Level of aflatoxins in dairy feeds, poultry feeds, and feed ingredients produced by feed factories in Addis Ababa, Ethiopia.

Aflatoxins are one of the major factors that affect the quality and safety of feeds. They can be transferred into livestock through contaminated feed and then onto humans via animal sources of food such as milk, meat, and eggs. The objective of this study was to detect and quantify the level of aflatoxins (B1, B2, G1, G2, and total aflatoxin) in dairy feeds, poultry (layer and broiler) feeds, and feed ingredients produced in Addis Ababa. A total of 42 feeds and feed ingredients consisting of dairy feeds (n = 5), poultry broiler feeds (n = 6), layer feeds (n = 6), and feed ingredients (n = 25) were collected from feed factories in the city and analyzed in fresh weigh basis. The aflatoxins were analyzed using high-performance liquid chromatography after clean-up with immunoaffinity columns. Aflatoxin B1 levels in feeds ranged from 51.66 to 370.51 µg/kg in dairy cattle feed, from 1.45 to 139.51 µg/kg in poultry layer feed, and from 16.49 to 148.86 µg/kg in broiler feed. Aflatoxin B1 levels in maize ranged from 2.64 to 46.74 µg/kg and in Niger seed cake from 110.93 to 438.86 µg/kg. Aflatoxin B1 levels in wheat bran, wheat middling, and soybean were below 5 µg/kg. 100% of dairy feeds, 67% of poultry layer, 67% of broiler feeds, and 24% of ingredients contained aflatoxin in levels higher than the maximum tolerable limit set by the US Food and Drug Administration and Ethiopian Standard Agency. This shows the need for strong regulatory monitoring and better feed management practices to prevent consumers of animal-source foods from significant health impacts associated with aflatoxins.

Association between normal-weight obesity and cardiometabolic risk factors among adults in Addis Ababa, Ethiopia.

The relationship between normal-weight obesity (NWO)-high percent body fat (%BF) in individuals with normal body mass index (BMI)-and cardiometabolic abnormalities has not been explored in Africa. We determined the prevalence of the NWO and evaluated its association with hypertension, elevated blood sugar and dyslipidaemia among adults in Addis Ababa, Ethiopia. A cross-sectional study was conducted among adults 18-64 years (n = 600). Blood pressure, blood glucose, lipid profile, and anthropometric measurements were completed. As a function of skinfold thickness, body density and %BF were estimated using Durnin & Womersley and Siri Equations, respectively. The relationship between the NWO and the outcomes of interest, assessed using adjusted linear and logit models. The age- and sex-standardised prevalence of NWO was 18.9% (95% confidence interval (CI) 15.8, 22.2%). Comparison between normal-weight lean (normal %BF and BMI) and normal-weight obese individuals suggested no difference in systolic blood pressure (ß = 2.55; 95% CI - 0.82, 5.92); however, diastolic blood pressure (ß = 3.77: 95% CI 1.37, 6.18) and odds of hypertension (adjusted odds ratio (AOR) = 2.46: 95% CI 1.18, 5.13) were significantly raised in the latter. Similarly, adults with NWO had elevated blood glucose (ß = 2.30; 95% CI 1.23, 15.66) and increased odds of high blood sugar level (AOR = 1.68; 95% CI 1.05, 2.67). LDL (ß = 8.73: 1.56, 15.90), triglyceride (ß = 20.99: 0.78, 41.22), total cholesterol (ß = 10.47: 1.44, 19.50), and Cholesterol to HDL ratio (ß = 0.65: 0.27, 1.04) were also raised among adults with NWO. NWO is common among adults in Addis Ababa and is associated with cardiometabolic derangements.

Chlorhexidine cord care after a national scale-up as a newborn survival strategy: A survey in four regions of Ethiopia.

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.

Determinants of adverse birth outcomes among women delivered in public hospitals of Ethiopia, 2020.

