Psychological impact and associated factors of the COVID-19 pandemic among pregnant women in Fafan Zone health institutions, Somali Region, Eastern Ethiopia, 2021.

BACKGROUND: Despite pregnant women's vulnerability to respiratory illnesses and pregnancy complications during the COVID-19 pandemic, research on its psychological impact in the study area, is limited. OBJECTIVE: This study aims to fill this gap by examining the prevalence and factors linked to the psychological impact among pregnant women in the Fafan zone, Somali region of Ethiopia. METHODS: A cross-sectional study conducted from April 1st to April 30th, 2021, randomly selected health facilities for inclusion. The Impact of Event Scale-Revised (IES-R) assessed psychological impact, and data were analyzed using SPSS V 22. Variables with a p-value ≤ 0.25 in bivariate analysis were considered for multivariate analysis via multiple logistic regressions with the backward elimination method. RESULTS: The study involved 294 pregnant women, constituting 73% of the respondents. The prevalence of psychological impact attributed to the COVID-19 pandemic was 27.2%. Factors such as being in the first trimester of pregnancy (AOR: 5.32), travel history to infected areas (AOR: 3.71), obtaining COVID-19 information from television (AOR: 4.81), and using social media for 1 to 2 hours daily for updates (AOR: 1.35) were significantly associated with this impact. CONCLUSION: While the psychological impact among pregnant women in this study was relatively lower compared to other research, factors such as gestational age, TV media exposure, travel history, and social media usage for COVID-19 updates were strongly linked to this impact, highlighting the necessity for psychological support services for pregnant women during challenging times.

Prevalence and correlates of post-traumatic stress disorder among internal displaced people in Qoloji Camps, Somali regional state, eastern Ethiopia.

OBJECTIVES: This study assessed the prevalence and correlates of post-traumatic stress disorder (PTSD) among internally displaced people (IDP) in the Qoloji Camp, Somali Regional State, Eastern Ethiopia. METHODS: A community-based cross-sectional study was conducted from October 20 to November 5, 2021. The study utilized systematic random sampling to identify 410 IDP participants from the Qoloji Camp. PTSD was measured using the PTSD Check-list for DSM-5 (PCL-5). Bivariate analysis was performed to determine the crude odds ratio, and multivariate analysis was used to calculate adjusted odds ratios for associations between PTSD and independent variables. RESULTS: A total of 404 participants were interviewed (98.5% response rate). The estimated prevalence of PTSD symptoms was 41.1%. In the multivariate logistic regression analysis, several factors were significantly associated with PTSD: being female (AOR = 2.5, 95% CI = 1.39-4.44), lack of food and water (AOR = 2.2, 95% CI = 1.17, 4.23), destruction of personal property (AOR = 3.1, 95% CI = 1.62-6.09), and experiencing torture or beatings (AOR = 1.8, 95% CI = 1.01-3.28). CONCLUSION: This study found a high prevalence of PTSD symptoms among IDPs, with factors such as female sex, property destruction, deprivation of essential goods and services, and experiences of torture or beatings significantly associated with those symptoms. To address these findings, prioritizing the well-being of IDPs with a specific focus on women, on-site screening, and the establishment of a referral system to facilitate access to specialized care are essential to enhance the overall mental health of such persons.

A community based seroprevalence of SARS-CoV-2 antibodies in Somali Region, Eastern Ethiopia.

