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Electronic and structural properties of Magnesium dibo ride using density Functional theory
No full textIn this thesis, electronic and structural properties of Magnesium diboride (MgB2) is investi
gated with the density functional theory by using Quantum EPRESSO Package. The gener
alized gradient approximation (GGA) is used to compute the exchange correlation energy. The
total energy of Magnesium diboride is computed as a function of cutoff energy and Monk Horst
pack grid size. The results show that the total energy per cell is monotonically decreasing with
increasing cutoff energy and converged at 70Ry plane wave cutoff energy and the ground state
energy has its minimumat-130.58056956 Ry. Thetotal energy of MgB2 percellhasconverged
at 11 × 11 ×9k-point grids with a ground state energy of-130.31353522 Ry. Besides, the opti
mized lattice constants of bulk MgB2 have been determined to be a = 5.8 Bohr and hence, c =
6.669288 Bohr with respect to our computational calculation. The experimental values of bulk
HCP Magnesium diboride are a = 5.808413 Bohr and c = 6.678954 Bohr. The lattice constant
determined using DFT calculation is compatible with an experimental result with a relative er
ror of 0.00144. Finally, the band structure and density of state of HCP magnesium diboride are
computed. The band structure calculation shows that there is overlap between the conduction
band and the valance band. This clearly shows that MgB2 is conductor or metal (zero band
gap material). The density of state also shows that there is no discontinuity before and after the
Fermi Level. The density of state is continuous and there is no an insulating regime
Seroprevalence and associated factors of transfusion Transmissible infections among blood donors at goba Blood bank, southeast Ethiopia
No full textBackground: Blood transfusion is a potentially life-saving procedure and plays a pivotal role in
the management of hemorrhage and other hematological disorders. But unsafe transfusion
practices, which can be life-threatening, can put millions of people at risk of transfusion
transmissible infections (TTIs). The existing understanding of TTIs seroprevalence and associated
risk factors among blood donors in the Bale zone community, southeastern Ethiopia, is limited,
impeding the development of targeted interventions to improve blood safety. The findings of this
study will have the potential to directly influence blood safety.
Objective: This study aimed to determine the seroprevalence of TTIs and identify associated
factors among blood donors at Goba Blood Bank in Southeast Ethiopia, 2024.
Method: From May to June 2024, a facility-based cross-sectional study was conducted at Goba
Blood Bank, involving 510 blood donors selected through systematic random sampling. Serum
specimens were screened for HIV, HBV, HCV, and syphilis using enhanced chemiluminescent
microparticle immunoassay (CMIA) technology. Data were analyzed using SPSS version 26 with
descriptive statistics, bivariate and multivariate logistic regression analyses to identify factors
associated with the outcomes. Statistical significance was defined as p < 0.05.
Result: A total of 510 blood donors participated in this study producing an overall prevalence of
TTI was 10.2%. HBV, Syphilis, HIV, and HCV prevalence was 6.1%, 1.8%, 1.4%, and 1.2%,
respectively. HBV-HCV co-infection was 0.2%. In multivariate logistic regression analysis,
multiple sexual partners (AOR=5.6, 95% CI: 2.74, 11.37), education level (AOR=0.05; 95% CI:
0.003, 0.758), alcohol consumption (AOR=2.5; 95% CI: 1.23, 5.21), khat chewing (AOR=4.3;
95% CI: 1.21, 15.12), knowledge about STIs (AOR=0.2; 95% CI: 0.10, 0.46), tooth extraction
(AOR=2.1; 95% CI: 1.02, 4.16), and communal use of sharp materials (AOR=5.0; 95% CI: 1.23,
20.77) were significantly associated with higher risk of TTIs. TTI risk was influenced by a
combination of strong behavioral and clinical factors, with higher education and STI knowledge
showing a protective effect.
Conclusion: The seroprevalence of TTIs among blood donors in this study was relatively high
with some significantly associated risk factors, which indicates a significant risk of transmission.
