Technical and Economic Evaluation of Different Methods of Newcastle Disease Vaccine Administration

Two types of locally produced live vaccines (HB1 and La Sota--lentogenic strains) and inactivated oil adjuvant (IOAV) vaccine were used to compare the efficiency of three vaccination techniques, namely drinking water, ocular and spray on broiler chicks. The ocular route of vaccination on 1-day-old chicks followed by a booster dose on the third week through the same route induced a significantly higher level of haemagglutination inhibition antibody titre (P < 0.0001). The highest mean antibody titre was log(2) 6.6 and 93.3% of the chicks were protected from the challenge. The spray technique induced a lower antibody titre (peak of log(2) 5.9) and only 53% of the chicks in this treatment survived against the challenge. The results of this study show that the ocular route is superior to the drinking water route, which is superior to the spray technique. The economic analysis result showed that the ocular HB1 and La Sota vaccine administration method to 1- and 21-day-old chicks gave the highest revenue followed by the drinking water method. In terms of total cost, the injection method required the highest cost (0.21 birr/chick) followed by the ocular method (0.18 birr/chick). The marginal cost of vaccine administration is too small compared with marginal revenues from relative effectiveness of the methods. The internal rate of return for the ocular method was very high. The results of sensitive analysis on revenues from different vaccination methods indicate that a 25% reduction in broiler price reduces the marginal revenue from the ocular method by 12 487 birr but this still does not prove that the ocular method is economically viable for small- and medium-scale poultry farms.

Effects of dietary level of Leucaena leucocephala on performance of Angora and Spanish doelings

Thirty Angora (16+/-2kg initial body weight) and 20 Spanish doelings (19+/-2kg initial body weight), approximately 8 months of age, were used in an 10 week experiment to evaluate effects of dietary level of Leucaena leucocephala on body weight (BW) gain and fiber growth. The control diet (CS) included 9% dry matter (DM) of formaldehyde-treated casein; other diets consisted of 15, 30, 45 or 60% DM of leucaena leaf meal (0.75% mimosine; 15, 30, 45 and 60l, respectively). Diets were formulated to be 2.13Mcal metabolizable energy/kg DM, and ranged in crude protein from 10 to 14% of DM. DM intake was greater (P<0.05) for 45l than for CS and 15l (710, 648, 815, 899 and 811g per day for CS, 15, 30, 45 and 60l, respectively) and similar (P>0.05) between Angora and Spanish doelings. BW gain was similar (P>0.05) among diets (48, 28, 38, 34 and 26g per day for CS, 15, 30, 45 and 60l, respectively) and between breeds. Mohair growth rate was lower (P<0.05) for 60 and 30l than for CS (1.34, 1.18, 0.94, 1.16 and 0.88mgcm(-2) per day, and mohair diameter was greatest (P<0.05) for CS and lowest (P<0.05) for 60l (27.7, 25.9, 25.1, 25.0 and 23.8µm for CS, 15, 30, 45 and 60l, respectively). Cashmere growth rate and fiber diameter for Spanish goats were similar among diets, and primary and secondary follicle activities for both Angora and Spanish goats were not affected by dietary treatments (P>0.05). Diet affected (P<0.05) plasma concentrations of urea, threonine, arginine, valine, phenylalanine, isoleucine, leucine and lysine, with concentrations increasing as dietary level of leucaena increased. In conclusion, diets of moderate to high levels (e.g., 45%) of leucaena with 0.75% mimosine can be fed to goats without adverse effects on BW gain or fiber growth. However, further study of the composition of leucaena-based diets appears necessary to achieve most efficient utilization.

Essential newborn care practice and associated factors among obstetric care providers of public hospitals in Sidama regional state, Ethiopia

Introduction:

The global neonatal death rate was predicted to be 18 per 1000 live births during the first 28 days of life. Ethiopia continues to have one of the highest neonatal mortality rates in the world. Essentially, over 70% of these deaths may have been averted or prevented if proper essential newborn care had been provided. The purpose of this study was to assess the practice of essential newborn care and associated factors among obstetric care providers in public hospitals in Sidama regional state, Ethiopia.

