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    Public health officer is a field of study in Ethiopia for non physicians’ clinicians
    (Addis Abeba Universty, 1954) Altamo, Biniyam; Sharma, Malika(PhD)
    Background: public health officer is a field of study in Ethiopia for non physicians’ clinicians. This was started in 1954 EC in Gonder college of Public Health to meet the health needs of rural communities. Objective- To explore the perceptions of public health officers on whether the curriculum prepares them for clinical practice in the real environment. Methodology-A qualitative research design will be used to explore health officers perceptions of whether the curriculum prepares them for clinical practice. Data collection will done using semistructured interview guide with open ended questions. The questions will be developed using personal experience and key informants. The source population for this study will be a graduated public health officers who will be interviewed until saturation of data is reached. Data analysis was begun with translation from Amharic to English during the transcription process. A thematic analysis approach was used. Result- the result of the study has revealed that some major curriculum related gap which contributes for perceived knowledge gap of public health officers. The main gap are disproportional time allocation for very crucial courses of basic sciences and clinical. The curriculum lack strict monitoring system of its implementation. Conclusion- Based on the result of this study some strength and weakness of the curriculum are identified. Some of the strength is mentioned are strong course content of both clinical and public courses. The main weakness in the curriculum is some of the courses are not proportionally allocated with adequate time and course contents like that of basic science and clinical courses.
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    Impact of Proper Excreta Disposal 0n the Heath Status of Children below Five Years of Age in Salale Community
    (Addis Ababa University, 1986-09) Adam, Zenam; Teka, Gabre- Emanuel
    A large-scale multi-disciplinary campaign which aimed at improving the agricultural, educational and health conditions of the general population of Sellale awraja was conducted in J'flL'.y 1981 , duri ng which , IVfuketuri , the present study ~-xeR9 ,.,as alleged to have achieved the maximum results by provi dine; jli t latrine facility to sa.ch and every household residing i n the to'ND . An evaluative study on the imrc.ct of proper hum[].n '"Rste disposal on the real th status of children belm, 5 years of age was conducted from July 14 - 21, 1986, which is five years "fter the mass introduction of "it latrines as an intervention into Hu.1(eturi t m·n1. Assessment \-:as also made on how residents of the tOlffi have former! the habi t of using the f",cili ty after it ""8 made available for them. Because of lack of basE line dat:l, a similar community unaffected by the 1981 car.Jpo.ign, but cOClp"rable in respect to pertinent socio- demogr arhic characterstics, "'as chosen c.s a control . Intestinal pexasitism, diexrheal illnesses, o.nthropometric measurements, infant and child rteaths werG chosen to me~sure health improvements that mi,;ht have resul tect from the interver:tion. vii Weie;ht anj hei~ht, mea.surin[ scq12s £',nri stool examinr:.tion were the instruments used, for tbe ohserv"til'nal '~ata coll ection >!hile a pre- tested am] pr8- strl1ctured qU8stionnaire ,ras employed f or intcrvi e>!ing head of house holds ".lld/or mothers . Analysis of data collecteil from " total of 19G subjects and 85 controls living in 132 & 65 f'lmilies resrectively, h2.S sho>!n that pit - l a trine facility avaibbility ,;as 81. S ~~ for the study group ;mel 42 . 1, ~b for the C'ontrols . In the attempt to determi ne the people's motive to h'LVe a latrine f Ctcil ity, it >!as found that morE. t'l2.ll 60 5~ of f","ilics in Nuketuri re;oorted thp;t the f aciE ties >!ere imposed by the ICebele , "hile s81f- ini' i a tion .1\nd advice from helll th wor:!orkers' advice . viii Study results denHJllstr:LteJ 3Jl ,- VOl' ~.ll h"".l til i mp0roveffient aGlont; the stujy Gre-up th,m their oontrols . !'revalence of intestinal Tarasites W,'lU 32 . 2 ~~ an'j 56 . [ c;.~ ~ p" 0 . 01 ) 2.!Jong children sturlie ... t in l'Iuketuri :md Chancho respectivly. l';ultiple intestinal pD.r?sitism among th€ rosi ti ves, IrJ1.G n1so higher in the controls tha..n i n subjects, 32 . 6 10 VS . 5.4 %. An D.lysis of anthropometric measurements using Wahrlow ' s cl:J.ss i~ ficaticn , revealed that protsin - 03nergy malnutriti on was COEUllc,n among both groups of children . However, co~~.~iS0~ between th~ two ~..roups show a r:1cro improved con,2i tion M10W; the sturly Sll~ j jects than th,,; controls . The two- weeks recall period rrev::112nce of chilCl di'_LrrhG3. \.J~S 3.1so found tobe higher amonG ths controls , 15 .3 . Vs 11 . 7 '7~ • But the difference \ons not statistic ~,lly signific:1nt . Resul ts in genera.1 indic-'lte th2..t provis i on of 8Y.:cret::t dispos~d faci1i ty m'w redUCE the IJreV?J.ence of intestin'1l pCLr2.si tic infections, di :lrrheal diseases and 1!alnutr.i tion C'Lnd m,w resul t in e;Ener"l h""l th improvement of children beloH 5 years of age . Availability of latrine in a family , hOHever, m?y not prctoct children i ndi vidualJ.y , unless the overall contamination of the environment of the c08munity i E prevented . The less - effective inputs by health "orkers alone and the i mportance of I!lultisectoral approach is 'J.180 discussed
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    Prevalence of Dentel Fluorosis among high School Students in Nazareath, Ethiopia.
