Knowledge,Attitude, Practice,and Determinants Emergency Contraceptive Use among Women Seeking Abortion Services in Dire Dawa,Ethiopia

Background

Unplanned pregnancy from casual sex, unplanned sexual activity, and sexual violence are increasing. Emergency Contraceptives (EC) are used to prevent unplanned pregnancies thereby preventing the occurrence and consequences of unplanned pregnancy. Emergency contraception is widely available in Ethiopia particularly in major cities. Yet the use of EC is very low and abortion rate in cities is high compared to the national average.

Objectives

To assess knowledge, attitude and practice and determinants on the use of emergency contraception among women obtaining abortion service at selected health institutions in Dire Dawa, Eastern Ethiopia.

Methods

A facility based cross-sectional study was conducted on 390 women selected by multi-stage random sampling technique. The samples were generated from government and private for non profit health facilities. Participant’s knowledge and attitude towards emergency contraception were measured using composite index based on 7 and 9 questions, respectively and analyzed using mean score to classify them as knowledgeable or not, and have positive attitude or not. Practice was assessed if the women reported ever use of emergency contraception. Determinants of use of emergency contraception were analyzed using logistic regression.

Result

Out of 390 women interviewed, 162 women (41.5%) heard about EC, only 133 (34.1%) had good knowledge, and 200 (51.3%) of the respondents had positive attitudes towards to EC. Ever use of EC was reported by 38 (9.7%). Age, living arrangement, education, marital status, religion were found to be significantly associated with the use of emergency contraceptives. Women with poor knowledge were less likely to use EC compared to the knowledgeable ones [AOR = 0.027, 95% CI (0.007, 0.105)].

Conclusion

The study identified that most respondents lack adequate knowledge on the method of EC. In addition ever use of EC is very low.

Recommendations

Health professions should give attention in increasing knowledge and uptake of Emergency Contraception.     

Breastfeeding practice and associated factors among female nurses and midwives at North Gondar Zone,Northwest Ethiopia: a cross-sectional institution based study

Background

Health care workers have a duty to promote and support breastfeeding among their clients. Although their ability to do this may be influenced by their knowledge and personal experience; little is known about breastfeeding practices and the perceived barriers. The objective of this study was to assess the breastfeeding practices and the associated factors among female nurses and midwives in North Gondar Zone; Northwest Ethiopia.

Methods

An institution based cross-sectional study design was conducted in 2013 among 178 nurses and midwives. In this study exclusive breastfeeding refers to breastfeeding exclusively for the first six months of a child’s life. Bivariate and multivariate logistic regressions were performed to identify the presence and strength of association. Odds ratios with 95% confidence interval were computed to determine the level of significance.

Results

Exclusive breastfeeding rate among respondents was found to be 35.9%. Nearly half (49.4%) of the respondents exclusively breastfed for only 3 months or less. The mean duration exclusive breastfeeding was 4.1?±?1.7 months. Older women (AOR?=?2.8; 95% CI 2.16, 3.24), rural residence (AOR?=?3.01; 95% CI 2.65, 3.84), being midwife (AOR?=?2.01; 95% CI 1.83, 2.56), a women who gave birth through vaginal delivery (AOR?=?2.0; 95% CI 1.68, 2.87), multiparous women (AOR?=?2.20; 95% CI 1.74, 2.67) and resumption of work after 3 months (AOR?=?1.61; 95% CI 1.24, 2.35) were independently associated with exclusive breastfeeding.

Conclusion

Though respondents had adequate knowledge on breastfeeding, the practice of exclusive breastfeeding was low. Maternal age, place of residence, profession, mode of delivery, parity and the time before resuming work were factors associated with exclusive breastfeeding. Appropriate education concerning breastfeeding, directed at nurses and midwives is required to enhance exclusive breastfeeding and duration of breastfeeding.

