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Angiotensin-converting enzyme inhibitors have been used as the standard of care for the treatment of diabetic nephropathy. Recently, dapagliflozin has been shown to reduce diabetic nephropathy when added to the standard of care.The objective of this study was to determine the cost effectiveness of dapagliflozin added to the standard of care in diabetic nephropathy in the United States of America (USA).A Markov model was developed to determine the cost-effectiveness outcomes from the Medicare/Medicaid health coverage perspective. Model inputs were derived from the literature. The primary outcomes were total costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio. Deterministic and probabilistic sensitivity analyses were performed to determine the robustness of our results. A willingness-to-pay threshold of $100,000 per QALY was applied, which is based on previous studies.Dapagliflozin yielded a lifetime QALY of 2.8. The discounted QALY associated with the standard of care was 2.6. The standard of care was the less costly treatment with a lifetime cost of $106,150.25 as compared with dapagliflozin, which costs $110,689.25. Dapagliflozin demonstrated an incremental cost-effectiveness ratio of $21,141.51 per additional QALY. The most influential parameters of the incremental cost-effectiveness ratio were the adverse drug reaction-related cost of the standard of care and dapagliflozin, the acquisition cost, and the adverse drug reaction-related cost of dapagliflozin. The effects and costs of the interventions were consistent between base-case analyses and the probabilistic model (incremental cost-effectiveness ratio: $19,023.35 [$13,637.8-$27,483.1]).Dapagliflozin added to the standard of care was cost effective relative to the standard of care alone in the USA for patients with diabetic nephropathy.

Solomon Berhanu Mogas,1 Temamen Tesfaye,2 Belay Zewde,3 Yonas Tesfaye,4 Ayantu Kebede,1 Mulualem Tadesse,5 Esayas Kebede Gudina,6 Dessalegn Tamiru,7 Lelisa Sena Dadi1 1Department of Epidemiology, Jimma University, Jimma, Oromia Region, Ethiopia; 2School of Nursing and Midwifery, Jimma University, Jimma, Oromia Region, Ethiopia; 3Department of Biomedical Sciences, Jimma University, Jimma, Oromia Region, Ethiopia; 4Department of Psychiatry, Jimma University, Jimma, Oromia Region, Ethiopia; 5School of Medical Laboratory Science, Jimma University, Jimma, Oromia Region, Ethiopia; 6Department of Internal Medicine, Jimma University, Jimma, Oromia Region, Ethiopia; 7Department of Nutrition and Dietetics, Jimma University, Jimma, Oromia Region, EthiopiaCorrespondence: Solomon Berhanu MogasDepartment of Epidemiology, Jimma University, P.O.Box-378, Oromia Region, EthiopiaTel +251913458961Email solo.berhanu@gmail.comBackground: Hypertension (HTN) is the leading risk factor for mortality due to cardiovascular diseases, it accounts for 7% of global disability adjusted life years. In 2015, it was estimated that around 1.13 billion adults had HTN globally with a high prevalence in low and middle-income countries where the health system is weak to diagnose, treat, and control HTN. Most people with HTN are asymptomatic and go undiagnosed for years. Therefore, the aim of this study was to assess the burden of undiagnosed HTN among adults in urban communities of Southwest Ethiopia.Methods: A community-based cross-sectional study involving 915 adults from June 17 to July 27, 2019 was performed. WHO STEPS questionnaire was used to collect data, and the collected data were entered using Epi Data version 3.1and analyzed using SPSS version 20, respectively. Binary logistic regression was used to check for a possible association between outcome and independent factors. P-value < 0.05 and 95% CI were used on multivariable logistic regression analysis as threshold for significant statistical association.Results: Undiagnosed HTN in the study area was 21.2% (194). Age (AOR=1.04, 95% CI=1.02– 1.05), BMI with overweight (AOR=2.52, 95% CI=1.35– 4.71), triglyceride (AOR=1.83, 95% CI=1.29– 2.59), and waist to hip ratio (AOR=1.62, 95% CI=1.03– 2.54) were factors significantly associated with HTN.Conclusion: As compared to studies performed before, the risk of undiagnosed HTN in the current study was high. Age, BMI, triglyceride, and waist to hip ratios were found to be the significant factors for it. Preventing the risk factors and screening of HTN should be promoted for early detection, prevention, and treatment of the burden of the disease on the population.Keywords: adult, burden, Ethiopia, hypertension, Jimma town, risk, undiagnosed