    (Addis Abeba Universty, 1986-09) Gillamichael, Fikremariam; Taka, Gebre-Emanuel
    JL cross-sectional study of the prevalence of dental fluorosis among Nazareath higb school student population and determination of the concentration of fluoride in tne water supoly of t he town was carried out in June 1986 . Of the 4092 9th , l0th and 11th grades student population 1023 (25%) students '!Jere selected f or dental examination and interview by the process of random sampling method using t a bl e of ran dom numbers . Out of the 1023 s tud en t s , 821 (80 . 3%) responded to t~e s t udy. Of the 821 , 334 (40 . 7%) are born i n ~Iazareath , 58 (7.1%) are b orn in ':ionji , Koka , lolenchiti and Hetehar a snd the remaining 429 students (52 . 2%) are born in othe r ol aces Rn~ a rri ved to live in Nazareath a t di ffe r ent year of their ages. The prevalence of dental fluoro Gis a~ong the High School student population is found to be 38 . 2% with no s tatistic a lly s ignifican t differ enc e betwe en the mal es (36 . 9%) and femal es ( 40 . 9%) (x 2 = 0 . 77 , x 2 95 ( 1 d. f) = 3.84 , x 2 99 (1 d.f) = 6 .63, P ", 0 . 01 , P 0 . 05) . i.nd the preva l enc e among those born and brought up in ~azR r ea th is 69 . 1% with significant difference when comnar ed to thos e who have come to live in Nazareath at differ en t times of t heir age (x 2 = 232 . 19, x2 99 ( ) d . £) = 11.34 , (p < 0 : 01) . There i s also sta tistically significant difference among the differen~ ege groups with the young er age gr oups the percent being high (x 2 = Yf . 22 , x 2 99 (~ d . fJ = 13 . 27 , P <0 . 01 ) . v iii Water samples from thr ee functioning sourc es of water SuoJply for trle to',1n ( g wells junction- main suppliers of t he town for the last 23 year s , Deke- Hadi and High way \l; ells - recently dug or on us e tV10 wells , 1983, 1984 r espectively) are also analysed and the results indicate high fluoride l evel (5.30, 1.32, and 1.16mg/litre of wat e r , respec t ive l y . Thus th ere is an assoc i at i on between t he flu oride cont en t of the water su~)ply and the prevalence of dental fluorosis in those that are born and brought up in Nazareath and those that have arrived t o Nazareath at an e a r l i e r age of th eir life .
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    Prevalelence of Tachoma among Children Attending Ketchene Debre-Selam Elementary School in Addis Ababa and a Case-Control Study of Risk Factors in Their Home Environment
    (Addis Abeba Universty, 1986-09) Erfo, Desta
    A total of 301 randomly selo c tod elumentary scbool chllaren f rDm kG~uuene Th ur cse l oll slsillenGary SChDOl A,ddis ilba oa , Nu L'0 tlAaflHhJ for Gr a CiJooa in June - July, 1986 , and a motcllud case-control st udy was carried out ~o taSG ~~U JsSO Cia~lon D~~uo~n the occurrance of GraC!1lJma and somu i'isk faco Drs i n the home environmutlt of the: studUIlIiS . Casas wuru all tboso !;I;t ud81lts dia ~ llosucJ to Ui?VO aotivu traohoma , match ~ d with tlOn-tr8ouomatous s Gud Qn~s Dy aso , sox, and ,j r vdo . Thul'o ,7as no sic nificant d i ff ~ r c ncu ill tba [JruvCllenco fat o ~ f traclloma bll t l/Utlll males illl0 fomal os ilmOtlG thu stud'lnts . How
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    Community Health Service in Ethiopia use of Community Health Agenta and Traditional Birth Attendants in Sidama Awraja (Sidamo)
    (Addis Abeba University, 1986-09) Mandefro, Gebre; Shamebo, Desta
    Since the launching of the Primary He~lth Care Program in Ethiopia, 6 717 Community Health Aqents (CHAs) and 6107 Traditional Birth Attendants (TBAs) have been selected by their local communiti es and trained by the Ministry of Health . Then they were sent back to their respective l ocalities and expected to perform disease pr evention, health promotion and rehabilitation services . In Sidamo F.cministrative Region, 436 CHAs and 632 TEAs have been trained. Out of these , 118 CHAs and 236 TEAs are found in Sidama Awraja (province ). Thus to flnd out hOI'} effectively they are being used 20 peasant associations \vhich have both CHAs and TBAs were studied . Out of the total number of CHAs and TBAs t hat were trained in the r e g ion, only 117 (2 6 . 8% ) of the CHAs and 242 (38 . 3% ) of the TEAs were found working in the entire region. Similarly 34 (28.8%) of the CHAs and 117 ( 49 . 6% ) of the TEAs were found working in Sidama Awra j a . The CHAs who were working, with the exception of Wacho, were found t o have a problem with recording preventive activities performed in their local ities. Over 90% of the TEAs ~}ere not able to identify the most common signs of ous signs of pregnancy. pregnancy and the dangerIn add ition , only two of t he TEAs mentio ned that they \,Jashed their hands before touching the woman during labor. Only one TEA mentioned the importance of sunshine . One stated how she managed a retained placenta and none of them mentioned anything about child spacing . It is therefore, suggested that a strong national policy for training and support for the use of CHAs and TEAs be formulated. viii
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    Assessment of the School Health Service in Addis Ababa during 1985/86 School Year
    (Addis Ababa University, 1986-09) Desta, Teshome; Desta, Asfaw (PhD)
