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INTRODUCTION: An intrauterine device (IUD) is a highly effective long-acting and reversible contraceptive method widely available around the world. However, only a small proportion of women in developing countries, including Ethiopia, are currently using the method. Therefore, this study aimed to identify why IUD utilization is low in southwestern Ethiopia. MATERIAL AND METHODS: A mixed-method study involving health facilities and communities was conducted. The focus group discussions and key informant interviewees for the qualitative study were selected purposively, whereas 844 women family planning users were selected using systematic random sampling from November 1-30, 2020. Quantitative data was collected using Open Data Kit and analyzed using Stata version 16.0. Multivariable logistic regression analyses were done to identify significant factors influencing IUD use. The qualitative data were tape-recorded, transcribed, and finally, thematic analyses were done. RESULTS: A total of 784 participants were involved in the study yielding a response rate of 92.9%. Among all respondents, only 1.3%, 2.4%, and 30.0% had been using an IUD, preferred an IUD, and had the intention to use an IUD, respectively. The main reported barriers to use an IUD among qualitative participants were fear of side-effects, religious prohibitions of contraception use, husband disapproval, lack of training by health workers, misconceptions, and longer duration of use. IUD information (AOR = 2.19 [CI: 1.56-3.08]), and rich wealth status (AOR = 1.70 [CI: 1.13-2.56]) were associated with the intention to continue or start to use an IUD. CONCLUSIONS: IUD use and information on IUDs in the study area was very low. Information about IUDs, wealth status, and partner disapproval were determinant factors for intention to use an IUD. Thus, a regular awareness creation program using accessible media platforms by the government and stakeholders on IUD use is necessary to provide reliable information to the community and resolve misconceptions. In addition, women's empowerment to balance partner dominance on decision-making of contraception use and health care worker training on long-acting reversible contraceptives (LARCs) to increase access to LARC services are necessary to increase uptake of LARCs in general and of IUDs, in particular in the study regions.
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Dispositivos Intrauterinos , Humanos , Feminino , Etiópia , Anticoncepção/métodos , Serviços de Planejamento Familiar/métodos , Pesquisa QualitativaRESUMO
A cross-sectional study was conducted to assess the prevalence, molecular detection, and antimicrobial resistance of Salmonella isolates within 162 poultry farms in selected urban and peri-urban areas of central Ethiopia. A total of 1515 samples, including cloacal swabs (n = 763), fresh fecal droppings (n = 188), litter (n = 188), feed (n = 188), and water (n = 188), were bacteriologically tested. The molecular detection of some culture-positive isolates was performed via polymerase chain reaction (PCR) by targeting spy and sdfl genes for Salmonella Typhimurium and Salmonella Enteritidis, respectively. Risk factors for the occurrence of the bacterial isolates were assessed. Antimicrobial susceptibility testing of PCR-confirmed Salmonella isolates was conducted using 12 antibiotics. In this study, it was observed that 50.6% of the farms were positive for Salmonella. The overall sample-level prevalence of Salmonella was 14.4%. Among the analyzed risk factors, the type of production, breed, and sample type demonstrated a statistically significant association (p < 0.05) with the bacteriological prevalence of Salmonella. The PCR test disclosed that 45.5% (15/33) and 23.3% (10/43) of the isolates were positive for genes of Salmonella Typhimurium and Salmonella Enteritidis, respectively. The antimicrobial susceptibility test disclosed multi-drug resistance to ten of the tested antibiotics that belong to different classes. Substantial isolation of Salmonella Typhimurium and Salmonella Enteritidis in poultry and on poultry farms, along with the existence of multi-drug resistant isolates, poses an alarming risk of zoonotic and food safety issues. Hence, routine flock testing, farm surveillance, biosecurity intervention, stringent antimicrobial use regulations, and policy support for the sector are highly needed.
