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ObjectiveTo investigate cost changes for health systems and participants, resulting from switching to short treatment regimens for multidrug-resistant (MDR) tuberculosis.MethodsWe compared the costs to health systems and participants of long (20 to 22 months) and short (9 to 11 months) MDR tuberculosis regimens in Ethiopia and South Africa. Cost data were collected from participants in the STREAM phase-III randomized controlled trial and we estimated health-system costs using bottom-up and top-down approaches. A cost-effectiveness analysis was performed by calculating the incremental cost per unfavourable outcome avoided.FindingsHealth-care costs per participant in South Africa were 8340.7 United States dollars (US$) with the long and US$ 6618.0 with the short regimen; in Ethiopia, they were US$ 6096.6 and US$ 4552.3, respectively. The largest component of the saving was medication costs in South Africa (67%; US$ 1157.0 of total US$ 1722.8) and social support costs in Ethiopia (35%, US$ 545.2 of total US$ 1544.3). In Ethiopia, trial participants on the short regimen reported lower expenditure for supplementary food (mean reduction per participant: US$ 225.5) and increased working hours (i.e. 667 additional hours over 132 weeks). The probability that the short regimen was cost-effective was greater than 95% when the value placed on avoiding an unfavourable outcome was less than US$ 19 000 in Ethiopia and less than US$ 14 500 in South Africa.ConclusionThe short MDR tuberculosis treatment regimen was associated with a substantial reduction in health-system costs and a lower financial burden for participants.

Introduction A December 2019 WHO rapid communication recommended the use of 9-month all-oral regimens for treating multidrug-resistant tuberculosis (MDR-TB). Besides the clinical benefits, they are thought to be less costly than the injectable-containing regimens, for both the patient and the health system. STREAM is the first randomised controlled trial with an economical evaluation to compare all-oral and injectable-containing 9–11-month MDR-TB treatment regimens.Methods and analysis Health system costs of delivering a 9-month injectable-containing regimen and a 9-month all-oral bedaquiline-containing regimen will be collected in Ethiopia, India, Moldova and Uganda, using ‘bottom-up’ and ‘top-down’ costing approaches. Patient costs will be collected using questionnaires that have been developed based on the STOP-TB questionnaire. The primary objective of the study is to estimate the cost utility of the two regimens, from a health system perspective. Secondary objectives include estimating the cost utility from a societal perspective as well as evaluating the cost-effectiveness of the regimens, using both health system and societal perspectives. The effect measure for the cost–utility analysis will be the quality-adjusted life years (QALY), while the effect measure for the cost-effectiveness analysis will be the efficacy outcome from the clinical trial.Ethics and dissemination The study has been evaluated and approved by the Ethics Advisory Group of the International Union Against Tuberculosis and Lung Disease and also approved by ethics committees in all participating countries. All participants have provided written informed consent. The results of the economic evaluation will be published in a peer-reviewed journal.Trial registration number ISRCTN18148631.