Lencho Megersa Marami,1 Getachew Mulatu Dilba,1 Dagmawit Atalel Babele,1 Edilu Jorga Sarba,2 Askale Gizaw,1 Wakuma Mitiku Bune,1 Morka Dandecha Bayu,1 Petros Admasu,2 Abraham Mekbeb,2 Miressa Tadesse,3 Kebede Abdisa,2 Dejene Bayisa4 1Ambo University, College of Agriculture and Veterinary Science, Department of Veterinary Laboratory Technology, Ambo, Oromia, Ethiopia; 2Ambo University, College of Agriculture and Veterinary Science, Department of Veterinary Science, Ambo, Oromia, Ethiopia; 3Ambo University, College of Computational and Natural Science, Department of Chemistry, Ambo, Oromia, Ethiopia; 4Jeldu Woreda, Livestock and Fishery Development Office, Gojo, Oromia, EthiopiaCorrespondence: Getachew Mulatu DilbaAmbo University, College of Agriculture and Veterinary Science, Department of Veterinary Laboratory Technology, P.O. Box 19, Ambo, Oromia, EthiopiaTel +251-912717217Email getachew.mulatu@ambou.edu.etBackground: Although traditional healers in Ethiopia have a long history of using medicinal plants to treat diseases in animals and humans, studies on the antibacterial activities and potential bioactive ingredients of most medicinal plants have been insufficient. Therefore, this study aimed to evaluate the in-vitro antibacterial activities and to screen phytochemical constituents of selected medicinal plants against reference bacterial strains.Methods: The fresh and healthy roots of Echinops amplexicaulis, fruits of Ruta chalepensis, and leaves of Salix subserrata were collected from West Shewa Zone, Ethiopia. Agar well diffusion and agar dilution methods were used to evaluate antibacterial activities and minimum inhibitory concentrations (MIC). All the crude plant extracts were tested against Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli and Pseudomonas aeruginosa at concentrations of 100, 50, and 25 mg/mL in each triplet (3x). MIC of crude extracts ranging from 1.5625 to 12.50 mg/mL was applied to all bacterial strains. The positive control was ciprofloxacin disk (5 μg) and the negative control was 5% dimethyl sulfoxide. The presence of secondary metabolites of each crude extract was screened. The group means comparisons were done using one-way ANOVA and results were presented as mean ± standard deviation.Results: Although all selected plant extracts had shown antibacterial activities, methanol extracts had a greater zone of inhibition against all reference bacterial strains when compared to petroleum ether extracts. The growth of P. aeruginosa was inhibited at a minimum concentration of both methanol and petroleum extracts (1.5625 mg/mL) when compared to the remaining bacterial strains. Phytochemical screening showed that saponins and alkaloids were found in all crude plant extracts, while phytosterol was meager.Conclusion: This study revealed that all tested plants had significant secondary metabolites and antibacterial activities against reference bacterial strains.Keywords: antibacterial activity, crude plant extract, ethnomedicine, methanol, petroleum ether

