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Determinants of Long Acting Reversible Contraception Method Use among Mothers in Extended Postpartum Period, Durame Town, Southern Ethiopia: A Cross Sectional Community Based Survey  [PDF]
Yirga Ewnetu Tamrie, Ewenat Gebre Hanna, Mesele Damte Argaw
Health (Health) , 2015, DOI: 10.4236/health.2015.710146
Abstract: Background: After a live birth, there is much unsatisfied interest in, and unmet family planning need for contraception. Waiting at least for 24 months before attempting the next pregnancy was recommended to reduce the risk of adverse maternal, perinatal and infant outcomes. The purpose of this study was to assess the determinants of long acting reversible contraception method use among mothers in extended postpartum period in Durame Town, Southern Ethiopia. Methods: A community based cross sectional study was conducted in Durame Town, Southern Ethiopia in December, 2014. Systematic random sampling technique was employed to recruit a total 460 study participants. Structured and pretested questioner was used to collect the data. Descriptive statistics was employed to characterize the study population using frequencies and proportions. Bivariate logistic regression analysis was conducted to identify all possible factors affecting utilization of LARC method. Multivariable logistic regression model was developed to control the confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed in identifying the real factors associated with use of LARC methods. Results: In this study we found that the prevalence of LARC method use among mothers during their extended postpartum period was 36.7% (95%CI: 32.2, 41.0). The unmet family planning need of mothers in the extended postpartum period was 123 (27.9%). The odds of using LARC by literate mother were four fold higher than their counterpart illiterate mothers (AOR 4.09 95%CI: 1.68, 9.58, P value < 0.001). The odds of mother who had pervious experiences of using LARC were up to eight folds higher than mother never used LARC methods (AOR 7.84 95% CI: 3.78, 16.23, P value< 0.001). Mother who received counseling service on LARC methods during delivery was up to three times more likely to utilize the services than not counseled (AOR 3.29 95% CI: 1.53, 7.03, P value < 0.001). And odds of mothers who received counseling service on LARC during immediate postpartum period were up to five fold more likely to opt method than never got the counseling service (AOR 4.55 95 % CI: 1.94, 10.66, P value < 0.001). Conclusions: In the study area, about one third of mothers utilized LARC methods during their extended postpartum period. Another one third of mother had unmet need for family planning. Participant’s education, previous history of using LARC methods, receiving counseling services on LARC during delivery and immediate postpartum periods were found major determinant for LARC
The Impact of Training and Development on Employee Performance and Effectiveness: A Case Study of District Five Administration Office, Bole Sub-City, Addis Ababa, Ethiopia  [PDF]
Abeba Mitiku Asfaw, Mesele Damte Argaw, Lemessa Bayissa
Journal of Human Resource and Sustainability Studies (JHRSS) , 2015, DOI: 10.4236/jhrss.2015.34025
Abstract: The focus of this study was to determine the impact of training and development on the employees’ performance and effectiveness at District Five Administration Office, Addis Ababa, Ethiopia. In this study we employed cross sectional institutional based quantitative research method. Data were collected using Likert’s scale tool from 100 employees after selecting participants using systematic random sampling technique. Ninety-four complete questionnaires with a response rate of 94% were considered during analysis. Training and development had positively correlated and claimed statistically significant relationship with employee performance and effectiveness. It is recommended that District Five Administration Office shall maintain providing employee training and development activities and ensure the participation of employees in planning, need or skill deficit identification and evaluation of training and development programs.
