Short-term recurrence rate of male urethral stricture and its predictors after treatment with optical internal urethrotomy: Prospective Cohort Study at a tertiary center in Ethiopia.

Background: Although optical internal urethrotomy is popular among the urologists due to its simplicity and safety, urethroplasty is considered the gold standard treatment for urethral strictures. This study aims to determine the 1-year recurrence rate of urethral strictures after optical urethrotomy and identify predictors of recurrence in a tertiary center in Ethiopia. Methods: A prospective observational cohort study was conducted on 80 male patients who underwent optical urethrotomy from November 2019 to August 2020 in a tertiary center in Ethiopia. Logistic regression was used to analyze the association between dependent and independent variables, with a P-value of <0.05 considered statistically significant. Results: The mean and median age (±SD) of patients at the time of the procedure were 54.76 (±14.74) and 58 years with a range [20-78], respectively. Urethral discharge was the most common etiology identified in 39 (48.75%) of patients. Eleven (13.75%) patients had no identifiable etiology for their urethral stricture disease.The majority of patients presented with at least one voiding lower urinary tract symptoms.Sixty-eight (85%) patients out of the total had a single stricture and 12 (15%) had multiple strictures. The location of the stricture was in the bulbar urethra on cystourethrography in 83% of the patients. The 1-year recurrence rate of urethral stricture after optical urethrotomy was 35% in our study.The number of strictures and the presence of hypertension were independent predictors of recurrence of urethral stricture within 1-year after treatment with optical urethrotomy (AOR=15.35, 95% CI: 2.92-80.61, P=0.00; AOR=19.47, 95% CI: 2.11-178.98, P=0.01, respectively). Conclusions: Our study identified that multiple strictures, and the presence of hypertension are associated with an increased recurrence rate in the first postoperative year.

Analysis of global Napier grass (Cenchrus purpureus) collections reveals high genetic diversity among genotypes with some redundancy between collections.

Genetic diversity amongst genotypes of several Napier grass collections was analyzed and compared with the diversity in a set of open pollinated progeny plants. A total of 114,881 SNP and 46,293 SilicoDArT genome-wide markers were generated on 574 Napier grass genotypes. Of these, 86% of the SNP and 66% of the SilicoDArT markers were mapped onto the fourteen chromosomes of the Napier grass genome. For genetic diversity analysis, a subset of highly polymorphic and informative SNP markers was filtered using genomic position information, a maximum of 10% missing values, a minimum minor allele frequency of 5%, and a maximum linkage-disequilibrium value of 0.5. Extensive genetic variation, with an average Nei's genetic distance value of 0.23, was identified in the material. The genotypes clustered into three major and eleven sub-clusters with high levels of genetic variation contained both within (54%) and between (46%) clusters. However, we found that there was low to moderate genetic differentiation among the collections and that some overlap and redundancy occurred between collections. The progeny plants were genetically diverse and divergent from the germplasm collections, with an average FST value of 0.08. We also reported QTL regions associated with forage biomass yield based on field phenotype data measured on a subset of the Napier grass collections. The findings of this study offer useful information for Napier grass breeding strategies, enhancement of genetic diversity, and provide a guide for the management and conservation of the collections.

Productivity and Feed Quality Performance of Napier Grass (Cenchrus purpureus) Genotypes Growing under Different Soil Moisture Levels.

In the semi-arid and arid environments of Sub-Sharan Africa, forage availability throughout the year is insufficient and highly limited during the dry seasons due to limited precipitation. Thus, the identification of drought stress-tolerant forage cultivars is one of the main activities in forage development programs. In this study, Napier grass (Cenchrus purpureus), an important forage crop in Eastern and Central Africa that is broadly adapted to produce across tropical environments, was evaluated for its water use efficiency and production performance under field drought stress conditions. Eighty-four Napier grass genotypes were evaluated for their drought stress tolerance from 2018 to 2020 using agro-morphological and feed quality traits under two soil moisture stress regimes during the dry season, i.e., moderate (MWS) and severe (SWS) water stress conditions, and under rainfed conditions in the wet season (wet). Overall, the results indicated the existence of genotype variation for the traits studied. In general, the growth and productivity of the genotypes declined under SWS compared to MWS conditions. High biomass-yielding genotypes with enhanced WUE were consistently observed across harvests in each soil moisture stress regime. In addition, the top biomass-yielding genotypes produced the highest annual crude protein yield, indicating the possibility of developing high-feed-quality Napier grass genotypes for drought stress environments.