Sileshi Kenate,1 Temamen Tesfaye,2 Solomon Berhanu Mogas,3 Belay Zawdie,4 Yonas Tesfaye,2 Lelisa Sena Dadi,3 Mulualem Tadesse,5 Ayantu Kebede,3 Esayas Kebede Gudina,6 Dessalegn Tamiru4 1Jimma Town Health Office, Jimma, Ethiopia; 2School of Nursing, Jimma University, Jimma, Ethiopia; 3Department of Epidemiology, Jimma University, Jimma, Ethiopia; 4Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia; 5Department of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia; 6Department of Internal Medicine, Jimma University, Jimma, EthiopiaCorrespondence: Dessalegn TamiruDepartment of Nutrition and Dietetics, Jimma University, P. O. Box-378, Jimma, Oromia Region, EthiopiaTel +251912373397Email dessalegn97@gmail.comIntroduction: Lack of regional- and local-based cut-off points of lipid profile and/or anthropometric measurements remains one of the challenges in prevention, early detection and control of non-communicable diseases. This study aimed to validate anthropometric-based screening of lipid profiles to develop locally appropriate optimal cut-off points for metabolic syndrome screening.Methods: A community-based cross-sectional study was conducted among randomly selected 977 adults in Jimma Town, Ethiopia. Data were collected using structured questionnaire, anthropometric and biochemical measurements. Data were analyzed using SPSS windows version 21 and Kappa statistic was used to validate the agreement between anthropometric measurement and lipid profile. A p-value of < 0.05 was considered statistically significant.Results: Body mass index (BMI) at ≥ 24.5 was used as screening of dyslipidemia (TG≥ 150mg/dl) with slight Kappa coefficient of 0.138 (P< 0.001) among females while it was ≥ 22.2 among males with fair (0.275) Kappa coefficient (P< 0.001). Waist circumference-based screening of dyslipidemia (TG≥ 150mg/dl) at ≥ 78.0cm had negative (− 0.005) Kappa coefficient (Pp< 0.001) among females (sensitivity: 72.6% and specificity: 26.7%). Yet, waist circumference at ≥ 83.7cm had slight Kappa coefficient of 0.13 (P< 0.005) among males (sensitivity: 38% and specificity: 74.9%). Waist hip ratio-based screening of dyslipidemia (TG≥ 150mg/dl) at ≥ 0.82 among females had negative (− 0.001) Kappa coefficient (p=0.763), whereas among males at ≥ 0.88, there was a slight (0.105) Kappa coefficient of (p=0.002) (sensitivity:77.5% and specificity:36.8%). This study showed that anthropometric-based high-density lipoprotein measurement was not applicable.Conclusion: This study indicated that BMI-based screening of triglyceride was more applicable for both sexes than other anthropometric measurements. Waist circumference and waist-to-hip ratio-based screening of triglyceride were slightly applicable only for males. However, anthropometric-based screening of high-density lipoprotein measurement was not applicable for both sexes. In conclusion, researchers and policy makers need to consider locally validated cut-off points to be used for screening metabolic syndrome in the community.Keywords: metabolic syndrome, lipid profile, anthropometric measurements, Jimma

Temamen Tesfaye Yunka,1 Solomon Berhanu Mogas,2 Belay Zawdie,3 Desalegn Tamiru,4 Yonas Tesfaye,5 Ayantu Kebede,2 Mulualem Tadesse,6 Esayas Kebede Gudina,7 Lelisa Sena Dadi2 1School of Nursing and Midwifery, Jimma University, Jimma, Oromia Region, Ethiopia; 2Department of Epidemiology, Jimma University, Jimma, Oromia Region, Ethiopia; 3Department of Biomedical Sciences, Jimma University, Jimma, Oromia Region, Ethiopia; 4Department of Nutrition and Dietetics, Jimma University, Jimma, Oromia Region, Ethiopia; 5Department of Psychiatry, Jimma University, Jimma, Oromia Region, Ethiopia; 6Department of Medical Laboratory, Jimma University, Jimma, Oromia Region, Ethiopia; 7Department of Internal Medicine, Jimma University, Jimma, Oromia Region, EthiopiaCorrespondence: Temamen Tesfaye YunkaSchool of Nursing and Midwifery, Jimma University, P.O.Box-378, Oromia region, EthiopiaTel +251913153299Email tekanetesfu@gmail.comIntroduction: Early detection of the unrecognized diabetes mellitus (DM) and its risk factors in the community is crucial to minimizing the burden of DM and associated complications. Hence, this study aimed to assess unrecognized DM and its relationship with behavioral characteristics, physical characteristics, and lipid profile among adults in Jimma Town, Southwest Ethiopia.Methods: A community-based cross-sectional study was conducted on 915 adults in Jimma Town from June 17 to July 27, 2019. Physical measurements, lipid profile, and blood sugar levels were measured. The collected data were entered and analyzed using Epi Data 3.1 and SPSS version 21, respectively. Multivariable logistic regression was fitted to assess predictors of unrecognized DM where adjusted odds ratio (AOR) with its corresponding 95% confidence interval (CI) was used to assess the strength of association at P-value ≤ 05.Results: The prevalence of unrecognized DM and impaired glucose metabolism (pre-diabetes) were 3.1% (95% CI; 2.0– 4.4) and 14.8% (95% CI; 12.5– 17.2), respectively. The risk of unrecognized DM was higher among male participants (AOR = 2.94, 95% CI: 1.19, 7.29), age group of 35 years and above (AOR = 3.45, 95% CI: 1.16, 10.27), and high waist circumference (AOR = 4.21, 95% CI: 1.72, 10.33). On the other hand, participants who perform sufficient physical activity (AOR = 0.14, 95% CI: 0.03, 0.58) had low risk of undetected DM.Conclusion: The prevalence of unrecognized diabetes mellitus was relatively high. Male sex, advanced age, physical inactivity, and high waist circumference were found to be predictors of unrecognized DM. Thus, awareness needs to be created among the community to practice regular physical activity and maintaining normal body weight. Additionally, screening of DM should be promoted for early detection, prevention, and treatment.Keywords: unrecognized DM, diabetes mellitus, adult, lipid profile, physical measurement

