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Girl’s Preference for Human Papilloma Virus Vaccination in Secondary Schools in Addis Ababa, Ethiopia, 2017: Discrete Choice Experiment
No full textBackground: There are three HPV vaccines that are safe and effective for protecting HPV
infection. These are: bivalent which protect from HPV type 16 and 18, quadrivalent for HPV type
6, 11, 16 and 18, and nonavalent for HPV type 6, 11, 16, 18, 31, 33, 45, 52 and 58. About 7,000
new cervical cancer cases are diagnosed annually in Ethiopia. It is the second cause of cancer
related death in women aged 15 to 44 year. Even thouge Ethiopia undergo a pilot for HPV vaccine
implementation at two sites in Oromia Region, Jimma zone, Gomma woreda and Tigray Region
Ahiferom Woreda with support of GAVI, there is no data that show a finding regarding the current
status of receiver’s attitude, acceptance, and mainly girls’ preference for HPV vaccine.
Objective: The aims of this study was to rank the contribution of the attributes for HPV
vaccination; and to measure the willingness-to-pay, the trade-offs, and choices of girls between
risk and benefits of the vaccination.
Methods: The study was done by using discrete choice experiment (DCE). The data was collected
from Februray to March 2017 among 4 different secondary schools in Addis Ababa. A total of 336
girls aged 15-18 year were included in the study. The vaccination program attributes considered in
the choice experiment were: degree of protection against cervical cancer, duration of protection,
age at vaccination, number of doses, risk of developing serious side effects, price of vaccine, and
way of delivery. Each choice set of all determined options were put in to mixed logit model to
determine the sign of the coefficient of each attributes. Trade-offs and WTP also determined.
Results: From all participants, only six of them had been vaccinated for HPV. Doctors
recommendation (34.9 %), mass-media campaign (81%) and positive familys’ opinion (80 %) were
factors encouraging respondents to get the vaccination. Girls were willing to trade-off 5 % of
protection against cervical cancer in order to get HPV vaccination which had protective duration
of 25 years instead of 8 years. On average the respondents were willing to pay 153 ETB for an
improvement in protection against cervical cancer from 70 % to 98 %.
Conclusion: There was significant variationeof preference among girls for all HPV vaccine
attributes. Degree of protection, number doses, and the risk of serious side effect were the three
most important attributes which guide the choice of girls, while cost of the vaccine had been the
least important factor. We found high level of tradd-offs level of protection against number of
doses, seriouse side effects and place of delivery
Assessment of Pattern and Treatment Outcome of Acute Poisoning in Adult Emergency Departments of Selected Public Referral Hospitals in Addis Ababa, Ethiopia
No full textBackground: - Poisoning is a substantial global public health concern. According to data from
the World Health Organization (WHO), worldwide, poisonings account for 5-10% of all
interventions and more than 3 million poisoning cases with 2, 51,881 deaths occur annually
Out of those, 91% occurred in low- and middle-income countries.
OBJECTIVE: - To assess the pattern and treatment outcome of acute poisoning among adult
patients admitted in Emergency departments of selected public referral Hospital in Addis Ababa,
Ethiopia. From Jan, 2016 – Jan, 2017.
Methodology: - Hospital based, cross-sectional study design was conducted from December to
June 2017.A total of 453 acutely poisoned patients were included in the study from Emergency
departments of four selected public referral hospitals (St Paul’s specialized hospital, ALERT
hospital, Zewditu Memorial hospital and Minillik the second hospital) The collected data was
checked for its completeness manually and then entered and analyzed using SPSS window
version 20 statistical software package. Bivariate and multivariate logistic regression was done
to identify factors that were associated with the final treatment outcome of acute poisoning. The
odds ratio with 95% Confidence interval was used to determine the association. A statistical
significance was declared at p value<0.05.
