Male involvement in the use of family planning and associated factors in Gondar City, Northwest Ethiopia: A community-based cross-sectional study.

OBJECTIVE: To assess the level of male involvement in the use of family planning and associated factors among married men. METHODS: A community-based cross-sectional study was conducted from March to April 2018. Married men were randomly selected from four randomly selected kebeles, the smallest administrative division in Ethiopia. Data were collected using an interviewer-administered structured questionnaire. A multivariable logistic regression model was fitted to identify the associated factors with male involvement in the use of family planning. RESULTS: A total of 741 of 744 (99.6%) married men responded to the interview. The overall involvement of men in family planning was 70%. Men aged 25-30 years (adjusted odds ratio [AOR] 3.78, 95% confidence interval [CI] 1.67-8.54), attending secondary school education (AOR 2.25, 95% CI 1.173-4.31), attending college and higher education (AOR 7.49, 95% CI 3.87-14.51), had more than five children (AOR 14.6, 95% CI 4.37-48.97), and had 3-4 children (AOR 16.13, 95% CI 6.31-41.16) were the factors significantly associated with male involvement in family planning. CONCLUSION: The involvement of married men in family planning was low. Encouraging the education of younger men by considering those who do not have any children is an essential measure to enhance men's involvement in family planning.

A Comparison between Electron Gamma Shower, National Research Council/Easy Particle Propagation (EGSnrc/Epp) and Monte Carlo N-Particle Transport Code (MCNP) in Simulation of the INTRABEAM ® System with Spherical Applicators.

BACKGROUND: Online Monte Carlo (MC) treatment planning is very crucial to increase the precision of intraoperative radiotherapy (IORT). However, the performance of MC methods depends on the geometries and energies used for the problem under study. OBJECTIVE: This study aimed to compare the performance of MC N-Particle Transport Code version 4c (MCNP4c) and Electron Gamma Shower, National Research Council/easy particle propagation (EGSnrc/Epp) MC codes using similar geometry of an INTRABEAM® system. MATERIAL AND METHODS: This simulation study was done by increasing the number of particles and compared the performance of MCNP4c and EGSnrc/Epp simulations using an INTRABEAM® system with 1.5 and 5 cm diameter spherical applicators. A comparison of these two codes was done using simulation time, statistical uncertainty, and relative depth-dose values obtained after doing the simulation by each MC code. RESULTS: The statistical uncertainties for the MCNP4c and EGSnrc/Epp MC codes were below 2% and 0.5%, respectively. 1e9 particles were simulated in 117.89 hours using MCNP4c but a much greater number of particles (5e10 particles) were simulated in a shorter time of 90.26 hours using EGSnrc/Epp MC code. No significant deviations were found in the calculated relative depth-dose values for both in the presence and absence of an air gap between MCNP4c and EGSnrc/Epp MC codes. Nevertheless, the EGSnrc/Epp MC code was found to be speedier and more efficient to achieve accurate statistical precision than MCNP4c. CONCLUSION: Therefore, in all comparisons criteria used, EGSnrc/Epp MC code is much better than MCNP4c MC code for simulating an INTRABEAM® system.

Prevalence of pregnancy-related complications and associated factors among reproductive-aged women in northwest Ethiopia: A community-based retrospective cross-sectional study.

OBJECTIVE: To determine the Prevalence and factors associated with pregnancy-related complications among reproductive-aged women in northwest Ethiopia. METHODS: A community-based retrospective cross-sectional study was conducted among 2367 mothers who delivered from November 2018 to April 2019. Two-stage stratified random sampling technique was employed in clustered villages from three districts out of 10. Pretested and semi-structured interviewer-administered questionnaire was used to collect information on pregnancy-related complications. A binary logistic regression model was fitted to identify the associated factors. RESULTS: Overall, 2335 (98.6%) women participated in the study. Mean age of respondents was 15.4 (SD ±3.2) years and 1763 (75.5%) of the women were below 18 years of age. The number of pregnancy-related complications was 372 (15.9%). Severe headache and high fever were the most frequently reported complications. Having a history of known health problem (adjusted odds ratio [aOR] 10.0, 95% confidence interval [CI] 7.10-14.10), history of hypertension (aOR 3.90, 95% CI 1.10-14.20), heart problems (aOR 1.90, 95% CI 1.10-3.30), and living in urban areas (aOR 1.40, 95% CI 1.10-1.81) were the factors associated with pregnancy-related complications. CONCLUSION: The number of pregnancy-related complications was high. Having a history of a known health problem, having a hypertension problem, having a heart problem, and being an urban resident were contributing factors.

Randomised comparison of two household survey modules for measuring stillbirths and neonatal deaths in five countries: the Every Newborn-INDEPTH study.

