Effects of cultivar resistances and chemical seed treatments on fusarium head blight and bread wheat yield-related parameters under field condition in southern Ethiopia.

Fusarium head blight (Fusarium graminearum Schwabe), FHB, is considered among the economically significant and destructive diseases of wheat. Thus, the study was worked out at seven sites in southern Ethiopia during the 2019 main cropping year to decide the effects of host resistance and chemical seed treatment on the progress of FHB epidemics and to decide grain yield benefit and yield losses derived from the use of wheat cultivars integrated with chemical seed treatments. The field study was worked out with the integration of two wheat cultivars, including Shorima as well as Hidase, and five chemical seed treatments, including Carboxin, Thiram + Carbofuran, Imidalm, Proceed Plus, and Thiram Granuflo. Twelve experimental treatments were arrayed in factorial arrangement with randomized complete block design. Each experimental treatment was replicated three times and delegated at random to experimental plots within a block. Significant (P < 0.01) variations were observed among the evaluated treatment combinations for rates of disease progress, incidence, severity, the area under the disease progress curve (AUDPC), and yield-related parameters across the locations. Results showed that the lowest incidence was registered on Shorima treated with Thiram + Carbofuran fungicide (27.40%). The lowest mean disease severity was recorded from Shorima integrated with Imidalm (21.23%) and Shorima treated with Thiram + Carbofuran (21.78%). The AUDPC was as low as 211.27, 226.39, and 236.46%-days were recorded on Shorima treated with Imidalm, Thiram + Carbofuran, and Proceed Plus, respectively. The highest disease severity of 57.91% (Hidase) and 27.22% (Shorima), and AUDPC of 552.71%-days (Hidase) and 313.04%-days (Shorima) were recorded from untreated control plots of the two cultivars. Paramount grain yield was found from Shorima treated with Imidalm and Dynamic fungicides, each of which was noted with GY of 4.40 and 4.05 t ha-1, respectively. Results also showed the highest yield losses (21.89 and 23.23%) were computed on untreated control plots of the cultivars Hidase and Shorima, respectively, compared with maximum protected experimental treatment for both cultivars. Moreover, cost-benefit analysis confirmed that Shorima treated with Imidalm exhibited the most prominent net benefit (NB) ($67,381.26 ha-1) and benefit-cost ratio (BCR) (4.43), followed by Shorima treated with Thiram + Carbofuran (NB of $60,837.76 ha-1 and BCR of 3.98). Based on the lowest yield loss and highest economic advantage, the use of Shorima treated with either Imidalm or Thiram + Carbofuran could be suggested to the farmers in the study areas and elsewhere having analogous agro-ecological conditions to manage the disease. However, sole use of chemical seed treatment is not as effective as post-anthesis aerial application up to maturity of the crop. For this reason, post-anthesis aerial application should be considered besides chemical seed treatment for effective management of FHB.

Occupational safety practices and associated factors among employees in Jinmao and Philip Van Heusen Textile Ethiopia, Hawassa Industrial Park, south Ethiopia.

Objectives. Occupational health and safety practice in the textile factory has been neglected and in Ethiopia there is little evidence on occupational safety practice and associated factors in a textile factory. This study aimed to assess the occupational safety practices and associated factors among employees in Jinmao and Philip Van Heusen Textile Ethiopia, Hawassa Industrial Park, south Ethiopia in 2019. Methods. An institutional cross-sectional study was conducted from January to February 2019. A total of 345 participants were included in the study using a stratified random sampling method. Data were collected through face-to-face interviews and an observational checklist, and analyzed using SPSS version 20. Bivariate and multivariate analysis assessed the association between dependent and independent variables. Results. Among the 345 (96%) respondents recruited, more than four-fifths (82%) were single. Almost two-thirds (63.8%) were in the age range 21-24 years. Attending safety training (adjusted odds ratio [AOR]: 1.73, 95% confidence interval [CI] [1.05-2.81]), orientation on occupational safety practice (AOR: 2.18, 95% CI [1.15-4.14]) and working in the weaving section (AOR: 3.58, 95% CI [2.09-6.12]) were independent predictors of safety practice. Conclusions. The level of occupational safety practice was very low compared to studies in developing countries.

