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Routes or spread or HIV infection into rural EthiopiaShabbir Ismail MD MPH, Charles Larson MD MSc. Department of community Health, Gondar College of Medical Sciences A multistage, cross-sectional, descriptive study of potential routes of spread of HIV infection from urban to rural populations was carried out in a rural district in Ethiopia. High risk practices for HIV infection and transmission were documented among rural residing former soldiers, merchants, and students (20 subjects per subgroup). In 45 to 50% of the subgroup subjects extramarital sexual contact in the 3 months prior to the study was reported. In 25 to 37% sex with urban commercial sex worker (CSW) was reported. Condom use was found to be very low, varying from 10to 30%. Knowledge about AIDS was low. Risk perceptions for Ams were low and changes in risk behaviour were minimal. A total of 502 rural farmers were also interviewed. An extramarital sexual contact during the 3 months prior to the study period was reported in 13.5%, with 7% reporting their most recent contact being with an urban CSW. Condom use among these groups was very low. Past history for Sill's was assessed. Gonorrhea was the most commonly reported illness at 10.2% .Knowledge of AIDS was limited to 50% and of these, only 28% perceived they were vulnerable. In this study knowledge was associated with high risk sexual practices but not with non-sexual practices. This study found urban CSWs and former ,soldiers to be important potential reservoirs of HIV infection. Spread into rural communities is likely to occur as a result of frequent high risk practices for HIV infection among several rural population subgroups frequently travelling into urban communities; these include merchants, students, former soldiers, and farmers. Knowledge, attitude and practice on IUV/AIDS among population of a rural high school in north western Ethiopia Asnake Hailu, Tesfu Lisanework, Chemet Negeri, Betelehem Ashenie, Edom Girmay, Taye Tulema, Dejene Fanta Gondar College of Medical Sciences
Yeshi Wlmedin, BSc, Amare Dejene, BSc, MSc, Hailu Tegenework, BSc, MSc National Research Institute of Health.
Retrospective study of cervical carcinoma in NRIH from 1988 to 1992Feleke Bojia; BSc,MD, 1I, Amare Dejene, Bsc,MSc, 2 Yared Mekonnen, BSc2 1Department of Pathology 2National Research Institute of Health The objective of this study was to retrospectively review the pattern of cervical carcinoma, its age distribution and identify the frequently occurring histologic types in order to depict the magnitude of the problem in our country . A total of 2126 proven cases were systematically included in the study from the record book of the Pathology Department of the National Research Institute of Health. Of these 178 (8.3%) were specimens from the cervix, of which 30% were found to be carcinoma of the cervix and the pattern showed an increasing trend by age. The most frequently occurring Histologic type of carcinoma was keratinizing and Non-keratinizing Squamous Cell Carcinoma (73%). Tuberculin response of Ethiopian children after BCG vaccination at birthAbebe Mebratu, MD, James Hanley, PhD, Derege Kebede, MD. Department of Community Health, Faculty of Medicine, Addis Ababa University In an attempt to evaluate the effectiveness of neonatal BCG vaccination policy, a tuberculin survey was conducted among different age groups of children in Lideta awraja, Addis ababa who had received BCG vaccination shortly after birth. Tuberculin PPD tests were also performed simultaneously. In addition, 60 children were revaccinated at the age of 10 years (within the study period) and tuberculin tests were performed 2 months after the second vaccination. Furthermore, 70 bacteriologically proven tuberculosis patients were also tuberculin tested at the beginning of the study, in order to check the potency of tuberculin PPD test and to estimate the diagnostic value of the test. A total of 895 children were studied between October 1992 and February 1993. Of these 563 (63%) had a defmite BCG scar. Some 55% of the children without a BCG scar showed no r~ponse to the tuberculin test, while 67% of those with a scar showed a positive tuberculin response. Meanwhile, a positive tuberculin reaction ( > 6 mm) was observed in 11% of children despite the absence of the BCG scar .All the children revaccinated at the age of 10 years showed a positive tuberculin reaction and elicited a larger size of BCG scar (> 4 mm). The tuberculosis patients showed tuberculin reactions according