Insights Into the Genetic Architecture of Complex Traits in Napier Grass (Cenchrus purpureus) and QTL Regions Governing Forage Biomass Yield, Water Use Efficiency and Feed Quality Traits.

Napier grass is the most important perennial tropical grass native to Sub-Saharan Africa and widely grown in tropical and subtropical regions around the world, primarily as a forage crop for animal feed, but with potential as an energy crop and in a wide range of other areas. Genomic resources have recently been developed for Napier grass that need to be deployed for genetic improvement and molecular dissection of important agro-morphological and feed quality traits. From a diverse set of Napier grass genotypes assembled from two independent collections, a subset of 84 genotypes (although a small population size, the genotypes were selected to best represent the genetic diversity of the collections) were selected and evaluated for 2 years in dry (DS) and wet (WS) seasons under three soil moisture conditions: moderate water stress in DS (DS-MWS); severe water stress in DS (DS-SWS) and, under rainfed (RF) conditions in WS (WS-RF). Data for agro-morphological and feed quality traits, adjusted for the spatial heterogeneity in the experimental blocks, were collected over a 2-year period from 2018 to 2020. A total of 135,706 molecular markers were filtered, after removing markers with missing values >10% and a minor allele frequency (MAF) <5%, from the high-density genome-wide markers generated previously using the genotyping by sequencing (GBS) method of the DArTseq platform. A genome-wide association study (GWAS), using two different mixed linear model algorithms implemented in the GAPIT R package, identified more than 35 QTL regions and markers associated with agronomic, morphological, and water-use efficiency traits. QTL regions governing purple pigmentation and feed quality traits were also identified. The identified markers will be useful in the genetic improvement of Napier grass through the application of marker-assisted selection and for further characterization and map-based cloning of the QTLs.

Author Correction: Genotyping by sequencing provides new insights into the diversity of Napier grass (Cenchrus purpureus) and reveals variation in genome-wide LD patterns between collections.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Genotyping by sequencing provides new insights into the diversity of Napier grass (Cenchrus purpureus) and reveals variation in genome-wide LD patterns between collections.

Napier grass is an important tropical forage-grass and of growing potential as an energy crop. One-hundred-five Napier grass accessions, encompassing two independent collections, were subjected to genotyping by sequencing which generated a set of high-density genome-wide markers together with short sequence reads. The reads, averaging 54 nucleotides, were mapped to the pearl millet genome and the closest genes and annotation information were used to select candidate genes linked to key forage traits. 980 highly polymorphic SNP markers, distributed across the genome, were used to assess population structure and diversity with seven-subgroups identified. A few representative accessions were selected with the objective of distributing subsets of a manageable size for further evaluation. Genome-wide linkage disequilibrium (LD) analyses revealed a fast LD-decay, on average 2.54 kbp, in the combined population with a slower LD-decay in the ILRI collection compared with the EMBRAPA collection, the significance of which is discussed. This initiative generated high-density markers with a good distribution across the genome. The diversity analysis revealed the existence of a substantial amount of variation in the ILRI collection and identified some unique materials from the EMBRAPA collection, demonstrating the potential of the overall population for further genetic and marker-trait-association studies.

Sharp Injury and Exposure to Blood and Body Fluids among Health Care Workers in Health Care Centers of Eastern Ethiopia.