There is a paucity of predictive models for uncontrolled diabetes mellitus. The present study applied different machine learning algorithms on multiple patient characteristics to predict uncontrolled diabetes. Patients with diabetes above the age of 18 from the All of Us Research Program were included. Random forest, extreme gradient boost, logistic regression, and weighted ensemble model algorithms were employed. Patients who had a record of uncontrolled diabetes based on the international classification of diseases code were identified as cases. A set of features including basic demographic, biomarkers and hematological indices were included in the model. The random forest model demonstrated high performance in predicting uncontrolled diabetes, yielding an accuracy of 0.80 (95% CI: 0.79–0.81) as compared to the extreme gradient boost 0.74 (95% CI: 0.73–0.75), the logistic regression 0.64 (95% CI: 0.63–0.65) and the weighted ensemble model 0.77 (95% CI: 0.76–0.79). The maximum area under the receiver characteristics curve value was 0.77 (random forest model), while the minimum value was 0.7 (logistic regression model). Potassium levels, body weight, aspartate aminotransferase, height, and heart rate were important predictors of uncontrolled diabetes. The random forest model demonstrated a high performance in predicting uncontrolled diabetes. Serum electrolytes and physical measurements were important features in predicting uncontrolled diabetes. Machine learning techniques may be used to predict uncontrolled diabetes by incorporating these clinical characteristics.

The objective of this study was to estimate enteric methane emissions of the Ethiopian cattle population using the Intergovernmental Panel on Climate Change (IPCC) Tier 2 approach. A comprehensive literature review was undertaken to obtain country-specific livestock activity data required to estimate emission factors using the Tier 2 method. Indigenous multi-purpose breeds in the mixed crop-livestock and pastoral/agro-pastoral production systems represent more than 96-97% of the cattle population, and the remainder are specialized dairy breeds. Mean enteric emissions factors from 1994 to 2018 for cattle sub-categories ranged from 3.4 kg to 74 kg methane/headgear for calves older than six months and adult cows in production systems, and from 5.2 kg to 57 kg methane/head/year and 6 kg to 64 methane/head/year for calves less than six months and adult cows in the mixed crop-livestock and pastoral/agro-pastoral production systems,. The national average emission factor for dairy and multi-purpose cows was 74 kg methane/head/year- and 60 kg methane/head/year, across the time series. The current study is the first of its kind for Ethiopia, relying on country-specific animal performance data. It is expected to contribute to an improved national greenhouse gas inventory and provide a basis for better quantification of mitigation targets. Uncertainty of enteric methane emission estimates could be further reduced in the future with more complete data on cattle populations, animal performance and feed characterization.

Funding: Bill & Melinda Gates Foundation. Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. Methods: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466–469, 470.0, 480–482.8, 483.0–483.9, 484.1–484.2, 484.6–484.7, and 487–489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4–B97.6, J09–J15.8, J16–J16.9, J20–J21.9, J91.0, P23.0–P23.4, and U04–U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age–sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age–sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. Findings: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240–275) LRI incident episodes in males and 232 million (217–248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18–1·42) male deaths and 1·20 million (1·07–1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16–1·18) and 1·31 times (95% UI 1·23–1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4–131·1]) and deaths (100·0% [83·4–115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (–70·7% [–77·2 to –61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7–61·8] in males and 56·4% [40·7–65·1] in females), and more than a quarter of LRI deaths among those aged 5–14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6–35·5] for males and PAF 25·8% [16·3–35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4–25·2) in those aged 15–49 years, 30·5% (24·1–36·9) in those aged 50–69 years, and 21·9% (16·8–27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5–27·9) in those aged 15–49 years and 18·2% (12·5–24·5) in those aged 50–69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2–15·8) of LRI deaths. Interpretation: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. Publisher PDF

