Trichiasis Recurrence in North Ethiopia: a one Year Prospective Study of Trachomatous Trichiasis Surgery done by Integrated Eye Care Workers

Background: Blindness due to trachomatous trichiasis can be prevented by simple eyelid surgery that can be performed by trained nurses. Objective: To evaluate the post- operative outcome of posterior tarsal rotation done by integrated eye care workers (IECWs) at the twelfth postoperative month. Methods: A prospective study to evaluate trichiasis surgery for recurrence was conducted in Yilmana Densa District. Trained IECWs did transverse tarsotomy with lid margin rotation for 455 patients with trichiasis following the standard procedure. Post-operative follow-up evaluation was done at the 12th month by IECWs who neither took part in the operation nor knew the specific surgeons for the corresponding patients. Results: Out of 695 a total of 560 operated eyelids were available for follow-up just at the 12th month. In terms of persons; 79.3(361/455) patients came for follow-up evaluation. The recurrence rate among the operated eyelids was found to be 16.6. There was an increase in likelihood of having recurrence with increasing age of patients (X2=5.6; P=0.02). We also found a statistically significant difference in rates of recurrence among patients operated by different surgeons(X2 =12.8; P=0.005). Conclusion: Trichiasis recurrence following surgery done by non-ophthalmologists is low indica- ting the possibility of avoiding preventable blindness due to trachoma through the training of integrated eye care workers. Moreover; monitoring mechanism appeared essential to track the performance of IECWs

Levels of Outpatient Satisfaction at Selected Health Facilities in Six Regions of Ethiopia

Background: Satisfaction is one of the meaningful indicators of patient experience of health care services. Asking patients what they think about the care and treatment they have received is an important step towards improving the quality of care; and to ensuring that local health services are meeting patients' needs. Various studies have reported that satisfied patients are more likely to utilize health services; comply with medical treatment; and continue with the health care provider. Objective: to assess and estimate the perceived levels of satisfaction with health services rendered at government health facilities in selected regions of Ethiopia. Methods: A cross-sectional study that involved an exit interview was conducted in purposively selected government health centers and general hospitals in six regions of Ethiopia. Data were collected using structured questionnaire between June and September 2004. Variables used in the study were grouped and summarized into three components; namely providers' characteristics; services characteristics and cleanliness of the health facilities. Each variable was scored on a 5 point Likert-like scale; ranging from 1 (very dissatisfied) to 5 (very satisfied). The mean score 2.5 is considered as a cut-off point and scores equal and above 2.5 are taken as an indicator of users' perceived satisfaction. Both bivariate and multivariate methods of data analyses were used as deemed necessary. Results: All the three components of investigated variables have reliability coefficients ranging from 0.57 to 0.82. Results of bivariate analyses depicted that the percentage for high mean score satisfaction with health providers' characteristics ranged from 77.25to 93.23; with service characteristics 68.64to 86.48; and satisfaction with cleanliness ranged from 76.50to 90.57. Results of multivariate analysis showed that relatively more explanatory variables were found to be significant ininfluencing cleanliness (cleanliness of waiting place; examination room and medical equipment). Most of the explanatory variables in service characteristics were not statistically significant as compared to other components. Conclusion: The investigators believe that improved service delivery in health facilities could be achieved by to proper and sustainable implementation of the newly initiated civil service reform program in civil service institutionsin the country. Furthermore; periodic assessment of health services and further study; especially from the user's satisfaction perspective is recommended as a fundamental initiative in the improvement of the performance of health facilities

Cyanobacterial N2 fixation in presence of nitrogen fertilizers.

Anabaena oryzae ARM 570 was examined for its growth (chlorophyll and protein), heterocyst frequency, nitrogenase (acetylene reduction) activity, ammonia excretion, and glutamine synthetase and nitrate reductase in response to two levels of urea-N vis-à-vis N2-N. Growth of cyanobacterium increased with duration of incubation. Reduction in heterocyst frequency (40%) was observed at 30 ppm of urea-N, whereas at 60 ppm of urea-N, filaments were completely devoid of heterocysts and no nitrogenase activity was observed. Maximum excretion of ammonia occurred at 30 ppm of urea-N, which was concomitant with minimum glutamine synthetase activity. These results suggested that A. oryzae could be effectively utilized in cyanobacterial biofertilizer programme even in the presence of combined nitrogen, for improving N-budget in rice cultivation.