Integration of host resistance, fungicides, and spray frequencies for managing Fusarium head blight of bread wheat under field conditions in southern Ethiopia.

A field experiment was carried out in Adiyo, Bonke, Chencha, Sodo zuriya, and North Ari districts, they are found in Southern Ethiopia, during the 2019 main production season. The objective of the experiment was to evaluate the effectiveness of the integrations of host resistance and application of fungicides with designated spray frequency on Fusarium head blight under natural epiphytotic conditions and to determine the management effects on yield and yield components of wheat. The treatments consisted of wheat cultivars (Shorima and Hidase) and fungicides (Propiconazole and Tebuconazole) with four spray frequencies, including an unsprayed one. The experiment was arranged in a split-split plot design with three replications. Wheat cultivars were assigned to the main plots and fungicides allotted to the sub-plots, while the spray frequencies were appointed to sub-sub plots. Results exhibited that integration of wheat cultivars and fungicides with spray frequencies significantly (p < 0.001) reduced disease pressure and increased grain yields across the locations. The highest disease severity (36.46%) and area under disease progress curve (AUDPC) (404.78%-day) and lowest grain yield (2.42 t ha-1) were recorded at North Ari. The lowest severity (7.70%), and AUDPC (130.26%-day), and the highest grain yield (6.68 t ha-1) were recorded in Bonke. The lowest severity (4.78 and 5.74%) and AUDPC (52.86 and 59.78%-day) were recorded from Shorima due to integrated use of Tebuconazole with three and two times spray frequencies, respectively. The highest grain yield of 5.30 t ha-1 was recorded on Shorima in combination with Tebuconazole with three times spray frequencies. The grain yield loss of 46.49% was computed on unsprayed plots of Hidase cultivar. Overall, the results exhibited a combination of moderately resistance wheat cultivars supplemented by fungicide with appropriate spray frequencies right at disease onset reduced disease pressure and increased grain yield. Planting of Shorima combined with Tebuconazole with three times spray frequencies was found effective in reducing FHB epidemics and increasing grain yield with the highest monetary advantage. Therefore, this could be recommended to growers in the study areas and similar agro-ecologies to manage F. graminearum causing FHB in wheat.

Knowledge and attitude towards COVID-19 and its prevention in selected ten towns of SNNP Region, Ethiopia: Cross-sectional survey.

BACKGROUND: COVID-19 is highly infectious viral disease that can lead to main clinical symptoms like fever, dry cough, fatigue, myalgia, and dyspnea. Since there is no drug to cure the disease, focusing on improving community awareness related to prevention methods is crucial. But there was no regional level study addressing the reach of information, community knowledge and attitude related to COVID-19 and its prevention, and this study was done to inform and assist communication related to the disease responses during early introduction of the disease to the setting. METHODS: Community based cross sectional study was conducted in selected ten towns of SNNPR, Ethiopia. Multi-stage sampling was used to select 1239 participants. Semi-structured questionnaire was designed, pre-tested and uploaded to SurveyCTO data collection system with security patterns. Knowledge was assessed considering awareness about signs and symptoms, confirmatory test (laboratory test), what to do if there is a suspect, availability of drug to cure the disease, mechanisms of transmission, prevention methods and most at risk groups. Attitude was assessed using 11 statements including seriousness of disease, being at risk, possibility of prevention, and benefits of staying at health facilities. Descriptive statistics and binary logistic regression were performed to manage data using SPSS version 25. RESULTS: Almost all respondents (99.8%) heard about the disease. The mean score of knowledge was 52.3% (SD = 18.9) while the mean score attitude was 80.8% (SD = 6.48). Educational status, housing condition and marital status were associated with having good knowledge while occupation, housing condition, age and overall knowledge were associated with having positive attitude. CONCLUSION: Even though almost all respondents had heard about the COVID-19, knowledge and attitude related to COVID-19 and its prevention were low. Awareness creation should be intensified using different local languages to improve community awareness, overcome misconceptions and minimize consequences of the disease.

Hospital-based ciprofloxacin use evaluation in Eastern Ethiopia: a retrospective assessment of clinical practice.