Therefore, emphasizing the need for multifaceted prevention strategies, implementing stricter
donor selection criteria and enhanced screening procedures is essential to improve blood safety
Epidemiology of malaria in pregnancy in majang zone of Gambella region, southwest Ethiopia
No full textMalaria is a febrile infectious disease caused by the Plasmodium parasite and transmitted by female
Anopheles mosquitoes. Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, and
Plasmodium ovale are the major species to cause human malaria. Plasmodium falciparum (P.
falciparum) and Plasmodium vivax (P. vivax) are the most virulent and the most widespread species,
respectively. Plasmodium knowlesi, which primarily infects non-human primates, has recently been
reported to cause human malaria in forested areas of the Pacific and Southeast Asia. The Plasmodium
life cycle follows both sexual and asexual reproduction involving sporogony in the mosquito and
schizogony in the vertebrate host (1). Anopheles arabiensis, Anopheles funestus, and Anopheles
gambiae are the major species of Anopheles mosquito involved in the transmission of malaria,
particularly in sub-Saharan Africa (SSA), where the largest burden with P. falciparum predominance
is found (2,3). In 2023, there were an estimated 263 million cases and 597 thousand deaths of malaria
in the world, from which 94% and 95%, respectively, occurred in Africa. Ethiopia was the 4th country
with the largest estimated number (9.56 million) of malaria cases (after Nigeria, Democratic Republic
of the Congo, and Uganda), in the world in 202
The effects of temperature and relative humidity on the Development and survival time of labstra in an Ophelia’s Arabinoses from Ethiopia
No full textMalaria is a significant vector-borne disease transmitted by an infective bite of female
Anopheles mosquitoes. It poses one of the most complex public health challenges in tropical
and subtropical regions. Climate change can directly affect the patterns of vector-borne
diseases by influencing the distribution, abundance, and dynamics of vectors thus, altering
disease transmission patterns. This study aimed to investigate the effects of temperature and
relative humidity on the development, abundance, and survival time of Anopheles arabiensis,
a primary malaria vector widely distributed in Ethiopia. The mosquitoes were reared under
both variable and constant temperatures and humidity conditions. A total of four hundred
(400) An. arabiensis eggs were subjected to temperatures ranging from 14.5-34.35 ℃ and
relative humidity (RH) levels from 64%-84%. The development rate and survival of immature
and adults were examined under 20 different temperature and humidity regimes. Statistical
analyses were performed using Package for the Statistical package for social sciences
Version (SPSS)26, with linear regression analysis assessing egg hatchability, developmental
time, and survival rates. Ordinary Least Squares (OLS) and Quadratic regression equations
were used to evaluate the combined effects of temperatures and relative humidity. The study
revealed that the optimal conditions for 80% of egg hatchability were temperatures between
25.3-34.35℃ with relative humidity levels of 64-68%. Adult emergence occurred over a
broad temperature range (16-34℃, peaking at 80% between 28.37-29.65℃ with 70% RH
except under extreme conditions below 16℃ and 64% RH. The maximum time required for
larvae L1 to L2 stage was 13 days at temperatures between 14.55 and 15.62℃ with 83-86%
RH. The highest survival time for adult mosquitoes was 25 days at a temperature between
23.65-24.72°C with 68-69% RH. Fluctuations in temperature and relative humidity
significantly impacted the development of all stages of Anopheles arabiensis. The study
demonstrated that temperature variations and RH affect the population dynamics and
developmental time from egg to larvae, from one instar to subsequent instars, to pupae, and
from pupae to adults. Further research is needed to explore the effects of temperature and
humidity on the development survival, and of wild An. arabiensis populations in Ethiopia.
Such studies are essential for developing models to assess malaria transmission risk
Understanding Gender Roles and Inequalities Influencing Maternal Health Care Behaviors in Rural Jimma, Ethiopia
No full textIntroduction: Gender is defined as what society believes about people's appropriate roles,
duties, rights, and responsibilities, as well as their attitudes, values, relative power, accepted
behaviors, and opportunities based on sex. Gender norms and roles have a significant impact on
the use of maternal healthcare services and affect women's access to antenatal care, skilled birth
attendance, and postnatal support. Research findings indicate how patriarchal systems, decision
making processes, and socio-cultural expectations can either hinder or promote access to
maternal healthcare. Various groups highly recommend gender-equity maternal and child health
service utilization at different times: the World Health Organization (WHO), the International
Conference on Population and Development (ICPD), the Beijing Declaration, and the Addis
Ababa Declaration. Despite all the efforts, maternal health service use and maternal and child
health are far from the target explicitly set in low and middle-income countries like Ethiopia.
