Acute poisonings during pregnancy and in other non-pregnant women in emergency departments of four government hospitals, Addis Ababa, Ethiopia: 2010-2015.

OBJECTIVE: To characterise acute poisonings in pregnant and non-pregnant women treated at emergency departments of government hospitals in Addis Ababa, Ethiopia, between 2010 and 2015. METHODS: All data for acutely poisoned women were retrospectively collected from patient medical charts at the emergency departments of Saint Paul's Hospital Millennium Medical College, Ras Desta Memorial Hospital, Yekatit 12 Hospital Medical College and Zewditu Memorial Hospital. Data were collected by extraction questionnaire and analysed using SPSSv. 20 statistical software. RESULTS: During the study period, 998 cases of acutely poisoned women were listed in the hospital registries. Of these, complete data for inclusion in the study were available for 592. 36.3% of the study participants were in the age group of 20-24, with a mean (±SD) age of 23.03 (±6.3) years. 80.9% were from Addis Ababa; 4.6% were pregnant. The mean arrival time of all cases was 4.14 h. 85.5% of all study cases were due to intentional self-poisoning, of whom 42.1% were discharged without complications. The most common poisons were bleach and organophosphates; 25.9% of pregnant cases and 32.6% of non-pregnant cases were poisoned by bleach; and 18.5% of pregnant cases and 18.9% of non-pregnant cases had organophosphate poisoning. 0.7% had a history of poisoning; all were non-pregnant women. The common route of poison exposure was oral, and the case fatality rate of organophosphate poisoning in pregnant and non-pregnant women was 20 and 1.87%, respectively. The pre-hospital intervention for the majority of the women was milk, in 12.0% of cases. CONCLUSION: Acute poisoning remains a public health problem in our community. Bleach is the most common poisons. Our present findings indicate the necessity of educational programmes on preventable reasons of acute poisonings and their outcomes on pregnant and non-pregnant women.

Obesity in young age is a risk factor for preeclampsia: a facility based case-control study, northwest Ethiopia.

BACKGROUND: Preeclampsia is one of the most commonly encountered hypertensive disorders of pregnancy. For many years, obesity has been suggested to play a role in preeclampsia. However, the hypotheses have been diverse and often revealed inconsistent results. This study has aimed to estimate the effect of obesity and dietary habits on preeclampsia in Bahir Dar City, north-western Ethiopia. METHODS: A facility-based unmatched case-control study was conducted on 453 (151 cases and 302 controls) pregnant women, attending antenatal care or skilled delivery at Bahir Dar City. Data were collected through face to face interviews and measurements of mid-upper-arm circumference (MUAC) at the time of the interviews. Data were cleaned and entered into IBM SPSS version 20 and later analyzed using STATA version 12. Univariate and multivariate logistic regression analyses were employed to estimate the effect of independent variables on preeclampsia. Stratified analysis was conducted to check for presence of confounding and/or effect modification between covariates. RESULT: The odds of preeclampsia were higher among obese (MUAC ≥25 cm) women than their leaner counterparts (AOR = 3.33, 95 % CI: 1.87, 5.79). Obesity was also found to have a similar magnitude of risk for late onset preeclampsia (AOR = 3.63, 95 % CI: 1.89, 6.97). When stratified by age, the effect of obesity on overall and late onset preeclampsia was significant among young (age < 35 years) women (COR = 1.81, 95 % CI: 1.11, 2.99) and (COR = 2.09, 95 % CI: 1.16, 3.86), respectively. As the age groups became more homogenous through adjusted stratification, obesity showed a particularly significant effect in women age ≤24 and 25-29 years; (AOR = 2.31, 95 % CI: 1.06, 5.12) and (AOR = 3.66, 95 % CI: 1.37, 10.87) respectively. Similarly, the effect of obesity on late onset preeclampsia was evident among younger women age ≤24 and 25-29 years; (AOR = 3.16, 95 % CI: 1.21, 8.24) and (AOR = 1.98, 95 % CI: 1.16, 3.40) respectively. However, obesity has no significant effect on early onset of preeclampsia (AOR = 1.98, 95 % CI: 0.79, 4.94). On the other hand, compliance to folate supplementation during pregnancy and fruit consumption were associated with reduced risk of preeclampsia. CONCLUSION: Obesity in young age was found to be a risk factor for preeclampsia while compliance to folate supplement and adequate fruit consumption were found to be protective against preeclampsia. Promoting healthy life style, including body weight control, consumption of fruits and vegetables, and folate supplementation should be promoted to reduce the risk of preeclampsia.