Introduction: Glucose-6-phosphate dehydrogenase deficiency is the most prevalent X-linked enzymatic deficiency affecting more than 400 million people worldwide. To date, Eritrean population have never been genotyped for glucose-6-phosphte dehydrogenase (G6PD) variants. The aim of this study is to characterize and determine the prevalence of four common G6PD variants in subjectively healthy all nine Eritrean ethnic groups.Methods: A total of 401 finger prick dried blood spot samples were collected onto 3 mm Whatman filter paper from volunteer unrelated subjectively healthy nine ethnic groups residing in all six zobas (regions) of Eritrea. Analysis was performed using polymerase chain reaction/restriction fragment length polymorphism for four common G6PD variants, namely, normal G6PD B, G6PD A (A376G), G6PD A- (G202A) and G6PD Mediterranean (C563T).Results: Molecular studies performed on a total 401 subjectively healthy Eritrean ethnic groups showed that 352 (89.1%) carried the normal G6PD B allele and 43 (10.9%) had the G6PD A (A376G) variant. The median age of study participants was 33 years, and 75% of the study participants were under 46 years. No cases of G6PD A- and Mediterranean mutations were identified, leaving six samples uncharacterized.Conclusions: The current study showed a high prevalence of normal G6PD B and G6PD A genotypes among subjectively healthy Eritrean ethnic groups.These findings are similar to those reported from neighboring countries, Ethiopia and Sudan and other parts of the world.

Habtamu Atnafu, Zelalem Belete, Hirut Kinfu, Mebkyou Tadesse, Mohammed Amin, Karen D Ballard Hamlin Fistula Ethiopia, Addis Ababa Fistula Hospital, Addis Ababa, EthiopiaObjective: To measure the impact of a maternal health package on health facility delivery and stillbirth rates.Methods: This is a cross-sectional study in Ethiopia where a maternal package was integrated into eight health centers across three regions. The package included trained midwives with a mentoring program, transport for referral, and equipment and accommodation for the midwives. Ten health centers without the package but in the same districts as the intervention centers and eight without the package in different districts were randomly selected as the comparison groups. Women living in the catchment areas of the 26 health centers, who delivered a baby in the past 12 months, were randomly selected to complete a face-to-face survey about maternal health experiences.Results: The maternal package did not significantly affect the stillbirth or facility delivery rates. Women were positively influenced to deliver in a health facility if their husbands were involved in the decision concerning the place of birth and if they had prior maternal experience in the health center. Barriers to delivering in a health facility included distance and ability to read and write.Conclusion: Women served by health centers with a maternal health package did not have significantly fewer stillbirths and were not more likely to deliver their babies in a health facility. Husbands played an important role in influencing the decisions to deliver in a health facility.Keywords: maternal health, institutional delivery, stillbirth, predictive factors, Ethiopia, globalhealth

