Search

Context. A solar eruption on 17 April 2021 produced a widespread Solar Energetic Particle (SEP) event that was observed by five longitudinally well-separated observers in the inner heliosphere at heliocentric distances of 0.42 to 1 au: BepiColombo, Parker Solar Probe, Solar Orbiter, STEREO A, and near-Earth spacecraft. The event produced relativistic electrons and protons. It was associated with a long-lasting solar hard X-ray flare and a medium fast Coronal Mass Ejection (CME) with a speed of 880 km/s driving a shock, an EUV wave as well as long-lasting radio burst activity showing four distinct type III burst. Methods. A multi-spacecraft analysis of remote-sensing and in-situ observations is applied to attribute the SEP observations at the different locations to the various potential source regions at the Sun. An ENLIL simulation is used to characterize the interplanetary state and its role for the energetic particle transport. The magnetic connection between each spacecraft and the Sun is determined. Based on a reconstruction of the coronal shock front we determine the times when the shock establishes magnetic connections with the different observers. Radio observations are used to characterize the directivity of the four main injection episodes, which are then employed in a 2D SEP transport simulation. Results. Timing analysis of the inferred SEP solar injection suggests different source processes being important for the electron and the proton event. Comparison among the characteristics and timing of the potential particle sources, such as the CME-driven shock or the flare, suggests a stronger shock contribution for the proton event and a more likely flare-related source of the electron event. Conclusions. We find that in this event an important ingredient for the wide SEP spread was the wide longitudinal range of about 110 degrees covered by distinct SEP injections.

The agro-processing sub-sector of the manufacturing industry has high recognition on the South African government’s development agenda. Yet, the contribution of the sector to the economy with respe...

Background: Vaccine-preventable diseases still claim 1.5 million lives annually because of poor immunization coverage, which could be avoided if global vaccination coverage improves. Though vaccination coverage in Ethiopia has shown steady progress over the years, there are districts within the country that are below the set target for vaccination coverage. Therefore, this study is aimed at investigating the magnitude and determinants of the uptake of recently introduced vaccines among children aged 12–23 months in Ethiopia.Methods: The data analysis was performed using the 2019 Ethiopia Mini Demographic and Health Survey. Considering the hierarchical nature of the data, a multilevel logistic regression analysis was employed, and the adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported to declare significant determinants. The results were considered statistically significant if p-value < 0.05. The intra-class correlation coefficient, median odds ratio, proportional change in Variance, and deviance (-2LL) were used for model comparison and for checking model fitness.Results: A total of 2833 mothers with children of age 12-23 months were included in the analysis. Our analysis revealed that 45.7%, 53.4%, and 43.5% of the children completed vaccination for Pneumococcal Conjugate vaccine (PCV), Rotavirus vaccine (RV), and both PCV and RV respectively. Being in the age group of 20-34 (AOR = 2.03, 95% CI: 1.37, 3.02) and 35-49 (AOR = 2.44, 95% CI: 1.52, 3.91), having at least 4 antenatal care contacts (AOR = 2.73, 95% CI: 2.06, 3.62), having postnatal care (AOR = 1.84, 95% CI:1.42, 2.37), delivery in the health facility (AOR = 1.45, 95% CI: 1.17, 1.79), and having exposure to media (AOR = 1.24, 95% CI:1.09, 1.56), and any of the wealth quintile categories higher than poorest category were positively associated with uptake of newly introduced vaccines Rural residency, on the other hand, was found to be negatively related with the uptake of newly introduced vaccines.Conclusion: The overall full uptakes of newly introduced vaccines among children 12-23 months were significantly lower. Hence, this study emphasizes the need to strengthen maternal and child health clinic services particularly, to the younger age mother and those with lower socio-economic status.

