Household organization, women's autonomy, and contraceptive behavior in southern Ethiopia

The Southern Nations, Nationalities, and People's Region of Ethiopia (SNNPR) is home to 11 million people constituting more than 45 language and ethnic groups, most of whom live in extremely poor rural communities. Data for currently married, fecund women aged 15-49 from demographic surveys conducted in the SNNPR in 1990 and 1997 are used to investigate contraceptive knowledge and communication, and the use and future need for family planning services in this population. This study focuses on how these processes are affected by household organization and women's status, and on their implications for population policies and programs. Considerations of the implications of these results for understanding the fertility transition of a highly diverse African population under severe stress are presented. Although household extension and polygamy characterize one-third of the women sampled, they do not affect the women's contraceptive behavior. Women's literacy and autonomy are, by far, the most significant forces in the movement toward lower fertility in the region.     

Evaluation of pilot control trial of intestinal schistosomiasis in the Finchaa Sugar Estate, Ethiopia

Intestinal schistosomiasis is undergoing a rapid increase in magnitude in Finchaa Sugar Estate in Ethiopia. A pilot control trial of intestinal schistosomiasis was instituted in 1995 to reduce the magnitude of the disease and introduce sustainable schistosomiasis control approaches in the Sugar Estate. Following initial parasitological survey of all the camps in the Sugar Project area in 1995 using Kato method, mass chemotherapy of the heavily infected residents of Camp 7 and selective treatment of lightly infected residents of other camps were made using praziquantel. Endod (type 44) was applied to transmission sites along Fekerie stream in Camp 7 on quarterly basis whenever Biomphalaria pfeifferi was detected. Other inputs to the project as parts of capacity building included transplantation of Endod cuttings (type 44), training and health education. Cross sectional parasitological surveys were made in 1998 to assess the impact of the pilot control trial. The results of stool examination showed that the prevalence of schistosomiasis was reduced from 30% in 1995 to 26% in 1998 among residents of Camp 7 and the intensity of infection from 198 eggs per gram of feces (EPG) in 1995 to 85 EPG in 1998. Similarly, the prevalence of infection among children in Finchaa Valley Elementary School was reduced from 78% in 1994 to 56% in 1998 and the reduction in respective intensity of infection was from 283 EPG to 114 EPG. Although significant reduction in the magnitude of the disease was not achieved, the control activities were taken over by the Sugar Project Polyclinic to ensure sustainability. In addition to chemotherapy and snail control using Endod, other disease non-specific methods such as health education should be used to get maximum benefit from such facilities as latrines, and ensure participation of the community in order to sustain the control activities.     

Efficacy of alebendazole and mebendazole in the treatment of Ascaris and Trichuris infections

This study was conducted to evaluate the efficacy of 100 mg mebendazole administered twice a day for three consecutive days and a single dose of 400 mg albendazole for the treatment of single or mixed Ascaris lumbricoides and Trichuris trichiura infections. Both drugs were found to be highly effective against Ascaris lumbricoides infection, with cure rate of over 96% and egg reduction of over 99.8%. However, the efficacy of the two drugs against Trichuris trichiura infection was low. Mebendazole appeared to be more effective against Trichuris trichiura in that it exhibited a cure rate of 34.7% and egg reduction of 92.3% as opposed to albendazole, which exhibited a cure rate and egg reduction rate of 13.9% and 63.4%, respectively. The two drugs appeared to have little effect on Schistosoma mansoni infection. More complaints were reported by individuals treated with albendazole than with mebendazole. In conclusion, mebendazole appears to be safer and more effective for the treatment of single or mixed infections with Trichuris trichiura and Ascaris lumbricoides as compared to albendazole.     

Analysis of serum lipids and lipoproteins in Ethiopian diabetic patients

Serum lipids and lipoproteins were determined in 302 randomly selected diabetic patients attending the Tikur Anbessa Hospital diabetic clinic. The main objective of the study was to analyse lipid levels in type 1 and type 2 diabetic patients. Lipid measurement was done by cholesterol pap method. The mean age was 41.4 +/- 14.4 years (range 14-85 years). One hundred sixty (53%) were males and 142 (47%) were females. There were 140 (46.4%) type 1 and 162 (53.6%) type 2 patients. The mean duration of diabetes mellitus, haemoglobin A1c, fasting blood glucose and random blood glucose were 9.4 +/- 5.4 years, 10.4 +/- 2.2%, 195.5 +/- 79.9 mg/dl and 273.1 +/- 114.5 mg/dl respectively. The mean cholesterol, triglycerides, LDL, VLDL and HDL were 166.5 +/- 45.5 mg/dl, 129.9 +/- 92.4 mg/dl, 94.5 +/- 36.4 mg/dl, 24.4 +/- 15.1 mg/dl and 44.3 +/- 11.5 mg/dl respectively. Hypercholesterolemia and Hypertriglyceridemia were seen in 18.5% and 14.2% of the patients. Total cholesterol was significantly higher in females than in males and in type 2 than in type 1 patients (179.3 +/- 48.4 mg/dl versus 154.1 +/- 38.2 mg/dl, P < 0.01 and 183.2 +/- 43.7 mg/dl versus 145.9 +/- 37.6 mg/dl, P < 0.001) respectively. Triglycerides and LDL cholesterol were also significantly higher in type 2 diabetic patients than in type 1 diabetic patients (162.7 +/- 10.5 mg/dl versus 91.5 +/- 53.3 mg/dl, P < 0.001 and 105.6 +/- 36.2 mg/dl versus 81.9 +/- 32.2 mg/dl, P < 0.001), but HDL cholesterol was the same in both types of diabetic patients. Similarly, hyperlipidemia was associated with obesity and hypertension. The study confirms that lipid values are high particularly in type 2 diabetic patients. Hence our patients are at increased risk of developing atherosclerosis therefore periodic check up of lipids in diabetic patients and effective treatment of the dyslipidemia along with a tight metabolic control was recommended.     

