Search

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, numerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have emerged, some leading to large increases in infections, hospitalizations and deaths globally. The virus's impact on public health depends on many factors, including the emergence of new viral variants and their global spread. Consequently, the early detection and surveillance of variants and characterization of their clinical effects are vital for assessing their health risk. The unprecedented capacity for viral genomic sequencing and data sharing built globally during the pandemic has enabled new variants to be rapidly detected and assessed. This article describes the main variants circulating globally between January 2020 and June 2023, the genetic features driving variant evolution, and the epidemiological impact of these variants across countries and regions. Second, we report how integrating genetic variant surveillance with epidemiological data and event-based surveillance, through a network of World Health Organization partners, supported risk assessment and helped provide guidance on pandemic responses. In addition, given the evolutionary characteristics of circulating variants and the immune status of populations, we propose future directions for the sustainable genomic surveillance of SARS-CoV-2 variants, both nationally and internationally: (i) optimizing variant surveillance by including environmental monitoring; (ii) coordinating laboratory assessment of variant evolution and phenotype; (iii) linking data on circulating variants with clinical data; and (iv) expanding genomic surveillance to additional pathogens. Experience during the COVID-19 pandemic has shown that genomic surveillance of pathogens can provide essential, timely and evidence-based information for public health decision-making. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion The global surgery movement aims to provide equitable surgical care in low‐ and middle‐income countries (LMICs) and attempts to address a wide range of issues around the lack of access and poor‐quality. In response, the Lifebox McCaskey Safe Surgery Fellowship was established in Ethiopia to train a multidisciplinary team of healthcare professionals. We conducted this study to evaluate the outcome of this training program.A qualitative study was conducted to evaluate the implementations and outcomes of the first three cohorts of the McCaskey Fellowship. Interviews with fellows, mentors, and program staff reveal valuable insights into the program's strengths and challenges.Key findings include positive feedback on the program's curriculum highlighting its multidisciplinary nature. Challenges were noted in maintaining schedules, communication with healthcare facilities, and budget constraints, suggesting the need for improved program management. The fellowship's impact was evident in altering participants' perceptions of teamwork and enhancing their research and leadership skills. Fellows initiated quality improvement projects impacting surgical practices positively. However, challenges, such as hospital resistance and the COVID‐19 pandemic, affected program implementation.Despite various challenges, the program's unique approach combining multidisciplinary training and local mentorship proves promising. It fosters a culture of teamwork, equips participants with essential skills, and encourages fellows to become advocates for safe surgery. As surgical quality champions emerge from this fellowship, there is optimism for lasting positive impacts on surgical care in LMICs. [ABSTRACT FROM AUTHOR]

Using structural equation modeling techniques on data from a nationally representative longitudinal survey, we first explored the reciprocal relationships between socio-economic status (SES) and health status. We then estimated the degree to which health-related lifestyles/behaviors and psychosocial distress are mediating mechanisms of these relationships. As predicted, SES positively affects health, and health positively affects SES. Although the causal path from SES to health is stronger than the reverse, these findings confirmed the hypothesis that both social causation and health selection contribute to social inequalities in health. In terms of the mediating mechanisms through which SES and health affect each other, more than a third of the overall SES-health relationship was accounted for by health-related lifestyles/behaviors and psychosocial distress. A notable part of the effect of SES on health is due to differences in psychological distress, with the effects of health-related lifestyles/behaviors being much smaller. On the other hand, in terms of the effects of health on SES, differences in weight and sleeping behavior are more important than psychological distress. [ABSTRACT FROM AUTHOR]

