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1.
BackgroundPolio is a disabling and potentially deadly disease caused by a wild poliovirus and vaccine-derived poliovirus. The purpose of this review is to discuss the current situation of polio in Ethiopia.MethodRelevant scientific articles on Polio were searched from different data bases and websites.ResultsThe first wild poliovirus in Ethiopia was detected in 1999, followed by detection of few cases in 2000 and 2001. No wild poliovirus was detected in Ethiopia for the next 3 years (2001–2003). However, the disease resurged again in the country between 2004 and 2008 due to challenge to provide sufficient oral poliovirus vaccine coverage, migration and cross border economic activities and lack of good acute flaccid paralysis surveillance. After almost 5 years with no wild polio virus, Ethiopia again affected by polio outbreak importation in 2013. However, due to multiple supplementary immunization activities campaigns of improved quality and enhanced surveillance, the outbreak was eventually successfully interrupted within 6 months of confirmation. The most recent emergence of polio in Ethiopia has seen in this year (2020) six years after the country documented zero polio cases since 2014. The cause of the resurgence of the disease is circulating vaccine derived polio virus-2. Currently, Ethiopia has been conducting outbreak response by declaring Mop-up campaigns since September 2020.ConclusionsTherefore, it can be recommended that: - 1. The country has to completely shift from oral polio virus vaccine to inactivated polio vaccine so that the risk of vaccine derived polio will be diminished; 2. Ethiopia has to strengthen the mop up campaign that it has started in September 2020 following the reemergence of the disease in the country; 3. Ethiopia has to strengthen surveillance for acute flaccid paralysis in order to rapidly detect any new virus importation and to facilitate a rapid response.  相似文献   

2.
BackgroundNoncommunicable diseases and injuries (NCDIs) are the leading causes of premature mortality globally. Ethiopia is experiencing a rapid increase in NCDI burden. The Ethiopia NCDI Commission aimed to determine the burden of NCDIs, prioritize health sector interventions for NCDIs and estimate the cost and available fiscal-space for NCDI interventions.MethodsWe retrieved data on NCDI disease burden and concomitant risk factors from the Global Burden of Disease (GBD) Study, complemented by systematic review of published literature from Ethiopia. Cost-effective interventions were identified through a structured priority-setting process and costed using the One Health tool. We conducted fiscal-space analysis to identify an affordable package of NCDI services in Ethiopia.ResultsWe find that there is a large and diverse NCDI disease burden and their risk factors such as hypertension and diabetes (these conditions are NCDIs themselves and could be risk factors to other NCDIs), including less common but more severe NCDIs such as rheumatic heart disease and cancers in women. Mental, neurological, chronic respiratory and surgical conditions also contribute to a substantial proportion of NCDI disease burden in Ethiopia. Among an initial list of 235 interventions, the commission recommended 90 top-priority NCDI interventions (including essential surgery) for implementation. The additional annual cost for scaling up of these interventions was estimated at US$550m (about US$4.7 per capita).ConclusionsA targeted investment in cost-effective interventions could result in substantial reduction in premature mortality and may be within the projected fiscal space of Ethiopia. Innovative financing mechanisms, multi-sectoral governance, regional implementation, and an integrated service delivery approach mainly using primary health care are required to achieve these goals.  相似文献   

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BackgroundAcute ischemic stroke has been reported to occur in a significantly higher number of COVID-19 patients as compared to healthy controls with variable proposed pathophysiologic mechanisms. To our knowledge, sufficient data regarding this subject is lacking in Ethiopia and the African continent at large. In this case series, we report the clinical characteristics and management of 5 cases with COVID-19 infection and acute ischemic stroke to shed light on the diagnostic and therapeutic challenges in resource-limited setups.MethodsThis is a case series including data collected from the medical records of 5 participants with confirmed RT-PCR positive COVID-19 infection and radiologically confirmed acute ischemic stroke, admitted at Eka Kotebe General Hospital Intensive Care Unit (ICU) in Addis Ababa, Ethiopia from June 10, 2020, to November 04, 2020.ResultsCryptogenic stroke was documented in 4/5 participants included in this series with the most common vascular risk factors identified for stroke being hypertension and diabetes mellitus. The median time from onset of COVID-19 symptoms to the identification of stroke was 07 days. Two fifth of the participants in this series died during their ICU admission with the immediate cause of deaths reported to be related to the severe COVID-19 infection but not stroke.ConclusionCryptogenic stroke was documented in 4/5 patients in this series despite the presence of vascular risk factors for other stroke subtypes. The overall prevalence, subtypes, and outcomes of stroke in COVID-19 patients in Ethiopia and the African continent as a whole needs additional research to elucidate the local burden of the disease and define the predominant pathophysiologic mechanisms for stroke in COVID-19 in the region.  相似文献   

