Bernt Lindtjørn Research Blog
On April 25, 2014 Diriba Korecha Dadi defended his PhD at the University of Bergen. Diriba was a part of the research programme “Ethiopian Malaria Prediction System”.
The Abstract of the thesis is found at: http://malaria.w.uib.no/emaps/phd-studies/diriba-korecha/
His thesis, Characterizing the Predictability of Seasonal Climate in Ethiopia, can be downloaded http://malaria.b.uib.no/files/2014/06/DiribaPhD.pdf
Hamusse SD, Demissie M, Lindtjorn B. Trends in TB case notification over fifteen years: the case notification of 25 Districts of Arsi Zone of Oromia Regional State, Central Ethiopia. BMC public health 2014; 14(1): 304.
Background The aims of tuberculosis (TB) control programme are to detect TB cases and treat them to disrupt transmission, decrease mortality and avert the emergence of drug resistance. In 1992, DOTS strategy was started in Arsi zone and since 1997 it has been fully implemented. However, its impact has not been assessed. The aim of this study was, to analyze the trends in TB case notification and make a comparison among the 25 districts of the zone.
Methods A total of 41,965 TB patients registered for treatment in the study area between 1997 and 2011 were included in the study. Data on demographic characteristics, treatment unit, year of treatment and disease category were collected for each patient from the TB Unit Registers.
Results The trends in all forms of TB and smear positive pulmonary TB (PTB+) case notification increased from 14.3 to 150 per 100,000 population, with an increment of 90.4% in fifteen years. Similarly, PTB+ case notification increased from 6.9 to 63 per 100,000 population, an increment of 89% in fifteen years. The fifteen-year average TB case notification of all forms varied from 60.2 to 636 (95% CI: 97 to 127, P<0.001) and PTB+ from 10.9 to 163 per 100,000 population (95% CI: 39 to 71, p<0.001) in the 25 districts of the zone. Rural residence (AOR, 0.23; 95% CI: 0.21 to 0.26) and districts with population ratio to DOTS sites of more than 25,000 population (AOR, 0.40; 95% CI: 0.35 to 0.46) were associated with low TB case notification. TB case notifications were significantly more common among 15-24 years of age (AOR, 1.19; 95% CI:1.03 to 1.38), PTB- (AOR, 1.46; 95% CI: 1.33 to 64) and EPTB (AOR, 1.49; 95% CI; 1.33 to 1.60) TB cases.
Conclusions The introduction and expansion of DOTS in Arsi zone has improved the overall TB case notification. However, there is inequality in TB case notification across 25 districts of the zone. Further research is, recommended on the prevalence, incidence of TB and TB treatment outcome to see the differences in TB distribution and performance of DOTS in treatment outcomes among the districts.
This paper reviews the sensitivity and specificity of RDTs for detecting P. falciparum and P. vivax in two different settings ¿ at health centres and in a household survey. The study includes a large number of patients (2,394 participants) and provides useful additional information about the performance of these RDTs.
Woyessa A, Deressa W, Ali A, Lindtjørn B. Evaluation of CareStartTM malaria Pf/Pv combo test for Plasmodium falciparum and Plasmodium vivax malaria diagnosis in Butajira area, south-central Ethiopia. Malaria Journal 2013, 12:218 doi:10.1186/1475-2875-12-218
This is a report on the Anopheles fauna found in three different villages located at three different altitudes ranging from 1,800 meters to 2,200 metres, showing the human/cattle blood meal preference for each species and the sporozoite rate and entomological inoculation rate for the vectors.
Animut A, Balkew M, Gebre-Michael T and Lindtjørn B. Blood meal sources and entomological inoculation rates of anophelines along a highland altitudinal transect in south-central Ethiopia. Malaria Journal 2013, 12:76 doi:10.1186/1475-2875-12-76
Background The role of anophelines in transmitting malaria depends on their distribution, preference to feed on humans and also their susceptibility to Plasmodium gametocytes, all of which are affected by local environmental conditions. Blood meal source and entomological inoculation rate of anophelines was assessed along a highland altitudinal transect in south- central Ethiopia.
Methods Monthly adult anopheline sampling was undertaken from July 2008 to June 2010 in Hobe (low altitude), Dirama (mid altitude) and Wurib (high altitude) villages located at average elevations of 1800 m, 2000 m and 2200 m, respectively. Anophelines were collected using CDC light trap, pyrethrum space spray catches (PSC) and artificial pit shelter methods. Upon collection, females were categorized according to their abdominal status and identified to species. Their human blood index, sporozoite rate and entomological inoculation rate was determined.
