64 research outputs found
sj-docx-1-smo-10.1177_20503121211051926 – Supplemental material for Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019
No full textSupplemental material, sj-docx-1-smo-10.1177_20503121211051926 for Incidence and associated factors of postdural puncture headache for parturients who underwent cesarean section with spinal anesthesia at Debre Tabor General Hospital, Ethiopia; 2019 by Basazinew Chekol Demilew, Aragaw Tesfaw, Alemitu Tefera, Bekalu Getnet, Keder Essa and Agazhe Aemero in SAGE Open Medicine</p
The effect of caregiver types on behavioral outcomes of children left behind due to parental migration in Southern Wollo, Ethiopia
No full textThough parents are migrating for the betterment of left-behind families and children, asignificant part of the story is overlooked. A quantitative, survey design was employedto investigate the effect of caregiver types and behavioral outcomes of children leftbehind. Data were gathered by using a strength and difficulty questionnaire (SDQ)from 311 left-behind children whose parents migrated abroad and who were selectedfrom two weredas using stratified sampling method. The results of the study showedthat a significant mean difference was observed among the children left behind andcared for by different caregivers (grandparents, mother only, father only, relatives,non-relatives). A significant mean difference was also shown on both internalizingand externalizing problems as measured by the Strength and Difficulty Questionnaire(SDQ) among children cared for by caregiver types. To conclude effects of caregivertypes on behavioral outcomes of children left behind due to parental migration wereobserved in the study. Implications of the study focus, therefore, on ensuring the bestinterest of the child by families, government, and non-government organizations thathave a stake in children affected by migration
Gut microbiome in Ethiopia:Gut microbiome dynamics in childhood diarrhea, enteric infections and malnutrition in Ethiopian children below the age of five years
No full textDiarrhea and acute malnutrition are significant contributors to childhood morbidity and mortality in low- and middle-income countries (LMICs). More than 90% of these cases occur in Sub-Saharan Africa and Southeast Asia, where diarrhea and acute malnutrition often coexist and exacerbate each other, increasing the risk of enteric infections, comorbidities, and mortality.In recent decades, extensive metagenomic data has revealed the critical role of gut microbiota (GM) in health and disease. A balanced and diverse GM is essential for human health, aiding in dietary metabolism, vitamin synthesis, immune regulation, and pathogen resistance. Conversely, an imbalanced GM can lead to harmful effects like diarrhea, acute malnutrition, and increased susceptibility to enteric infections.During this PhD project, we studied the GM of Ethiopian children under five with diarrhea, Giardia infection, and severe acute malnutrition (SAM) and found associations with GM diversity and compositional changes. Children with diarrhea had lower bacterial diversity and were enriched in putative pathogens like Escherichia spp., Campylobacter spp., and Streptococcus spp. They were also depleted in gut commensals such as Prevotella copri, Faecalibacterium prausnitzii, and Dialister succinatiphilus, with greater depletion in prolonged diarrhea cases, suggesting that loss of gut commensals may contribute to the progression from acute to prolonged diarrhea. Furthermore, Giardia-infection and higher Giardia pathogen burden were significantly associated with higher GM diversity and largescale GM compositional changes, regardless of diarrhea status and duration. Giardiainfection seemed to promote the expansion of potent short-chain fatty acid (SCFA) producing taxa such as P. copri, F. prausnitzii, and D. succinatiphilus, while depleting potential pathogenic taxa like Escherichia spp. The Giardia pathogen burden was negatively associated with Escherichia spp. We also observed that the GM of children with SAM was enriched in putative pathogens such as Escherichia spp. and Campylobacter spp., with a reduction in obligate anaerobes. Fecal samples collected after treatment with ready-to-use therapeutic food (RUTF) and antibiotics showed an immature GM compared to admission samples, indicating that RUTF alone is insufficient to repair the immature GM in children with SAM.These findings highlight the importance of considering the role of the GM when designing interventions aimed at improving health outcomes for children with diarrhea, Giardia infection, and SAM
Impact of Parental Migration on Education and Behavioural Outcomes of Children Left Behind in Southern Wollo
No full textThe migration of parents is believed to be for the sake of children and families left behind. However, its impact on children left behind has been overlooked in Southern Wollo, Ethioipia. The impact of parental migration on the education and behavioral outcomes of children left behind has to be investigated in the migration-prone area. The objective of this study was to examine the impact of the migration of parent(s) on the education and behavioral outcomes of children left behind. A total of 622 children of migrating parents and children living with both parents were selected for this study. Data were gathered by using a strength and difficulty questionnaire (SDQ) from children of non-migrating parents and children whose either one or both parents migrated abroad in two weredas of southern Wollo, Ethiopia through the use of a stratified sampling method. Morover18 teachers