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: The productivity of maize in Ethiopia has remained lower than the world average because of several biotic and abiotic factors. Stemborers and poor soil fertility are among the main factors that contribute to this poor maize productivity. A novel cropping strategy, such as the use of push-pull technology, is one of the methods known to solve both challenges at once. A push-pull technology targeting the management of maize stemborers was implemented in the Hawassa district of Ethiopia with the ultimate goal of increased food security among smallholder farmers. This study evaluated farmers’ perception of push-pull technology based on their experiences and observations of the demonstration plots that were established on-farm in Dore Bafano, Jara Gelelcha and Lebu Koremo village of the Hawasa district in 2016 and 2017. This study examined farmers’ perception of the importance of push-pull technology in controlling stemborers and improving soil fertility and access to livestock feed. In both cropping seasons, except for Jara Gelelcha, the maize grain yields were significantly higher in the climate-adapted push-pull plots compared to the maize monocrop plots. The majority (89%) of push-pull technology-practising farmers rated the technology better than their maize production methods on attributes such as access to new livestock feed and the control of stemborer damage. As a result, approximately 96% of the interviewed farmers were interested in adopting the technology starting in the upcoming crop season. Awareness through training and effective dissemination strategies should be strengthened among stakeholders and policymakers for the sustainable use and scaling-up of push-pull technology.

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: The wide-ranging application of location-based services (LBSs) through the use of mobile devices and wireless networks has brought about many critical privacy challenges. To preserve the location privacy of users, most existing location privacy-preserving mechanisms (LPPMs) modify their real locations associated with different pseudonyms, which come at a cost either in terms of resource consumption or quality of service, or both. However, we observed that the effect of resource consumption has not been discussed in existing studies. In this paper, we present the user-centric LPPMs against location inference attacks under the consideration of both service quality and energy constraints. Moreover, we modeled the precision-based and dummy-based mechanisms in the context of an existing LPPM framework, and also extended the linear program solutions applicable to them. This study allowed us to specify the LPPMs that decreased the precision of exposed locations or generated dummy locations of the users. Based on this, we evaluated the privacy protection effects of optimal location obfuscation function against an adversary’s inference attack function using real mobility datasets. The results indicate that dummy-based mechanisms provide better achievable location privacy under a given combination of service quality and energy constraints, and once a certain level of privacy is reached, both the precision-based and dummy-based mechanisms only perturb the exposed locations. The evaluation results also contribute to a better understanding for the LPPM design strategies and evaluation mechanism as far as the system resource utilization and service quality requirements are concerned.