Methods:

This study was conducted from 1 to 30 July 2020, using an institutionally based cross-sectional study design. The study comprised 182 obstetric care professionals from six hospitals chosen at random. EpiData (version 3.1) was used to enter data, which was then exported to SPSS (version 20). Descriptive, bivariable, and multivariable logistic regression were used. Statistical significance of the explanatory variables was declared at p values <0.05.

Results:

The overall prevalence of good practice on essential newborn care was 56.6% (95% confidence interval = 49.4–63.7). Working in the delivery room (adjusted odds ratio = 3.53, 95% confidence interval = 2.04–10.06), having training in essential newborn care (adjusted odds ratio = 3.65, 95% confidence interval = 1.63–8.17), and access to established essential newborn care protocols (adjusted odds ratio = 6.88, 95% confidence interval = 3.10–15.26) were found to be statistically significant factors of essential newborn care practice.

Conclusion:

The study found that having necessary newborn care standards, being interested in working in the delivery room, and having essential newborn care training are all important factors in implementing essential newborn care practices. Important knowledge gaps were noted in key areas of essential newborn care.

Composition, digestibility and feed intake of Opuntia ficus indica by Ogaden sheep

First of all spineless Opuntia is an important source of water for livestock in tropical regions. The water content of one-year sprouts amounted to 92.5%. 70 to 75% of dry matter of Opuntia ficus indica were crude carbohydrates, approximately 20% were crude ash. The apparent digestibility of organic matter was considerably high (70.9%), the energy content amounts to 35 and 467 EFUc per kg of fresh and dry matter respectively. Opuntias are roughage, their energy content is similar to that of grass or legumes during flowering. The protein content is too low (4.5 to 5.5% crude protein of dry matter) in order to meet the protein requirements of animals. When they had the choice rams preferred chopped fresh Opuntia (61.6% of the whole DM intake) to chopped dried Opuntia (34.7%) and whole fresh Opuntia (3.7%) apart from a certain basal diet (200 g of meadow hay and 200 g of concentrate per animal and day). If only one of the three differently treated forms of Opuntia was fed (apart from the basal diet) the sheep consumed daily 359 g of dry matter of chopped fresh Opuntia (approximately the same amount as if they had the choice, 101%), 313 g of dry matter of chopped dried Opuntia (88%) and 121 g of dry matter of whole fresh sprouts of Opuntia (34% of the total intake when they had the choice.) According to the obtained results spineless Opuntia ficus indica can be used in chopped form as an additional feed to other roughages (like grass, hay, straw) especially during the dry season.

Predictors of antiretroviral treatment-associated tuberculosis in Ethiopia: a nested case-control study

Little is known about the predictors of antiretroviral treatment (ART)-associated tuberculosis (TB) in developing nations. The objective of this study was to determine predictors of ART-associated TB in adults with HIV infection at Jimma University Hospital, Ethiopia. A nested case-control study was conducted in October 2009. The study population consisted of adults with HIV infection (aged >14 years) who developed active TB in the first six months since ART initiation and controls that did not develop active TB. Data were collected using a structured and pretested questionnaire. Cox proportions hazards analysis was done to determine predictors of ART-associated TB. A total of 357 patients (119 cases and 238 controls) participated in the study. After six months of follow-up, cumulative incidence of ART-associated TB was 5.2% (123/2355). Forty (33.6%) cases were lost to follow-up after they developed ART-associated TB and 11 (9.2%) died. Fifty-one (21.4%) controls interrupted ART and 11 (4.6%) died. A CD4 lymphocyte count increase >0.5/μL/day (adjusted hazard ratio [AHR] = 19.80, 95% confidence interval [CI]: 9.52, 41.12, P < 0.001), a base-line CD4 lymphocyte count <200 cells/μL (AHR = 9.59, 95% CI: 2.36, 39.04, P = 0.002), World Health Organization (WHO) clinical stage 3 or 4 (AHR = 3.04, 95% CI: 1.62, 5.69, P < 0.001), night sweats during ART initiation (AHR = 1.53, 95% CI: 1.06, 2.21, P < 0.001) and high ART adherence (AHR = 1.30, 95% CI: 1.13, 1.50, P < 0.001) were independent predictors of ART-associated TB. HIV-infected adults with these risk factors should be followed cautiously for the development of ART-associated TB. Good ART adherence and a good immunological response during ART were associated with ART-associated TB, most likely because of an immune reconstitution inflammatory syndrome unmasking the TB.