were selected for an interview and focus group discussion to explore their perception of the influence of migration on the education and literacy of children. The results found that the mean score of LBC with parental migration was 15.86 (SD= 3.18) as compared to children living with intact families with a mean score of 12.06 (SD=3.20). The results of the study demonstrated that a significant mean difference was found between children of migrating parents and children living with both parents (F(1,620)= 219.25, p.01). Interview and FGD results also demonstrated that children experienced isolation, longing, sadness, and lack of motivation in schooling following their parents’ migration. To mitigate the problem families, government, and non-government organizations that have a stake in children's well-being and education that can be affected by migration should discharge their responsibilities accordingly. It is necessary to look at the hidden costs of parental migration on children left behind
The Global Cohort of Doctoral Students: Building Shared Global Health Research Capacity in High-Income and Low- and Middle-Income Countries
No full textDoctoral students in high- and low-income countries pursuing careers in global health face gaps in their training that could be readily filled through structured peer-learning activities with students based at partnering institutions in complimentary settings. We share lessons learned from the Global Cohort of Doctoral Students, a community of doctoral students based at the Harvard T. H. Chan School of Public Health, Haramaya University. University of Gondar, University of Botswana, and University of Rwanda College of Medicine and Health Sciences. Students in the Global Cohort program engage in collaborative research, forums for constructive feedback, and professional development activities. We describe the motivation for the program, core activities, and early successes.This work was funded by the Rose Traveling Fellowship and Deborah Rose Service Learning Fellowship at the Harvard T. H. Chan School of Public Health. The funding sources had no role in the writing of the manuscript or decision to submit it for publication.Iyer, HS (corresponding author), Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA.
[email protected]
Isolation of Extended-Spectrum β-lactamase- (ESBL-) Producing Escherichia coli and Klebsiella pneumoniae from Patients with Community-Onset Urinary Tract Infections in Jimma University Specialized Hospital, Southwest Ethiopia
No full textBackground. Klebsiella pneumoniae and Escherichia coli are the major extended-spectrum β-lactamase- (ESBL-) producing organisms increasingly isolated as causes of complicated urinary tract infections and remain an important cause of failure of therapy with cephalosporins and have serious infection control consequence. Objective. To assess the prevalence and antibiotics resistance patterns of ESBL-producing Escherichia coli and Klebsiella pneumoniae from community-onset urinary tract infections in Jimma University Specialized hospital, Southwest Ethiopia, 2016. Methodology. A hospital-based cross-sectional study was conducted, and a total of 342 urine samples were cultured on MacConkey agar for the detection of etiologic agents. Double-disk synergy (DDS) methods were used for detection of ESBL-producing strains. A disc of amoxicillin + clavulanic acid (20/10 µg) was placed in the center of the Mueller–Hinton agar plate, and cefotaxime (30 µg) and ceftazidime (30 µg) were placed at a distance of 20 mm (center to center) from the amoxicillin + clavulanic acid disc. Enhanced inhibition zone of any of the cephalosporin discs on the side facing amoxicillin + clavulanic acid was considered as ESBL producer. Results. In the current study, ESBL-producing phenotypes were detected in 23% (n = 17) of urinary isolates, of which Escherichia coli accounts for 76.5% (n = 13) and K. pneumoniae for 23.5% (n = 4). ESBL-producing phenotypes showed high resistance to cefotaxime (100%), ceftriaxone (100%), and ceftazidime (70.6%), while both ESBL-producing and non-ESBL-producing isolates showed low resistance to amikacin (9.5%), and no resistance was seen with imipenem. In the risk factors analysis, previous antibiotic use more than two cycles in the previous year (odds ratio (OR), 6.238; 95% confidence interval (CI), 1.257–30.957; p = 0.025) and recurrent UTI more than two cycles in the last 6 months or more than three cycles in the last year (OR, 7.356; 95% CI, 1.429–37.867; p = 0.017) were found to be significantly associated with the ESBL-producing groups. Conclusion. Extended-spectrum β-lactamases- (ESBL-)producing strain was detected in urinary tract isolates. The occurrence of multidrug resistance to the third-generation cephalosporins, aminoglycosides, fluoroquinolones, trimethoprim-sulfamethoxazole, and tetracyclines is more common among ESBL producers. Thus, detecting and reporting of ESBL-producing organisms have paramount importance in the clinical decision-making
The prevalence and correlates of social phobia among undergraduate health science students in Gondar, Gondar Ethiopia
No full textGroup a streptococcal infection among children with Pharyngitis in jimma town, southwest ethiopia
No full textBackground: Group A Streptococcus (GAS) is an important cause of morbidity and mortality
with clinical presentation ranges from pharyngitis and pyodrema, to life threatening
immunological complications such as acute rheumatic fever and glomerulonephritis. GAS is
the most common cause of bacterial pharyngitis responsible for 20–30% in children and 5 –
15% in adults.