Antidiarrheal activities of methanolic crude extract and solvent fractions of the root of Verbascum sinaiticum Benth. (Scrophularaceae) in mice.

Background: In Ethiopian traditional medicine, V. sinaiticum is one of the most often utilized medicinal herbs for the treatment of diarrhea. Therefore, this study was conducted to validate the use of the plant for the treatment of diarrhea in the traditional medical practice of Ethiopia. Methods: Castor oil-induced diarrhea, enteropooling, and intestinal motility test models in mice were used to evaluate the antidiarrheal properties of the 80% methanol crude extract and the solvent fractions of the root component of V. sinaiticum. The effects of the crude extract and the fractions on time for onset, frequency, weight, and water content of diarrheal feces, intestinal fluid accumulation, and intestinal transit of charcoal meal were evaluated and compared with the corresponding results in the negative control. Results: The crude extract (CE), aqueous fraction (AQF), and ethyl acetate fraction (EAF) at 400 mg/kg (p < 0.001) significantly delayed the onset of diarrhea. Besides, the CE and AQF at 200 and 400 mg/kg (p < 0.001) of the doses, and EAF at 200 (p < 0.01) and 400 mg/kg (p < 0.001) significantly decreased the frequency of diarrheal stools. Furthermore, CE, AQF, and EAF at their three serial doses (p < 0.001), significantly reduced the weights of the fresh diarrheal stools as compared to the negative control. The CE and AQF at 100 (p < 0.01), and 200 and 400 mg/kg (p < 0.001) of their doses and EAF at 200 (p < 0.01) and 400 mg/kg (p < 0.001) significantly decreased the fluid contents of diarrheal stools compared to the negative control. In the enteropooling test, the CE at 100 (p < 0.05), and 200 and 400 mg/kg (p < 0.001), AQF at 200 (P < 0.05) and 400 mg/kg (p < 0.01), and EAF at 200 (p < 0.01) and 400 mg/kg (p < 0.001) significantly decreased the weights of intestinal contents compared to the negative control. Additionally, the CE at 100 and 200 (p < 0.05) and 400 mg/kg (p < 0.001), AQF at 100 (p < 0.05), 200 (p < 0.01), and 400 mg/kg (p < 0.001) of the doses, and EAF at 400 mg/kg (p < 0.05), produced significant reductions in the volumes of intestinal contents. In the intestinal motility test model, the CE, AQF, and EAF at all their serial doses (p < 0.001), significantly suppressed the intestinal transit of charcoal meal and peristaltic index compared to the negative control. Conclusion: Overall, the results of this study showed that the crude extract and the solvent fractions of the root parts of V. sinaiticum had considerable in vivo antidiarrheal activities. Besides, the crude extract, especially at 400 mg/kg, produced the highest effect followed by the aqueous fraction at the same dose. This might indicate that the bioactive compounds responsible for the effects are more of hydrophilic in nature. Moreover, the antidiarrheal index values were increased with the doses of the extract and the fractions, suggesting that the treatments might have dose-dependent antidiarrheal effects. Additionally, the extract was shown to be free of observable acute toxic effects. Thus, this study corroborates the use the root parts of V. sinaiticum to treat diarrhea in the traditional settings. Furthermore, the findings of this study are encouraging and may be used as the basis to conduct further studies in the area including chemical characterization and molecular based mechanism of actions of the plant for its confirmed antidiarrheal effects.

Utilization of non-pneumatic anti-shock garment for the management of obstetric hemorrhage among healthcare providers in north Shewa zone, Ethiopia.