Result: - Majority of patients were Female (267), frequently observed age group was 14-19 with
the mean age of (23.5). Around 367 (81%) lived in urban area, at about 375 (83%) poisoning
cases happened at home and most 346(74.7%) of them were intentional in nature. 195(43%) of
patients arrived within 1- 6 hours after exposure. GI clinical manifestation was common in
majority of cases and the commonest management was GI decontamination which accounts
64(14.1%). Majority of patients were recovered.
Conclusion: - acute poisoning is a public health problem which could be highly preventable as a
result prevention, early approach and management could decrease a burden in a hospital as well
as in a community
Assessments of Nurses Knowledge, Attitude and Practice Regarding Non-Pharmacological Pain Management and Associated Factors at Tikur Anbessa Hospital, in Addis Ababa, Ethiopia, 2017
No full textBackground: Non- pharmacological interventions are essentially useful for pain management
than pharmacological pain management, because they are low cost, easy to provide, safe and
nurses can implement them with little difficulty or resources. Therefore, Nurses must have a
great knowledge of non- pharmacological methods to practice effectively.
Objective: To assess knowledge, altitude and practice regarding non pharmacological pain
management and associated factors among nurses in Tikur Anbessa specialized hospital, Addis
Ababa Ethiopia, 2017
Methods: A cross-sectional study design was conducted among nurses who are working in Tikur
Anbessa specialized hospital from March25, 2017 to April 25, 2017.Total sample size was 270
nurses in the study selected by using simple random technique. Data were collected using
structured self-administered questionnaire. Data was cleaned and entered using Epi-data version
3.1and then imported to SPSS version 22.0 software and was data analysis.
Results: About 52 % nurses had good knowledge about non-pharmacological pain management;
positive attitude 34.6% and about 52.8%% had good non-pharmacological pain management
practice. Factors significantly associated with non-pharmacological pain management practice at
p value<0.05 were age (AOR=0.348(95%CI (0.188, 0.643)),In-service training (AOR=2.173(95%CI
1.21, 3.903)), and patient/family need pill (AOR=1.832(95%CI 1.017, 3.3))
CONCLUSION AND RECCOMENDATION: About 52 %nurses had good knowledge, 34.6%
positive attitudes and 52.8% had good practice. Age, in-service training and patient need pill
being about non-pharmacological pain management were significantly associated with nonpharmacological pain management practice. Therefore, in-service training program and nurses
educate patient about benefits of non-pharmacological method
Assessment of Hypogonadism and Associated Risk Factors among Male Patients with Type 2 Diabetes Mellitus Attending Diabetic Clinic of Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia
No full textBackground: Global estimate of world health organization (WHO) indicated that 422 million
adults aged over 18 years were living with diabetes in 2016. Type 2 diabetes Mellitus (T2DM)
accounts for 90 to 95% of the incidence of diabetes. The increased prevalence of T2DM has
resulted in increased prevalence of hypogonadism which is proved to be linked to it by many
researchers. This in turn creates a substantial public health burden in terms of inadequate sexual
function, potential infertility and poor quality of life. However, hypogonadism is under
recognized and under treated in sub-Saharan African countries including Ethiopia. Therefore, the
finding of this research regarding prevalence and risk factors of hypogonadism will alert
clinicians and health policy makers to give attention to this problem and initiate the need for
further research and appropriate intervention.
Objectives: To assess hypogonadism and its associated risk factors in men with T2DM attending
Diabetic Clinic at TASTH, Addis Ababa, Ethiopia.
Method: A cross-sectional study was conducted among 115 male patients with T2DM from
February to April 2017 at Diabetic Clinic of TASTH in Addis Ababa, Ethiopia. Demographic
data were collected using a structured questionnaire. Clinical data were obtained from medical
records. Anthropometric indices were determined. Clinical assessment of androgen deficiency
was done using ADAM questionnaire. TT, LH, and FSH were determined by ECLIA method
with Cobas e 411, Elecsys® 2010 analyzer. HDL-C, LDL-C, TC and TRIG were determined by
enzymatic colorimetric method with Cobas 6000 module 501whereas FBG was determined by
glucose oxidase method with Mindray-200E.