INTRODUCTION: ciprofloxacin is a second-generation fluoroquinolone, which has been used as one of the top three antibacterial agents prescribed in Ethiopia. However, its use has deviated from the recommendation of standard treatment guidelines resulting in a gradual increase in antimicrobial resistance. Therefore, this study aimed to evaluate the annual use of ciprofloxacin in 2016 based on the standard Ethiopian treatment and World Health Organization guidelines, in governmental hospitals, in Eastern Ethiopia from 1st May to 30th June 2018. METHODS: a hospital-based retrospective cross-sectional study was conducted to evaluate medical records of patients who had taken ciprofloxacin in 2016. The total sample size (n=522) was proportionally allocated to each hospital based on the respective consumption data. A simple random sampling method was employed to collect the required sample. The collected data were entered into SPSS version 21 and analyzed using descriptive analysis. RESULTS: in this study, 522 medical records were reviewed, with a male to female ratio of 1.03: 1. Ciprofloxacin was indicated in 478 (91.6%) participants whose age was greater than eighteen years. The majority were treated in the medical and emergency outpatient departments (n=477, 91.4%). Urinary tract infections (n=224, 42.9%), acute febrile illnesses (n=68, 13.0%), and typhoid fever (n=54, 10.4%) were the top indications to which ciprofloxacin was prescribed. Non-steroidal anti-inflammatory drugs (NSAIDs) (n=241, 34.7%) and antimicrobials (n=135, 19.6%) were among the most frequently co-indicated agents. Based on the standard Ethiopian treatment guidelines, therapy was appropriate in 30% (n= 159) of patients. The major reason for inappropriate utilization (95%) was the wrong duration of antibiotic use (n=228). Evaluation based on World Health Organization criteria showed that indication, dose, and frequency were in line with the recommendation. CONCLUSION: ciprofloxacin was primarily indicated for urinary tract infections. The drug was appropriately used in less than one-third of patients, with the wrong duration being the main reason for overall inappropriate utilization. This trend may potentially impose a high risk to the emergence of drug-resistant microorganisms. To this end, further studies addressing the susceptibility pattern of bacterial isolates towards ciprofloxacin should be carried out.

Task shifting of emergency caesarean section in south Ethiopia: are we repeating the brain drain.

INTRODUCTION: preventable mortality from complications which arise during pregnancy and childbirth continue to claim more than a quarter of million women´s lives every year, almost all in low- and middle-income countries. However, lifesaving emergency obstetric services, including caesarean section (CS), significantly contribute to prevention of maternal and newborn mortality and morbidity. Between 2009 and 2013, a task shifting intervention to train caesarean section (CS) teams involving 41 CS surgeons, 35 anesthetic nurses and 36 scrub nurses was implemented in 13 hospitals in southern Ethiopia. We report on the attrition rate of those upskilled to provide CS with a focus on the medium-term outcomes and the challenges encountered. METHODS: a cross-sectional study involving surveys of focal persons and a facility staff audit supplemented with a review of secondary data was conducted in thirteen hospitals. Mean differences were computed to appreciate the difference between numbers of CSs conducted for the six months before and after task shifting commenced. RESULTS: from the trained 112 professionals, only 52 (46.4%) were available for carrying out CS in the hospitals. CS surgeons (65.9%) and nurse anesthetists (71.4%) are more likely to have left as compared to scrub nurses (22.2%). Despite the loss of trained staff, there was an increase in the number of CSs performed after the task shifting (mean difference=43.8; 95% CI: 18.3-69.4; p=0.003). CONCLUSION: our study, one of the first to assess the medium-term effects of task shifting highlights the risk of ongoing attrition of well-trained staff and the need to reassess strategies for staff retention.

Understanding performance data: health management information system data accuracy in Southern Nations Nationalities and People's Region, Ethiopia.

