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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.

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]

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 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.