Background: Global maternal deaths have either increased or stagnated tragically. Obstetric hemorrhage (OH) remains the major cause of maternal deaths. Non-Pneumatic Anti-Shock Garment (NASG) has several positive results in the management of obstetric hemorrhage in resource-limited settings where getting definitive treatments are difficult and limited. Therefore, this study aimed to assess the proportion and factors associated with the utilization of NASG for the management of obstetric hemorrhage among healthcare providers in the North Shewa zone, Ethiopia. Methods: A cross-sectional study was conducted at health facilities of the north Shewa zone, Ethiopia from June 10th-30th/2021. A simple random sampling (SRS) technique was employed among 360 healthcare providers. Data were collected using a pretested self-administered questionnaire. EpiData version 4.6 and SPSS 25 were used for data entry and analysis, respectively. Binary logistic regression analyses were undertaken to identify associated factors with the outcome variable. The level of significance was decided at a value of p of <0.05. Results: The utilization of NASG for the management of obstetric hemorrhage among healthcare providers was 39% (95%CI: 34-45). Healthcare providers who received training on NASG (AOR = 3.3; 95%CI: 1.46-7.48), availability of NASG in the health facility (AOR = 9.17; 95%CI: 5.10-16.46), diploma (AOR = 2.63; 95%CI: 1.39-3.68), bachelor degree (AOR = 7.89; 95%CI: 3.1-16.29) and those healthcare providers who have a positive attitude toward utilization of NASG (AOR = 1.63; 95%CI: 1.14-2.82) were variables positively associated with the utilization of NASG. Conclusion: In this study, almost two-fifths of healthcare providers used NASG for the management of obstetrics hemorrhage. Arranging educational opportunities and continuous professional development training for healthcare providers, providing in-service and refresher training, and making it available at health facilities may help healthcare providers to effectively use the device, thereby reducing maternal morbidity and mortality.

Women's traditional birth attendant utilization at birth and its associated factors in Angolella Tara, Ethiopia.

BACKGROUND: In developing countries, home delivery without a skilled birth attendant is a common practice. It has been evidenced that unattended birth is linked with serious life-threatening complications for both the women and the newborn. Institutional delivery with a skilled birth assistance could reduce 20-30% of neonatal mortality. This study aimed to assess traditional birth attendants' (TBAs) utilization and associated factors for women who gave birth in the last two years in Angolella Tara District, Ethiopia. METHODS: A community-based cross-sectional study was employed among 416 women who gave birth in the last two years at rural Angolella Tara District. Study participants were recruited by using a simple random sampling technique. Data were collected using a structured, pretested, and interviewer-administered questionnaire. Epi Data 4.6 and SPSS version 25 were used for data entry and analysis, respectively. A multivariable logistic regression model was fitted to identify factors associated with women's utilization of traditional birth attendants. The level of significance in the last model was determined at a p-value of <0.05. RESULT: Overall, 131 (31.5%) participants were used traditional birth attendants in their recent birth. Unmarried marital status (AOR 2.63; 95% CI: 1.16, 5.97), age at first marriage (AOR 2.31; 95%CI: 1.30, 4.09), time to reach health facility (AOR = 3.46; 95% CI: 1.94, 6.17), know danger sign of pregnancy and childbirth (AOR = 5.59, 95% CI; 2.89, 10.81), positive attitude towards traditional birth attendants (AOR = 2.56 95% CI; 1.21,5.52), had antenatal care follow-up (AOR: 0.11 95% CI 0.058, 0.21), and listening radio (AOR = 0.43; 95% CI: 0.18, 0.99) were significantly associated factors with the use of traditional birth attendants. CONCLUSION: Nearly one-third of women used traditional birth attendant services for their recent birth. TBAs availability and accessibility in the community, and respect for culture and tradition, problems regarding infrastructure, delay or unavailability of ambulance upon call, and some participants knowing only TBAs for birth assistance were reasons for preference of TBAs. Therefore, effort should be made by care providers and policymakers to ensure that modern health care services are accessible for women in a friendly and culturally sensitive manner. In addition, advocacy through mass media about the importance of maternal health service utilization, particularly antenatal care would be important.

Does Moringa stenopetala based diet consumption decrease burden of under nutrition in under-five children, Southern Ethiopia?

