Incremental system costs of introducing combined DTwP–hepatitis B–Hib vaccine into national immunization services in Ethiopia

Objective

With support from the GAVI Alliance a fully liquid combined DTwP–HepB–Hib (pentavalent) vaccine in a single dose vial was introduced into Ethiopia's routine immunization services in March 2007. This vaccine was substituted with DTwP in a 10-dose vial. We aimed to estimate the incremental system costs of pentavalent vaccine delivery.

Methods

Data on cold storage expansion and increased vaccine transport frequency were collected in four regions of Ethiopia over a 2-week period, as part of a Post-Introduction Evaluation of the new vaccine. Interviews were conducted with individuals at all levels of the health system. Information on the costs of training and communication to facilitate the introduction was collected from the Ministry of Health, UNICEF and WHO in Addis Ababa.

Results

The switch from a 10-dose DTwP to a single dose pentavalent vaccine increased refrigeration storage volume per fully vaccinated child by 106% at national and regional levels and by 71% at the three lower levels of vaccine distribution. Cold storage equipments were purchased at all levels and the frequency of vaccine collection more than doubled in many places. Incremental capital costs of cold storage equipment, training and communication amounted to US$ 4.8 million, or US$ 1.53 per child in the 2007 birth cohort. After annualizing capital costs and adding recurrent costs, system costs came to US$ 0.80 per child in the 2007 birth cohort. With a vaccination coverage rate of 78% this is equivalent to US$ 1.13 per fully vaccinated child. The most important system cost item is cold storage, amounting to US$ 0.62 per child in the birth cohort and US$ 0.03 per additional cm³ of cold storage.

Conclusion

In Ethiopia introduction of pentavalent vaccine necessitated considerable investments in additional cold storage equipment as well as an increase in vaccine transport frequency. A GAVI Alliance introduction grant of US$ 0.30 per child in the birth cohort would cover approximately 20% of the capital investments undertaken to facilitate introduction.     

Seasonal influence on some blood and biochemical parameters of pigeons (Columba livia) in Rajasthan, India

This study was undertaken to investigate the effect of season on some haematological and biochemical parameters in pigeons (Columba livia) in Rajasthan, India. Blood samples of 80 pigeons were collected in four different seasons (20 from each season) for analysing haematological and biochemical parameters. In the haematological parameters, haemoglobin, packed cell volume and total erythrocyte count were significantly lower (p?<?0.05) in summer compared with winter season. Whereas, no significant difference (p?<?0.05) was observed in the values of total leucocyte count in different seasons. Albumin, total protein, serum alanine amino transaminase and aspartate amino transaminase were significantly increased (p?<?0.05) in summer compared with winter season, whereas alkaline phosphatase values in summer were significantly low when compared to winter. In conclusion, heat stress during summer caused deterioration in some haematological and serum biochemical constituents of pigeons (C. livia). This study highlights the relevance of seasonal variations when monitoring the health and physiological state of pigeons     

Delayed initiation of adjuvant chemotherapy among women with breast cancer in Addis Ababa,Ethiopia

Breast Cancer Research and Treatment - Chemotherapy within 90&nbsp;days following surgery for non-metastatic breast cancer is the standard of care. There are no data, however, on the extent of...     

Reaction of Medical Students to Experiences in Dissection Room

Background

As preclinical medical students start and/or enter the course, they go through the anatomy curriculum, which involves interaction with cadavers and cadaveric material. The objective of this study was to determine the reactions of preclinical medical students from year two and year three to the dissecting room.

Methods

Questionnaire was distributed to all second and third year medical students. The questionnaire was designed with the objective of identifying specific patterns of attitudes held and problems faced by the students in their first exposure to the human cadaver. The results are analyzed statistically using the SPSS 16.0 software and P< 0.05 was considered statistically significant.

Results

The commonest symptoms experienced were loss of appetite (43.29% year 2 and 34.86 % third year students). The commonest cause of their symptoms was studied and the result shows that it was the smell of the dissection room, as reported by 67.01% of year two students; and 54.12% for year 3 students.

Conclusion

The present study findings show that smell of the dissection room, touch and fear of cadaver were the commonest cause of their symptoms experienced while study in dissection room for the majority of students. Thus, instructors are should give awareness raising education before the commencement of the dissection session to the students both mentally and emotionally ready to do their work enthusiastically and confidently. Moreover, it is necessary to make the laboratory tidy for the students so that they develop a love for the dissection room.     

The potential of biotechnology in Ethiopia: Present situation and expected development

Conventional research approaches have tried to address the major research and development problems in Ethiopia. However, these approaches could not achieve the desired level of improvement unless they are supported by modern biotechnological tools. Biotechnological facilities exist scattered in different institutions in Ethiopia, a country with immense genetic biodiversity, but no precise information is available as to their capacities, capabilities and the associated technical and administrative gaps. A study based on structured questionnaires, interviews with key informants and reviewing secondary sources was initiated in 2006 by the Horn Biotechnology Forum to generate such information and design strategies for bridging the gaps. The study showed that seven institutions with a total of 24 branches are engaged in biotechnology research/teaching and development at different stages, mainly tissue culture, but including bio-fertilizers, molecular marker, embryo transfer, immunology, vaccine and diagnostic kit development and epidemiology. Ten centers have modest to well equipped laboratories and a few other laboratories are also under expansion. By and large, the future success of biotechnological research and development in Ethiopia depends on the level of attention to be given by the government on capacity building and on the level of collaboration among the institutions.     

Spatial analysis of malaria incidence at the village level in areas with unstable transmission in Ethiopia

Background  

Malaria is the leading cause of morbidity and mortality in Ethiopia, accounting for over five million cases and thousands of deaths annually. The risks of morbidity and mortality associated with malaria are characterized by spatial and temporal variation across the country. This study examines the spatial and temporal patterns of malaria transmission at the local level and implements a risk mapping tool to aid in monitoring and disease control activities.     

Child sexual abuse and its outcomes among high school students in southwest Ethiopia

Child sexual abuse (CSA) is a major contributing factor to the burden of disease among children and adolescents. The aim of this study is to determine the prevalence of CSA and its outcomes among female high school students in Ethiopia. A cross-sectional study was conducted among Jirren high school female students in April 2005. A total of 323 female students from grade 9 were selected by systematic random sampling and they completed a self-administered questionnaire on experiences of sexual abuse. Data were cleaned and analysed by SPSS/PC statistical package. The results revealed that the prevalence of CSA was 68.7%. Among the different forms of sexual abuses, verbal harassment was the most common (51.4%) followed by sexual intercourse, 18.0% and unwelcome kissing, 17.1%. The commonly indicated abusers in this study were unknown persons (36%) followed by school-mates (31.5%). Among victims of sexual abuse, 7.2% had an unwanted pregnancy and 5.9% had sexually transmitted diseases. The rate of other psychological effects of CSA, such as suicide ideation, suicide attempt, and sexual dysfunction, was high. The overwhelming majority (86.4%) considered sexual abuse to be a major social problem. The study revealed that the prevalence of CSA is high. Reproductive health education should be provided to students. Parents, police, and the public in general should be made aware of the problem before it endangers the lives of children and adolescents.