Ethiopian Journal of Health Development https://www.ajol.info/index.php/ejhd <p><span lang="EN-US">The Journal publishes analytical, descriptive and methodological articles, as well as original research, on public health problems, management of health services, health care needs and socio-economic and political factors related to health and development. More specifically, the Journal focus on important topics in health development that include: health policy and health politics; health planning, monitoring and evaluation; health administration and organization of health services; hospital administration; health manpower, including training; health economics, financing, and health development; health statistics and health information systems; maternal and child health, including family planning; environmental health and water; food and nutrition; health education; epidemiology and communicable diseases including HIV/AIDS, TB and STI; community involvement and inter-sectoral approaches to primary health care; drug supply and distribution; socioeconomic factors related to health and health services, medical geography, broader topics on scientific work on health care technologies; rights and obligations of communities in participation in health care; and international health organizations and technical cooperation among developing countries.</span></p> <p>Other websites related to this journal:&nbsp;<span lang="EN-US"><a title="www.ejhd.org" href="http://www.ejhd.org/" target="_blank" rel="noopener">www.ejhd.org</a></span></p> Ethiopian Public Health Association en-US Ethiopian Journal of Health Development 1021-6790 Copyright for articles published in this journal is retained by the journal. One health research ethics https://www.ajol.info/index.php/ejhd/article/view/203335 <p>Emerging and re-emerging infectious diseases (EIDs) present major threats to public health, global security, and economic development. Coronavirus disease 2019 (COVID-19) is the latest EID to demonstrate the devastation, suffering, and scale of death that an EID can cause. Pandemics involving emerging and re-emerging infectious agents and associated infectious diseases, climate change, urbanization, biodiversity loss and financial instability have been identified as the most critical global issues today (1). Close to three-quarters of today’s EIDs are known to be of zoonotic origin (where infectious agents spread to humans from domestic or wild animals), and their frequency and economic impact are on the rise</p> Dónal P. O’Mathúna Andréia G. Arruda Getnet Yimer Copyright (c) 2020-10-21 2020-10-21 34 4 Supervised framework for COVID-19 classification and lesion localization from chest CT https://www.ajol.info/index.php/ejhd/article/view/203216 <p><strong>Abstract</strong></p> <p>Background: Quick and precise identification of people suspected of having COVID-19 plays a key function in imposing quarantine at the right time and providing medical treatment, and results not only in societal benefits but also helps in the development of an improved health system. Building a deep-learning framework for automated identification of COVID-19 using chest computed tomography (CT) is beneficial in tackling the epidemic.</p> <p>Aim: To outline a novel deep-learning model created using 3D CT volumes for COVID-19 classification and localization of swellings.</p> <p>Methods: In all cases, subjects’ chest areas were segmented by means of a pre-trained U-Net; the segmented 3D chest areas were submitted as inputs to a 3D deep neural network to forecast the likelihood of infection with COVID-19; the swellings were restricted by joining the initiation areas within the classification system and the unsupervised linked elements. A total of 499 3D CT scans were utilized for training worldwide and 131 3D CT<br>scans were utilized for verification.</p> <p>Results: The algorithm took only 1.93 seconds to process the CT amount of a single affected person using a special graphics processing unit (GPU). Interesting results were obtained in terms of the development of societal challenges and better health policy.