Background: Moringa stenopetala is used for medicinal and nutritional purposes. This study was, therefore, conducted to assess the contribution of Moringa stenopetala based diet in reducing under nutrition in under-five children in four districts of Southern Ethiopia. Method: A community-based comparative cross-sectional study design was employed from August to September 2016 in randomly selected comparative sites among 732 under five children. Anthropometric measurements of weight and height of children were measured based on the standard measurement protocol. Regarding moringa stenopetala diet, the consumption habit was collected by using a seven days food frequency questionnaire. Amount of moringa stenopetala leaf biomass portion size consumption was measured with local measurement and converted to kilograms. Anthropometric data were analyzed using WHO Anthro software to determine the nutritional status of the child. An independent t-test was conducted to compare the mean difference of WHO-Z score of child nutritional index. Statistical mean significance difference was measured based on p-value less than 0.05 with 95% confidence level. In addition chi-square test with a p-value, less than 0.05 with a 95% confidence level was used to compare the prevalence of stunting, wasting, and underweight in moringa stenopetala based diet and non-moringa stenopetala based diet consuming area. Result: The prevalence of stunting was 19% vs. 28.8%, wasting 4.7% vs. 9.6%, and underweight 12.19% vs 13.71% in moringa stenopetala based diet consuming and non-consuming participants respectively. There was a significant difference in stunting and wasting (p < 0.05) among moringa stenopetala based diet-consuming and non-consuming participants. Conclusion: The present study showed that moringa stenopetala based diet consumption had a significant contribution in reducing under-nutrition in under-five children.

The Pan African Vivax and Ovale Network (PAVON): Refocusing on Plasmodium vivax, ovale and asymptomatic malaria in sub-Saharan Africa.

The recent World Malaria report shows that progress in malaria elimination has stalled. Current data acquisition by NMCPs depend on passive case detection and clinical reports focused mainly on Plasmodium falciparum (Pf). In recent times, several countries in sub-Saharan Africa have reported cases of Plasmodium vivax (Pv) with a considerable number being Duffy negative. The burden of Pv and Plasmodium ovale (Po) appear to be more than acknowledged. Similarly, the contribution of asymptomatic malaria in transmission is hardly considered by NMCPs in Africa. Inclusion of these as targets in malaria elimination agenda is necessary to achieve elimination goal, as these harbor hypnozoites. The Pan African Vivax and Ovale Network (PAVON) is a new consortium of African Scientists working in Africa on the transmission profile of Pv and Po. The group collaborates with African NMCPs to train in Plasmodium molecular diagnostics, microscopy, and interpretation of molecular data from active surveys to translate into policy. Details of the mission, rational and modus operandi of the group are outlined.

Experience and Challenges of Objective Structured Clinical Examination (OSCE): Perspective of Students and Examiners in a Clinical Department of Ethiopian University.

BACKGROUND: Invented nearly half a century ago, Objective Structured Clinical Examination (OSCE) is overwhelmingly accepted clinical skills assessment tool and has been used worldwide for evaluating and teaching learners' competences in health care disciplines. Regardless of factors affecting the attributes, OSCE is considered as reliable and powerful tool with certain validity evidences. In spite of its advantages and various promotion efforts, the progress of OSCE implementation in Ethiopian public universities has not been satisfactory. Therefore, the objective of this study was to explore the experience and challenges of OSCE implementation from the perspective of clinical year-II medical students and their examiners in Ob-Gyn Department of Jimma University. METHODS: Forty-nine students and seven examiners voluntarily participated in Ob-Gyn Department where OSCE has been used as one of summative assessment methods. Qualitative study design using structured open-ended questionnaire as a tool and descriptive phenomenology as underpinning method were employed. Collaizzi's descriptive analysis was used as phenomenological analysis approach. RESULT: Poor organization, inadequate student preparation time, and inadequate number and duration of stations were thematically emerged as umbrellas of factors negatively affecting OSCE implementation. Satisfaction with OSCE was the only theme with findings that encourage OSCE implementation. CONCLUSION: There should be team approach, shared responsibility and proper planning among faculty to minimize hindering factors of OSCE implementation. Besides faculty development on OSCE, the department should improve skill lab utilization arranging schedule for both students and faculty members to increase guided students' exposure to simulation-based learning and ultimately enhance OSCE implementation.

Effectiveness and Key Success Factors for Implementation of Problem-Based Learning in Debre Tabor University: A Mixed Methods Study.