Implementation of Tuberculosis and Human Immune-Deficiency Virus Programs Collaborative Services in Public-Private Mix Direct Observed Therapy Short Course Facilities in Addis Ababa, Ethiopia: Cross Sectional Facility Based Mixed Method  [PDF]
Lakew Huluka Bahiru, Mesele Damte Argaw, Maeza Demissie
Open Journal of Epidemiology (OJEpi) , 2016, DOI: 10.4236/ojepi.2016.62011
Abstract: Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partnership Mix (PPM) approach was in place since 2006. But the status of its implementation has never been assessed. Methods: In this cross sectional study we employed mixed methods; we interviewed 272 tuberculosis patients, reviewed their records, and facilitated six in-depth interviews and four focus group discussions. The survey was conducted from January through March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV counseling for all TB patients; whereas 87.5% of TB patients have received HIV testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV patients were enrolled into chronic disease care services, 64.8% were put on Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly active anti-retro viral therapy (HAART) services. All PPM facilities don’t have IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly linked with the public health sector which was documented by developing inclusive work plan which create access to supplies and conducting joint supportive supervisions. However, the majorities of PPM facilities don’t have Multi-Disciplinary Team and lacks some essential supplies. The predictor for uptake of CPT were: being females TB patients was 86% lower than their counter part males (AOR = 0.14; 95% CI = 0.04 - 0.92 P = 0.002), patients who has attended their TB/HIV care at private for the profit facilities were 84% lower than those attend in private not for profit facilities (AOR = 0.16; 95% CI = 0.49 - 0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at program level are stronger but only half of patients didn’t get the comprehensive TB/HIV collaborative services to achieve recommended quality of care. Strengthening the services and ensuring the availability of essential supplies was highly recommended.
Magnitude and Factors Associated with Self-Medication Practices among University Students: The Case of Arsi University, College of Health Science, Asella, Ethiopia: Cross-Sectional Survey Based Study  [PDF]
Shimelis Adugna Bekele, Mesele Damte Argaw, Alemayehu Worku Yalew
Open Access Library Journal (OALib Journal) , 2016, DOI: 10.4236/oalib.1102738
Background: Self-medication is the selection and use of medicines by individuals to treat self- recognized illnesses or symptoms without any medical supervision. It resulted in wastage of resources, increases in resistance of pathogens, and causes health hazards such as adverse drug reactions, prolonged suffering and drug dependence. Despite this fact, studies on the subject matter indicated that health science students continued to practice & recommend self-medication to society. Accordingly, the purpose of this study was to estimate the prevalence of self-medication among students of Arsi University College of Health Science and investigate factors associated with it. Methods: A cross-sectional quantitative study with three months illness recall was conducted in Arsi University College of Health Science students from January to February 2015. Data were collected randomly from each department using self-administered questionnaires. Data entry was made using Epi-Info version 3.5.2 and analysis was done using SPSS IBM version 20. Results: From a total of 575 questionnaires distributed, 548 questionnaires with a response rate of 95.30% were collected back assessed as complete, 70.8% (388/575) reported at least one episode of an illness during three months prior to the day of the questionnaire, and 77.10% (299/388) of them accessed to and practiced self-medication during the study period. Students reported for the study period commonly perceived illnesses such as headache 169 (46.50%), gastrointestinal disease 102 (34.10%) and respiratory tract infection 95 (31.80%) accessed mainly antibiotics 179 (59.90%) and analgesics 143 (47.80%) mostly from drug retail outlets 184 (61.50%). The odds of being female university student was 2 fold accessed self-medication than their counter part males with Adjusted Odds Ratio (AOR) 1.84 with 95% Confidence Interval (CI): 1.01 - 3.34, p = 0.046. With regards to field of studies, students of midwifery were 3 folds accessed self-medication than their counter part students of medicine (AOR 2.78; 95%CI = 1.03, 7.39, p = 0.043). Those students who accepted self-medication for low income segment of the population 2 folds accessed self-medication than their counter part who disagree (AOR 1.76; 95%CI = 1.02, 3.06, p = 0.04). The major reasons indicated for self-medication by respondents were perceived mildness of their illness 132 (44.1%), poor quality of routine health care services 81 (27.1%) and it saves their time 60 (20.3%). Most respondents had a positive attitude towards practicing self-medication as especially, they believed a prospective health professionals & low income segments of the populations have a right to practice self-medication (p < 0.05). Conclusions: Significant numbers of students were self-medicated in this study with antibiotics as major accessed drugs. Being female was significantly associated with self-medication. Conducting tailored behavioral change communication by the health authorities, universities and other stakeholders is recommended.
