Reanalysis of the Maltrials study

Our malaria prevention trial in Zeway was recently reanalysed. When analysing the trial results, we particularly questioned why the entomological data showed an effect of our interventions while the randomised cluster trial was negative.

In the last year, we have tried several new reanalysis methods, and we believe we had a negative trial because we needed to account for unequal community levels. In the future, we should pay much more attention to multi-level data structures.

As you may read from the paper, we postulate that visible and hidden layers could affect the analysis of such community studies. Thus, we are currently working with people familiar with remote sensing to evaluate if the distribution of, for example, maise fields plays an essential role in the variation of malaria in communities. In addition, we are trying to map the distribution of small and temporary ponds often seen as breeding sites for Anopheles arabiensis. We’re trying to use remote sensing by downloading high-resolution satellite data for our Hawassa and Arba Minch studies.

Is it time to recruit new students, master’s or PhD, with a keen interest and relevant educational background to do work on the interdisciplinary aspects of epidemiology, remote sensing and GIS?

You can read our paper by following this link,  where you will find related research papers.

South Ethiopia Network of Universities in Public Health II (SENUPH II)

The SENUPH II project represents a network of three universities in southern Ethiopia as well as the University of Bergen. The focus is on public health. Based on history of 20-year collaboration, we aim to strengthen the existing collaboration so to enhance efforts to improve capacity building, research, building independent senior researchers, and collaborate with the Ministry of Health with the relevant health information to improve the health of peoples in southern Ethiopia.

Project’s particular importance

Even if there has been a substantial economic growth in Ethiopia, the country remains among the 20 poorest countries. The population is in a transition with declining fertility, increasing life expectancy, heavy burdens of poverty-related diseases and increasing load of non-communicable diseases. Thus, the country needs evidence-based healthcare to improve health policy and improve the health of the population.

This project focuses on health challenges and priority setting. We believe universities in southern Ethiopia, can produce relevant information for policymakers to enhance public health work. By focusing on infectious diseases, malnutrition and the emerging burden of non-communicable diseases, we aim to build capacity in higher education both at universities and at the Ministry of health.

By the end of the project and through building strong research groups, we expect to have nine independent researchers capable of research leadership, supervising future PhD students, mentoring post docs, that further can develop their institutions when this project ends. Furthermore, we expect to have strengthened two PhD programs that would be sustainable in an Ethiopian context.

Building on a previous joint PhD degree programme between Hawassa University and the University of Bergen, and strengthening research at Dilla and Arba Minch University, we plan through PhD and post doc research, linked to training at the master’s level, strengthen the ownership, capability, and sustainability of the universities and of the Ministry of health to carry out evidence-based healthcare. The teaching, research, and implementation work will be interdisciplinary and integrated and involve disciplines such as epidemiology, medicine, priority setting and health economics, household economy, essential laboratory disciplines for emerging and existing epidemics.

Project goals

Through this six-year project, we aim to strengthen the institutional capacity for teaching, supervision and research by developing teams of researchers consisting of both senior (post docs) and junior researchers (PhD students and PhD holders) and thereby obtaining a critical mass needed for future sustainability of the institution. This will also focus on enhancing leadership capability of researchers so that they become independent researchers.

We shall strengthen research groups on thematic areas such as communicable diseases (malaria, emerging and re-emerging infections, and tuberculosis), nutrition, and priority setting on non-communicable diseases and health economics.

Relevant SDGs in the project

This project will deal with several of the sustainable development goals. The main goal is good health and well-being (SDG3). However, a large proportion of the efforts will be to reduce hunger in an area where chronic malnutrition is highly prevalent (SDG2). Our program will be based on quality teaching (DG4), and gender equality (SDG5).

Partner institutions

In Ethiopia, Hawassa University, Arba Minch University, and Dilla University, and the University of Bergen

Human-biting activities of Anopheles species in Ethiopia

Kenea O, Balkew M, Tekie H, Gebre-Michael T, Deressa W, Loha E, Lindtjørn B, Overgaard HJ: Human-biting activities of Anopheles species in south-central Ethiopia. Parasites & vectors 2016, 9(1):1-12.


Background    Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the key malaria vector control interventions in Ethiopia. The success of these interventions rely on their efficacy to repel or kill indoor feeding and resting mosquitoes. This study was undertaken to monitor human-biting patterns of Anopheles species in south-central Ethiopia.

Methods   Human-biting patterns of anophelines were monitored for 40 nights in three houses using human landing catches (HLC) both indoors and outdoors between July and November 2014, in Edo Kontola village, south-central Ethiopia. This time coincides with the major malaria transmission season in Ethiopia, which is usually between September and November. Adult mosquitoes were collected from 19:00 to 06:00 h and identified to species. Comparisons of HLC data were done using incidence rate ratio (IRR) calculated by negative binomial regression. The nocturnal biting activities of each Anopheles species was expressed as mean number of mosquitoes landing per person per hour. To assess malaria infections in Anopheles mosquitoes the presence of Plasmodium falciparum and P. vivax circumsporozoite proteins (CSP) were determined by enzyme-linked immunosorbent assay (ELISA).

