Ethiopian adolescents' attitudes and expectations deviate from current infant and young child feeding recommendations

PURPOSE: Suboptimal infant and child feeding practices are highly prevalent in many developing countries for reasons that are not entirely understood. Taking an anthropological perspective, we assessed whether nulliparous youth have formulated attitudes and expectations in the domain of infant and child feeding behaviors, the extent to which these varied by location and gender, and the extent to which they deviated from current international recommendations. METHODS: A population-based sample of 2077 adolescent girls and boys (13-17 years) in southwest Ethiopia answered a questionnaire on infant and young child feeding behaviors. RESULTS: Results indicate high levels of agreement among adolescents on items relating to infant and young child feeding behaviors. Attitudes and intentions deviated widely from current international recommendations. Youth overwhelmingly endorsed items related to early introduction of nonbreast milk liquids and foods. For girls, fewer than 11% agreed that a 5-month infant should be exclusively breastfed and only 26% agreed that a 6-month infant should be consuming some animal source foods. Few sex differences emerged and youth responses matched larger community patterns. CONCLUSIONS: The results indicate that attitudes and expectations deviate widely from current international child feeding guidelines among soon to be parents. To the extent that youth models are directive, these findings suggest that youth enter into parenthood with suboptimal information about infant and child feeding. Such information will reproduce poor health across generations as the largest cohort of adolescents ever become parents. These results suggest specific points of entry for adolescent nutrition education interventions.     

Immunohematological Reference Ranges for Adult Ethiopians

A cross-sectional survey was carried out with 485 healthy working adult Ethiopians who are participating in a cohort study on the progression of human immunodeficiency virus type 1 (HIV-1) infection to establish hematological reference ranges for adult HIV-negative Ethiopians. In addition, enumeration of absolute numbers and percentages of leukocyte subsets was performed for 142 randomly selected HIV-negative individuals. Immunological results were compared to those of 1,356 healthy HIV-negative Dutch blood donor controls. Immunohematological mean values, medians, and 95th percentile reference ranges were established. Mean values were as follows: leukocyte (WBC) counts, 6.1 × 10⁹/liter (both genders); erythrocyte counts, 5.1 × 10¹²/liter (males) and 4.5 × 10¹²/liter (females); hemoglobin, 16.1 (male) and 14.3 (female) g/dl; hematocrit, 48.3% (male) and 42.0% (female); platelets, 205 × 10⁹/liter (both genders); monocytes, 343/μl; granulocytes, 3,057/μl; lymphocytes, 1,857/μl; CD4 T cells, 775/μl; CD8 T cells, 747/μl; CD4/CD8 T-cell ratio, 1.2; T cells, 1,555/μl; B cells, 191/μl; and NK cells, 250/μl. The major conclusions follow. (i) The WBC and platelet values of healthy HIV-negative Ethiopians are lower than the adopted reference values of Ethiopia. (ii) The absolute CD4 T-cell counts of healthy HIV-negative Ethiopians are considerably lower than those of the Dutch controls, while the opposite is true for the absolute CD8 T-cell counts. This results in a significantly reduced CD4/CD8 T-cell ratio for healthy Ethiopians, compared to the ratio for Dutch controls.     

Comparison of Parental and Adolescent Views on the Confidential Interview and Adolescent Health Risk Behaviors within the Gynecologic Setting

Study Objective

To explore parental and adolescent views on the confidential interview in the gynecologic setting and compare adolescent reported risk-taking behaviors with parental perception.

Pattern of widal agglutination reaction in apparently healthy population of Jimma town, southwest Ethiopia