Factors Associated with Early Initiation of Complementary Feeding in Bishoftu Town, Oromia, Ethiopia  [PDF]
Gizaw Gemechu Deme, Shimelis Adugna Bekele, Mesele Damte Argaw, Yemane Berhane
Open Access Library Journal (OALib Journal) , 2015, DOI: 10.4236/oalib.1101949
Abstract: Background: Early initiation of complementary feeding which was widely documented in many countries exposed infants to increased risk of morbidity and mortality. The purpose of this study was to assess the prevalence of early initiation of complementary feeding and associated factors in Bishoftu Town, Oromia, Ethiopia. Methods: An institutional based cross-sectional study design was conducted from January-February 2015 among 422 mothers of infant aged less than 6 months selected from four public health facilities. Prevalence of early initiation of complementary feeding was determined using “recall since birth” method. Multi-variable logistic regression analysis was employed to control confounders in determining association between early initiation of complementary feeding and selected independent variables. Adjusted Odds Ratio (AOR), 95% Confidence Interval (CI) and P < 0.05 were used to claim statistical significance. Results: The prevalence of early initiation of complementary feeding was 32.9% (137/416, 95% CI: 28.0, 37.0). The odd of mothers with delayed initiation of Breastfeeding was 4.76 times higher to expose their child to early complementary feeding than women who initiated breastfeeding within one hour after delivery with AOR 4.76 (95% CI; 2.48 -9.13, P value < 0.001). This finding was a little higher than estimates of other studies. The odds of house wife mothers and mothers who delivered at health institution had 64% and 74% lower risk to early initiate complementary feeding than employed and home delivered mothers with AOR 0.34 (95% CI; 0.21, 0.55) and AOR 0.26 (95% CI; 0.08, 0.89), respectively. The odd of mothers who lacked knowledge on the duration of optimum breastfeeding duration was 3.91 times higher to practice early initiation of complementary feeding than who correctly knew it with AOR 3.91 (95%; 2.33, 6.54, P-value 0.001). Conclusions: Almost one third of mothers initiated early initiation of complementary feeding at four months of their child’s age. Encouraging all mothers to initiate breastfeeding within an hour, providing counseling service on recommended six-month duration of exclusive breastfeeding was recommended.
Endothelin A-receptors and the coronary circulation  [PDF]
Evangelos Polymeropoulos, Mesele Valenti, Zenon S. Kyriakides
World Journal of Cardiovascular Diseases (WJCD) , 2013, DOI: 10.4236/wjcd.2013.35057

We review the role of endothelin (ET) A-receptors (R) on the coronary circulation. ET-1 maintains the normal coronary artery tone. ET-1 plasma levels are increased during and after coronary angioplasty and this increase is related to myocardial ischaemia rather than to mechanical artery injury. ETAR antagonists inhibit coronary artery vasoconstriction induced by ET release after coronary angioplasty in humans. ET promotes neointimal formation and ETAR antagonism has been shown to inhibit restenosis after angioplasty in the animal model but not in humans. ETAR blockade increases coronary blood flow, dilates distal coronary arterial segments and decreases coronary vascular resistance. Coronary collaterals are less sensitive than other coronary vessels to ET-1. ETAR blockade decreases collateral blood flow and, consequently, perfusion of the ischemic myocardium.