BACKGROUND: An estimated 5·1 million stillbirths and neonatal deaths occur annually. Household surveys, most notably the Demographic and Health Survey (DHS), run in more than 90 countries and are the main data source from the highest burden regions, but data-quality concerns remain. We aimed to compare two questionnaires: a full birth history module with additional questions on pregnancy losses (FBH+; the current DHS standard) and a full pregnancy history module (FPH), which collects information on all livebirths, stillbirths, miscarriages, and neonatal deaths. METHODS: Women residing in five Health and Demographic Surveillance System sites within the INDEPTH Network (Bandim in Guinea-Bissau, Dabat in Ethiopia, IgangaMayuge in Uganda, Matlab in Bangladesh, and Kintampo in Ghana) were randomly assigned (individually) to be interviewed using either FBH+ or FPH between July 28, 2017, and Aug 13, 2018. The primary outcomes were stillbirths and neonatal deaths in the 5 years before the survey interview (measured by stillbirth rate [SBR] and neonatal mortality rate [NMR]) and mean time taken to complete the maternity history section of the questionnaire. We also assessed between-site heterogeneity. This study is registered with the Research Registry, 4720. FINDINGS: 69 176 women were allocated to be interviewed by either FBH+ (n=34 805) or FPH (n=34 371). The mean time taken to complete FPH (10·5 min) was longer than for FBH+ (9·1 min; p<0·0001). Using FPH, the estimated SBR was 17·4 per 1000 total births, 21% (95% CI -10 to 62) higher than with FBH+ (15·2 per 1000 total births; p=0·20) in the 5 years preceding the survey interview. There was strong evidence of between-site heterogeneity (I2=80·9%; p<0·0001), with SBR higher for FPH than for FBH+ in four of five sites. The estimated NMR did not differ between modules (FPH 25·1 per 1000 livebirths vs FBH+ 25·4 per 1000 livebirths), with no evidence of between-site heterogeneity (I2=0·7%; p=0·40). INTERPRETATION: FPH takes an average of 1·4 min longer to complete than does FBH+, but has the potential to increase reporting of stillbirths in high burden contexts. The between-site heterogeneity we found might reflect variations in interviewer training and survey implementation, emphasising the importance of interviewer skills, training, and consistent implementation in data quality. FUNDING: Children's Investment Fund Foundation.

"Every Newborn-INDEPTH" (EN-INDEPTH) study protocol for a randomised comparison of household survey modules for measuring stillbirths and neonatal deaths in five Health and Demographic Surveillance sites.

BACKGROUND: Under-five and maternal mortality were halved in the Millennium Development Goals (MDG) era, with slower reductions for 2.6 million neonatal deaths and 2.6 million stillbirths. The Every Newborn Action Plan aims to accelerate progress towards national targets, and includes an ambitious Measurement Improvement Roadmap. Population-based household surveys, notably Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys, are major sources of population-level data on child mortality in countries with weaker civil registration and vital statistics systems, where over two-thirds of global child deaths occur. To estimate neonatal/child mortality and pregnancy outcomes (stillbirths, miscarriages, birthweight, gestational age) the most common direct methods are: (1) the standard DHS-7 with Full Birth History with additional questions on pregnancy losses in the past 5 years (FBH+) or (2) a Full Pregnancy History (FPH). No direct comparison of these two methods has been undertaken, although descriptive analyses suggest that the FBH+ may underestimate mortality rates particularly for stillbirths. METHODS: This is the protocol paper for the Every Newborn-INDEPTH study (INDEPTH Network, International Network for the Demographic Evaluation of Populations and their Health Every Newborn, Every Newborn Action Plan), aiming to undertake a randomised comparison of FBH+ and FPH to measure pregnancy outcomes in a household survey in five selected INDEPTH Network sites in Africa and South Asia (Bandim in urban and rural Guinea-Bissau; Dabat in Ethiopia; IgangaMayuge in Uganda; Kintampo in Ghana; Matlab in Bangladesh). The survey will reach >68 000 pregnancies to assess if there is ≥15% difference in stillbirth rates. Additional questions will capture birthweight, gestational age, birth/death certification, termination of pregnancy and fertility intentions. The World Bank's Survey Solutions platform will be tailored for data collection, including recording paradata to evaluate timing. A mixed methods assessment of barriers and enablers to reporting of pregnancy and adverse pregnancy outcomes will be undertaken. CONCLUSIONS: This large-scale study is the first randomised comparison of these two methods to capture pregnancy outcomes. Results are expected to inform the evidence base for survey methodology, especially in DHS, regarding capture of stillbirths and other outcomes, notably neonatal deaths, abortions (spontaneous and induced), birthweight and gestational age. In addition, this study will inform strategies to improve health and demographic surveillance capture of neonatal/child mortality and pregnancy outcomes.