Results: Among the total 115 male study participants with T2DM, 104 (90.4%) had androgen
deficiency symptoms but only 29(25.2%) had testosterone deficiency [TT≤12.1nmol/L].
However, hypogonadism was observed in 27(23.5%) of which 20(74.1%) and 7(25.9%) were
with secondary (HH) and primary hypogonadism, respectively. Age, duration of diabetes,
monthly income, alcohol consumption, and diabetic complications were not statistically
associated with TT level except hypertension. BMI, WC, FBG, TRIG were negatively and
significantly correlated with TT with (r=-0.363, p<0.001) ;(-0.465, p<0.001); (rho=-0.328,
p=0.001) ;( rho=-0.357, p<0.001), respectively whereas HDL-C was positively and significantly
correlated with TT with (r=0.339, p<0.001). However, SBP, DBP, TC, LDL-C, LH and FSH
were not significantly correlated with TT. BMI, WC, FBG, TRIG are significantly increased in
hypogonadal group but HDL-C was significantly decreased in hypogonadal group with p value
<0.05. WC and FBG were identified as independent risk factors for hypogonadism.
Conclusion: Though symptoms of hypogonadism are highly prevalent among men with T2DM
in this tertiary care, testosterone deficiency were less prevalent. Visceral obesity and
hyperglycemia are independent risk factors for hypogonadism
Assessment of Concomitant Use of Herbal and Conventional Medicines among Patients with Diabetes in Public Hospitals of Addis Ababa, Ethiopia
No full textIntroduction: Majority of population in developing countries including Ethiopia are dependent
on traditional medicines. Patients who have chronic illness like diabetes mellitus were
dissatisfied with conventional drugs are more likely to take simultaneously herbal remedies from
traditional medicine (TM), with conventional treatment. However, such use could result in
potential herb-drug interaction.
Objective: To assess the prevalence of concomitant use of herbal and conventional anti diabetic
medicines; and to identify the commonly used herbal medicines among patients with diabetes in
public hospitals of Addis Ababa, Ethiopia.
Method: A mixed approach of quantitative and qualitative designs was employed. A health
facility based cross sectional study design was employed to determine the magnitude of
concomitant use of herbal and conventional medicines among patients with diabetes in Addis
Ababa. A qualitative study design with an in-depth interview data collection method was also
employed to describe prescribers' history taking practice about TM during their encounter with
the patients. Patients with diabetes from four public hospitals in Addis Ababa who were
attending outpatient diabetic clinics were the study population for the quantitative study. All
prescribers working in the diabetic clinic during an interview were considered as both the source
and study population for the qualitative study. Data was collected from April 17 to August 30,
2016. Quantitative results from 791 questionnaires were entered in EPI-INFO version 3.5.1 and
analyzed by SPSS Version 20 computer statistical software's. Simple descriptive statistics were
used to describe variables and content analysis had been conducted manually for qualitative data.
Result: From a total of 845 questionnaires, 791 were complete; making the response rate 93.6%.
Out of 791 respondents, 409 (51.7%) used TM at least once in their life time and 357 (45.1%)
used TM in the last six months prior to data collection. Majority 288 (80.7%) of respondents
used herb/herbal products after starting the conventional anti diabetic drugs. Leaves of plants
were used by most 187 (64.9%) of the patients and oral administration was the major route as
cited by 281 (97.6%) of the respondents.. Moringa, thyme, fenugreek, black seed and garlic were
among the frequently mentioned herbs used by diabetic patients. Sizable number of respondents
199 (69.1%) also perceived that herbal medicines they took were effective.None of the prescribers in the qualitative study gathered patients' herbal medicine use history in
their history taking practice. They only would like to take any herbal medicine related
information when they saw sign of liver toxicity and skin disease. Almost all key informant
interviewees revealed that they had no adequate knowledge about drug-herb interactions.