</p> <p>Conclusions: The deep-learning model can precisely forecast COVID-19 infectious probabilities and detect swelling areas in chest CT, with no requirement for training swellings. The easy-to-train and high-functioning deep-learning algorithm offers a fast method to classify people affected by COVID-19, which is useful to monitor the SARS-CoV-2 epidemic. [Ethiop. J. Health Dev. 2020; 34(4):235-242]</p> <p>Key words: COVID-19, CT scan, deep learning, neural network, DeCoVNet, RT-PCR, computed tomography</p> Junyong Zhang Yingna Chu Na Zhao Copyright (c) 2020-10-21 2020-10-21 34 4 Knowledge, attitudes and practices regarding COVID-19 among the Turkish and Malaysian general populations during lockdown: A cross-sectional online survey https://www.ajol.info/index.php/ejhd/article/view/203220 <p><strong>Abstract</strong><br>Background: COVID-19 is public health threat across the globe. The aim of the study is to assess the knowledge, attitudes and practices of the Turkish and Malaysian general populations regarding COVID-19 during the lockdown.</p> <p>Methods and materials: A cross-sectional quick survey was conducted online on 01-07 April 2020. Data were collected from samples of the general public in both Turkey and Malaysia.</p> <p>Results: A total of 1,320 people from the two countries participated in the study. In Turkey, only gender and education were demonstrated to have an association with overall knowledge (p˂0.001), while in Malaysia it was shown that age and marital status (p˂0.001) were statistically significant. In Turkey, those who had a good attitude towards COVID-19 were mostly male, married and postgraduates; in Malaysia, females, married those who had completed a middle-school education, and postgraduates demonstrated a good attitude towards COVID-19. In Turkey, 55.3% of study participants wore masks and 90.9% avoided crowded places; in Malaysia, 87.1% wore masks and 93.4% avoided crowded places.</p> <p>Conclusions: Participants had good knowledge about COVID-19, however they also showed misconceptions about COVID-19, especially in relation to its transmission. Participants’ confidence was high and they believe that their country can win the battle against the COVID-19 virus. [Ethiop. J. Health Dev. 2020; 34(4):243-252]</p> <p>Key words: COVID-19; knowledge, attitudes and practices; Turkish community; Malaysian community; pandemic</p> Al-abed Ali. A. Al-Abed Nimetcan Mehmet Mehmet Enes Gökler Asita Elengoe Egemen Ünal Salih Mollahaliloğlu Copyright (c) 2020-10-21 2020-10-21 34 4 Characteristics of traditional Chinese medicine users and prescription analysis for pediatric atopic dermatitis https://www.ajol.info/index.php/ejhd/article/view/203222 <p><strong>Abstract</strong></p> <p>Background: Traditional Chinese medicine is commonly used to treat children with atopic dermatitis. This research study reviewed patients with atopic dermatitis, recorded in Taiwan’s National Health Insurance Research Database, to investigate the characteristics and prescriptions of traditional Chinese medicine (TCM) so as to propose the use of TCM for a broader societal application.</p> <p>Objective: The aim of this study is to determine the application mode of TCM in children with atopic dermatitis, specifically the combination of Chinese herbal medicines (CHMs) used.</p> <p>Methods: The database reported atopic dermatitis-diagnosed children aged 5 to 12. TCM users documented data relate to age, diagnostic code, residence area and the use of corticosteroids. An analysis of the medications used for atopic dermatitis was achieved through a review of examining the association of various factors.</p> <p>Results: A total of 13,646 children with atopic dermatitis, and treated using TCM, were sampled from different area of Taiwan. The use of TCM is associated with use by women (male: OR 0.83), adolescence (OR: 10.0, 95% CI: 8.88-11.15) and allergic rhinitis (OR: 2.44; 95 % CI: 2.10-2.85). Fewer TCM users than non-users receive corticosteroid therapy (35.8% of all users receive TCM). Still, the percentage of TCM users who use long-lasting<br>corticosteroid therapy is greater than TCM non-users (10.6% of TCM users and 2.0% of TCM non-users). In total, 36,398 CHM prescriptions were used by 93.7% of Chinese medicine users. There was a total of 5.62 types CHM types used. Relationships between the Chinese herbal medicine forms network, where Xiao fengsan is the primary treatment for atopic dermatitis.