Objective: To determine prevalence, antimicrobial susceptibility pattern and clinical
predictors of GAS among children with pharyngitis in Jimma Town Southwest, Ethiopia.
Methods: A cross sectional study was conducted on 355 children (5-15 years old) with
pharyngitis attended in two selected Health Centers in Jimma town from May 8-December
31, 2013. Demographic and clinical data were collected by using questionnaire and checklist.
Throat swabs were collected using sterile cotton swab, inoculated on blood agar plates and
incubated for 24-48 hrs at 35-370C with 5% CO2. β- hemolytic colonies that were susceptible
for 0.04U bacitracin and pyrrolidonylarylamidase (PYR) positive were considered as GAS.
Disc diffusion method was used for antimicrobial sucesbtibility testing for selected antibiotics.
McIsaac score was used to determine the diagnostic perfomnance of modified centor score
for the diagnosis of GAS. Descriptive statistics and multivariate logistic regression analysis
was done by SPSS version 20. P-value less than 0.05 was considered as statistically significant
at 95% confidence level.
Results: The sex profile of 355 children with pharyngitis showed that about 57.7% were
females. Majority (66%) of the children were 5-9 years old giving mean ± SD age of 8.5 ± 2.7II
years. The prevalence of GAS was 11.3%. All isolates of GAS were 100% susceptible to
penicillin, amoxicillin, erythromycin, clindamycin, chloramphenicol and ceftriaxone but
52.5% were resistant to tetracycline. Absence of cough [AOR 3.77, 95% CI 1.73-8.22],
tonsillar swelling or exudate [AOR 4.48, 95% CI 1.63-12.31], temperature >380C [AOR 3.47,
95% CI 1.61-7.49] (p<0.05) were found independent predictors for GAS infection. The
sensitivity and specificity of a total McIsaac score ≥ four was 65% and 87.9% respectively
compared to culture results.
