Mesfin Y.M.,Haramaya University |
Hailemariam D.,Addis Ababa Institute of Technology |
Biadglign S.,Freelance Public Health Research Consultant |
Kibret K.T.,Wollega University
PLoS ONE | Year: 2014
Background: Human immunodeficiency virus (HIV), multi-drug resistant tuberculosis (MDR) is emerging as major challenge facing tuberculosis control programs worldwide particularly in Asia and Africa. Findings from different studies on associations of HIV co-infection and drug resistance among patients with TB have been contradictory (discordant). Some institution based studies found strongly increased risks for multi-drug resistant TB (MDR TB) among patients co-infected with TB and HIV, whereas other studies found no increased risk (it remains less clear in community based studies. The aim was to conduct a systematic review and meta-analysis of the association between multi-drug resistant tuberculosis and HIV infection. Methods and findings: Systematic review of the published literature of observational studies was conducted. Original studies were identified using databases of Medline/Pubmed, Google Scholar and HINARI. The descriptions of original studies were made using frequency and forest plot. Publication bias was assessed using Funnel plot graphically and Egger weighted and Begg rank regression tests statistically. Heterogeneity across studies was checked using Cochrane Q test statistic and I2. Pool risk estimates of MDR-TB and sub-grouping analysis were computed to analyze associations with HIV. Random effects of the meta-analysis of all 24 observational studies showed that HIV is associated with a marginal increased risk of multi-drug resistant tuberculosis (estimated Pooled OR 1.24; 95%, 1.04-1.43). Subgroup analyses showed that effect estimates were higher (Pooled OR 2.28; 95%, 1.52-3.04) for primary multi-drug resistance tuberculosis and moderate association between HIV/AIDS and MDR-TB among population based studies and no significant association in institution settings. Conclusions: This study demonstrated that there is association between MDR-TB and HIV. Capacity for diagnosis of MDR-TB and initiating and scale up of antiretroviral treatment, and collaborations between HIV and TB control programs need to be considered and strengthened. © 2014 Mesfin et al.
Getahun A.,Wollega University |
Deribe K.,Fayya Development Association |
Deribew A.,Jimma University
Malaria Journal | Year: 2010
Background. Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods. A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done. Results. A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34), who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36), who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42) and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45) were more likely to be late for the treatment of malaria in under-five children. Conclusion. Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment. © 2010 Getahun et al; licensee BioMed Central Ltd.
Yalew E.,Wollega University |
Zegeye D.T.,Health Science University |
Meseret S.,Health Science University
BMC Public Health | Year: 2012
Background: The introduction of antiretroviral therapy (ART) has sharply decreased morbidity and mortality rates among HIV infected patients. Due to this, more and more people with HIV live longer and healthier lives. Yet if they practice sex without condom, those with high viral load have the potential to infect their sero-negative sexual partner or at risk of acquiring drug resistant viral strains from their sexual partner who are already infected. Hence, we aimed to assess practice of condom use and associated factors among HIV positive clients at Felege Hiwot Referral Hospital in North Western Ethiopia. Methods: Hospital based comparative cross sectional study was conducted at Felege Hiwot Referral Hospital in northwest Ethiopia. Systematic random sampling technique was used to select 466 study participants from the ART and pre ART clinic of the Hospital. A structured interview administered questionnaire first prepared in English then translated into Amharic was used to collect data. Nurses who were working in the hospital but not in the HIV clinic were recruited and trained as data collectors. Results: A total of 454 (224 respondents from ART naive and 230 ART experienced groups) were included in the study. Females constitute 151 (67.4%) and 133 (57.8%) of pre ART and ART group respectively. The ages of the participants ranged from 18 to 72 years. The average age was 31.7 years for women and 36.6 years for the men. About half of the participants (47.4% of ART group and 50.4% of the pre ART group) were sexually active. Inconsistent condom use was reported by 61(56%) ART and 50 (44.2%) of the pre ART sexually active study participants. Conclusions: The study found that those who are on ART were at lower risk of using condom inconsistently as compared to the ART nave patients living with HIV. Therefore, these results are of high importance in order to design tailored interventions. © 2012 Yalew et al.; licensee BioMed Central Ltd.
