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An assessment of the health care system for diabetes in Addis Ababa, Ethiopia
Yeweyenhareg Feleke, Fikre Enquselassie
Ethiopian Journal of Health Development , 2005,
Abstract: Background: During the past decade, diabetes mellitus has emerged as an important clinical and public health problem through out the world. WHO estimated the number of cases of diabetics in Ethiopia to be about 800,000 in 2000, and projected that it would increase to about 1.8 million by the year 2030. Care for diabetic patients may require close and sustained support from a health care team, adequate financial resources, and advanced patient knowledge and motivation. In this respect, there is lack of information in the country. Objective: This study was conducted with the aim of assessing the characteristics of the health care system for diabetic patients, how diabetic patients are cared for including medical care and adequacy of facilities for the prevention of complications and outcomes at primary health care and secondary health care levels. Methods: An assessment of the characteristics of the health care system (structure) for diabetic patients was conducted in 21 health centres (primary health care level) and 5 regional hospitals (secondary health care level) in Addis Ababa. Furthermore, a total of 106 diabetic patients drawn from six out of the 21 health centres and another 123 diabetic patients drawn from three of the six hospitals were consecutively interviewed. Results: All the Regional hospitals and one of the health centres were running established diabetic referral clinics. Similarly, a lack of professionals was observed in all the health institutions in general and the health centres, in particular. Only 21% of patients had access for blood glucose monitoring at the same health institutions. The emphasis given for diabetic education (24%) was less than expected. Only 11 (5%) of diabetic patients were able to do self blood glucose monitoring at home. Fifty one percents of patients didn't have urine analysis, BUN, creatinine and lipid profile in the previous 1-2 years. None of diabetic patients had haemoglobin Alc (HbA1c) determination. Nearly 75% of the patients required admissions directly or indirectly due to uncontrolled diabetes. About 87% of the diabetics had regular follow ups at their respective health centres and hospitals. Hypertension (34%), diabetes related eye disease (33%) and renal disease (21%) were the major associated illnesses observed among the diabetics. Sixty-six patients (23%) had a total of about 131 admissions. Conclusion: Although there is a well-established health infrastructure for diabetics care in Addis Ababa, the diabetic care is below the acceptable standard. The finding of this study may, thus, help to clarify issues related to potential changes in the health care system dealing with diabetes and for strengthening the referral system for diabetes health care. Ethiopian Journal of Health Development Vol. 19(3) 2005: 203-210
The Practice of US Execution of Juvenile Delinquents in Dated Times Vis-à-Vis International Human Rights Laws and Case Laws  [PDF]
Nuruye Beyan Feleke
Beijing Law Review (BLR) , 2015, DOI: 10.4236/blr.2015.64029
Abstract: The prohibition against the death penalty as applied to juveniles is widely practiced across the globe. The United Nations treaties have prescribed age requirements for extreme sentences such as the juvenile death penalty. Despite these requirements very few countries continue to sentence juveniles to the death penalty that ignore the age of the offender. The United States leads the world in state-sanctioned juvenile executions. However, recently the United States came into compliance with international norms and heralded a major shift by banning the death penalty as applied to juveniles in the Supreme Court case of Roper v. Simmons in 2005. Due to that, the overwhelming majority of states do not sentence juveniles to the death penalty and the prohibition against sentencing children to die has become accepted. On the contrary, for over three centuries, the United States executed juvenile delinquents and the Supreme Court, for a long time, held there was no national consensus rejecting juvenile executions and not a violation of the Eighth Amendment. The US is already a party to a number of fundamental human rights treaties that impact capital punishment. To some extent, the US has isolated itself from the most direct effects of these treaties through reservations or by invoking domestic law. But the US is committed to the underlying human rights principles of these treaties and these instruments can serve as a starting point for reforming and restricting the death penalty from a human rights perspective.
Intestinal parasites infection and associated factors among school children in Dagi primary school, Amhara National Regional State, Ethiopia  [PDF]
Mulat Alamir, Worku Awoke, Amsalu Feleke
Health (Health) , 2013, DOI: 10.4236/health.2013.510228

Introduction: Intestinal parasitic infections are among the most common communicable diseases worldwide, particularly in developing countries. Worldwide, about 3.5 billion people are affected, and 450 million are ill as a result of these infections, among whom, the majority are children. The objective of this study was to assess prevalence of intestinal parasites infection and associated risk factors among school children in Dagi primary school, ANRS, Ethiopia. Methods: Institutional-based cross-sectional study was conducted by involving 399 school children from 24 September to 19 October, 2012. Structured questionnaires were used to identify environmental, socio-demographic and behavioral factors and stool specimens were collected and examined for parasites using direct smear and formal-ether concentration technique. Data analysis was done by using SPSS version 15 statistical soft ware. Results: Eight species of intestinal parasites were identified with an overall prevalence of 77.9%. Students were infected with one or more intestinal parasites and the predominant parasite was hook worm, 94 (23.6%) followed by G. lamblia 91 (22.8%), E. histoltica 86 (21.6%) and Strongyloides 6 (1.5%). The presence of mixed parasitic infection was 106 (34.1%), double and triple infections were 97 (91.5%) and 9 (8.5%) respectively. Intestinal parasitic infection was higher in children whose fathers’ occupational status were farmers, who had unclean finger nails and who did not have the habit of wearing shoes (p < 0.05). Conclusions: Intestinal parasites infection was an important public health problem among Dagi primary school children. Therefore, the local health office and other governmental and non-governmental organizations need to give attention to this serious problem of intestinal parasitic infection of school children.