Various initiatives that encourage and promote various actors like community members,
religious leaders, and partners are believed to significantly improve maternal health service
utilization and help to achieve the Sustainable Development Goal (SDG), reducing maternal
mortality to 70/100,000. Ethiopia has shown improved maternal service utilization and reduced
maternal and newborn mortality rates. However, the maternal health service utilization, maternal
morbidity, and mortality are very high in developing countries, including Ethiopia, compared
with developed countries.
Objective: The objective of the current study is to understand qualitatively about gender
based roles beliefs, perceptions, knowledge, attitude, decision making, and support regarding
MCH services utilization. The gender dimension basically compared between men and women.
The study also determined couples ODS (Obstetrics Danger Signs) knowledge and attitude
towards maternal healthcare, as well as, couples concordance and discordance decision-making
on financial and maternal and child healthcare.
Method and materials: The study was conducted in three districts of rural Jimma Zone,
Oromia, Ethiopia. Overarching mixed-method community-based comparative cross-sectional
quantitative and qualitative studies were used. 24 Primary health care units (PHCUs) were
randomly selected from Gomma, Seka, and Kersa districts; eight from each district. A total of
3840 women who gave live and dead birth, and a history of abortion one year before data
collection, with their partners included in the study. This study used the baseline qualitative and
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quantitative data for further analysis. A total of 3235 couple participants were identified based on
the household ID for quantitative analysis. For the qualitative study, data were purposively
collected from Health extension workers, women's health development army, men's health
development army, primary health care unit directors, and midwifery nurses till saturation of
information was reached. Descriptive, chi-square, and logistic regression analyses were applied
to quantitative studies. Odds ratio, p-value less than 0.05, and 95% confidence interval were used
to declare the level of significant association.
Result: Under the first qualitative analysis to understand gender perception during pregnancy,
gender-based roles and norms, psychosocial variation, social support, and gender relations
emerged in the analysis. The informants described that men's and women's independent and
shared roles were improving maternal health care service use during pregnancy. Once the women
became pregnant, men undertook various demanding duties to enhance maternity service
consumption. Gender relations and shared decision-making were essential to facilitate maternal
healthcare utilization during pregnancy and beyond. In the second qualitative study, independent
and shared gender-based roles, norms, and decision-making were identified to determine the
utilization of maternal healthcare services during the delivery and postnatal period. Men can
persuade pregnant women to use delivery services and postnatal care. The place of delivery was
determined by the levels of gender power relations at the household level, but women were
usually the final decision-makers.
Furthermore, the women’s belief that giving birth in a health facility makes women look clean
and neat, as opposed to home delivery, increases their intention to use maternal health care
services. In the quantitative analysis, on average, men and women participants identified at least
two obstetric danger signs. Most women could mention more antenatal, childbirth, and postnatal
obstetrics danger signs than their male partners. Both women and their male partners who
listened to the radio at least once per week had a statistically significant positive attitude towards
obstetric care. Nonetheless, both had almost similar magnitudes of attitude towards obstetric care
irrespective of belonging to different occupational, educational, and other social strata. Men's
knowledge of obstetrics danger signs during pregnancy (95% CI= (1.07-1.62), AOR=1.32,
P<.008) and postnatal care (95% CI= (1.16-1.89), AOR=1.48, P<.002) had a statistically
significant association with the women utilization of antenatal care (ANC) service, though not
delivery care (DC) or postnatal (PNC), respectively. In the fourth quantitative study, household
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couple joint decision-making was positively associated with higher ANC and PNC utilization.
Conversely, decisions made solely by the husband, especially regarding finances, negatively
impacted women's access to healthcare services, with a 63% reduction in ANC utilization when
men exclusively controlled financial decisions. Women's involvement in financial decision
making increased the odds of women utilizing ANC services by 1.32 times.
Conclusion: The study revealed that obstetric maternal health care should not be limited to
women alone. Men's and women's prior maternal health experiences, in addition to their knowledge
and beliefs, have made a significant impact on the utilization of maternal healthcare services during
pregnancy. Men's and women's improved roles, knowledge level, belief, decision-making, and social
support contribute to pregnant women receiving delivery and postnatal services at the health facility.