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BACKGROUND: Even though the immediate postpartum period is a golden time and a great opportunity to provide long-acting reversible contraceptives to prevent unintended pregnancy, its utilisation is very low in Ethiopia. Quality of care in postpartum long-acting reversible contraceptive provision is thought to be an issue for this low utilisation. Thus, continuous quality improvement intervention is necessary to increase the use of postpartum long-acting reversible contraceptives at Jimma University Medical Center. METHOD: A quality improvement intervention to offer long-acting reversible contraceptive methods to immediate postpartum women at Jimma University Medical Center was initiated in June 2019. To study the baseline prevalence of long-acting reversible contraceptive use at Jimma Medical Centre over 8 weeks, we reviewed postpartum family planning registration logbooks and patients' charts. Based on the baseline data, the quality gaps were identified, prioritised and change ideas were generated and tested over another 8 weeks towards achieving the immediate postpartum long-acting reversible contraceptive prevalence target set. RESULT: This new intervention resulted in an average increase in immediate postpartum long-acting reversible contraceptive methods use from 6.9% to 25.4% by the end of the project intervention. The major barriers to low long-acting reversible contraceptive use were lack of attention from hospital administrative staff and quality improvement teams on the provision of long-acting reversible contraceptives, lack of training of healthcare providers on postpartum contraception and unavailability of contraception commodities at each postpartum service delivery points. CONCLUSION AND RECOMMENDATIONS: The immediate postpartum long-acting reversible contraceptive use at Jimma Medical Centre was increased by training of healthcare providers, availing contraception commodities through administrative staff involvement, weekly audit and feedback on contraception use. Thus, training of the newly hired healthcare providers on postpartum contraception, involvement of hospital administrative staff, regular audits and feedback on contraception use is necessary to increase postpartum long-acting reversible contraception uptake.
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Anticoncepcionais , Melhoria de Qualidade , Gravidez , Humanos , Feminino , Etiópia , Período Pós-Parto , Recursos Humanos em HospitalRESUMO
Animal sourced foods, such as dairy products, are common sources of Salmonella enterica, a foodborne pathogen of increasing global concern, particularly in developing countries. In Ethiopia, most data on the prevalence of Salmonella in dairy products is highly varied and limited to a specific region or district. Furthermore, there is no data available on the risk factors for Salmonella contamination of cow milk and cottage cheese in Ethiopia. This study was therefore conducted to determine the presence of Salmonella throughout the Ethiopian dairy value chain and to identify risk factors for contamination with Salmonella. The study was carried out in three regions of Ethiopia, including Oromia, Southern Nations, Nationalities and Peoples, and Amhara during a dry season. A total 912 samples were collected from milk producers, collectors, processors, and retailers. Samples were tested for Salmonella using the ISO 6579-1: 2008 method, followed by PCR confirmation. Concurrent with sample collection, a survey was administered to study participants to identify risk factors associated with Salmonella contamination. Salmonella contamination was highest in raw milk samples at the production (19.7%) and at milk collection (21.3%) levels. No significant difference in the prevalence of Salmonella contamination among regions was detected (p > 0.05). Regional differences were apparent for cottage cheese, with the highest prevalence being in Oromia (6.3%). Identified risk factors included the temperature of water used for cow udder washing, the practice of mixing milk lots, the type of milk container, use of refrigeration, and milk filtration. These identified factors can be leveraged to develop targeted intervention strategies aimed at reducing the prevalence of Salmonella in milk and cottage cheese in Ethiopia.
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Background: Salmonella is one of the most common foodborne pathogens globally, and it remains a major public health concern with the increasing concern of the emergence and spread of antimicrobial-resistant strains. In Ethiopia, the information on the prevalence of Salmonella is scarce in export abattoirs. Objective: To estimate the magnitude and antimicrobial susceptibility profile of Salmonella recovered from export abattoirs located in East Shewa, Ethiopia. Methods: A cross-sectional study was conducted from January to October 2020. In the study, 345 samples were collected from five export abattoirs using a systematic random sampling method. There were 150 carcass swabs (100 from goats and 50 from sheep), 60 goat skin swabs, 60 knife swabs, and 75 human stools. The isolates were identified and characterized using standard bacteriological procedures and confirmed using Salmonella genus-specific primer by polymerase chain reaction. Isolates were subjected to antimicrobial susceptibility to 14 antibiotics using the Kirby-Bauer disk diffusion method, and the results were assessed by using Clinical and Laboratory Standards Institute 2018. Results: Of the 345 samples, 21 (6.08%; 95% CI 4.9-11.2%) were positive for Salmonella. The specific prevalence of Salmonella in carcass, skin, and knife swabs were 10 (6.67%; 95% CI 3.5-11.19%), 7 (11.67%; 95% CI 5.70-23.00%), and 4 (6.67%; 95% CI 2.50-16.64%), respectively. There was no statistically significant difference in the occurrence of Salmonella among export abattoirs and types of samples (P>0.05). In the current study, Salmonella was not isolated from sheep carcass and human stool samples. Among the 21 Salmonella isolates, 7 (33.3%) were resistant to at least 1 of the 14 antimicrobial agents tested and 2 (9.04%) of isolates were resistant to two antibiotics, tetracycline, and streptomycin. All isolates were susceptible to kanamycin, chloramphenicol, cephalothin, gentamycin, and ceftriaxone. Conclusion: Salmonella was detected in carcass, skin, and knife samples from export abattoirs, which can have serious public health consequences. Some commonly used drugs in veterinary medicine have developed antimicrobial resistance. Therefore, sufficient sanitation at abattoirs, appropriate cooking of carcasses, and rational drug use is strongly advised. Further in-depth study such as serotyping and antimicrobial-resistant gene identification is recommended.