</p> <p>Conclusions: The article describes features of children with atopic dermatitis who are treated with Chinese medicine. Xiao fengsan is the most common CHM used to treat atopic dermatitis in children. Further research on the safety and efficiency of this treatment is still required. [Ethiop. J. Health Dev. 2020; 34(4):253-261]</p> <p>Key words: Traditional Chinese medicine, atopic dermatitis, paediatrics, Chinese herbal medicine</p> Zhang Yi Liu Yongkun Wang Shuang Copyright (c) 2020-10-21 2020-10-21 34 4 Role of traditional Chinese medicine in the regulation of inflammatory mediators in paediatric asthma https://www.ajol.info/index.php/ejhd/article/view/203227 <p><strong>Abstract</strong></p> <p>Background: In many nations, there has been an increase in the prevalence of allergic diseases, many of which lack therapies for recovery. In addition, there are concerns regarding the use of conventional medicine, particularly corticosteroids, in children. Accordingly, in the case of asthma, many chronic allergic patients are looking at complementary and alternative drugs to treat their condition.</p> <p>Objective: The study intended to observe the impact of traditional Chinese medicine (TCM) prescriptions children with asthma, with a specific focus on their impact on the molecular mechanism of asthma.</p> <p>Method: A total number of 167 children with symptom of asthma were included in the study and were randomly allocated to two groups – those who received traditional Chinese medicine (TCM, the TCM group, n = 90) and those who were given salbutamol plus montelukast (SM, the SM group, n = 77). Different TCM treatments were given to patients in the TCM group, while salbutamol and montelukast were given to the SM group. The<br>appropriate treatment was given to both groups for 12 weeks. The patient who are getting TCM treatment had 42 cases, and the SM group had 35 cases. Real-time quantitative fluorescent PCR detects interleukin 10 and interleukin 17 (IL-10 and IL17 respectively) and matrix metal-oproteinase 9 commonly known as MMP-9 expression levels including monocyte blood transforming growth factor 1 (MBTGF-β1). A diagnosis of IL-10 or<br>IL-17 or, MMP-9 as well as MBTGF- β1 is monitored in peripheral blood which were treated before and after consecutively.</p> <p>Results: MBTGF-β1-RNA decreased among the SM group children after the treatment Whereas after treatment no major variances in MMP-9 among TCM and the SM children group were noted (0.05&gt;0.05). The amount of IL-10 including IL-17 and MMP-9 expressively declined (p = 0.01, 0.04 and 0.03 respectively) in the TCM group. On the other hand, MMP-9 and MBTGF- β1 levels expressively declined in the SM group following therapy. The IL-10 as well as IL-17, and MBTGF-β1 and MMP-9 values in the two groups were not significantly different (&gt; 0.05). The differences between IL-17 and c-ACT scores in the Chinese medicine group and SM group were adversely correlated.</p> <p>Conclusions: Traditional Chinese Medicine has controlling consequence on secretions of childhood asthma inflammatory mediators and help in asthma management immune mechanism. [Ethiop. J. Health Dev. 2020; 34(4):262-266]</p> <p>Key words: Paediatric asthma, traditional Chinese medicine, children, Chinese herbal medicine</p> Wang Shuang Pang Xinqin Liu Yongkun Copyright (c) 2020-10-21 2020-10-21 34 4 The effect of improved water and sanitation on diarrhea: Evidence from pooled Ethiopia Demographic and Health Surveys – A multilevel mixed-effects analysis https://www.ajol.info/index.php/ejhd/article/view/204521 <p><strong>Abstract</strong></p> <p><strong><em>Background:</em></strong> In Ethiopia, diarrhoea is the leading cause of illness and hospital admissions among children, and the persistence of diarrheal epidemics in urban and rural areas warrants an exploration of the impact of WASH facilities over recent years.</p> <p><strong><em>Objective:</em></strong> The study aimed to assess the effect of improved water sources and sanitation on the occurrence of diarrhea in Ethiopia, while controlling for household and child-related factors and accounting for higher-level variables.</p> <p><strong><em>Methods:</em></strong> A total of 42,282 study subjects were pooled from the four rounds of the Ethiopian Demographic and Health Survey. A multilevel mixed-effects logistic regression model was run to identify the effect of water and sanitation on diarrhea, after adjusting for higher-level and confounding factors. SPSS version 24 was used for data management, while Stata version 15.1 was used for descriptive and multilevel analysis.</p> <p><strong><em>Results:</em></strong> An improved water source was strongly associated with the occurrence of diarrhea in the final model, (AOR 95% CI: 1.02-1.2), while improved sanitation had a marginal association, (AOR 95% CI: 0.87-1.20). The interaction between improved water sources and improved sanitation has maintained the relevance of improved water sources, but not for improved sanitation, on diarrhea.