Studying the context of psychoses to improve outcomes in Ethiopia (SCOPE): Protocol paper.

BACKGROUND: Global evidence on psychosis is dominated by studies conducted in Western, high-income countries. The objectives of the Study of Context Of Psychoses to improve outcomes in Ethiopia (SCOPE) are (1) to generate rigorous evidence of psychosis experience, epidemiology and impacts in Ethiopia that will illuminate aetiological understanding and (2) inform development and testing of interventions for earlier identification and improved first contact care that are scalable, inclusive of difficult-to-reach populations and optimise recovery. METHODS: The setting is sub-cities of Addis Ababa and rural districts in south-central Ethiopia covering 1.1 million people and including rural, urban and homeless populations. SCOPE comprises (1) formative work to understand care pathways and community resources (resource mapping); examine family context and communication (ethnography); develop valid measures of family communication and personal recovery; and establish platforms for community engagement and involvement of people with lived experience; (2a) a population-based incidence study, (2b) a case-control study and (2c) a cohort study with 12 months follow-up involving 440 people with psychosis (390 rural/Addis Ababa; 50 who are homeless), 390 relatives and 390 controls. We will test hypotheses about incidence rates in rural vs. urban populations and men vs. women; potential aetiological role of khat (a commonly chewed plant with amphetamine-like properties) and traumatic exposures in psychosis; determine profiles of needs at first contact and predictors of outcome; (3) participatory workshops to develop programme theory and inform co-development of interventions, and (4) evaluation of the impact of early identification strategies on engagement with care (interrupted time series study). Findings will inform development of (5) a protocol for (5a) a feasibility cluster randomised controlled trial of interventions for people with recent-onset psychosis in rural settings and (5b) two uncontrolled pilot studies to test acceptability, feasibility of co-developed interventions in urban and homeless populations.

Species composition, relative abundance, and habitat association of birds in Dodola dry evergreen afro-montane forest and sub-afro-alpine scrubland vegetation, southeast Ethiopia.

Background: Birds' functional groups are useful for maintaining fundamental ecological processes, ecosystem services, and economic benefits. Negative consequences of loss of functional groups are substantial. Birds are usually found at a high trophic level in food webs and are relatively sensitive to environmental change. Methods: The first surveillance bird study was carried out southeast of Ethiopia adjacent to Bale Mountain National Park aimed at investigating the composition, relative abundance, and distribution of Aves. Using regular systematic point transact sampling, the density and species composition were analyzed through the mark recapture distance sampling engine assisted by R statistical software. Results: This study recorded a total of seventy-eight bird species over two distinct seasons. Among these, fifteen species were exclusive to Erica habitats, twenty-six were found in natural forest habitats, and three were specific to plantation forest habitats. The study also discovered three endemic species. Based on the 2018 IUCN Red List categories, six of the species are globally threatened, three are near threatened, and the remaining sixty-nine are classified as least concern. The relative abundance of birds did not significantly differ across habitats and seasons, but variations were observed among blocks. Bird density was found to fluctuate across the three habitats and two seasons; however, these habitat differences were not influenced by seasonal changes. Conclusion: The findings of this study reveal that the differences in composition and relative abundance are not merely seasonal changes in the forest and Erica habitats. Instead, these habitats create microclimates that cater to specific bird species. However, this localized endemism also presents challenges. The concentration of endemic species and potential resource constraints could pose a threat to these habitat-specialist birds.

The role of Dodola Community Conservation Area for large mammal conservation, Ethiopia.

The role of community conservation areas for large mammals is rarely evaluated. We investigated the species richness and frequency of sightings of large mammals in the Dodola Community Conservation Area. The study area was stratified into three habitat types, and 49 lines transect was laid (27 Dry evergreen Afromontane forests, 20 Sub-afro-alpine habitats, and 2 plantation forests) based on the topography, land use, and vegetation cover of the study area. A total of 24 species of large mammals were identified and recorded in the study area. Though the community conservation area is home to diverse species of mammals, including some endemic and endangered ones such as mountain nyala and Bale Monkey, human encroachment, agriculture, and overgrazing are prominent in the area, putting huge pressure on flora and fauna. Therefore, we recommend the participatory approach be strengthened to ensure sustainable coexistence between people and wildlife.

Population structure and distribution of geladas (Theropithicus gelada, Ruppell 1835) in Kotu forest, Northern Ethiopia.