BACKGROUND: Coronavirus disease 19 (COVID-19) is life-threatening infectious disease caused by SARS-CoV-2 virus that caused a global pandemic. SARS-CoV-2 has been widely transmitted throughout Ethiopia, with over 501,060 cases confirmed and 7574 deaths until November 2023. This study assessed for the first time the seroprevalence SARS-CoV-2 in the general population of the Somali Region during the COVID-19 pandemic. METHODS: A cross-sectional study design was conducted from May to June 2021 in 14 districts of Somali Region. Blood samples were collected in 820 participants in addition to administering a questionnaire that included sociodemographic characteristics and history of clinical symptoms of COVID-19. Blood samples were tested for the presence or absence of anti-SARS-CoV-2 using a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit (Euroimmun). RESULTS: Overall, 477 (58.2%) were male and 343 (41.8%) were female. The majority of the participants (N = 581; 70.9%) were between 18 and 34 years old and not vaccinated against COVID-19 (N = 793; 96.7%). The overall seroprevalence of SARS-CoV-2 antibodies was 41.7% (95% CI: 33.3%-47.6%). The highest prevalence was found in Goljano district (70%) and the lowest in Gunagado district (22.5%). Only age was found to be associated with COVID-19 seropositivity. CONCLUSION: Prevalence of SARS-CoV-2 antibodies was the highest ever reported in Ethiopia, indicating that a large proportion of the population had been infected 14 months after the start of the outbreak in the country. Such studies are important to swiftly reassess and improve specific COVID-19 preventive and control measures to reduce transmissions within the community in a given setting.

Depression and glycaemic control among adult patients with type 2 diabetes: a cross-sectional study in a comprehensive specialised hospital, Jigjiga, Ethiopia.

OBJECTIVES: The primary objective of this study was to evaluate the prevalence of depression and its sociodemographic predictors, clinical predictors and glycaemic control among adult patients with type 2 diabetes at Sheik Hassan Yabare Comprehensive Specialized Hospital (SHYCSH), Jigjiga, Ethiopia. DESIGN: A hospital-based cross-sectional study was conducted. SETTING: Patients with type 2 diabetes mellitus (T2DM) at Sheik Hassan Yabare Comprehensive Specialized Hospital, for chronic follow-up from 3 October 2022 to 13 November 2022. PARTICIPANTS: Randomly selected 278 patients with T2DM age 18 years and older, with a duration of 1 year or more since diagnosis, who had a diabetic follow-up at SHYCSH. MAIN OUTCOME MEASURES: Depression was assessed using the Patient Health Questionnaire. RESULTS: A total of 263 participants were included, with a response rate of 94.6%. Of the respondents, 134 (51%) were male, making up more than half of the total. The overall prevalence of depression was 47.1% (95% CI 41.1 to 53.2). Depression was further classified, as follows, based on its severity: the majority (66 or 25.1%) had mild depression, followed by 44 (16.7%) with moderate depression, 9 (3.4%) with moderately severe depression and 5 (1.9%) with severe depression. A multivariable logistic regression analysis indicated that poor glycaemic control (adjusted OR (AOR)=1.93; 95% CI 1.05 to 3.53), DM complications (AOR=2.02; 95% CI 1.09 to 3.74) and DM duration of 6-10 years since diagnosis (AOR=2.29; 95% CI 1.21 to 4.34) were independently associated with depression. CONCLUSIONS: Our study revealed a significant burden of depression among patients with T2DM receiving follow-up care at the hospital. Glycaemic control, the presence of complications and a longer duration of diabetes were identified as predictors of depression. Therefore, concerned stakeholders should work to improve blood sugar control and promote healthy behaviour, particularly among those with complications or who have been sick for an extended period of time.

Species Diversity, Structure, and Regeneration Status of Woody Plants in Saleda Yohans Church Forest, South Wollo, Ethiopia.