Hide and Skins are important economic products contributing to the largest share of the total and agricultural export commodities followed by live animals in Ethiopia. The current study was conducted with the objective of assessing the major causes of hide and skin defect, quality, and marketing of the raw materials in Adami-Tulu and Bora district. A total of 768 (382 sheep and 220 goat skins and 76 cattle hides) sample was randomly selected and visually examined for defects at the collection centers. Further, 20 apparently health and 20 apparently defective goat skins were selected randomly and tested for physicochemical characteristics including tensile strength/mm², elongation percentage, tear load, thickens (mm), fat content and moisture content at crust stage of processing. A questionnaire survey was also done with 200 respondents to assess the marketing situation of hide and skins in the study areas. Major defects before processing were cockle (36.6%), flay defect (51.6%), scratch (60.7%), scar (26.2%) and putrefaction (17.5%), and brand (0.5%). The proportions of scratch, flay defect and cockle were higher in goat skin, sheep skin and cattle hide, respectively (P

Background: Lack of well-functioning referral and quality of the service are challenges for many of the developing countries health care system. This study evaluated the referral transport services for maternal and newborn care in Ethiopian health facilities. Methods: The study used 2016 Ethiopian Emergency Obstetric and Newborn care assessment data. All public and private health facilities that provided maternal and newborn health services were included in the study. The data analysis was done on a total of 3,804 facilities. Results: Overall, in this study only 17% (95% CI: 16-18) of health facilities had their dedicated functioning ambulance (motor vehicle, motorcycle, or tricycle ambulance). Among these, reports of using the ambulance for non-emergency transport were common. Use of the ambulance for transporting client’s home was reported by 48% (95% CI: 44-52) of facilities. A total of 62% health facilities provided by district health offices. Hospitals/MCH centres had almost 5 times (95% CI: 3.16, 7.12) more likely to have ambulance on-site compared with health centres/speciality clinics. The urban-based health facilities were three times (aOR =2.86, 95% CI: 2.29, 3.58) more likely to have ambulance onsite than their counter. Availability of ambulance on-site in public facilities was found to be 80% and 63% less to that of private owned and private-for-profit health facilities. Facilities that didn’t provide onsite obstetric surgery were also less likely to have an ambulance on-site. There was no significant difference in ambulance availability for the facilities that have referred in/out and in the provision of 24/7 service for emergency obstetric and newborn care. There is no relation between institutional delivery and availability of ambulance on-site (ρ=0.14). Conclusions: In this study, low ambulance availability for emergency referral for maternal and newborn cases in Ethiopian facilitates was observed. There is a disparity in the availability of Ambulance onsite by regions facility location and type of health facility. No effect of referral transport service on-site availability on institutional deliveries was noted. An ambulance is mandatory for interconnected health centers to hospital referrals. However, this needs to be backed up with an adequate supply of basic and emergency obstetric care at all facilities.

In order to decipher the nature of the slowly growing Mycobacterium tuberculosis (M.tuberculosis) lineage 7, the differentially abundant proteins in strains of M. tuberculosis lineage 7 and lineage 4 were defined. Comparative proteomic analysis by mass spectrometry was employed to identify, quantitate and compare the protein profiles of strains from the two M. tuberculosis lineages. Label-free peptide quantification of whole cells from M. tuberculosis lineage 7 and 4 yielded the identification of 2825 and 2541 proteins, respectively. A combined total of 2867 protein groups covering 71% of the predicted M. tuberculosis proteome were identified. The abundance of 125 proteins in M. tuberculosis lineage 7 and 4 strains was significantly altered. Notably, the analysis showed that a number of M. tuberculosis proteins involved in growth and virulence were less abundant in lineage 7 strains compared to lineage 4. Five ABC transporter proteins, three phosphate binding proteins essential for inorganic phosphate uptake, and six components of the type 7 secretion system ESX-3 involved in iron acquisition were less abundant in M. tuberculosis lineage 7. This proteogenomic analysis provided an insight into the lineage 7-specific protein profile which may provide clues to understanding the differential properties of lineage 7 strains in terms of slow growth, survival fitness, and pathogenesis.