Sisay Feleke*, Abeba Brehane
Bulletin of the Chemical Society of Ethiopia , 2005,
Abstract: Two pentacyclic triterpenoids of oleanane and ursene structures have been isolated from the latex of the Ficus sur. The compounds isolated from the latex are naturally acetylated in the 3-position and their structures have been elucidated on the basis of spectroscopic studies. KEY WORDS: Latex, Ficus sur, Moraceae, Triterpenoids Bull. Chem. Soc. Ethiop. 2005, 19(2), 307-310.
Sensitivity of chest X-rays and their relation to sputum results in the diagnosis of pulmonary tuberculosis in Hosanna Hospital
Mengistu Asnake, Daniel Feleke
Ethiopian Journal of Health Development , 2000,
Abstract: A retrospective analysis of records of Tuberculosis (TB) patients from Hossana Hospital was done from May to July 1994 to assess the relationship of chest radiographic patterns and the likelihood of finding Acid Fast Bacilli (AFB) in sputum smears done for pulmonary TB patients. The sputum results, clinical diagnosis, and other demographic variables were obtained from the hospital tuberculosis register. The chest-X Ray (CXR) findings of each patient were reviewed by a radiologist. A total of 352 hospital records with sputum and CXR results were included in the study and 43.8% and 66.2% of the patients had positive smear results for AFB and CXR suggestive for pulmonary TB, respectively. Among the major CXR findings, cases with cavity, interstitial shadowing, and lung collapse showed over 50% smear positivity. In this study it is noted that the CXR was used for all suspects of TB which resulted in an increased cost for routine diagnosis. The use of the flow sheet for the diagnosis of pulmonary TB and to use additional clinical tools is recommanded if the need arises. (Ethiopian Journal of Health Development, 2000, 14(2): 199-204)
Utilization of insecticide treated nets in Arbaminch Town and the malarious villages of Arbaminch Zuria District, Southern Ethiopia
A Astatkie, A Feleke
Ethiopian Journal of Health Development , 2009,
Abstract: Introduction: Malaria causes an overwhelmingly large number of cases and deaths round the globe every year. Insecticide treated nets (ITNs) have become important tools that provide a simple, but effective means of preventing malaria in highly endemic areas. Methods: A community-based cross-sectional study design was used to investigate possession, utilization, and factors affecting possession and utilization of ITNs in Arbaminch Town and the malarious villages of Arbaminch Zuria District, southern Ethiopia from 22nd January to 1st February 2007 on a sample of 454 households. Data were collected using structured, pretested, interviewer-administered questionnaire. Data entry and analysis was performed using SPSS 11.0 for windows. Univariate, bivariate and multivariate analyses were carried out. Results: The coverage for any net and ITN was 75.1% and 58.8% respectively; the utilization rate for any net and ITN by any member of the household the night prior to the study was 71% and 73% respectively. Both coverage and utilization were higher in rural areas than in urban areas. The proportion of pregnant women and children under five years who slept under ITNs the night preceding the study was 35% and 40.3% respectively. Education and income of head of households, place of residence of households and presence of high risk groups in the household were found to be predictors of net possession. Sex and income of head of households, and presence of radio in the households were predictors of utilization of nets by any household member. Education of head of households and place of residence of households were predictors of utilization of nets by high risk groups. Conclusions: A wide gap exists between coverage and utilization of ITNs. Use of ITNs by high risk groups is far below the Abuja target. Appropriate BCC interventions are required to narrow the gap between coverage and utilization of ITNs and to escalate use of ITNs by high-risk groups.