    This study is an assessment of the school heal t h service in Addis Ababa which has been operating for the last 45 years. Fifty-seven school clinics serving a student population of 197,181 were se l ected according to set criteria . 'rhese school clinics were visited, medi cal records and reports for the 1985/86 school year revie\'19d , and school health workers interviewed. Najar he alth problems of school childr"n and problems in th ... delivery of the school h~alth servi ce its ~lf are i dentified . Accidents and injuries were .round to be the most prevalert health problems of school childrf;n \vith .:in overall incidence rate of about 22%. Over 45% of the: report ed deaths fer W1lich causes were possibly kno\vn during ·the same period were also aue t o accidents . Other categories of health problems includ.~ inte stinal parasite, dental problems, skin infections, eye and Ear probl ems and venereal diseases .. Available data s ugge !3t that most of these problems were cons istantl y o':;curring over the past 26 yeurs, E~X Cl2:pt for dental caries which has possibly appedred as .1 new phenomena in recent years. Comparison of the morbidity patterns between the school population and the general population of Addis 1lbaba did not show major differences . On the whole 1 most of the dis eas~ s and conditions idantified are o f the typc that can be prevent"d through general public health m€i1c.ures . Nost of the school clinics havL~ seri ous probl (:::l-:IS of space, budget 7 drugs and ffillnpower:_u Over T:::'r of the school clinics surveyed have only onc room each and about £:5% W'2re staffed by on0 hedlth worker each. Lack o f provision [or refresher courSGS r i nadequatt. supervisi on and ambulance problenls we r e a lso r eported. School }j;!alth s e r vice activiti es were found to be incomple t e in most of the important 3ctivities like pariodic medical examination of children, screening f o r defects and vaccinations . From the f i ndings of this study it can safely be concluded 'that school health servi ce i s a n.Ajlected <&rea of service demanding urgent acti on and therefore I' some recoTrUllendatiuns a:re made to help ill improving the exi sting s ituation
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    Cost of Training Nurses in Ethiopia
    (Addis Ababa University, 1986-09) Dinku, Tefera; Desta, Asfaw (PhD)
    In manpower training, as in any other area , efficient uses of resources is always desirable since it is one of the most important determining factors . Simulteneously, quality of the training should also be givDn due consideration in parallel with that ) f efficiency . The promissi Dg or effective out come of training of nurses obviously is not different .Qu t of the five schools fo r the training of nurses in the country , the Centralized School of Nursing of Addis Ababa and the Nursing School of l~smara are studied . Choice of these schools i s based on convenience and feasibility for the study . The main concern of the study is to estimate the cost of training nurse s in Ethiopia based on the experiences of the two schools of nurs ing . The study also c overs the effect of attrition ~n the cost of traini n g & the staff - student ratios during 1973 - 1977 E , C. The study sho>ls that , on the average the Centralized School of Nursing spends Birr 2145 . 35 per student per year while the Asmara Nurs i ng School spends Birr '1306 . ·t4 per student per year . The average total cost per student from enrollment up to graduation at the Centralized School of Nurs ing i s Birr 6233 . 12 while at Asmara School of Nursing it is Birr 3686 . 00 . An average Bttrition rate of students of 20 . 4% per y ear at the Centralized School of Nursing and 15 . 5% per year at Ls:nara Nursing School is observed based on studying three consecuti ve batches in both schools . Attrition has shNID a s tatistically s i gnificant effect on the cost of the training in both schools . v v l If there Here not any attritirn of students , the mean cost "auld be reduced by 27 . 5% for tlae Centralized School " f Nursing and by 19% for the Asmara Nursing School . Cost per student per year and cost per trained student betHeen the t'10 schools Here also compared . And it Has found out that the Centralized School of Nursing spends significantly m~re in both aspec t s • . ( P < 0 . 0005 ) . The !tsmara Nursing School has staff- student ratio Hith an annual average of 1 :20 and ranging frnm 1:13 to 1 :24 . The Centralized School rf Nurs i ng has an aver age staff- student rati " 0f 1:13 , ranging f~0m 1 : 10 to 1 :15 . In b oth cases only the teaching staff are considered frr calculating staff- student ratios . Recommendations are made based on the findings of the study
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    Utilization of Trained Traditional Birth Attendant s in Three Farmers Associations in Haykoch and Butajira Awrajil
    (Addis Ababa University, 1986-10) Abebe, Salelesh; Alemu, Tadecse (PhD)
    The utiliza t i on of the trfl inad traditional birth at t endantn Associ a t.ions includ<2 li'eyt! G"bri ~ l , Gp.raba Fila and Aedo Konte la . The method of the s tudy \07.:18 by qu e:-J ti o rs~ <1:lr(! i n t(!rvi~ 'h' ..... \.i r" . _ All mot hers with children l es9 the.n t hr e~ years of age in Aedo Kontcln a nd 'with ch i ldr.cn l eGs thcm six months of age in the Q~he:r t\.;ro Farmers ' ASDocifltlons ~'lere intcrvit:.wed. Five t rained tradi tio ll.~ l birth attendants, one community health agent , the c hRirpersons of v]omen ~ s Associ.1.tions, f!nd the h·~a lth personnel wh'21 Cl r C! invob 7ed in t h :~ t7.:'~in ing nnd l or su p ~ rv :!.sion of thr~ trained tr
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    Utilization of Trained Traditional Birth Attendants in Three FarBters Associations in Haykoch &nd Butajira Awraja
    (Addis Abeba Universty, 1986-10) Abebe, Salelesh; Alemu, Tadesse (PhD)
    The utilization of the tra i[wd traditionnl birth nttendant8 ill thre (~ F'lrmot's 1 Ass:lciat i cns W[,,3 studi ed. These Farmer::; 7 Associat.ions include \':eyu GebrLJ1J Geraba Fila end AHdo Kontela. The method of the s tudy \0],')8 by questi {)r~n
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    Beeast Feeding Practices among Factory Warking Mothers in Akaki
    (Addis Abeba Universty, 1986-10) Bekele, Shimelis; Desta, Asfaw (PhD)
    A crcss sectionco,l study on p~'::;c Hces of ureastfeeding has been carried out from July 11 to July 30, 1906 in !)kald J3eseka. All mothers 'Iho hnve children ° - 2,\ !:tonths .in ilknki 'T€xtile factory ( and house\1i yes 'vho have chj.ldren of t he same age group \rives 91. 71 .:;, . The mean duration of breastfeeiling af!lone the st:lc1y population \vas also determined . rrhe prevalence and duration of breastfGedin~ were lOHer among factory working mothers than among housewives . ·The differences were signific:: mt both for the in·(,valence and duration of br8?stfeeding. The study findini~s >lill help to understand some of proolems related to bre~stfeec1ing practices ~nd may hel::: ili .' ~~::li:.-'LC ~:l:proprii1.te prog- , .~~.~:. r aOr!l8S by concerned 6:0vernrnent or. '"'.nis. ·~io!1s to increase prevalence and duration of ore'"stfeed i ng •