Psychometric properties of scores on the Amharic version of the State-Trait Anxiety Inventory (STAI-A) were explored with 551 students in Ethiopia. Results show strong correlations (r[62]≤.89) between the corresponding scores on State Anxiety (SA) and Trait Anxiety (TA) scales of the STAI-A and the original STAI. High levels of internal consistency reliabilities (αs≤.85) and moderately high median item-remainder correlations (rs≤.47) were found for scores on the two scales of STAI-A. As predicted, SA scores were higher on a hypothetical exam condition than on a normal condition. SA scores were also more strongly correlated with life event stress scores than were TA scores. TA scores, in turn, were more strongly related to global psychopathology scores than were SA scores. These findings suggest that scores on STAI-A have acceptable reliability and validity and that STAI-A can be used for clinical and research purposes in Ethiopia. [ABSTRACT FROM AUTHOR]

By using data from a representative longitudinal survey, the authors provide strong evidence that complex leisure time activities increase intellectual functioning for workers and nonworkers. Although the effects were relatively moderate, both the present article and its predecessor on the effects of paid work (C. Schooler. Mulatu, & Oates. 1999) showed that, even in old age, carrying out complex tasks has a positive effect on intellectual processes. In both cases, initially high levels of intellectual functioning led to high levels of environmental complexity, which in turn raised levels of intellectual functioning, thus providing a pathway contributing to the high correlation of intellectual functioning over a 20-year period in middle and late adulthood. The present findings indicate that even in old age carrying out substantively complex tasks builds the capacity to deal with the intellectual challenges such complex environments provide. [ABSTRACT FROM AUTHOR]

Focuses on the perceptions of mental and physical illnesses in Ethiopia. Importance of various treatments for attitudes towards six, mental and physical illnesses; Dimensions of causal beliefs; Intercorrelations among illness causal beliefs, treatments and illness category.

Using a nationally representative sample of employed men and women in this longitudinal study, the authors extended for another 20 years findings based on 1964 and 1974 data (Kohn & Schooler, 1983) that substantively complex work improves intellectual functioning. This study provides evidence that intellectual functioning and substantive complexity of work continue to reciprocally affect each other. In addition, it shows that the intellectual flexibility measure used earlier (Kohn & Schooler, 1978, 1983) is highly correlated with more standard measures of intellectual functioning. Most importantly, it shows that, although substantively complex work significantly increased the level of intellectual functioning of both the younger and older halves of the sample, the effect is significantly greater among the older workers. [ABSTRACT FROM AUTHOR]

Discusses the prevalence and risk factors associated with psychopathology in Ethiopian children. Measurement of psychopathology; Maternal psychopathology; Family stressors; Child disability; Demographic variables; Risk factors; Prevalence of psychopathology.

Background: A record number of people survived Ebola virus infection in the 2013-16 outbreak in west Africa, and the number of survivors has increased after subsequent outbreaks. A range of post-Ebola sequelae have been reported in survivors, but little is known about subsequent mortality. We aimed to investigate subsequent mortality among people discharged from Ebola treatment units.Methods: From Dec 8, 2015, Surveillance Active en ceinture, the Guinean national survivors' monitoring programme, attempted to contact and follow-up all survivors of Ebola virus disease who were discharged from Ebola treatment units. Survivors were followed up until Sept 30, 2016, and deaths up to this timepoint were recorded. Verbal autopsies were done to gain information about survivors of Ebola virus disease who subsequently died from their closest family members. We calculated the age-standardised mortality ratio compared with the general Guinean population, and assessed risk factors for mortality using survival analysis and a Cox proportional hazards regression model.Findings: Of the 1270 survivors of Ebola virus disease who were discharged from Ebola treatment units in Guinea, information was retrieved for 1130 (89%). Compared with the general Guinean population, survivors of Ebola virus disease had a more than five-times increased risk of mortality up to Dec 31, 2015 (age-standardised mortality ratio 5·2 [95% CI 4·0-6·8]), a mean of 1 year of follow-up after discharge. Thereafter (ie, from Jan 1-Sept 30, 2016), mortality did not differ between survivors of Ebola virus disease and the general population. (0·6 [95% CI 0·2-1·4]). Overall, 59 deaths were reported, and the cause of death was tentatively attributed to renal failure in 37 cases, mostly on the basis of reported anuria. Longer stays (ie, equal to or longer than the median stay) in Ebola treatment units were associated with an increased risk of late death compared with shorter stays (adjusted hazard ratio 2·62 [95% CI 1·43-4·79]).Interpretation: Mortality was high in people who recovered from Ebola virus disease and were discharged from Ebola treatment units in Guinea. The finding that survivors who were hospitalised for longer during primary infection had an increased risk of death, could help to guide current and future survivors' programmes and in the prioritisation of funds in resource-constrained settings. The role of renal failure in late deaths after recovery from Ebola virus disease should be investigated.Funding: WHO, International Medical Corps, and the Guinean Red Cross. [ABSTRACT FROM AUTHOR]