BACKGROUND: Health management information system (HMIS) is a system whereby health data are recorded, stored, retrieved and processed to improve decision-making. HMIS data quality should be monitored routinely as production of high quality statistics depends on assessment of data quality and actions taken to improve it. Thus, this study assessed accuracy of the routine HMIS data. METHODS: Facility based cross-sectional study was conducted in Southern Nations Nationalities and People's region in 2017. Document review was done in 163 facilities of different levels. Statistical Package for the Social Sciences (SPSS) for windows version 20 was used to perform data analysis. Data accuracy was presented in terms of mean and standard deviation of data verification factor. RESULTS: Though inaccuracy was noted for all data elements, 96.9 and 84.7% of facilities reported institutional maternal death and skilled birth attendance within acceptable range respectively while confirmed malaria (45.4%), antenatal care fourth visit (46.6%), postnatal care (55.2%), fully immunized (55.8%), severe acute malnutrition (54.6%) and total malaria (50.3%) were reported accurately only by about half of facilities. Antenatal care fourth visit was over reported by 24% while total malaria was under reported by 28%. Reasons for variations included technical, behavioral and organizational factors. CONCLUSIONS: Majority of facilities over reported services while under reporting diseases. Data quality should be monitored routinely against data quality parameters quantitatively and/or qualitatively to catch-up country's information revolution agenda.

Burden of NCDs in SNNP region, Ethiopia: a retrospective study.

BACKGROUND: Non-communicable diseases (NCDs) are medical conditions or diseases that are non-transmissible. As NCDs are becoming one of major public health problem, providing local description of diseases and injuries is key to health decision- making and planning processes. So, this study aimed to describe caseload of NCDs in Southern Nations Nationalities and People's Region, Ethiopia. METHODS: A facility based retrospective study was conducted in February 2015 in SNNPR, Ethiopia. A total of 22,320 records of three years retrieved from 23 health facilities using systematic sampling. Data were entered in to Epi-Info 3.5.3 and descriptive analysis was carried out using SPSS version 20. RESULTS: From 22,320 records reviewed, 6633 (29.7%) clients visited health facilities due to Non-Communicable Diseases (NCDs). Majority (37.2%) of NCD cases were in productive age groups (20-35 year). Near to half (43%) of NCD cases were from rural and 45.8% were females. Digestive disorder (26.7%), cardiovascular diseases (18.8%) and Diabetes Mellitus (13.1%) were the most prevalent types of NCDs. CONCLUSION: Health facilities are burdened with significant proportion of clients with NCDs. Young population accounts large share and NCDs are becoming public health problem of urban and rural area within a health care system that focus on communicable diseases. There is a need to strengthen the health system to work towards NCDs, and investigate risk factors associated with NCDs at individual level.

Where we should focus? Myths and misconceptions of long acting contraceptives in southern nations, nationalities and People's region, Ethiopia: qualitative study.

BACKGROUND: Despite its wider benefits and access made at community level, contraceptive methods are one of underutilized services in study area and it is believed to be influenced by misconceptions and socio cultural values. This study was designed to explore women's perceptions, myths and misconception to inform program implementers. METHODS: Study was conducted in Southern Nations, Nationalities and People's Region, Ethiopia in 2015. Five focus group discussions with 50 women of reproductive age and 10 key informant interviews with providers and program officers were done. The discussions and interviews were tape-recorded, transcribed verbatim and analyzed manually using framework analysis with deductive and descriptive approaches. RESULTS: Improving community awareness about contraceptives and benefits of contraceptive utilization were acknowledged by majority of participants. Long acting methods were less preferred due to perceived side effects, myths and misconceptions and desire to have more children. Additionally, socio-economic status and partner influence were listed as reason for non-use. Poor provider-client interaction on available methods was also reported as system related gap. CONCLUSION: Program implementers need to address fears, myths and misconceptions. Quality of family planning counselling should be monitored.

Contraceptive utilization and associated factors among women of reproductive age group in Southern Nations Nationalities and Peoples' Region, Ethiopia: cross-sectional survey, mixed-methods.

BACKGROUND: Though contraceptive utilization has comprehensive benefit for women, it was one of underutilized public intervention in Ethiopia and in the study area. Thus, assessing status and factors affecting contraceptive utilization among women of reproductive age group was found key step for program improvement. METHODS: Community based cross-sectional study was conducted from March to April, 2015 in Southern Nations and Nationalities Peoples' Region, Ethiopia. A multistage stratified cluster sampling method was used to select 3205 study subjects. Study used both quantitative and qualitative methods. Statistical Package for Social Sciences version 20 was used to analyze quantitative data. The association between variables was determined using odds ratio at 95% confidence interval. RESULTS: Contraceptive utilization was 53.3% among women of reproductive age groups. Nearly three fourth, (73.6%), of current users were using short-term contraceptive methods. Factors associated with contraception utilization were overall knowledge of and attitude towards contraceptives, age, residence, number of alive children, experience of child death, marital status and deciding number of children. Contraceptive utilization was also affected by various misconceptions. CONCLUSION: Contraceptive utilization was below national Health Sector Development Program IV target. Program implementers need to address socio-cultural barriers. Gender myths and specific roles and power inequalities that can function as a barrier to contraceptive utilization should be assessed.