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    Protein Energy Malnutrition and the Risk of Diarrheal Diseases and Ari in Preschool Children Harar Zuria Awraja
    (Addis Abeba Universty, 1987-02) Bantirgu, Mulugeta
    A 6 weeks fo l low up study regarding the association between P.E .M and diarrh e~ l dis eases and AR I was performed in 1757 children under fiv e years living in 8 peasants ' villages of Harar Awraja , Harrarghe Region . 2% thes~ children were found to be below -2 Z-score of weight - far - height index. In children aged 1 - 5 years 8.7% were severly malnourished «12 . 5 cms of MUAC) , and 22% were moderat8ly malnouri.shed OIUAC = 12.5- 13 . 5 em) . During the follow up period 63 . 6% children developed new episodes of diarrhea and 63.4% had new symptoms of ARI . Diarrheal attack rat e o f 2 . 5 p e r c hild and mean duration of 4 . 9 days was observ ~ d . Fo r AIlI the rates were 2 . 2 and 4 . 5 respectively . Both the duration and frequenc~ o f AR I and diarrh eal diseases were found to be associated with ag e and nutri tional status . Diarrh ea l di seases and ARI were more frequent and of lo nger du r ation in chi l dren less t han 2 year s of age chi Idren (MUAC relative to older c hildren . Ma l nourished <13 . 5 cms) showed attack rates and l onger duration significantly h igher than th e ade quately nour i shed by the same standard . Nutritional s tatus as assessed by weight - far - height index was not found to be associated with morbidity . At the end of the follow up period 18 . 7% of c hildren lost weigh t from what they have initIally. 77 . 6% had gained weight and 3.7% did not show any change . 47 . 5% showed decrease in their MUAC from wllat was obser ved at the beginning . 29 . 3% had increased MUAC an d in 23 . 3% v i I the initial and the last r e adjn[;s were s imilar. More children in the younger age group s howed a tend ency to gain weight and MUlIC whil~ jn th e old e r ones the tend ency was towards n e[; ~ tive gain, 'fhe InajoriLy n~ children who lost weight and MUAC had diarrhea (70.4 % \ and was fotmd to be statistically signifi c ant . ARI did not s how a s sociation to weight and MUAC chan ges . This study proves thaL ma.lllll Lril. iun in c rcas es morbidity from infectious diseases and inf ec ti o ns parti cularly diarrhea can contribut e Lo malnu t riti on. This focus es attention on the importanc e o f a combined at t ack on both infections & ''''alnut ri t jon II'h ich is b est a c h i e ved by coordinatedmllltisectora l co llabo raLl on. Vill
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    Malnutrition and Measles ig. G. Elisa in 0-23 Months children Comparison of Seroconversion and Vaccine Side Effects, Addis Ababa
    (Addis Abeba Universty, 1988) Abebe, Amare; Abebe, Amare
    A cohort of 9 23 mo nths old Addis Ababa children were assessed as to their immune response to meas l es vaccine in relation to their nutriti o nal status. Of the 307 pairs of blood spec imens analyzed for meas les antibody, 207 ( 67.4 %) (32.6%) had had a negati ve preva c einiltion tit er while 10 0 prevaccination titers th a t we r e s e rop os iti~ e. Am 0 n g the s e ron ega t i ve s a 95% s e ro c 0 n "e r s ion rat e was obtained with no difference b et"r>en the malnourished and well n o urish e d. Ther!' Has n o differen ce in side e ffe cts repo rt e d to th e meas l es vaccin e betwe!'n well n ou ri shed and maln o urished c hildr e n. raccination of thos e wh o were seropositive at th e outset didn't r esults in an), booster e f f e c t, de fin e d by a f 0 u r f 0 I d r i s e fr o m the pre \- i 0 U s tite r'. Only 9 (9%) o f these ch ildr e n showed a booster effect. A va lidity test f or his to r y of measles aga inst the laboratory results gave a 9 5. 1% specificity and 3 1% sensitivity rat e . A secon
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    Health Status in Resettled and Indigenous Population (Keto Settlement) in Kelem Awraja, Wollega Region, SouthWestern Ethiopia
    (Addis Abeba Universty, 1988) Mekonnen, Adane; Hanson, Mark(PhD); Okubagzhi, Gebreselassie(PhD)
    This study is a cross sec tional sample s urvey on t he health status of 10 villages (5 resettlement and 5 indigenous) in Kelem Awraja, Wollega Regio n, Southwestern Ethi opi a . The fi e l d study was conduc ted i n September and October 1987 . The survey c onsisted of a s e t of qu es tionnaires on s ocio- demograph ic , he al th status, nutri tional as sessment of unde r-five c hildren and stool e xamination for ova and paras ites. The soc i odemographi c data reveal ed that the total popul at ion covered by the study was 3779 people , out of which 2040 were settlers (54%) and 1739 were indi ge no us ( 46%) . The Ii terac y rate b e t wee n the two groups s howed no diff erence 32 .6% a n d 33 .4 %, but much lower wh e n compared to the national figure which 1S 60% . The major sources o f water s uppl y f o r mo r e t han 50% were from unprotected spr ing s and river water for both gro ups. The avai l ability of latrine s and garbage disposal pits for settlers was more t han 90%. For the indigenous group a bout 50% had latrines and l ess than 30% had a garbage disposal pit. In hea lth facilities a nd h ealth care, again the settlers were i n a better position compared to the indig e n o us. Immuni zation coverage, ant e natal attendance and delivery services we r e significant l y higher in t he settlers. As far as mo rbidity was concerned 25 . 2% and 19. 7% of the sett l ers and indigenous resp e ctively reported s i ck during the last ix two weeks. Nutritional status in under-five children was poor but showed no difference between the two groups . With regards to prevalence of intestinal parasites in the two groups, 69 .4% of the settlers were found positive whereas i n the indigenous 77.1% were positive. Explanations were offered for the better health services and health status of the settlers . x