Results   Altogether 3,408 adult female anophelines were collected, 2,610 (76.6 %) outdoors and 798 (23.4 %) indoors. Anopheles zeimanni was the predominant species (66.5 %) followed by An. arabiensis (24.8 %), An. pharoensis (6.8 %) and An. funestus (s.l.) (1.8 %).

The overall mean anopheline density was 3.3 times higher outdoors than indoors (65.3 vs19.9/person/night, IRR: 3.3, 95 % CI: 1.1–5.1, P = 0.001). The mean density of An. zeimanniAn. pharoensis and An. funestus (s.l.) collected outdoors was significantly higher than indoors for each species (P < 0.05). However, the mean An. arabiensis density outdoors was similar to that indoors (11.8 vs 9.4/person/night, IRR: 1.3, 95 % CI: 0.8–1.9, P = 0.335). The mean hourly human-biting density of An. arabiensis was greater outdoors than indoors and peaked between 21:00 and 22:00 h. However, An. arabiensis parous population showed high indoor man biting activities during bedtimes (22:00 to 05:00 h) when the local people were indoor and potentially protected by IRS and LLINs. All mosquito samples tested for CSP antigen were found negative to malaria parasites.

Conclusions   Results show much greater mosquito human-biting activities occurring outdoors than indoors and during early parts of the night, implying higher outdoor malaria transmission potential in the area. However, high bedtime (22:00 to 05:00 h) indoor biting activities of parous An. arabiensissuggest high potential intervention impact of IRS and LLINs on indoor malaria transmission.

The San Francisco Declaration on Research Assessment

In May 2013, more than 480 researchers and 80 scientific organisations published a declaration condemning the use of the journal impact factor to measure scholarly success.  Journals and organisations such as Science, Proceedings of The National Academy Of Sciences (PNAS), Times Higher Education, and Wellcome Trust are among the organisations backing this call.

The San Francisco Declaration on Research Assessment states the journal impact factor is misused to assess the significance of work by scientists who publish in those journals. A number of themes run through these recommendations:

  • “the need to eliminate the use of journal-based metrics, such as Journal Impact Factors, in funding, appointment, and promotion considerations;
  • the need to assess research on its own merits rather than on the basis of the journal in which the research is published; and
  • the need to capitalise on the opportunities provided by online publication (such as relaxing unnecessary limits on the number of words, figures, and references in articles, and exploring new indicators of significance and impact)”.

The first and general recommendation is:  “Do not use journal-based metrics, such as Journal Impact Factors, as a surrogate measure of the quality of individual research articles, to assess an individual scientist’s contributions, or in hiring, promotion, or funding decisions.”

The declaration concludes that we need a cultural change where papers are mainly evaluated for their own scientific merit.

A note in Nature (2005) stated that research assessment “rests too heavily on the inflated status of the impact factor”. And the biologist Stephen Curry of Imperial College London wrote in a blog post: “I am sick of impact factors and so is science”.

Too many journals – too little good research

Erlend Hem’s  Editorial in the Norwegian Medical Journal “Too many journals – too little good research” is thought-provoking, especially the question of whether we publish too much. Fewer and better publications is a good conclusion of his Editorial. But, if we should publish good articles in traditional journals or in electronic “Open Access” (OA) journals is difficult to answer.

OA has improved access to medical journals. Researchers in developing countries can access them free.

Hem suggests that traditional journals have better peer-review  than OA journals such as BioMedCentral. I know of examples of articles that have inadequate peer review. However, this applies to both OA and traditional publications. In the research training programme at the University of Bergen, students criticize scientific papers, often from well-known journals such as BMJ and Lancet. And, they often find serious mistakes in the papers.

My question is: Is the editor best suited to choose what is good and important science, and what is essential to publish? And, we know that editors favour scientists they learn to know at conferences and meetings.

Many electronic journals (such as PLoS ONE and BioMedCentral) accepts all submitted articles as long as they meet minimum scientific criteria. Such a policy means that they publish many scientific articles. And such journals have a surprisingly high impact factor, and the best research institutions use them.

Is not it time the Norwegian medical Journal (and other journals) are more “Open Access”? I suggest that all articles that meet the minimum scientific requirements should be published electronically. The Editor can then choose articles they wish to publish in the printed paper version.

(This is a translation of the Norwegian text on the Journal’s blog)


Impact Factor and Tropical Medicine

The 2010 edition of Thomson Reuter’s Journal Citation Reports has been released. Two open access journals rank as number 1 and number 2 in the Tropical Medicine category.

