ALBERT

Description: Background: In this study, we hypothesized that TB co-infection independently increases the risk of poor treatment outcomes in such patients even if they are on antiretroviral therapy (ART). Therefore, this study was aimed at investigating this hypothesis among cohort of adult PLWHs in South West Ethiopia.MethodologyCohort study comparing the immunologic and clinical outcomes of 130 HIV/TB co-infected and 520 only HIV patients starting ART was enrolled. Chi square and student t test were used to compare outcome variables and logistic regression was used to assess the effect of TB on treatment failure. Results: In this study, TB co-infection didn’t increase immunologic failure even in univariate analysis at both 6 [OR, 1.10 (0.59–1.69), P = 0.85] and 12 months [OR, 1.06 (0.58–1.93), P = 0.89] of ART initiation. However, it increased the risk of clinical failure at both 6 [Adjusted Odd Ratio (AOR), 2.90 (1.41–6.09), P = 0.028] and 12 months [AOR, 2.93 (1.41–6.09), P = 0.004] of ART initiation. Conclusion: This study showed that TB co-infection didn’t adversely affect the immunologic outcomes, weight and hemoglobin responses even though it increased the risk of clinical failure nearly three times. Therefore, beside the concern given for TB prevention and treatment, several patient and policy related factors need to be addressed to maximally benefit from highly active antiretroviral therapy rollout in resource limited settings.

Description: Bamboo is an abundant resource in Ethiopia and has a great potential for commercialization, which can drive rural development. In view of these realities, this study analyzed the state and determinants of small-scale bamboo commercialization in Ethiopia. Data were collected from three major bamboo-growing districts (Awi, Sidama, and Sheka) and four urban centers (Masha, Hawassa, Bahir Dar, and Addis Ababa) via semi-structured interviews, group discussions, and questionnaire surveys with key actors along the value chain. Results revealed distinctive differences in proportion of cash income, value chain structure, and management engagement among the districts. Percentages of cash income were 60.15, 42.60, and 9.48 at Awi, Sidam, and Sheka, respectively. Differences were statistically significant between Sheka and both other districts (p = 0.05), but not between Awi and Sidama. The value chain structure showed that compared with Sheka, Awi and Sidama have a relatively large number of actors involved. The major factors explaining commercialization differences among regions were distance to market and presence of alternative forest products. Within Sheka, households with larger family size, higher education attainment, and access to training reportedly engaged more in commercial extraction. Therefore, we conclude that development of infrastructure for linking resource and consumer centers and expansion of extension education among producers may enhance the commercial engagement of producers and improve the accessibility of bamboo resources for commercial production.

Description: ABSTRACT This study presents an assessment of the skill and economic benefits of a seasonal forecast carried out by nine-member ensembles of regional and global models over southern Africa for the period of 1991–2002. The regional ensemble seasonal hindcasts were conducted at a resolution of 25 km by driving RegCM4 with the corresponding ensembles of the European Centre for Medium-Range Weather Forecasts (ECMWF) seasonal hindcasts. Skill and cost/loss ratio analysis were carried out on the probabilistic hindcasts to assess how much added value a regional model would bring over the driving ECMWF forecasts. RegCM4 shows an added value over most areas of southeastern Africa where the skill of the global circulation model (GCM) is already positive. In terms of economic benefits, RegCM4 brings additional benefits for southeastern Africa either by benefiting more users with interest in larger cost/loss ratio or by providing a higher economic value for users with small cost/loss ratio. Additional RegCM4 simulations with the same resolution were performed using a near ‘perfect’ boundary conditions with ‘continuous (climate)’ and ‘reinitialized’ modes to test the impact of land surface initialization/ spin up time on the seasonal mean precipitation simulation. Evaluation of the ‘perfect’ boundary forced simulations reveals that the regional model not only generates finer spatial-scale features that are missing in the ECMWF GCM, in terms of the December to April (DJFMA) climatology, but also reduced the wet bias of the driving GCM. Land surface initialization is found to have less impact on the DJFMA seasonal mean rainfall for forecasts initialized on 1 November, suggesting that 1 month is enough to recover from the shock of poor soil moisture initialization.