BACKGROUND: Problem-based learning has been adopted as a core educational strategy for education of health professionals in more than a dozen of higher education institutions in Ethiopia. Debre Tabor University College of Health Sciences (DTUCHS) is one of the adopters. However, its effectiveness has not been researched yet. Thus, the objective of this study is to assess the quality of PBL implementation, its effectiveness in developing desired student learning outcomes and factors that facilitate or impede PBL implementation. METHODS: A cross-sectional study was conducted in DTUCHS from May to June 2018. We collected quantitative data from students and tutors using self-administered questionnaire. We complemented this with key informant interviews with academic leaders. We computed descriptive statistics from quantitative data while qualitative data were subjected to thematic analysis. RESULTS: A total of 308 students, 42 tutors and 8 academic leaders were included in the study. Students, tutors and academic leaders perceived that PBL was effective in developing knowledge, problem-solving skills, self-directed learning skills and collaboration competencies. The implementation process showed the existence of clear objectives, appropriate cases, and reasonable workload. Students rated tutors' performance positively, and tutors also rated student learning affirmatively. However, unlike tutors, students thought that the assessment of student performance in PBL was not appropriate. The factors that facilitated PBL implementation were students' and tutors' buy-in, clear curriculum design, adequate infrastructure, commitment to hire more faculty and develop their teaching skills continuously and strong coordination and monitoring. CONCLUSION: The findings of our study support the introduction of PBL in a resource-constrained setting. Students, tutors and academic leaders perceived PBL to be effective in achieving desired student learning outcomes. Its implementation was considered consistent with the principles of PBL. Respondents identified the presence of enabling factors to implement PBL in Debre Tabor University (DTU).

Factors Associated with the Unplanned Pregnancy at Suhul General Hospital, Northern Ethiopia, 2018.

BACKGROUND: Unplanned pregnancy is a fundamental concept that is used to recognize the fertility of populations and the unmet need for contraception and family planning. Unplanned pregnancy happened mainly due to the results of not using contraception or inconsistent or incorrect use of effective methods. Reducing the number of unplanned pregnancy endorses reproductive health mainly by reducing the number of times a woman is exposed to the risk of pregnancy and childbearing. OBJECTIVE: This study is aimed at assessing the magnitude of unplanned pregnancy and associated factors among pregnant mothers attending antenatal care at Suhul General Hospital, Northern Ethiopia. METHODS: A facility-based cross-sectional study design was conducted among pregnant mothers visiting antenatal care follow-up from February to April 2018 at Suhul General Hospital, Shire, and Northern Ethiopia. The study participants were selected using a systematic sampling method, and the data was collected using a pretested structured questionnaire through face-to-face interviews. Bivariate and multivariate logistic regression analyses were done to determine the association of each independent variable with the dependent variable. RESULT: The magnitude of unplanned pregnancy among 379 pregnant mothers was 20.6%. Unmarried women [AOR: 4.73, 95% CI: (1.56, 14.33)], age above forty [AOR: 4.17, 95% CI: (1.18, 14.6)], had no history of unplanned pregnancy [AOR: 3.26 95% CI: (1.65, 6.44)], and unemployed [AOR: 6.79; 95% CI: (2.05, 22.46)] were the variables significantly associated with the magnitude of unplanned pregnancy. Conclusion and Recommendation. The findings of this study showed that the magnitude of unplanned pregnancy was high and age, marital status, occupation, and history of unplanned pregnancy were statistically associated with an unplanned pregnancy. There is seeming necessity to plan strategies of communication within couples or individuals on reproductive especially on fertility and promote family planning methods.

Unmet need for family planning in Ethiopia and its association with occupational status of women and discussion to her partner: a systematic review and meta-analysis.

BACKGROUND: Unmet need refers to fecund women who either wish to postpone the next birth (spacers) or who wish to stop childbearing (limiters) but are not using a contraceptive method. Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for family planning. Therefore, the objective of this systematic review and meta-analysis is to estimate the pooled prevalence of unmet need for family planning and its association to occupational status of women and discussion to her partner among fecund women in Ethiopia. METHOD: A systemic review and meta-analysis was conducted using published and unpublished research on the prevalence of unmet need for family planning and its association to occupational status of women and discussion to her partner among fecund women in Ethiopia. Data extraction was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were accessed through electronic web-based search from PubMed, Cochrane Library, Google Scholar, CINAHL, and Embase. All statistical analysis were done using STATA version 14 software using random effects model. The pooled prevalence was presented in forest plots. RESULTS: A total of 9 studies with 9785 participants were included, and the overall pooled estimated prevalence of unmet need for family planning among fecund women in Ethiopia was 34.90% (95% CI: 24.52, 45.28%). According to subgroup analysis the estimated prevalence of unmet need for family planning in studies conducted in Amhara was 32.98% (95% CI: 21.70, 44.26%), and among married women was 32.84% (95% CI: 16.62, 49.07%). Additionally, housewife women were 1.6 times more likely have unmet need for family planning compared to government employed women (OR: 1.6, 95% CI: 1.29, 1.99). Moreover, women who don't discuss to partner were 1.87 times more likely to have unmet need for family planning compared to women who had discussion to her partner (OR 1.87; 95% CI: 1.52, 2.31). CONCLUSION: The analysis revealed that the overall prevalence of unmet need for family planning among fecund women in Ethiopia was high. Family planning programs should identify strategies to improve communication in family planning among couples and to ensure better cooperation between partners.