</p> <p><strong><em>Conclusions and recommendations:</em></strong> Improved water source was a strong predictor of diarrhea. Improved water sources and improved sanitation are both required to get the maximum benefit of reducing diarrhea among children. [<em>Ethiop. J. Health Dev. </em>2020; 34(4):268-276]</p> <p><strong><em>Key words:</em></strong> Diarrhea, improved water source, improved sanitation, interaction, effect, Demographic and Health Survey</p> Abera Kumie Copyright (c) 2020-10-21 2020-10-21 34 4 The factors associated to justify the physical partner violence among married women in Turkey https://www.ajol.info/index.php/ejhd/article/view/203462 <p><strong>Abstract</strong></p> <p>Background: Gender-based violence is widespread in Turkey, and the internalization of patriarchal values is an important barrier for women to develop resistance to such violence.</p> <p>Aims: This study aims to assess the attitudes of married women in Turkey towards the justification of physical partner violence, and to examine the predictors for justifying such violence so that ways of resisting it can be identified.</p> <p>Methods: The data for the study was taken from the 2013 Turkish Demographic and Health Survey. A sub-sample of 6,655 married women of reproductive age were included in the analysis. Binary logistic regression analysis was carried out.</p> <p>Results: In this cross-sectional study, women with no formal education and women who had completed the primary level of education only were more likely to justify the use of physical violence against them (OR = 4.04, 95% CI = 1.96-8.36 and OR = 2.44, 95% CI = 1.24-4.79, respectively) compared to higher educated women. Women who had three or more children were more likely to justify the use of physical violence compared to women with two or fewer children (OR = 1.31, 95% CI = 1.10-1.56). Women who did not use the internet were 1.67 times more likely to justify the use of physical violence compared to women who use the internet (OR = 1.67, 95% CI = 1.27-2.20).</p> <p>Discussion and conclusions: Although women who had fewer children, women who lived in an urban setting, and women in wealthy households justify partner physical violence less than women with more children, women living in a rural setting and women in poor households, the education, and profession of women’s partners are critical factors, too. Education and internet access for women are crucial ways of developing strategies to resist partner violence. Such access helps to involve women in the public sphere, assists in the development of internet literacy, can change their way of thinking about violence, and open up the development of resistance strategies. [Ethiop. J. Health Dev. 2020; 34(4):277-285]</p> <p>Keywords: Gender-based violence, physical partner violence, internet literacy, Turkey</p> Ebru Inal Fahad Ahmed Nüket Paksoy Erbaydar Copyright (c) 2020-10-21 2020-10-21 34 4 The mediation effect of learning organization in the relationship between internal service quality and job satisfaction of nurses https://www.ajol.info/index.php/ejhd/article/view/203464 <p><strong>Abstract</strong></p> <p>Background: There is little evidence about the influence of internal service quality on nurses’ job satisfaction and their ability to provide efficient patient care. This study aims to explore the mediating effect of ‘learning organization in the relationship between the internal service quality and job satisfaction of nurses in public hospitals in Cameroon.</p> <p>Methods: A total of 400 questionnaires were distributed to nurses in public hospitals between 20 February to 31 December 2017. The mediation analysis was conducted using SPSS and PROCESS model 4.</p> <p>Results: The impact of internal service quality and learning organization on the job satisfaction of nurses was significant and positive. In addition, learning organization fully mediates the relationship between internal service quality and job satisfaction.