The study was conducted to determine woody plant species composition, structure, and regeneration status in Saleda Yohans Church forest, South Wollo Zone, Ethiopia. Five transect lines oriented to north-south directions at a distance of about 500 m were laid down along transects across the forest. Fifty main plots of 20 m × 20 m were laid for tree/shrub data collection. Within each main plot, 5 small quadrats of 5 m × 5 m were laid in the corners and centre for the collection of seedling and sapling data of woody species. All vegetation data within the plots were counted and recorded. Tree height and diameters at the breast height of plants were also measured and estimated. Moreover, frequency, basal area, diversity, evenness, and other vegetation data were analyzed. The result showed that this Church forest is composed of 50 woody plant species distributed in 31 families. The Shannon-Wiener diversity index and evenness values of the forest were found to be 3.82 and 0.84, respectively. Lamiaceae was the dominant family followed by Fabaceae in their species composition. The density of trees/shrubs, saplings, and seedlings was 625, 650, and 935 ha-1, respectively. Based on the result, the entire vegetation of Saleda Yohans Church forest is in good regeneration status. In conclusion, although this Church forest appears to be in a good regeneration status, its species richness is low compared to a similar study of some other vegetation. Therefore, attention should be given to the rehabilitation of this forest.

The need for a tailored national dementia plan in Ethiopia: A call for action.

Globally, a rapid demographic transition is occurring with a significant increment in the proportion of older individuals. For the first time in history, individuals aged 65 and above outnumber that of children under 5 years of age. In Ethiopia, the life expectancy has shown dramatic improvements in the past few decades and is expected to reach 74 years by mid-century. Older age is considered the most important non-modifiable risk factor for dementia. Likewise, other modifiable diseases such as infectious diseases, non-communicable diseases, particularly cardiovascular diseases, and traumatic brain injuries are associated with dementia. Despite, the high prevalence of dementia risk factors and impending economic and health impact from dementia, no country in the sub-Saharan Africa (SSA), including Ethiopia, has developed a standalone or an integrated national dementia strategic plan to guide the overall effort to improve dementia care in the country. It is vital to design and develop a national dementia plan in line with a framework outlined by the 2017 World Health Organization (WHO) global action plan. The health, social, and economic burden from dementia is expected to be high to the developing countries such as Ethiopia unless clear prevention and management strategies are designed at a national level to cascade the care to the primary care level. The planned strategic policy may focus on improving the knowledge and skills of health care professionals. Translation and cultural adaptation of cognitive, functional, and behavioral assessment batteries is of paramount importance in improving the diagnostic accuracy along with availability of advanced imaging, biomarkers, and dementia treatment.

Ethnobotanical Study of Traditional Medicinal Plants Used to Treat Human and Animal Diseases in Sedie Muja District, South Gondar, Ethiopia.

A variety of traditional medicinal plants has been widely used by different indigenous people in Ethiopia for many human and livestock ailments. This study was conducted to investigate and document the use of medicinal plants in the Sedie Muja district. Sixteen key informants were selected purposively and 72 informants were selected randomly from 5 wards. Data were collected using semi-structured questionnaires, group discussions, and field observation. Besides descriptive statistics, the data were analyzed using some ethnobotanical analysis tools like preference ranking, paired comparison, direct matrix ranking, informant consensus factor, and fidelity level index. A total of 89 species of medicinal plants were identified and collected with 82 genera and 44 families. Out of these, 60 species (67.42%) were used against human ailments, 10 species (11.24%) were used against livestock ailments, and 19 species (21.34%) were used to treat both human and livestock ailments. Herbs constituted the largest growth habit (40 species) followed by shrubs (33 species). The most frequently used plant part was leaves (39.9%), followed by roots (23.83%), and the condition of preparation was fresh plant materials (70.98%). The most widely used method of preparation was crushing (22.8%) followed by crushing-squeezing (11.39%). The most common route of administration was oral (49.74%) followed by dermal (30.05%). Ruta chalepensis was the predominant medicinal plant cited by most of the informants 62 (70%) followed by Ocimum lamiifolium 59 (67%). The disease category with the highest ICF value (0.90) was the evil eye. There was a high preference for Euphorbia abyssinica to treat stomachache. Ocimum lamiifolium was the most preferred species for the treatment of febrile illness. Anthropogenic factors are the major threats to medicinal plants. In general, the study area is rich in medicinal plants that have a significant role in the management of various human and livestock diseases.

Integrated community based human and animal syndromic surveillance in Adadle district of the Somali region of Ethiopia.