Importance of labelling and patient knowledge to ensure proper care during drug dispensing: A case study from a tertiary hospital in Ethiopia  [PDF]
Seblework Mekonen, Wondimu Samuel, Argaw Ambelu
Open Journal of Preventive Medicine (OJPM) , 2014, DOI: 10.4236/ojpm.2014.41001

Correct drug labelling is central for ensuring proper drug dispensing and thus for patient safety. Labelling errors may result in adverse health outcomes. The objective of this study was, therefore, to assess the effect of labelling on the quality of drug dispensing and patient knowledge about dispensed drugs in Jimma University model and specialized hospital outpatient Pharmacies. Individual packages with prescribed drugs were examined using pretested questionnaire and observational check lists during the dispensing process. Patients’ knowledge about drugs dispensed to them was assessed at the exit interview using a pretested questionnaire. Out of 743 prescribed drugs, 682 (91.8%) were dispensed to 426 patients. The average labelling score (range from 0 to 6) of dispensed drugs in Model and Outpatient pharmacy was 2.00 (95% CI 1.97 to 2.04) and 1.73 (95% CI 1.6 to 1.8) respectively, with overall average labelling score of 1.90 (95% CI 1.84 to 1.91). The average patient knowledge score (range from 0 t0 5) was 3.45 (95% CI 3.31 to 3.59) and 3.5 (95% CI 3.35 to 3.64) for model and outpatient pharmacy, respectively, while the overall average knowledge score was 3.46 (95% CI 3.37 to 3.57). Major labelling problems were absence of patient’s name and dose followed by frequency of administration, duration of treatment, and the reason for prescription. Literacy status of patients had a significant effect on their knowledge (p < 0.005) but age had not (p > 0.05). We recommend that corrective measures targeting both, labelling and patients’ knowledge should be implemented to improve the patients’ safety and drug therapy adherence.

Prevalence, Knowledge and Self-Reported Containment Practices about Bedbugs in the Resource-Limited Setting of Ethiopia: A Descriptive Cross-Sectional Survey  [PDF]
Kaliyaperumal Karunamoorthi, Buzuna Beyene, Argaw Ambelu
Health (Health) , 2015, DOI: 10.4236/health.2015.79130
Abstract: Over the past decade, a dramatic rise in bedbug resurgence has become one of the top potential public health hazards. This study was conducted to determine prevalence, knowledge and self-reported containment practices about bedbugs in the resource-limited setting of Ethiopia. A community based, cross-sectional survey was conducted between January and May 2014. Selected 260 respondents were interviewed by the administration of a pre-tested questionnaire on knowledge and practices about bedbug infestation in the resource-limited setting of Ethiopia. Overall, 91.6% (238/260) of the residents had ample awareness on bedbug infestation. The majority of them (97.2%) extremely bothered about infestations because of bad odors (83.8%), insomnia (79.8%), biting (66.9%), and skin rashes (56.9%). A high prevalence of infestation (72.7%) was observed. Bedrooms and main hall/salon were identified as potential high-risk areas. Chi-square exhibited a strong association between sanitary status and housing conditions (χ2 = 40.91; df = 4; P = 0.0001). Besides, there was a strong association between respondents’ monthly income (χ2 = 42.1; df = 6; P = 0.0001) and educational status (χ2 = 26.01; df = 5; P = 0.0001) with the presence or absence of bedbug infestation. Though the majority of respondents had adequate knowledge, they suffer with deprived practices attributable to deficient resources as well as negligence/ignorance. This study emphasizes the following key interventions: 1) community-based awareness campaigns, 2) implementation of sustainable preventive/containment strategies, 3) educational interventions to ensure translation of knowledge into practices, and 4) the implementation of appropriate poverty alleviation programs to enhance the local-residents living-standard in the future.