The 2014–2016 Ebola virus (EBOV) disease outbreak affected over 29000 people and left behind the biggest cohort (over 17000 individuals) of Ebola survivors in history. Although the persistence of EBOV in body fluids of survivors was reported before the recent outbreak, new evidence revealed that the virus can be detected up to 18 months in the semen, which represents the biggest risk of Ebola resurgence in affected communities. In this study, we review the knowledge on the Ebola flare-ups that occurred after the peak of the 2014–2016 Ebola epidemic in West Africa. [ABSTRACT FROM AUTHOR]

The 2014-2016 Ebola virus (EBOV) disease outbreak affected over 29000 people and left behind the biggest cohort (over 17000 individuals) of Ebola survivors in history. Although the persistence of EBOV in body fluids of survivors was reported before the recent outbreak, new evidence revealed that the virus can be detected up to 18 months in the semen, which represents the biggest risk of Ebola resurgence in affected communities. In this study, we review the knowledge on the Ebola flare-ups that occurred after the peak of the 2014-2016 Ebola epidemic in West Africa. [ABSTRACT FROM AUTHOR]

Sesame is a crucial oilseed crop that contains vital fatty acids. The objective of this study was to build calibration equations using near-infrared reflectance spectroscopy for quality screening of sesame. A total of 136 sesame samples were scanned in the reflectance mode and their wet chemistry was determined by n-hexane extraction and gas chromatography mass spectroscopy. Models for oil and four fatty acids were developed with 110 samples and had an acceptable value of calibration coefficient of determination (R2 c), with suitable one minus the ratio of unexplained variance divided by variance (1-VR) value were found except palmitic acid. The prediction of an external validation with 26 datasets revealed a blameless correlation between reference values and NIRS values based on the coefficient of determination of validation (R2 v) and relative prediction deviation (RPD v). The models for oil, stearic, oleic, and linoleic acids had suitable values of coefficient of determination of validation and relative prediction deviation, which were more than 2.0 and 0.8, respectively. As a result of this research, it was discovered that the NIRS technology could be used to examine the oil and fatty acid contents of sesame seed qualities directly in breeding program, standard agency and commodity exchanges. • NIRS method reduces analysis time, non-destructive, and does not require solvents. • 110 samples for calibration and 26 samples for validation were used. • Second derivative and standard normal variate and detrend of spectral pretreatment were used. • The visible plus near-infrared region and modified partial least square was used to develop calibration equations. • NIR analysis of sesame could accurately predict oil content and three fatty acids. [ABSTRACT FROM AUTHOR]