Pregnant women were the final decision makers for utilizing a health facility to give birth. There
were gender based knowledge gap and negative beliefs that limits health facility delivery and
postnatal services utilization. There were inequalities in obstetric danger signs knowledge between
females and their male partners. Male partners' knowledge of obstetric danger signs is not only
significant during pregnancy and delivery but also has a lasting impact on postnatal service
utilization, which underlines the importance of their involvement in maternal healthcare service
utilization. Joint couple household decision-making was the common form of decision-making,
positively associated with using maternal healthcare services.
Recommendation: Growing community-level social support can improve maternal health care
service utilization. Men's concern about institutional delivery should be increased when they are
viewed as the primary audience during maternal health education. Researchers should focus on
the mechanisms by which men participate at the time of pregnancy, childbirth, and postnatal
services to address men's involvement in maternal health care services fully. Policymakers and
academics should consider men's essential contribution in the continuum of maternal healthcare.
However, to increase their intention to use maternal health care services, it is necessary to
identify the interests of women in how and when men should be involved. A gender-responsive
maternal healthcare policy that recognizes the role of couples' decision-making power in the
household in maternal health care and women's empowerment in financial decision-making in
households should be promoted. Gender transformative studies should be promoted to educate,
targeting both men and women, which could play a pivotal role in shifting gender norms and
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promoting more equitable decision-making within households, which is crucial for maternal
health care service utilization
Patterns of admission and outcome of patients Admitted to the intensive care unit in jimma medical Center, Ethiopia
No full textBackground: The intensive care unit (ICU) is a specialized environment designed for the
care of critically ill patients, offering advanced medical and nursing support and improved
monitoring capabilities during severe organ system failure. Despite its importance, global
annual deaths from critical illness reach approximately 45 million, with ICU mortality rates
in Africa ranging from 32.9% to 54%, and a national prevalence of 40% in Ethiopia. Given
the uncertainty regarding ICU mortality and disease patterns in local settings, this study
investigates the admission trends and clinical outcomes of adult patients admitted to the
adult ICU at Jimma Medical Center.
Object: The study aims to evaluate the admission patterns and outcomes of adult patients
in the intensive care unit of Jimma Medical Center in Ethiopia over one year.
Methods: This study is a retrospective cross-sectional analysis of 244 patients admitted to
the adult intensive care unit at Jimma Medical Centre from January to December 2024.
Participants were selected using systematic random sampling, and data were collected from
patient charts and processed in SPSS version 27.0. Descriptive statistics were utilized, and
multivariable binary logistic regression was conducted to identify independent factors
associated with in-hospital death, with a significance threshold set at P < 0.05.
Results: This study analyzes 244 ICU patients, revealing a slight male predominance
(52%) with a mean age of 38.09 years. The most common admission sources were the
emergency department and operating room, primarily for conditions like septic shock,
delayed awakening, and severe malaria. Hypoxia was prevalent in 58.6% of cases, while
19.3% had a Glasgow Coma Scale (GCS) score below 8. Laboratory findings showed that
47.7% exhibited elevated white blood cell counts. Additionally, 63% had elevated blood
urea nitrogen levels, and sodium abnormalities were common, with 29.5% having
hyponatremia and 52.1% having hypernatremia. The ICU stay of patients involves various
therapeutic interventions, with mechanical ventilation (49.4%) and gastrointestinal ulcer
prophylaxis (79.4%) being the most common. Major complications include aspiration
pneumonia, infection, and hypotension, contributing to an overall mortality rate of 36.9%.
Risk factors strongly impacting outcomes include gender, septic shock, severe malaria,
Glasgow Coma Scale (GCS) scores, and aspiration pneumonia, with female patients having
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a 4.6-fold increased mortality risk. The case fatality rates are particularly high for septic
shock (86.7%) and severe malaria (65.4%).
