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Mortality Level and Predictors in a Rural Ethiopian Population: Community Based Longitudinal Study
Berhe Weldearegawi, Mark Spigt, Yemane Berhane, GeertJan Dinant
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0093099
Abstract: Background Over the last fifty years the world has seen enormous decline in mortality rates. However, in low-income countries, where vital registration systems are absent, mortality statistics are not easily available. The recent economic growth of Ethiopia and the parallel large scale healthcare investments make investigating mortality figures worthwhile. Methods Longitudinal health and demographic surveillance data collected from September 11, 2009 to September 10, 2012 were analysed. We computed incidence of mortality, overall and stratified by background variables. Poisson regression was used to test for a linear trend in the standardized mortality rates. Cox-regression analysis was used to identify predictors of mortality. Households located at <2300 meter and ≥2300 meter altitude were defined to be midland and highland, respectively. Results An open cohort, with a baseline population of 66,438 individuals, was followed for three years to generate 194,083 person-years of observation. The crude mortality rate was 4.04 (95% CI: 3.77, 4.34) per 1,000 person-years. During the follow-up period, incidence of mortality significantly declined among under five (P<0.001) and 5–14 years old (P<0.001), whereas it increased among 65 years and above (P<0.001). Adjusted for other covariates, mortality was higher in males (hazard ratio (HR) = 1.42, 95% CI: 1.22, 1.66), rural population (HR = 1.74, 95% CI: 1.32, 2.31), highland (HR = 1.20, 95% CI: 1.03, 1.40) and among those widowed (HR = 2.25, 95% CI: 1.81, 2.80) and divorced (HR = 1.80, 95% CI: 1.30, 2.48). Conclusions Overall mortality rate was low. The level and patterns of mortality indicate changes in the epidemiology of major causes of death. Certain population groups had significantly higher mortality rates and further research is warranted to identify causes of higher mortality in those groups.
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.
Determinates of Childhood Pneumonia and Diarrhea with Special Emphasis to Exclusive Breastfeeding in North Achefer District, Northwest Ethiopia: A Case Control Study  [PDF]
Molla Gedefaw, Resom Berhe
Open Journal of Epidemiology (OJEpi) , 2015, DOI: 10.4236/ojepi.2015.52014
Abstract: Studies showed that exclusive breast feeding reduced infant morbidity and mortality. In low income countries such as Ethiopia where under-five mortality is very high, the role of exclusively breastfeeding could be even more critical. However, studies assessing the place of exclusive breast freeing in the prevention of childhood illnesses in our area are scarce. The aim of the study was to identify determinant factors of childhood pneumonia and diarrhoea. An institution based case control study was conducted in Achefer District in July, 2012. The cases were 122 children of 7 - 24 months old who had repeated attack of diarrhoea or pneumonia over three months prior to the survey while controls were 122 children who visited well baby clinic for vaccination. Data were collected by using pre-tested and structured questionnaire, and analysed using SPSS version 16 for windows. Logistic regression was performed, and strength of associations was estimated using odds ratio and 95% confidence interval. About 83% of the controls and only 12.3% of the cases were exclusively breast fed. Children who were exclusively breast fed were 83 times less likely to develop pneumonia or diarrhea than those who were not exclusively fed. Marital status, monthly income, prelacteal feeding, and late initiation of breast feeding were found to have statistically significant association with childhood diarrhea and pneumonia. This study brought local evidence that exclusive breast feeding had a protective effect against common childhood infectious diseases—pneumonia and diarrhoea—in the study area. Therefore, culture sensitive and plausible health education is recommended to strengthen exclusive breast feeding practices in order to decrease mortality and morbidity of infants and children from pneumonia and diarrhoea.
