37 research outputs found
Evaluation on the Potential of Entomopathogenic Fungal Isolates for the Control of Mexican Bean Bruchid (Zabrotes Subfasciatus) (Coleoptera: Bruchidae
No full textThe efficacy of five isolates of entomopathogenic fungi belonging to the genus Metarhizium was assessed against Mexican bean bruchid, Zabrotes subfasciatus (Boheman) (Coleoptera: Bruchidae) in a laboratory experiment. Four local isolates namely META-B, META-D, PPRC-6, PPRC-29 and one standard isolate ICIPE-30 were evaluated. Pathogenicity of the isolates was conducted with three different conidia concentrations including 106, 107 and 108 conidia/ml. The adults of Mexican bean bruchid were treated by spraying one ml of fungal concentrations ranging from 1x106 to 1x108. All the isolates tested were virulent at all concentrations ranging from 1x106 to 1x108 conidia/ml. However, pathogenicity (based on speed and magnitude of mortality) varied among isolates and concentration. Among the M. anisopliae isolates, ICIPE-30 and META-D were most pathogenic. A significant difference (p<0.05) in mortality was recorded between treatments of fungal concentrations and the control. None of the control treatment units gave more than 15% mortality. All tested isolates were able to infect and cause mycosis in adult Mexican bean bruchid, out of which isolate META-B showed the least virulence compared to others with less than 67.5% mortality with confirmed symptom of mycosis. The study suggests that entomopathogenic fungi may be used as a component of IPM in stored beans under Ethiopian condition
Utilization of PMTCT services in Awassa Ethiopia
No full textBackground- Mother to child transmission of HIV (MTCT) is the major source of HIV infection among children under the age of 15 years. For the prevention of MTCT (PMTCT) a package of services including HIV counselling and testing, provision of prophylactic antiretroviral (ARV) drugs for mothers and babies, safe delivery practices and infant feeding counselling is made available. The effectiveness of PMTCT program largely depends on utilization of prophylactic ARV drugs by the women and their babies. In resource poor settings Nevirapine (NVP) single dose given to women during labour and to babies within 72 hours of birth prove to reduce the MTCT by 41%. In Ethiopia the PMTCT program was first launched in 2003 and is being scaled up across the country. According to the 2006 WHO report only 3% of the women in need of prophylactic NVP received the drug and only 28.1% of women attending antenatal care where PMTCT services were offered enrolled into the PMTCT programs. The PMTCT program was launched in Awassa Health Centre in 2005 with an opt-in approach then shifted in to an opt-out approach since August 2006.Objective -To assess utilization of PMTCT services and to identify determinants of the PMTCT service utilization in Awassa town, EthiopiaMethod -A cross sectional triangulation study using both quantitative and qualitative methods was conducted from January to July 2006 and in September 2007. In the quantitative part 377 women who had been visited two antenatal clinics in the town participated in the survey when HIV testing was offered in an opt-in approach. A trained data collector did the survey using a pretested structured questionnaire. PMTCT registers found in Awassa Health Centre were reviewed to assess the changes in PMTCT service utilization before and after the introduction of an opt-out approach. Nineteen in-depth interviews with nurse/midwife counsellors working in eight VCT/PMTCT clinics were conducted in their respective work places. Twenty one exit interviews were conducted with women after posttest counselling in Awassa Health Centre. Participant observation was also conducted in Awassa Health Centre PMTCT site. The qualitative interviews were conducted by the principal investigator using prepared interview guides.Results- The PMTCT services utilization was 9.8% (37/377) among the survey participants'. PMTCT service utilization was independently associated with being attending antenatal care in Awassa Health Centre (OR 4.6, 95% CI 1.7-12.5), being aware of the availability of NVP for PMTCT (OR 4.3, 95% CI 1.4-12.8) and having more than one antenatal visits (OR 2.1, 95% CI 0.9-5.1). The VCT service utilization in non antenatal setting was 49.4% (163/340) and in 83.2 of the cases the women were tested together with their husband. VCT service utilization in non antenatal setting was independently associated with having discussion with husband about HIV testing before hand (OR 8.5, 95% CI 3.3-21.9) and husband ever tested for HIV (OR 28.1, 95% CI 13.8-57.4).The PMTCT registers revealed that among women who attended antenatal care in Awassa Health Centre only 9.7% got pretest counselling on PMTCT when the service was offered in an opt-in approach while 38.9% when the services was offered in an opt-out approach. Among the women who got pretest counselling 82.6% were actually tested during the opt-in approach and 98.8% during the opt-out approach. However,..