Description: Background: Inadvertent ligation of the left pulmonary artery during attempted surgical closure of a Patent Ductus Arteriosus has long been recognized as one of the less common complications of this procedure. Surgical reconstruction of the left pulmonary artery was then often attempted but was difficult or impossible in some of the patients with hypoplasia of the left pulmonary artery and the left lung.Case presentationA 10-year-old girl presented with marked exercise intolerance and palpitations and was diagnosed to have large PDA. She had feeding difficulty, diaphoresis, failure to gain weight, recurrent chest infections during infancy and early childhood. Physical examination revealed an underweight child with wide pulse pressure and bounding peripheral pulses. She had active precordium with accentuated P 2 and machinery murmur in the left 2nd intercostal space and mid diastolic rumble at the mitral area. Echocardiography showed a 12 mm patent arterial duct. She was taken for an intended surgical ligation of the duct but a control echocardiogram on the 3rd postoperative day revealed that the left pulmonary artery, instead of the duct, was ligated. Surgical reconstruction of the left pulmonary artery was undertaken 3 years later, however, this was complicated by post reconstruction left pulmonary artery stenosis. Successful percutaneous stenting of the left pulmonary artery was performed 18 months after the surgical reconstruction. Conclusion: The incidence of inadvertent LPA ligation may be underestimated where PDA ligation is done by less experienced surgeons and postoperative echocardiography is not routinely performed. Late correction of inadvertent LPA ligation is an important surgical challenge, especially if the duct is still patent. Percutaneous stenting as a primary option may carry significant risk, as the ligated pulmonary artery is fragile. In our case, a good result was achieved with surgical repair followed by percutaneous stenting.

Description: Child undernutrition is a major public health concern in Ethiopia (stunting national prevalence: 44%; wasting: 10%), despite the overall improvement in child health status during the last decade. Hundreds of small-scale surveys are conducted in Ethiopia’s emergency pockets under ENCU’s supervision. We reviewed the evidence from small-scale surveys conducted between 2008 and 2013 with two objectives: to provide a summary estimate of wasting prevalence from emergency pockets and to examine reasons for variation in prevalence estimates. We created a dataset by combining data from the Complex Emergency Database, the Famine Early Warning System Network and the Armed Conflict Location Event Data. We conducted a meta-analysis of small-scale surveys using a random effects model with known within-study heterogeneity. The influence of survey covariates on estimated prevalence was investigated with meta-regression techniques. We included 158 surveys in the analysis. A high degree of heterogeneity among surveys was observed. The overall estimate of wasting prevalence was 10.6% (95% CI 9.8–11.4), with differences among regions and between residents and refugees. Meta-regression results showed that vaccination coverage, child mortality, diarrhea prevalence and food insecurity are significantly associated with wasting prevalence. Child care and displacement status were not. Aggregated analysis of small-scale surveys provides insights into the prevalence of wasting and factors explaining its variation. It can also guide survey planning towards areas with limited data availability.

Description: Background: Hepatitis B virus infection is a significant health problem. Approximately two billion people worldwide have chronic Hepatitis B virus infection and over one million die annually. Hepatitis B virus infection and Human Immunodeficiency Virus co-infection is an emerging concern in the clinical management of patients because of shared routes of transmission. Methods: Hospital based cross-sectional study was performed from January to June, 2012 at Goba General Hospital. Socio-demographic and possible risk factors data from study subjects were collected using pre-test and structured questionnaire. Venous blood was collected and the serums were tested for Hepatitis B surface antigen and Human Immune Deficiency Virus using commercially available rapid test kits. Data were entered and analyzed using the SPSS software package (version15). Binary and multivariable logistic regressions were used to identify factors associated factors. A p-value of

Description: Background: Anemia during pregnancy is a well known medical condition most of the time under-recognized as it is overshadowed by the normal physiological condition during pregnancy. This study aimed at determining the prevalence and predictors of anemia among pregnant women residing in the rural surroundings of Arbaminch Town, south Ethiopia. Methods: A cross-sectional community based study was conducted between April and June, 2013. A structured questionnaire was used to collect socio-economic and socio-demographic characteristics of the pregnant women. Hematocrit (HCT) level was determined to classify the pregnant women as anemic and non-anemic. Diagnosis of asymptomatic malaria parasitemia was done by Giemsa stained blood smear microscopy. HCT 

Description: Background: The effects of highly active antiretroviral therapy (HAART) on glucose and lipid metabolism among sub-Saharan Africans, for whom access to antiretroviral therapy is expanding, remain largely unknown. Therefore, the aim of this study was to assess antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu health center, Addis Ababa, Ethiopia. Methods: A cross-sectional comparative study was conducted among HIV infected adults at Burayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equal number of HAART naive and HAART initiated patients (n = 126 each) were included in the study. Demographic data were collected using a well-structured questionnaire. Total cholesterol (TC), Triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and glucose were determined. The data were analyzed using SPSS version 20 software.Result: Of 252 study participants, 72.2% were females; mean age was 35.3 years; mean Body Mass Index (BMI) was 21.4(kg/m2); mean time living with the virus was 20.6 months and 15.5% were TB-HIV co-infected. The prevalence of hyperglycemia, increased LDL-C hypercholesterolemia, hypertriglyceridemia and decreased HDL-C were 7.9%, 23%, 42.1%, 46.8% and 50.8% in HAART and 5.6%, 7.1%, 11.1%, 31% and 73% in non-HAART groups, respectively. First line antiretrovirals were drugs containing 2 nucleoside backbones (from Zidovudine/Stavudine/Lamivudine/Tenofovir) with either Nevirapine or Efavirenz. There was statistically significant increase in serum lipid profile levels among HAART initiated patients than HAART naive individuals (p =0.01 for TG and