</p> <p>Conclusions: Internal service quality increases the job satisfaction of health workers via learning organization practice in public hospitals. Health care managers should be aware of factors that foster job satisfaction and provide a high quality of internal services that incorporate learning organization activities, to enhance existing medical skills and improve the job satisfaction of health workers for better health service delivery to patients. [Ethiop. J. Health Dev. 2020; 34(4):286-292]</p> <p>Key words: Nurses, internal service quality, learning organization, job satisfaction</p> Chrystelle Mayap Njilo Georgiana Karadaş Zanete Garanti Copyright (c) 2020-10-21 2020-10-21 34 4 Long non-coding RNA LUCAT1 promotes cell proliferation and invasion in melanoma https://www.ajol.info/index.php/ejhd/article/view/203465 <p><strong>Abstract</strong></p> <p>Background: Melanoma is a serious malignant cancer with a low survival rate. On a global scale, breast cancer is the most frequent malignancy and leading cause of cancer death in women. Long non-coding RNAs (lncRNAs) can be used effectively as regulators and biomarkers in several cancers. Accordingly, the treatment plans of cancer patients could be made easier because of this. It has been reported that lncRNAs can play regulatory functions in various cancers, including melanoma. It is necessary to improve melanoma research programs and health policies, including in poor countries, around the world.</p> <p>Objective: The function of lncRNA lung cancer associated transcript 1 (LUCAT1) in melanoma has still not been identified. In the present study, large-scale screening for the differentially expressed lncRNAs was performed by lncRNAs microarray and finding the relationship between LUCAT1 and stemness marker.</p> <p>Methods and materials: LncRNA LUCAT1 expression was assessed in cancer tissues by in situ hybridization. Sphere-formation assay and colony-formation assay were used to detect cell self-renewal and proliferation, respectively. RNA pull-down and luciferase reporter assays were used to identify LUCAT1.</p> <p>Results: Silenced LUCAT1 can reduce cell growth, migration and invasion, and promote cell apoptosis, of melanoma. Conversely, over-expressed LUCAT1 can promote the progression of melanoma cells.</p> <p>Conclusions: The expression of LUCAT1 in melanoma cells was detected via quantitative real-time polymerase chain reaction (qRT-PCR) assay. We found that lncRNA LUCAT1 was significantly upregulated in melanoma cells. Then, we further searched the role of lncRNA LUCAT1 in melanoma. [Ethiop. J. Health Dev. 2020; 34(4):293-300]</p> <p>Key words: LUCAT1, melanoma, QRT-PCR assay, transwell migration, health science</p> Wei Zhu Wei Ding Dalun Lv Longsheng Duanmu Fu Han Copyright (c) 2020-10-21 2020-10-21 34 4 COVID-19 in Ethiopia in the first 180 days: Lessons learned and the way forward https://www.ajol.info/index.php/ejhd/article/view/203466 <p><strong>Abstract</strong><br>Within just nine months of its official identification by the World Health Organization, coronavirus disease 2019 (COVID-19) has caused 34 million confirmed infections and about 1 million deaths worldwide. The collateral damage and spill over effects to all sectors has caused severe social disruption and an economic crisis that the world was unprepared for. Despite the relentless global effort, the pandemic remains a serious threat to lives and livelihood. As a result, all countries are faced with the daunting task of balancing outbreak prevention strategies against efforts to save their economies. Nevertheless, almost every country now has months of local evidences about the pandemic that will support contextualized and measured actions.<br>The number of confirmed cases and deaths attributable to COVID-19 in Ethiopia has steadily increased since the first reported case on 13 March 2020. Although the country has so far avoided the feared catastrophe, the true burden of the problem may be far beyond what has been reported due to limited testing capacity. With the current trends of widespread community transmission, COVID-19 remains a serious public health threat in the country. In addition, multiple human-related and environmental factors, combined with relaxed COVID-19 mitigation strategies, have put the country at a high epidemic risk. Thus, proactive and balanced measures based on local evidence should be taken to prevent the country from slipping into a dire public health crisis. [Ethiop. J. Health Dev. 2020; 34(4):301-306]<br>Key words: COVID-19, Ethiopia, pandemic</p> Esayas Kebede Gudina Million Tesfaye Dawd Siraj Abraham Haileamilak Daniel Yilma Copyright (c) 2020-10-21 2020-10-21 34 4 COVID-19 response in Ethiopia: Challenges and opportunities https://www.ajol.info/index.php/ejhd/article/view/203467 <p><strong>Abstract </strong></p> <p>Ethiopia implemented public health measures to curve COVID pandemics earlier than many countries. Airport screening, followed by partial closure of international flights and quarantine of all international travelers have slowed the trajectory of COVID-19 pandemics in its early phase. Early adoption of Public health measures including hand hygiene and use of facemask have also