the Rift Valley dry lands where a pastoral way of life is still present. © 2012 Elsevier B.V.

Berhan Y.,Hawassa University | Haileamlak A.,Jimma University
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2016

Background The mode of delivery in term singleton breech presentation has been debated for more than half a century and has been examined in both randomised and observational studies. Objective To determine the absolute and relative risks of perinatal mortality and morbidity in planned vaginal breech delivery. Search strategy A computer-based literature search was conducted mainly in the databases of HINARI, PubMed and Google scholar for studies comparing planned vaginal delivery and planned caesarean section. Selection criteria Studies that assessed the perinatal mortality and morbidity in relation to the term singleton breech mode of delivery between 1993 and 2014 were included. Data collection and analysis In this meta-analysis, 27 articles with a total sample size of 258 953 women were included. Relative and absolute risks of perinatal mortality and morbidity in relation to mode of delivery were determined. Main results The relative risk of perinatal mortality and morbidity was about two- to five-fold higher in the planned vaginal than in the planned caesarean delivery group. The absolute risks of perinatal mortality, fetal neurologic morbidity, birth trauma, 5-minute Apgar score <7 and neonatal asphyxia in the planned vaginal delivery group were 0.3, 0.7, 0.7, 2.4 and 3.3%, respectively. Conclusion Perinatal mortality and morbidity in the planned vaginal breech delivery were significantly higher than with planned caesarean delivery. Even taking into account the relatively low absolute risks of vaginal breech delivery, the current study substantiates the practice of individualised decision-making on the route of delivery in a term breech presentation. Tweetable abstract Although vaginal breech delivery is controversial, this review has shown low absolute risk. Tweetable abstract Although vaginal breech delivery is controversial, this review has shown low absolute risk. © 2015 Royal College of Obstetricians and Gynaecologists.

Background: To promote rational drug use in developing countries, it is important to assess drug use pattern using the World Health Organization (WHO) drug use indicators. The aim of this study was to assess the drug prescription patterns at the Medical Outpatient Pharmacy of Hawassa University Teaching and Referral Hospital, using some of the WHO core drug use indicators. Methods. A descriptive, quantitative, and cross-sectional survey was conducted to determine the current prescribing practices at Hawassa University Teaching and Referral Hospital. The sample was selected using systematic random sampling. 1290 patient encounters were reviewed retrospectively for a 2-year period from September 2007 to September 2009. Data were collected from prescriptions and Prescription registration books retained in the pharmacy. Result: The average number of drugs prescribed per encounter or mean was 1.9 (SD 0.91) with a range between 1 and 4. The percentage of encounters in which an antibiotic or injection was prescribed was 58.1% (n = 749) and 38.1% (n = 491), respectively. The Percentage of drugs prescribed by generic name and from an essential drug list was 98.7% (n=2419) and 96.6% (n=2367), respectively. The most commonly prescribed forms of antibiotics were amoxicillin (16.4%), ampicillin (15%), gentamicin (14.9%) and chloramphenicol (11.6%). On the other hand, the most commonly prescribed injections were ampicillin (21.4%), cloxacillin (13.4%), crystalline penicillin (12.4%), ceftriaxon (9.8%) gentamicin (9.8%), diclofenac (9.4%), chloramphenicol 41 (8.4%) and furosemide 25 (5.1%). Conclusion: On the basis of the finding of this study, the prescribing practices for antibiotic and injection shows deviation from the standard recommended by WHO. These two commonly overused and costly forms of drug therapy need to be regulated closely. Drug use evaluation should be done for some of the antibiotics to check whether they were appropriately prescribed or not. On the other hand, polypharmacy, generic prescribing and prescribing from EDL were not found to be a problem in this study. Teaching hospitals have a special responsibility to society to promote rational prescribing by their staff and, through them, the future generations of doctors. © 2013 Desalegn; licensee BioMed Central Ltd.

Agency: GTR | Branch: NERC | Program: | Phase: Research Grant | Award Amount: 227.60K | Year: 2013

ALTER aims to demonstrate that there are real and lasting benefits for wide scale poverty alleviation, particularly for the rural poor, by tackling soil degradation at a range of spatial scales, from field to landscape, and using opportunities within agricultural as well as severely degraded land. Throughout the world, soil degradation impacts on the health, wealth and well-being of rural people in many different ways. Soils have a key supporting role in maintaining agricultural yields, water availability, water quality, resources for grazing animals and other ecosystem services. Some are perhaps less obvious but still valued such as maintaining habitats to support honey-bees and local wildlife. In Africa, soil degradation is recognised as a major constraint to alleviating poverty in rural communities. We have chosen to work in Ethiopia and Uganda where there are contrasting issues of soil degradation in mineral and organic soils are a result of agricultural land use but similar reliance in rural communities on a range of benefits from soils. Solutions to soil degradation are not simple and require a much better understanding of how people benefit from soils, what they stand to gain if they can improve the condition of the soils that they manage whether for crops, livestock, timber production or as semi-natural areas, what they would need to do to accomplish this and what barriers may prevent this. In parallel we need to gain better insight into the likely success of different management options to improve soils. Ultimately these options will require some form of investment whether that be via money, time, resources or other mechanisms. We will investigate the relative pros and cons of these mechanisms from the perspective of local people, organisations involved with markets for Payments for Ecosystem Services and national objectives in alleviating poverty. A broader view of carbon benefits and trading is an opportunity to invest in lasting improvements in degraded ecosystems and the livelihoods of the poor that depend on these. All of this research and evidence building needs to be placed into the context of climate change. We need to establish that whatever might be suitable, acceptable and viable for tackling soil degradation now will have long-term benefits to local people and that these benefits will not be negated by the on-going changes to local climate. The ALTER project is an international consortium between The James Hutton Institute (UK), University of Aberdeen (UK), Hawassa University (Ethiopia), The Ethiopian Governments Southern Agricultural Research Institute (SARI, Ethiopia), Carbon Foundation for East Africa (CAFEA, Uganda) and the International Water Management Institute (Nile Basin & Eastern Africa Office, Ethiopia). This team brings together natural scientists, social scientists and economists to work together with rural communities and other local decision-makers and facilitators to improve our capacity to predict how human-environment linked systems respond to incentives and other drivers change. This predictive capacity is needed to be able to explore whether different options for change could result in substantive poverty alleviation.

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