     

Molecular phylogenetics and definition of the Acrapex minima Janse group (Lepidoptera,Noctuidae, Apameini,Sesamiina) with the description of four new species from the Afrotropics

Five morphologically similar species of Acrapex Hampson (Lepidoptera, Noctuidae, Noctuinae, Apameini), from sub-Saharan Africa are reviewed, including four new species that are described: Acrapex mondogeneta Le Ru n. sp., A. mubale Le Ru n. sp., A. robe Le Ru n. sp. and A. rubona Le Ru n. sp. These five species belong to a species complex that we hereby define as the Acrapex minima group. Host plants of three species are recorded; Acrapex minima is recorded for the first time on a host plant, Digitaria natalensis Stent; A. mondogeneta on Hyparrhenia hirta (L.) Stapf and A. rubona on Imperata cylindrica (L.) P. Beauv. We also conducted molecular phylogenetics (using both Bayesian inference and maximum likelihood) and molecular species delimitation analyses (Poisson tree processes) on a six gene multi-marker dataset (four mitochondrial and two nuclear gene fragments; 4582 nucleotides in length) of 42 specimens and 22 species, including 23 specimens from the Acrapex minima group. The results of the corresponding analyses support the monophyly of the group and the species status of the newly described taxa.     

Comparison of genomic signatures of selection on <Emphasis Type="Italic">Plasmodium falciparum</Emphasis> between different regions of a country with high malaria endemicity

Background

Genome wide sequence analyses of malaria parasites from widely separated areas of the world have identified contrasting population structures and signatures of selection. To compare relatively closely situated but ecologically contrasting regions within an endemic African country, population samples of Plasmodium falciparum clinical isolates were collected in Ghana from Kintampo in the central forest-savannah area, and Navrongo in a drier savannah area ~350 km to the north with more seasonally-restricted transmission. Parasite DNA was sequenced and paired-end reads mapped to the P. falciparum reference genome.

Results

High coverage genome wide sequence data for 85 different clinical isolates enabled analysis of 121,712 single nucleotide polymorphisms (SNPs). The local populations had similar proportions of mixed genotype infections, similar SNP allele frequency distributions, and eleven chromosomal regions had elevated integrated haplotype scores (|iHS|) in both. A between-population Rsb metric comparing extended haplotype homozygosity indicated a stronger signal within Kintampo for one of these regions (on chromosome 14) and in Navrongo for two of these regions (on chromosomes 10 and 13). At least one gene in each of these identified regions is a potential target of locally varying selection. The candidates include genes involved in parasite development in mosquitoes, members of variant-expressed multigene families, and a leading vaccine-candidate target of immunity.

Conclusions

Against a background of very similar population structure and selection signatures in the P. falciparum populations of Ghana, three narrow genomic regions showed evidence indicating local differences in historical timing or intensity of selection. Sampling of closely situated populations across heterogeneous environments has potential to refine the mapping of important loci under temporally or spatially varying selection.

     

Comparison of genomic signatures of selection on Plasmodium falciparum between different regions of a country with high malaria endemicity

Background

Genome wide sequence analyses of malaria parasites from widely separated areas of the world have identified contrasting population structures and signatures of selection. To compare relatively closely situated but ecologically contrasting regions within an endemic African country, population samples of Plasmodium falciparum clinical isolates were collected in Ghana from Kintampo in the central forest-savannah area, and Navrongo in a drier savannah area ~350 km to the north with more seasonally-restricted transmission. Parasite DNA was sequenced and paired-end reads mapped to the P. falciparum reference genome.

Results

High coverage genome wide sequence data for 85 different clinical isolates enabled analysis of 121,712 single nucleotide polymorphisms (SNPs). The local populations had similar proportions of mixed genotype infections, similar SNP allele frequency distributions, and eleven chromosomal regions had elevated integrated haplotype scores (|iHS|) in both. A between-population Rsb metric comparing extended haplotype homozygosity indicated a stronger signal within Kintampo for one of these regions (on chromosome 14) and in Navrongo for two of these regions (on chromosomes 10 and 13). At least one gene in each of these identified regions is a potential target of locally varying selection. The candidates include genes involved in parasite development in mosquitoes, members of variant-expressed multigene families, and a leading vaccine-candidate target of immunity.

Conclusions

Against a background of very similar population structure and selection signatures in the P. falciparum populations of Ghana, three narrow genomic regions showed evidence indicating local differences in historical timing or intensity of selection. Sampling of closely situated populations across heterogeneous environments has potential to refine the mapping of important loci under temporally or spatially varying selection.