Who takes the medicine? Adherence to antiretroviral therapy in Southern Ethiopia.

BACKGROUND: Treatment adherence is critical for the success of antiretroviral therapy (ART) for people living with HIV. There is limited representative information on ART drug adherence and its associated factors from Southern Ethiopia. We aimed at estimating the level of adherence to ART among people living with HIV and factors associated with it in 20 randomly selected ART clinics of Southern Ethiopia. METHODS: In this cross-sectional study, we interviewed consecutive HIV patients on first-line antiretroviral regimen attending the clinics in June 2014 using a pretested and structured questionnaire. For measuring adherence, we used 4-day recall method based on "The AIDS Clinical Trial Group adherence assessment tool". Patients were classified as "Incomplete adherence" if they missed any of the doses in the last 4 days. Data were singly entered using EpiData and descriptive analysis, and unadjusted odds ratios were calculated using EpiDataStat software. Multivariate logistic regression analysis was performed using Stata v12.0. RESULTS: Of 974 patients interviewed, 539 (56%) were females, and mean age was 35 years. The proportion of patients with incomplete adherence was 13% (95% confidence interval: 11%-15%). In multivariate analysis, factors significantly associated with incomplete adherence included young age, being Protestant Christian, consuming alcohol, being single, and being a member of an HIV association. Psychosocial factors like stigma, depression, and satisfaction to care were not associated with incomplete adherence in the current context. CONCLUSION: The overall adherence to ART was good. However, there were certain subgroups with incomplete adherence who need special attention. The health care providers (especially counselors) need to be aware of these subgroups and tailor their counseling to improve adherence among these groups. Exploratory qualitative studies may help uncover the exact reasons for incomplete adherence.

Do loss to follow-up and death rates from ART care vary across primary health care facilities and hospitals in south Ethiopia? A retrospective follow-up study.

BACKGROUND: Decentralization and task shifting has significantly improved access to antiretroviral therapy (ART). Many studies conducted to determine the attrition rate in Ethiopia have not compared attrition rates between hospitals and health centers in a relatively recent cohort of patients. This study compared death and loss to follow-up (LTFU) rates among ART patients in hospitals and health centers in south Ethiopia. METHODS: Data routinely collected from patients aged older than 15 years who started ART between July 2011 and August 2012 in 20 selected health facilities (12 being hospitals) were analyzed. The outcomes of interest were LTFU and death. The data were entered, cleaned, and analyzed using Statistical Package for the Social Sciences version 20.0 and Stata version 12.0. Competing-risk regression models were used. RESULTS: The service years of the facilities were similar (median 8 and 7.5 for hospitals and health centers, respectively). The mean patient age was 33.7±9.6 years. The median baseline CD4 count was 179 (interquartile range 93-263) cells/mm(3). A total of 2,356 person-years of observation were made with a median follow-up duration of 28 (interquartile range 22-31) months; 24.6% were either dead or LTFU, resulting in a retention rate of 75.4%. The death rates were 3.0 and 1.5 and the LTFU rate were 9.0 and 10.9 per 100 person-years of observation in health centers and hospitals, respectively. The competing-risk regression model showed that the gap between testing and initiation of ART, body mass index, World Health Organization clinical stage, isoniazid prophylaxis, age, facility type, and educational status were independently associated with LTFU. Moreover, baseline tuberculous disease, poor functional status, and follow-up at a health center were associated with an elevated probability of death. CONCLUSION: We observed a higher death rate and a lower LTFU rate in health centers than in hospitals. Most of the associated variables were also previously documented. Higher LTFU was noticed for patients with a smaller gap between testing and initiation of treatment.