Conclusion: This study examines 244 ICU patients, revealing the common admissions
including septic shock, severe malaria, and delayed awakening. A significant number of
patients had comorbidities, including diabetes and hypertension. The patients had
significant levels of hypoxia, leukocytosis, and various electrolyte imbalances. Though
interventions included mechanical ventilation, GI, and DVT prophylaxis, the overall
mortality rate was high, with high case fatality rates linked to septic shock and severe
malaria. Being female, level of GCS scores, and aspiration pneumonia were associated
with increased mortality among ICU patients
Assessment of knowledge and practice towards Insecticide Treated Nets (ITNs) and Indoor Residual Spray (IRS) among Pregnant Women in Abobo District, Gambella, Ethiopia
No full textPregnant mothers are at considerable risk of malarial infection in Ethiopia. Indoor residual
spraying (IRS) and long-lasting insecticidal nets (LLINs) are two core interventions for control
and prevention of malaria infection. However, its utilization among pregnant mothers was
unsatisfactory. This descriptive cross-sectional study was aimed to determine the knowledge
and practices of pregnant women regarding malaria and its preventive measures in a malarious
area Abobo district, Gambella, Ethiopia.The study was conducted from October to December
2024. Data was collected from 430 pregnant mothers through a two-stage random cluster
sampling method in eight villages. Pre-tested structured questionnaire was used to collect data.
During the survey, visual observations were also made by the interviewers to check use of
LLINs and IRS. The data were analyzed by SPSS software version 21. The majority of
households had a high level of knowledge about symptoms (98%, n=392) and transmission
(74.5%, n=298) of malaria. The main preventive measures against malaria were: LLINS
(39.5%, n=158), IRS (32%, n=128), and others. In addition, participants with primary or higher
educational level reported that they practice more malaria preventive measures, compared to
those who were illiterate (OR=3.3, 95% CI= 1.6–6.6, p=0.0001, Table 6). In spite of positive
perceptions about IRS and LLINs, only 35.5% (n=149) and 17% (n=68) of households used
IRS and LLINs, respectively. According to the results of this study, despite a high level of
knowledge about malaria and its preventive measures, a small number of participants use
LLINs and IRS for malaria prevention. Therefore, implementation of effective educational
interventions is recommended to improve preventive practices against malaria in the study area
Effectiveness of Simplified Approach for the Management of Wasting Among Children (6-59 Months) Compared To Standard Approach in Ethiopia: A Non-Inferiority Randomized Controlled Trial
No full textChapter One This section presents the definition, prevalence, and history of managing Severe Acute
Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) globally and in Ethiopia, as well as
the significance and objectives of the study. Wasting is a type of acute malnutrition characterized by
a mid-upper arm circumference (MUAC) of less than 12.5 cm or a weight-for-length/height z-score
below -2 standard deviations (SD) in children aged 6 to 59 months. Approximately 45 million children
are affected by wasting globally; among these, over 95% of all children with wasting live in Asia and
Africa. Children with severe acute malnutrition (SAM) are nine times more likely to die than well
nourished children. In Sub-Saharan and Southeast Asian countries, it accounts for nearly one million
deaths each year, partly due to increased susceptibility to infections. In 2023, more than 4 million
children under the age of five are estimated to be suffering from wasting in Ethiopia, representing
11% of the total under-five population. Consequently, Ethiopia is seeing a rising trend in severe acute
malnutrition admissions to treatment centers from 2019 to 2023. However, the number of children
receiving treatment is only about 56% of the target.
Ethiopia has over two decades of experience implementing community-based management of acute
malnutrition. The Therapeutic Feeding Program for treating severe acute malnutrition (SAM) in
Ethiopia started in 2000 with a pilot implementation and, by 2020, had expanded to over 20,000
health facilities providing services throughout the country. The Disaster Risk Management Food
Security Sector (DRMFSS) handled the management of moderate acute malnutrition separately. In
2019, guidelines for managing acute malnutrition in Ethiopia were finalized, establishing protocols
for addressing SAM and moderate acute malnutrition (MAM) through the health system. Additionally,
MAM and uncomplicated SAM are addressed in different programs using two distinct food products
(RUTF for uncomplicated SAM and CSB++/RUSF for MAM).