Electronic supplementary material

The online version of this article (doi:10.1186/s12864-015-1746-3) contains supplementary material, which is available to authorized users.     

Trends of Modern Contraceptive Use among Young Married Women Based on the 2000, 2005, and 2011 Ethiopian Demographic and Health Surveys: A Multivariate Decomposition Analysis

Introduction

Accessing family planning can reduce a significant proportion of maternal, infant, and childhood deaths. In Ethiopia, use of modern contraceptive methods is low but it is increasing. This study aimed to analyze the trends and determinants of changes in modern contraceptive use over time among young married women in Ethiopia.

Methods

The study used data from the three Demographic Health Surveys conducted in Ethiopia, in 2000, 2005, and 2011. Young married women age 15–24 years with sample sizes of 2,157 in 2000, 1,904 in 2005, and 2,146 in 2011 were included. Logit-based decomposition analysis technique was used for analysis of factors contributing to the recent changes. STATA 12 was employed for data management and analyses. All calculations presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance.

Results

Among young married women, modern contraceptive prevalence increased from 6% in 2000 to 16% in 2005 and to 36% in 2011. The decomposition analysis indicated that 34% of the overall change in modern contraceptive use was due to difference in women’s characteristics. Changes in the composition of young women’s characteristics according to age, educational status, religion, couple concordance on family size, and fertility preference were the major sources of this increase. Two-thirds of the increase in modern contraceptive use was due to difference in coefficients. Most importantly, the increase was due to change in contraceptive use behavior among the rural population (33%) and among Orthodox Christians (16%) and Protestants (4%).

Conclusions

Modern contraceptive use among young married women has showed a remarkable increase over the last decade in Ethiopia. Programmatic interventions targeting poor, younger (adolescent), illiterate, and Muslim women would help to maintain the increasing trend in modern contraceptive use.     

Drug-resistant genotypes and multi-clonality in Plasmodium falciparum analysed by direct genome sequencing from peripheral blood of malaria patients

Naturally acquired blood-stage infections of the malaria parasite Plasmodium falciparum typically harbour multiple haploid clones. The apparent number of clones observed in any single infection depends on the diversity of the polymorphic markers used for the analysis, and the relative abundance of rare clones, which frequently fail to be detected among PCR products derived from numerically dominant clones. However, minority clones are of clinical interest as they may harbour genes conferring drug resistance, leading to enhanced survival after treatment and the possibility of subsequent therapeutic failure. We deployed new generation sequencing to derive genome data for five non-propagated parasite isolates taken directly from 4 different patients treated for clinical malaria in a UK hospital. Analysis of depth of coverage and length of sequence intervals between paired reads identified both previously described and novel gene deletions and amplifications. Full-length sequence data was extracted for 6 loci considered to be under selection by antimalarial drugs, and both known and previously unknown amino acid substitutions were identified. Full mitochondrial genomes were extracted from the sequencing data for each isolate, and these are compared against a panel of polymorphic sites derived from published or unpublished but publicly available data. Finally, genome-wide analysis of clone multiplicity was performed, and the number of infecting parasite clones estimated for each isolate. Each patient harboured at least 3 clones of P. falciparum by this analysis, consistent with results obtained with conventional PCR analysis of polymorphic merozoite antigen loci. We conclude that genome sequencing of peripheral blood P. falciparum taken directly from malaria patients provides high quality data useful for drug resistance studies, genomic structural analyses and population genetics, and also robustly represents clonal multiplicity.     

A post-assembly genome-improvement toolkit (PAGIT) to obtain annotated genomes from contigs

Genome projects now produce draft assemblies within weeks owing to advanced high-throughput sequencing technologies. For milestone projects such as Escherichia coli or Homo sapiens, teams of scientists were employed to manually curate and finish these genomes to a high standard. Nowadays, this is not feasible for most projects, and the quality of genomes is generally of a much lower standard. This protocol describes software (PAGIT) that is used to improve the quality of draft genomes. It offers flexible functionality to close gaps in scaffolds, correct base errors in the consensus sequence and exploit reference genomes (if available) in order to improve scaffolding and generating annotations. The protocol is most accessible for bacterial and small eukaryotic genomes (up to 300 Mb), such as pathogenic bacteria, malaria and parasitic worms. Applying PAGIT to an E. coli assembly takes ～24 h: it doubles the average contig size and annotates over 4,300 gene models.     