BACKGROUND: Adverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. Factors such as the age of the mother, antepartum hemorrhage, history of abortion, gestational age, anemia, and maternal undernutrition have predisposed the mother to adverse birth outcome. For appropriate prevention of the adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. Therefore, this study was aimed to assess the determinants of adverse birth outcomes among women who give birth in public hospitals of western Ethiopia. METHODS: An institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. From mothers who gave birth in public hospitals of Wollega zones, 165 cases and 330 controls were selected. Mothers with adverse birth outcomes were cases and mothers without adverse birth were controls. Data was collected by structured interviewer-administered questionnaires. In addition to the interview, the data collectors abstracted clinical data by reviewing the mother and the babies' medical records. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Finally, multivariable logistic regression was used to identify determinants of adverse birth outcomes at P-value < 0.05. RESULTS: A total of 495 mothers (165 cases and 330 controls) were included in the study with a mean age of 28.48 + 5.908. Low ANC visit (AOR = 3.92: 95% CI; 1.86, 8.2), premature rupture of membrane (AOR = 2.83: 95% CI; 1.72,4.64), being Anemic (AOR = 2: 95% CI; 1.16,3.44), pregnancy induced-hypertension (AOR = 2.3:95% CI; 1.4,3.85), not getting dietary supplementation (AOR = 2.47:95% CI; 1.6,3.82), and physical abuse (AOR = 2.13: 95% CI; 1.05,4.32) were significantly associated with the development of the adverse birth outcome. CONCLUSION: Low antenatal care visit, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve antenatal care follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.

The adverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Birth outcomes are measures of health at birth and their magnitude is dramatically decreased in the past 40 years. However; there is still a large gap between developing and developed countries. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. For appropriate prevention of adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. An institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. In this study, low Antenatal care (ANC) visits, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve ANC follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.

Assessment of challenges of crop production and marketing in Bench-Sheko, Kaffa, Sheka, and West-Omo zones of southwest Ethiopia.

This study was conducted to identify the challenges of crop production and marketing in southwest Ethiopia. Primary and secondary sources of data were used. Qualitative and Quantitative data types were collected from 385 respondents through interviews, focus group discussion, key informant interviews, and observations. The collected data were analyzed by using descriptive statistics and econometric models. Crop productivity was analyzed by the Cobb Douglas model and its efficiency and determinants were identified by the stochastic frontier model. The major bottlenecks of crop production were the low attitude of farmers towards improved technology, low supply and usage of improved seed varieties (94.5%), low supply and use of fertilizers (95%), knowledge and skill gap of farmers (80.1%), poor extension service (57.3%), soil acidity (94.8%), diseases and insect pest (77.8%), conflict (84.9%) and the outbreak of human diseases (60%). Marketing challenges were poor infrastructure (87.3%), lack of market linkage (62.5%), and lack of credit services (70.6%). The Cobb Douglas model result revealed that land size, local seed, improved seed, repetition of weeding, and labor force influenced crop productivity. The mean level of crop technical efficiency was 51.3%. Education level, extension service, access to credit, cooperative membership, number of livestock owned, and soil fertility were influenced crop inefficiency negatively and distance to the farm was positively related to technical inefficiency. Improving extension services and skill of farmers through practical based training and building capacity of extension workers and systems to enhance the attitude of farmers towards technology usage and proper management practices, timely provision of farm inputs, improving road and market access, and provision of credit services to producers were some of the recommendations forwarded to alleviate crop production and marketing challenges in the study areas.

Gestational weight gain in sub-Saharan Africa: Estimation based on pseudo-cohort design.