Introduction: Chlorhexidine cord care is an effective intervention to reduce neonatal infection and death in resource constrained settings. The Federal Ministry of Health of Ethiopia adopted chlorhexidine cord care in 2015, with national scale-up in 2017. However, there is lack of evidence on the provision of this important intervention in Ethiopia. In this paper, we report on the coverage and determinants of chlorhexidine cord care for newborns in Ethiopia. Methods: A standardized Nutrition International Monitoring System (NIMS) survey was conducted from January 01 to Feb 13, 2020 in four regions of Ethiopia (Tigray, Amhara, Oromia, and Southern Nations, Nationalities and Peoples Region [SNNPR]) on sample of 1020 women 0–11 months postpartum selected through a multistage cluster sampling approach. Data were collected using interviewer-administered questionnaires in the local languages through home-to-home visit. Accounting for the sampling design of the study, we analyzed the data using complex data analysis approach. Complex sample multivariable logistic regression was used to identify the determinants of chlorhexidine cord care practice. Results: Overall, chlorhexidine was reportedly applied to the umbilical cord at some point postpartum among 46.1% (95% confidence interval [CI]: 41.1%– 51.2%) of all newborns. Chlorhexidine cord care started within 24 hours after birth for 34.4% (95% CI: 29.5%– 39.6%) of newborns, though this varied widely across regions: from Oromia (24.4%) to Tigray (60.0%). Among the newborns who received chlorhexidine cord care, 48.3% received it for the recommended seven days or more. Further, neonates whose birth was assisted by skilled birth attendants had more than ten times higher odds of receiving chlorhexidine cord care, relative to those born without a skilled attendant (adjusted odds ratio [AOR]: 10.36, 95% CI: 3.73–28.75). Besides, neonates born to mothers with knowledge of the benefit of chlorhexidine cord care had significantly higher odds of receiving chlorhexidine cord care relative to newborns born to mothers who did not have knowledge of the benefit of chlorhexidine cord care (AOR: 39.03, 95% CI: 21.45–71.04). Conclusion: A low proportion of newborns receive chlorhexidine cord care in Ethiopia. The practice of chlorhexidine cord care varies widely across regions and is limited mostly to births attended by skilled birth attendants. Efforts must continue to ensure women can reach skilled care at delivery, and to ensure adequate care for newborns who do not yet access skilled delivery. [ABSTRACT FROM AUTHOR]

This study tried to assess the impact of climate change on water resources of the upper Awash River subbasin (Ethiopia) using a statistical downscaling model (SDSM). The future climatic parameters (rainfall, maximum and minimum temperatures) were generated by downscaling outputs of HadCM3 (Hadley Centre Coupled Model, version 3) general circulation model to watershed level for A2a (medium-high) and B2a (medium-low) emission scenarios at representative stations (Addis Ababa, Ginchi and Bishoftu). These SDSM generated climatic data were used to develop current/baseline period (1971-2010) and future climate change scenarios: 2020s (2011-2040), 2050s (2041-2070) and 2080s (2071-2099). The projected future rainfall and mean monthly potential evapotranspiration at these stations were weighted and fed to HBV hydrological model (Hydrologiska Byråns Vattenbalansavdelning model) for future stream flow simulation. These simulated future daily flow time series were processed to monthly, seasonal and annual time scales and the values were compared with that of base period for impact assessment. The simulation result revealed the possibility for significant mean flow reductions in the future during Summer or "Kiremt" (main rainy season) and apparent increase during "Belg" or winter (dry season). Autumn flow volume showed decreasing trend (2020s), but demonstrated increasing trend at 2050s and 2080s. A mean annual flow reduction (ranging from 13.0 to 29.4%) is also expected in the future for the three studied benchmark periods under both emission scenarios. Generally, the result signals that the water resources of upper Awash River basin will be expected to be severely affected by the changing climate. Therefore, different adaptation options should be carried out in order to reduce the likely impact and ensure water security in the sub-basin. [ABSTRACT FROM AUTHOR]

The coronavirus disease-19 (COVID-19) pandemic has challenged and forced the community pharmacies across the world to take various measures to prevent its spread. This survey was conducted to assess the community pharmacy practice and challenges in Ethiopia amid the coronavirus disease-19 pandemic. The survey was conducted involving 67 community pharmacy professionals in Jimma and Mizan-Aman towns in the period from November 25 to December 10, 2020. A checklist was used for the data collection, and descriptive analysis was conducted using SPSS V.22. In this study, druggists were higher in proportion than pharmacists (64.2% vs. 35.8%). Of the stock of the COVID-19 infection protection supplies, facemask was well-stocked (73.1%), whereas most respondents (73.1%) reported no stock of face shields. Practicing a distance of >1 meter from the customers (85.1%) and keeping hand hygiene (83.6%) were among the measures reported to prevent cross-infection. Above two-third of the respondents reported an increase in verbal queries of the COVID-19 information (68.7%). Financial implication (89.6%) and staff cross-infection risk (89.6%) were the major worries reported by the respondents. In this study, some of the sociodemographic information were identified to affect the COVID-19 precautionary measures and challenges. In conclusion, the present study revealed problem with availability of some of the COVID-19 prevention supplies, like face shields (73.1%), requiring effort to avail. An increase in COVID-19 related queries from customers was also reported. The COVID-19 precautionary measures, such as practicing hand hygiene, physical distancing, and others were reported. The reported financial and other challenges of the COVID-19 needs mitigation measures. [ABSTRACT FROM AUTHOR]