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    Socio - Cultural Factors Related to Breast Feeding in Jimma Town - 1987
    (Addis Abeba Universty, 1988-01) Addus, Abdulaziz; Dkubagzhi, Gebreselassie
    Recent evidence suggests that th ere is currently a trend away from breastfseding in developing countries, despite the large numbers of studies documenting its beneficial effects on child heal1;h. The prevalence of breast feeding in Jimma Town was found to be ~6,5 - percent in a cross sectional study of 975 methers, -The mean duration of exclusive breastfeeding was 4,4 months and the mean duration of over all breastfeeding was 15 months, -Forty three percent of methers gave food supplements for their children by the age of 4 w 6 months, Additionally, i t was found that 60 percent of the methers breast fed f or mere than 18 months, - Seventy eight percent of mothers started breast feeding immediatly after birth and the majority breast fed on dsma~d, Forty two percent of mothers gave milk and milk products as a supplement and 76.5 percent of them gave the milk with bott~e, Twenty five percent of mothers were of the opinion that mothers should exclusively breast feed children for 4 w 6 menths, -Seventy nine percent felt that mothers should optimally breast feed for 18 months or mere. Only Thirty six percent of methers considered breast feeding to be superior to bottle feeding for a child of 4 '- (3 months, A search for social and cultural determinants for the occurrances of extended breast feeding was conducted and it was found ou t that family income, educational 1avel of both the mother and her huSband to have a negative correlation with the length of breast feedi~g.
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    Byssinosis Respiratory Conditions among Textile Mill Workers in Bahir Dar - Ethiopia
    (Addis Abeba Universty, 1988-02) W. Yohannes, Mentesinot; Todesse, Getachew (PhD)
    This study was conducted to investigate the prevalence of byssinosis and ather respiratory conditions among 595 workers (322 male and 273 female) involved in dusty operations of a typical Ethiopian textile mill located in Bahir Dar, Ethiopia. A respiratory questionnaire was administered and pre-and post-shift forced vital capacity (F VC) and forced expiratory volume in one second (FEV 7) were determined for each worker. Multiple area air samples were analysed fUr , elutriated dust concentration (range \- / \ 3 .. 0.86-3.52 mg/m ) and personal sampling dust concentration (range: 7.03 - 3.83mg/m 3 ) The case study groups and control groups were stratified by time weighted dust concentration and then cross-tabulated with respect to high and low cumulative dust exposure. The prevalence of byssinosis was assessed to be 43.2% among blowers and 37.5% in carders in comparison to 4 to 24% among workers in other sections. Chronic bronchitis and bronchial asthma also occurred in the range of 77.6 to 47.7% and 8.5 to 20.5% respectively, x vi in all sections. Significant accrass- shift decrements in FEV 7 and F VC were observed in the case study groups when compared with control group . The estimated relative risk of developing byssinosis, bronchial osthma and chronic bronchitis accountable to high cumulative dust ex posure were significant with an odds ratio of 27.76 , 5.72 and 3.64 than to low cumulative dust ex posure . Significant dose-response relationship for pulmonary function and respiratory illnesses models was also observed by regression analysis. The result of this study revealed that the prevalence of byssinosis and other respiratory illnesses was very high in one of the mills processing raw cotton. Applications of proposed preventive measures and early detection of exposure e ffects are expected to reduce the prevalence of byssinosis and other respiratory illnesses. Further research including a nationwide survery is suggested in order to determine the magnitude of the problem nationwide. This study represents the first epidemiological study of the textile industry in Ethiopia using diagnostic criterion similar to those which are applied in developed countries, such as the United States and Creat Britain. The study has also enhanced our knowledge end experience in integrating occupational health and intersectoral co-opera tion into practical implementation of primary health care .
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    Risk Factors in Childhood Malnutrition Genale Awraja South East Ethiopia
    (Addis Ababa University, 1988-02) Geressu, Takele; Mrisho, F. (PhD)
    The nutritional status of a homogenous rural Ethiopian community was st udi ed. A tota l of 1020 children. 498 (48.8% boys & 522 (51.2%) girls ill the age group 6-59 months participated in the study. Factors that may possibly be involved in protein energy malnutrition were studied. As age of study children was difficult to determine to the exact month the' re l atively age indepe ndent anthropometric index weight for he i ght was used. III all cases bivariate analyses was done. 302 (29. 6%) of the study children were found to be below -2 Z-SCORE of the NCHS weight for h ei~.t refere nce. There was no difference in the prevalence of malnutrition in the two sexes . However, boys were heRvier & t aller than girls. Socia- demographic variables like I,.come, family size, polygamy, membership of the family to a farmers' producers co- operatives and maternal literacy did not show any correlation with the nutritional status of the child. Having more t han one child in the age group 6- 59 months old in a family predicted malnutrition. Duration of breast feeding was shown to be inversly related to nutritional status. Recent illnesses of diarrhoea, fever & cough were strongly associated with poor nutritional status. Two hudred fifteen (21.1%) of the study children were cOlnpletely imml.nizcd
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    The occurrence and Determinants of Accidents: a Case - Control Study among Wor Kers in the Assab Port.
