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A Qualitative Study of Barriers to Effectiveness of Interventions to Prevent Mother-to-Child Transmission of HIV in Arba Minch, Ethiopia
Adebola Adedimeji,Nareen Abboud,Behailu Merdekios,Miriam Shiferaw
International Journal of Population Research , 2012, DOI: 10.1155/2012/532154
Abstract: Objectives. Despite the availability of services to prevent mother-to-child transmission (PMTCT) of HIV, socio-cultural, health system and operational factors constrain many pregnant women from accessing services or returning for followup thereby increasing the risk of vertical transmission of HIV to newborns. We highlight and describe unique contextual factors contributing to low utilization of PMTCT services in Arba-Minch, Ethiopia. Methods. Qualitative research design was utilized to obtain data through focus group discussions and in-depth interviews with antenatal clinic attendees, health workers health facilities in the study area. Results. Awareness of PMTCT services and knowledge of its benefits was nearly universal, although socioeconomic, cultural and health system factors, including stigma and desire to prevent knowledge of serostatus, impede access to and utilization of services. Health system factors—lack of appropriate followup mechanisms, inadequate access to ARV drugs and poorly equipped manpower also contribute to low utilization of services. Conclusion. Reducing mother-to-child transmission of HIV in sub-Saharan Africa will be more effective when unique contextual factors are identified and addressed. Effectiveness of PMTCT interventions rests on a well functioning health system that recognize the importance of social, economic, cultural contexts that HIV positive pregnant women live in. 1. Background In 2009, the United Nations AIDS Program (UNAIDS) reported that 430,000 of the approximately 2.5 million children under the age of 15 living with HIV were newly infected, the majority in sub-Saharan Africa [1]. Many of these children acquired the infection from their mothers during pregnancy, birth, or breastfeeding. Timely administration of antiretroviral drugs to a HIV-positive pregnant woman and her newborn child significantly reduces the risk of mother-to-child transmission [2]. Now recognized as an attainable public health strategy, preventing mother-to-child transmission (PMTCT) has four basic components: (i) prevention of primary infection among women, (ii) prevention of unintended pregnancies among HIV positive women, (iii) provision of specific interventions to reduce the risk of mother-to-child transmission, and (iv) provision of care, treatment and support to HIV infected women, their infants and families [3, 4]. Providing highly active antiretroviral therapy to a woman will reduce viral replication and viral load during pregnancy, and as a postexposure prophylaxis, prevent infection in newborns [3, 5, 6]. Interventions to
Children Who Received PCV-10 Vaccine from a Two-Dose Vial without Preservative Are Not More Likely to Develop Injection Site Abscess Compared with Those Who Received Pentavalent (DPT-HepB-Hib) Vaccine: A Longitudinal Multi-Site Study
Yemane Berhane, Alemayehu Worku, Meaza Demissie, Neghist Tesfaye, Nega Asefa, Worku Aniemaw, Berhe Weldearegawi, Yigzaw Kebede, Tigist Shiferaw, Amare Worku, Lemessa Olijira, Behailu Merdekios, Yemane Ashebir, Takele Tadesse, Yadeta Dessie, Solomon Meseret, Gestane Ayele
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0097376
Abstract: Background The single dose pneumonia ten-valent vaccine has been widely used and is highly efficacious against selected strains Streptococcus pneumonia. A two-dose vial without preservative is being introduced in developing countries to reduce the cost of the vaccine. In routine settings improper immunization practice could result in microbial contamination leading to adverse events following immunization. Objective To monitor adverse events following immunization recommended for routine administration during infancy by comparing the rate of injection-site abscess between children who received PCV-10 vaccine and children who received the Pentavalent (DPT-HepB-Hib) vaccine. Methods A longitudinal population-based multi-site observational study was conducted between September 2011 and October 2012. The study was conducted in four existing Health and Demographic Surveillance sites run by public universities of Abraminch, Haramaya, Gondar and Mekelle. Adverse events following Immunization were monitored by trained data collectors. Children were identified at the time of vaccination and followed at home at 48 hour and 7 day following immunization. Incidence of abscess and relative risk with the corresponding 95% Confidence Intervals were calculated to examine the risk difference in the comparison groups. Results A total of 55, 268 PCV and 37, 480 Pentavalent (DPT-HepB-Hib) vaccinations were observed. A total of 19 adverse events following immunization, 10 abscesses and 9 deaths, were observed during the one year study period. The risk of developing abscess was not statistically different between children who received PCV-10 vaccine and those received Pentavalent (RR = 2.7, 95% CI 0.576–12.770), and between children who received the first aliquot of PCV and those received the second aliquot of PCV (RR = 1.72, 95% CI 0.485–6.091). Conclusion No significant increase in the risk of injection site abscess was observed between the injection sites of PCV-10 vaccine from a two-dose vial without preservative and pentavalent (DPT-HepB-Hib) vaccine in the first 7 days following vaccination.