to an unimodal distribution. Of these 12% showed 10 -15mm induration. A reaction of 10-15 mm were also observed in 3.3% of children without a scar 11 % of children with a large scar size( > 5mm) and in 10% of revaccinated children with out tuberculosis infection. This revealed ~at the lack of specificity of the test. Overall, this finding emphasized the poor tuberculin response in infants at the age of 2 months compared to 18 months after vaccination at birth and the waning effect of tuberculin response at the age five years compared to 18 months. It indicates that the BCG induced allergy tended to disappear in this age group and the need for revaccination. Thus we suggest a further study in deciding the age of first vaccination and revaccination at the age of 5 years without tuberculin test. Tuberculin test survey in yebu elementary school children-Jimma zoneSeid Mohammed MD,MPH, Fasil Tessema BSc, Assefa Alem Department of Community Health, Jimma Institute of Health Sciences A cross-sectional tuberculin test survey was conducted in Yebu elementary school, Yebu town, Mana-district, Jimma zone in June 1993. In this survey 201 elementary school children between the ages of 6 to 15 years were included, 96 males and females. The survey consisted of a questionnaire format, examination for the presence of BCG scar and tuberculin skin testing with PPD- Rt 32. The overall prevalence of tuberculosis infection was found to be 42.8% .The prevalence of tuberculosis infection excluding BCG scar was 28.4%. It is estimated that the annual risk of infection (ARI) is 1.6%. Boys and girls are equally affected (p>0.05), students who came from a larger family size have a greater risk of infection (p< 0.01). It was also found out that students who drink un-boiled cow's milk have high risk of infection compared with those who do not (p < 0.01) the BCG coverage late in the study population is found to be 22.9%. Tuberculin postitivity among children with BCG scar is 91.3. Based on the findings of the survey important conclusion and recommendations are made. Rotavirus infection in paediatrics diarrhoea in Addis Ababa, Ethiopia Almaz Abebe, Msc. 1, Solomon Abebe, Dip. Senior Lab. Tech. 1, Miruts Giday, Bsc. 1, Belachew Taffesse, MD2 1National Research Institute of Health, Addis Ababa, Ethiopia, 2Yekatit 12 Hospital, Addis Ababa, Ethiopia Rotavirus was studied on 358 cases of acute diarrhoea and 93 randomly selected controls of infants and young children at Yekatit 12 Hospital, Addis Ababa, Ethiopia, for a period of 13 months. The virus was detected in faeces of 65 (18.2%) of the patients with acute diarrhoea tested by ELISA. Rotavirus was frequently detected among infants and children up to 24 months. The virus had two peak incidences: one occurred during the months of June to July, when it was wet and warm with high relative humidity, and the second one in November and December when the weather was dry and cool with low relative humidity. This study shows the prevalence of rotavirus among infants and young children and how the magnitude of the problem vary from season to season. Status of the Guinea worm eradication programme in EthiopiaSeyoum Taticheff, PhD National Research Institute of Health Guinea worm diseases has been targeted for global eradication by 1995. In Ethiopia, a National Steering Committee and various task forces in endemic regions have been established. The combined efforts of the above groups has now ascertained endemicity of the disease in Gambella and S.Omo region. The overall total number of endemic villages is presently 116 with 817 people confirmed of having contracted the disease. Comprehensive interventions that include the introduction of local health personnel and village-based volunteer workers, community mobilization, village-based surveillance, development and distribution of health education materials and filters, and application of Abate in water ponds are gradually in progress while improvement of water supply systems is at the planning stage. Eradication attempts along with constraints in the programme will be addressed. Urban ulcer problem in Hansen's diseaseTesfaye Bulto,MD, MPH, Roland Kazen, MD, Heather Currie All Africa Leprosy and Rehabilitation Center According to the 1986-1990 annual reports of the Addis Ababa Leprosy Hospital (Alert), ulcer dressings were done daily, Monday Through Friday,on 100 to 130 HD patients. In 1991 a total of 443 cases were registered and among them 73.4% were from "WORREDA" 23 (where the Hospital is located and large population of HD patients