Browsing by Author "Bekele, Mekdes"

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    “Consumer Protection in Ethiopia's Telecom Sector: New Beginnings and Prospects”
    (AAU, 2021-09) Bekele, Mekdes; Yilma, Kinfe (PhD)
    A few sectors have been selected for special treatment because of their unique importance to society. The telecom industry is one such identified sector in which consumers have legal protection. Telecom consumers' legal protection has progressed through several stages. This thesis examines the legal protection of consumers in Ethiopia's telecommunication sector. Ethiopia had no tailored consumer protection laws for telecom consumers, and safeguards were only made with generic consumer laws. Special telecom consumer protection has been enacted as a result of the recent (and ongoing) telecom policy reform. In line with international trends, Ethiopia's consumer laws in the telecom sector consider the particular characteristics of telecom consumers. The laws are designed to counter the power gap in bargaining power between consumers and telecom operators, uphold social injustice, address knowledge asymmetry and transaction costs. The quality of legal and institutional framework of consumer protection determines the effectiveness of consumer protection in the sector. The thesis examines Ethiopia's consumer protection framework based on comparative studies. It argues that current Ethiopian law exhibits several normative gaps that undermine consumer rights. The country fails to legislate laws to protect vulnerable consumer rights, a structurally independent regulator, consumer civil association representation in the regulator, net neutrality rules on Voice over Internet Protocol (VOIP) services, and data breach notification standards. There are no clear rules and an independent investigative team made up of system managers in the Ethiopian Communications Authority (ECA) to determine operator’s violation of consumer privacy. The Ethiopian Communications Service Proclamation (EthCSP) specifies access rights to Service Number Portability (SNP), but not how the procedures shall be carried out. Surveillance of Internet and phone correspondence is permitted under a number of broad statutes with a low burden of proof that has only rudimentary protection for the right to privacy. In addition, the modest survey of the practice shows there was an awareness gap among consumers about their own rights in the industry. The operator fails to have disclosure terms on privacy and data protection on the subscriber’s service agreement. And the contract is an adhesive in nature that does not include the rights of consumers in a clear manner which needs amendment. The ECA is yet to educate consumers and inform their rights.
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    The magnitude of PulmonaryTuberculosis and Comparison of Lipoarabinomanan RapidTest Assayswith Conventional Tuberculosis Diagnosis atSaint Peter SpecializedHospitalAddis Ababa, Ethiopia
    (Addis Ababa University, 2021-08) Bekele, Mekdes; Desta, Kassu(MSc, PhD fellow, Associate Professor); Asmamaw, Asegedech(MSc, Lecturer)
    Background:-Tuberculosis (TB) is a communicable disease that is caused byMycobacteriumtuberculosis.It is widely distributed globally with high mortalityand morbidity. Africa isone ofthe continents which ismostly affected. Poor and shortage of diagnostic facilities were proven tobe the major limitations in preventing the disease.Lowenstein–Jensen (LJ) cultureandAFBsmear microscopyare the gold standard diagnostic testing strategies for TB even though theyboth have a variety of limitations, especially in resource-limited countries. Additional rapid testthat can help the diagnosisof TB in antigen and the antibody-based assay is Lipoarabinomanan(LAM) which candetect the antigen from urine and its antibody from serum in patients withactive TB. Objective: To assess the magnitude of Pulmonary Tuberculosis and Comparison ofLipoarabinomanan Rapid Test Assays with culture-based tests at Saint Peter SpecializedHospital, Addis Ababa, Ethiopia Methods:A cross-sectional study was conducted on 314 study participants from March 2021 toJune 2021. After obtaining informed consent, data were collected using a standardizedquestionnaire. Urine, sputum, and serum samples were collected from pulmonary tuberculosissuspected patients that showed signand symptoms of TB. Then Lowenstein–Jensen (LJ) culture,gene expert, and LAM rapid kit testing were done following standard procedures. Thedata wereentered and analyzed using Epi Data version 3.1 and SPSS version 23. We used descriptivestatics including, KAPPA analysis. Results:a total of 314 participants wereenrolled in this study and 176 (56.1%) were male.Themagnitude of PulmonaryTuberculosisbased on Lowenstein–Jensen culture methods was 20.7%, amongculture pulmonary positive cases blood Lipoarabinomanan, urine Lipoarabinomanan,GeneXpert detected 50, 42, 45 cases respectively. The sensitivity and specificity of bloodLipoarabinomanan was 76.9 and 94%; urine Lipoarabinomanan was 64.6 and 91.5%; andGeneXpertwas69.2 and 92.3% respectively. Conclusion:Accordingly to the present finding, theLipoarabinomanan test hasgood sensitivityand specificity for pulmonary tuberculosis diagnosis versus GeneXpert methods.Further largescale study is required to understand the use of LAM based assay for the diagnosis ofPTB.
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    Treatment Outcome of Adult Patients with Retreatment Tuberculosis in Relation to HIV Status in Addis Ababa, Ethiopia: a Retrospective Study
    (Addis Abeba Universty, 2014-02) Bekele, Mekdes; Deressa, Wakgari (PhD)
    Background: Retreatment tuberculosis poses a significant threat including drug resistance to tuberculosis control program. However, recurrence and its cause in the era of Human Immuno Deficiency Virus (HIV) have not been well described. Thus, this study was conducted in Addis Ababa to determine recurrent TB treatment outcomes by type of recurrence and HIV status. Objective: The aim of the study was to assess treatment outcome of retreatment tuberculosis in relation to retreatment TB category and HIV status and investigate factors associated with successful treatment outcome. Method: A retrospective registered based cohort study design was used to assess the outcome of retreatment tuberculosis category patients above the age of 15 years covering from July 2009 to July 2012 was conducted to determine the treatment outcome of retreatment tuberculosis category in nine health centers in Addis Ababa. Sex, age of TB patients, TB categories, weights, residence categories of treatment regimen, HIV status, ART status, sputum testing and results and documented treatment outcome were extracted from purposively selected three sub-cities that have optimal case in Addis Ababa, Ethiopia. Results: Five hundred sixty-five retreatment pulmonary TB patients were included in this study. 525 (92.9%) were HIV tested, 192 (36.6%) were HIV positive 105(54.6%) were in antiretroviral treatment, more females were HIV positive 95 (43.4%) compared with male 97 (32.4%), there were 485 (85.5%) with relapse TB, 42 (7.4%) with treatment after default and 40 (7.1%) with failure after treatment TB. The overall treatment success was 65.6%with 11.4% defaulted being the most unsuccessful treatment outcome. Patients who converted sputum at intensive phase had higher treatment success. (Adjusted OR=6.53, 95% CI: 3.059-13.97) and among retreatment TB categories relapse cases had successful treatment outcome (Adjusted. OR= 2.4, 95% CL: 1.017-10.09). Conclusions: Types of TB and sputum test at intensive phase were significantly associated with treatment success. The treatment success obtained in this study was lower than the global success in 2011 and the small number of drug sensitivity test may hinder the actual number of MDR cases in retreatment tuberculosis. To improve treatment outcome continuous monitoring and follow-up during the course of treatment and further investigation on the cause of the observed finding in lower treatment success will be recommended.