High resolution XUV Fourier transform holography on a table top.

Today, coherent imaging techniques provide the highest resolution in the extreme ultraviolet (XUV) and X-ray regions. Fourier transform holography (FTH) is particularly unique, providing robust and straightforward image reconstruction at the same time. Here, we combine two important advances: First, our experiment is based on a table-top light source which is compact, scalable and highly accessible. Second, we demonstrate the highest resolution ever achieved with FTH at any light source (34 nm) by utilizing a high photon flux source and cutting-edge nanofabrication technology. The performance, versatility and reliability of our approach allows imaging of complex wavelength-scale structures, including wave guiding effects within these structures, and resolving embedded nanoscale features, which are invisible for electron microscopes. Our work represents an important step towards real-world applications and a broad use of XUV imaging in many areas of science and technology. Even nanoscale studies of ultra-fast dynamics are within reach.

High speed and high resolution table-top nanoscale imaging.

We present a table-top coherent diffractive imaging (CDI) experiment based on high-order harmonics generated at 18 nm by a high average power femtosecond fiber laser system. The high photon flux, narrow spectral bandwidth, and high degree of spatial coherence allow for ultrahigh subwavelength resolution imaging at a high numerical aperture. Our experiments demonstrate a half-pitch resolution of 15 nm, close to the actual Abbe limit of 12 nm, which is the highest resolution achieved from any table-top extreme ultraviolet (XUV) or x-ray microscope. In addition, sub-30 nm resolution was achieved with only 3 s of integration time, bringing live diffractive imaging and three-dimensional tomography on the nanoscale one step closer to reality. The current resolution is solely limited by the wavelength and the detector size. Thus, table-top nanoscopes with only a few-nanometer resolutions are in reach and will find applications in many areas of science and technology.

Influence of detector noise in holographic imaging with limited photon flux.

Lensless coherent diffractive imaging usually requires iterative phase-retrieval for recovering the missing phase information. Holographic techniques, such as Fourier-transform holography (FTH) or holography with extended references (HERALDO), directly provide this phase information and thus allow for a direct non-iterative reconstruction of the sample. In this paper, we analyze the effect of detector noise on the reconstruction for FTH and HERALDO with linear and rectangular references. We find that HERALDO is more sensitive to this type of noise than FTH, especially if rectangular references are employed. This excessive noise, caused by the necessary differentiation step(s) during reconstruction in case of HERALDO, additionally depends on the numerical implementation. When considering both shot-noise and detector noise, we find that FTH provides a better signal-to-noise ratio (SNR) than HERALDO if the available photon flux from the light source is low. In contrast, at high photon flux HERALDO provides better SNR and resolution than FTH. Our findings will help in designing optimum holographic imaging experiments particularly in the photon-flux-limited regime where most ultrafast experiments operate.

Use of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide for rapid detection of rifampin-resistant Mycobacterium tuberculosis.

We describe a test which uses the ability of viable cells to reduce 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) to detect resistance to a bactericidal drug, rifampin, in in vitro-cultured Mycobacterium tuberculosis. The assay shows a linear relationship between the number of viable bacteria and the ability to reduce MTT. Dead mycobacteria were unable to reduce MTT. Rifampin-sensitive M. bovis (BCG) and M. tuberculosis exposed to rifampin showed a rifampin concentration-dependent inhibition of the ability to reduce MTT, while the resistant strains were unaffected. The inhibition of MTT reduction after treatment with rifampin paralleled the reduction in the number of CFU. By using mixing experiments in which the population percentages of rifampin-sensitive and -resistant strains were varied, the assay could detect the presence of rifampin resistance in the mixture when at least 1% of the bacterial population was composed of drug-resistant strains. The assay is cheap, can be visually read, and requires less than 3 days to obtain susceptibility results. The total time required to obtain results, from the time sputum is received in the laboratory, is, in most cases, less than 4 to 5 weeks, which is the time required for primary culture of the bacteria. The MTT assay could, in combination with a test to detect resistance to isoniazid, be a cheap and rapid screening method for multidrug-resistant M. tuberculosis that is affordable even by low-income countries where tuberculosis is a major public health problem.

An in vitro model for screening antileishmanial drugs: the human leukaemia monocyte cell line, THP-1.