5.
ObjectivesPreventive strategy for falls in demented elderly is a clinical challenge. From early-stage of Alzheimer's disease (AD), patients show impaired balance and gait. The purpose of this study is to determine whether regional white matter lesions (WMLs) can predict balance/gait disturbance and falls in elderly with amnestic mild cognitive impairment (aMCI) or AD.DesignCross-sectional.SettingsHospital out-patient clinic.ParticipantsOne hundred sixty-three patients diagnosed with aMCI or AD were classified into groups having experienced falls (n = 63) or not (n = 100) in the previous year.MeasurementsCognition, depression, behavior and psychological symptoms of dementia, medication, and balance/gait function were evaluated. Regional WMLs were visually analyzed as periventricular hyperintensity in frontal caps, bands, and occipital caps, and as deep white matter hyperintensity in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalamus, and brain stem. Brain atrophy was linearly measured.ResultsThe fallers had a greater volume of WMLs and their posture/gait performance tended to be worse than nonfallers. Several WMLs in particular brain regions were closely associated with balance and gait impairment. Besides polypharmacy, periventricular hyperintensity in frontal caps and occipital WMLs were strong predictors for falls, even after potential risk factors for falls were considered.ConclusionsRegional white matter burden, independent of cognitive decline, correlates with balance/gait disturbance and predicts falls in elderly with aMCI and AD. Careful insight into regional WMLs on brain magnetic resonance may greatly help to diagnose demented elderly with a higher risk of falls.  相似文献   

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《Vaccine》2022,40(14):2161-2167
BackgroundIn Ethiopia, cervical cancer is the second most common cancer among women of the reproductive age group. Since 2018, the quadrivalent human papillomavirus (4vHPV) vaccine targeting four HPV types (6/11/16/18) has been introduced in the national immunization program in Ethiopia. Currently, however, a nonavalent HPV (9vHPV) vaccine which provides broader protection against nine HPV types (?6/11/16/18/31/33/45/52/58) is available for global use. Our study, therefore, aims to estimate the cost-effectiveness of 9vHPV vaccine compared to the current HPV vaccination program in Ethiopia.MethodA static Markov cohort model was used to simulate the progression of HPV infection to cervical cancer for a cohort of 12-years-old girls (N = 100,000) in Ethiopia. The model ran up to the age of 100 years, with a cycle length of 1 year. One-way and probabilistic sensitivity analyses were used to explore the robustness of the model and uncertainties around the parameters included in the model. Cost-effectiveness thresholds of one and three times gross domestic product (GDP) per quality-adjusted life-year (QALY) gained were considered.ResultsAt a price of US$ 6.9, the incremental cost-effectiveness ratio (ICER) per QALY gained for the 9vHPV vaccine was US$ 454 compared to the 4vHPV vaccine, which is less than one times GDP per capita of Ethiopia. The ICER was most sensitive to the change in the discount rate of QALYs. Compared to 4vHPV vaccine, for 9vHPV vaccine to remain very cost-effective and cost-effective, its price per dose should not exceed US$ 8.4 and US$ 15, respectively, at a threshold of one and three times GDP per capita.ConclusionCompared to the 4vHPV vaccine, the 9vHPV vaccine is a cost-effective option in Ethiopia, given that its price per dose does not exceed US$15.  相似文献   