On September 13, 2013 the Federal Ministry of Health (FMoH) of Ethiopia and UNICEF announced that Ethiopia has successfully reduced the under-five mortality rate by two thirds between 1990 and 2012, which is the target for achieving Millennium Development Goal-4. In 1990, the under-five mortality rate in Ethiopia was one of the highest in the world at 205/1,000 live births. However, by 2012, this rate had declined to 68/1,000 live births with an average annual rate of decline of 5.0%. This exceeded the 4.3% annual rate of decline needed to reach MDG4 and was significantly higher than the decline rates observed in many sub-Saharan African countries and even other low and middle-income countries. In an effort to understand the story behind Ethiopia’s remarkable achievement of MDG-4, EPHI has conducted this in-depth Case Study which is supported by Countdown to 2015. The findings are believed to generate valuable lessons and guidance for other low-income countries in their quest for accelerating health improvements and reducing child deaths.

Background: Non-communicable diseases (NCDs) are the leading causes of death globally. Available data demonstrate that nearly 80% deaths of NCDs occur in low- and middle-income countries. Of these deaths, an estimated 1.5 million, or 4% were due to diabetes. In Ethiopia, data on the preparedness of health facilities to cope with the rising epidemic of diabetes are insufficient.Objective: This survey was aimed to assess service availability and readiness for diabetes health care.Methods: The data used in this study is part of the 2014 Ethiopian service provision assessment survey which was conducted from 10 March to 25 July, 2014. The study employed stratified random sampling designed to provide representative results for Ethiopia. In this study, health facility types managed by different management authorities were included from the eleven administrative regions of the country.There were a total of 873 health facilities included in this particular study. Data were collected using a facility inventory questionnaire that assessed whether the providers in the facility are prepared to provide required services to patients with diabetes. Information about readiness of facilities to provide good-quality client services on diabetes, including the availability of guidelines, trained staff, basic medical equipment, and essential medicines were also collected.Results: Among all health facilities, 59% of health facilities offer services for diabetes. Forty percent of the facilities have diagnostic capacity for blood glucose while 56 % have capacity for urine protein test and 52 % has urine glucose test. Of the facilities that offer service for diabetes, 12 % of them had guidelines for diagnosis and management of diabetes at the service site during the survey. On the other hand, facilities that offer diabetes services were more likely to have basic equipment that support and enhance the provision of services.Conclusions: The findings indicate that availability of treatment services, guidelines for diagnosis and management, trained staff and medicines for diabetes were found to be inadequate. But the availability of the basic medical equipment necessary for the diagnosis and management of diabetes appear to be adequate. Therefore, strengthening health care system towards improved service delivery through availing national guidelines, protocols or standards for managing diabetes, in-service training for providers, and provision of essential medicines are required to improve diabetes service delivery in health facilities. [Ethiop. J. Health Dev. 2017;31(2):110-118]Keywords: Diabetes Mellitus, Disease, Service, Availability, Readiness, Health Facility, Ethiopia

Background: Consuming any form of tobacco is one of the leading causes of preventable morbidity and mortality. Tobacco smoking has been identified as one of the major risk factors for NCDs, including cardiovascular, chronic respiratory diseases, and different cancers. Although there is national information on magnitude of tobacco use, to date there is limited nationally representative data on factors associated with tobacco use. The aim of this study is to assess the distribution and predicators of tobacco use in Ethiopian adult population between 15 -59.Objectives: The main aim of this study was to assess the prevalence of tobacco use and its predictor in Ethiopia.Methods: A cross-sectional population based study design was employed among population age from 15- 69 years. A stratified, three-stage cluster sampling was used to identify the study subjects. Households in each cluster were selected using simple random sampling method. The sampling frame was based on the population and housing census conducted for Ethiopia in 2007. Data was collected using WHO NCD STEPS questionnaire; current tobacco use of any type was taken as the dependent variable. Five hundred thirteen enumeration areas (EAs) as primary sampling units (PSUs) (404 rural and 109 urban) were selected with probability proportionate to size, followed by selection of households as a secondary sampling units (SSUs). A total of 10,260 households were selected from the 513 EAs (20 households per EA). Eligible individuals were selected from households using Kish method (a pre-assigned table of random numbers to find the person to be interviewed). Descriptive statistics using frequency table, mean, median, interquartile range and standard deviations were computed. Step wise logistic regression was used to analyse the predictors of tobacco use. An Estimator of 95% confidence interval was used both for computing descriptive statistics as well testing associations using logistic regression.Results: The prevalence of tobacco use (all tobacco products) was 4.2%. The mean age (± SD) of starting tobacco use was 21(7) years. The mean frequency of tobacco use was 2 times per day. Hierarchical Logistic regression analysis revealed that participants in age groups 30-44 years, and 60-69 years were less likely to use any tobacco type compared to younger age group of15-29 years. Heavy episodic drinking, AOR 2.46 [95% CI= 1.4 – 4.5], and khat chewing, AOR 4.71[95%= 2.26 – 9.8], were independently associated with tobacco use.Conclusion and recommendations: The overall prevalence of tobacco use was relatively higher in males. Factors associated with tobacco use were heavy episodic drinking and khat chewing. Although tobacco use is an important risk factor for different disease on its own, the additional use of these substances exposes individuals to increased risk of NCDs. The findings warrant the need to implement existing anti-tobacco laws in the country, enhance anti-tobacco awareness raising efforts, and implement interventions to help current tobacco users, focusing attention more on regions with high rates of tobacco use and males. Key words: Ethiopia, NCDs, Predictors, Risk factors, Tobacco use, WHO STEPS