Time to initiate postpartum modern contraceptives among pregnant women in Ambo Town, Central Ethiopia; Cox-proportional hazard regression analysis

BACKGROUND

Timing of postpartum family planning is crucial for maternal and child wellbeing by preventing unintended and closely spaced pregnancies. However, studies are limited on the time to use modern contraceptives in Ethiopia. Therefore, this study aimed to fill these gaps by assessing the time to initiate postpartum modern contraceptive and identifying its predictors among pregnant women in Ambo town, central Ethiopia.

METHODS

An institution based cross-sectional study was conducted among 356 pregnant women in Ambo town, Central Ethiopia. The data were analysed using STATA-16 software. Kaplan-Meier estimates were performed to explain time-to- modern contraceptive use. A Cox-proportional hazard regression analysis was conducted to identify predictors. The adjusted hazard ratio (AHR) with a 95% confidence interval was considered to declare a statistically significant association.

RESULTS

This study showed that the median survival time to initiate postpartum modern contraceptives was 6 months. In this study, the risk of modern contraceptive use was 2.13 times higher (AHR = 2.13; 95% CI: 1.02-4.45) among younger women, 1.44 times higher (AHR = 1.44; 95% CI: 1.09-2.66) among women with no desire for more children, and 2.25 times higher (AHR = 2.25; 95% CI: 1.02-4.95) among nulliparous women. However, it is 57% times lower (AHR = 0.57; 95% CI: 0.32-0.94) among pregnant women with current unintended pregnancy.

CONCLUSION AND RECOMMENDATION

The median survival time to initiate postpartum modern contraceptive was 6 months. Age of the women, desire for more children, parity and pregnancy status were found to be the significant predictors of time to initiate postpartum modern contraceptive. Therefore health care providers and concerned stakeholders should consider these factors to increase the uptake of the postpartum contraceptive methods.

Person-centered maternity care during childbirth and associated factors at public hospitals in central Ethiopia

Objectives

Person-centered maternity care during childbirth is crucial for improving maternal and newborn health outcomes. Therefore, this study was aimed at assessing the determinants of person-centered maternity care in Central Ethiopia.

Methods

An institutional-based cross-sectional study was conducted in public hospitals in Central Ethiopia from 30 January to 1 March 2023. A systematic random sampling technique was employed to enroll the study participants. Data were collected through face-to-face interviews using a structured questionnaire. After data collection, it was checked for completeness and consistency, then coded and entered into Epi Data version 4.4.2 and exported to SPSS version 26 for analysis. Both bivariate and multivariable logistic regressions were used to identify associated factors.

Results

In this study, a total of 565 participants were involved, resulting in a response rate of 98.77%. The respondents mean score for person-centered maternity care was 60.2, with a 95% CI of (59.1, 62.3). No formal education (β = -2.00, 95% CI: -4.36, -0.69), fewer than four antenatal contacts (β = -4.3, 95% CI: -5.46, -2.37), being delivered at night (β = 2.20, 95% CI: 1.56, 6.45), and complications during delivery (β = -6.00, 95% CI: -9.2, -0.79) were factors significantly associated with lower person-centered maternity care.

Conclusion

This study revealed that person-centered maternity care is low compared with other studies. Consequently, it is imperative to prioritize initiatives aimed at enhancing awareness among healthcare providers regarding the benchmarks and classifications of person-centered maternity care. Moreover, efforts should be directed toward fostering improved communication between care providers and clients, along with the implementation of robust monitoring and accountability mechanisms for healthcare workers to prevent instances of mistreatment during labor and childbirth.

