Health and economic burden of foodborne zoonotic diseases in Amhara region, Ethiopia.
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ABSTRACT:
SUBMITTER: Mekonnen SA
PROVIDER: S-EPMC8719781 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Neglected tropical zoonotic diseases (NTZDs) continue to have a major effect on the health of humans and animals. In this study, a one health approach was used to prioritize and rank neglected tropical zoonotic diseases at the regional and zonal levels in Tigray National Regional State, Ethiopia. For prioritization of NTZDs a cross-sectional study through a structured questionnaire was administered to 313 health experts from human and animal health sectors. In addition, focus group discussions (FGD) were held with purposively selected key informants. Descriptive, and Multivariable analysis was applied to report the results and a ranked list of diseases was developed at the zonal and regional level. In the region, 8 of the 12 World Health Organization listed NTZDs were considered major diseases including anthrax, brucellosis, bovine tuberculosis, taeniasis, leishmaniasis, rabies, schistosomiasis, and soil-transmitted helminths. Considering the zoonotic and socioeconomic importance of the diseases at the regional level, rabies ranked 1stwhereas anthrax, bovine tuberculosis, leishmaniasis, and brucellosis were ranked from 2nd to 5th, respectively. The FGD result also supported the prioritization result. The Multivariable analysis showed a statistically significant difference in the zonal distribution of anthrax (р = 0.009, OR = 1.16), taeniasis (p<0.001, OR = 0.82), leishmaniasis (p<0.001, OR = 1.91), rabies (p = 0.020, OR = 0.79) and soil-transmitted helminths (p = 0.007, OR = 0.87) but not for brucellosis (p = 0.585), bovine tuberculosis (p = 0.505), and schistosomiasis (p = 0.421). Anthrax (p<0.001, OR = 26.68), brucellosis (p<0.001, OR = 13.18), and taeniasis (p<0.001, OR = 6.17) were considered as the major zoonotic diseases by veterinary practitioners than human health practitioners whereas, leishmaniasis was recognized as a major health challenge by human health professionals. Understanding the priority diseases in the region is supportive for informed decision-making and prioritizes the limited resources to use. Furthermore, strengthening the collaboration between human and animal health professions is important to control the diseases.
| S-EPMC8297755 | biostudies-literature
Project description:BackgroundPodoconiosis is one of the leading causes of lymphoedema-related morbidity in low-income settings, but little is known about the scale of its health and economic impact. This information is required to inform control programme planning and policy. In this study, we estimated the health and economic burden of podoconiosis in Ethiopia.MethodsWe developed a model to estimate the health burden attributed to podoconiosis in terms of the number of disability-adjusted life years (DALYs) and the economic burden. We estimated the economic burden by quantifying the treatment and morbidity-management costs incurred by the healthcare system in managing clinical cases, patients' out-of-pocket costs and their productivity costs.ResultsIn 2017, there were 1.5 million cases of podoconiosis in Ethiopia, which corresponds to 172 073 DALYs or 182 per 100 000 people. The total economic burden of podoconiosis in Ethiopia is estimated to be US$213.2 million annually and 91.1% of this resulted from productivity costs. The average economic burden per podoconiosis case was US$136.9.ConclusionsThe national cost of podoconiosis is formidable. If control measures are scaled up and the morbidity burden reduced, this will lead to Ethiopia saving millions of dollars. Our estimates provide important benchmark economic costs to programme planners, policymakers and donors for resource allocation and priority setting.
| S-EPMC7139123 | biostudies-literature
Project description:IntroductionClient satisfaction is a key indicator to measure quality of healthcare and provides information on the level of success forproviders whether client expectations and values are met. Although there are some institutional based studies done in Ethiopia, still client satisfaction in our settings is not well addressed. Thus, this study was aimed to assess client satisfaction level and identify the underlying factors of poor health service provision in West Amhara, Ethiopia.MethodsA cross-sectional study design was conducted from July to August, 2013. A structured questionnaire was used to collect data from 422 outpatient diagnosis (OPD) service users. The data were entered into EPI Info version 3.5.2 and analyzed usingSPSS version 16.ResultsAmong the 422 study participants, 234 (55.5%) males, the mean (±SD) age was 37.3 (±16.4) years. The overall satisfaction level of the study participants was 39.3%. Poor cleanliness of the facility, fewer service access provision, lack of prescribed drugs within the facility and longer waiting time to get the health care service wasreported by 73.2%, 67.8%, 65.6% and 59.2% of the clients respectively. Paying service users (AOR: 2.03, 95% CI: 1.22-3.39, P: 0.007), divorced clients (AOR: 4.26, 95% CI: 1.11-16.26, P: 0.034) and hospital users (AOR: 2.18, 95% CI: 1.29-3.69, P: 0.004) were more dissatisfied.ConclusionsClient satisfaction was lowin the health provision in West Amhara region. Expansion of health facilities in remote areas, maintaining continuous availability of prescribed drugs, improving cleanliness of health facilities, and fast health service provision are recommended to satisfy clients in the setting.