Purpose: To assess traditional medicine practice claims by the community for the prevention and treatment of COVID-19. Methods: A community-based cross-sectional study design was conducted among 422 households of Jimma Zone, and the data were collected by interviewing individuals from the selected households. The medicinal plants were recorded on Microsoft excel 2010 with their parts used, dosage form, route of administration and source of plants and tabulated in the table. Descriptive statistics were used to describe and organize the data. The Relative Frequency of Citation (RFC) was calculated for each traditional medicine to identify the top 10 medicinal products. Results: Around 46% of participants used traditional medicines for the prevention and treatment of COVID-19. The study recorded 32 herbal and non-herbal medicinal products. Garlic (RFC: 0.166), ginger (RFC: 0.133), lemon (RFC: 0.133), garden cress (RFC: 0.069) and "Damakase" (RFC: 0.031) were the frequently used herbal medicines. Seeds (47.22%) and leaves (30.56%) were the most used parts of medicinal plants. Most preparation of medicinal plants (90.63%) was administered through the oral route. The majority of medicinal plants were from home gardens. Conclusions and Recommendations: Around half of the participants practiced traditional medicines for COVID-19. Garlic, ginger, lemon, garden cress and "Damakase" were the frequently used herbal products. Seeds and leaves were regularly used parts. The oral route is the most used route of administration. The majority of medicinal plants were from home gardens. This quantity of traditional medicine practice is probably challenging to control the pandemic. However, it might open possibilities for pharmaceutical industries and researchers to look into the effectiveness and safety of claimed medicinal products. Therefore, all responsible bodies are advocated to behave accordingly. [ABSTRACT FROM AUTHOR]

The impact of climate change is a global threat, and its effect is more pronounced in developing countries. It is vital to link physical data analysis with endogenous knowledge and practices of farmers to strengthen their adaptive capacity. This study was conducted to explore spatial variability and temporal trends of temperature and rainfall in association with farmers' perceptions and their adaptation strategies in Southwest Ethiopia. Daily rainfall and temperature data of twelve weather stations were collected from the National Meteorological Agency of Ethiopia for the period 1983 to 2016. Farmers' perceptions about climate change and its impact and their adaptation strategies were assessed through a survey. Spatial variability and temporal trends of rainfall and temperature were analyzed using ArcGIS and R software. Sen's slope estimator and Mann–Kendall's trend tests were used to detect the magnitude and statistical significance of changes in rainfall and temperature. Spatial analysis of rainfall showed high variability over the region. There were no consistent and significant temporal trends of annual and seasonal rainfall of the area. Significant and upward trends of annual maximum and minimum temperatures were reported for all stations. Accordingly, annual maximum and minimum temperatures were increased by 0.71 and 0.65°C, respectively, over the period 1983 to 2016. Farmers had a good awareness of climate change and its impact. Adaptation strategies used by farmers included soil and water conservation practices (66.21%), crop diversification (62.16%), modifying planting date (42.56%), agroforestry practices (35.13%), use of drought-tolerant variety (33.95%), use of early maturing crop (27.03%), and livelihood diversification (25.42%). As most of these adaptation strategies were familiarized by a small number of farmers, further effort is needed to identify factors limiting the adoption of these strategies. Furthermore, additional planned strategies and supports that widen available options at the farmers' disposal should be introduced to strengthen their adaptive capacity. [ABSTRACT FROM AUTHOR]