Garoma S.,Wollega University
Ethiopian Journal of Health Development | Year: 2012
Background: The youth is vulnerable to risky sexual and reproductive health behaviors such as unprotected sexual intercourse and not using family planning that could lead to unfavorable health outcomes. Youth communication can be one of the most effective strategies in reducing risky sexual and reproductive health behaviors. Objective: To assess levels of communication between the youth and their parents, peers and teachers about reproductive health issues and HIV/AIDS in Nekemte town. Methods: A cross-sectional community-based study was conducted using both quantitative and qualitative research methods. Four hundred twenty youngsters aged 15-24 years were selected from three sub-cities of Nekemte using simple random sampling procedures. In addition, 12 focus group discussions targeting the youth, parents, governmental and non-governmental employees, religious and elderly people took place in order to complement the quantitative findings. Results: Overall, 61% of the youth scored the mean and above in four-point scale and considered to have good level of communication on reproductive health (RH) and HIV/AIDS. In the multivariate analysis, age, place of residence, education and income were significantly associated with youth communication. Conclusion: A good level of communication about reproductive health and HIV/AIDS issue was documented in this study. However, emerging program interventions on reproductive health and HIV/AIDS by various stakeholders need to take into consideration those who have poor level of communication.
Kenea O.,Wollega University |
Balkew M.,Addis Ababa Institute of Technology |
Gebre-Michael T.,Addis Ababa Institute of Technology
Journal of Vector Borne Diseases | Year: 2011
Background & objectives: Larval control is an integral part of malaria vector management in Ethiopia and elsewhere. For effective larval control, a sound understanding of the factors responsible for spatio-temporal variation in larval production is essential. A study was thus conducted to characterize larval habitats of anopheline mosquitoes in irrigation and major drainage areas between Adami Tulu and Meki towns, in the middle course of the Ethiopian Rift Valley. Methods: Aquatic habitats were sampled for anopheline larvae and the associated environmental variables (water temperature, turbidity, water current, water pH and other variables) were measured, characterized and analyzed. Results: Microscopic identification of the late instars (III and IV) of anopheline larvae collected throughout the study period yielded nearly 47.6% Anopheles pharoensis, 32.1% An. arabiensis, 17.1% An. squamosus and only 3.2% of other species (An. coustani and An. cinereus). Larvae of the local malaria vectors, An. arabiensis and An. pharoensis were most abundantly sampled from sand pools and natural swamps, respectively. Logistic regression analysis detected four best predictor variables associated with larval abundance of malaria vector species. Thus, relative abundance of An. arabiensis larvae was significantly and inversely associated with aquatic vegetation and water current, whereas the relative abundance of An. pharoensis larvae was significantly and positively associated with water temperature and the presence of algae in the water bodies. Conclusion: Dry season anopheline larval habitats such as riverine sand pools that are created and maintained by perennial water bodies and their associated water development projects need to be considered in vector control operations.
Feyissa T.R.,Wollega University |
Genemo G.A.,Health Science University
PLoS ONE | Year: 2014
Background: Place of delivery is a crucial factor which affects the health and wellbeing of the mother and newborn. Institutional delivery helps the women to access skilled assistance, drugs, equipment, and referral transport. Even though 34% of pregnant women received at least one antenatal care from a skilled provider in Ethiopia by 2013, institutional delivery was 10%. The main objective of the study was to assess determinants of institutional delivery in Western Ethiopia. Methods: Retrospective unmatched case control study design was used to assess determinants of institutional delivery in Western Ethiopia from September to October 2013. A total of 320 respondents from six districts of East Wollega zone, West Ethiopia were included. Data were collected using pretested and structured questionnaires. Data were entered and cleaned by Epi-info then exported and analyzed using SPSS software. Statistical significance was determined through a 95% confidence level. Results: Education [Adjusted Odds Ratio (AOR) (95% Confidence Interval (CI)) = 2.754(1.510-8.911)], family size [AOR (95% CI) = .454(.209-.984)], residence [AOR (95% CI) = 3.822 (1.766-8.272)] were important predictors of place of delivery. Four or more antenatal care [(ANC) (AOR (95% CI) = 2.914(1.105-7.682)], birth order [(AOR (95% CI) = .136(.054-.344), age at last delivery [(AOR (95% CI) = 9.995(2.101-47.556)], birth preparedness [AOR (95% CI) = 6.957(2.422-19.987)], duration of labour [AOR (95% CI) = 3.541(1.732-7.239)] were significantly associated with institutional delivery. Moreover service related factors such as distance from health institutions [AOR (95% CI) = .665(.173-.954)], respondents' awareness of skill of health care professionals [AOR (95% CI) = 2.454 (1.663-6.255)], mode of transportations [AOR (95% CI) = .258(.122-.549)] were significantly associated with institutional delivery. Conclusions and Recommendations: Policy makers, health service organizations, community leaders and other concerned bodies have to consider the predictors of institutional delivery like education, birth order, antenatal care utilization and residence to improve institutional delivery in the area. © 2014 Feyissa, Genemo.