| S-EPMC5493333 | biostudies-literature
Project description:BACKGROUND:The emergence of pre-extensively and extensively drug-resistant tuberculosis (Pre-XDR/XDR-TB) is the major hurdle for TB prevention and care programs especially in developing countries like Ethiopia. The less emphasis on universal access to laboratory techniques for the rapid diagnosis of TB and drug susceptibility testing (DST) makes the management of MDR-TB a challenge. Early detection of second line anti-TB drugs resistance is essential to reduce transmission of Pre-XDR/XDR-TB strains and adjusting the treatment regimen in MDR-TB. OBJECTIVE:To determine the prevalence and resistance pattern of Pre-XDR- and XDR-TB among MDR-TB patients in the Amhara region, Ethiopia. METHODS:A cross sectional study was carried out in nine MDR-TB treatment centers in the Amhara region. Sputum samples were collected from all pulmonary rifampicin resistant (RR) or MDR-TB patients prior to anti-TB treatment. L?wenstein-Jensen (LJ) culture, Ziehl Neelsen (ZN) smear, MTBDRplus and MTBDRsl assays were performed according to the standard procedures. Data were analyzed using SPSS 20 software. Chi-square and/or Fishers exact test was employed. RESULTS:Overall, 6.3% of MDR-TB isolates were resistant to at least one second line drugs. Pre-XDR-TB and XDR-TB isolates accounted 5.7% and 0.6% respectively. Moreover, 3.4% were resistant to FQs and 3.4% were resistant to second line injectable drugs. All isolates were susceptible for low level kanamycin. Almost all pre-XDR-TB strains (90%) were previously treated with anti-TB drugs. Drug resistant Mycobacterium tuberculosis isolates were disproportionately distributed in districts of the Amhara region and the majorities were concentrated in urban areas. CONCLUSIONS:The high proportion of MDR-TB patients resistant to at least one second line drug is alarming. Strengthening the laboratory facilities to monitor pre-XDR and XDR-TB patients is crucial. The TB programs need to give emphasis on the effective and rational use of second line drugs for newly diagnosed MDR-TB patients to prevent the emergence of pre-XDR/XDR-TB strains.
| S-EPMC7018133 | biostudies-literature
Project description:BACKGROUND:Microscopic examination of peripheral blood smear produces reliable results both about the malaria infection status and level of parasitemia. However, test results are affected by skill of the laboratory personnel, workload, condition of microscopes and quality of laboratory supplies. Therefore, continuous monitoring of the performance of laboratories is of pivotal importance in order to make timely correction. METHODS:A facility based cross-sectional study was conducted from July 2017 to July 2019 to assess malaria microscopy performance among thirty malaria diagnostic laboratories in west Amhara region. Thirty slides were collected from participating laboratories every quarter. Collected slides were taken to Amhara Public Health Institute reference laboratory and re-checked by malaria microscopists who were blind to the results from health facilities. Percentage of test agreement, rates of false positive, false negative and species misdiagnosis were calculated using Excel 2010. RESULTS:Among a total of 6689 slides re-checked, results of 6146 slides were the same with that of participating laboratories. The test agreement was 97.31 and 94.6% for parasite detection and species identification, respectively. Variations in the overall performance of individual laboratories were seen within a range of 81.55 to 97.27% test agreement. Results of 543 (8.12%) slides were discordant, of which 363 (5.4%), 93 (1.4%) and 87 (1.3%) slides were due to species misdiagnosis, false positive and false negative results, respectively. CONCLUSION:There was good test agreement between participated laboratories and Amhara Public Health Institute. More accurate performance is expected as the country is tracking to malaria elimination. Hence, further strengthening the external quality assurance program is recommended.