Challenges of Groundwater Flow Model Calibration Using MODFLOW in Ethiopia: With Particular Emphasis to the Upper Awash River Basin  [PDF]
Behailu Berehanu, Tenalem Ayenew, Tilahun Azagegn
Journal of Geoscience and Environment Protection (GEP) , 2017, DOI: 10.4236/gep.2017.53005
Abstract: In this work, most important problems related to model calibration have been assessed using MODFLOW. Particular emphasis is given to the Upper Awash river basin where many boreholes have been drilled for municipal and industrial uses compared with other regions in Ethiopia. Static Water Level (SWL) records from water supply wells drilled for about 32 years in the Upper Awash basin is considered to illustrate the commonly used groundwater flow model calibration procedures and associated problems. The assumptions made in the modeling procedures to use SWL data collected over many years from water supply boreholes to calibrate steady state models is too much of an assumption. Alternatives on steady and pseudo transient model calibration approaches in data scarce areas based on logical assumptions and reasonable representation of groundwater systems has been suggested. Hence, numerical groundwater flow models may play the expected key role for the sustainable groundwater resource management of the country, which is solving practical ground-water related problems.
Effectiveness of interventions to prevent mother-to-child transmission of HIV in Southern Ethiopia
Merdekios B, Adedimeji AA
International Journal of Women's Health , 2011, DOI: http://dx.doi.org/10.2147/IJWH.S23124
Abstract: tiveness of interventions to prevent mother-to-child transmission of HIV in Southern Ethiopia Original Research (2449) Total Article Views Authors: Merdekios B, Adedimeji AA Published Date November 2011 Volume 2011:3 Pages 359 - 366 DOI: http://dx.doi.org/10.2147/IJWH.S23124 Behailu Merdekios1, Adebola A Adedimeji2 1College of Medicine and Health Sciences, Arba Minch University, Ethiopia; 2Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, New York, USA Background: In Ethiopia, Progress in Reducing Mother-to-Child-Transmission (PMTCT) of human immunodeficiency virus (HIV) is being curtailed by behavioral and cultural factors that continue to put unborn children at risk, and mother-to-child transmission is responsible for more than 90% of HIV infection in children. The objective of this study was to assess PMTCT services by examining knowledge about reducing vertical transmission among pregnant women. Methods: A multistaged sampling institution-based survey was conducted in 113 pregnant women in Arba Minch. Qualitative and quantitative data were obtained. Results: Of the 113 respondents, 89.4% were from Arba Minch, 43.4% were at least 25 years of age, 73.4% had formal education at primary level or above, 100% reported acceptance of voluntary counseling and testing, 92.0% were knowledgeable about mother-to-child transmission, and 90.3% were aware of the availability of the PMTCT service in the health facility. Of 74 HIV-positive women in PMTCT, only three (4.1%) had had skilled birth attendants at delivery. There was an unacceptable degree of loss of women from PMTCT. Maternal educational level had a statistical association with income (P < 0.001) and voluntary counseling and testing for pregnant women (P < 0.05). Factors that determined use of PMTCT included culture, socioeconomic status, and fear of stigma and discrimination. Conclusion: In the area studied, intervention to reduce mother-to-child transmission of HIV is failing to reach its goal. This is an alarming discovery requiring quick reconsideration and strengthening of preventive strategies at all levels.