Standard anti-leishmanial drugs were tested for their ability to inhibit the growth of intracellular amastigotes of Leishmania aethiopica, L. donovani and L. infantum in the human leukemia monocyte THP-1 cell line. Sodium stibogluconate and meglumine antimoniate were active against L. donovani with ED50 values of 8.9 micrograms SbV/ml and 2.9 micrograms SbV/ml, respectively. L. aethiopica was less sensitive to sodium stibogluconate with an ED50 value of 25.3 micrograms SbV/ml while pentamidine had an ED50 value of 0.6 microM. Both L. donovani (ED50, 9.3 microM), and L. aethiopica (ED50, 6.4 microM), were sensitive to aminosidine sulphate. An L. infantum isolate, clinically resistant to meglumine antimoniate treatment, had an ED50 of 22.2 micrograms SbV/ml. The toxic level of drugs on host cells was determined by colorimetric Methyl Tetrazolium (MTT) assay prior to activity tests. The results obtained with the THP-1 in vitro drug screening model were similar to those obtained in the mouse peritoneal macrophage model.

Mycobacterial-induced cytotoxic T cells as well as nonspecific killer cells derived from healthy individuals and leprosy patients.

Little information is available about the generation and specificity of the cytotoxic cells that eliminate human monocytes/macrophages infected with mycobacteria. To address this we have developed a cytotoxicity assay in which 51Cr-labeled monocytes pulsed with bacillus Calmette Guerin (BCG) or Mycobacterium leprae, were used as target cells in overnight cytotoxicity assays. As effector cells, peripheral blood mononuclear cells from healthy occupational contacts or from leprosy patients stimulated with antigen for 7 days were used. Cytotoxicity against antigen-pulsed monocytes that could be induced by mycobacterial antigens was proportional to the degree of antigen responsiveness in each individual, as measured in lymphocyte transformation tests. The lepromatous leprosy patients tested were often poor responders to BCG as well as M. leprae, both with regard to induction of cytotoxicity as well as in lympho-proliferation. Killing was significantly higher against antigen-pulsed vs. nonpulsed monocytes, although significant killing was induced against the latter as well and paralleled by induction of natural killer activity against the K-562 target cell. Cross-reactivity was observed between BCG and M. leprae, but not with unrelated antigen (tetanus toxoid) or with endogenous stress proteins induced by heat shock. M. leprae- and BCG-activated cytotoxic cells were found in both the CD4-CD8+ and CD4+CD8- populations, whereas in contrast the soluble antigen, purified protein derivative of M. tuberculosis, generated cytotoxic cells that were exclusively of the CD4+ phenotype. The involvement of both specific T cells as well as nonspecific cells in the killing of human macrophages may be important with respect to protection and immunopathology induced by mycobacterial antigens.

Electron microscopical studies on cutaneous leishmaniasis in Ethiopia. II. Parasite and host cell differences between the localized and the diffuse form.

The ultrastructure of Leishmania aethiopica parasites and their host cells was investigated in lesions of 7 patients suffering from diffuse cutaneous leishmaniasis (DCL) and in lesions of 4 patients with localized cutaneous leishmaniasis (LCL). The appearance of host cells and parasites varied considerably in both disease forms. Host cell variations occurred especially in the number of cytoplasmic vesicles, the size of the parasitophorous vacuoles, and the number of amastigotes per parasitophorous vacuole. Differences concerned the occurrence of a special macrophage-type in DCL-lesions which was characterized by an electron-translucent cytoplasm and a low degree of parasitization, larger parasitophorous vacuoles with higher numbers of amastigotes per vacuole in infected macrophages from DCL-patients, and the number of electron dense granules in host cell vacuoles of DCL-patients. The parasites inducing DCL and LCL significantly differed in size and membrane structure: Amastigotes had a length of 2.27 +/- 0.48 micron and a width of 1.77 +/- 0.40 micron in DCL-lesions, and 1.92 +/- 0.40 micron and 1.48 +/- 0.32 micron in LCL-lesions. Promastigotes obtained from DCL-patients revealed 2078 +/- 308 integral membrane particles (IMP)/micron2 and 892 +/- 246 IMP/micron2 on the P- and E-fracture faces of plasma membranes, while the corresponding values of LCL-derived promastigotes amounted to 1690 +/- 376 IMP/micron2 and 652 +/- 274 IMP/micron2, respectively.

HLA-DR and DQ antigens in insulin-dependent diabetics in Ethiopia.

Thirty-one Ethiopian insulin-dependent (or type I) diabetes mellitus (IDDM) patients and thirty-three healthy controls from the same ethnic background were typed for HLA-A, B, C, DR and DQ specificities. The frequencies of both DR3 and DR4 were significantly increased among IDDM patients (resp. p = 0.02, p = 0.01), confirming results in other populations. In contrast to observations in Caucasians, no significant negative association was found with TA10, a newly recognized DQ specificity, at least in the population studied here, whereas DQwl was more frequently observed among healthy controls (p = 0.01). Although this latter difference does not retain statistical significance after correction for the number of comparisons made, these findings may support previous results suggesting the existence of IDDM susceptibility genes associated with DR3 and DR4 and of IDDM resistance genes associated with DQ antigens.