There are still coverage gaps for treatments of SAM, and MAM treatment is not routinely
implemented in all districts. Therefore, simplification of acute malnutrition treatment is required to
ensure continuity of care, increase coverage, and minimize costs. The evidence related to combining
different simplifications is quite recent, and a context-specific approach has been promoted. Trials
recommend that simplified approaches need to be country-specific, along with evidence generation
based on each country for a combination of simplifications.
Given the simplified approach, studies were conducted in settings that differ from the Ethiopian
context. It is important to test and adapt these simplifications and combinations in Ethiopia; thus far,
no study has addressed this issue. Therefore, the research objective was to assess the effectiveness of
a simplified approach for treating wasting among children aged 6 to 59 months in comparison to the
standard protocol.
Chapter Two The outlines of methods and materials clarify a cluster randomized controlled non
inferiority trial conducted in three woredas in the Oromia, SNNPR, and Amhara regions. Health posts
served as clusters. The study subjects were children aged 6 to 59 months with uncomplicated severe
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or moderate acute malnutrition. The sample size was estimated to detect a non-inferiority margin of
15% for recovery using the simplified protocol compared to the standard protocol. A total of 58 health
posts (clusters) were estimated, with a sample size of 1,052 children (430 with SAM and 622 with
MAM). However, data were collected from 55 health posts and 1,032 children. The intervention for
the simplified group involved a modified dosage and a single type of ready-to-use therapeutic food
(RUTF) to treat both severe acute malnutrition (SAM) and moderate acute malnutrition (MAM).
Specifically, two sachets of RUTF were administered daily for SAM, while one sachet of Ready to
Use Therapeutic Food (RUTF) for MAM. In contrast, for the standard group (control), weight
based RUTF was given to children with SAM, meaning the amount of RUTF increased with the
child’s weight, while RUSF was administered at one sachet per day for children with MAM. This
trial was registered with the Pan African Clinical Trial under the unique identification number
PACTR202202496481398.
The effect of a simplified approach on the recovery of children 6–59 months with wasting was
described in Chapter Three, This emphasizes the key finding of the simplified approach to the
standard protocol for treating acute malnutrition during recovery. In the Per Protocol analysis, the
recovery rate of children with wasting in the simplified group (97.8%) was non-inferior to that of the
standard protocol group (97.7%), P= 0.399. The cost of RUTF per treatment for a child with SAM
was 42.78 for the simplified one. In conclusion, the
simplified method is non-inferior to the standard protocol regarding the recovery rate from wasting.
Furthermore, a simplified approach (modified dosage) for managing SAM and MAM is cost
effective, allowing for the treatment of more children given the limited resources available.
Comparing Time to Recovery in Wasting Treatment on Simplified Approach vs. Standard Protocol
was described in Chapter Four. For SAM cases, the average length of stay was 8.86 (±3.91) weeks
for the simplified protocol and 8.26 (±4.18) weeks for the standard protocol (P=0.13). For MAM
cases, the average length of stay was 8.18 (±2.96) weeks for the simplified approach and 8.32
(±3.55) weeks for the standard (P=0.61). No significant difference (P=0.502) was observed
between the simplified protocol, 8 weeks (IQR: 7.06, 8.94), and the standard protocol, 9 weeks
(IQR: 8.17, 9.83), among children with SAM regarding the median time to cure. Similarly, there
was no significant difference (P=0.502) in the time to cure between the simplified approach, 8
weeks (IQR: 7.53 - 8.47), and the standard protocol, 8 weeks (IQR: 7.66, 8.34), among children
with MAM. The survival curves displayed similarity, with the log-rank test showing no
significance (P>0.5), indicating the non-inferiority of the simplified approach for cure time. The
effect of a simplified approach on Weight and MUAC gain in the management of wasting
compared to the standard protocol was presented in Chapter Five. The overall weight gain of
children with wasting was 1.001 (+0.762) kg and 1.075 (+0.750) kg for the standard protocol and
simplified approach, respectively (P=0.634). The overall MUAC gain of children with wasting was
1.207 (+0.667) cm and 1.320 (+0.706) cm for the standard protocol and simplified approach,
respectively (P=0.326). The overall weekly weight gain of children with wasting was 0.106
(+0.105) kg and 0.108 (+0.104) kg for the standard protocol and simplified approach, respectively
(P=0.799). The overall weekly MUAC gain of children with
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wasting was 0.173 (+0.134) cm and 0.177 (+0.119) cm for the standard protocol and simplified
approach, respectively (P=0.601). The mean weight gain in grams per kg per day for children with
uncomplicated SAM was 3.80 (+3.17) from the standard group and 3.52 (+2.94) from the simplified
group (P=0.359). Similarly, the mean weight gain in grams per kg per day for children with MAM
was 2.11 (+2.26) from the standard group and 2.30 (+2.35) from the simplified group (P=0.329). The
mean MUAC gain in mm per day for children with uncomplicated SAM was 0.35 (+0.22) from the
standard group and 0.33 (+0.17) from the simplified group (P=0.510). The mean MUAC gain in mm
per day for children with MAM was 0.21 (+0.11) from the standard group and 0.21 (+0.14) from the
simplified group (P=0.520). The results indicated that the simplified approach used in this study for
treating acute malnutrition (both MAM and SAM) is non-inferior to the standard treatment in terms
of weight gain and MUAC gain. Future research should examine the analysis of micronutrient levels
in the bodies of both SAM and MAM children.