Exploring inequities in skilled care at birth among migrant population in a metropolitan city Addis Ababa, Ethiopia; a qualitative study
No full textIntroduction: Ethiopia records high levels of inequity in skilled birth care (SBC), where the gaps are much wider among urban migrant women. An intervention project has been conducted in Addis Ababa, intending to improve quality and to ensure equitable access to maternal and newborn care services. As part of the project, this study explored the inequities in maternal health care among migrant women in Addis Ababa, Ethiopia. Methods: A qualitative community based study was conducted from April to May 2014 among 45 purposefully selected internal migrant women. Eleven women who give birth at home and eight who gave birth at health facility in the last year preceding the study participated in in-depth interviews. Four primiparas’ young women, 18 women who have children and four grandmothers participated in focus group discussions. Guides were used for data collection. Using framework and content analysis three themes and four sub-themes emerged. Results: According to the informants, patterns of service utilization varied widely. Antenatal care and infant immunization were fairly equally accessed across the different age groups of informants in their most recent birth irrespective of where they gave birth, yet obvious access gaps were reported in SBC and postpartum care. There were missed opportunities to postpartum care. Only few women had received postpartum care despite, some of the women delivering in the health facility and many visiting the health facilities for infant immunization. The four emerged sub-themes reportedly influencing access and utilization of SBC were social influences, physical access to health facility, risk perceptions and perceived quality of care and disrespect. Of these social, structural and health system factors, informants presented experiences of disrespectful care as a powerful deterrent to SBC. Conclusions: Migrant women constitute disadvantaged communities in Addis Ababa and have unequal access to SBC and postpartum care. This happens in the backdrop of fairly equitable access to antenatal care, infant immunization, universal health coverage and free access to maternal and newborn care. Addressing the underlying determinants for the inequities and bridging the quality gaps in maternal and newborn services with due emphasis on respectful care for migrant women need tailored intervention and prioritization
Successes and challenges of the national programme for the prevention of mother-to-child HIV transmission (PMTCT) in Addis Ababa, Ethiopia. Implementation and impact
No full textMother-to-child HIV transmission (MTCT) is the main source of HIV infection among children under the age of 15. The majority of these transmissions occur in utero and during the intra-partum period and are associated with high rate of mortality in the first year of life. Virtual elimination of peri-natal HIV transmission has become the global target following the availability of highly efficacious prophylactic medications. However, persistent programmatic challenges where the epidemic is most severe are threatening the realization of the target. These challenges include unsolved issues related to HIV testing, ensuring access and adherence to prophylaxis medication, access to safe delivery services, access to infant follow up and partner involvement in PMTCT programmes. This thesis aims at addressing these issues and to assess the impact of the national PMTCT programme in Addis Ababa, the capital of Ethiopia. The study uses cross-sectional, mixed methods and prospective cohort designs. Retrospective data were collected in 2009 from the national PMTCT programme in Addis Ababa. In the cross-sectional design, 663,603 pregnant mothers attending a national PMTCT programme across the city over a six years period were studied. Trends in PMTCT service utilization were analysed, and the rate of MTCT was assessed in relation to changes in HIV testing policy and changes in prophylactic medication regimen. In the mixed methods design, focus group discussions were conducted first to inform a Theory of Planned Behaviour (TPB) questionnaire. The TPB was applied to explain intended and actual HIV testing. Three thousand and thirty three first time antenatal attendees completed the baseline TPB interviews and 2,928 completed their follow up. The prospective cohort study enrolled 282 HIV-positive mothers. The study assessed the proportions of mothers and infants who adhered to medication recommendations and exposed infants follow up. In the same cohort, the rate of intra-partum transfers and associated adverse outcomes were assessed among the 228 mothers who reported to have given birth. In the trend analysis a year by year increase in the proportion of mothers receiving HIV counselling and testing was observed between 2004 and 2009. In parallel with the increased number of mothers