BACKGROUND: Health care workers are facing certain occupational hazards because of sharp injury and exposure to human blood and body fluids as a result of handling wastes. Though much attention is paid for the protection of these workers, the number of exposures and injuries do not show a sign of decline from time to time. OBJECTIVE: To examine the occurrence of sharp injury and exposure to blood and body fluids in health care workers in health care centers in Ethiopia. METHODS: In a case-control study, a randomly selected sample of 65 health facilities with 391 cases and 429 controls were studied. Data were collected through a self-administered questionnaire. Detailed analysis of exposure among the health care workers was done by logistic regression analysis with generalized estimating equations model to control correlation effects of responses within the cluster of health facilities. RESULTS: The number of health care workers who got sharp injury was 217 (26.5%). 296 (36.1%) had exposure to blood and body fluids. Working at Harari region (adjusted OR 0.44, 95% CI 0.26 to 0.75) and East Hararghea (adjusted OR 0.61, 95% CI 0.40 to 0.94), being male (adjusted OR 0.56, 95% CI 0.44 to 0.91), and a being nurse (adjusted OR 0.188, 95% CI 0.06 to 0.63) were independent risk factors of the exposure. CONCLUSION: Regardless of the anticipated low self-reporting for exposure status, the number of health care workers reported having sharp injury and exposure to blood and body fluids was high. Such high exposures indicate that health care workers are at high risk of acquiring blood-borne viral infections such as hepatitis B, hepatitis C, and HIV.

Adolescents' undernutrition and its determinants among in-school communities of Ambo town, West Oromia, Ethiopia.

BACKGROUND: Adolescence is the most important period of life where growth and development are accompanied by various physical, physiological, behavioral, and social changes leading to increased demand for nutrients which could pose a greater risk of malnutrition. OBJECTIVES: To assess the magnitude of adolescents' undernutrition and its determinants in public schools of Ambo town. METHODS: A cross-sectional study design with analytical component was conducted between March 20 and April 10, 2008. A total of 425 in-school adolescents were assessed for their nutritional status. Weight, height and other important socio-demographic and dietary information were taken using pre-tested questionnaire. Body Mass Index (BMI) was computed and compared to the reference standards. RESULTS: The overall prevalence of underweight and overweight was 27.5% and 4.3% respectively. The proportion of underweight was higher in males (29.8%) than females (24.6%) while overweight were higher in females (4.9%) than males (3.8%). However, the difference noted was not significant (P = 0.4). Underweight was significantly higher in early (38.1%) than late (18.6%) adolescent (p = 0.001). The most important predictors identified for underweight were adolescent's age, menarche onset, food source for consumption and family possession of cattle (p < 0.05). CONCLUSION: Underweight in the in-school adolescents is prevalent. To help adolescents build better futures with more civic education and life skills, an integrated nutrition and health related services that meet the needs of adolescents in the school community is recommended.

Determinants of adolescent fertility in Ethiopia

Background: Worldwide, adolescents suffer from a disproportionate share of reproductive health problem. Throughout the world, over 14 million adolescents aged 15-19 years give birth annually. The purpose of this study was to assess the level and identify proximate and other determinants of adolescent fertility in Ethiopia. Methods: Raw data collected from all part of the country using stratified cluster sampling method by the Ethiopian Demographic Health Survey 2005 (EDHS-2005) was used. After the data for adolescents aged from 15 to 19 years were extracted from the large data set, Multivariate logistic regression model was applied to identify socio-demographic and economic determinants whereas Bongaarts model was used to determine proximate determinantsfertility. Results: Of the 3,266 adolescent women, 443 (13.6%) had given birth at least once prior to the survey and 133 (4.1%) were pregnant. Of the 443 adolescents who had at least given birth, the majority (72.7%) had one child while about a quarter (23.2%) had 2 live births and the rest 1.0% gave four live births with a mean number of child ever born of 1.33±0.6. The major factors associated with adolescent fertility were age, educational status, place of residence, employment, marriage, contraceptive use and postpartum infecundability. The odds for increased adolescent fertility was significantly higher in early adolescents (AOR=7.6; 95% CI=6.0 to 9.9), had lower education(AOR=6.7; 95%CI=4.1 to10.9), among rural teens (AOR=3.6; 95%CI=1.9 to 6.9) and currently not working (AOR=1.7; 95%CI= 1.3 to 2.2) than their counterparts. The observed fertility rate of 0.52 children per woman obtained from Bongaarts model of fertility indicated about 1.98 births per woman were averted due to non-marriage, delayed marriage, contraceptive use and postpartum infecundability.Conclusion: Since adolescent fertility is felt to be a problem, concerted efforts are needed to empower adolescents to fight early marriage, promote education and encourage the utilization of family planning targeting the rural teenagers