Effectiveness of interventions to prevent mother-to-child transmission of HIV in Southern Ethiopia
Merdekios B,Adedimeji AA
International Journal of Women's Health , 2011,
Abstract: Behailu Merdekios1, Adebola A Adedimeji2 1College of Medicine and Health Sciences, Arba Minch University, Ethiopia; 2Albert Einstein College of Medicine, Jack and Pearl Resnick Campus, New York, USA Background: In Ethiopia, Progress in Reducing Mother-to-Child-Transmission (PMTCT) of human immunodeficiency virus (HIV) is being curtailed by behavioral and cultural factors that continue to put unborn children at risk, and mother-to-child transmission is responsible for more than 90% of HIV infection in children. The objective of this study was to assess PMTCT services by examining knowledge about reducing vertical transmission among pregnant women. Methods: A multistaged sampling institution-based survey was conducted in 113 pregnant women in Arba Minch. Qualitative and quantitative data were obtained. Results: Of the 113 respondents, 89.4% were from Arba Minch, 43.4% were at least 25 years of age, 73.4% had formal education at primary level or above, 100% reported acceptance of voluntary counseling and testing, 92.0% were knowledgeable about mother-to-child transmission, and 90.3% were aware of the availability of the PMTCT service in the health facility. Of 74 HIV-positive women in PMTCT, only three (4.1%) had had skilled birth attendants at delivery. There was an unacceptable degree of loss of women from PMTCT. Maternal educational level had a statistical association with income (P < 0.001) and voluntary counseling and testing for pregnant women (P < 0.05). Factors that determined use of PMTCT included culture, socioeconomic status, and fear of stigma and discrimination. Conclusion: In the area studied, intervention to reduce mother-to-child transmission of HIV is failing to reach its goal. This is an alarming discovery requiring quick reconsideration and strengthening of preventive strategies at all levels. Keywords: human immunodeficiency virus, mother-to-child transmission, pregnant women, Ethiopia
Prevalence of Catha edulis (Khat) Chewing and Its Associated Factors among Ataye Secondary School Students in Northern Shoa, Ethiopia  [PDF]
Awoke Lakew, Behailu Tariku, Nigussie Deyessa, Yared Reta
Advances in Applied Sociology (AASoci) , 2014, DOI: 10.4236/aasoci.2014.410027
Abstract: The life time and current prevalence of khat chewing are 15.36% (95% CI; 11.7, 19.8) and 13.25% (95% CI; 11.0, 18.1) respectively. Multivariable logistic regression model revealed that male students [Adjusted OR = 2.15 (95% CI; 1.02, 4.56)], presence of chewer friends [Adjusted OR = 3.14 (95% CI; 1.53, 6.41)], having chewer family [Adjusted OR = 2.68 (95% CI; 1.13, 6.37)] and place of residency [Adjusted OR = 1.89 (95% CI; 1.0, 3.79)] were associated risk factors for khat chewing. Khat chewing is prevalent among students who are male, urban residents and students who have chewer friends and family. Therefore, to reduce the prevalence, social, economic and health effect of khat chewing, Minister of Education in collaboration with Ministry of Health has to work to incorporate life skill training in high school students’ curricula.
Chemical Composition of Industrial Effluents and Their Effect on the Survival of Fish and Eutrophication of Lake Hawassa, Southern Ethiopia  [PDF]
Behailu Berehanu, Bekele Lemma, Yosef Tekle-Giorgis
Journal of Environmental Protection (JEP) , 2015, DOI: 10.4236/jep.2015.68072
Abstract: Growing trends in industrialization in Ethiopia have raised concerns about pollution of water bodies particularly of lakes. This study was therefore conducted to 1) characterize the chemical contents of major industrial effluents (namely textile ceramic and soft drink factories) that reached Lake Hawassa and 2) investigate the effects of the above mentioned factory effluents on survival of larvae fish and growth of algae. Effluent samples were collected from the outlet lagoons of each factory in December, 2009. Then, effluent samples were analyzed for total N, NO3-N, NH4-N, S2-, \"\", \"\", COD, total dissolved solids (TDS) and heavy metals at the federal Environmental Protection Agency (EPA) Laboratory, Addis Ababa. The experiments on the impact of effluents on survival of fish larvae and growth of algae were conducted using six concrete paved ponds (with different concentration of effluent). The results of chemical analysis showed that textile effluent had high COD (nearly 3 times higher), TDS (19 times higher) as well as \"\"(39 times higher) than the maximum permissible limits (MPL) set by Environmental Protection Authority (EPA). Among heavy metals, Zn and Fe of textile effluent were much higher (41 and 1.5 times higher, respectively) than the MPL set by EPA. Ceramic effluent also contained high concentration of \"\"(24.5 times), S2-, \"\"(2 times) and Zn (14 times) exceeding the limit of EPA. Regarding soft drink factory, high values of COD, \"\"and Zn were found in the effluent than the limit specified by EPA. The biological treatment lagoons of the respective source were not effective since the effluents were taken from the last treatment lagoon (outlet lagoon) and some of the measured parameters were higher than MPL. Results of the pond experiment showed that 5%, 10% and 20% concentration levels of the HTF effluent killed significantly high proportion of the fry (65%, 86.8% and 88.7%, respectively). In contrast, fry mortality in ceramic and soft drink effluent treatments, even at 10 and 20% concentration levels, stayed nearly below 10%, which were not far off from the mortality of the control groups. Algal biomass in the treated ponds