Comparing the effect of the simplified approach with standard protocol in terms of treatment outcomes
in the younger age group 6-12 month s was described in Chapter Six. Complete data were collected
from 480 children aged 6 to 12 months with wasting. In the intention-to-treat (ITT) analysis, the
recovery (cure) rate for children with wasting in the standard group was 94.6%, compared to 93.4%
in the simplified group (P=0.732). In the per-protocol (PP) analysis, the recovery rates were similar
for both groups, at 97.2% (P=0.629). The average length of stay for children in the standard group
was 9.44 weeks, while it was 9.02 weeks for the simplified group. Additionally, the median length of
stay was 9 weeks for the standard group and 8 weeks for the simplified group (P=0.172). The average
daily weight gain of children with wasting was 16.3 (+10.77) grams in the standard protocol and 17.2
(+13.10) grams in the simplified approach (P=0.457). The overall daily MUAC gain of children with
wasting was 0.256 (+0.165) mm in the standard protocol and 0.274 (+0.151) mm in the simplified
approach, respectively (P=0.264). The overall daily weight gain in grams per kilogram for children
with wasting was 2.7 (+1.94) grams in the standard protocol and 2.9 (+2.55) grams in the simplified
approach, respectively (P=0.238). Chapter Seven discusses the broader implications of its findings on
the continuum of care for managing acute malnutrition, the coverage of acute malnutrition treatment,
the cost and sustainability of such treatments, and the overall policy and programmatic consequences
related to managing wasting. Additionally, it outlines future research perspectives, conclusions, and
recommendations.
In conclusion, this PhD research provides evidence for the effectiveness of a simplified approach.
It demonstrates that the simplified treatment protocol does not significantly differ from the standard
protocol in terms of recovery, weight, and MUAC gains in the treatment of wasting among children
aged 6 to 59 months. The findings indicated that the simplified and standard protocols exhibited no
significant differences in terms of the average length of stay and time needed for recovery.
The study findings have practical implications and offer an opportunity to review the policies and
programs, including those addressing vulnerable segments of the population
Treatment outcome, selected biochemical profiles, and Associated factors among children diagnosed with nephrotic Syndrome in jimma town hospitals, southwest Ethiopia
No full textBackground: Nephrotic syndrome (NS) is a common childhood kidney disease characterized by
proteinuria, hypoalbuminemia, and edema. It is caused by increased glomerular permeability, leading
to proteinuria and biochemical changes like hypoalbuminemia and hyperlipidemia, which raise the risk
of cardiovascular disease. Treatment involves corticosteroids, but steroid-resistant cases face a higher
risk of chronic kidney disease. Despite its impact, data on certain biochemical profiles and treatment
outcome of children diagnosed with NS, especially in resource-limited settings, are limited.
Objective: To assess the treatment outcome, selected biochemical profiles, and associated factors
among children diagnosed with NS in Jimma town hospitals, Southwest Ethiopia, from December 1,
2023, to April 30, 2024.