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A cross-sectional study was conducted in December 2018 in four purposively selected villages of Bedele district, Oromia Regional State, Southwest Ethiopia. The study aimed to determine the prevalence of bovine trypanosomosis and associated risk factors of trypanosome infections in cattle. A total of 384 blood samples were collected from systematically selected cattle and examined using buffy coat and thin blood smear examination methods. The overall prevalence of bovine trypanosomosis was 8.3%. Trypanosoma congolense (68.8%) and T. vivax (31.2%) were the prevailing trypanosome species identified in the area. A statistically significant difference (P < 0.05) was observed in the prevalence of bovine trypanosomosis between body condition scores of cattle. The prevalence of bovine trypanosomosis was slightly higher in female (9%) as opposed to male (7.3%) cattle, but the difference was not statistically significant (P > 0.05). Similarly, no statistically significant difference (P > 0.05) was observed between age categories of cattle. The mean PCV value of trypanosome infected cattle (21.4 ± 3.6) was significantly (P < 0.05) lower than that of non-infected (25.6 ± 4.6). The current study indicated that, despite vector control measures implemented for several years, bovine trypanosomosis persists and continues to be a core problem to cattle health and production in the Bedele district. Therefore, more attention should be given to control the disease and its vectors based on temporal and spatial distribution. Also, the use of molecular techniques should be encouraged in view of their greater sensitivity when compared to the buffy coat method.
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PURPOSE: Salmonellosis is a foodborne zoonoses found worldwide. The main purpose of this study was to isolate and identify Salmonella and assess their antimicrobial susceptibility profiles from smallhold broilers supply chains and slaughterhouses in Bishoftu and Modjo, central Ethiopia. METHODS: Four smallhold broiler farms under the auspices of Chico Meat were selected randomly. Feed, water, and water- and feed-trough samples were collected from broiler farms, while cecal contents were collected from slaughtered chicken at Chico Meat slaughterhouse. Conventional bacteriological techniques were used to isolate and identify Salmonella from the samples. Kirby-Bauer disk diffusion was employed to assess the antimicrobial susceptibility of the isolates. RESULTS: Salmonella was isolated from 131 (24.3%, 95% CI 20.74-28.15) of the 539 samples tested. Salmonella was found in 43 of the 250 samples collected from Bishoftu (22%, 95% CI 17.02%-27.65%) and 76 of the 289 samples collected from Modjo (26.29%, 95% CI 21.32%-31.77%). Salmonella was isolated from 26.46% of the cloacal samples, 21% of the cecal contents, 30.77% of the feed samples, 25% of the water samples, 22.22% of samples from feed troughs, and 20% of samples from water troughs. The highest level of resistance (80.81%) was observed against tetracycline, followed by kanamycin (71.72%), chloramphenicol and amoxicillin (67.68%), sulfamethazole-trimethoprim (61.62%), naldixic acid (63.64%), and streptomycin (59.60%), whereas most of the isolates were susceptible to gentamicin (69.70%). Resistance to more than two drugs was also observed. CONCLUSION: Salmonella was found in high prevalence in broilers, their feed, and their environment. Moreover, a majority of the isolates were resistant to most antimicrobials used in medical and poultry practices. This has significant implications for public health and antimicrobial resistance.