| S-EPMC7236141 | biostudies-literature
Project description:IntroductionPostpartum intrauterine contraceptive devices (PP-IUCD) are one type of post-partum family planning method, which can be provided to a post-partum woman starting from the placental delivery time (within 10 minutes), or within the first 48 hours of postpartum period. In most developing countries, delivery time is the primary opportunity for women to access post-partum family planning methods, especially for those living in remote areas. Hence, this study assesses providers' knowledge on postpartum intrauterine contraceptive device service provision.MethodsA facility-based cross-sectional study was conducted in Amhara region health center and hospitals. Health providers surveyed included obstetricians, gynecologists, general practitioners, emergency surgical officers, health officers, midwives and nurses from September 18, 2015 to December18, 2016. Simple random sampling was used to select 864 subjects. Data were collected by using a structured self-administered questionnaire and observing the facility. Multilevel analysis was done to see factors associated with outcome.ResultsA total of 197 health facilities and 864 providers are included in the final analysis. Of the total providers 524 (60.6%) were from a health center. The mean age (±SD) of participants was 27.8 years (±5.4). The number of providers with good knowledge accounted for 253 of those surveyed (29.3%). The proportion of good knowledge among trained PP-IUCD providers was 35.7% (those who scored above average), and 27.9% was untrained about PP-IUCD. A considerable heterogeneity was observed between health facilities for each indicator of provider's knowledge. Gender differences were observed as the mean knowledge score deference on PP-IUCD by 0.4 points (β = -0.41; -0.72, -0.10) when the participant was female. Having experience of regular counseling of pregnant women increases PP-IUCD knowledge score by 0.97. (β = 0.97; 95% CI: 0.48, 1.47). Where the health facility requested clients to purchase the IUCD themselves, the mean knowledge score decreased by 0.47 points compared with free of charge at the facility level (β = -0.47; 95%CI: -0.87, -0.07).ConclusionOur findings showed that providers' knowledge about postpartum IUCD was low in the Amhara region public health facility. The lowest knowledge score was noted among nurses, health Officers, midwives, and general practice professionals. Factors associated with providers' knowledge on PP-IUCD are the status of health facility, female sex, training on PP-IUCD, regular counseling of pregnant women, and unavailability of IUCD service.
| S-EPMC6449033 | biostudies-literature
Project description:BackgroundTrachoma recrudescence after elimination as a public health problem has been reached is a concern for control programs globally. Programs typically conduct district-level trachoma surveillance surveys (TSS) ≥ 2 years after the elimination threshold is achieved to determine whether the prevalence of trachomatous inflammation-follicular (TF) among children ages 1 to 9 years remains <5%. Many TSS are resulting in a TF prevalence ≥5%. Once a district returns to TF ≥5%, a program typically restarts costly mass drug administration (MDA) campaigns and surveys at least twice, for impact and another TSS. In Amhara, Ethiopia, most TSS which result in a TF ≥5% have a prevalence close to 5%, making it difficult to determine whether the result is due to true recrudescence or to statistical variability. This study's aim was to monitor recrudescence within Amhara by waiting to restart MDA within 2 districts with a TF prevalence ≥5% at TSS, Metema = 5.2% and Woreta Town = 5.1%. The districts were resurveyed 1 year later using traditional and alternative indicators, such as measures of infection and serology, a "wait and watch" approach.Methods/principal findingsThese post-surveillance surveys, conducted in 2021, were multi-stage cluster surveys whereby certified graders assessed trachoma signs. Children ages 1 to 9 years provided a dried blood spot and children ages 1 to 5 years provided a conjunctival swab. TF prevalence in Metema and Woreta Town were 3.6% (95% Confidence Interval [CI]:1.4-6.4) and 2.5% (95% CI:0.8-4.5) respectively. Infection prevalence was 1.2% in Woreta Town and 0% in Metema. Seroconversion rates to Pgp3 in Metema and Woreta Town were 0.4 (95% CI:0.2-0.7) seroconversions per 100 child-years and 0.9 (95% CI:0.6-1.5) respectively.Conclusions/significanceBoth study districts had a TF prevalence <5% with low levels of Chlamydia trachomatis infection and transmission, and thus MDA interventions are no longer warranted. The wait and watch approach represents a surveillance strategy which could lead to fewer MDA campaigns and surveys and thus cost savings with reduced antibiotic usage.
| S-EPMC10914254 | biostudies-literature
Project description:BackgroundStandards represent benchmarks against which improvements can be measured. In 2016, the Federal Ministry of Health developed and endorsed a set of standards entitled the Ethiopian Health Center Reform Implementation Guidelines (EHCRIGs). This study aims to assess the effects of planned interventions on performance and quality of services in primary health care units (PHCUs).MethodsA quasi-experimental pre-post study design was used to compare the performance of PHCUs against the ECHRIG standards before and after its implementation in 76 woredas of the Amhara region from July - December 2017. Pre and post-intervention validation measurements of performance improvement in 76 woredas were conducted. The data were entered and analyzed using Statistical Package for Social Sciences.ResultFor this study, ten sessions of two-day trainings were conducted for 1306 staff. Additionally, on-site mentoring and coaching was conducted for a period of three months. The average EHCRIG standards met before and after intervention totaled 59 and 66%, respectively. The scores showed a positive correlation coefficient (r = 0.74) with statistical significant paired sample t-test with t = - 7.15, df = 75, P < 0.000. In addition, the mean scores among performance tiers were 74, 66 and 65% for high, medium and low performing woredas respectively. The One-way Analysis of Variance (ANOVA) showed a borderline significant difference between groups with (F = 2.4, P < 0.09).ConclusionsThe implementation of the standards has garnered significant improvements in performance at the primary health care level. Therefore, continuing the initiated strengthening of health system performance against the standards and evaluation of the quality of primary health services is recommended.