Medication Administration Errors Involving Paediatric In-Patients in a Hospital in Ethiopia
Y Feleke, B Girma
Tropical Journal of Pharmaceutical Research , 2010,
Abstract: Purpose: To assess the type and frequency of medication administration errors (MAEs) in the paediatric ward of Jimma University Specialized Hospital (JUSH), Jimma, Oromia Region, southwestern Ethiopia. Methods: A prospective case-based observational study was performed. The required data were collected by observing the health professionals and attendants in charge of administering medications to in-patients in the three units of the paediatric ward of JUSH from February 18 to March 2, 2009. Results: A total of 196 (89.9 %) MAEs were identified from the 218 observations made. From these, 178 (90.8 %) occurred with intravenous (IV) bolus medications while 16 (8.2 %) of them pertained to oral medications. The most frequent of the MAEs observed was wrong time error with 55 errors or 28.1 % of the total, while 52 (26.5 %) were dose errors and 42 (21.4 %) were due to drugs omitted during drug administration. Furthermore, wrong administration technique errors and unauthorized drug errors were 41 (20.9 %) and 6 (3.1 %), respectively. The drug mostly associated with error was gentamicin with 29 errors (1.2 %). Conclusion: During the study, a high frequency of error was observed. There is a need to modify the way information is handled and shared by professionals as wrong time error was the most implicated error. Attention should also be given to IV medication administration with special emphasis on gentamicin, ampicillin, cloxacillin and crystalline penicillin.
Triterpene compounds from the latex of Ficus sur I.
Sisay Feleke,Abeba Brehane
Bulletin of the Chemical Society of Ethiopia , 2005,
Abstract: Two pentacyclic triterpenoids of oleanane and ursene structures have been isolated from the latex of the Ficus sur. The compounds isolated from the latex are naturally acetylated in the 3-position and their structures have been elucidated on the basis of spectroscopic studies.
Missed opportunities for earlier HIV testing and diagnosis at the health facilities of Dessie town, North East Ethiopia
Netsanet W Fetene, Amsalu D Feleke
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-362
Abstract: A confidential client exit interview and medical record review was made on 427 clients who attended health facilities of Dessie town between November-December 2008. Data collection was done by counselors trained on Provider Initiated Counseling and Testing (PICT) and data collection tool included demographics, reason for visit to health facilities, HIV test initiation by service providers, clients self risk perception, clients willingness and acceptance of HIV test, HIV test result and review of client medical records.Among 427 clients, missed opportunities for HIV testing were found in 76.1% (325) of clients. HIV test initiation was made by data collecting counselors during interview period and 80.0% (260) of clients not initiated by service providers were found to be willing to have HIV test. Large number, 43.0% (112), of the willing clients actually tested for HIV. Of the tested clients, 13.4% (15) were found to be HIV positive. Most, 60% (9), of HIV positive clients who lost the opportunities of diagnosis felt themselves as having no risk for HIV infection. Missed opportunities for HIV diagnosis of 51.7% (15), overall HIV test acceptance rate of 36.5% (154) and positivity rate of 6.9% (29) were found.The missed opportunities for earlier HIV test and diagnosis of patients attending health facilities were found to be high and frequent. Testing only clients with HIV risk misses large number of HIV positive patients. Asking clients' willingness for HIV testing should be conducted by all service providers irrespective of the clients' risk behaviors for HIV infection or the type of services they need.AIDS is the gravest global pandemic of our time. It has already claimed over 20 million lives, with another 39 million individuals currently estimated to be living with HIV worldwide, and millions more becoming newly infected each year[1]. Sub-Saharan Africa continues to bear the brunt of the global epidemic. Two thirds (63%) of all adults and children with HIV globally l
Fluoride in black and green tea (Camellia sinensis) infusions in Ethiopia: measurement and safety evaluation
Samuel Zerabruk, Bhagwan Singh Chandravanshi, Feleke Zewge
Bulletin of the Chemical Society of Ethiopia , 2010,
Abstract: The fluoride contents in the infusions of 21 commercially available Ethiopian and imported black and green tea brands; in leaf and bag forms was determined by a fluoride ion-selective electrode method. Of the samples analyzed twelve were products from Ethiopia and the remaining nine were imported tea brands. The effect of brewing time on fluoride release from tea was assessed. Results showed that fluoride release increased with increasing brewing time (3, 5 and 10 min). Fluoride level after 5 min brewing for black tea leaves, green tea bags, and black tea bags was in the range of 117–682 mg/kg, 111–190 mg/kg and 141–246 mg/kg, respectively. The WHO guideline for daily fluoride intake is 2 mg for children and 4 mg for adults. Assuming that one consumes 4 cups of tea everyday (400 mL) and each cup uses 2.5 g of tea leaves, the daily fluoride intake from black tea leaves may be in the range between 1.11 and 6.82 mg. For the same condition, if consumption of one green tea bag is considered, the fluoride intake can be in the range between 1.00 and 1.38 mg. Similarly, intake from the black tea bags may range from 0.86 to 1.81 mg. Considering the Ethiopian black tea alone, the daily fluoride intake may range from 2.48 to 6.82 mg. Thus according to the WHO recommendation for daily fluoride intake and ignoring other possible sources; the black and green tea bags and imported black tea leaves are safe for all age groups. None of the 10 Ethiopian black tea leaf brands are safe for children but 30% of the analyzed samples are safe for adults. KEY WORDS: Black tea infusion, Green tea infusion, Fluoride intake, Brewing time, Safety evaluation Bull. Chem. Soc. Ethiop. 2010, 24(3), 327-338.
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