Conclusions: The prevalence of GAS was low. The seasonality of GAS infection may
understimate the prevalence in this study, so that large-scale prospective study in the entire
season and in various settings is required to understand the actual burden of GAS infection
among children’s with pharyngitis. In addition, future studies on children with pharyngitis
should focus on estimation of rheumatic heart disease cases that follows from pharyngitis
complications. The use of a McIsaac score had a good diagnostic performance to identify
GAS infection, which can be considered for the diagnosis in resource-limited settings where
culture facilities and rapid antigen tests are not affordabl
Improving Medium- and Long-Range Hydrological Forecasts with Ensemble Meteorological Forecasts and Climatic Information
No full textTitle: Improving Medium- and Long-Range Hydrological Forecasts with Ensemble Meteorological Forecasts and Climatic Information, Author: Getnet Y. Muluye, Location: MillsThe ability to provide reliable and accurate medium- and long-range hydrological
forecasts is fundamental for the effective operation and management of water resources
systems. The principal objectives of this thesis are (i) to develop a framework for
advancing the long-range forecasting skills of hydrological models by coupling pertinent
and leading climate information with regional hydro-meteorological variables; and (ii) to
develop effective mechanisms for integrating meteorological ensemble systems in a
hydrologic prediction system, which would be useful for risk analysis by policy makers
for operating both large-scale as well as small-scale water resources systems. This
research constitutes three principal components: long-range forecasts, downscaling, and
medium-range forecasts. For long-range hydrological forecasting, four data-driven models, including multilayer perceptron (MLP), time-lagged feedforward network (TLFN), Bayesian neural network (BNN) and recurrent multilayer perceptron (RMLP) were designed by
incorporating low-frequency climatic indices to forecast seasonal reservoir inflows. The
results indicated that the incorporation of modes of climatic indices in a hydrologic
forecasting model resulted in a considerable improvement in the seasonal forecast
accuracy. Furthermore, the extended Kalman filter approach was used to train the
recurrent multilayer perceptron for capturing the complexity associated with the long range
streamflow forecasting. Results showed that the proposed methodology was able to
provide a robust modeling framework capable of capturing the complex dynamics of the
hydrologic system. Different statistical methods were developed and evaluated for downscaling local scale information of precipitation and temperature from the numerical weather prediction model output. Three different methods were considered: (i) hybrids; (ii) neural networks; and (iii) nearest neighbor-based approaches. The findings revealed that the skills in the downscaled temperature forecasts were superior to those in the downscaled precipitation forecasts. In particular, for downscaling daily precipitation, the artificial neural network-logistic regression (ANN-Logst), partial least squares (PLS) regression and recurrent
multilayer perceptron trained with the extended Kalman filter (EKF) models yielded
greater skill values, and the conditional resampling method (SDSM) and K-nearest
neighbor (KNN) based models showed potential for characterizing the variability in daily
precipitation. For the case of medium-range hydrological forecasting, the downscaled and the raw numerical model outputs were forced into an HBV hydrologic model in order to
generate an ensemble of reservoir inflows. The simulation results indicated that the
downscaled-based flows had greater skill values, and yielded more accurate forecasts
than the raw-based flows. The potential economic values of flow forecasts were further
assessed based on a simple optimal decision-making, cost-loss analysis technique. The
principal outcomes emerging from the analyses included: (i) the economic benefits
associated with probabilistic flow forecasts were more useful than their deterministic
counterparts; and (ii) the downscaled-based flow forecasts offered greater benefits, which
are applicable to a much wider range of users, than the raw-based flow forecasts.ThesisDoctor of Philosophy (PhD
Time to Death and Associated Factors among Tuberculosis Patients in Dangila Woreda, Northwest Ethiopia.
No full textBackgroundTuberculosis (TB) is among the leading causes of morbidity and mortality worldwide. More than 70% of the deaths of TB patients occur during the first two months of TB treatment. The major risk factors that increase early death of TB patients are being positive for human immunodeficiency virus (HIV), being of old age, being underweight or undergoing re-treatment.ObjectiveTo assess the time of reported deaths and associated factors in a cohort of patients with TB during TB treatment.MethodsAn institution-based retrospective cohort study was analyzed in Dangila Woreda, Northwest Ethiopia from March 1st through March 30, 2014. All TB patients registered in the direct observed treatment (DOTs) clinic from 2008-2012 were included in the study. Data were entered into EpiData and exported to SPSS for analysis. The survival probability was analyzed by the Kaplan Meier method and Cox regression analysis was applied to investigate factors associated with death during TB treatment.ResultsFrom a total of 872 cases registered in TB registry log book, 810 were used for the analysis of which 60 (7.4%) died during the treatment. The overall mortality rate was 12.8/1000 person months of observation. A majority of TB deaths 34 (56.7%) occurred during the intensive phase of the treatment, and the median time of death was at two months of the treatment. Age, HIV status and baseline body weight were independent predictors of death during TB treatment.ConclusionsMost deaths occurred in the first two months of TB treatment. Old age, TB/HIV co-infection and a baseline body weight of <35 kg increased the mortality during TB treatment. Therefore, a special follow up of TB patients during the intensive phase, of older patients and of TB/HIV co-infected cases, as well as nutritionally supplementing for underweight patients may be important to consider as interventions to reduce deaths during TB treatment
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