The effects of advanced maternal age on perinatal mortality in Ethiopia: A systematic review and meta-analysis

Background

Pregnancy in women over the age of 35 years is considered advanced maternal age. The relationship between advanced maternal age and the risk of perinatal mortality is still controversial. As a result, this systematic review and meta-analysis were carried out to clarify the relationship between advanced maternal age and perinatal mortality in Ethiopia.

Methods

The following electronic databases were used for this systematic review and meta-analysis: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, HINARI, and African Journals Online up to March 2022. Addis Ababa, Gondor, and Jimma University research repositories were also searched. A random-effects model was used to pool study-specific odds ratios.

Results

A total of 18 articles, including a total of 45,541 participants, were included in the meta-analysis. A total of 11 cross-sectional, 2 case-control, and 5 cohort studies were included. The overall pooled estimate indicates that women with advanced maternal age had a 1.58 higher risk of perinatal mortality compared to women in the younger age group (odds ratio = 1.58; 95% Confidence Interval: 1.13-2.03). The subgroup analysis also revealed that there were differences in the effect size as the geographical region differed. The result showed that the odd of perinatal mortality was highest in the Oromia region and lowest in the Southern Nations Nationalities and Peoples' Region.

Conclusion

The overall pooled estimate indicates that women with advanced maternal age had a 1.58-fold higher risk of perinatal mortality. Even though this risk could also be increased with other comorbid diseases, it is important for healthcare providers and other concerned stakeholders to be aware of the increased risks associated with advanced maternal age and provide different intervention programs designed to create awareness and provide counseling services to couples who seek to have a child in their later ages about the risks of advanced maternal age pregnancy on perinatal mortality and other adverse pregnancy outcomes.

Case-fatality of adult tetanus at Jimma University Teaching Hospital, Southwest Ethiopia

BACKGROUND

Tetanus remains a major health problem in Ethiopia like in most other developing countries.

OBJECTIVES

To assess the clinical presentation, complications and outcome of tetanus patients.

METHODS

In this retrospective study, patients (age > 13 years) who were admitted to Jimma University Teaching Hospital from 1996 to 2009 were included.

RESULTS

Data from 171 patients were analyzed (129 males, 42 females, mean age 33 years). The mean hospital stay for patients discharged cured and deceased was 21.5 ± 12 and 6.5 ± 6.7 days, respectively. None of our patients was immunized for tetanus. Tracheostomy and mechanical ventilation (MV) was done in 10.5% and 11 %, respectively. The case-fatality was 38%. The mean annual admission and case-fatality increased over the study period from 9 to 20.5 and from 21 % to 51%, respectively. Establishment of intensive care unit (ICU) did not improve mortality due to infrequent tracheostomy and MV.

CONCLUSIONS

The case-fatality was high like in most other studies and the majority of patients died in the first few days indicating that adequate respiratory support was not given. Establishment of ICU did not improve mortality. Tetanus can be prevented by vaccination and if it occurs it needs well equipped ICU.

Severe menopausal symptoms and associated factors among post-menopausal women in Ambo town, West Shewa, Ethiopia: a cross-sectional study

BACKGROUND

Post-menopause is the permanent cessation of menstruation for 12 consecutive months at the age of 45 to 55 years. Post-menopausal women all over the world suffer from symptoms associated with menopause. Despite the fact that the population of menopausal women in Ethiopia is growing in parallel with their life expectancy, little is known about the severity and factors associated with menopausal symptoms among post-menopausal women. While previous studies in Ethiopia have primarily focused on the prevalence of severe menopausal symptoms, they have not thoroughly explored the underlying factors that may influence the severity of these symptoms. As a result, the specific factors that contribute to the severity of menopausal symptoms in Ethiopian women remain largely uninvestigated, leaving an important knowledge gap in this area. Therefore, this study was intended to assess severe menopausal symptoms and associated factors among post-menopausal women in Ambo town.