Inter-Basin Groundwater Transfer and Multiple Approach Recharge Estimation of the Upper Awash Aquifer System  [PDF]
Behailu Berehanu, Tilahun Azagegn, Tenalem Ayenew, Marco Masetti
Journal of Geoscience and Environment Protection (GEP) , 2017, DOI: 10.4236/gep.2017.53007
Abstract: Multiple approaches have been used to estimate groundwater recharge in the Upper Awash river basin. The amount of recharge reaching the Upper Awash aquifer system from the Blue Nile sub-basins is also estimated. Water Balance, Chloride Mass Balance and HYDRUS 1D infiltration model are used to estimate recharge. A total of 29 sites were selected for the HYDRUS 1D multiple “at point” recharge simulations. Base Flow Separation (BFS) methods, using both River Analysis Package software Version 3.0.3 and Excel-based Time Plot program are also used as a proxy for recharge. Besides, overlay analysis in Processing MODFLOW, ArcGIS, and SURFER environments has been done to thoroughly consider spatial heterogeneity between any two point estimates and appreciate the effect of lineament density, topography, slope and major urbanized land on pattern of spatial distribution of recharge. Because of differences inherent in the assumptions and datasets used, the various methods employed give wide range of differences in recharge estimates. Recharge estimated for the Upper Awash basin ranges from 51.5 mm/year to 157 mm/year and for the two southern left-bank sub-basins of the Middle Blue Nile basin (Mugher and Jema) ranges from 86 mm/year to 239 mm/year. Consequently, annual average volumetric recharge in the Upper Awash and annual groundwater flux from portion of the Blue Nile sub basins to the Upper Awash aquifer system are estimated to be 983 Mm3 and 365 Mm3 respectively. The significant flux joining the Upper Awash groundwater system from part of the Middle Blue Nile basin, which is almost 37% of the total annual recharge to the Upper Awash basin makes this part of the Middle Blue Nile basin an important recharge zone for the Upper Awash groundwater. Estimating recharge using integrated approaches was found to be useful to identify range of plausible recharge rates in the two basins. Besides, the new methodological approach of superimposing recharge governing factors on interpolation of point recharge estimates helps to produce physical based spatial distribution of recharge.
Prevalence and Risk Factors of Child Malnutrition in Community Based Nutrition Program Implementing and Nonimplementing Districts from South East Amhara, Ethiopia  [PDF]
Behailu Tariku,Afework Mulugeta,Mache Tsadik,Girma Azene
Open Access Library Journal (OALib Journal) , 2014, DOI: 10.4236/oalib.1100425
Abstract: Background: The burden of malnutrition in Ethiopia is the second highest in sub Saharan Africa. According to the recently released Ethiopian Demographic and Health Survey report of 2011, the prevalence of child stunting, underweight and wasting were 44% stunted, 10% wasted and 29% underweight respectively. Objectives: To determine the magnitude and risk factors of malnutrition among 6 - 59 months children from Community Based Nutrition Program implementing and nonimplementing districts from south east Amhara. Methodology: Descriptive community based, cross sectional study in which a total of 987 children (620 from Community Based Nutrition im-plementing and 367 from nonimplementing districts) were sampled. A structured questionnaire was administered to mothers or caregivers of the children. Anthropometric measurements were taken following standard procedures. Nutritional status of the children was determined based on Z scores of < ?2 or >= ?2 Standard Deviation. Logistic regression was used to test significant asso-ciations between outcome and factor variables. Setting: Rural communities from Artuma Fursi and Kemissie districts. Results: A total of 987 children of 6 - 59 months of age and 987 mothers/care- givers had participated in the study, giving a response rate of 99%. The percentage of male and female children in CBNP district was 330 (53.2%) and 290 (46.8%) and that of non Community Based Nutrition Program (CBNP) district was 192 (52.3%) & 175 (47.7%) respectively. The prev-alence of stunting, underweight and wasting were 60.6%, 31.1%, 12.6% and 39.0%, 27.5%, 14.7% in CBNP and nonCBNP implementing districts, respectively. The possible risk factors for child malnutrition were area specific and different for the two districts. Conclusion: Child under nutrition is a serious public health problem in both districts, so that holistic programs need to be designed and implemented according to the guidelines.
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