Endemic gelada populations outside protected areas are less investigated, and population census data are not available. As a result, a study was conducted to investigate the population size, structure, and distribution of geladas in Kotu forest and associated grasslands, in northern Ethiopia. The study area was stratified into five dominant habitat types namely, grassland, wooded grassland, plantation forest, natural forest, and bushland based on dominant vegetation type. Each habitat type was further divided into blocks, and a total counting technique was used to count the individuals of gelada. The total mean population size of gelada in Kotu forest was 229 ± 6.11. The mean ratio of male to female was 1:1.178. The gelada age composition comprised is as follows: 113 (49.34%) adults, 77 (33.62%) sub-adults, and 39 (17.03%) juveniles. The mean number of group one-male unit ranged from 1.5 ± 0.2 in the plantation forest to 4.5 ± 0.7 in the grassland habitat. On the other hand, all-male unit social system group was recorded only from grassland (1.5) and plantation forest (1) habitats. The average band size (number of individuals per band) was 45.0 ± 2.53. The largest number of geladas was recorded from grassland habitat 68 (29.87%), and the lowest was recorded from plantation forest habitat 34 (14.74%). Even though, the sex ratio was female biased, the proportion of juveniles to other age classes was very low compared with geladas in relatively well-protected areas, indicating negative consequences for the future viability of the gelada populations in the area. Geladas were widely distributed over open grassland habitat. Therefore, for sustainable conservation of the geladas in the area, there is a need for integrated management of the area with special attention on the conservation of the grassland habitat.

Causes of stillbirth and death among children younger than 5 years in eastern Hararghe, Ethiopia: a population-based post-mortem study.

BACKGROUND: Child mortality is high in Ethiopia, but reliable data on the causes of death are scarce. We aimed to gather data for the contributory causes of stillbirth and child deaths in eastern Ethiopia. METHODS: In this population-based post-mortem study, we established a death-notification system in health facilities and in the community in Kersa (rural), Haramaya (rural) and Harar (urban) in eastern Ethiopia, at a new site of the Child Health and Mortality Prevention Surveillance (CHAMPS) network. We collected ante-mortem data, did verbal autopsies, and collected post-mortem samples via minimally invasive tissue sampling from stillbirths (weighing at least 1000 g or with an estimated gestational age of at least 28 weeks) and children who died younger than 5 years. Children-or their mothers, in the case of stillbirths and deaths in children younger than 6 months-had to have lived in the catchment area for the past 6 months to be included. Molecular, microbiological, and histopathological analyses were done in collected samples. Cause of death was established by an expert panel on the basis of these data and classified as underlying, comorbid, or immediate separately for stillbirths, neonatal deaths (deaths aged 0-27 days), and child deaths (aged 28 days to <5 years). FINDINGS: Between Feb 4, 2019, and Feb 3, 2021, 312 deaths were eligible for inclusion, and the families gave consent in 195 (63%) cases. Cause of death was established in 193 (99%) cases. Among 114 stillbirths, the underlying cause of death was perinatal asphyxia or hypoxia in 60 (53%) and birth defects in 24 (21%). Among 59 neonatal deaths, the most common underlying cause was perinatal asphyxia or hypoxia (17 [29%]) and the most common immediate cause of death was neonatal sepsis, which occurred in 27 (60%). Among 20 deaths in children aged 28 days to 59 months, malnutrition was the leading underlying cause (15 [75%]) and infections were common immediate and comorbid causes. Pathogens were identified in 19 (95%) child deaths, most commonly Klebsiella pneumoniae and Streptococcus pneumoniae. INTERPRETATION: Perinatal asphyxia or hypoxia, infections, and birth defects accounted for most stillbirths and child deaths. Most deaths could have been prevented with feasible interventions, such as improved maternity services, folate supplementation, and improved vaccine uptake. FUNDING: Bill & Melinda Gates Foundation.

Daily Activity Pattern of Geladas (Theropithecus gelada, Ruppell 1835) in Kotu Forest, Northern Ethiopia.

Gelada (Theropithecus gelada) is one of the endemic primates of Ethiopia. The ecology of meta populations of geladas outside protected areas is less studied, and their population status is uncertain. As a result, we conducted a study to investigate the daily activity pattern of gelada in Kotu forest and associated grasslands in northern Ethiopia from August 2017 to February 2018 covering both wet and dry seasons. The instantaneous scan sampling method was employed to collect behavioral data. The activity pattern of three selected focal groups of geladas was studied, and predominant behavioral activities were scanned in 15 minutes intervals from dawn 7:00 h to dusk at 18:00 h. Feeding comprised 61.65% of the total scan, followed by moving 18.49%. Feeding activity was more frequent during the dry season (about 65%) than in the wet season (58.20%). On the other hand, moving activity was more frequent during the dry season (about 22%) than in the wet season (about 14%). The daily activity pattern of gelada showed a feeding peak early in the morning and in the late afternoon. The time allocated by geladas for feeding and moving in the study area is higher than other activities. Therefore, there is a need for further in-depth research on diet availability and quality to justify why geladas allocate more time for feeding and moving nexus for conservation interventions.