Utilization of antenatal care services among teenagers in Ethiopia: a cross sectional study

Background: Teenaged women suffer from a disproportionate share of reproductive health problem. The purpose of this study was to estimate the utilization of antenatal care (ANC) services among teenagers (13-19 years) during delivery in Ethiopia. Methodology: Raw data collected from all part of the country on child bearing aged women using stratified cluster sampling method by the Ethiopian Demographic Health Survey 2005 was used. From the large dataset of women; a total of 994 teenage women at the time of their most recent childbirth five years prior to the survey was selected and analyzed. Both bivariate and multivariate analyses were performed to determine the differentials of ANC by explanatory variables. Result: Most (60) of the subjects were in the age group between 18 and 19 years. The vast majority (90) was from the rural settings and most (87) were in marital union. Almost three out of four (72.4) of those who had given birth has no any form of formal education. Over a quarter (27.3) of most recent childbirths had at least one ANC service; of this; 21had started their first antenatal visit in the first trimester of pregnancy. The majority (80.4) of the women who attended ANC delivered at home without being assisted. The major deriving factors for the utilization of ANC service were education level of women and their male partners; better wealth index and urban residence. Conclusion: Education of partners; rich wealth index and urban residence seemed to encourage teenagers to utilize ANC. Appropriate interventions targeting teenaged women with poor socioeconomic status is recommended with more emphasis on the rural underserved segment of population. [Ethiop. J. Health Dev. 2010;24(3):221-225]

Determinants of exclusive breastfeeding practices in Ethiopia

Background: Despite the demonstrated benefits of breast milk; the prevalence of breastfeeding; in-particular exclusive breastfeeding (EBF); in many developing countries including Ethiopia is lower than the international recommendation of EBF for the first six months of life Objective: To assess the practice of EBF and explore its determinants in Ethiopia and provide policy makers and NGOs with relevant information for future planning and interventions. Methods: Raw data collected from nine regions and two city administrations using stratified cluster sampling method by the Ethiopian Demographic Health Survey (EDHS) 2005 were used to study the practice and determinants of EBF countrywide. Analysis was based on children whose age was less than six months and alive at the time of interview that was extracted from the women's database. Results: The overall rates of exclusive and full breastfeeding were 49.0and 68.2respectively. Maternal education; marital status; wealth index and age of the child were closely associated with EBF practices; nonetheless; in the hierarchical analysis; being not married; middle/ richer/ richest wealth index; and child age 0-1and 2-3 month were retained as the predictors of EBF (P0.05). Conclusion: A range of maternal and child health attributes such as marital status; economical status and child age were found to influence the practice of EBF in Ethiopia. Actions to empower women and promotion of EBF campaignare recommended to achieve the fourth millennium development goal

Malaria, schistosomiasis, and intestinal helminths in relation to microdams in Tigray, northern Ethiopia.