Antifungal medications are vital in combatting fungal diseases that affect over a billion people annually. Antifungal medications for people and equids are scarce in Ethiopia, where lack of resources to treat fungal infection, in particular histoplasmosis, is a major health challenge. Histoplasmosis is endemic within the equine population in Ethiopia, where it is estimated that one in five horses are infected. This disease has far reaching impacts on equine welfare and the socio-economic wellbeing of families. The burden of histoplasmosis in people in Ethiopia is currently unknown, representing a blind spot in public health surveillance. Previous research has identified contact with wildlife, and domestic animal species as possible transmission pathways for histoplasmosis however, questions remain about the role of equids in human histoplasmosis. Given the close proximity of people and animals in this setting, the high level of endemic disease among equids, and the common sources of anti-fungals in Ethiopia, our study adopted a One-Health approach to examine how systemic issues affect access to, and use of antifungals to treat histoplasmosis among people and equids. A qualitative study was conducted in 6 urban regions of Oromia, Ethiopia in December 2018, incorporating semi-structured face-to-face interviews and focus group discussions. Twenty-seven individual interviews were held with doctors (n = 7), pharmacists (n = 12), veterinarians (n = 5), para-veterinarians (n = 2) and an equid owner (n = 1). Eleven focus groups were conducted with equid owners (n = 42), 3 with veterinarians (n = 6), 1 with para-veterinarians (n = 2) and 1 with pharmacists (n = 2). Transcripts were analysed using thematic analysis, and dimensions of key themes conceptualised and compared. Two overarching themes namely, 'Structural', and 'Human factors', summarised the main limitations to access to antifungal medications. 'Structural factors' included the national reliance on importation of medicines or pharmaceutical ingredients, inaccurate demand forecasting due to poor recording of the shortfall within the pharmaceutical supply chain, deficiencies in diagnostic capacity for fungal disease and, a healthcare system funded with a significant component of out-of-pocket expenditure. 'Human factors' that influenced access to antifungals included the perception of the expense of antifungals compared with competing needs such as food and education, the social stigma attached to histoplasmosis that could lead to delays in treatment seeking and, readily available home remedies or alternative treatment options. Furthermore, it was reported that trust in healthcare and veterinary provisions was undermined by a perceived lack of efficacious medications. Access to antifungals remains an urgent public health and animal welfare concern in Ethiopia. Key points within the supply and distribution chain that affect access to anti-fungals are identified, and policies that facilitate anti-fungal procurement and distribution should be reviewed. This paper highlights the structural, socio-economic and cultural factors influencing the management of infection with histoplasmosis, including how it is understood, identified and treated. This study identifies areas where further cross-sectorial work is needed to address these factors to improve disease control and clinical outcomes observed in human and animal histoplasmosis within Ethiopia. [ABSTRACT FROM AUTHOR]

Introduction. Whilst the coronavirus disease 2019 (COVID-19) vaccination rollout is well underway, there is a concern in Africa where less than 2% of global vaccinations have occurred. In the absence of herd immunity, health promotion remains essential. YouTube has been widely utilised as a source of medical information in previous outbreaks and pandemics. +ere are limited data on COVID-19 information on YouTube videos, especially in languages widely spoken in Africa. +is study investigated the quality and reliability of such videos. Methods. Medical information related to COVID-19 was analysed in 11 languages (English, isiZulu, isiXhosa, Afrikaans, Nigerian Pidgin, Hausa, Twi, Arabic, Amharic, French, and Swahili). Cohen's Kappa was used to measure inter-rater reliability. A total of 562 videos were analysed. Viewer interaction metrics and video characteristics, source, and content type were collected. Quality was evaluated using the Medical Information Content Index (MICI) scale and reliability was evaluated by the modified DISCERN tool. Results. Kappa coeFcient of agreement for all languages was p < 0.01. Informative videos (471/562, 83.8%) accounted for the majority, whilst misleading videos (12/562, 2.13%) were minimal. Independent users (246/562, 43.8%) were the predominant source type. Transmission of information (477/562 videos, 84.9%) was most prevalent, whilst content covering screening or testing was reported in less than a third of all videos. +e mean total MICI score was 5.75/5 (SD 4.25) and the mean total DISCERN score was 3.01/5 (SD 1.11). Conclusion. YouTube is an invaluable, easily accessible resource for information dissemination during health emergencies. Misleading videos are often a concern; however, our study found a negligible proportion. Whilst most videos were fairly reliable, the quality of videos was poor, especially noting a dearth of information covering screening or testing. Governments, academic institutions, and healthcare workers must harness the capability of digital platforms, such as YouTube to contain the spread of misinformation. [ABSTRACT FROM AUTHOR]