The economy of Ethiopia largely depends on agriculture and roughly 80% of the households have direct contact with domestic animals which make the community vulnerable to zoonotic diseases, especially in pastoral areas like the Somali Regional State (SRS) of Ethiopia. However, in addition to low reporting rates, especially in livestock, there is also lack of coordination between public health and animal health surveillance and there is no linkage between public health system and animal health system and mechanism or structure for sharing information on zoonotic diseases in SRS. In view of these challenges, a small scale study was conducted to evaluate the feasibility of mobile communication in the early detection of human and animal syndromes in remote pastoral areas including where there are no human and animal health facilities by engaging local communities in the diseases surveillance. METHOD: A small scale study, testing a community based human and animal syndromic surveillance was conducted from August 2017 to February 2018 in 20 villages in four Kebeles of Adadle district in the SRS with an estimated 1390 households and 112,850 livestock. The selected community leaders were trained on disease surveillance and detection. The communication was done by direct calls. Two dollars per month were provided to the village leaders recruited for the surveillance. RESULTS: A total of 904 and 671 human and animal syndrome cases were reported in seven months of the study period. In addition to syndromes, suspected anthrax, sheep and goat pox (SGP), rabies, salmonellosis and mass abortion outbreaks were reported in animals. In humans, suspected cholera and chicken pox outbreaks were reported. Furthermore, tuberculosis and malaria cases were also confirmed in the study villages. In humans, gastrointestinal tract (GIT) disorder was the most common syndrome observed, which constituted (42.8%) of all syndromes, followed by respiratory disorder (37.8%) and febrile illness (15.5%). In livestock, cattle contributed (40.8%) of all cases of illness, while sheep, goats and camels contributed 24.1%, 18% and 17% of the cases respectively. Responses were organized for emergency treatment and vaccination campaigns against certain suspected disease outbreaks and emergencies such as SGP and cholera. CONCLUSION: This study suggests that engaging and empowering the village local leaders in disease surveillance in pastoral setting areas, including where there are no human and animal health facilities, coupled with mobile technologies (non-smart phone), would improve early detection and response to human and animal health events including zoonotic emergencies, and consequently improve the reporting rate at district, regional and national level. However, the collaboration between sectors (human health and animals health) and the capacity to respond to zoonotic diseases and etiological identification are crucial elements for effective integrated human and animals disease surveillance and response.

From reverse innovation to global innovation in animal health: A review.

Reverse innovation refers to learning from or diffusion of innovations developed in low income settings and further translated to industrialized countries. There is lack of consensus regarding terminology, but the idea that innovations in low-income countries are promising for adoption in high-income contexts is not new. However, in healthcare literature globally, the vast majority of publications referring to 'disruptive innovation' were published in the last ten years. To assess the potential of innovative developments and technologies for improving animal health, we initiated a literature review in 2020. We used a combined approach, incorporating targeted searching in PubMed using a key word algorithm with a snowball technique, to identify 120 relevant publications and extract data for qualitative coding. Heterogeneity of articles precluded meta-analysis, quality scoring and risk of bias analysis. We can distinguish technical innovations like new digital devices, diagnostic tests and procedures, and social innovations of intersectoral cooperation. We profile two case studies to describe potential global innovations: an integrated surveillance and response system in Somali Regional State, Ethiopia and a blockchain secured One Health intervention to optimally provide post-exposure prophylaxis for rabies exposed people in West Africa. Innovation follows no borders and can also occur in low-income settings, under constraints of cost, lack of services and infrastructure. Lower administrative and legal barriers may contribute to produce innovations that would not be possible under conditions of high density of regulation. We recommend using the term global innovation, which highlights those emanating from international partnership to solve problems of global implications.

Alkaline hydrogen peroxide pretreatment of cladodes of cactus (opuntia ficus-indica) for biogas production.