Background: The rapid spread of COVID-19 infection has led countries across the globe to take various measures to contain the outbreak, including the closure of Universities. Forcing University students to stay at home has created enormous stress and uncertainty in their daily life. Objective: This study aimed to assess the perceived stress and coping strategies among undergraduate health science students of Jimma University amid the COVID-19 outbreak. Materials and methods: An online cross-sectional survey was conducted involving 337 undergraduate health science students from August to September 5, 2020. The perceived stress scale (PSS)-10 and Brief-COPE scale were used to assess the level of stress and coping strategies, respectively. Statistical Package for Social Science (SPSS) Version 22 was employed for data analysis. Logistic regression was conducted to identify predictors of high perceived stress. Results: The overall mean [±standard deviation (SD)] age of the participants was 22.88 (±1.78) years. The mean (±SD) PSS score was 22.16 (±1.41), and high perceived stress was reported in 121 (35.9%) participants. The overall mean (±SD) coping score was 72.34 (±12.31), and approach coping was the predominantly used strategy for coping with stress. Personal perception of being stressed by the daily number of COVID-19 cases/deaths in Ethiopia (AOR = 4.61, p < 0.01), rare online talk/chat with friends (AOR = 4.07, p = 0.01), presence of confusion due to the inconsistent strategies developed by the health/government authorities in view of the scientific recommendations (AOR = 2.22, p = 0.01), perception of self/family members being at risk of getting sick (AOR = 0.53, p = 0.03), decreased household income following the COVID-19 pandemic (AOR = 3.92, p = 0.01), practicing denial (AOR = 1.34, p < 0.01), self-blame (AOR = 1.23, p = 0.02), planning (AOR = 1.28, p = 0.01), and religion (AOR = 1.41, p < 0.01) as means of coping with stress were associated with high perceived stress. Conclusion: Over one-third of the participants had a high level of perceived stress, and the majority of them were practicing effective means of coping with stress. The authors recommend that the hosting University in collaboration with the concerned bodies develop innovative strategies to improve the psychological well-being of the students. [ABSTRACT FROM AUTHOR]

Purpose: Diabetes mellitus complications are responsible for increased disability, morbidity, and mortality. This study aimed to assess prevalence, patterns, and predictors of chronic complications of diabetes among people with diabetes. Patients and Methods: The study was conducted using a prospective observational study design which was done on people with diabetes attending the ambulatory clinic of Mettu Karl Referral Hospital. The data were collected using a consecutive type of sampling technique from April 15 to August 9, 2019. The data were entered into Epidata manager version 4.4.2. Logistic regression analysis was done to identify predictors of chronic complications of diabetes. Results: A total of 330 participants were included in this study. The mean age of participants was 49.9± 14.2, and 156 (47.3%) were 41 to 60 years old. About 127 (38.5%) had one or more chronic complications. The predictors of chronic diabetes complications were resident in urban areas [AOR: 1.94; 95% CI: (1.17, 3.20); p = 0.010], duration of diabetes 10 years [AOR: 2.05, 95% CI: (1.21, 3.47); p = 0.007], hypertension [AOR: 4.19; 95% CI: (2.54, 6.91); p < 0.001] and poor glycemic control [AOR: 2.82; 95% CI: (1.53, 5.21); p = 0.001]. Conclusion: Almost two-fifth of the study participants had chronic complications of diabetes. Residents in urban areas, longer duration of diabetes, hypertension and poor glycemic control were predictors of chronic diabetes complications. It is important to achieve good glycemic control and manage comorbid diseases like hypertension to minimize the risk of chronic diabetes complications. [ABSTRACT FROM AUTHOR]