Background: Ethiopia has made tremendous effort by cutting under five mortality by two third from the 167 in 1999 to 68 in 2012. Nevertheless, nearly 277,186 under five children die each year mostly from diseases which can be prevented or treated. Sound information on the supply and quality of health services is necessary for health systems management, monitoring, and evaluation.Objective: The objectives of this study are to assess the availability of child health services and how often these services are available in Ethiopian health facilities.Method: The assessment is part of the 2014 Ethiopia Service Provision Assessment Plus (ESPA+) Survey which was designed to be a cross-sectional study, which combines MEASURE DHS SPA, World Health Organization’s service Availability and Readiness Assessment (SARA) and the World Bank’s Service Delivery Indicator (SDI). A total of 1,327 health facilities were assessed. All hospitals, selected health centres, private clinics (Higher, Lower, & Medium), and health posts were assessed using a facility inventory questionnaire. .Results: Among all facilities, 62 % of them provide all three basic child health services (out-patient curative care for sick children, routine childhood vaccination services (EPI), and routine growth monitoring services) as a package. Seventy three percent of government facilities provide all three basic child health services. While 68 % of rural facilities provide all the services, in urban settings, 32 % of the facilities provide all the three basic child health services while majority of Health centres (82 %) provide all the services, only 1 % of lower clinics provide all three basic services. Out-patient curative care for sick children is the most commonly provided (95 %) service of all the three basic services. These services are almost universally available across all facility types, except in higher clinics which are less than 80 %. Among all facilities offering outpatient curative care for sick children, majority (78 %) of them offer the service 5 or more days per week at the facility.Conclusion: Majority of facilities provide all three basic child health services (Outpatient Curative Care, Child Vaccination, and Child Growth Monitoring). Out-patient curative care for sick children is the most commonly provided service. Government facilities mostly provide all three basic child health services. Among all facilities offering outpatient curative care for sick children, majority of them offer the service 5 or more days per week at the facility. [Ethiop. J. Health Dev. 2017;31(2):67-74]Keywords: Availability, Child health service, Frequency

Introduction: According to the 2012 national immunization coverage survey report of Ethiopia, EPI coverage by antigen is 79.6% for BCG, 80.0% for DPT-HepB-Hib1 90.1% for OPV1 65.7%; for adjusted DPT-HepB-Hib 3; 65.7 % for OPV3 and 68.2% for Measles. Similarly, the prevalence of full vaccination was 50%. However, the prevalence of valid vaccination dose for all vaccines is 18.6 %. Therefore, the aim of this study is to identify factors that determine the administration of full valid vaccines dose to set effective interventions.Methods: Data was obtained from the 2012 Immunization Coverage survey of Ethiopia, a cross- sectional study administered at the household level. Data were analyzed using SPSS version 20. Binary and multivariate logistic regression with 95% CI was done to assess factors associated with getting full valid vaccination dose. Results: As documented from the 2012 national immunization coverage survey, the coverage of full valid vaccination dose were very low as compared to full immunization coverage that is 18.6% Vs 50%, respectively. Urban residence 2.6 (95% CI: 2.50, 2.68), mothers with age groups of 21-34 and >35 were 1.26 (95% CI: 1.22, 1.29) and 2.4 (95% CI: 2.3, 2.44); children with caretakers with primary, secondary, and higher level of education were 1.6 (95% CI: 1.22, 1.29), 2.8 (95% CI: 2.76, 2.92), and 2.2 (95% CI: 2.13, 2.27) times more likely to get valid vaccination dose.Conclusion: The rich wealth quintile, rural place of residence, living more than 5km proximity to nearest health facility, having more than six sibling, having teenage (

© 2016 The Author(s). Background: Countdown to 2015 was a multi-institution consortium tracking progress towards Millennium Development Goals (MDGs) 4 and 5. Case studies to explore factors contributing to progress (or lack of progress) in reproductive, maternal, newborn and child health (RMNCH) were undertaken in: Afghanistan, Bangladesh, China, Ethiopia, Kenya, Malawi, Niger, Pakistan, Peru, and Tanzania. This paper aims to identify cross-cutting themes on how and why these countries achieved or did not achieve MDG progress. Methods: Applying a standard evaluation framework, analyses of impact, coverage and equity were undertaken, including a mixed methods analysis of how these were influenced by national context and coverage determinants (including health systems, policies and financing). Results: The majority (7/10) of case study countries met MDG-4 with over two-thirds reduction in child mortality, but none met MDG-5a for 75 % reduction in maternal mortality, although six countries achieved >75 % of this target. None achieved MDG-5b regarding reproductive health. Rates of reduction in neonatal mortality were half or less that for post-neonatal child mortality. Coverage increased most for interventions administered at lower levels of the health system (e.g., immunisation, insecticide treated nets), and these experienced substantial political and financial support. These interventions were associated with ~30-40 % of child lives saved in 2012 compared to 2000, in Ethiopia, Malawi, Peru and Tanzania. Intrapartum care for mothers and newborns - which require higher-level health workers, more infrastructure, and increased community engagement - showed variable increases in coverage, and persistent equity gaps. Countries have explored different approaches to address these problems, including shifting interventions to the community setting and tasks to lower-level health workers. Conclusions: These Countdown case studies underline the importance of consistent national investment and global attention for achieving improvements in RMNCH. Interventions with major global investments achieved higher levels of coverage, reduced equity gaps and improvements in associated health outcomes. Given many competing priorities for the Sustainable Development Goals era, it is essential to maintain attention to the unfinished RMNCH agenda, particularly health systems improvements for maternal and neonatal outcomes where progress has been slower, and to invest in data collection for monitoring progress and for rigorous analyses of how progress is achieved in different contexts.