The alkaline hydrogen peroxide (AHP) pretreatment of cladodes of cactus (Opuntia ficus-indica) for biogas production was evaluated based on the delignification of cladodes of cactus. The effects of alkaline hydrogen peroxide concentration (30% w/w solution) and the pretreatment time (3, 6, 9, and 12 h) were evaluated at pH 11.5, temperature of 30 °C, and 180 rpm for removal of lignin. A batch of anaerobic digestion experiments were conducted at mesophilic temperature conditions (37 ± 1 °C) with the pretreated biomass. The feed stock (cladodes of cactus) used in this study contained 12.51 ± 1.25 cellulose, 16.34 ± 2.93% hemicellulose, and 10.45 ± 2.31% lignin, and the balance were (carbohydrate, protein, lipid, and ash). After AHP pretreatment, the lignocellulosic content of the feed stock was changed to 12.50 ± 1.84%, 13.63 ± 3.23%, and 7.49 ± 3.05% for cellulose, hemicellulose, and lignin respectively. The AHP pretreatment of cladodes of cactus highly affected the lignin structure relative to cellulose and hemicellulose. The alkaline hydrogen peroxide pretreatment resulted in a higher amount of biogas produced from 877.9 ± 15.12 ml biogas/g VS to 1613.5 ± 10.76 ml biogas/g VS which is an 83.4% increment and decreased after 9 h treatment to 1398.8 ± 17.8 ml biogas/g VS. In addition, the measured methane yields range from 302.48 ± 0.33 to 602.65 ± 3.24 ml CH4/g VS. The results showed that alkaline hydrogen peroxide pretreatment of cladodes of cactus is an effective strategy for enhance biogas yield.

Practices and Challenges of Household Solid Waste Management in Woldia Town, Northeastern Ethiopia.

BACKGROUND: The rapid growth of urban populations has led to a dramatic increase in urban waste generation with environmental and public health problems associated with water contamination, emission of toxic and noxious fumes, soil contamination and introduction of disease vector populations. OBJECTIVES: The aim of the present study was to assess solid waste disposal practices and challenges of solid waste management in Woldia town, northeastern Ethiopia. METHODS: A descriptive research design was employed, using a survey method and naturalistic observational methods. A total of 236 households were surveyed, including waste collectors and cleaners, waste pickers, and 20 students and ten teachers from Woldia secondary and preparatory schools. A purposive sampling technique (made up of municipal officers, scavengers (waste pickers), waste collectors and cleaners and a simple random sampling technique (of teachers, students and kebeles of the study area) was employed, then proportional allocation was made for each randomly selected kebeles based on population size to determine the sample. Finally, survey questionnaire, interview, focus group discussion and observation were used as data collecting tools. Bivariate and multivariate analyses were also employed. RESULTS: The current study revealed that educational status (AOR = 10.92, 95% CI = (3.12-38.27)), occupational status (AOR = 8.08, 95% CI = (2.08-31.31)), monthly income (AOR = 5.72, 95% CI = (1.55-21.13)), and age (AOR = 2.53, 95% CI = (1.04-6.19)) were found to be the major factors associated with solid waste management practices. Additionally, shortage of storage materials, lack of alternative waste disposal options, household attitudes, and lack of awareness were the major challenges for low performance of solid waste management practices of the local government and households. The focus group individuals and interviewed participants indicated that solid waste management practices were poor. CONCLUSIONS: The present study revealed that solid waste management practices in Woldia town remain inadequate. Therefore, efforts by the municipality and other stakeholders are needed to mitigate the problem of waste management and disposal practices. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: The study was approved by the Institutional Research Ethics Review committee (IRERC) of Woldia University. COMPETING INTERESTS: The authors declare no competing financial interests.

Trends of community-based systemic antibiotic consumption: Comparative analyses of data from Ethiopia and Norway calls for public health policy actions.