contributed to the slow trajectory seen in the early days of the pandemics. Unfortunately, early gains have been beset by slow scale-up of public health measures, recent lifting of the state of emergency and public fatigue. Hospitals are already at capacity and not equipped to handle even the lowest estimate the country expects at the peak of the pandemic. To mitigate the impact of the pandemics, Ethiopia must return to the basics of public health measures: increase testing, upscale contact tracing, social distancing and universal use of face mask quickly and across the country. [Ethiop. J. Health Dev. 2020; 34(4):307-309]</p> Dawd Siraj Copyright (c) 2020-10-21 2020-10-21 34 4 The evolution of hospice and palliative care in Ethiopia: From historic milestones to future directions https://www.ajol.info/index.php/ejhd/article/view/203468 <p><strong>Abstract</strong></p> <p>Introduction: This article reviews the genesis of hospice and palliative care in Ethiopia, examines recent progress, and makes recommendations for the way forward.</p> <p>Result:Although the delivery of palliative care in Ethiopia has shown significant progress over the past two decades, it remains patchy, with the interdisciplinary components of psychological, social and spiritual support lagging behind the primarily medical approach.</p> <p>Discusion: As a pillar of healthcare provision, and in conjunction with health promotion, disease prevention, curative services and rehabilitation, PC awareness and its development should be a high priority</p> <p>Conclusion: More research on the root causes of lack of integrated services for PC and genuine conversation is required [Ethiop. J. Health Dev. 2020; 34(4):310-312]</p> <p>Key words: Palliative care, Ethiopia, life-threatening chronic illness, hospice, end-of-life care</p> Yoseph Mamo Anteneh Habte Nardos W/Giorgis Aynalem Abreha Nicola Ayers Ephrem Abathun Eleanor Reid Mirgissa Kaba Copyright (c) 2020-10-21 2020-10-21 34 4 Why has Africa reported relatively few COVID-19 cases so far? A web-based survey https://www.ajol.info/index.php/ejhd/article/view/203472 <p><strong>Abstract</strong></p> <p>Background: Africa’s first COVID-19 case was identified in Egypt on 14 February 2020. Since then, almost all African countries have reported cases. The pandemic is transitioning to more widespread community transmission in most African countries, underscoring the need to further scale-up COVID-19 testing with a much wider geographic coverage. In Africa, the expected devastation caused by COVID-19 has been ‘delayed’ compared to some European countries and the USA. The reason behind this is not well understood. The aim of this Google survey was to collect speculations about the phenomena in Ethiopia, in particular.</p> <p>Methods: This web-based survey used Google Forms to collect data from 28 April to 13 May 2020. Participants from the general public with different expertise were invited via email to take part in the survey. Participants’ voluntarism to fill in the form, and their age, sex and educational status, were recorded. In addition, they were asked whether they worried about COVID-19 and the role of lockdowns to minimize the transmission rate of the disease in Africa. Multiple suggestions about the possible reasons behind the relative low number of COVID-19 case and fatalities were recorded, and the collected data were summarized using a Microsoft Excel spreadsheet.</p> <p>Results: A total of 102 participants took part in the web-based survey. Respectively, 92.1% and 64.4% of the participants worried about COVID-19 in Africa and believed that lockdowns could contain the disease in Africa. As for the question why, Africa still has a low number of COVID-19 cases and fatalities compared to other continents, participants reported the following points as the main factors: poor COVID-19 screening practice in the continent (71.3%); God is saving Africa (33.7%); Africans are immune to the virus (18.8%); and poor connection to the rest of the world (18.8%).</p> <p>Conclusions: There is a big concern about COVID-19 in Africa. Timely and accurate epidemiological data is one of the most important tools to inform and drive the COVID-19 response on the continent. Until researchers know exactly what is going on with COVID-19 in Africa, its member states need to keep on measuring and testing. [Ethiop. J. Health Dev. 2020; 34(4):313-316]</p> <p>Key words: COVID-19, SARS-CoV-2, Africa</p> Awoke Derbie Daniel Mekonnen Yimtubezinash Woldeamanuel Tamrat Abebe Copyright (c) 2020-10-21 2020-10-21 34 4