Negeri E.L.,Wollega University
BMC Public Health | Year: 2014
Background: Ethiopia is a developing country with a demographic profile dominated by young population with in the ages of 15-24, constituting one third of the total population. Only little has been explored about the role of parenting process and peers in protecting youths from risky sexual behaviors. Thus, this study tried to assess risky sexual behaviors, risk perception and the influences of family and peers for possible interventions among youths in western Ethiopia. Methods. The study applied a comparative cross-sectional design triangulated with qualitative study. A pre-tested, structured, interviewer administered questionnaire was used to gather data. SPSS software version 20 was used to perform descriptive statistics, univariate, bivariate and multivariable logistic regression analyses. Results: Over one third of in-school and 41.4% out-of-school youths reported unprotected sex during the 12 months period prior to interview. More than one third of in-school youths (37.1%) reported to have two and more than two lifetime sexual partners compared to 32.6% of out-of-school youths. Out-of-school youths feel that they are at higher risk of getting HIV than in-school youths (AOR = 2.93; 95% CI: 1.45, 4.35). Youths who had high family connectedness were less likely to commence sexual activity and have multiple sexual partners than their counterparts (AOR = 1.98; 95% CI: 0.63, 0.94) and (AOR = 2.79; 95% CI: 1.24, 4.43) respectively. Having pressure from peer to have sex was significantly associated with having multiple sexual partners (AOR = 2.82; 95% CI: 1.62, 2.49). Conclusion: A substantial proportion of out-of-school youths engaged in risky sexual behaviors than in-school youths. Parents and peers play a role in shaping the behavior of youths. Consequently, the dimension of good parental process and positive peer factors has to be strengthened. © 2014 Negeri; licensee BioMed Central Ltd.
Yeneabat T.,Wollega University |
Belachew T.,Jimma University |
Haile M.,Jimma University
BMC Pregnancy and Childbirth | Year: 2014
Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old.Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed.Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding.Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding. © 2014 Yeneabat et al.; licensee BioMed Central Ltd.
Ambalam K.,Wollega University
Journal of Sustainable Development | Year: 2014
Food is a basic human right. One of the humanity's significant achievements has been to produce adequate food for the largest growing population. However, the co-existence of chronic hunger and malnutrition with presence of adequate capacities to address it is one of the gravest paradoxes of our time. In one-third of African countries the average daily calorie intake remains below the recommended level of 2100 kcal. The need and importance for greater food sovereignty has emerged out of broader concerns over the negative impact of world's food system on food security and environmental sustainability. Adoption of the food sovereignty principles are essential to empower local communities to have greater control over their productive resources, use and sustain ecologically friendly means of production, and access local markets as well as nutritious and culturally accepted food. The majority of African farmers are smallholders. However, the existing trend of land grabbing in Africa seriously affects food sovereignty in an unprecedented level. Based on the secondary sources, this paper explores different dimensions of the complex relationship between food sovereignty and land grabbing in African countries. It also analyses the various aspects on how the ongoing process of land grabbing in Africa affects food sovereignty which in turn leads to food insecurity of millions. The introduction of intensive agricultural production, due to land grabbing often based on a transformation of complex farming systems for commercial purpose can seriously threaten biodiversity. There is a need to balance the local circumstance while favouring large scale agricultural projects. © 2014 by the authors.
Bacha B.,Wollega University |
Regassa F.G.,Addis Ababa Institute of Technology
Tropical Animal Health and Production | Year: 2010
A study was carried out on 59 clinically healthy Zebu x Friesian crossbred cows to determine the prevalence of subclinical endometritis, associated factors and its effect on the reproductive performance. Subclinical endometritis was diagnosed by endometrial cytology using uterine lavege technique and subclinical mastitis using CMT. The clinical, management and reproductive data were obtained from a weekly follow up visit of each cow for a period of 6 months after calving. The prevalence of subclinical endometritis, with ≥5% neutrophil count, was 47.5% and 30.5% at week 4 and 8, significantly decreasing (P = 0.002) as postpartum period advanced. Body condition score at week 4 postpartum (OR = 4.5, P = 0.017) and regular cow exercise (OR = 4.8, P = 0.026) were the significant risk factors while post-calving hygiene (P = 0.06) was poorly associated. Subclinical endometritis was also directly associated with subclinical mastitis at both week 4 (OR = 4.5, P = 0.012) and 8 (OR = 3.6, P = 0.031) postpartum. The risk of first service pregnancy (OR = 5.1, P = 0.004) was higher in cows negative for subclinical endometritis at week 8 postpartum and the proportion of cows that required more than 3 services was higher in cows with uterine inflammation. Also the proportion of cows diagnosed pregnant within 180 DIM was higher in cows with normal uterus at both week 4 (OR = 10.3, P = 0.001) and week 8(OR = 21.8, P = 0.001). These results indicated that subclinical endometritis was directly associated with poor body condition and subclinical mastitis and that it had negative effect on reproductive traits of dairy cows. This association may also reflect the possibility of translocation of bacteria/bacterial products from the uterus to the udder or vic-versa or else the presence of common cause for both endometritis and mastitis. © 2009 Springer Science+Business Media B.V.