8.
BackgroundDiabetes has no cure so far, but appropriate self-management contributes to delay or control its progression. However, poor self-management by diabetic patients adds to disease burden. The pooled prevalence of overall, and its main components of poor self-management among Ethiopian diabetic patients remain elusive. Hence, this study aimed to determine the prevalence of poor diabetes self-management behaviors among diabetic patients in Ethiopia.Methodby using different combinations of search terms, we accessed articles done until February 15, 2020 through Pubmed, Scopus, Web of Science and Embase databases. Newcastle-Ottawa quality assessment scale was used for quality assessment, and STATA version 14 software along with the random-effects model was employed for statistical analyses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA.) guideline was followed to report the results.ResultTwenty-one studies with 7,168 participants were included in this meta-analysis. The overall pooled prevalence of poor self-management behavior among diabetic patients in Ethiopia was 49.79% (95% CI: 43.58%, 56.01%). Based on subgroup analysis, the estimated magnitudes of poor self-management by regions were 68.58% in Tigray, 55.46% in Harari, 54.74%, in Amhara, 40.90%, in SNNPRS and 37.06% in Addis Ababa. The worst (80.91%) and relatively better (24.65%) self-management components were observed on self-blood glucose monitoring and medication adherence, respectively.ConclusionOne in two diabetic patients in Ethiopia had poor self-management. Thus, we strongly recommend to the ministry of health and universities to train diabetes health educators, and the health facilities to deliver tailored diabetes health education.  相似文献   

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Background: Due to trends of population movements, Israeli family physicians are treating increasing numbers of African immigrants from Ethiopia. These immigrants were found to have complete blood counts (CBC) that are different from other ethnic groups, with a higher prevalence of eosinophilia and neutropenia.

Objectives: To evaluate haematological findings in an attempt to define whether they behave as familial (genetic) or environmental.

Methods: Retrospective chart review of 300 patients from a primary care clinic: 100 individuals of Ethiopian heritage born in Ethiopia (EE); 100 individuals of Ethiopian heritage born in Israel, whose parents were born in Ethiopia (EI), and a control group of 100 patients who were not of Ethiopian heritage (C).

Results: Absolute eosinophilia (greater than 500/dl) was found in 13% of the EE study group significantly higher than the two other groups (P?P?Conclusion: On the one hand, findings point to a marked environmental influence on the eosinophilic response (most probably due to intestinal parasites present in immigrants from Ethiopia). On the other hand, a familial-genetic nature is probably the reason for the higher prevalence of neutropenia in this population, although some environmental influence may play a role. The knowledge of these findings may be useful for physicians treating people migrating from Africa.  相似文献   

11.
BackgroundEthiopia is the second most populous nations in Africa. Family planning is a viable solution to control such fast-growing population. This study aimed to assess the prevalence of contraceptive use and its predictors in Ethiopia.MethodsAbout 4,563 women were drawn randomly by Central Statistics Agency from its master sampling frame. The survey was conducted from January, 2014 to March, 2016 within six months'' interval for the study period. The study was conducted using secondary data collected by PMA2020/Ethiopia project. Negative Binomial regression model was employed for data analysis. The model was selected using information criterion.ResultsPredictors like easy access of health service, residence area, level of health institutions, regions, availability of community health volunteers, experience sharing, support from husbands, level of education and employment status of women as well as residence area significantly affected the performance of contraceptive use in Ethiopia. From the interaction effects of health centers with region and health post with number of opening days per a week were significant predictors of the contraceptive use.ConclusionThe performance of contraceptive use was different from one individual to another because of their experience sharing, support from their husbands, employment status and education level. A woman who got encouragement to use birth control from her husband had good performance to be effective for her contraceptive use. There should be an experience sharing/orientation, about use of birth control to protect women from unwanted pregnancy. Hence, rural women should get experience from urban women.  相似文献   