| S-EPMC6381692 | biostudies-literature
Project description:Adequate supplies of tuberculosis laboratory reagents and consumables are necessary for tuberculosis diagnosis and monitoring of treatment response. This study assessed the distribution and stock levels of laboratory commodities used in tuberculosis control in health centers of Amhara region, Ethiopia. A cross-sectional study was conducted in 82 health centers, among 801, providing sputum microscopy services. Stock levels were calculated, and distribution of reagents and consumables assessed. Thirty three (40.2%) health centers were under stocked for at least one of the key items for tuberculosis diagnosis at the time of visit. Fifteen (18.3%) health centers had no stocks of at least one of the key items (methylene blue (11%), carbol fuchsin (11%), acid alcohol (8.5%) and sputum cups (3.7%)). Of the 82 health centers, 77 (93.9%) did not fulfill the criteria for effective distribution of tuberculosis laboratory reagents and consumables. There were many health centers that had no or only low stocks of key tuberculosis laboratory reagents and consumables as a result of ineffective distribution system. It is necessary to strengthen supply chain management to ensure uninterrupted TB diagnostic service.
| S-EPMC4671647 | biostudies-literature
Project description:Introduction In resource-limited settings incorporating the Telemedicine system into the healthcare system enhances exchanging valid health information for practicing evidence-based medicine for the diagnosis, treatment, and prevention of diseases. Despite its great importance, the adoption of telemedicine in low-income country settings, like Ethiopia, was lagging and increasingly failed. Assessing the readiness of health professionals before the actual adoption of telemedicine is considered the prominent solution to tackle the problem. However, little is known about Health professionals’ telemedicine readiness in this study setting. Objective Accordingly, this study aimed to assess health professionals’ readiness and its associated factors to implement a Telemedicine system at private hospitals in North West, Ethiopia. Materials and methods An institution-based cross-sectional study was conducted from March 3 to April 7, 2021. A total of 423 health professionals working in private hospitals were selected using a simple random sampling technique. Multi-variable logistic regression was fitted to identify determinant factors of health professional readiness after the other covariates were controlled. Result In this study the overall readiness of telemedicine adoption was 65.4% (n = 268) [95% CI:60.1–69.8]. Knowledge (AOR = 2.5;95% CI: [1.4, 4.6]), Attitude (AOR = 3.2;95% CI: [1.6, 6.2]), computer literacy (AOR = 2.2; 95% CI: [1.3, 3.9]), computer training (AOR = 2.1;95% CI: [1.1, 4.1]), Computer skill (AOR = 1.9;95% CI: [1.1, 3.4]), computer access at office (AOR = 2.1;95% CI: [1.1, 3.7]), Internet access at office (AOR = 2.8; 95% CI: [1.6, 5.1]), Own personal computer (AOR = 3.0; 95% CI: [1.5, 5.9]) and work experience (AOR = 3.1; 95% CI: [1.4, 6.7]) were significantly associated with the overall health professionals readiness for the adoption of telemedicine using a cut point of p-value lessthan 0.05. Conclusion and recommendation Around two-thirds of the respondents had a good level of overall readiness for the adoption of telemedicine. The finding implied that less effort is required to improve readiness before the implementation of telemedicine. This findings implied that respondents who had good knowledge and a favorable attitude toward telemedicine were more ready for such technology. Capacity building is needed Enhance computer literacy, and computer skills building their confidence to rise ready for such technology. Building their capacity through training, building good internet connection, and availability of computers, where the necessary measures to improve Telemedicine readiness in this setting. Additionally, further studies are recommended to encompass all types of telemedicine readiness such as organizational readiness, technology readiness, societal readiness, and so on. Additionally, exploring the healthcare provider opinion with qualitative study and extending the proposed study to other implementation settings are recommended to be addressed in future works. The study has a positive impact on the successful implementation and use of telemedicine throughout hospitals at countries level by providing pertinent information about health professionals’ preparedness status. Therefore, implementing telemedicine will have a significant contribution to the health system performance improvement in terms of providing quality care, accessibility to health facilities, reduction of costs, and creating a platform for communication between health professionals across different health institutions for providing quality patient care.
| S-EPMC9522275 | biostudies-literature