Studies on antibiotic utilization trends are invaluable because they offer data for evaluation of impacts of antimicrobial stewardship policies. Such studies help determine correlations between the use of specific antibiotic classes and trends in emergence of resistance (resistance-epidemiology). This study aims to quantify the consumption systemic antibiotics (J01)-in defined daily doses (DDD) per 1000 inhabitants per day (DID)-in Ethiopia's public healthcare sector (2016-2020). By so doing, it attempts to capture the extent of population exposure to antibiotics in the country. Data were also compared with those from Norway to establish rough estimate of the country's status vis-à-vis some globally acknowledged better practices with regard to optimal use of antibiotics. Raw data obtained from registers of Ethiopian Pharmaceutical Supply Agency were converted into DDD, per the standard methodology recommended by WHO. To control for population size, antibiotics consumption data were presented as DID. Since official population census data for Ethiopia were not available for the study period, population projection data from the World Bank were used. Community-based consumption of systemic antibiotics increased from 11.02 DID in 2016 to 12.83 DID in 2020 in Ethiopia-an increase by 16.4%. Moreover, analysis of a log-linear regression model showed that the average growth rate in the community-based systemic antibiotics consumption per year between 2016 and 2020 was about 3.3% (R2 = 0.89). The highest percentage change in community-based systemic antibiotics consumption happened for glycopeptides (J01XA) and the fourth generation cephalosporins (J01DE)-1300% and 600% compared to the baseline year (2016), respectively. At product level, 9 antibiotics constituted the common domain in the list of medication cocktails in the drug utilization 90% (DU90%) for the study period. Community-based consumption of systemic antibiotics for Ethiopia and Norway showed opposite trends, calling for public health policy actions in Ethiopia.

Drug and Therapeutics Committee (DTC) evolvement and expanded scope in Ethiopia.

As a key partner of Ministry of Health (MOH) Ethiopia, The Clinton Health Access Initiative (CHAI) had been implementing the Child Survival Project (CSP) since October 2015. Strengthening DTC was one of its focuses to improve overall supply chain management (SCM). The objective of this study are to review the evolution of DTCs in Ethiopia from their early years to current practice and identify the major driving and hindering factors for their functionality. A descriptive mixed study design was employed. The study made use of qualitative data supplemented with quantitative data, generated from both primary and secondary sources through key informant interviews and desk review methods. DTCs were introduced in Ethiopia in the early 1980s. The mandate of DTCs has been given to four different government organizations during that time. As a result, due to a lack of coordination among these organizations, its implementation was lagging. Recently, the government and its partners have given attention to DTCs. More than 5847 professionals underwent DTC training from 2016 onwards. DTC establishment in health facilities improved from 85% to 98% between 2015 and 2019 during baseline and end-line assessments carried out by CHAI/CSP. Similarly, DTC functionality in HFs improved from 20% to 63%. The CHAI/CSP regular supervision data analysis revealed that DTC establishment improved from 83% to 100% of HFs, while its functionality improved from 5% to 72% between 2016 and 2019, respectively. A chi-square test of independence examining the relationship between facility and pharmacy head training on DTCs and functionality of DTC in the same facility revealed a significant association between the two variables at p<0.0001. Conclusions: Providing consistent capacity building and availing strong monitoring and evaluation system improves functionality of DTCs. Moreover, national coordinating bodies for DTCs and similar structures at Regional Health Bureaus and woreda health offices should be established.

Africa's Nomadic Pastoralists and Their Animals Are an Invisible Frontier in Pandemic Surveillance.

The effects of COVID-19 have gone undocumented in nomadic pastoralist communities across Africa, which are largely invisible to health surveillance systems despite the fact that they are of key significance in the setting of emerging infectious disease. We expose these landscapes as a "blind spot" in global health surveillance, elaborate on the ways in which current health surveillance infrastructure is ill-equipped to capture pastoralist populations and the animals with which they coexist, and highlight the consequential risks of inadequate surveillance among pastoralists and their livestock to global health. As a platform for further dialogue, we present concrete solutions to address this gap.