Methods: An institution-based mixed, prospective and cross-sectional study was conducted among
children diagnosed with and treated for NS in Jimma town hospitals, selected through consecutive
sampling. The mobile Kobo Toolbox was used to collect data. Five milliliters of venous blood and 20
milliliters of urine were collected from each participant and analyzed for selected biochemical profiles
at Jimma Medical Center Laboratory using a Cobas 6000 chemistry analyzer. The collected dataset was
exported to SPSS version 25 for analysis. Descriptive and inferential statistics were used to describe
and present the data. Bivariate & multivariate logistic regression were used to identify factors associated
with the outcome variable, with statistical significance at p-value < 0.05 and 95% confidence interval.
Results: The study included 114 children diagnosed with and treated for NS. The mean age of
participants was 7.09 ± 2.913 years, with 59.6% being male. The overall proportion of steroid resistance
was 13.2% (95% CI: 7.6%-20.8%). The biochemical profile revealed 15.8%, 38.6%, 10.5%, 41.2%,
and 63.2% of the participants had low serum albumin, low serum protein, elevated serum creatinine,
hypercholesterolemia, and hypertriglyceridemia, respectively. Additionally, hematuria, comorbidities,
and infections were present in 15.8%, 7.9%, and 28.1% of the participants, respectively. Older age (>
6 years) (AOR: 5.84; 95% CI: 1.13-26.15), presence of hematuria (AOR: 6.03; 95% CI: 1.25-29.02),
low serum albumin level (≤1.5 g/dL) (AOR: 5.75; 95% CI: 1.29-25.43), and hypercholesterolemia
(AOR: 5.44; 95% CI: 1.13-26.15) were independent predictors of steroid resistance.
Conclusion and Recommendation: Key predictors of steroid resistance include older age at diagnosis,
hematuria, low serum albumin, and hypercholesterolemia, highlighting that thorough risk assessments
and tailored treatments targeting these factors are crucial to improve patient outcomes
Assessment of Organ chlorine Pesticide Residues In Water, Soil, Selected Vegetables And Wheat Irrigated With Downstream Akaki River, Ethiopia
No full textIn this study the residual concentrations of sixteen organochlorine pesticides (OCPs) were
analyzed in soils, water, some vegetables (cabbage, tomato, potato, beetroot, and onions) and
wheat irrigated with water from the downstream catchment of the Akaki River in the Oromia
regional state of Ethiopia. Sample preparation and extraction were carried out using standard
procedures (quick easy cheap effective rugged and safe (QuEChERS) multi- residue extraction
and clean up techniques). For vegetables and wheat, a liquid-liquid microextraction procedure
was used for water and a Soxhlet extraction for soil samples and followed by gas
chromatography-mass spectrometry (GC-MS) analysis. From the studied OCPs eight of them
were detected in vegetables, wheat, and water and soil samples. The OCPs found in all studied
samples include alpha-linden (α-HCH), delta-linden (δ-HCH) gamma-linden (γ-HCH),
heptachlor (HC), heptachilorepoxide (HCE), paradichlorodiphenyldichloroethylene (p, p’DDE),
dieldrin,
Endrin,
Para
dichlorodiphenyldichloroethane
(p,
p’-DDD) and Para
dichlorodiphenyltrichloroethane (p, p’-DDT). The concentrations of these OCPs in vegetables
and wheat samples ranged from 0.11 ± 0.01µg/kg (for ES-I) 18.78 ± 0.17 µg/kg (α-HCH) in the
Hechu zone cabbage and Meteli zone samples, respectively. Whereas, in water and soil samples,
the detected concentrations ranged from highest at Dawaratino zone water sample gamma
linden (10.88µg/L), the lowest in meteli zone water sample delta-linden (0.61(0.01) µg/kg) &
highest at mekana zone soil sample endosulfansulphate (ESS) (44.73 (0.33) µg/kg), the lowest in
dawara Tino zone soil sample p, p’-DDE (4.74 (0.12) µg/kg). Indeed, the concentrations of the
OCPs detected in the vegetables and wheat samples analysed were observed to be at alarming
levels, exceeding the maximum residue limits (MRL) set by the EU. ESS was not detected in any
of beetroot and wheat samples. The presence of pesticides residues in the analyzed samples
poses a significant threat to human health. Therefore, continuous monitoring is recommended so
as to regulate the use of these pesticides in the study area