Conclusion: The study revealed that majority of respondents used herb/herbal products
concomitantly with conventional antidiabetic drugs. Moringa, thyme, fenugreek, black seed and
garlic were identified as the most commonly used herbs by patients with diabetes. This combined
use of herbal medicines and conventional antidiabetic medicines could cause potentially serious
herb-drug interactions. More studies with scientific methodology are required on dose,
frequency, duration and modes of interaction to better healthcare of patients
Freedom of Expression and Prior Restraining Factors in Ethiopia: Focus on Printing Media
No full textSince the adoption of UDHR, recognizing FOE as one of fundamental rights and freedoms is
widely accepted and guaranteed under different core international and national human right
instruments including national Constitutions. FOE refers not only to freely express one's
view, but it includes freedom to hold opinions without interference and to seek, receive and
impart information and ideas through any media regardless of frontiers. As a best instrument
of FOE, media plays a great role in the realization of FOE. FOE is widely accepted for its
justification of Personal fulfillment and development, get the truth and democratic
governance.
The FDRE Constitution has recognized such right in elaborated manner and further obliges
any actor involved in implementation of fundamental rights and freedoms to act in line with
those international human right instruments to which Ethiopia is a party.
However, this recognition is being affected by various subsidiary laws, procedures and
practices of the government and other actors in different forms. To examine these
impediments against FOE, the relevant legislations have been thoroughly analyzed. Also to
understand the realities from the ground, selected court cases have been analyzed critically
as well as in-depth interview conducted with legal practitioners, media professionals,
scholars, and other relevant individuals both from governmental and non-government
organizations. Mostly the courts are not interpreting those controversial legislations which
incorporate vague and wide terms, considering the spirit of FDRE constitution as well as
international human right laws in which Ethiopia is a party. In the same manner, EBA,
BSPE, Attorney general has been applying different legal based and other impediments
which developed through practice against FOE in general and freedom of Media in
particular. However, though the extent recognition to FOE and Media is acceptable, the
reality from the ground is so far from the text of FDRE Constitution and other internationally
accepted principles which designed in favor of FOE and Media
Involving Constituent States in Negotiating Tax Treaties in Ethiopia
No full textThis paper scrutinizes whether there is a constitutional background for the regional states of Ethiopia to participate in the negotiation of tax treaties and /or be consulted before the tax treaties of Ethiopia are signed or ratified. It also assesses the practical scenario of the involvement of the regional states in negotiating tax treaties and /or being consulted in relation to the tax treaties.
The paper argues that regional states have constitutional right to participate in the negotiation of tax treaties and also the right to be consulted before the tax treaties of Ethiopia are signed or ratified. The researcher discovered that regional states are not involved in the negotiation of tax treaties and also are not consulted by the federal government before the tax treaties are signed or ratified.
Finally, the writer recommends that an administrative mechanism has to be implemented so that regional states can actively participate in the negotiation of tax treaties and also be consulted on the tax treaties before the tax treaties are signed/ ratified. Also, the provisions of the FDRE Constitution must clearly stipulate that regional states should be involved in the negotiation and also be consulted on international treaties, especially on matters affecting their special interest
Criteria and Implementation of Secession Right under the FDRE Constitution in light of the International Law Regime: A Critical Analysis of the Law and the Practice.
