Utilization and Associated Factors of Modern Contraceptives During Extended Postpartum Period among Women Who Gave Birth in the Last 12 Months in Gondar Town, Northwest Ethiopia

Background

The postpartum period is a critical period for addressing widespread unmet needs in family planning and for reducing the risks of closely spaced pregnancies. However, many women do not realize that they are at risk for pregnancy during this period. Therefore, the aim of this study was to assess utilization and associated factors of modern contraceptives during extended post-partum period.

Methods

Institutional based cross-sectional study was conducted from March to April, 2015 in six health institutions among women who gave birth in the last 12 months prior to the study period in Gondar Town, Northwest Ethiopia. A systematic random sampling technique was used to select the study participants. Data were analyzed using SPSS version 20. Bivariate and multivariate logistic regression models were fitted to identify the determinants of postpartum modern contraceptive use. Adjusted odds ratios with 95% confidence intervals were calculated, and p-values <0.05 were considered to indicate statistical significance.

Result

Of the total 404 participants, 45.8% mothers used modern contraceptives during postpartum period. Injectable contraceptive was the most frequently used method. Menstruating [AOR =3.84, 95% CI: (2.33, 6.35)], resumption of sex [AOR= 3.17, 95% CI: (1.80, 5.58)], 37–51 weeks of postpartum period [AOR= 2.48, 95% CI: (1.11, 5.55)], husband approval of contraceptive [AOR= 2.10, 95% CI: (1.16, 3.82)] and current knowledge on FP [AOR= 5.01, 95% CI: (2.23, 11.24)] were factors affecting contraceptive use in postpartum period.

Conclusion

Utilization of modern contraceptive during the postpartum period was significantly decreased placing women at risk for a pregnancy in the extended postpartum period. Menstruating, resumption of sex, variation on postpartum period and husband approval of contraceptive were factors associated with contraceptive use. Strengthening FP counseling service at the ANC clinic and postnatal care would improve contraceptive use during the postpartum period.

A miRNA signature suggestive of nodal metastases from laryngeal carcinoma

The discovery that miRNAs are frequently deregulated in tumours offers the opportunity to identify them as prognostic and diagnostic markers. The aim of this multicentric study is to identify a miRNA expression profile specific for laryngeal cancer. The secondary endpoint was to identify specific deregulated miRNAs with potential as prognostic biomarkers for tumour spread and nodal involvement, and specifically to search for a miRNA pattern pathognomonic for N+ laryngeal cancer and for N- tissues. We identified 20 miRNAs specific for laryngeal cancer and a tissue-specific miRNA signature that is predictive of lymph node metastases in laryngeal carcinoma characterised by 11 miRNAs, seven of which are overexpressed (upregulated) and four downregulated. These results allow the identification of a group of potential specific tumour biomarkers for laryngeal carcinoma that can be used to improve its diagnosis, particularly in early stages, as well as its prognosis.

HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HIV testing services in Ethiopia

INTRODUCTION

HIV is still an enormous global burden and it is also causing loss of huge health care workers (HCWs) on the already limited human resource capacity in health care services in Sub-Saharan Africa. Variety of methods of accelerating HIV testing is required to increase the rate of HIV testing and expand treatment services. Therefore, this study was aimed to find out the prevalence, feasibility and options of HIV self-testing practices in Ethiopia.

METHODS

A cross-sectional study design triangulated with qualitative method was conducted from February to May, 2012. The data was collected using a semi-structured pretested questionnaire and in-depth interview, at government and private health centers or clinics and hospitals. During the data collection all the available healthcare workers (HCWs) which encompass the internship students including: Medical, Health Officer, Nurses, Midwives and Laboratory students, and health professionals working in the selected health institutions were involved.

RESULTS

A total of 307 HCWs were included in the analysis and we found that 288(94.4%) of them were ever tested for HIV, of which majority 203 (70.5%) were tested by themselves though 244(80%) of the HCWs had motivation or interest to be tested by themselves. Generally, of the ever tested only 85(29.5%) were tested by the help of health care providers/counselors other than self. Regarding the place where the HCWs had the test, majority 136 (69.4%) tested by themselves at the health facility and the rest were tested at their home, office, market and church. The main reason stated for self-testing was the need for confidentiality for the test result, which was mentioned by 205(82%). Moreover, 35(14.0%) claims lack of time to access the ordinary counseling and testing services.