Preparedness and Responses of Healthcare Providers to Combat the Spread of COVID-19 Among North Shewa Zone Hospitals, Amhara, Ethiopia, 2020.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging respiratory disease that is caused by a novel coronavirus and was first detected in December 2019 in Wuhan, China. The disease is highly infectious, and its main clinical symptoms include fever, dry cough, fatigue, myalgia, and dyspnea. Healthcare providers are in front in fighting the coronavirus spread by making themselves the risk of contracting the disease. OBJECTIVE: To assess the preparedness and responses of healthcare providers to combat the spread of COVID-19 among North Shewa Zone Hospitals, Amhara, Ethiopia. METHODS: Facility-based cross-sectional study was conducted from April to May 2020 among 422 healthcare providers in the North Shewa Zone, Amhara, Ethiopia using a self-administered questionnaire. Study subjects were selected through systematic random sampling based on their proportional distribution of sample size to each hospital. A structured questionnaire was used to collect the data. The data were coded and entered into the Epi data 4.2.1 version and the analysis was carried out in Statistical Package for Social Science 25 versions. RESULTS: Four hundred four participants involved in the study have been given a response rate of 95.7%. The self-satisfaction of healthcare providers revealed 301 (74.5%) of study participants feel unsafe in their workplace. Two-third, 260 (64.4%), of them responded that they feel anxious while working with febrile patients. Nearly one-third (31%), 27.4%, 15.9%, 14.5%, 14.2% of HCPs had access to gloves, facemask, goggle, shoe, and apron respectively in hospitals. CONCLUSION: Protecting healthcare workers is a public health priority. Access to essential personal protective equipment during the COVID-19 pandemic was limited. The poor perception of healthcare professionals about not having enough support from medical institutions and public health authorities raises the need to urgently implement strategies to protect healthcare workers in the time of the COVID-19 pandemic.

Unmet need for family planning and its associated factor among women of reproductive age in Debre Berhan Town, Amhara, Ethiopia.

OBJECTIVE: Unmet need refers to fecund women who either wish to postpone the next birth (spacers) or who wish to stop childbearing (limiters) but are not using a contraceptive method. The aim of this study was to assess the unmet needs of family planning and identify associated factors in Debre Berhan town among women in reproductive age. The community-based cross-sectional study design was used among 411 study participants (women with reproductive age) at Debre Berhan town. A systematic sampling technique was used to select the households. Bivariate and multivariable analyses were done to determine the association of each independent variable with the dependent variable. RESULTS: The overall unmet need for family planning among women in reproductive age groups was found to be 30.9%. Occupational status AOR = 13.992 (1.054-185.833), from whom the respondents got information about family planning AOR = 0.018 (0.002-0.170), having a discussion with husband AOR = 16.692 (2.911-95.713) and support from husband AOR = 0.005 (0.001-0.025) was significantly associated with the outcome variable. The level of unmet need for family planning in the study area is still high compared to the target set (10%) in the national family planning guide plan for Ethiopia.

Iodine level concentration, coverage of adequately iodized salt consumption and factors affecting proper iodized salt utilization among households in North Ethiopia: a community based cross sectional study.