Rank Abbreviated Journal Title Total Cites 2010 impact factor 5-Year


1 PLOS NEGLECT TROP D 2020 4,752 4,849
2 MALARIA J 4012 3,489 3,551
3 TROP MED INT HEALTH 5503 2,841 2,967
4 T ROY SOC TROP MED H 8015 2,832 2,615
5 AM J TROP MED HYG 16905 2,446 2,884
6 ACTA TROP 4527 2,262 2,5
7 MEM I OSWALDO CRUZ 5385 2,058 2,081
8 ANN TROP MED PARASIT 2782 1,288 1,579
9 J TROP PEDIATRICS 1416 1,248 1,286
10 LEPROSY REV 516 1,162 1,038

PhD Reviews

Global Health Action (GHA) is an international, peer-reviewed Open Access journal, which was launched in 2008. It is affiliated with the Umeå Centre for Global Health Research (CGH) in Sweden.

The Journal is registered in PubMed, and reaches a global audience in 190 countries.

The journal has recently started a new area of editorial content called PhD Reviews.

They invite young researchers that have recently defended their PhDs within the field of global health to write a paper based on their cover stories. One background reason for this is that Scandinavian PhDs are usually based on a set of articles synthesized into a “cover story” of some 30-50 pages. Some of these syntheses provide excellent reviews of the research area but they seldom reach beyond the host institution or the close collaborators and examiners. Condensing them into a PhD Review may also serve as incentive for the young researcher to publish their first post doc paper as a sole author.

You may find a few examples at their website,, or by clicking here to find the section ‘PhD Reviews.

Science blogging and peer-review

Should science bloggers play a role in discussing peer-reviewed publications? That is the question an interesting Editorial in Nature raise on December 16, 2010.

The background for was a paper about the discovery a bacterium can replace the phosphorus in its DNA with arsenic paper (F. Wolfe-Simon et al. Science doi:10.1126/science.1197258; 2010). The researchers had widely publicised their findings on the web, but when bloggers and researchers raised thoughtful reservations about the paper’s method and findings, the authors refused to comment because the blog was not peer-reviewed.

Unfortunately, few papers get substantive comments. Nature states that bloggers have an important part to play in assessing research findings, especially when the criticism is from the researchers’ peers (a person of the same age, status, or ability as another named person).

It is encouraging that journals now encourage post-publication discussion on blogs and online commenting facilities. This is a complement to, and not a substitute for conventional peer review. However, it is equally true that online commenting and blogs contribute little and few authors bother to respond to online criticisms of their papers (P. C. Gøtzsche et al. Br. Med. J. 341, c3926; 2010).

Ethiopian Journal of Health Development Vol 24 No 2

Volume 24, No 2, 2010, 87 – 153


pdf Bridging the divide: Linking training to services. Damen Haile Mariam
Original articles
pdf Assessing communication on sexual and reproductive health issues among high school students with their parents, Bullen Woreda, Benishangul Gumuz Region, North West Ethiopia. Desalegn Gebre Yesus, and Mesganaw Fantahun.
pdf Applicability of the theory of planned behavior in predicting intended use of Voluntary HIV Counseling and Testing services among teachers of Harari Region, Ethiopia. Shemsedin Omer, and Jemal Haidar
pdf Community based assessment on household management of waste and hygiene practices in Kersa Woreda, Eastern Ethiopia. Bizatu Mengistie, and Negga Baraki
pdf Assessment of the impact of latrine utilization on diarrhoeal diseases in the rural community of Hulet Ejju Enessie Woreda, East Gojjam Zone, Amhara Region. Andualem Anteneh, and Abera Kumie
pdf Healthcare waste generation and its management system: the case of health centers in West Gojjam Zone, Amhara Region, Ethiopia. Muluken Azage, and Abera Kumie
pdf The status of rabies in Ethiopia: A retrospective record review. Asefa Deressa, Abraham Ali, Mekoro Beyene, Bethelehem Newaye Selassie, Eshetu Yimer and Kedir Hussen
pdf Byssinosis and other respiratory symptoms among factory workers in Akaki textile factory, Ethiopia. Kassahun Alemu, Abera Kumie, Gail Davey
pdf Collective radiation dose from diagnostic x-ray examination in nine public hospitals in Addis Ababa, Ethiopia. Daniel Admassie, Seife Teferi and Kalkidan Hailegenaw
Bibliography on HIV/AIDS
Hypertension, obesity and central obesity in diabetics and non diabetics in Southern Ethiopia. Araya Giday, Mistire Wolde and Dawit Yihdego
pdf Comparison of formol-acetone concentration method with that of the direct iodine preparation and formol-ether concentration methods for examination of stool parasites. Feleke Moges, Yeshambel Belyhun, Moges Tiruneh, Yenew Kebede, Andargachew Mulu, Afework Kassu and Kahsay Huruy
Book review
pdf Water Resources Management in Ethiopia: Implications for the Nile Basin. Edited by: Helmut Kloos and Worku Legesse. Reviewed by: Abera Kumie
ISSN 1021-6790