Assessing the Awareness and Usage of Quality Control Tools with Emphasis to Statistical Process Control (SPC) in Ethiopian Manufacturing Industries  [PDF]
Leakemariam Berhe, Tesfay Gidey
Intelligent Information Management (IIM) , 2016, DOI: 10.4236/iim.2016.86011
Abstract: Introduction: The present work was devoted to assess the awareness and usage of quality control tools with the emphasis on statistical process control in Ethiopian manufacturing industries. Semi structured questionnaire has been employed to executive and technical managers of manufacturing industries of various size and specialism across the country. Stratified random sample method by region was used to select sample industries for the study. The samples used for this study are industries mainly from Oromiya, Addis Ababa, Tigray, Amara, SNNP and Diredawa regions proportional to their size of the available industries. Methods: Exploratory method and descriptive statistics was used for data analysis. Available documents and reports related to quality control policy of the selected companies were investigated. Results and Discussions: The number of manufacturing industries involved in this study was 44. Of the sampled manufacturing industries about 60% are from Oromiya and Addis Ababa regions. It has been reported that 100% of the respondents said that the importance of quality control tools is very important to their organizations’ productivity and quality improvement (Figure 3). Quality control professionals were also asked the extent to which quality control system is working in their industry and majority of the respondents (45%) have indicated that quality control system is working to some extent in their respective industries (Figure 18). Conclusions and Recommendations: Most of the quality department of the industries did not fully recognize the importance of statistical process control as quality control tools. This is mainly due to lack of awareness and motivation of the top managements, shortage of man power in the area, and others together would make it difficult to apply quality control tools in their organization. In general, the industries in Ethiopia are deficient in vigor and found to be stagnant hence less exposed to a highly competitive market and don’t adopt the latest quality control techniques in order to gain knowledge about systems to improve quality and operational performance. We conclude that quality management system has to be established as an independent entity with a real power and hence the quality control department which is responsible for quality can make an irreversible decision with respect to quality of any given product. Moreover, the concerned bodies (government and ministry of industries) should give attention and work together with universities to ensure how these statistical process control techniques could be
Volume and Implicit Taper Functions For Cupressus Lusitanica and Pinus Patula Tree Plantations in Ethiopia
L Berhe
Ethiopian Journal of Environmental Studies and Management , 2009,
Abstract: Data from Cupressus lusitanica and Pinus patula were used to develop total and exponential form merchantable volume models, and implicit taper functions. The exponential form merchantable volume model to a specified top diameter limit showed marked improvement compared with the unbounded non exponential form merchantable volume model of Burkhart (1977). Implicit taper functions derived from the exponential form merchantable volume models were found superior to taper functions obtained from the non exponential merchantable volume models. In general, these models are essential management tools for the plantation of the species and in particular provide stock volume estimates by end use type.
Haftu Berhe* and Alemayehu Bayray
International Journal of Pharmaceutical Sciences and Research , 2013,
Abstract: Objective: The aim of this study was to determine the prevalence of depression and associated factors among people attending ART clinics in Tigray, Ethiopia. Method: Institution based cross-sectional study was conducted on patients attending ART clinics for persons living with HIV/AIDS (PLWHA) at Adigrat, Mekelle and Maichew Hospitals in Tigray region. Sample size was calculated using Epi info statcalc and 269 PLWHA were included in the study. The patients were interviewed by psychiatric nurses using the 21 item Hamilton’s depression scale Questionnaire. Data was analyzed using the Statistical Package for the Social Sciences (SPSS, version 19.0). Levels of depression were calculated among various subgroups of patients, according to the Hamilton’s depression scale questionnaire. The possible associations of the presence and severity of depression with socio-demographic variables was explored using appropriate parametric and non-parametric tests. Specifically, the odds square and logistic regression was used in the exploration of associations; ethical clearance was obtained from Mekelle University College of health sciences. Result: Out of 269 total participants, 142(52%) were females, 213 (79.2%) were from urban area and 56(20.8) were from rural. One hundred nine (40%) of the study subjects’ age range was 35-44 and 129 (48%) were married. Orthodox religion constituted 80% followed by Muslim (11.5%) and Catholic (0.4%). Sixty (22.3%) were unemployed and majority, 229(85.2%) had a minimum of primary education. Among 269 participants 43.9 % were depressed. Depression was associated with urban dwellers, with lower socio-economic class, unemployed and government employees, with OR of 3.19(1.5, 6.65), 4.43(1.35, 14.58), 2.74(1.34, 5.57), and 3.56(1.73, 7.30) respectively.Conclusion: In summary, the magnitude of depression in PLWHA on ART was found to be high and was positively associated with urban dwellers, with lower socio-economic class, unemployed, and government employees. Hence, depression among PLWHA on ART is still under diagnosed and under treated; there is a need to incorporate mental health service as an integral component of HIV care.