A survey was undertaken in Tigray, Northern Ethiopia, to assess the prevalence of malaria, schistosomiasis, and intestinal helminths in relation to microdams. The survey took place from March to June 1995, during the dry season, at 41 microdams. At each site the village nearest the dam (within thirty minutes walk) was selected, ten households were randomly chosen, and all family members were examined for malaria and intestinal parasites. The overall study sample was 2271 people, of all age groups. Plasmodium falciparum infection was documented in four villages (at 10% of microdams); prevalence was 1.2% (range 0-20% by village). Larvae of Anopheles gambiae s.l. were found at one microdam. Infection with intestinal schistosomiasis was documented in 20 villages (at 49% of microdams), and one third of those infected had moderate to heavy infections. Biomphalaria species, the intermediate host snails of Schistosoma mansoni, were found at 16 microdams (39%), and snails infected by mammalian cercariae were found in one locality. Infections with soil-transmitted nematodes were prevalent: hookworm was detected in more than two thirds of the villages, and Ascaris lumbricoides and Trichuris trichiura were present in almost half of the villages. Out of 2078 stool examinations, the prevalence of S. mansoni infection was 7.2% (range 0-48% by village), of A. lumbricoides 2.3% (range 0-31%), of T. trichiura 2.4% (range 0-21%), and of hookworm 8.9% (range 0-78%). The prevalence of malaria, S. mansoni and hookworm was higher at altitudes below 2000 metres above sea level. S. mansoni was more prevalent in microdams built more than 5 years before the survey, while T. trichiura was more prevalent at recently constructed microdams. The widespread distribution of schistosomiasis and intestinal helminths, and the presence of malaria infection during the dry season confirm that microdams create favourable conditions for the transmission of these parasitic diseases. Health safeguards must be incorporated into the planning, construction, and operation of microdams and irrigation systems in order to prevent or reduce these diseases. In areas with high prevalence, control activities should be intensified.

Pattern of drug use in Addis Ababa community.

Though important in the development of educational materials for the public, community drug use studies are rare in Ethiopia. This community based cross-sectional study was conducted in Addis Ababa between November 1995 and January 1996 to describe community's perception on drugs, identify people's various sources of modern drugs and determine factors associated with drug use. The study results show that out of the 903 persons who reported an illness in the four weeks recall period, 231 (26%) did not take any action for their illness. The reasons being mainly the perception that the illness was minor and economic inaccessibility. Regarding sources of modern drugs, the majority 398 (63%) of those who used modern drugs obtained their medications from government health institutions. Drug sharing was practiced by 156 (17%) of the respondents. In addition, 39 (6%) prematurely discontinued their treatment course and the majority did so either due to inability to comprehend the instructions or having some social entertainment. It was also found that 178 (20%) of the studied households were found hoarding drugs and the most common ones were oral antibiotics and antipyretic analgesics. In addition, gender and education were found to have an association with drug hoarding. The study also identified factors associated with household drug hoarding and drug sharing among family members or neighbours; in this respect, the former was found associated with education and gender but the latter was associated with sex, age, education and marital status. In conclusion, drug sharing among families, friends or relatives are commonly practiced in Addis Ababa community. In addition, many patients stopped taking their prescribed drugs once they started to feel better.

Community participation in malaria control in Tigray region Ethiopia.

During the Ethiopian civil war from 1974 to 1991, the Tigrean People's Liberation Front established a primary health care system in Tigray in which community residents helped to plan and implement health services through health committees and community health workers (CHWs). To strengthen and update this system, a Community-Based Malaria Control Programme was initiated in 1992. The primary objectives of the Programme are to reduce malaria morbidity and mortality and to prevent malaria in pregnant women through early diagnosis and treatment of cases, chemoprophylaxis during pregnancy, and vector control by environmental management. A secondary objective is to introduce a cost-sharing scheme for eventual development of a village revolving fund. A total of 681 volunteers chosen by their communities have received malaria training and serve a rural population of 1,682319 (CHW/population ratio 1:2,500). The principal success of the programme at this stage is that a significant proportion of the rural population at risk for malaria is now being treated at the village level. During the last major transmission season from September through November 1993, each CHWs treated a mean of 45178 clinical malaria cases per month. Under-utilization of treatment services by women and children under 5 years and low chemoprophylaxis coverage of pregnant women have been documented. After focus group discussions with community members and CHWs to identify the reasons for these problems, changes in programme policies were made to improve coverage of these groups. Since 1992, considerable progress toward meeting programme objectives has been made, and continued evaluation will allow for interventions that should further strengthen the malaria control efforts in the region.