receiving HIV testing, the HIV prevalence showed a steady decline. Substantial increase in HIV testing occurred following the shift to routine opt-out approach. The data collected using the mixed methods design following the implementation of opt-out testing approach revealed that intention and type of pre-test counselling/information received were independent, significant determinants of HIV testing. Further analysis showed that the majority of mothers who had low intention to test were also tested. Positive attitude towards HIV testing and approval from social network were significant determinants of intended use of HIV testing. In the trend analysis the proportions of mothers and infants receiving medication for prophylaxis did not show progress over the years. One year after the shift to routine opt-out approach, only 53% of the mothers and 47% of the infants had received medication. The cohort data further revealed gaps in initiating medication during pregnancy (82%) and ingestion of the medication at birth by mother-infant pairs (68%). Delivering at a health facility was an independent determinant of mother-infant pairs’ ingestion of medication at birth. Overall, 75% of the mothers in the cohort gave birth at emergency obstetric and neonatal care (EmONC) facilities and 42% of them were transferred between facilities during the intra-partum period. Multiple transfers happened to 36% of the mothers due to practical constraints within the health system. Mothers in their second pregnancy were less likely to be transferred than mothers in their first pregnancy. The rate of stillbirths was high. Transferred mothers were about six times more likely to experience stillbirth than mothers who did not. There was no significant association between stillbirth and syphilis test result, mothers’ CD4 cell count and initiating lifelong ART. Both the trend and the cohort data showed sub-optimal infant follow up services. A small proportion of the exposed infants were HIV tested. The cumulative HIV infections among babies on single dose nevirapine (sdNVP) regimen who were tested at 18 months were 14.9% in 2007. In 2009, among infants on combined ZDV regimen the rates of MTCT were 8.2% and 8.4% at six weeks postpartum in the trend data and in the cohort respectively. The proportion of partners involved in PMTCT programme remained low. In the cohort the majority of the HIV-positive mothers had disclosed their HIV sero-status to their partner and about one-third of the partners who underwent HIV testing were sero-discordant. The PMTCT programme has expanded rapidly and has been accompanied by an increased rate of testing. However, the performance of the health system was inadequate in providing subsequent PMTCT services for HIV-positive mothers. Missed opportunities to prophylactic medication uptake, intra-partum care, infant follow up and partner involvement in the PMTCT programme could undermine the effectiveness of the PMTCT programme and negatively impact the survival of exposed infants. This should be a matter of immediate concern and a topic of further research
ANALYSES OF TEN-YEAR MALARIA TRANSMISSION DYNAMICS IN RELATION TO METEOROLOGICAL VARIABLES IN JABI TEHNAN DISTRICT, NORTHWEST ETHIOPIA
No full textRetrospective studies of malaria cases from health facilitiesand the impact of meteorological factors provide insight into the dynamics ofmalaria transmission and the effectiveness of malaria control interventions.This study aimed to analyze inter-annual and monthly trends in malaria casesand determine the correlations between meteorological variables andprevalence of malaria. Retrospective data on malaria cases were extractedfrom 11 health centres and 39 health posts in Jabi Tehnan district, northwestEthiopia, for 10 years (July 2011–May 2021). Trends in monthly and annualmalaria cases were analyzed and correlated with meteorological data. Of1,500,868 individuals with febrile complaints examined at the health facilitiesin the district, 13.4% were diagnosed as clinical malaria cases. Furthermore,12.6% of those with febrile symptoms had malaria confirmed withmicroscopy and with rapid diagnostic test (RDT). Plasmodium falciparumcomprised 56.48%, with 36.56% P. vivax, and with 6.96% mixed (P.f + P.v)infections. There were significant variations in inter-annual and monthlymalaria cases (P<0.001; P = 0.004, respectively). Malaria cases peaked in2011–2013, and 2015–2016, with reduced and relatively lower malaria casesin 2017–2021. Two malaria peaks in May-June, and in October-Novemberwere recorded. Inter-annual and monthly malaria trends were closelycorrelated with relative humidity and average temperatures. Plasmodiumfalciparum was predominant compared to P. vivax. Understanding trends inmalaria transmission in relation to climatic variables, and monitoring theeffectiveness of malaria control interventions are needed to reduce malaria inthe area
Current evidence on basic emergency obstetric and newborn care services in Addis Ababa, Ethiopia; a cross sectional study