Background: The burden of disease, injury and death associated with excessive alcohol consumption remains high in most countries. Although there were studies done in different parts of Ethiopia that looked at hazardous use and dependence, no national survey was done on excessive alcohol consumption which is an important risk factor for many health and social problems. This study assessed the magnitude and predictors of excessive alcohol use and associated factors in Ethiopia.Methods: A community based cross-sectional survey was conducted using the WHO STEPwise approach to explore risk factors for NCDs including excessive alcohol consumption. A mix of stratified, three-stage cluster and simple random sampling were used to the study setting or clusters and households. The sampling frame was based on the population and housing census conducted in Ethiopia in 2007. A total of 10,260 households were selected from the 513 enumeration areas. Data were collected using WHO STEPS questionnaire. For this report, Heavy Episodic Drinking was taken as a dependent variable. Descriptive statistics including frequency table, mean, median, interquartile range and standard deviations were computed. Logistic regression was used to analyze the predictors of Heavy Episodic Drinking.Results: A total of 9,800 participants were interviewed in the study. The majority59.4% of the study subjects were female, 40.4% were aged 15-29 years. The overall prevalence of lifetime alcohol consumption was 49.3%, and 40.7% of the study participants reported consumption of alcohol in the past 30 days, defined as current drinkers. Heavy episodic drinking was reported by 12.4% of the participants (20.5% males and 2.7% females). In multivariate logistic regression, factors independently associated with heavy episodic drinking, after adjusting for other characteristics, were male sex, rural residence, married, and current tobacco smoking.Conclusion: More than one in five males reported heavy episodic drinking which will predispose them to non-communicable diseases and other risks. Concurrent tobacco smoking is also a major concern. The findings will be helpful to initiate effective public health interventions to reduce heavy episodic drinking and consequently reduce the risks associated with it. It will also serve as a baseline to conduct further studies on this issue in Ethiopia. Key words: Alcohol, Heavy Episodic Drinking, NCD, Ethiopia, WHO STEPS