Derbew Fikadu Berhe
International Journal of Pharmaceutical Sciences and Research , 2012,
Abstract: Assessment of antimicrobial use can be performed by evaluating their use. Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. The objective of this study was to evaluate the rational use of ceftriaxone in Ayder referral Hospital, Mekelle-Ethiopia. Retrospective cross sectional study was used to assess rational use of ceftriaxone. The study was conducted by reviewing medication records of 296 patients who received ceftriaxone during hospitalization at Ayder referral Hospital from September 11, 2009 to September 10, 2010. A systematic sampling method was used to select inpatient prescriptions with ceftriaxone and patient cards were located based on the medical record number on the prescription papers. Data was collected by using structured format and evaluated against WHO criteria for drug use evaluation as per standard treatment guideline of Ethiopia. Most patients were dosed as 2 g/day (79.4%). The duration of therapy was found to be high in the range 2-7 days (51.69%). Ceftriaxone was mainly used as preoperative prophylaxis (38.8%). Maintenance fluids were the most commonly co-administered medications with a frequency of 62.16%. The use of ceftriaxone was appropriate only in 106 cases (35.8%) for the justification of use. Most of inappropriate uses were seen in terms of duration. Consistency of prescriber to the national standard treatment guideline was found to be low. To improve rational use and prevent the development of resistance; prescribers should adhere to the national standard treatment guideline. Intensification of short term trainings and antibiotic control systems are some of the possible solutions the hospital has to do.
Knowledge about Obstetric Danger Signs and Associated Factors among Mothers in Tsegedie District, Tigray Region, Ethiopia 2013: Community Based Cross-Sectional Study
Desta Hailu, Hailemariam Berhe
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0083459
Abstract: Background In many developing countries including Ethiopia, maternal morbidity and mortality still pose a substantial burden and thus progress towards the fifth Millennium Development Goal (MDG) remains slow. Raising awareness of women about the danger signs of pregnancy and childbirth is the first essential step in accepting appropriate and timely referral to obstetric care. However, in Ethiopia little is known about the knowledge level of mothers about obstetric danger signs. The objective of this study was to assess the status of knowledge of danger signs of pregnancy and childbirth among mothers who gave birth in the past two years prior to the survey in Tsegedie district, Tigray regional state, Ethiopia. Methods A Community based cross-sectional study was conducted from November 20, 2012 to June 30, 2013 on a randomly selected sample of 485 women who had at least one delivery in the past two years. Multistage sampling technique was employed to select the study participants. A pre-tested structured questionnaire was used to collect quantitative data. Focus group discussion and in-depth interviews were utilized to supplement the Quantitative data. Bivariate and multivariate data analysis was performed using SPSS version 17.0 software. Result Four hundred eighty five mothers participated in the study making a response rate of 100%. Vaginal bleeding was the most commonly mentioned danger signs of pregnancy (49.1%) and childbirth (52.8%). Two hundred eighty five (58.8%) and 299 (61.6%) of respondents mentioned at least two danger signs of pregnancy and childbirth respectively. One hundred seventy (35.1%) and 154 (31.8%) of respondents didn't know any danger signs of pregnancy and childbirth respectively. Educational status of the mother, place of delivery and having functional radio were found to be independent predictors of knowledge of women about the danger signs of pregnancy and childbirth. Conclusion Educational status of the mother, place of delivery and having functional radio were independently associated with knowledge of women about obstetric danger signs. Thus, provision of information, education and communication targeting women, family and the general community on danger signs of pregnancy and childbirth and associated factors was recommended.