No full textBackground: Emergency obstetric and neonatal care (EmONC) is a high impact priority intervention highly recommended for improving maternal and neonatal health outcomes. In 2008, Ethiopia conducted a national EmONC survey that revealed implementation gaps, mainly due to resource constraints and poor competence among providers. As part of an ongoing project, this paper examined progress in the implementation of the basic EmONC (BEmONC) in Addis Ababa and compared with the 2008 survey. Methods: A facility based intervention project was conducted in 10 randomly selected public health centers (HCs) in Addis Ababa and baseline data collected on BEmONC status from January to March 2013. Retrospective routine record reviews and facility observations were done in 29 HCs in 2008 and in10 HCs in 2013. Twenty-five providers in 2008 and 24 in 2013 participated in BEmONC knowledge and skills assessment. All the data were collected using standard tools. Descriptive statistics and t-tests were used. Results: In 2013, all the surveyed HCs had continuous water supply, reliable access to telephone, logbooks & phartograph. Fifty precent of the HCs in 2013 and 34% in 2008 had access to 24 hours ambulance services. The ratio of midwives to 100 expected births were 0.26 in 2008 and 10.3 in 2013. In 2008, 67% of the HCs had a formal fee waiver system while all the surveyed HCs had it in 2013. HCs reporting a consistent supply of uterotonic drugs were 85% in 2008 and 100% in 2013. The majority of the providers who participated in both surveys reported to have insufficient knowledge in diagnosing postpartum haemorrhage (PPH) and birth asphyxia as well as poor skills in neonatal resuscitation. Comparing with the 2008 survey, no significant improvements were observed in providers’ knowledge and competence in 2013 on PPH management and essential newborn care (p > 0.05). Conclusion: There are advances in infrastructure, medical supplies and personnel for EmONC provision, yet poor providers’ competences have persisted contributing to the quality gaps on BEmONC in Addis Ababa. Considering short-term in-service trainings using novel approaches for ensuring desired competences for large number of providers in short time period is imperative
Hydrothermal Modelling and Analysis of Sensible Heat Energy Storages for Small-scale Dwellings Considering Natural Convection
No full textAbstractThe coupled hydrothermal behaviour of a cement-based thermal energy storage system for domestic applications is modelled under saturated conditions using the Finite Element Method along with an extensive experimental analysis program for parameter detection. For this purpose, the temperature and heat distribution of a prototype model is investigated under specific hydrothermal conditions by considering the effect of buoyancy-driven or natural convection, thus providing an accurate estimation of the loading/unloading rates and preventing the overdesign of such systems, which typically occurs when they are analysed considering conduction only by neglecting the heat transfer contribution from the buoyancy-driven convection
Promising outcomes of a national programme for the prevention of mother-to-child HIV transmission in Addis Ababa: a retrospective study
No full textAbstract Background Prevention of Mother-to-Child HIV Transmission (PMTCT) is still the most effective intervention in combating new HIV infections. In 2008, revised national PMTCT guidelines that incorporated new policies on HIV counselling and testing, antiretroviral prophylaxis regimen and infant HIV diagnosis came into effect in Ethiopia. In the present study we have examined trends in PMTCT service utilization and assessed the rate of MTCT in relation to policy changes in the national PMTCT programme. Methods Reports from February 2004 to August 2009 were reviewed in 10 sub-cities in Addis Ababa, Ethiopia. The data was collected from May to October 2009. Results The proportion of women who received HIV counselling and testing among new antenatal care attendees increased from 50.7% (95% CI 50.2-51.2) in 2007 to 84.5% (95% CI 84.1-84.9) in 2009 following the shift to routine opt-out testing. Nevertheless, in 2009 only 53.7% of the positive women and 40.7% of their infants received antiretroviral prophylaxis. The HIV prevalence among antenatal attendees decreased significantly from 10.5% in 2004 to 4.6% in 2009 in parallel to the increased number of women being tested. The HIV positive women were over 18 times (RR 18.5, p =18 months was 15.0% (95% CI 9.8-22.1) in 2007, whereas it was 8.2% (95% CI 5.55-11.97) among babies on Zidovudine regimen who were tested at >=45 days in 2009. Conclusion The paper demonstrates trends in PMTCT service utilization in relation to changing policy. There is marked improvement in HIV counselling and testing service utilization, especially after the policy shift to routine opt-out testing. However, despite policy changes, the ARV prophylaxis uptake, the loss to follow up and the partner testing have remained unchanged across the years. This should be a matter of immediate concern and a topic for further research.</p