No full textThis thesis, among other things, studies both the theoretical and practical
paradoxes of secession right under the FDRE constitution. Given the wider significance
of this thesis, there is a serious concern regarding the current absurd incorporation of
the unconditional secession right under the FDRE constitution and the criminalization of
some aspects of this right at the same time. The paradox that, the grant of the widest form
of the right to secession and lack of constitutional quests of secession rather the
occurrence of many criminal cases of secession i.e. Crimes against the National State
committed by the secessionist/separatist groups is continuing as a obscurity. Subsequent
to reviewing the relevant literature, international legal frameworks, case laws, interviews
and other methods, the author will identify and establish the international law regime
and practice on secession. Pursuant to the findings, the thesis draws the FDRE
constitution is not in conformity with the international legal regime, theories and state
practice as far as secession and its implementation are concerned. Consequently, it also
tries to create a coherence in implementing the right in doing so, possible demarcation
will be made on the distinction between ‘secession as a constitutional right’ as against
‘secession as a crime’. Thus, the thesis will bring possible alternatives which might
thwart the paradoxes on the strange stand taken by the FDRE constitution on secession
right and its application, as a way forward
Electronic Litigation (e-litigation) in the Federal Supreme Court of Ethiopia and Access to Justice
No full textThis paper discusses on the e-litigation system in the Federal Supreme Court of Ethiopia and access to justice. As a basic right and as a means to secure other human rights, the concept of justice has been one of the most discussed issues in the human rights discourse. There are many barriers to access to justice. To deal with such hurdles, especially the physical and financial barriers, technologies are introduced in the Ethiopian justice system. In particular, the Federal Supreme Court has taken the initiative to support its judicial services with technologies. The main purpose of the research is to find out how the e-litigation system is affecting effective access to justice. Whether the system is based on human rights-based approach or not, is also discussed in the research.
The paper is structured in five chapters. The notion ‘access to justice’ and human rights based approach are discussed. Effective access to justice includes equally accessible justice system with just results and in conformity with human rights standards. Normative framework, legal awareness, access to legal services and effective enforcement of decisions are manifestations of effective access to justice. The adjudication system must conform to human rights standards and due process of law. The e-litigation system, especially videoconferencing litigations and e-filing services of FSC, which are under the scope of the research, are also raised in detail. The findings revealed the benefits and the challenges of the system. Creating physical proximity to judicial services and minimizing cost and time of litigants and government are the main benefits of the system. But Technical challenges have made court litigations difficult and litigants’ right to have a fair trial is compromised. The principles of due process of law are also breached due to lack of audio and video quality, repetitive interruptions of proceedings and adjournments. It has been also found out that the program is not formulated in a human-rights based approach. Justice delay, the imbalance between opposition parties, the limitation on free and well conducted proceedings, compromising open trial and the absence of laws and regulations are the challenges of the system.
In conclusion, technology is not the final solution for the problems in the justice sector. The gaps of the e-litigation system must be filled by actors of the justice sector. In addition the already existing problems in the justice sector have aggravated the challenges of the system. So, the researcher recommended that the program must be reformulated in a human rights-based approach and the network capacity of the Court must be upgraded. Laws and regulations must be drafted to guide the system. The system has enduring benefits; but its challenges on effective access to justice must be tackled if it needs to serve its purpose of bringing effective and efficient justice
Sexual Violence and the Risk of HIV Infection among VCT Users in South Wollo Zone, ANRS
No full textIntroduction: sexual violence is one form of gender based violence which is the most silent
epidemic; affect the health and life of women in the world. Because women have much less
control over decision making, as a result of low status, and have less access to health and
social services they are more vulnerable for violence and the risk of HIV infection. As a
result of this gander based violence and HIV infection are the two most important factors
which affect the health and wellbeing of women globally.
Objective: The objective of this study is to assess the relationship between sexual violence
and HIV infection among VCT user women in South Wollo Zone.
Methods and Materials: A facility based cross sectional study was conducted using
quantitative methods on a sample of 800 people living in seven selected districts of VCT
centers of the south Wollo.
Result: The quantitative study reveled that the prevalence of life time sexual violence, life
time partner violence, and last 12 month partner violence was 34.6%. 32.3 and 10.5 %
respectively. The prevalence of HIV among VCT users is 21.5%. Violence is significantly
associated with the risk of HIV infection (life time sexual violence OR= 1.95, 95% CI =1.33-
2.86), last 12 month intimate partner violence (OR= 2.55, 95% CI=1.5- 4.33).
Conclusion: The prevalence of sexual violence and the risk of HIV infection is higher among
illiterate women. Therefore, women empowerment is an important tool to reduce both sexual
violence and HIV/AIDS, which are the major public health problem