CONCLUSION

This study depicts high rate of HIV self-testing practice among HCWs. This shows that HIV self-testing can be considered as one pillar to increase the HIV-testing services and a means for the HIV prevention and control policy, through increasing HIV testing uptake and awareness of HIV status. However, the implementation may require the role of different stakeholders and decision makers with further study to extend the options.

[Methodological aspects in the evaluation of turn-over and up/down sizing as indicators of work-related stress]

We discuss the methodological aspects related to the evaluation of turn-over and up-down sizing as indicators of work-related stress, in complex organizations like a university hospital. To estimate the active workers population we developed an algorithm which integrated several administrative databases. The indicators were standardized to take into account some potential confounders (age, sex, work seniority) when considering different hospital structures and job mansions. Main advantages of our method include flexibility in the choice of the analysis detail (hospital units, job mansions, a combination of both) and the possibility to describe over-time trends to measure the success of preventive strategies.

Stridulatory sound emission of Panstrongylus rufotuberculatus Champion, 1899, (Hemiptera: Reduviidae: Triatominae)

This study contains the first report of stridulatory sound observed in Panstrongylus rufotuberculatus Champion, 1899, and also a new record of this species in Venezuela. The conditions in which stridulation occurred are described, as well as the general environmental characteristics of the localities where it was found. This triatomine only performs the sound in conditions of extreme provocation.

Pest management strategies in traditional agriculture: an African perspective

African agriculture is largely traditional--characterized by a large number of smallholdings of no more than one ha per household. Crop production takes place under extremely variable agro-ecological conditions, with annual rainfall ranging from 250 to 750 mm in the Sahel in the northwest and in the semi-arid east and south, to 1500 to 4000 mm in the forest zones in the central west. Farmers often select well-adapted, stable crop varieties, and cropping systems are such that two or more crops are grown in the same field at the same time. These diverse traditional systems enhance natural enemy abundance and generally keep pest numbers at low levels. Pest management practice in traditional agriculture is a built-in process in the overall crop production system rather than a separate well-defined activity. Increased population pressure and the resulting demand for increased crop production in Africa have necessitated agricultural expansion with the concomitant decline in the overall biodiversity. Increases in plant material movement in turn facilitated the accidental introduction of foreign pests. At present about two dozen arthropod pests, both introduced and native, are recognized as one of the major constraints to agricultural production and productivity in Africa. Although yield losses of 0% to 100% have been observed on-station, the economic significance of the majority of pests under farmers' production conditions is not adequately understood. Economic and social constraints have kept pesticide use in Africa the lowest among all the world regions. The bulk of pesticides are applied mostly against pests of commercial crops such as cotton, vegetables, coffee, and cocoa, and to some extent for combating outbreaks of migratory pests such as the locusts. The majority of African farmers still rely on indigenous pest management approaches to manage pest problems, although many government extension programs encourage the use of pesticides. The current pest management research activities carried out by national or international agricultural research programs in Africa focus on classical biological control and host plant resistance breeding. With the exception of classical biological control of the cassava mealybug, research results have not been widely adopted. This could be due to African farmers facing heterogeneous conditions, not needing fixed prescriptions or one ideal variety but a number of options and genotypes to choose from. Indigenous pest management knowledge is site-specific and should be the basis for developing integrated pest management (IPM) techniques. Farmers often lack the biological and ecological information necessary to develop better pest management through experimentation. Formal research should be instrumental in providing the input necessary to facilitate participatory technology development such as that done by Farmer Field Schools, an approach now emerging in different parts of Africa.

Trypanosoma cruzi and human ubiquitin are immunologically distinct proteins despite only three amino acid difference in their primary sequence

The high similarity between Trypanosoma cruzi and human ubiquitin prompted us to characterize the human humoral immunity to host and parasite ubiquitin in Chagas disease and its possible role in Chagas autoimmunity. We have used a simplified one step purification procedure to partially purify T. cruzi ubiquitin. Using this preparation we have performed ELISA and Western blots, to show that chagasic sera recognise T. cruzi but not human or Leishmania ubiquitin indicating a species-specific response. Our results show that despite the high degree of similarity in the primary structure of human and T. cruzi ubiquitins, the three amino acid difference is sufficient to distinguish parasite versus host proteins.