On September 13, 2013 the Federal Ministry of Health (FMoH) of Ethiopia and UNICEF announced that Ethiopia has successfully reduced the under-five mortality rate by two thirds between 1990 and 2012, which is the target for achieving Millennium Development Goal-4. In 1990, the under-five mortality rate in Ethiopia was one of the highest in the world at 205/1,000 live births. However, by 2012, this rate had declined to 68/1,000 live births with an average annual rate of decline of 5.0%. This exceeded the 4.3% annual rate of decline needed to reach MDG4 and was significantly higher than the decline rates observed in many sub-Saharan African countries and even other low and middle-income countries. In an effort to understand the story behind Ethiopia’s remarkable achievement of MDG-4, EPHI has conducted this in-depth Case Study which is supported by Countdown to 2015. The findings are believed to generate valuable lessons and guidance for other low-income countries in their quest for accelerating health improvements and reducing child deaths.

Potato viruses are the major causes of yield loss and reduction in quality of seed tubers in Eritrea. A study was conducted to investigate the prevalence of viruses in potatoes (Solanum tuberosum L.)grown in Eritrea and to evaluate methods for their elimination. Leaf samples of two indigenous, (Tsaeda embaba and Keyih embaba) and three exotic varieties, (Ajiba, Spunta and Cosmos) were collected fromfields growing potatoes in Maekel and Debub Administrative Zones and tested using the double antibody sandwich enzyme linked immunosorbent assay (DAS ELISA) technique. Five of the six mostimportant potato viruses, PVX, PVY, PLRV, PVS and PVA, were detected in single and multiple infections. Virus elimination techniques were tested using in vitro plantlets of T. embaba establishedfrom field-grown tubers. Presence of PVX, PLRV and PVS was confirmed by ELISA test. The plantlets were then subjected to thermotherapy treatment for one and two weeks at 37oC. The treatment wassuccessful in eliminating only PLRV but failed to eliminate PVX and PVS. When meristem culture was combined with thermotherapy treatment for one week all three viruses PVX, PLRV and PVS wereeliminated with a success rate of 86, 83 and 100%, respectively.

Laccases catalyze the one-electron oxidation of a broad range of substrates coupled to the 4 electron reduction of O2 to H2O. Phenols are typical substrates, because their redox potentials (ranging from 0.5 to 1.0 V vs. NHE) are low enough to allow electron abstraction by the T1 Cu(II) that, although a relatively modest oxidant (in the 0.4-0.8 V range), is the electron-acceptor in laccases. The present study comparatively investigated the oxidation performances of Trametes villosa and Myceliophthora thermophila laccases, two enzymes markedly differing in redox potential (0.79 and 0.46 V). The oxidation efficiency and kinetic constants of laccase-catalyzed conversion of putative substrates were determined. Hammett plots related to the oxidation of substituted phenols by the two laccases, in combination with the kinetic isotope effect determination, confirmed a rate-determining electron transfer from the substrate to the enzyme. The efficiency of oxidation was found to increase with the decrease in redox potential of the substrates, and theMarcus reorganisation energy for electron transfer to the T1 copper site was determined. Steric hindrance to substrate docking was inferred because some of the phenols and anilines investigated, despite possessing a redox potential compatible with one-electron abstraction, were scarcely oxidised. A threshold value of steric hindrance of the substrate, allowed for fitting into the active site of T. villosa laccase, was extrapolated from structural information provided by X-ray analysis of T. versicolor lac3B, sharing an identity of 99% at the protein level, thus enabling us to assess the relative contribution of steric and redox properties of a substrate in determining its susceptibility to laccase oxidation. The inferred structural threshold is compatible with the distance between two phenylalanine residues that mark the entrance to the active site. Interaction of the substrate with other residues of the active site is commented on.