    (Addis Abeba Universty, 1988-02) Demissie, Kitaw; Tadesse, Getachew (PhD)
    The h igh incidence of accidents related to the port in the (( w rojo of Assab, during 7986-87 led to a mare detailed observation and analysis of accidents in the part of Assab in 7987 . Same 6,500 workers are employed in the port of Assab, but of these 570 (8.8. %) are lis ted as " nan- indus trial", or are employed an work that is unlikely to bring them into contact with industrial hazards. The r emainder 5,930 (97. 2% ), were an the list of the four departments principally concerned with industrial work. Th is number was made up of 5725 (96.5%) males, and 205 (3.5%) females. To describe the occurrence and determinants of accidents among workers in the port of Assab, a one con trol per case (247 pairs) study, matched on the basis of their similarity with respect to the selected variables was designed . The study was conducted over a 55 days period, from October 76, 7987 to December 9, 7987 . The total number of accidents that occurred among workers exposed to the risk of accidents in the port of A ssab were 247 (4.7 %) ,giving a rate of 8.2 accidents per 700,000 worked man-hours, 40.6 accidents per 7, 000 exposed workers or 2. 03 accidents per 7 00 employee - months . The real highest department rate of accidents was produced by the departmet of Haleb boaty(uJ construction projec t with an accident rate of 75.5 per 7 00, 000 man-hours, 77.8 per 7, 000 exposed workers or 3 . 9 per 700 employee - months. No significant difference was noted in the rate of accidents among the worker's categories labeled as skilled, unskilled and apprentice. The occident frequency was highest on Mondays and fell to its lowest level at mid-week, with an increase once more on Saturdays. The frequency rate of accidents was observed to be highest in the period of the second shift (8 p . m to 4 p. m) with on accident rate of 10.6 per 100,000 worked man- hours, 50.4 per 1,000 workers at risk, or 2. 52 per 100 employee-months . T his is probably due to the peak environmental temperature occurring in the second shift. Analysis of man-days lost showed, 1,571 total man days to be los t due to the 241 accidents over a period of 55 days. The average man-days lost per accident works out to 6 . 5, the range being from a to 91 days. The rate of seriousness in Assab port study was 0.5, and the index of seriousness was found to be 0.3. Analysis of the cost of accidents showed 31,606 birr, the average being 131.2 birr per occident to be spent over the 55 days. This cost is only for the medical and man-days lost expenses and does not include the insurance payments and other indirec t cos ts. Analysis of accidents by category of causation showed both the environmental and human factors to be involved in 57% of the accidents . In 25 . 7% it was the environmental factor alone, and in 16.6% the human factor alone. Among the causes by environmental factors, the most frequent causes were: defects in agencies (35. 2%) hazardous methods or procedures (22. 5%), and placement hazards ( 22. q%). Among the causes by the human factors, the most frequent were = inatten tion to footing or surroundings (18. q%), improper use of hands or body ports (18%), and failure to wear safe personal attire (12.3%) . The main determinants identified for the human factors ' from this study are; age of the worker, educational status of the worker, job title of the worker, experience of the worker in the port of Assab, and work shift of the worker. Thus the risk groups identified for the epidemiology of accidents in the port of Assab include: port workers between the ages of 18-2q years, port workers with no formal education , Port workers classified as fI electricians, welders, plumbers, and carpenters fl. , and port workers who are employed to work in the second shift. From the findings of this study, the recommendations given are:- I. A firm and well defined policy. 2. Employment of a fUlltime safety Officer in the port. 3. Formation and Organization of a safety committee in the port. q. Introduction of on effective investigation and recording system of accidents in the Assab port. 5. To adopt a systematic inspection and follow - up system by various level of personnel, till all the environmental factors identified as a couse of accidents in the Assab port are rectified, and J 6. Strong efforts in the areas of safety training and education, safety supervision and safety communication to the risk groups identified are necessary to effectively reduce the accidents resulting from the human factors
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    Community Involvement in Cohmtltlity Health Service
    (Addis Abeba Universty, 1988-02) Wakbulcho, Mathewos