INTRODUCTION: Adequate iodine fortified salt is the most common and effective method of preventing iodine deficiency. Studies showed households using iodized salt (15 Parts Per Million (PPM) to 80 PPM) of iodine at household level were low in Tigray region and other regions of Ethiopia. Limited studies have conducted on utilization of iodized salt at the household level and none of them did not addressed on factors affecting to proper iodized salt utilization. The aim of this study was to determine the iodine concentration in the collected salt samples, adequately iodized salt consumption coverage and identify factors affecting to proper iodized salt utilization amongst the households of Northern Ethiopia. METHODS: Community based cross-sectional designs on selected 318 household food caterers were interviewed and salt samples were accordingly collected. Data was analyzed by the SAS-9.2 statistical software package. The iodine concentrations of the salt samples were determined by using the golden standard iodometric titration technique. Logistic Generalized Estimating Equation (GEE) statistical analysis method was used to assess factors affecting proper iodized salt utilization at household level. RESULTS: Adequately iodized salt coverage among the households was only 51 (17.5%). About 42 (14.38%) had 15 ppm (ppm) - 80 ppm, 9 (3.08%) had > 80 ppm, 188 (64.4%) had 1.1 ppm to 14.9 ppm and 53 (18.2%) had no iodine in the salt (0 ppm). Only 26 (8.9%) of the households had used iodized salt properly. Family size with Adjusted Odds Ratio (AOR) (0.82) and 95%CI [0.67, 0.92], residency of the household with AOR (2.83) and 95%CI [1.48, 5.40], the availability of iodized salt with AOR (3.90) and 95% CI [1.74, 8.7] and affordability to iodized salt with AOR (3.33) and 95% CI [1.41, 7.34] was strong predictors to proper iodized salt utilization. CONCLUSIONS: Coverage of adequately iodized salt was low. Family size, residency, availability and affordability of iodized salt were the predictors of proper iodized salt utilization. To enhance USI utilization effective inspection and regulatory measures should be taken to prevent the production and distribution of under/ over iodized salt in the market.

Effect of rice variety and blending proportion on the proximate compositions, minerals and phytic acid contents of bread from rice-teff blend.

Development of bakery products containing rice ( Oryza sativa, Linn.) and teff ( Eragrostis tef) could have potential health benefits due to their gluten free nature. Nine experimental runs were generated using custom design by JMP 8 software. The effect of two factors, rice variety (Edeget, X-jigna and Nerica-4) and blending proportions of rice and teff (0.5:0.5, 0.7:0.3 and 0.9:0.1) were studied. The data analysis was conducted using SAS software package for the mean comparison and custom design by JMP 8 software. Response surface methodology was applied to study the interaction effect of the main factors and to generate the predictive equations. An optimal value (1.60%) of fiber was obtained when the proportion of the blend was 50% Edeget and 50% teff because teff grain is high in fiber. A maximum value (10.75%) of protein was obtained when the proportion of the blend was 70% Nerica-4 and 30% teff. Carbohydrate was optimal (81.37%) when 90% Edeget and 10% teff were blended because rice grain is high in carbohydrate. Optimal iron content (12.97 mg/100g) was obtained when the proportion of the blend was 50% Nerica-4 and 50% teff because teff grain is high in iron. Optimal zinc content (4.14 mg/100g) was obtained when the proportion of the blend was 50% X-jigna and 50% teff. The optimal value (61.25 mg/100g) of calcium was obtained when the proportion of the blend was 50% Edeget and 50% teff.  Optimum (lower) value (0.31mg/g) of phytic acid was obtained when the proportion of the blend was 90% Nerica-4 and 10% teff because rice grain is lower in phytic acid content. It was concluded that rice variety and rice-teff blending proportion had a significant effect on the physico-chemical properties of rice-teff blend bread. An optimal nutrient blend (high in nutrients, low in anti-nutrients) was obtained when 70% Edeget rice variety was blended with 30% teff. All the derived mathematical models for the various responses were found to fit significantly to the predicted data.

The McGill Pain Questionnaire in Amharic: Zwai Health Center patients' reports on the experience of pain.

This paper presents for the first time an Amharic translation of the McGill Pain Questionnaire developed by Melzack and used in many countries around the world. It allows for a quantitative and qualitative assessment of the intensity, location, and nature of experienced pain, as well as conditions that relieve pain. Data collected from one hundred patients attending the Zwai Health Center indicated that 81% reported pain at the time, one-quarter of whom were in severe pain. The most commonly chosen descriptors were: burning, stabbing, sore, gnawing, aching, and cramping. Descriptors were often associated with certain diagnoses: burning with gastrointestinal problems, stabbing with respiratory diseases, and gnawing or aching with myalgia/neuralgia. Approximately 40% of those in pain had previously sought relief from a clinic or pharmacy and were attending the center because the pain persisted. Analgesics were more likely to be prescribed for those in mild pain, while other medication without analgesics were prescribed for those in severe pain. The McGill Pain Questionnaire--Amharic (MPQ-Am) could be a useful tool for future studies of illness-specific pain, and of the effectiveness of pharmaceutical and non-pharmaceutical strategies for pain management.