Background: Chewing of the leaves of the plant khat (Catha edulis Forsk) is a common habit in some countries of East Africa and the Arabian Peninsula. Khat is chewed by an estimated 20 million population every day in the Arabian Peninsula and in Eastern Africa region including Ethiopia. Ethiopia is believed to be the country of origin of khat where millions chew khat on a daily bases. Khat is also one of Ethiopia's biggest export commodities. This particular study assessed the prevalence of khat chewing and its predictors in Ethiopia.Method: We used a community based cross-sectional data collected in 2015 as part of the National STEPs survey on NCD risk factors. .. The target population for this survey was all men and women aged 15-69 years who had been living at their place of residence for at least six months prior to the survey. A mix of stratified, three-stage cluster and simple random sampling were used to the study setting or clusters and households. The sampling frame was based on the population and housing census conducted in Ethiopia in 2007. A total of 10,260 households were selected from the 513 enumeration areas. Data were collected using WHO STEPS questionnaire and a locally constructed structured questionnaire to collect data on life time and current khat chewing and associated factors. Data were analyzed using SPSS Version 20, descriptive statistics as well as association tests were carried out.Result: Nineteen percent of the respondents had ever chewed khat where among these, the majority (83%) were current khat chewers giving an overall prevalence of current khat chewing rate of 15.8% (21.1% of males and 9.4% of females). Khat was significantly higher in Afar [AOR and (95% CI)] [7.23 (2.01-26.01)], Dire Dawa [AOR and (95% CI)] [5.945 (2.116-16.706)], Harari [AOR and (95% CI)] [5.83 (1.49-22.87)] and Somali [AOR and (95% CI)] [4.315 (1.36-13.71)] among others. Similarly, the odds of khat chewing in urban areas [AOR and (95% CI)] [1.726 (1.18-2.53)] and current users of tobacco [AOR and (95% CI)] [2.882 (1.744 to 4.764)] were higher than their counterparts. Those who were in the third and fourth quartile income ranges [AOR and (95% CI)] 0.612 (0.384-0.974)], [AOR and (95% CI)] [0.508(0.309-0.84)] and those in high school education [AOR and (95% CI)] [0.386 (0.213-0.70)] were less likely to use Khat respectively.Conclusion: Almost 1 out of 5 respondents had ever chewed khat and among these, the vast majority, more than 80%, reported to have been current khat chewers. Being educated and in a better economic status were the protective factors for current khat chewing. Current tobacco use was associated with khat chewing increasing the risk to NCDs. Hence, policy measures aiming at prevention of khat chewing are recommended. Further studies aiming at problematic khat chewing and associated psychosocial and physical health problems is recommended. [Ethiop. J. Health Dev. 2017;31(Special Issue):320-230]Key words: Ethiopia, Risk Factors, Khat, NCD, Protective Factors, Tobacco

Background: Neglected tropical diseases (NTDs) are a group of infections which are especially endemic in low-income populations in developing regions of Africa, Asia, and the Americas. In sub-Saharan Africa, the impact of these diseases as a group is comparable to malaria and tuberculosis. The diseases recognized as neglected tropical diseases by the World Health Organization (WHO) are: Chagas disease, Cysticercosis and taeniasis, Dengue fever, Dracunculiasis, Echinococcosis, Human African trypanosomiasis, Leishmaniasis, Leprosy, Lymphatic filariasis, Onchocerciasis, Rabies, Schistosomiasis, Soil-transmitted helminthiasis, Trachoma, and Yaws. Most of these diseases are either preventable through mass drug administration (MDA) and proper hygiene and sanitation, or treatable through systematic case finding and management. This study was conducted with the aim of assessing the availability of services for neglected tropical diseases management at health facilities in Ethiopia.Method: The assessment is part of the 2014 Ethiopian Service Provision Assessment Plus (ESPA+) Survey. A total of 873 health facilities were assessed for this analysis. All Hospitals, selected health centre, and private clinics were assessed if they provide services for Neglected Tropical Diseases.Result: More than half of all health facilities offer services for both soil transmitted helminthes (64 percent), and services for trachoma (60 percent). About four of every ten health facilities offer services for schistosomiasis. On the other hand, services for onchocerciasis, leishmanianis and lymphatic filariases were available in less than a third of all health facilities (27%, 25% and 24%, respectively).Conclusion and recommendation: Even though, the availability of service for neglected tropical disease in health facilities is relatively good in general, there should be equitable distribution of neglected tropical disease service provision among regions. And private facilities should give emphasis for the provision of these services. Key words: Service Availability, NTDs, SPA+, Ethiopia.

Correction to Lancet Gastroenterol Hepatol 2022; 7: 627-47. Lancet Gastroenterol Hepatol. 2022 Aug;7(8):704. doi: 10.1016/S2468-1253(22)00210-2. PMID: 35809605. Background: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. Methods: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. Findings: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age