    Nine hundred households from t ~ irt y separate c ommunities were surveyed in one urban district, Ketena 5 in t he city of Addis Ababa, and one rura l ri i strict, Chebo-Gurege , to assess c ommunity involvement i n decision-making , planning and implementation of sev,"n ~; p ec ific communi ty health act i vi ties. The health activities se lectcl were recruitment and support of CHAs and TEAs, construction of a he alth post, cons truction of lat rine and refuse pits, immunization program activity and provision of safe water sunply. The s t udy c ommunities were also assessed with respect to the ava i l abi lity of community health services by l ooking at the activi t ] of CHAs and TEAs and the existence of a health post and activity of t he local health committee, while the r a te of i mmunizat ion covera2:e in the under two year olds and pregnant women was a lso determined. In all three areas of community invo l vement i.e decisionmaking, implementa tion and planning , rur a l communities scored higher than urban communities, with the exception of environmental activities where urban communities were slightly more involved than rural communities in im o le~ A nt a ti o n but not in the decision-making an~ l ' l a ~ nt n ~ asnec ts . Lower c ommunit y invo lvcr",en t i ll l~ :: h "" '1 T i!" ] S VI"" '1ssoci'Jted ": .~ J. with lower activity in t.hc .ir "nmmIlJlit~- hp.tllt-h Sf'J'\-iJ'es and in some cases almost i::\ totn.l 1;1, -,, 1;; o f s ll r h rnmlllilnit.y h ~illt. h services , \..-hereas rural C'OfJlm\ lnTt i( ' ~ hnd fl higher l e\-e ] of activity and existence o f r.nmnll!llit~,: h p. <1lth sp.rvi~es . However , d "spi te a lower l evpl of r:omml1ni t,' i nvol vement and lower activity in thp. communit:: h("alt.h sp.rvir.p.~, llrh:1n communi ties had modernteb' hi«h 1e,' e [" of immunization coverage in the undpr two ;.:p.nr .r\'Jd s , S \lt!gf' stin~ t hat immunization coverage can h" ;1 ,'h i (" ' e d de<;pi te th" r ,.,co rded weakness in such are as. The clns~ association of commtJnity involve me nt and activity in tlH' c nmml1nit,' h ea lth servi c es does seem to be at l east partly rp<;ponsih1c for t hp relatively high levels of immuni zation covprage ohtained th e re and may indicates t.he .o:rcater" i mportnnc(' o f <;11"h features in rural life. Study of the fifteen rura l comml.nities in more detail revea led gradations of CHS activity, community in vo lv emen t and immunization coverage . Comparisons of "reas o f high, mod e rate and l ow coveragf' support.ed the over,.,11 eo n c 1usions and in addition r evp.aled somf' othrr int p. rf' sti nt! f0.,'1tll!'f"s. The fact thnt. n di stnnc0. of ll'ss t hall ~ l;; TI1 ~ t Il t 1\(" n r' :! n~st conve n t.ional health unit apppnJ"~rl to p~prt A n ~unt i ,' ~ effect on thn act i vlt.~· of ("OTl1lOllllit.:,-- h (.>:'l lt h ~f" t~\'i("r~" prnvrrl to be a feature of r.ural :\'''; I , P ! \ " ; \ .. . ; ' 11 · ' ( 1 1l1· 111 '~1;ti ,-' s . v i 1 L community in CHS c oulrl h~ ~ lnt0rl to thr '-sY'inti n n s in d C'mog rnphi c , snC "jo -f'c'o llcHn i ' organi za tions n oted hrtlJl;f; f) ,· tI ,.. .. r . t," f) communit.ic:s. rn rurn I communities, most of I'".h(' 1l f';\f 1'~ of' households \",; c r 0. n Jdcr , male dominated. full emp 10;· .... .1, homo.,,,, nr.ous \,,; th rpspeet to cuI t.ure and ethnici t.y ns t-:" I I as I"' "r.,, t. ne .... d of he nl th service, with strollg 0 rganiz~tinl' o f ppnsant associat i ons, produ ce r s cooperatives Rnrl \ 11 l i"l z~t iol' schemes . Urban heads of h ousehold s ""r·~. on thle o therhanrl, c harn cterized b:v :voung0r :1~'" s;n .e:lf"' m~rit ;:d status , marC' f emn l (~ h ends, I'01nt:i\"0. 1:-- hi ~ h IIn r lllpl o :,--m0nt , gr0:lt. "' I~ h e t.erog eneity in et hni cit~' alld cultnrC' And l oose l ocal organization and coorrlination in he alth rlr.vel opmr.n t as well as greate r accessibility to conventional I,enlth unit.s. In both rural and urban communiti es. they still wou ld prefer external support of their hea lth sprvi ce , particularly from th e gov~rnment, ind i cati ng a npe rl for stre ngthening PHC manage me nt s nnd rnhnnc .... rl rommlllli t ;' education about the blenefits of sel f r le linnre in h .... nlth. as in other matters. In general t n ~urprising nppreci.ation and acceptance of community health workprs I'BS p~ prRss p d with the largest numbel' of complnintF h .... l n~ rlirr r t .... d t owards t he inadequate nllJT1h"I"" ( jf' th0m :l\' :l i l '1h l r- nnrl t h 0.ir inahil ity to trp :lt n h'i~( "' l " ,": 11 1'.." ()I h,"' ,'l! t! l p I'0h 1 0 nl S . l ,X
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    Barriers to access to Modern Contraception
    (Addis Abeba Universty, 1988-02) Tekalegne, Agonafer