Retinopathy in patients of Tikur Anbessa Hospital diabetic clinic

A total of 302 diabetic patients were selected from regular attendants of the Tikur Anbessa Hospital (TAH) diabetic clinic to determine the prevalence of retinopathy from December 1994 to March 1995. The mean age was 41.4 +/- 14.4 years (range 14-85). There were 160 males (53%) and 142 females (47%). One hundred forty (46%) were type 1 and 162 (53.6%) were type 2. The mean duration of diabetes was 9.4 +/- 5.4 years and the mean Hemoglobin Alc (HbAlc) was 10.4 + 2.2%. On the day of the examination the mean fasting blood glucose (FBG) and random blood glucose (RBG) were 195.5 +/- 79.9 mg/dl and 273.1 +/- 114.5 mg/dl respectively. The mean serum total cholesterol, triglycerides, LDL, VLDL and GDL were 166.5 +/- 45.5 mg/dl, 129.9 +/- 92.4 mg/dl, 94.5 +/- 36.4 mg/dl, 24.4 +/- 15.1 mg/dl and 44.3 +/- 11.5 mg/dl respectively. The overall prevalence of retinopathy was 37.8% out of which 108 patients (36.1%) had background retinopathy and 5 patients (1.7%) had proliferative retinopathy. The retina could not be visualized in three patients because of dense cataract. Retinopathy correlated positively with age, duration of diabetes and blood pressure respectively, however no significant correlation was seen with mean total HgAlc and serum lipids. Prevalence of retinopathy was comparable in type 1 and type 2 (p > 0.05). The prevalence of retinopathy in our patients relative to the duration of diabetes mellitus is high. Therefore, improving facilities for the diagnosis and treatment of retinopathy is recommended.     

Assessment of the potential of competitor snails and African catfish (Clarias gariepinus) as biocontrol agents against snail hosts transmitting schistosomiasis

The objective of this study was to assess the potential of the snails Physa acuta and Melanoides tuberculata and the African catfish Clarias gariepinus as biological control agents against the Schistosoma mansoni intermediate host Biomphalaria pfeifferi under laboratory conditions. Groups of five target and five competitor snails were raised together in experimental aquaria and same number in separate aquaria as controls. Shell size, number of eggs and mortality rate were recorded for twelve consecutive weeks. The stocking density for C. gariepinus was one fish per aquarium. Fish were provided with adequate or inadequate supplementary food and fifteen B. pfeifferi were added to each aquarium. The snails and their eggs were counted daily. Significant differences in shell growth and fecundity were noted between B. pfeifferi and M. tuberculata. Physa acuta was noted to be voracious in food consumption. Snail consumption was faster by fish provided with inadequate supplementary food. Based on the present findings, it is suggested that the two competitor snails and African catfish could be used as biological control agents against B. pfeifferi. Nevertheless, the susceptibility of the competitor snails to other trematodes in Ethiopia must first be ruled out before introducing these snails into new habitats. Follow-up field observation and rigorous laboratory studies remain areas for further research.     

Hepatoprotective and antioxidant arylbenzofurans and flavonoids from the twigs of Morus mesozygia

The chemical investigation of the twigs of Morus mesozygia resulted in the isolation of three new prenylated 2-arylbenzofurans, named moracin KM, LM, and SC (1-3), nine known 2-arylbenzofurans (4-12), and two known flavonoids (13-14). The structures of the new compounds were established as [2',3':6,7]-(6-(S)-hydroxymethyl-6-methylpyrano)-2-(3,5-dihydroxyphenyl)benzofuran-5-ol (1), [2',3':6,7]-(4,7-dihydro-6-methyloxepine)-2-(3-hydroxy-5-methoxyphenyl)benzofuran-5-ol (2), and [2',3':6,7]-(6,6-dimethylpyrano)-2-(3,5-dihydroxyphenyl)benzofuran (3). One of the new compounds, moracin LM (2), displayed modest antioxidant activity, whereas known compounds 4, 13, and 14 showed significant hepatoprotective and antioxidant activities.