For ensuring food demand of the fast growing population in developing countries, quantification of crop yield gaps and exploring production constraints are very crucial. Sorghum is one of the most important climate change resilient crops in the rainfed farming systems of semi-arid tropics. However, there is little information about yield gaps and production constraints. This study aimed at analysing existing yield gaps and exploring major constraints of sorghum production in Southwest Ethiopia. A crop simulation model approach using AquaCrop and DSSAT was used to estimate potential yield and analyse the yield gaps. Model calibration and evaluation was performed using data from field experiments conducted in 2018 and 2019. Sorghum production constraints were assessed using a survey. The actual and water-limited yield of sorghum ranged from 0.58 to 2.51 and 3.6 to 6.47 t/ha, respectively for the period 2003–17. The regional yield gaps of sorghum for the targeted period were 3.02–3.95 t/ha with a mean value of 3.51 t/ha. Majority of respondent farmers considered seasonal rainfall risk (98%), poor soil fertility (86%), lack of improved varieties (78%) and inadequate weed management (56%) as major factors responsible for the existing yield gaps. The mean exploitable yield gap (2.5 t/ha) between water-limited and actual yield showed the level of existing opportunity for improvement in the actual productivity of sorghum. The gaps also call for introduction of proper interventions such as adoption of improved varieties, planting date adjustment, conservation tillage, fertilizer application and on time weed management. [ABSTRACT FROM AUTHOR]

BACKGROUND: Food handlers have been recognized to play a major role in the transmission of food borne diseases, contributing significantly to the global incidence and burden of the diseases. This study, therefore, aimed to assess the nasal and hand carriage of Staphylococcus aureus among food handlers in Jimma Town. METHODS: A community based cross sectional study was conducted from February to May 2017. Swab specimens from nasopharyngeal and hands of food handlers working in food establishments were collected for isolation and identification of S. aureus using standard bacteriological methods. Antimicrobial susceptibility test was done using disc diffusion method. Associations of selected variables for S. aureus colonization were determined using SPSS version 20 with p = 0.05 taken as statistically significant. RESULTS: Among the 300 food handlers working in hotels and restaurants in Jimma Town, 86(28.7%) were colonized by S. aureus. The frequency of isolation of S. aureus from nose, hand and both parts (nose and hand) were 27(9%), 34(11.3%) and 25(8.3%), respectively. There was strong association (P=0.00336) between carriage rate of S. aureus and food handlers' job category. The majority (90.7%) of the isolates were resistant to Penicillin and Ampicillin. Increased levels of sensitivity were observed against Ciprofloxacin (96.5%), Cefoxitin (95.3%) and Amoxicillin- Clavulanic Acid (94.2%). CONCLUSIONS: This study revealed a high prevalence of S. aureus carriers among food handlers and high antibacterial resistance towards commonly prescribed drugs, justifying the screening of food handlers to detect and treat carriers and protect restaurant customers from staphylococcal food poisoning. [ABSTRACT FROM AUTHOR]

Abstract: Maternal and neonatal mortality are unacceptably high in developing countries. Essential nutrition interventions contribute to reducing this mortality burden, although nutrition is poorly integrated into health systems. Universal health coverage is an essential prerequisite to decreasing mortality indices. However, provision and utilization of nutrition and health services for pregnant women and their newborns are poor and the potential for improvement is limited where health systems are weak. The Community‐Based Maternal and Neonatal Health and Nutrition project was established as a set of demonstration projects in 4 countries in Africa with varied health system contexts where there were barriers to safe maternal health care at individual, community and facility levels. We selected project designs based on the need, context, and policies under consideration. A theory driven approach to programme implementation and evaluation was used involving developing of contextual project logic models that linked inputs to address gaps in quality and uptake of antenatal care; essential nutrition actions in antenatal care, delivery, and postnatal care; delivery with skilled and trained birth attendant; and postnatal care to outcomes related to improvements in maternal health service utilization and reduction in maternal and neonatal morbidity and mortality. Routine monitoring and impact evaluations were included in the design. The objective of this paper is to describe the rationale and methods used in setting up a multi‐country study that aimed at designing the key maternal and neonatal health interventions and identifying indicators related to inputs, outcomes, and impact that were measured to track change associated with our interventions. [ABSTRACT FROM AUTHOR]

