Background

The risk of acquiring tuberculosis by People living with HIV (PLHIV) could significantly be reduced through provision of isoniazid preventive therapy (IPT). In Ethiopia, it is neither practiced well nor researched in depth. Our objective was to assess IPT provision and awareness among PLHIV in Addis Ababa City Administration.

Methods

Between February 2008 and May 2008, a cross sectional facility-based survey was conducted by exit interview of 406 PLHIV from six health facilities. The findings were analyzed and described in this report.

Results

The proportion of PLHIV ever had been provided with IPT were 74 of 231 TB free PLHIV (32.0%) and the proportion of having information about IPT among study participants was 29.8%. Females were about two times more informed about the provision of IPT in their health facilities than males [AOR (95%CI): 2.18 (1.31-3.61)].

Conclusions

We conclude that the practice of provision of IPT for PLHIV is high, but there is room for improvement. Provision of INH for TB free PLHIV has to be strengthened with better diagnostic facilities to certainly rule out active TB cases.

The Ethiopian Field Epidemiology and Laboratory Training Program (EFELTP) is a comprehensive two-year competency-based training and service program designed to build sustainable public health expertise and capacity. Established in 2009, the program is a partnership between the Ethiopian Federal Ministry of Health, the Ethiopian Health and Nutrition Research Institute, Addis Ababa University School of Public Health, the Ethiopian Public Health Association and the US Centers of Disease Control and Prevention. Residents of the program spend about 25% of their time undergoing didactic training and the 75% in the field working at program field bases established with the MOH and Regional Health Bureaus investigating disease outbreaks, improving disease surveillance, responding to public health emergencies, using health data to make recommendations and undertaking other field Epidemiology related activities on setting health policy. Residents from the first 2 cohorts of the program have conducted more than 42 outbreaks investigations, 27analyses of surveillance data, evaluations of 11 surveillance systems, had28oral and poster presentation abstracts accepted at 10 scientific conferences and submitted 8 manuscripts of which 2are already published. The EFELTP has provided valuable opportunities to improve epidemiology and laboratory capacity building in Ethiopia. While the program is relatively young, positive and significant impacts are assisting the country better detect and respond to epidemics and address diseases of major public health significance.

Background

In many developing countries, including Ethiopia, few have the skills to use data for effective decision making in public health. To address this need, the U.S. Centers for Disease Control and Prevention (CDC), in collaboration with two local Ethiopian organizations, developed a year long Leadership in Strategic Information (LSI) course to train government employees working in HIV to use data from strategic information sources. A process evaluation of the LSI course examined the impact of the training on trainees' skills and the strengths and weaknesses of the course. The evaluation consisted of surveys and focus groups.

Findings

Trainees' skill sets increased in descriptive and analytic epidemiology, surveillance, and monitoring and evaluation (M and E). Data from the evaluation indicated that the course structure and the M and E module required revision in order to improve outcomes. Additionally, the first cohort had a high attrition rate. Overall, trainees and key stakeholders viewed LSI as important in building skilled capacity in public health in Ethiopia.

Conclusion

The evaluation provided constructive insight in modifying the course to improve retention and better address trainees' learning needs. Subsequent course attrition rates decreased as a result of changes made based on evaluation findings.

Background

Eastern Ethiopia hosts a substantial number of refugees originated from Somalia. Female genital mutilation (FGM) is a common practice in the area, despite the campaigns to eliminate it.

Methods

A cross-sectional study was conducted among 492 respondents sampled from three refugee camps in Somali Regional State, Eastern Ethiopia, to determine the prevalence and associated factors of FGM. Data were collected using pre-tested structured questionnaires.

Results

Although the intention of the parents to circumcise their daughters was high (84%), 42.4% of 288 ≤12 girls were reported being undergone FGM. The prevalence increased with age, and about 52% and 95% were circumcised at the age of 7–8 and 11–12 years, respectively. Almost all operations were performed by traditional circumcisers (81%) and birth attendants (18%). Clitoral cutting (64%) and narrowing of the vaginal opening through stitching (36%) were the two common forms of FGM reported by the respondents. Participation of the parents in anti-FGM interventions is statistically associated with lower practice and intention of the procedures.

Conclusion

FGM is widely practised among the Somali refugee community in Eastern Ethiopia, and there was a considerable support for the continuation of the practice particularly among women. The findings indicate a reported shift of FGM from its severe form to milder clitoral cutting. More men than women positively viewed anti-FGM interventions, and fewer men than women had the intention to let their daughters undergo FGM, indicating the need to involve men in anti-FGM activities.

Background

Khat (an evergreen plant with amphetamine-like properties) and alcohol are widely consumed among the youth of Ethiopia. However, their relationship to risky sexual behaviour is not well described. This study was conducted to describe the magnitude of risky sexual behaviour (unprotected sex and early initiation of sexual activity) and its association with Khat and alcohol consumption in Ethiopian youths.

Methods

A probabilistic national sample of 20,434 in-school and out-of-school youths aged between 15 and 24 years of age was selected and interviewed regarding their sexual behavior and substance use.

Results

Over 20% of out-of-school youth had unprotected sex during the 12-month period prior to interview compared to 1.4% of in-school youth. Daily Khat intake was also associated with unprotected sex: adjusted OR (95% CI) = 2.26 (1.92, 2.67). There was a significant and linear association between alcohol intake and unprotected sex, with those using alcohol daily having a three fold increased odds compared to those not using it: adj. OR (95% CI) = 3.05 (2.38, 3.91). Use of substances other than Khat was not associated with unprotected sex, but was associated with initiation of sexual activity: adj. OR (95% CI) = 2.54 (1.84, 3.51).

Conclusion

A substantial proportion of out-of-school youth engage in risky sex. The use of Khat and alcohol and other substances is significantly and independently associated with risky sexual behaviour among Ethiopian youths.