Diet composition and preferences of Bohor reedbuck (Redunca redunca ) in the compound of Alage College, Central Rift Valley of Ethiopia.

Numerous indices have been developed to compare use and availability of foods in field diets of wild ungulates. However, little attention has been given to laboratory analysis for comparing food preferences. To this end, a study aimed at investigating the diet composition and preference of Bohor reedbuck was conducted in the compound of Alage Agricultural College, Central Rift Valley of Ethiopia from 2017 to 2018 encompassing both dry and wet seasons. Bohor reedbuck is a medium sized horned antelope species endemic to Africa. Continuous focal animal observation was used to collect the data on plant species included in the diet of Bohor reedbuck. Focal individuals' observation was carried out for 30 min in 10 min sampling interval during their active feeding period (early morning and late afternoon) over four different habitat types. The nutrient composition of plants consumed was determined using wet chemistry laboratory analysis. Bohor reedbucks consumed 15 species of plants; herbs comprised 94.3% of the foods they consumed. Digitaria abyssinica was the most preferred plant species with highest crude protein (23.75%) and less fiber (61.8% nitrogen detergent fiber and 27.8% acid detergent fiber). These findings suggest that food preference of Bohor reedbuck is determined by the nutritional content of the plant it consumed, since the area is more or less natural habitat in terms of plant species composition. For sustainable conservation of the species, there is a need to actively promote management of the plant species most preferred by the reedbuck to feed on.

Using Participatory Workshops to Assess Alignment or Tension in the Community for Minimally Invasive Tissue Sampling Prior to Start of Child Mortality Surveillance: Lessons From 5 Sites Across the CHAMPS Network.

The Child Health and Mortality Prevention Surveillance (CHAMPS) program is a 7-country network (as of December 2018) established by the Bill & Melinda Gates Foundation to identify the causes of death in children in communities with high rates of under-5 mortality. The program carries out both mortality and pregnancy surveillance, and mortality surveillance employs minimally invasive tissue sampling (MITS) to gather small samples of body fluids and tissue from the bodies of children who have died. While this method will lead to greater knowledge of the specific causes of childhood mortality, the procedure is in tension with cultural and religious norms in many of the countries where CHAMPS works-Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa. Participatory Inquiry Into Community Knowledge of Child Health and Mortality Prevention (PICK-CHAMP) is a community entry activity designed to introduce CHAMPS to communities and gather initial perspectives on alignments and tensions between CHAMPS activities and community perceptions and priorities. Participants' responses revealed medium levels of overall alignment in all sites (with the exception of South Africa, where alignment was high) and medium levels of tension (with the exception of Ethiopia, where tension was high). Alignment was high and tension was low for pregnancy surveillance across all sites, whereas Ethiopia reflected low alignment and high tension for MITS. Participants across all sites indicated that support for MITS was possible only if the procedure did not interfere with burial practices and rituals.

Seasonal abundance and habitat use of bird species in and around Wondo Genet Forest, south-central Ethiopia.

The habitat use and seasonal migratory pattern of birds in Ethiopia is less explored as compared to diversity studies. To this end, this study aimed at investigating the patterns of distribution related to seasonality and the effect of habitat characteristics (elevation, slope, and average vegetation height) on habitat use of birds of Wondo Genet Forest Patch. A stratified random sampling design was used to assess the avian fauna across the four dominant habitat types found in the study area: natural forest, wooded grassland, grassland, and agroforestry land. A point transect count was employed to investigate avian species richness and abundance per habitat type per season. Ancillary data, such as elevation above sea level, latitude and longitude, average vegetation height, and percent slope inclination, were recorded with a GPS and clinometers per plot. A total of 33 migratory bird species were recorded from the area, of which 20 species were northern (Palearctic) migrants while 13 were inter-African migrants. There was a significant difference in the mean abundance of migratory bird species between dry and wet seasons (t = 2.13, p = .038, df = 44). The variation in mean abundance per plot between the dry and wet seasons in the grassland habitat was significant (t = 2.35, p = .051, df = 7). In most habitat types during both dry and wet seasons, omnivore birds were the most abundant. While slope was a good predictor for bird species abundance in the dry season, altitude and average vegetation height accounted more in the wet season. The patch of forest and its surrounding is an important bird area for migratory, endemic, and global threatened species. Hence, it is conservation priority area, and the study suggests that conservation coupled with ecotourism development is needed for its sustainability.