    This study IJas pro mpt. e d by a rf'p o rt on mat ", rnn] mortal i t~ ... F.lsRoc l nted 'hi; t h ::\ hi rt h nllmhf'r n f nhnrtionR dll 0. t.o lIn\·lI\ nt, ,.. r-j pr pg n a n c ies, 11 persi strnt hi I( h hi rth rat.e, and th" larg" number of poo rl y spaced pregnanci es . Th e ai m of t h is st.ud"IJas to analyze the use and th" barriers to use of ~ I o dern Co n trace pt ive met h ods a nd to ""amine the o ut. en mp () f un- t h e stud:v group (66 %) . The preferred s ources for most. o f the wome n we r e MOH h e al t h institutions. In t hC'! study gr oup tilosC! Hho 1l :lrJ r'o!'m :l l ,, !I1 1t-;\1 i nn, hi ...; h01~ eco nomi c and b e t tp r oC('\lpnt.ionr-t] c:;ti'1tl l ~, mnrripd ilnd yo unger age group t"ere u s in g the nl tl d n rn rontr:1rr:p t inn mn r p ofte n than their counte r parts . Am 0 n g 1 68 w 0 men h' h 0 ~ \ ' ("' r I I ~ r (1 m 1l rl r r n ;' (' n t- ,- i\ r r> p t i n n t ei ghteen o f them be c- a mr prC' ~ nant· "hi I e' l lsi n g morlf' rn c ontracept.ion . Th e fni l l1 rc- o f thr mr· t h nd ,;~ s h i,, " " s t " it.h co n d 0 m 5 (25 %), f 0 I J 0" p d h >- I 11 h" ] I i 0; n tin n i l 2 X. I, 0 r n I contracept i ve methods (IIX. ) and TUDS I <) r.,) . Among ·169 women h'hn hrf':1111(, r1·1""'[1l1nnt i nduc e rl abor'ti0n o f ,;ili eh 1-2 rtipd . Th e e~ti m [1ted IDat e rn<11 mort(1] i t~· r ntl":> h' a s 7 I r q rr r 10 r.O li ve birth s . Th 8: n nl ~,' q ll!rl~' n il rn~t' rrn~ll Inn rt' " l i +' III Eti1iopin S tl g~p~ts thr r'nt-r tn t, r"' I : I' / I(I() I' li\'("> hir l- hs . The main rp.asons f nr not 11;::,. in~ mf"' (I,.....- 11 rn n'"r,r pp t in n t:r rr irlf'nti fied: I ,- la c k of f:::tctU;ll i~ · !'or m;\ t i n il :11")(1 d(~si rr for additional c hildr e n (12 %) . fea r of f.'ont.rnr·rpti.ve pnmpli ,· :\!· in n s (~%). misco nception s o r f31~('1 jdf" n~. nhollt. PP (()%) opposition by th~ mnl ~ pnrtnrrs a nd Religious/ Culturn] tabons (~% each). Generally, the age of first interrnllrse was "ery close to the start of menarc hf'. Tf'n p"r c(' nt: nf cas p !,; , hnd i nt."rcourse b e fore menR.r c he. l'urthf'rm nrf' , "h"n Ino lting "t t.h" relationship of the age nf thO" '''om" n "hpn the~- had their first child and th"ir first int."r ro "r "~ anr:! m"nnrrIH', we see adol e sc e nt women w"r" at ri ,, ), f o r prpgnancy Rnd t.pmpt.prl to have an ill ega l abortion . Cnnsirlf'ring that many have not ye t established a fami 1 ~- or m"'~' sti 11 be in sc h oo l, significant problems can he expec t ed for thps" adolescents. In addition, also detailed the role nf and finally th" "pn"!';,, 1 n ram i h - P] nnni ng i s the so luti on!'; f o r better serv i ces are indicate d in t he di !';r ll "s ion . Of the tested h ypoth"",,,,, n )l 'Jf're r nnfirmer:! cxcept h~' pothesjs four "hich 'Jas rclnt en In th e r e lat.i o nship o f tl.e ~ri"ate v endo r s nf cont. ra rrp ti vrs . It h nd h prn hypoth esizc r:! t. hat gr p nter nUI1,h"r" "ith o r without presc ripti o n 'Jould be ohtaininl t l,rm fr om private source s . This was not so.
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    Sexually Transmitted Disease in Gondar Town
    (Addis Abeba University, 1988-05) G / Selassie, Hailemichael
    A case-control study of sexun lly t r:l n s mitt ed di ~e as es wa s carried out in two h e a l th uni.ts in Gondar Town no rth-w es t e rn Ethiopia between Se ptemb e r 1987 and November 19 8 7. A total of 285 cases and 570 controls participated in th e study. The peak age range was 15 - 19 yea r s (43.9%) and 20-24 year s (34.6%) for female and mal e case s r es pectively. In con trast to reports from other parts o f Afrj~R, th e male-tofemale ratio was 1.2:1 i n t his s t ud~· . Over 40 [: o f the cases were found in Ke ft pgnn four in whi ch there are predominantly soldiers and pros titu tes. Of 153 mal e cases, only 26.2% were married. Ma rri ed women constituted 33.1% of t he cases. While a further 33 . 3% wprA di.vorc ed womAn. Soldiers, prostitut e s and s tudent s (28.8 %, 19.7% and 13.3% of the total cases respectively) were identified as high risk groups. The commonest diagonsis was gonorrhoea (56.5 X), with further 21.8% of the mixed infections including gonorrhoea. Over 40% of the case s admitted to a previous history of STD. A past history of four or more STD inf ection s occurred in 10.9% of the total cases. Casual contact or unknown contact as a source of infection accounted for 50% of the infections rivalling prostitutes who accounted for 52.3% of the contacts. Of the total cas es, 54.4% sought a cure from druggists without see ing a h e al t h worker . The practice of self-medication was high and did not appear to differ greatly between educat ed and illite rat e groups (P>.lO) . Age at first sexual intercourse of l ess than 20 y ears was a s sociated with a statis ti c :llly s i g ni f i ca n t inCr0:lSed ri s k of STD (OR mh = 3. 6 , P<.'OOl ) . H:l\' in:~ '10 s pOLl s e or living away from marit a l partn e r nnel/o r ~ :ln I 11 y we r e :l~ s oc j ntc el with STD infection (1R f = 2 .3, pC. OO I '~;f d CR I ". 3 , /)1 , t !ii I P<. OO l) r es p c('. li v( ·l y) . Jil r""1: '! "" 'i ," 1·,,, ,1 I, i" " " :: "r I I 2 premarital sex was foun d to jn~ r rR~e t.h p ri s k of acquiring STD 4.8 t imes . Hot h the p ra ctic~ of mUltiple partner within on week and o ne year ]l e riod we re a lso associated with an increased risk or ~~'1uir i nf': STD (OR f : 13, P<.OOI tnt CHId OR tnh .. = 9.7 P<. 001, !tc. ~I_',,-c .tl\'c.eyl . This study has implications for the control of sexually t ran s mitted di seases in general and AIDS in parti cular