Standard basic emergency obstetric and neonatal care training in Addis Ababa; trainees reaction and knowledge acquisition
No full textBackground: In 2010, the Federal Ministry of Health of Ethiopia (FMOH) has developed standard Basic Emergency Obstetric and Neonatal Care (BEmONC) in-service training curricula to respond to the high demand for competency in EmONC. However, the effectiveness of the training curricula has not been well documented. A collaborative intervention project in Addis Ababa has trained providers using the standard BEmONC curricula where this paper presents Krikpartick level 1 and level 2 evaluation of the training. Methods: The project has been conducted in 10 randomly selected public health centers (HC) in Addis Ababa. Providers working in the labour wards of the selected HCs have received the standard BEmONC training between May and July 2013. Using standard tools, trainees’ reaction to the course and factual knowledge during the immediate post-course and six months after the training were assessed. Descriptive statistics and t-tests were done. Results: Of the total 82 providers who received the training, 30 (36.6%) were male, 61 (74.4%) were midwives. Providers’ work experiences ranged from 1 month to 37 years. Seventy-four (89%) providers reported that the training was appropriate for their work, 95% reported that the training have updated their knowledge & skills, while 27 (32.9%) reported that the training facilities & arrangements were unsatisfactory. The mean immediate post-course knowledge score was 83.5% and 33 (40%) providers did not achieve knowledge-based mastery in their first attempt. The midwives were more likely to achieve knowledge-based mastery than the nurses (p < 0.05). The mean knowledge score six-months post-training was 80.2% and 40% have scored knowledge based mastery. Conclusions: Being one of the first papers reporting the implementation of the standard in-service BEmONC training curriculum, we have identified an important limitation on the course evaluations of the curriculum, which need urgent consideration. The majority of the trainees has reported favourable reaction to the training, but many of them did not achieve knowledge-based mastery in the immediate post training although the knowledge retention six months post training was encouraging
Health workers’ experience of providing second-trimester abortion care in Ethiopia: a qualitative study
No full textAbstract Background Second-trimester abortions are less common than abortions in the first trimester, yet they disproportionately account for a higher burden of abortion-related mortality and morbidity worldwide. Health workers play a crucial role in granting or denying access to these services, yet little is known about their experiences. Ethiopia has been successful in reducing mortality due to unsafe abortion over the past decade, but access to second trimester abortion remains a challenge. The aim of this study is to better understand this issue by exploring the experiences of second-trimester abortion providers working in Addis Ababa, Ethiopia. Methods A qualitative study with 13 in-depth semi-structured interviews with 16 health workers directly involved in providing second-trimester abortions, this included obstetrician and gynaecologist specialists and residents, general practitioners, nurses, and midwives. Data was collected at four public hospitals and one non-governmental clinic in Addis Ababa, Ethiopia and analysed using Malterud’s text-condensation method. Results The providers recognized the critical need for second-trimester abortion services and were motivated by their empathy towards women who often sought care late due to marginalisation and poverty making it difficult to access abortion before the second trimester. However, service provision was challenging according to the providers, and barriers like lack of access to essential drugs and equipment, few providers willing to conduct abortions late in pregnancy and unclear guidelines were commonly experienced. This led to highly demanding working conditions. The providers experienced ethical dilemmas pertaining to the possible viability of the fetus and women desperately requesting the service after the legal limit. Conclusions Second-trimester abortion providers faced severe barriers and ethical dilemmas pushing their moral threshold and medical risk-taking in efforts to deliver second-trimester abortions to vulnerable women in need of the service. Effort is needed to minimize health system barriers and improve guidelines and support for second-trimester abortion providers in order to increase access and quality of second-trimester abortion services in Ethiopia. The barriers forcing women into second trimester abortions also need to be addressed