Nutritional status and intestinal parasites among young children from pastoralist communities of the Ethiopian Somali region.

Pastoralist children in the Ethiopian Somali Regional State (ESRS) are at high risk for undernutrition and intestinal parasitic infections (IPIs). We assessed the nutritional status and its association with IPIs in 500 children <5 years of age in a clustered cross-sectional study in Adadle district, ESRS. Stool samples were microscopically examined for IPIs and biomarkers for iron and vitamin A status, anthropometry, and food variety score (FVS) were assessed. Median (interquartile range [IQR]) FVS was 2.0 (2.0, 4.0), and 35% of children were exclusively breastfed up to age 6 months. Prevalence of stunting, wasting, underweight and mid-upper arm circumference (MUAC) <12.5 cm was 30, 34, 40, and 16%, respectively. Median (IQR) haemoglobin, ferritin, and retinol-binding protein concentrations were 9.5 g dL-1 (8.2, 10.9), 6.2 µg L-1 (4.0, 10.2), and 0.8 µmol L-1 (0.67, 0.91), respectively. Prevalence of anaemia, iron, and vitamin A deficiency was 75, 91, and 30%, respectively. IPIs' prevalence was 47%; the most prevalent IPIs were Giardia lamblia (22%) and Ascaris lumbricoides (15%). Giardial infections but not A. lumbricoides increased the risk for MUAC <12.5 cm (adjusted odds ratio [aOR]: 3.50, 95% confidence interval [CI] [2.21, 5.54]). The odds for anaemia were 97% (aOR: 0.03, 95% CI [0.03, 0.07]) and 89% (aOR: 0.11, 95% CI [0.11, 0.23]) less for children with FVS >2 or with exclusive breastfeeding up to 6 months, respectively. Undernutrition and IPIs are alarmingly high in <5 years of age children in ESRS. Giardial infections and low nutritional adequacy of the diet seem to be major contributing factors to the precarious nutritional status and should be addressed by appropriate interventions.

The impact of pastoralist mobility on tuberculosis control in Ethiopia: a systematic review and meta-synthesis.

BACKGROUND: Directly observed treatment, short-course (DOTS) is the current mainstay to control tuberculosis (TB) worldwide. Context-specific adaptations of DOTS have impending implications in the fight against TB. In Ethiopia, there is a national TB control programme with the goal to eliminate TB, but uneven distribution across lifestyle gradients remains a challenge. Notably, the mobile pastoralist communities in the country are disproportionately left uncovered. The aim of this study was to summarize the evidence base from published literature to guide TB control strategy for mobile pastoralist communities in Ethiopia. MAIN TEXT: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and systematically reviewed articles in seven electronic databases: Excerptra Medical Database, African Journal Online, PubMed, Google Scholar, Centre for Agriculture and Bioscience International Direct, Cochrane Library and Web of Science. The databases were searched from inception to December 31, 2018, with no language restriction. We screened 692 items of which 19 met our inclusion criteria. Using a meta-ethnographic method, we identified six themes: (i) pastoralism in Ethiopia; (ii) pastoralists' livelihood profile; (iii) pastoralists' service utilisation; (iv) pastoralists' knowledge and awareness on TB control services; (v) challenges of TB control in pastoral settings; and (vi) equity disparities affecting pastoralists. Our interpretation triangulates the results across all included studies and shows that TB control activities observed in pastoralist regions of Ethiopia are far fewer than elsewhere in the country. CONCLUSIONS: This systematic review and meta-synthesis shows that TB control in Ethiopia does not align well with the pastoralist lifestyle. Inaccessibility and lack of acceptability of TB care are the key bottlenecks to pastoralist TB service provision. Targeting these two parameters holds promise to enhance effectiveness of an intervention.

Morphometric and genetic variation in 8 breeds of Ethiopian camels (Camelus dromedarius).

