Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning.

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.

Prevalence of Intestinal Schistosomiasis and Associated Factors among School Children in Wondo District, Ethiopia.

BACKGROUND: Human schistosomiasis is one of the neglected tropical diseases caused by Schistosoma mansoni. Children in the developing countries live in areas with poor sanitation and most often spend time swimming or bathing in the water bodies contaminated with cercariae, the infective stages of schistosomiasis, which results in growth retardation and poor school performance. Thus, having effective control of the disease requires assessment of prevalence and risk factors. OBJECTIVE: This study was aimed at assessing the prevalence of S. mansoni and its associated factors among primary schoolchildren in Wondo district, West Arsi Zone, Ethiopia, 2018. METHODS: A cross-sectional study was carried out between January and March 2018. Stool samples from 298 schoolchildren, who were selected by simple random sampling, were examined for the ova of S. mansoni using Kato-Katz technique. Information on sociodemographic factors and other risk factors was obtained using questionnaires. The data were cleaned, coded, and entered into SPSS 22.0 statistical software and analyzed. Bivariable and multivariable logistic regression analysis was done to identify factors associated with S. mansoni infection. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was calculated, and the level of significance was declared at p values of less than 0.05. The result was presented using tables, figures, and text form. RESULT: A total of 298 study participants were involved in this study resulting in a response rate of 96.4% (298/309). The prevalence of S. mansoni infection was 11.4% (34/298). The prevalence was 8% (12/140) among males while it was 13% (22/158) among females. Swimming in rivers or ponds (AOR: 9.592; 95% CI: 1.972-46.655; P=0.005), latrine availability at household level (AOR: 0.075; 95% CI: 0.13-0.422; P=0.003), and awareness about schistosomiasis (AOR: 0.058; 95% CI: 0.004-0.409; P=0.007) were the factors independently associated with S. mansoni infection at p value < 0.05. CONCLUSION: The prevalence of S. mansoni was moderate as per the World Health Organization standard, since it was in the range of 10%-50%. This implies that schistosomiasis is still among major health problems. Thus, intensified effort is needed to address risk factors contributing to infection and control disease. Additionally, biannual mass drug administration with praziquantel is required according to the WHO standard.

Infant Feeding Practice and Associated Factors Among HIV Positive Mothers at Health Institution of Shashemene Town, South Ethiopia.

Objective: To assess Infant feeding practice and associated factors among HIV positive mothers at health institution of Shashemene town, South Ethiopia. Materials and methods: Facility based cross sectional study was conducted. The study used all the study population as source of data since they are small in number hence sample size calculation was not needed. This study was conducted at health institutions which provide ART and PMTCT service at Shashemene town. Structured questionnaires were developed by reviewing different literatures. Data collectors were trained and data were collected from February to March 2018. The data were analyzed using statistical package for social science (SPSS) version 20, descriptive statistics as well as bivariate and multivariate analysis were computed to identify the independent predictor of infant feeding practice and to control effect of confounders. Results: On this study majority 175 (90.7%) of respondent breast feed their infants. Regarding feeding option about 154 (79.8%) chose EBF followed by complementary feeding. Concerning feeding practice majority of respondent 172 (89.1%) utilize safe feeding practice. On multivariate analysis only Counseling provided by health professional on infant feeding option was found as independent predictors of infant feeding practice with [AOR = 4.538 (CI = 1.099, 18.736)]. Conclusion: Higher proportion of HIV positive mothers follow safe infant feeding practice. Counseling by health professional was found as independent predictors of infant feeding practice. Further counseling by health professional needed to discourage mixed feeding practice.

Reproductive Health Services Utilization and Associated Factors Among Adolescents in Anchar District, East Ethiopia.

Objective: To assess reproductive health service utilization and associated factors among adolescents in Anchar District, West Hararghe Zone, Oromia Region, East Ethiopia. Materials and methods: A community based cross-sectional study using quantitative and qualitative method of data collection was applied from March 1to 30, 2013. Simple random sampling method was used for quantitative and Purposive sampling technique used for qualitative method. Four hundred two adolescents were interviewed for quantitative study. Four focus groups and ten in-depth interviews were conducted for qualitative study. Binary and Multiple logistic regressions were used for association at p < 0.05 using SPSS Version 16.0 software. Qualitative data was transcribed, and result was presented by narration. Results: Forty two (39.3%) female adolescents have ever used family planning. One hundred eight four (45.8%) adolescents have ever used VCT services. Males were 5.25 times more likely to use VCT than females (AOR = 5.25,C.I = 1.07, 25.87) and those perceived themselves as high risk for HIV were 8.22 times more likely to use VCT than their counterparts (AOR = 8.22, C.I = 1.065, 35.49). Lack of adolescent reproductive health services, Harmful Traditional Practices, lack of privacy and inconvenient service hour were reasons for not utilizing the service. Conclusion: More than half of adolescents were not utilizing family planning, and VCT services. Therefore, intensified effort is needed to increase utilization of these services for adolescents.