12.
BackgroundAn inflammatory diet is related to poorer cognition, but the underlying brain pathways are unknown.ObjectiveThe aim of this study was to examine associations between the Energy-Adjusted Dietary Inflammatory Index (E-DII) and brain volume, small vessel disease, and cognition in people with and without type 2 diabetes mellitus (T2DM).DesignThis is a secondary cross-sectional analysis of data from the Cognition and Diabetes in Older Tasmanians study.Participants/settingsThis study included 641 participants (n = 326 with T2DM) enrolled between 2005 and 2011 from Tasmania, Australia.Main outcome measuresThe E-DII was computed from the 80-item Dietary Questionnaire for Epidemiological Studies, version 2. Brain volumes (gray matter, white matter, and white matter hyperintensities), infarcts, and microbleeds were obtained from magnetic resonance imaging. Global cognition was derived from a comprehensive battery of neuropsychological tests.Statistical analysisLogistic and linear regressions were performed to examine associations between E-DII and brain measures and a global cognitive score, adjusting for demographics, energy, T2DM, mood, ambulatory activity, and cardiovascular risk factors. An E-DII × T2DM interaction term was tested in each model.ResultsThe mean (standard deviation) age of participants was 69.8 (7.4) years. There were no associations between the E-DII and any of the brain structural measures or global cognitive function in fully adjusted models. There was a modification effect for T2DM on the association between E-DII and gray matter volume (T2DM: β = 1.38, 95% CI –3.03 to 5.79; without T2DM: β = –4.34, 95% CI, –8.52 to –0.16), but not with any of the other outcome measures.ConclusionsIn this cross-sectional study, E-DII was not associated with brain structure or global cognition. In 1 of the 7 outcomes, a significant modification effect for T2DM was found for the associations between E-DII and gray matter. Future prospective studies are needed to clarify the associations between diet-related inflammation and brain health.  相似文献   

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《Vaccine》2021,39(45):6700-6711
BackgroundAntimicrobial resistance (AMR) poses an imminent threat to global health security. Pneumococcal vaccination reduces disease incidence, prevents antibiotic use, and decreases antibiotic-resistant infections. However, the benefit of vaccination in reducing AMR has been poorly quantified to date.MethodsWe developed an agent-based model, DREAMR (Dynamic Representation of the Economics of AMR) to evaluate the economic value of childhood immunization with the pneumococcal conjugate vaccine (PCV) in mitigating the development of AMR. Our model incorporates vaccination coverage, disease incidence, care seeking, and antibiotic use. Accumulation of AMR is simulated based on antibiotic exposure through pharmacokinetics and resulting pharmacodynamics. The model was applied to Ethiopia.ResultsIntroduction of PCV vaccination has helped slow the development of AMR by 14.77% for amoxicillin and 0.59% for ceftriaxone in Ethiopia since 2011. In addition to the benefit of reduction in disease incidence, PCV vaccination has averted approximately 718,100 antibiotic treatment failures and 9,520 AMR-related deaths (27.8% reduction) in Ethiopia between 2011 and 2017, resulting in savings of $32.7 million. Maintaining current PCV immunization coverage will contribute an additional $7.67 million in annual AMR cost savings over five years compared to no vaccination scenario, which could increase to $11.43 million by increasing PCV coverage to 85% by 2022.ConclusionsThis study is the first to demonstrate the broader economic value of pneumococcal vaccination in controlling the development of AMR in Africa. Vaccination not only saves lives by preventing illnesses, but also benefits society by reducing antibiotic utilization and treatment failures due to AMR.  相似文献   

14.
BackgroundMultiple sexual partnerships were one of the public health issues in the spread of high rates of sexually transmitted infections in sub-Saharan regions. An increase in the number of non-marital sexual partners can lead to a loss of satisfaction as well as other mental health repercussions such as greater rates of anxiety, depression, etc. This study examined the predictors of multiple sexual partners among men in Ethiopia.MethodsThis study used 2016 nationally representative data which was conducted using a multistage stratified cluster sampling method. Multilevel binary logistic regression models were employed to estimate the predictors of multiple sexual partners among men in Ethiopia with the assistance of the STATA software.ResultsIn this study 6778 participants were considered with an overall prevalence rate of multiple sexual partners of 6.5% during the 12 months preceding the survey. The findings showed that older-age, urban-resident, inconsistent use of a condom, exposure to any media, abuse of alcohol, early-time first-sex, and religion were predictors of multiple sexual partners among men in Ethiopia.ConclusionsThe findings revealed that the prevalence rate of men''s multiple sexual partners in Ethiopia was very high. Therefore, the country needs to re-examine the behavioral change strategies periodically to adapt to the contextual realities and engage relevant stakeholders. Specifically, health sectors and religious organizations should develop strategies to create awareness in society on the risk of having multiple sexual partnerships. In addition, we highly recommend stakeholders prepare risk reduction interventions that take the significant predictors of multiple sexual partners.  相似文献   