Dromedary camels (Camelus dromedarius) are a domesticated and closely guarded economic staple of indigenous people located throughout Ethiopian territorial states. Seventeen morphometric variables were examined to determine intraspecific variation among 8 pastoralist-designated breeds of camels. Additionally, DNA sequences from mitochondrial cytochrome-b gene and genotyping of 6 nuclear microsatellite loci were examined to assess genetic diversity and phylogenetic relationship of Ethiopian camels. Examination of 525 individuals revealed significant morphometric differentiation in Afar as compared with the remaining 7 breeds. Analysis of cytochrome-b sequences failed to recover monophyletic groups associated with pastoralist-recognized breeds. Analysis of 6 microsatellite loci from 104 individuals depicted no resolution of distinct genetic lineages in accordance to geographical or designated breeds. Overall, separation of 2 ecotypes based on the morphometric data was supported; however, genetic analysis of cytochrome-b and microsatellite data failed to support any unique genetic lineage or statistically significant population structure.

Vancomycin-Resistant Enterococci and Its Associated Risk Factors among HIV-Positive and -Negative Clients Attending Dessie Referral Hospital, Northeast Ethiopia.

BACKGROUND: Enterococci are becoming the most important public health concern and emerging as multidrug-resistant organisms around the world including Africa particularly in Ethiopia where there is a lack of availability of effective antimicrobial drugs. However, there is a paucity of data on the prevalence and associated risk factors of vancomycin-resistant enterococci in Ethiopia. OBJECTIVE: This study was aimed to assess the prevalence of vancomycin-resistant enterococci and its associated risk factors among HIV-positive and -negative clients. METHODS: A comparative cross-sectional study was conducted from February to May, 2017, on 300 participants at Dessie Referral Hospital. Data were gathered using a pretested structured questionnaire, stool samples were collected and inoculated on to bile esculin agar, and presumptive colonies were inoculated in brain-heart infusion broth containing 6.5% NaCl for selective identification of enterococci. Antibiotic susceptibility tests were done using the Kirby-Bauer disk diffusion method. Data were analyzed using SPSS version 22 software package. RESULTS: A total of 300 study participants were enrolled in this study, of which 57.7% were females with a mean age of 34.4, a range of 19-73 years. The overall prevalence of enterococci was 37.3%. The prevalence of VRE was 6.3%. From all isolates, the prevalence of VRE among HIV-positive and -negative clients was 5.9% and 7.4%, respectively. Resistance gentamicin, ampicillin, penicillin, and erythromycin was 37.5%, 34.8%, 34.8%, and 22.3%, respectively. Prevalence of multidrug resistance was (29.5%). Being low in hemoglobin content was significantly associated with VRE. CONCLUSION: The high prevalence of VRE and multidrug-resistant enterococci in this study signals the emergence of VRE. Detection of VRE in this study indicates decreased antibiotic treatment options of multidrug-resistant enterococci. Therefore, there should be a need to perform continuous surveillance, rational use of antibiotics, and more detailed study using phenotypic and genotypic methods.

Climate change and One Health.

The journal The Lancet recently published a countdown on health and climate change. Attention was focused solely on humans. However, animals, including wildlife, livestock and pets, may also be impacted by climate change. Complementary to the high relevance of awareness rising for protecting humans against climate change, here we present a One Health approach, which aims at the simultaneous protection of humans, animals and the environment from climate change impacts (climate change adaptation). We postulate that integrated approaches save human and animal lives and reduce costs when compared to public and animal health sectors working separately. A One Health approach to climate change adaptation may significantly contribute to food security with emphasis on animal source foods, extensive livestock systems, particularly ruminant livestock, environmental sanitation, and steps towards regional and global integrated syndromic surveillance and response systems. The cost of outbreaks of emerging vector-borne zoonotic pathogens may be much lower if they are detected early in the vector or in livestock rather than later in humans. Therefore, integrated community-based surveillance of zoonoses is a promising avenue to reduce health effects of climate change.