Background: Tenofovir (TDF) based regimen was reported to have better immunological outcomes. Unfortunately, there is limited information regarding the immunologic outcome associated with this regimen in Ethiopia, as its routine utilization in this setting begun since 2013. Methods: A 2 years retrospective cohort study was conducted at Jimma University Specialized Hospital, 346 km Southwest of Addis Ababa, Ethiopia. A total of 280 patients' data from September 2012 to July 2014 was extracted from records from February 10, 2015 to March 10, 2015. Records were selected using a simple random sampling technique. Data on socio-demographic, clinical and drug related variables were collected; entered into EpiData 3.1 and analyzed by STATA 13.1. Mixed effect linear regression was performed to assess difference in CD4+ change between groups adjusting for baseline characteristics. The change in predicted CD4 count attributed to each regimen was also assessed by marginal analysis. P < 0.05 for slopes of the random effect linear regression was used as indicators for presence of association. Results: The mean (SD) duration of cohort follow up was 714.2 (69.6) and 708.8 (78.9) days (P = 0.753) for TDF and AZT groups respectively. The minimum follow up duration was 7.4 and 8.9 months for TDF and AZT groups respectively. Most of TDF (93.6%) and AZT (91.4%) groups completed their follow up, 5 (3.6%) TDF and 6 (4.3%) AZT groups died and 4 (2.9%) TDF and 6 (4.3%) AZT groups were lost for follow-up (P = 0.769). There was statistically significant difference in immunologic recovery between the groups (B = +34.08, 95% CI [7.8, 60.35], P = 0.027) over time. The predicted CD4+ count for TDF/3TC/EFV was (B = +347.65 cells/mm³ P < 0.001) whereas that of AZT/3TC/EFV was (B = +281.54 cells/mm³, P < 0.001). Conclusions: TDF based regimens have shown more efficacy compared to AZT based regimens though AZT based regimens are more affordable in low income countries like Ethiopia. However, we recommend further study with quality design to assess the prevalence of sub-optimal CD4+ response (net CD4 gain <50 cells/µl/6 month) in this set-up among TDF users. [ABSTRACT FROM AUTHOR]

Background: Presumably bundling/co-packaging of zinc with ORS encourages the combined use of the products for diarrhea treatment; however, empirical evidences are scarce. The purpose of this work is to evaluate whether co-packing using a plastic pouch can enhance the joint adherence to the treatment or not. The study also compares the cost effectiveness (CE) of two co-packaging options: 'central' and 'health center (HC)' level bundling.Methods: This cluster-randomised controlled trial was conducted in 2015 in eight districts of Ethiopia. Thirty two HCs were randomly assigned to one of the following four intervention arms: (i) 'Central bundling' (zinc and ORS bundled using a pouch that had instructional message, distributed to HCs); (ii) 'HC level bundling' (zinc, ORS and a similar pouch distributed to the HCs and bundled by health workers); (iii) 'Bundling without message' (zinc, ORS and plain pouch distributed and bundled by the health workers); and, (iv) 'Status quo' (zinc and ORS co-administered without bundling). In each of the four arms, 176 children 6-59 months of age, presented with acute diarrhea were enrolled. Twelve days after enrollment, level of adherence was assessed. A composite scale of adherence was developed and modeled using mixed effects linear regression analysis. The unit costs associated with the arms were estimated using secondary data sources. Incremental CE analysis was made by taking the cost and level of adherence in fourth arm as a base value.Results: The follow-up rate was 95.6 %. As compared with the 'status quo' arm, the joint adherences in the 'central' and 'HC level' bundling arms raised substantially by 14.8 and 15.7 percentage points (PP), respectively (P < 0.05). No significant difference was observed between 'bundling without message' and the 'status quo' arms. The unit cost incurred by the 'central bundling' is relatively higher (USD 0.658/episode) as compared with the 'HC level bundling' approach (USD 0.608/episode). The incremental CE ratio in the 'central bundling' modality was two times higher than in the 'HC based bundling' approach.Conclusion: Bundling zinc with ORS using a pouch with instructional messages increases adherence to the treatment. 'HC level bundling' is more CE than the 'central bundling' approach. [ABSTRACT FROM AUTHOR]