are found) and 26.6% were from other localities in and outside Addis Ababa a detailed Socio-Economic and clinical review done on 105 systematically sampled cases is presented and future plans to find solutions for the problem is discussed. Dermatological manifestions in mv infected Ethiopian patientsTaye Engida, MD, Belayneh Hialu, MD All Africa Leprosy & Rehabilitation Training Center A review of HIV- screened patients was made at Addis Ababa Leprosy Hospital (ALERT) in the years between Ian. 1987 and Sept. 1993. A total of 1537 patients mainly with dermatological manifestations were screened. Among them 1058 were found to be positive. Of all positives about 70% were diagnosed with herpes zoster at different sites. Other indicator diseases like kaposi's sarcoma; oral candidiasis and molluscum contagiosum constitute about 7%. As studies have shown elsewehere, skin disease manifestation in the majority of HIV positive patients seen at Alert is also herpers zoster. Evaluation of an Amharic version of the cmI and prevalence estimation of mental disordersaccording to DSM-III-R in arada district, Addis Ababa. Eskindir Rashid1, MD, Derege Kebede1, MD, Atalay Alem Ejigou2;MD 1Department of Community Health, Faculty of Medicine, Addis Ababa University 2 St. Amanuel Psychiatric Hospital, Addis Ababa. The feasibility, reliability, and acceptance of the Amharic version of the CIDI (Composite International Diagnostic Interview) was tested in Addis Ababa city using clinician and non clinician interviewers. In the first part of the study a total of 64 subjects from three different sources (community, psychiatric inpatient and outpatient) were interviewed. The CIDI was judged to be acceptable by most clinician and non clinician interviewers. The few concerns about it include, the length of the interview and difficulties with a few of the items. For specific diagnoses made with frequency of five or more time, percent agreement and kappa ranged from 92.5%-100% and 0.78-0.92, respectively. The second part of the study determined the life time prevalence of specific DSM-111-R disorders using the Amharic CIDI modified after the reliability study, 502 community subjects selected from Arada district by systematic random sampling were interviewed. The most frequent specific diagnoses found were; Organic brain syndrome mild (14.1%), severe (4.4%), Agoraphobia without history of panic disorder (3.0%) and dysthymia (3.0% ). The very high rate found for organic brain syndrome, compared to other studies, made the reliability of the CIDI for that diagnoses questionable. Otherwise, it is concluded that the Amharic version of CIDI is reliable, acceptable, and feasible for use in the country .Thus similar studies that facilitate CIDI to be used with better designs are recommended. Cigarette smoking among pupils of a rural high school in northwestern EthiopiaAsnake Hailu, Mandefero Mengistu, Negib Salih, Wondimagenehy Hailu, Yemane Solomon, Yoseph Assefa, Zelalem Tesfaye Gondar College of Medical Sciences
Solid waste problem, collection and disposal programs in Jimma town: south-western EthiopiaKebede Faris, Dip. Sasc., Dip. WSS., BSc., MSc(EH), Tasew Berhe, Dip. Sasc. and Halemariam Churco, Dip. Sasc. Jimma Institute of Health Sciences(JIHS) A study on the quantity, type, and composition of solid waste in Jimma town was conducted based on the existing collection and disposal program of the municipality of Jimma. The collection program covers 43% of the town, that is 9 out of the 29 Urban Dwellers Associations (Kebeles). The study was conducted for 38 consecutive days and included a collection of mixed solid wastes and the analysis of the constituent parts. It was found that the per capita solid waste generation is 0.71 kilograms. The mixed wastes were composed of 8.45% garbage, 70.42% combustible waste and 21.13% incombustible waste. The total solid waste that may be generated each day in Jimma town with a population of 84,395 is estimated to be 118m3, the equivalent of 30 truck loads. At present, the municipality is collecting only 22m3 or 4 truck loads. This collection program costs the municipality approximately 27 birr (Us dollar 4.80) per ton. Of the generated solid waste, about 78.9% was organic in nature. If such waste is decomposed, a humus product can be recovered, which can be useful for soil conditioning by farmers and gardeners. Publication of this issue was financially supported by Addis Ababa University , the Ethiopian Science and Technology Commission (SAREC), and the McGill-Ethiopia Community Health Project. |