METHODS

A community-based cross-sectional study was conducted from August 3 to September 3, 2022, in Ambo town. The source population encompassed all post-menopausal women residing in Ambo Town. From this broader group, the study population was all post-menopausal women living in the three selected kebeles (the smallest administrative unit of Ethiopia). The sampling unit for this study was the household with post-menopausal women. A simple random sampling method was employed using computer-generated random numbers using the sampling frame taken from the conducted preliminary survey. Data were collected using a structured, interviewer-administered questionnaire. The data were entered using Epi Info version 7.1 and exported to SPSS version 25.0 for analysis. Bivariate analysis was used to examine individual relationships between independent variables and severe menopausal symptoms. Multivariable analysis then evaluated the combined impact of independent variables on severe menopausal symptoms while controlling for confounding factors, offering a comprehensive understanding of the factors that significantly influence symptom severity. Odds ratios with 95% Cl were estimated to identify the associated factors of the outcome variables, and statistical significance was affirmed at a p-value ≤ 0.05.

RESULTS

This study showed that one hundred thirty-three participants (30.4%), with a 95% CI (26.2%-35%), experienced severe menopausal symptoms during the past month. Age greater than 60 years [AOR = 3.2, 95% CI (1.3, 7.7)], not performing physical activity [AOR = 2.1, 95% CI (1.1, 4.4)], consuming alcohol [AOR = 1.8, 95% CI (1.1, 3.1), unfavorable attitude towards menopause [AOR = 1.8, 95% CI (1.1, 3.0)], and BMI > 29.9 kg/m2 [AOR = 6.1, 95% CI (2.7, 14.2)] were associated with severe menopause symptoms.

CONCLUSION AND RECOMMENDATION

According to this study, one in three postmenopausal women experienced severe menopausal symptoms. In conclusion, several factors were significantly associated with severe menopausal symptoms. Positive predictors of severe menopausal symptoms include; age over 60 years, lack of physical activity, alcohol consumption, unfavorable attitudes towards menopause, and a BMI greater than 29.9 kg/m2. These results highlight the role of both lifestyle behaviors and individual characteristics in determining the severity of menopausal symptoms. Therefore, we recommend implementing targeted support programs specifically for post-menopausal women. Promoting regular physical activity through tailored exercise programs and reducing alcohol consumption through education and counseling are essential. Additionally, educational interventions should aim to foster a positive attitude towards menopause. Weight management strategies, including both nutrition and exercise, should be prioritized for post-menopausal women with a BMI greater than 29.9 kg/m2.

Concomitant use of medicinal plants and pharmaceutical drugs among pregnant women in southern Ethiopia

Background

In several African nations, including Ethiopia, improving mother and child health is a top public health concern. Unfortunately, there is a dearth of study on pregnant women in Ethiopia who concomitantly utilize pharmaceutical drugs and medicinal plants. Hence, the objective of this research was to assess the concomitant use of pharmaceutical drugs and medicinal plants among pregnant women in Southern Ethiopia in 2021.

Methods

A community-based cross-sectional study was conducted among systematically selected 400 pregnant women in Shashamane town, Southern Ethiopia, from July 1-30/2021. An interviewer-administered structured questionnaire was used to collect data. Binary logistic regression was performed to examine the association between a dependent variable and independent variables.

Results

According to this study, among those who self-medicated, 90 (22.5%) reported using at least one pharmaceutical drug, while 180 (45%) reported using at least one medicinal plant. Moreover, 68 (17%) of the participants who had taken drugs while pregnant also used pharmaceutical drugs and medicinal plants concomitantly. Having a medical condition during pregnancy (AOR = 5.6, 95% CI: 2.7-11.6), not having ANC follow up (AOR = 2.9, 95% CI: 1.3-6.2), gestational age (AOR = 4.2, 95% CI: 1.6-10.7), and not having a formal education (AOR = 4.2, 95% CI: 1.3-13.4) were all significantly associated with concomitant use of pharmaceutical drugs and medicinal plants during pregnancy.

Conclusion

This study showed that nearly one in five pregnant women used medicinal plants concomitantly with pharmaceutical drugs. Mother's educational status, medical illness during pregnancy, having ANC follow up and gestational period were significantly associated with concomitant use of medicinal plants and pharmaceutical drugs. Therefore, health care providers and concerned stakeholders should consider these factors to minimize the risks associated with drug use during pregnancy on both mother and fetus.