Batch Sorption Experiments: Langmuir and Freundlich Isotherm Studies for the Adsorption of Textile Metal Ions onto Teff Straw (Eragrostis tef) Agricultural Waste
Mulu Berhe Desta
Journal of Thermodynamics , 2013, DOI: 10.1155/2013/375830
Abstract: Adsorption of heavy metals (Cr, Cd, Pb, Ni, and Cu) onto Activated Teff Straw (ATS) has been studied using batch-adsorption techniques. This study was carried out to examine the adsorption capacity of the low-cost adsorbent ATS for the removal of heavy metals from textile effluents. The influence of contact time, pH, Temperature, and adsorbent dose on the adsorption process was also studied. Results revealed that adsorption rate initially increased rapidly, and the optimal removal efficiency was reached within about 1 hour. Further increase in contact time did not show significant change in equilibrium concentration; that is, the adsorption phase reached equilibrium. The adsorption isotherms could be fitted well by the Langmuir model. The value in the present investigation was less than one, indicating that the adsorption of the metal ion onto ATS is favorable. After treatment with ATS the levels of heavy metals were observed to decrease by 88% (Ni), 82.9% (Cd), 81.5% (Cu), 74.5% (Cr), and 68.9% (Pb). Results indicate that the freely abundant, locally available, low-cost adsorbent, Teff straw can be treated as economically viable for the removal of metal ions from textile effluents. 1. Introduction Demands of clothing and apparel increase with the improving sense of fashion and lifestyle; thus textiles are manufactured to meet the growing demands. In developing countries such as Ethiopia, textile production becomes their source of income that contributes to their gross domestic product (GDP). However, this has brought both consequences to such countries either in a positive way which is an improvement of economy or in a negative way which led to an increased anthropogenic impact on the biosphere. Heavy metals, particularly, Pb, Cr, Cd, and Cu are widely used for the production of color pigments of textile dyes. These heavy metals which have transferred to the environment are highly toxic and can bioaccumulate in the human body aquatic life and natural water bodies and also possibly get trapped in the soil [1]. These toxic heavy metals entering in the aquatic environment are adsorbed onto particulate matter, although they can form free metal ions and soluble complexes that are available for uptake by biological organisms [2]. Various methods of treating effluents containing heavy metals have been developed over years, such as chemical precipitation, chemical oxidation or reduction, electrochemical treatment, ion exchange, reverse osmosis, filtration, evaporation recovery, and electrocoagulation [3–11]. These methods have significant disadvantages,
Current Status, and Correlates of Abortion among Rural Women of Gonji Kollela District, Northwest Ethiopia  [PDF]
Girum Meseret, Molla Gedefaw, Resom Berhe, Adane Nigusie
Open Journal of Epidemiology (OJEpi) , 2015, DOI: 10.4236/ojepi.2015.52018
Abstract: Background: Evidences indicate that unsafe abortion is one of the most important causes of maternal mortality in Ethiopia. Ethiopia strives to curb maternal mortality. Hence, current data on abortion, and its correlates are required. Objective: To assess the prevalence and associated factors of abortion among women of reproductive age (15 - 49 years) in rural kebeles of Gonji Kolela District. Methods: A community based cross-sectional study was conducted among randomly selected 611 women in six rural kebeles of Gonji Kolela District, Northwest Ethiopia. A structured pre-tested questionnaire was used to collect data on socio-demographic and obstetric histories. The data were checked for completeness and cross-checked for accuracy and consistency. Result: The overall prevalence of abortion was 12% (10.9% spontaneous and 1.1% induced). Of these, 12.3% of them had experienced abortion more than once. Most of abortion took place at home, no medical care. The most important predictor of abortion was educational status. Those women whose educational attainment was primary and above were 2.4 times more likely to experience abortion than those who were not able to read and write (AOR [95%CI] = 2.4 [1.13 - 5.10]). Most women attributed abortion to work overload. Conclusion: Abortion is high among rural women. Recommendation: Mechanism should be devised to educate the community about care to pregnant women. Why abortion is high among women who have visited school warrants further research.
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