At the end of the 2013-2016 Ebola virus disease outbreak in Guinea, we implemented an alert system for early detection of Ebola resurgence among survivors. Survivors were asked to report health alerts in their household and provide body fluid specimens for laboratory testing. During April-September 2016, a total of 1,075 (88%) of 1,215 survivors participated in the system; follow up occurred at a median of 16 months after discharge (interquartile range 14-18 months). Of these, 784 acted as focal points and reported 1,136 alerts (including 4 deaths among survivors). A total of 372 (91%) of 408 eligible survivors had >1 semen specimen tested; of 817 semen specimens, 5 samples from 4 survivors were positive up to 512 days after discharge. No lochia (0/7) or breast milk (0/69) specimens tested positive. Our findings underscore the importance of long-term monitoring of survivors' semen samples in an Ebola-affected country. [ABSTRACT FROM AUTHOR]

We report on an Ebola virus disease (EVD) survivor who showed Ebola virus in seminal fluid 531 days after onset of disease. The persisting virus was sexually transmitted in February 2016, about 470 days after onset of symptoms, and caused a new cluster of EVD in Guinea and Liberia. [ABSTRACT FROM AUTHOR]

In 2014, Ebola virus disease (EVD) in West Africa was first reported during March in 3 southeastern prefectures in Guinea; from there, the disease rapidly spread across West Africa. We describe the epidemiology of EVD cases reported in Guinea's capital, Conakry, and 4 surrounding prefectures (Coyah, Dubreka, Forecariah, and Kindia), encompassing a full year of the epidemic. A total of 1,355 EVD cases, representing ≈40% of cases reported in Guinea, originated from these areas. Overall, Forecariah had the highest cumulative incidence (4× higher than that in Conakry). Case-fatality percentage ranged from 40% in Conakry to 60% in Kindia. Cumulative incidence was slightly higher among male than female residents, although incidences by prefecture and commune differed by sex. Over the course of the year, Conakry and neighboring prefectures became the EVD epicenter in Guinea. [ABSTRACT FROM AUTHOR]

Background: In 2003, the Ethiopian Ministry of Health (MOH) started to implement a national antiretroviral treatment (ART) program. Using data in the monthly HIV/AIDS Updates issued by the MOH, this paper examines the spatial and temporal distribution of ART on a population basis for Ethiopian towns and administrative zones and regions for the period February to December 2006. Results: The 101 public ART hospitals treated 44,446 patients and the 91 ART health centers treated 1,599 patients in December 2006. The number of patients currently receiving ART doubled between February and December 2006 and the number of female patients aged 15 years and older surpassed male patients, apparently due to increased awareness and provision of free ART. Of 58,405 patients who ever started ART in December 2006, 46,045 (78.8%) were adhering to treatment during that month. Population coverage of ART was highest in the three urban administrative regions of Addis Ababa, Harari and Dire Dawa, in regional centers with referral hospitals, and in several small road side towns that had former mission or other NGO-operated hospitals. Hospitals in Addis Ababa had the largest patient loads (on average 850 patients) and those in SNNPR (Southern Nations and Nationalities Peoples Republic) (212 patients) and Somali (130 patients) regions the fewest patients. In bivariate tests, number of patients receiving treatment was significantly correlated with population size of towns, urban population per zone, number of hospitals per zone, and duration of ART services in 2006 (all p < 0.001). The stronger relationship with urban than total zonal populations (p < 0.001 versus p = 0.014) and the positive correlation between distance from 44 health centers to the nearest ART hospital and patients receiving treatment at these health centers may be due to a combination of differential accessibility of ART sites, patient knowledge and health-seeking behavior. Conclusion: The sharp increase in ART uptake in 2006 is largely due to the rapid increase in the provision of free treatment at more sites. The marked variation in ART utilization patterns between urban and rural communities and among zones and regions requires further studies. Recommendations are made for further expansion and sustainability of the ART scale-up. [ABSTRACT FROM AUTHOR]