Background Despite the efforts to reduce iron deficiency during pregnancy, information on the coverage and factors associated with utilization of iron supplements is lacking. The study is intended to assess the coverage, compliance and factors associated with the use of prenatal iron supplements in eight rural districts of Ethiopia. Methods The study comprised two independent surveys conducted among pregnant women (n = 414) and women who gave birth in the preceding year of the survey (n = 1573). In both cases, respondents were selected using multistage sampling technique and data were collected via structured questionnaire. Predictors of iron supplement utilization (ranked categories of number of prenatal supplements taken) were identified using ordinal logistic regression. The outputs of the analysis are given using adjusted Odds Ratio (OR) with 95% Confidence Interval (CI). Results Among women who gave birth in the preceding year, 35.4% (95%CI: 31.3-39.5) were given/prescribed prenatal iron supplement during the index pregnancy and only 3.5% were supplemented for the recommended 91 or more days. Compared to women who had 4 or more ANC visits, those with 0, 1, 2 and 3 visits had 0.04, 0.33, 0.50 and 0.60 times less odds of iron supplement utilization, respectively. Women lacking comprehensive knowledge of anemia (OR = 0. 75 (95%CI: 0.57-0.97)) and those who weren't informed about the importance of iron supplementation during the pregnancy (OR = 0. 05 (95%CI: 0.04-0.07)) had significantly lower utilization. On the other hand, in pregnant women the prevalence of anemia was 33.2%. Among pregnant women who were given/prescribed supplements, the average level of compliance was 74.9% and about 25.1% had less than 70% adherence. The leading reported reasons for non-adherence were side-effects (63.3%) and forgetfulness (16.7%). Conclusion Promoting early and frequent ANC, enhancing the quality of ANC counseling and promoting the knowledge of women on anemia are essential strategies for improving the utilization of iron supplements. [ABSTRACT FROM AUTHOR]

The article focuses on the commitment of Ethiopia to achieve its green economy goals by implementing an innovation policy. Topics include the Climate Resilient Green Economy (CRGE) Strategy adopted by the country in 2011 for green development, and climate change mitigation and adaptation, the highest emission potential impact of greenhouse gases (GHG) in agriculture and forestry, and the four pillars of green economy development including agriculture, energy, and forestry.

Purpose: To assess traditional medicine practice claims by the community for the prevention and treatment of COVID-19., Methods: A community-based cross-sectional study design was conducted among 422 households of Jimma Zone, and the data were collected by interviewing individuals from the selected households. The medicinal plants were recorded on Microsoft excel 2010 with their parts used, dosage form, route of administration and source of plants and tabulated in the table. Descriptive statistics were used to describe and organize the data. The Relative Frequency of Citation (RFC) was calculated for each traditional medicine to identify the top 10 medicinal products., Results: Around 46% of participants used traditional medicines for the prevention and treatment of COVID-19. The study recorded 32 herbal and non-herbal medicinal products. Garlic (RFC: 0.166), ginger (RFC: 0.133), lemon (RFC: 0.133), garden cress (RFC: 0.069) and "Damakase" (RFC: 0.031) were the frequently used herbal medicines. Seeds (47.22%) and leaves (30.56%) were the most used parts of medicinal plants. Most preparation of medicinal plants (90.63%) was administered through the oral route. The majority of medicinal plants were from home gardens., Conclusions and Recommendations: Around half of the participants practiced traditional medicines for COVID-19. Garlic, ginger, lemon, garden cress and "Damakase" were the frequently used herbal products. Seeds and leaves were regularly used parts. The oral route is the most used route of administration. The majority of medicinal plants were from home gardens. This quantity of traditional medicine practice is probably challenging to control the pandemic. However, it might open possibilities for pharmaceutical industries and researchers to look into the effectiveness and safety of claimed medicinal products. Therefore, all responsible bodies are advocated to behave accordingly., Competing Interests: The authors disclose no conflicts of interest in this work., (© 2021 Umeta Chali et al.)