Prevalence of Trachoma at Sub-District Level in Ethiopia: Determining When to Stop Mass Azithromycin Distribution
Jonathan D. King ,Tesfaye Teferi,Elizabeth A. Cromwell,Mulat Zerihun,Jeremiah M. Ngondi,Mesele Damte,Frew Ayalew,Zerihun Tadesse,Teshome Gebre,Ayelign Mulualem,Alemu Karie,Berhanu Melak,Mitku Adugna,Demelash Gessesse,Abebe Worku,Tekola Endashaw,Fisseha Admassu Ayele,Nicole E. Stoller,Mary Rose A. King,Aryc W. Mosher,Tesfaye Gebregzabher,Geremew Haileysus,Peter Odermatt,Jürg Utzinger,Paul M. Emerson
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0002732
Abstract: Background To eliminate blinding trachoma, the World Health Organization emphasizes implementing the SAFE strategy, which includes annual mass drug administration (MDA) with azithromycin to the whole population of endemic districts. Prevalence surveys to assess impact at the district level are recommended after at least 3 years of intervention. The decision to stop MDA is based on a prevalence of trachomatous inflammation follicular (TF) among children aged 1–9 years below 5% at the sub-district level, as determined by an additional round of surveys limited within districts where TF prevalence is below 10%. We conducted impact surveys powered to estimate prevalence simultaneously at the sub-district and district in two zones of Amhara, Ethiopia to determine whether MDA could be stopped. Methodology Seventy-two separate population-based, sub-district surveys were conducted in 25 districts. In each survey all residents from 10 randomly selected clusters were screened for clinical signs of trachoma. Data were weighted according to selection probabilities and adjusted for correlation due to clustering. Principal Findings Overall, 89,735 residents were registered from 21,327 households of whom 72,452 people (80.7%) were examined. The prevalence of TF in children aged 1–9 years was below 5% in six sub-districts and two districts. Sub-district level prevalence of TF in children aged 1–9 years ranged from 0.9–76.9% and district-level from 0.9–67.0%. In only one district was the prevalence of trichiasis below 0.1%. Conclusions/Significance The experience from these zones in Ethiopia demonstrates that impact assessments designed to give a prevalence estimate of TF at sub-district level are possible, although the scale of the work was challenging. Given the assessed district-level prevalence of TF, sub-district-level surveys would have been warranted in only five districts. Interpretation was not as simple as stopping MDA in sub-districts below 5% given programmatic challenges of exempting sub-districts from a highly regarded program and the proximity of hyper-endemic sub-districts.
Management of Helicoverpa armigera (Lepidoptera: Noctuidae) by Nutritional Indices and Botanical Extracts of Millettia ferruginea and Azadirachta indica  [PDF]
Tarekegn Fite, Tadele Tefera, Mulugeta Negeri, Tebekew Damte, Waktole Sori
Advances in Entomology (AE) , 2018, DOI: 10.4236/ae.2018.64019
Abstract: The development of hosts that are resistant and evaluation of botanical extracts to H. armigera Hübner (Lepidoptera: Noctuidae) is crucial for sustainable management, yet very limited in Ethiopia. Therefore, this study was done to identify alternative methods to insecticide control through host consumption study and botanical extracts. The performance of third-fifth larval stages of H. armigera on three host plant varieties including chickpea, tomato and faba bean and botanical extracts against the third larval instars and oviposition deterrence was studied under laboratory condition (22°C ± 2°C, 55% ± 5% RH, 12:12 L: D photoperiod). Significant differences were found in the efficiency of conversion of ingested food (ECI%) (F = 80.06; df = 6, 2; p < 0.05) and efficiency of conversion of digested food (ECD%) (F = 175.91; df = 6, 2; p < 0.05) values of H. armigera reared on the three host plant varieties of the whole larval instars. The minimum relative consumption rate (RCR) (11.271 ± 0.328) and maximum approximate digestibility (AD) (177.9 ± 1.928) values of the whole larval instars were on Dagaga and Koshari, respectively. The values of relative growth rate (RGR), ECI% and ECD% of the whole larval instars were highest on chickpea varieties and lowest on tomato Koshari. Among chickpea varieties, Habru was relatively resistant to larval instars of H. armigera. Botanical extracts at 50% neem oil (NO), 5% birbira seed extract (BSE) and 5% neem seed extract (NSE) (18.4%) resulted superior in larval mortality however, statistically not different. At both 5% and 2.5% concentration level of botanical extracts the minimum larval mortality was recorded from neem leaf extract (NLE). Maximum numbers of eggs were laid on control treatments and the minimum eggs were on 5% BSE. The deterrent effect of 50% neem oil was stronger (ODI = 17.66%) than that of 5% BSE (ODI = 14%) which is statistically similar value with 5% NSE (ODI = 13%). In conclusion, the result indicated that use of Habru chickpea variety with 50% NO was very effective in controlling both the larvae and deterring the adults of H. armigera from egg lying. These measures could be important in the wider managements of H. armigera by integrating host resistance and botanical extracts.
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