BACKGROUND: Inadequate or excess gestational weight gain (GWG) leads to multiple undesirable birth outcomes. Yet, in sub-Saharan Africa (SSA) little is known about the weight gain pattern in pregnancy. The purpose of the study is to estimate the average gestational weight gain (GWG) in sub-Saharan Africa (SSA) and to examined whether there had been recent improvements or not. METHODS: Based on cross-sectional anthropometric data extracted from multiple Demographic and Health Surveys conducted in SSA, we estimated the average GWG in the region. Pseudo-cohort design was used to reconstruct GWG trajectories based on aggregated data of 110,482 women extracted from 30 recent surveys. Trend in GWG between 2000 and 2015 was determined using the data of 11 SSA countries. Pre-pregnancy weight was estimated based on the weight of non-pregnant women at risk of conception. RESULTS: On average, women in SSA gain inadequate weight (6.6 kg, 95% confidence interval, 6.0-7.2) over pregnancy. No meaningful gain was observed in the first trimester; whereas, women in the second and third trimesters put on 2.2 and 3.2 kg, respectively. The highest weight gain (10.5, 8.2-12.9 kg) was observed in Southern African sub-region and the lowest in Western Africa (5.8, 5.0-6.6 kg). The GWG among women who had secondary or above education (9.5, 8.2-10.9 kg) was higher than women with lower education (5.0, 4.3-5.8 kg). Likewise, GWG in women from richest households (9.0, 7.2-10.7 kg) was superior to those from poorest households (6.1, 5.3-7.0 kg). The estimated recent (2015-20) mean GWG (6.6, 5.8-7.4 kg) was not significantly different from what had been at beginning of the new millennium (6.7, 5.9-7.5 kg). CONCLUSION: In SSA GWG is extremely low and is not showing improvements.

Predictors of preterm birth in Western Ethiopia: A case control study.

BACKGROUND: Early neonatal death caused by preterm birth contributes the most for perinatal death. The prevalence of preterm birth continues to rise and is a significant public health problem. The exact cause of preterm birth is yet unanswered, as mostly preterm birth happens spontaneously. Predictors of preterm birth in developing countries like Ethiopia were not well investigated, and no study was conducted before this in the study area. OBJECTIVES: To identify predictors of preterm birth in Western Ethiopia, 2017/2018. METHODS: Health facility-based unmatched case-control study was conducted from October 20/2017-march 20/2018 in 4 Hospitals. A total sample size of 358 women was recruited. From this 72 were cases and 286 were controls. Cases were mothers who gave Preterm birth, and controls were mothers who gave birth at term. Ethical clearance was obtained from Wollega University ethical review committee. A pre tested, structured questionnaire was used to collect data. Data entry and analysis was done using Epi Data 3.1 and SPSS version 21, respectively. Logistic regression was done to identify predictors of preterm birth. RESULT: Three hundred fifty-eight women participated in this study of which 72 were cases and 286 were controls; making the overall response rate of 100%. Lack of antenatal care visit [AOR = 3.18, 95% CI 1.37-7.38]),(Having 1-2 antenatal care visit [AOR = 2.27, 95% CI 1.18-4.35]),history of previous preterm)[AOR = 5.19, 95% CI1.29-20.88],Short Interpregnancy Interval [AOR = 4.41.95% CI 2.05-9.47],Having Reproductive tract infections [AOR = 2.54, 95% CI 1.02-6.32] and having Obstetric complications [AOR = 2.48,95% CI 1.31-4.71] were found to be predictors of preterm birth. CONCLUSION AND RECOMMENDATION: Risk factors of preterm delivery are multifactorial and depend on geographical and demographic features of the population studied. Hence results of studies from one area might not be applicable to another area. Antenatal care visits are unique opportunities for early diagnosis and treatment of problems. Therefore, antenatal care should be strengthened, and appropriate counseling should be given at each antenatal care follow up. Maintainning optimum birth interval through family planning, and early identification and treatment of reproductive tract infections are mandatory.

Evaluating the African food supply against the nutrient intake goals set for preventing diet-related non-communicable diseases: 1990 to 2017 trend analysis.