Enhancing biological nitrogen removal from tannery effluent by using the efficient Brachymonas denitrificans in pilot plant operations

Summary Laboratory scale and pilot plant reactors were inoculated with an efficient denitrifier, Brachymonas denitrificans(CCUG 45880), in order to evaluate whether a bio-augmentation approach can be used to enhance biological nitrogen removal from tannery effluents. To determine the effectiveness of the introduced strain, denitrifying activity in the activated sludge was monitored by nitrate uptake rate (NUR) measurement of NO₃-N. Fluorescent in situ hybridization (FISH) technique was used to monitor the growth of the augmented species. The laboratory scale nitrate removal efficiency with the introduced B. denitrificans (3.7±0.6 mg NO₃-N gVSS ⁻¹ h ⁻¹) was higher than that of the activated sludge without the addition of the bacteria (3.5±0.7 mg NO₃-N gVSS ⁻¹ h ⁻¹); the NUR in the pilot plant after and before the introduction of the strain was also of the magnitude of 12.0±1.4 and 10.6±1.4 mg NO₃-N gVSS ⁻¹ day ⁻¹ , respectively. In situ hybridization results revealed that the introduced denitrifying bacteria significantly facilitated the development of a dense denitrifying bacterial population in the activated sludge, which enhanced in situ denitrification activity. FISH data indicated that once introduced, B. denitrificans remained abundant throughout the experimental period. The ability to seed a bioreactor with bacterial strain capable of removing target pollutants from tannery effluents in a mixed microbial community suggests that this approach could have commercial applications.     

The polyphosphoinositides,phosphatidylinositol monophosphate and phosphatidylinositol bisphosphate,are present in nuclei isolated from carrot protoplast

Summary Nuclei were isolated from carrot protoplasts and the distribution of [³H]inositol-labeled phospholipids was analyzed by thinlayer chromatography. Phosphatidylinositol (PI), lysophos-phatidylinositol (LPI), phosphatidylinositol monophosphate (PIP), lysophosphatidylinositol monophosphate (LPIP), and phosphatidylinositol bisphosphate (PIP₂) were 55.7%, 12.3%, 5.0%, 11.5%, and 3.6% of the respective [³H]inositol-labeled lipids recovered from the nuclear fraction. While both the plasma membrane and nuclear fraction contained polyphosphoinositides, the distribution of the phosphoinositides and the amount of inositol-labeled lipid were distinct. For example, the nuclear fraction had a higher percentage of LPI and PIP₂ and less PI and LPIP than the plasma membrane fraction. The amount of [³H]inositol-labeled lipid recovered from the nuclear fraction per mg protein was an order of magnitude lower than that recovered from either the plasma membrane of lower phase fraction isolated by aqueous two-phase partitioning, or from whole cells and protoplasts. In addition, when the ratio of the [³H]inositol-labeled lipid was compared to total [¹⁴C]myristate-labeled lipid recovered there was three to ten fold less [³H] relative to [¹⁴C] in the nuclear fraction.These data indicate that while the polyphosphoinositides are a relatively high percentage of the inositol lipid in the nuclear fraction, the inositol lipid was only a small portion of the total lipid in the nuclei. Despite this low concentration of inositol lipid, when [ ³²P]-ATP was added to the isolated nuclei,³²P-labeled PIP and PIP₂ were synthesized. Thus, the carrot nuclei contained PI and PIP kinase as well as the polyphosphoinositides.Abbreviations PI phosphatidylinositol - LPI lysophosphatidylinositol - PIP phosphatidylinositol monophosphate - LPIP lysophosphatidylinositol monophosphate - PIP₂ phosphatidylinositol bisphosphate - DAG diacylglycerol - IP₃ inositol 1,4,5-trisphosphate