15.
BackgroundMalaria is an infectious disease caused by Plasmodium parasites. Of the five human malaria parasites Plasmodium falciparum and Plasmodium vivax are the two co-endemic predominant and widely distributed species in Ethiopia, with major public health importance. Even though enormous effort has been made countrywide to reduce the disease burden little was reported about trends of malaria transmission in the several localities of malarious areas like East Shawa Zone, Ethiopia. Thus, the present study was aimed at assessing fiveyear (2016–2020) trends of malaria transmission at Adama, Boset and Lume districts of East Shawa Zone of Oromia Regional State, Ethiopia.MethodsRetrospective data was extracted from the central surveillance database of East Shawa Zone Health Office. The data collected was analyzed from September 2020 to December 2020 to examine trends of malaria epidemiology in three malarious districts in the Zone.ResultsThe results of the present study showed a remarkable decrease in slide positivity rate (SPR) from 16.3 to 1.4% from 2016 to 2018 in the areas. However, a recent slight increase of malaria SPR was observed. On the other hand, as age increases more male individuals were infected with malaria compared to female of similar age groups. Falciparum, vivax and mixed malaria infection accounted for 53%, 41% and 6% respectively.ConclusionsEven though, an overall reduction of malaria incidence was revealed in the study areas, an increase in malaria SPR was observed in 2019 and 2020. Such inconsistency in reduction of malaria cases in the study area demands due attention of health planners.  相似文献   

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BackgroundMycobacterial infections are known to cause a public health problem globally. The burden of pulmonary disease from nontuberculous mycobacteria is reportedly on the rise in different parts of the world despite the fact that there is limited data about the disease in sub-Saharan Africa including Ethiopia. Hence, we aimed to assess the magnitude of M. tuberculosis and nontuberculous mycobacteria (NTM) among presumptive pulmonary tuberculosis patients attending St. Paul''s hospital Medical College, Addis Ababa, Ethiopia.MethodsA cross-sectional study was conducted from June to September 20/2016. Morning sputum specimens were collected, processed and cultured in Lowenstein Jensen medium and BACTEC MGIT 960 media. The nontuberculous mycobacteria were further confirmed and characterized by Genotype CM/AS assays. The socio-demographic, clinical and chest x-ray data were collected using a structured questionnaire. The data was analyzed using SPSS version 20.ResultsOut of 275 presumptive tuberculosis patients enrolled in the study, 29(10.5%) were culture positive for Mycobacteria. Of these, 3(10.3%) were found to be NTM and 26(89.6%) were Mycobacterium tuberculosis complex. Of the NTM, two were unidentified and one typed as M.peregrinum. There was no co-isolation of Mycobacterium tuberculosis complex and nontuberculous mycobacteria. Overall, 6(23.1%) Mycobacterium tuberculosis complex isolates were resistant to at least one anti-tuberculosis drug. Of these, two were multidrug resistant tuberculosis cases (7.7%) detected from previously treated patients.ConclusionRelatively low magnitude of Mycobacterium tuberculosis complex and nontuberculous mycobacteria isolates were seen in the study area. Therefore, further study using a large sample size is needed to be done to consider nontuberculous mycobacteria infection as a differential diagnosis in presumptive pulmonary tuberculosis patients.  相似文献   

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BackgroundThe objective of the study was to report on the main parameters of ocular biometry and Intraocular lens (IOL)power of patients attending a cataract surgical campaign in Eastern Ethiopia.MethodsThe study was a cross-sectional study on 765 eyes which were eligible for cataract surgery during a mass cataract surgical campaign conducted from April 04 to April 10, 2018 at Bisidimo Hospital, Eastern Ethiopia. Ocular biometric parameters were measured by automated keratorefractometer and Sonomed A-Scan (Model 300AP) using contact applanation method. Multiple linear regression analysis was done to determine association of ocular biometry components with socio demography of the study subjects.ResultsThe mean corneal curvature and anterior chamber depth (ACD, measured from corneal epithelium to lens) were found to be 7.61 mm and 2.88mm respectively. The mean axial length was estimated to be 22.98 mm. The mean refractive power of IOL was calculated to be 19.34D. The mean axial length in females was shorter than that of males by 0.24 (P - value = 0.01). The mean ACD in males was also larger than that of females by 0.1 (P - value = 0.001).ConclusionThis study provided a larger population based normative data on ocular biometry in Ethiopia. The female sex was a strong predictor of small axial length. Increasing age had no effect on axial length but was found to be a stronger predictor of shallow ACD.  相似文献   