Background: As infection with the Human Immunodeficiency Virus (HIV) has evolved into a chronic disease, perceived health-related quality of life (HRQoL) is becoming a prominent and important patient-reported outcome measure in HIV care. This study aimed to assess HRQoL among people living with HIV on highly active antiretroviral therapy and factors associated with HRQoL in Ethiopia., Methods: An institution-based cross-sectional study was conducted among 160 HIV-infected patients who were initiated highly active antiretroviral therapy at Jimma University Medical Center in 2016. HRQoL was assessed using the patient-reported outcome quality of life-HIV (PROQOL-HIV) measuring scale. Linear regressions were used to identify factors associated with outcome. Statistical significance was considered at p-value <0.05., Results: Out of a total of 160 participants, 63.13% were females. The mean (± SD ) age of study participants was 41.47±9.45 years. The median baseline CD 4 + cell count was 182.00 cells/µL (IQR: 104.53-262.40 cells/µL). The mean (±SD) score of PROQOL-HIV scale domains was 77.58 ±15.11, 58.32 ±7.79, 61.75± 17.95, 85.07 ±15.67, 76.92 ± 20.52, 80.00 ±16.83, 74.37 ± 1.47, 81.45 ± 8.17 for physical health and symptoms, emotional distress, health concerns, body change, intimate relationships, social relationships, stigma, and treatment impact domains, respectively. Second line antiretroviral therapy showed a negative effect on the quality of life, especially on the treatment impact domain (β=-6.301). Cotrimoxazole preventive therapy had a significant positive effect on the physical health and symptoms of HIV patients (β= +8.381, p<0.05). Advanced disease (β=-2.709, p<0.05), and non-communicable disease comorbidity (β=-14.340, p<0.001) showed a significant negative effect on physical health and symptoms., Conclusion: Several behavioral, clinical & immunological factors were negatively associated with health-related quality of life. The double burden of chronic non-communicable disease(s) and the impact of treatment were highly significant in all dimensions of HRQoL measures. Therefore, with HRQoL emerging as a key issue for HIV-infected patients, its routine assessment and appropriate interventions at each clinic visit would be very crucial., Competing Interests: The authors have no competing interests to declare. The funder had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript., (© 2020 Melaku et al.)

Background: Tenofovir (TDF) based regimen is one of the first line agents that has been utilized routinely since 2013 in Ethiopia. Unfortunately, there is limited information regarding the Clinical outcomes and associated risk factors in this setting, where patients generally present late, have high rates of TB and other infectious conditions., Methods: A two year retrospective cohort study was conducted from February 10/2015 to March 10/2015 at Jimma University Specialized Hospital. A total of 280 records were reviewed by including data from September 3, 2012 to July 31, 2014. Records were selected using a simple random sampling technique. Data was collected on socio-demographic, clinical and drug related variables. Data was analyzed using STATA 13.1. Kaplan-Meier and Cox regression were used to compare survival experience and identify independent predictors. Propensity score matching analysis was conducted to elucidate the average treatment effects of each regimen over opportunistic infections., Results: Of 280 patients, 183(65.36%) were females and 93(33.32%) of females belong to Tenofovir group. Through 24 months analysis, TDF based regimen had a protective effect against death and opportunistic infections (OIs), (AHR=0.79, 95% CI [0.24, 2.62]) and (AHR=0.78, 95%CI [0.43, 1.4] respectively. The average treatment effect of TDF/3TC/EFV was (-71/1000, p=0.026), while it was (+114/1000, p=0.049 ) for AZT/3TC/EFV. However, TDF/3TC/NVP was associated with statistically insignificant morbidity reduction (-74/1000, p=0.377 ). Those with body mass-index (BMI) <18.5kg/m2 (AHR=3.21, 95%CI [0.93, 11.97]) had higher hazard of death. Absence of baseline prophylaxis (AHR=8.22, 95% CI [1.7, 39.77]), Cotrimoxazole prophylaxis alone (AHR=6.15, 95% CI [1.47, 26.67]) and BMI<18.5kg/m2 (AHR=2.06, 95% CI [1.14, 3.73]) had higher hazards of OIs., Conclusion: The survival benefit of TDF based regimen was similar to AZT based regimen and therefore can be used as an alternative for HIV/AIDS patients in resource limited setups. However, since this study was not dealt with toxicity of the regimens, we recommend to conduct high quality design on this issue.