Attitudes of modern and traditional medical practitioners toward cooperation

Between 1985 and 1987 a total of 103 modern and 91 traditional medical practitioners were interviewed in seven towns in northwestern and central Ethiopia. The main aim was to assess their attitudes toward the legitimacy of each other's medical system and, especially, toward the question of cooperation or integration between modern and traditional medicine. It was found that the majority of the two groups of health workers believed that cooperation between the two systems of medicine would be useful and that they themselves would be willing to participate in such cooperative efforts. Those willing to cooperate suggested that traditional healers be (1) brought into the existing, official health-care settings, (2) given regular government wages for their services, and (3) guided and supervised by their modern counterparts.     

Effects of mavacamten on Ca2+ sensitivity of contraction as sarcomere length varied in human myocardium

Background and PurposeHeart failure can reflect impaired contractile function at the myofilament level. In healthy hearts, myofilaments become more sensitive to Ca²⁺ as cells are stretched. This represents a fundamental property of the myocardium that contributes to the Frank–Starling response, although the molecular mechanisms underlying the effect remain unclear. Mavacamten, which binds to myosin, is under investigation as a potential therapy for heart disease. We investigated how mavacamten affects the sarcomere‐length dependence of Ca²⁺‐sensitive isometric contraction to determine how mavacamten might modulate the Frank–Starling mechanism.Experimental ApproachMulticellular preparations from the left ventricular‐free wall of hearts from organ donors were chemically permeabilized and Ca²⁺ activated in the presence or absence of 0.5‐μM mavacamten at 1.9 or 2.3‐μm sarcomere length (37°C). Isometric force and frequency‐dependent viscoelastic myocardial stiffness measurements were made.Key ResultsAt both sarcomere lengths, mavacamten reduced maximal force and Ca²⁺ sensitivity of contraction. In the presence and absence of mavacamten, Ca²⁺ sensitivity of force increased as sarcomere length increased. This suggests that the length‐dependent activation response was maintained in human myocardium, even though mavacamten reduced Ca²⁺ sensitivity. There were subtle effects of mavacamten reducing force values under relaxed conditions (pCa 8.0), as well as slowing myosin cross‐bridge recruitment and speeding cross‐bridge detachment under maximally activated conditions (pCa 4.5).Conclusion and ImplicationsMavacamten did not eliminate sarcomere length‐dependent increases in the Ca²⁺ sensitivity of contraction in myocardial strips from organ donors at physiological temperature. Drugs that modulate myofilament function may be useful therapies for cardiomyopathies.     

Intersections of girl child marriage and family planning beliefs and use: qualitative findings from Ethiopia and India

Child marriage and subsequent early first birth is a considerable social, economic and health concern, and a pervasive practice in sub-Saharan Africa and South Asia. This study explores barriers and facilitators to family planning among women and girls, and their marital decision-makers subsequent to receipt of child marriage prevention programmes in Ethiopia and India. In-depth interviews with 128 women and girls who were married as minors or who cancelled or postponed marriage as minors and their marital decision-makers were analysed using content analysis. Respondents identified social norms, including child marriage and pressure to have children, and lack of information as barriers to family planning. Benefits included delayed first birth and increased birth spacing, improved maternal and child health and girls’ educational attainment. Respondents associated family planning use with delayed pregnancy and increased educational attainment, particularly in Ethiopia. Child marriage prevention programmes were identified as important sources of family planning information. Ethiopia’s school-based programme strengthened access to health workers and contraception more so than India’s community-based programme. Findings highlight young wives’ vulnerability with regard to reproductive control, and support the need for multi-sector approaches across communities, schools and community health workers to improve family planning among young wives.     

Khat use among HIV voluntary counselling and testing centre clients in Ethiopia

Khat (Catha edulis, a natural stimulant), has been used in Ethiopia for centuries. Over the past few decades, however, its use has dramatically increased, with recent research linking khat use to HIV status. Using qualitative methods, we explored the individual and micro-environmental characteristics of khat use and the social and physical contexts influencing type, acceptability and consequences of khat use. Among khat chewers attending an HIV voluntary counselling and testing centre in Addis Ababa, Ethiopia, we found that chewing typically starts at an early age (15–18 years). The majority of users are young (aged 18–35) and chew for pleasure, primarily in social settings. Over 25 types of khat, with varying effects were reported. Approximately half of the participants perceived khat to enhance sexual desire, while the rest claimed the effect on sexual desire to be the opposite. Alcohol use among chewers was high. Our findings suggest the need for culturally appropriate interventions that highlight the factors associated with khat use and the potential interplay between khat, alcohol and risky sexual behaviour.     

Knowledge and practice concerning malaria,insecticide-treated net (ITN) utilization and antimalarial treatment among pregnant women attending specialist antenatal clinics

Aim  

This study was conducted to determine the knowledge and practice of pregnant women attending specialist antenatal clinics (ANCs) concerning malaria, ITN (insecticide-treated net) utilization and antimalarial treatment.     

Probable Vanishing White Matter Disease: A Case Report and Literature Review

BackgroundVanishing white matter disease is one of the most prevalent inherited childhood leukoencephalopathies. The disease is characterized by chronic, progressive and episodic deterioration with ataxia and spasticity.Case PresentationHere, we report a 15-month-old female child from Dire-Dawa, eastern part of Ethiopia, who presented with regression of developmental milestones and truncal ataxia since her age of 11 months following a febrile illness that occurred one month earlier. Magnetic resonance imaging of brain is suggestive of vanishing white matter disease.ConclusionsWe believe this case report will increase curiosity, awareness and knowledge of health professionals in Ethiopia and sub-Saharan Africa working with children in early consideration and the diagnosis of the disease.     

Promoting traditional medicine in Ethiopia: a brief historical review of government policy

Past and current official policy toward Ethiopian traditional medicine is reviewed. To facilitate the objective assessment of official policy, the nature and historical origins of Ethiopian traditional medicine is examined briefly. It is noted that there is no single system of traditional medicine in Ethiopia, even though themes that are common to the many cultural groups constituting the society have been evolving. Common to most systems of Ethiopian traditional medicine are the interdigitation of 'mystical' and 'natural' explanations of ill-health and other misfortune and the holistic approach employed in dealing with illness and other personal misfortune. It is also noted that since the 1974 change of government in Ethiopia, official attitude toward the promotion and development of traditional medicine appears to have become more positive, especially, after the adoption of the Primary Health Care strategy in 1978. While this is true as far as official statements are concerned, in actual practice there continues to be considerable uncertainty about the interpretation and implementation of Government policy. It is suggested that misconceptions regarding the nature and role of traditional medicine in Ethiopian society will have to be corrected if appropriate plans and strategies are to be formulated.