18.
Abstract

Objective: To describe the evidence on the development of the National Healthcare System in Ethiopia. Method: The databases Embase, Ovid Emcare, Ovid MEDLINE, and Scopus were searched, together with the reference lists of the identified articles, relevant reports and books were searched. Articles were included if they described health services development in Ethiopia. Results: In Ethiopia, medical care has historically been performed by traditional healers who use magic and superstition. Over time, modern medicine continued to develop, and by 2014, 5% of Ethiopia’s total Gross Domestic Product was spent on health. In 2017, nearly 1.26 healthcare workers per 1000 population provided services through 21,071 healthcare organizations, with the majority being rural health posts. There are shortages of healthcare workers and limited numbers of hospitals. However, the introduction of the Health Extension Program and Health Extension Workers has improved access to healthcare in the country and could be a model for other African nations. Conclusion: Although the health care strategies introduced by the Ethiopian government have improved some health issues, accessibility to healthcare institutions that provide curative services is limited.  相似文献   

19.
《Global public health》2013,8(7):719-731
Abstract

A large proportion of breast cancer patients in Ethiopia present for biomedical care too late, or not at all, resulting in high mortality. This study was conducted to better learn of beliefs and practices among patients accessing breast cancer services in a large referral centre in Ethiopia. Using a mixed-method design, we interviewed 69 breast cancer patients presenting for care at Tikur Anbessa Hospital in Addis Ababa, Ethiopia, about their beliefs, experiences and perspectives on breast cancer. Awareness of breast cancer is low in Ethiopia and even among those who are aware of the disease, a sense of hopelessness and fatalism is common. Early signs/symptoms are frequently ignored and patients often first present to traditional healers. Breast cancer is perceived as being caused typically from humoral anomalies or difficulties resulting from breast feeding, and study participants indicate that stigmatisation and social isolation complicate discussion and action around breast cancer. Consistent with other studies, this study shows that traditional beliefs and practices are common around breast cancer and that numerous barriers exist to identification and treatment in Ethiopia. Integrating health beliefs and practice into public health action in innovative ways may reduce stigma, increase awareness and promote survivability among breast cancer patients.  相似文献   

20.
BackgroundCervical cancer remains the most common cancer of women worldwide. Its burden is more serious in developing countries. It is also the second common cancer deaths of women in Ethiopia followed by breast cancer. The aim of this study was to determine the pooled prevalence and associated factors of precancerous cervical lesions among women in Ethiopia.MethodsWe systematically searched published and unpublished articles reported from 2010 to 2019 using a comprehensive search of electronic databases including PubMed and Google scholar for grey literature from August 1 to September 1, 2019. The methodological qualities of included studies were evaluated using Joanna Briggs Institute meta-analysis of Statistics Assessment. The pooled prevalence estimate was calculated using MedCalc software-version 19.0.7, and the pooled odd ratios for predictors was calculated using RevMan software version 5.3.ResultsThe pooled prevalence of precancerous cervical lesions among women in Ethiopia was 13.4% (95% CI:10.63% 16.37%). Statistically significant heterogeneity between studies was detected (I2=83.1%, P < 0.001). Among all measured associated factors: numbers of women life time sexual partners > 1, OR=2.5 (95% CI:3.70,4.76), being HIV positive women, OR=2.4 (95% CI:1.33,4.61) and women having history of STI, OR=2.0 (95% CI:1.02,3.87) had statistically significant association with precancerous cervical lesions among women in EthiopiaConclusionThe pooled prevalence of precancerous cervical lesions among women in Ethiopia was high as compared to the 5-year worldwide cervical cancer prevalence. Women having more than one life time sexual partners, being HIV positive women and women having history of STI had a statistically significant association with precancerous cervical lesions.  相似文献   

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