BACKGROUND: Typhoid fever is leading cause of morbidity in developing countries including Ethiopia. Isolation of Salmonella Typhi by culturing, from blood or other source, is the surest way of making laboratory diagnosis. However, in resource-limited countries, the Widal agglutination test provides cheaper and easy alternatives, though inappropriate technique and interpretation continue to cast a shadow on its usefulness. METHODS AND MATERIALS: A cross-sectional study was carried out during the period of February to May 2004 to determine the baseline antibody tube titration and slide agglutination pattern to Widal antigen and the usefulness of rapid slide agglutination test for diagnostic purposes among apparently healthy population of Jimma town, southwest Ethiopia. Blood samples were collected from subjects who gave their consents after thorough explanation of the procedure and the purpose of the study. The study participants were selected by a systematic random sampling technique. The sera of subjects were tested for Widal agglutination by an experienced laboratory technologist according to the standard procedural protocol-using antigen from Chronolab AG, Switzerland Data were cleaned edited and entered in to a computer and analyzed using SPSS for window version 11.0. Major results were expressed as 95% probability limit, and validity scoring; agreement test (Kappa) was determined. RESULTS: The result indicated that among the apparently health population, almost all the blood tested showed some titer of the antibody and reactivity of agglutination slide tests. The 95% probability limit (mean + 2SD) for anti H and anti O antigen titration was 1:276.89 and 1:207.89, respectively. These figures are closer to a cut-off titer of 1.320. There was a fair agreement between slide agglutination test and tube titer for 0 antigen (Kappa=0.225) and a poor agreement for H antigen (Kappa=0.066). When agglutination test result of highly reactive (+4) and titration of 1:320 were used, few cases became reactive indicating the need to raise the cut-off value to these points respectively. CONCLUSION: It is recommended that if Widal test is to be used for the clinical work up of typhoid fever in adult population, a cut-off value highly reactive (+4),for rapid slide agglutination and a titer of 1.320 and above for tube titration test be used. At the cut-off values indicated above, Widal test has low sensitivity and positive predictive value and high specificity and negative predictive values. This makes the test useful support to clinical suspicion but unlikely means ofJscreening.     

Comparison of minimal incision aortic surgery with endovascular aortic repair

BACKGROUND: Enthusiasm for endovascular aortic repair (EVAR) has been tempered by midterm outcomes that raise valid concern about long-term durability. METHODS: This article compares outcome data from a prospective nonrandomized comparison of a less-invasive open surgical repair technique-minimal incision aortic surgery (MIAS)-and EVAR. RESULTS: MIAS and EVAR had comparable intensive care unit stays (1 day or less), quick return to general dietary feeding (2 days), and comparable hospital length of stay (4.8 days [3.4 days for uncomplicated cases MIAS] and 2.0 days for EVAR). Overall morbidity and mortality for MIAS and EVAR were comparable (18% versus 27%). MIAS was more cost effective than EVAR (net revenue MIAS = +8,445 US dollars, EVAR -7,263 US dollars). CONCLUSIONS: MIAS is a safe, cost-effective alternative to endovascular aortic repair.     

Burden and determinants of undernutrition among young pregnant women in Ethiopia

Undernutrition is a major public health concern due to its association with the mortality and disease burden of women and children. This study aimed at identifying the extent and determinants of undernutrition among young pregnant women in Ethiopia. A multivariable regression analysis was fitted to identify determinants of undernutrition and anaemia in a sample of 1,393 pregnant women. Risk ratios (RRs) with 95% confidence interval (CI) were estimated. All the analyses were performed using STATA version 14 and adjusted for clustering. The study revealed that 38% of the women were undernourished and 22% were anaemic. Improved maternal education, RR = 0.94, 95% CI [0.89, 0.98]; higher wealth status, RR = 0.72, 95% CI [0.47, 0.95]; higher minimum dietary diversity for women, RR = 0.87, 95% CI [0.77, 0.98]; increased maternal height, RR = 0.96, 95% CI [0.94, 0.98]; and protected water source, RR = 0.93, 95% CI [0.86, 0.96], have decreased the risk of undernutrition while using unimproved toilet, RR = 1.31, 95% CI [1.06, 1.63], and depression, RR = 1.33, 95% CI [1.14, 1.55], increased the risk of anaemia. Animal source food consumption decreased both the risk of undernutrition, RR = 0.85, 95% CI [0.77, 0.94], and anaemia, RR = 0.91, 95% CI [0.85, 0.95]. The burden of undernutrition is still high. Although improved socio‐economic status and dietary practices decreased the risk of undernutrition, poor health and environmental conditions were still significant risk factors. These findings suggest the need to target this set of important determinants to significantly decrease the burden of undernutrition among young pregnant women.