Insect pests of beans in Africa: their ecology and management

Damage by insect pests, inter alia, is considered the limiting factor of bean production in Africa. This paper reviews the current status of insect pests of beans, focusing on their ecology and management, as well as the potential for integrated pest management (IPM) approaches in subsistence farming conditions, under which most beans are grown in Africa. Although numerous insect pests attack all parts of beans, bean stem maggots and bruchids are the most important field and storage pests, respectively. Foliage beetles, flower thrips, pollen beetles, pod borers, pod bugs, and sap suckers such as aphids also inflict significant damage. Control of bean pests in Africa is achieved through the use of a traditional IPM approach that consists of appropriate sowing dates, optimum plant density, varietal mixtures, intercropping, good crop husbandry, and locally available materials. Research should focus on low-input IPM approaches that encompass farmers' current practices, host-plant resistance, and natural biological control.

Social and Ecological Aspects of Resettlement and Villagization among the Konso of Southwestern Ethiopia

TEKLEMARIAM AYELE(2) This is a study of the changing settlement and land use patterns of the Konso in three peasant associations in southwestern Ethiopia and an evaluation of their attitudes toward government-sponsored villagization in the lowlands. Over the years, the Konso have moved spontaneously from the overpopulated highlands toward lower elevations and have recently begun to cultivate on the Yanda plain, but without settling there. Fear of tropical diseases, armed conflict with pastoralists and the Konso perception of lowland living continue to be powerful deterrents to settlement in the lowlands. Major objectives of the government villagization programme are unlikely to be achieved in the Konso area and may instead lead to disaster unless this programme is drastically revised to provide suitable conditions for resettlement and to meet the specific needs of the population.

Cyclic AMP in the Malpighian tubule fluid and in the urine of Rhodnius prolixus

We demonstrate the presence of cyclic adenosine monophosphate (cAMP) in the fluid secreted by isolated Malpighian tubules of Rhodnius prolixus. In addition, we show that fifth-instar R. prolixus excrete cAMP in the urine after a meal of human blood. Nonstimulated isolated Malpighian tubules secrete small amounts of cAMP that increase about 10-fold after the addition of 5-hydroxytryptamine (5-HT). 5-HT is known to mimic R. prolixus diuretic hormone. The present findings demonstrate that 5-HT also acts via cAMP. The presence of cAMP in the rectal sac of the insect could be of importance in the differentiation of Trypanosoma cruzi and in the cycle of Chagas disease.

Intracellular signaling transduction in the differentiation of Trypanosoma cruzi: role of cAMP

We have studied the cell differentiation of Trypanosoma cruzi in an vitro system that allows the transformation of epimastigotes into metacyclic trypomastigotes. Intracellular cAMP levels of epimastigotes increased 3 fold prior to their differentiation into metacyclics where cAMP remained elevated 3.7 fold with respect to epimastigotes. We also observed a 3 fold increase in the specific activity of cAMP-binding of metacyclics crude homogenates. This activity resided in a cAMP-binding receptor protein (CARPT) which was different from the typical cAMP-binding subunits (RI and RII) of cAMP-dependent protein kinases, as shown by the use of polyclonal antibodies prepared against these two types of proteins. Anti-RI antibodies did not react with CARPT, and anti-RII antibodies gave a cross reaction with CARPT which was at least 1,000 fold less sensitive than the one shown by the homologous antigen. On Western blots CARPT displayed a major band with Mr = 87,000 instead of Mr = 56,000 for RII. These studies implicate that cAMP may act as a mediator of the cell differentiation of T. cruzi by a mechanism involving a novel type of cAMP-binding receptor.

Cyclic AMP as an inducer of the cell differentiation of Trypanosoma cruzi

The addition to epimastigotes cultures of T. cruzi, of either cAMP, monobutyryl-cAMP, dibutyryl-cAMP, 8-Br-cAMP (at 2 mM each), or the cAMP-phosphodiesterase inhibitor, papaverine (0.2 mM), promoted the in vitro differentiation of these parasite forms into metacyclics. This effect of cAMP may also be exerted in vivo in the insect vector, since cAMP was detected in the urine and in the Malpighi secretion fluids of Rodnius prolixus.