BACKGROUND: Population intake goals intended to prevent diet-related non-communicable diseases (NCDs) have been defined for multiple nutrients. Yet, little is known whether the existing food supply in Africa is in conformity with these goals or not. We evaluated the African food balances against the recommendations for macronutrients, free sugars, types of fatty acids, cholesterol and fruits and vegetables over 1990 to 2017, and provided regional, sub-regional and country-level estimates. METHODS: The per capita supply of 95 food commodities for 45 African countries (1990-2017) was accessed from the FAOSTAT database and converted into calories, carbohydrate, fat, protein, free sugars, cholesterol, saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acids contents using the Food Data Central database. The supply of fruits and vegetables was also computed. RESULTS: In Africa the energy supply increased by 16.6% from 2,685 in 1990 to 3,132 kcal/person/day in 2017. However, the energy contribution of carbohydrate, fat and protein remained constant and almost within acceptable range around 73, 10 and 9%, respectively. In 2017, calories from fats surpassed the 20% limit in upper-middle- or high-income and Southern Africa countries. Energy from SFA remained within range (<10%) but that of PUFA was below the minimum desirable level of 6% in 28 countries. Over the period, energy from free sugars remained constant around 7% but the figure exceeded the limit of 10% in upper-middle- or high-income countries (14.7%) and in Southern (14.8%) and Northern (10.5%) sub-regions. Between 1990 and 2017 the availability of dietary cholesterol per person surged by 14% but was below the upper limit of 300 mg/day. The supply of fruits and vegetables increased by 27.5% from 279 to 356 g/capita/day; yet, with the exception of Northern Africa, the figure remained below the target of 400 g/capita/day in all sub-regions. CONCLUSION: According to this population level data, in Africa most population intake goals are within acceptable range. Yet, the supply of fruits and vegetables and PUFAs are suboptimal and the increasing energy contributions of free sugars and fats are emerging concerns in specific sub-regions.

Evaluation of improved taro (Colocasia esculenta(L.) Schott) genotypes on growth and yield performance in North-Bench woreda of Bench-Sheko zone, South-Western Ethiopia.

Taro is the world's fourth most important root crop in terms of production by weight, behind cassava, potato, and sweet potato, and the second most significant staple root crop in terms of consumption, after sweet potato. However, a shortage of well-adapted cultivars is one of the production problems that contribute to low yields and small planted areas across the country. As a result, genotypes with high production potential and adaptability for local environmental circumstances must be evaluated. During the 2018 and 2019 main cropping seasons, field experiments were done in the North-Bench woreda in the Bench-Sheko zone, south-western Ethiopia, to improve taro production and productivity by evaluating and selecting high yielding taro cultivars. Three improved and one local taro variety were used in the trial, which was laid out in a randomized complete block design (RCBD) with three replications at the North bench location. The data were collected and analyzed by using SAS 9.2 Version statistical software. The study's findings revealed that variety had a significant (P < 0.01) impact on all of the variables considered. Accordingly, combined analysis over years indicated that the highest leaf number per plant (7.76), plant diameter (40.82cm), corm diameter (8.28cm), cormel number per plant (6.10), and total yield (22.34 t/ha) were observed for Boloso-1 variety. The highest value of the number of suckers per plant was also observed for the Boloso-1 variety in both years (8.2 in 2018 and 6.2 in the 2019 growing season). However, combined analysis over years indicated the highest corm length in local variety (12.15cm) followed by Boloso-1 variety (10.34cm). Therefore, based on the overall results of this study, the Boloso-1 variety performed best and was more adapted to the area as compared to other varieties. This variety should be popularized and disseminated to users to boost the production and productivity of taro in the testing location and similar agro-ecologies of the region.

Inclusion and exclusion errors in the targeted supplementary feeding programme of Ethiopia.

Ethiopia's targeted supplementary feeding (TSF) programme aims to rehabilitate moderately malnourished children and pregnant and lactating women in selected chronically food-insecure districts. Screening for malnutrition is made by health extension workers through the quarterly community health days (CHD) events based on mid-upper arm circumference (MUAC) thresholds. This validation study examined the extent of targeting errors of inclusion (providing aid to the nonneedy) and exclusion (failure to reach the needy) in the TSF programme, among preschool children in 6 TSF districts. The study was conducted within 7 days after the completion of the CHD event. Multistage cluster sampling was employed to recruit 1,104 children. Data were collected using interviewer-administered questionnaire and by reviewing CHD registers. A paired t test was used to compare the MUAC measurements taken during the CHD and during the survey. The study found a global acute malnutrition prevalence of 13.0%. During the CHD, only 54.8% of the children were screened for malnutrition. The overall inclusion and exclusion errors of the TSF were 16.5% and 40.3%, respectively. The reasons for the exclusion errors were low coverage of the screening programme (67.2%) and MUAC measurement errors (32.8%). The mean including standard deviation (M ± SD) of the MUAC measured by health extension workers (11.8 ± 0.9 cm) was significantly lower than the measurements made by fieldworkers in the survey (12.1 ± 1.0 cm; p < .001). The study concluded that high targeting errors are committed in the TSF programme of Ethiopia. Targeting can be enhanced through accurate measurement of MUAC and maximization of the coverage of the screening programme.

Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia.

OBJECTIVE: The aim of this study was to assess the level and predictors of dietary diversity (DD) in predominantly food-insecure area of South Wollo, Ethiopia among children ages 6 to 23 mo. METHODS: The study was conducted in October 2014. We selected 2080 children using a multistage sampling technique. DD in the preceding day of the survey was assessed with the standard seven-food group score. Predictors of DD were identified via Poisson regression model and the outputs are presented using adjusted incidence rate ratio (IRR) with 95% confidence interval (CI). RESULTS: Only 7% (95% CI, 5.9%-8.1%) of the children met the recommended minimum DD. Child age and maternal knowledge of infant and young child feeding (IYCF) were significant predictors of DD with IRR of 1.027 (95% CI, 1.022-1.032) and 1.026 (95% CI, 1.010-1.043). Households with moderate and severe food insecurity had 9% (95% CI, 3.8-13.9%) and 24.9% (95% CI, 14.6-44%) reduced chance of providing diversified food. Husbands' direct involvement in IYCF increased DD by 13.7% (95% CI, 7.4-20.4). Caregivers who discussed IYCF with health extension workers, participated in cooking demonstrations, and heard radio spots about IYCF in the preceding 3 mo had 11.7% (95% CI, 3.4-20.7%), 18.9% (95% CI, 0.3-40.9%), and 11.4% (95% CI, 4.8-18.4) higher chance of providing diversified food, respectively. Backyard gardening (IRR, 1.088; 95% CI, 1.031-1.148) and number of chickens owned (IRR, 1.011; 95% CI, 1.001-1.021) also were significant predictors. CONCLUSIONS: In predominately food-insecure areas, nutrition education, implementation of nutrition-sensitive agriculture, and husband involvement in IYCF can improve children's DD.

Tissue reactivity and suture handling characteristics of "jimat" against silk and chromic gut in cat thigh muscle: A comparative study.

AIM: This study was conducted to evaluate and compare the tissue reactivity and suture handling characteristics of chromic gut, silk, and 'jimat' suture materials in cat thigh muscle. MATERIALS AND METHODS: This experimental study was conducted from November, 2013 to April, 2014 in Kombolcha Animal Diseases Survey, Research and Diagnostic Laboratory, Kombolcha, Ethiopia. A total of 36 local breed male cats were randomly assigned into chromic gut, silk, and "jimat" groups of 12 cats each as A, B, and C, respectively. The hind leg muscle biceps femoris was incised and sutured with suture materials according to their groups. The muscle samples with its suture were collected at six different days interval i.e. 1, 3, 7, 14, 21, and 28 and processed histopathologically to assess the degree of leukocytic infiltration and fibrous and granulation tissue formation (GTF). In addition, all suture materials were evaluated intraoperatively about their handling characteristics, by rating the precision of knot tying, square knot positioning, and resistance to knot slippage. The statistical analysis was done with two-way ANOVA, Kruskal-Wallis, and Chi-square tests. RESULTS: The histopathology showed that "jimat" thread (2.4±1.2) had produced least leukocytic infiltration than chromic gut (4.5±1.9) and silk (4.3±1.5) sutures during the study period. Higher GTF was seen at day 3 (6 [100%]), 7 (6 [100%]) and day 14 (4 [66.7%]) in all sutures, whereas "jimat" showed significantly (p<0.05) higher fibrous tissue formation (10 [83.3%]) than others. Moreover, "jimat" suture had equal suture handling characteristics (p>0.05) with both chromic gut and silk. CONCLUSION: The result indicated that a single strand "jimat" thread appears to be the most satisfactory suture material as regards to both tissue reaction and suture handling characteristics for skeletal muscle approximation in cats and provided that studies on its carcinogenic effects should be done.