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BACKGROUND: Bovine rotavirus (BRV) and bovine coronavirus (BCoV) are the most common viral agents in neonatal calf diarrhea and result in serious economic consequences. The aim of the study was to determine the epidemiology of those viruses in randomly selected dairy farms of Addis Ababa. METHODS: A cross-sectional study was conducted from November 2018 to April 2019 using a probability proportional to size (PPS) sampling technique. A total of 110 calves, less than 30 days of age, from 57 dairy herds were involved in the study. Associated factors of herds and calves were collected using semistructured interviews from farm owners and through physical observation of selected calves. Fecal samples were collected and analyzed using the sandwich ELISA method. Data generated from both semistructured interviews and laboratory investigation were analyzed using STATA_MP version 15. RESULTS: From the total 110 calves, 42 (38.18%) had diarrhea during the survey. The prevalence of bovine rotavirus and coronavirus was 3.64% (4/110) and 0.91% (1/110), respectively. Diarrhea, feeding colostrum timing, and sex of the neonatal calves had statistically significant association with bovine rotavirus infection (p < 0.05). All rotavirus-positive neonatal calves were identified in small scale dairy farms and in dairy farms that reported mortality though they lack statistically significant association. Only one coronavirus case was detected among the neonatal calves. The case was identified among small scale herds and in a herd with diarrheal cases. The sex of the coronavirus calf was female, diarrheic, and among 11-20 days old. CONCLUSION: The prevalence of rotavirus and coronavirus infections in neonatal calves was seldom in dairy farms of the study area. Rotavirus was more common than coronavirus, and further studies should be initiated on other (infectious and noninfectious) causes of neonatal calf diarrhea in the area.
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Doenças dos Bovinos/epidemiologia , Infecções por Coronavirus/veterinária , Infecções por Rotavirus/veterinária , Animais , Animais Recém-Nascidos , Bovinos , Doenças dos Bovinos/virologia , Infecções por Coronavirus/epidemiologia , Coronavirus Bovino/isolamento & purificação , Estudos Transversais , Diarreia/epidemiologia , Diarreia/veterinária , Diarreia/virologia , Etiópia/epidemiologia , Fazendas/estatística & dados numéricos , Fezes/virologia , Feminino , Masculino , Mortalidade , Prevalência , Rotavirus/isolamento & purificação , Infecções por Rotavirus/epidemiologiaRESUMO
Bovine tuberculosis (BTB) is a zoonotic bacterial infection caused by Mycobacterium bovis and is characterized by the development of granulomatous lesions in the lymph nodes, lungs and other tissues. It poses serious public health impacts and food security challenges to the agricultural sector in terms of dairy and meat productions. In Ethiopia, BTB has been considered as a priority disease because of its high prevalence in urban and peri-urban dairy farms. However, there has not been any national control program in the country. Thus, in order to initiate BTB control program in the country, information on control options is needed to tailor the best option for the Ethiopian situation. The objective of this study was to identify, evaluate and rank various BTB control options in Ethiopia using a multi-criteria decision analysis based on preference ranking organization method for enrichment evaluations (PROMETHEE) approach while accounting for the stakeholders' preferences. Control options were evaluated under two scenarios: with (scenario 1) and without (scenario 2) bacillus Calmette-Guérin (BCG) vaccination. Nine potential control options were identified that include combinations of three control options (1) test and slaughter with or without government support, (2) test and segregation, and (3) BCG vaccination. Under scenario 1, BCG vaccination, BCG vaccination and test and slaughter with partial compensation by government, and BCG vaccination and test and slaughter with full compensation by government were the top three ranked control options. Under scenario 2, test and slaughter with full compensation by government was the preferred control option, followed by test and segregation supported by test and slaughter with full government compensation, and test and slaughter with half compensation by government. Irrespective of the variability in the weighting by the stakeholders, the sensitivity analysis showed the robustness of the ranking method. In conclusion, the study demonstrated that BCG vaccination, and test and slaughter with full compensation by government were the two most preferred control options under scenarios 1 and 2, respectively. National level discussions were strongly recommended for further concretization and implementation of these control measures.