Results A total of 4,558 female anophelines of which Anopheles arabiensis was the most prevalent (53.3%) followed by Anopheles demeilloni (26.3%), Anopheles christyi (8.9%), Anopheles pharoensis (7.9%) and Anopheles cinereus (3.6%) were caught and tested for blood meal source or sporozoite infection depending on their abdominal status. The proportions of human fed and bovine fed An. arabiensis were generally similar. In the low altitude village, there were 0.3% (1/300) and 0.2% (1/416) Plasmodium falciparum infected An. arabiensis among the CDC trap catches and PSC respectively. The percentage of Plasmodium vivax infected An. arabiensis were 3% (9/300) and 0.7(3/416) among the CDC and PSCs respectively in the village. In addition, there were 1.4% (1/71) and 50% (1/2) P. vivax infected An. pharoensis from the CDC light trap and PSCs, respectively. In the mid altitude village, 2.5% (1/40) and 1.7% (1/58) from among the CDC and PSCs of An. arabiensis respectively carried P. vivax sporozoites. Among the CDC light trap catches; there were 3.7 and 0 P. falciparum infective bites per year per household for An. arabiensis in the years July 2008 to June 2009 and July 2009 to June 2010 respectively in the low altitude village. The corresponding numbers for P. vivax infective bites for An. arabiensis were 33 and 14.5 in the same village. Space spray catches revealed 0.32 P. vivax infective bites per household for An. pharoensis during the first year in the low altitude village.
Conclusion Anopheles arabiensis was the most prevalent vector of P. vivax and P. falciparum malaria in the low and mid altitude villages followed by An. pharoensis. Annual entomological inoculation rates showed that vivax malaria transmission was higher than that of the falciparum and both decreased with increase in altitude.
The objective of this study was to characterize the pattern related to ITN use in one village in south Ethiopia. A huge discrepancy was reported between ownership versus utilization of insecticide-treated bed nets (ITNs). To acquire the benefits of ITNs, households need to use and not merely own them.
Eskindir Loha, Kebede Tefera and Bernt Lindtjørn. Freely distributed bed-net use among Chano Mille residents, south Ethiopia: a longitudinal study. Malaria Journal 2013, 12:23 doi:10.1186/1475-2875-12-23
Background: A huge discrepancy was reported between ownership versus utilization of insecticide-treated bed nets (ITNs). To acquire the benefits of ITNs, households need to use and not merely own them. The objective of this study was to characterize the pattern of, and assess factors related to ITN use in one village in south Ethiopia.
Methods: A prospective cohort study involving 8,121 residents (in 1,388 households) was carried out from April 2009 to April 2011 (101 weeks). Every week, individuals were asked whether they slept under an ITN the night before the interview. Descriptive statistics was used to report the availability and use of ITN. A negative, binomial, probability, distribution model was fitted to find out significant predictors of ITN use. Reasons for not using ITN were summarized.
Results: The total number of ITNs available at the beginning of the study was 1,631 (1.68 ITNs per household). On week 48, 3,099 new ITNs (PermaNet2.0) were distributed freely (2.3 ITNs per household). The number of households who received at least one new ITN was 1,309 (98.4%). The percentage of children <5 years and pregnant women not using ITNs exceeded that of other adults. The mean (range; SD) ITN use fraction before and after mass distribution was 0.20 (0.15-0.27; 0.03) and 0.62 (0.47-0.69; 0.04), respectively. Before mass ITN distribution, the most frequent reason for not using ITN was having worn out bed nets (most complained the bed nets were torn by rats); and after mass ITN distribution, it was lack of convenient space to hang more than one ITN. Males, younger age groups (mainly 15–24 years) and those living away from the vector-breeding site were less likely to use ITN.
Conclusions: The ITN use fraction reached to a maximum of 69% despite near universal coverage (98.4%) was achieved. Gender, age differences and distance from vector breeding site were associated with ITN use. Strategies may need to be designed addressing disproportions in ITN use, lack of convenient space to hang more than one ITN (for those receiving more than one), and measures to prolong usable life of ITNs.
I have recently updated the information about our Ethiopian Malaria Prediction System.
In line with the Millennium Development Goal for maternal health (MDG-4 and 5), I take part in a project to support regional and local government in their work to cut maternal and neonatal deaths. The Reducing Maternal Mortality programme, which started in 2008, is today viewed as a pilot programme for Ethiopia, and efforts are under way to scale up these efforts for the whole country. It is funded by NORAD and Norwegian Lutheran Mission.
The overall development goal of this collaboration with three Regional Health Bureaus is to improve maternal health and make large decline in neonatal and maternal mortality among the target population.
The target population for this project are pregnant women in remote areas in south-west Ethiopia (Gamu Gofa Zone, Basketo Special Woreda, Saggan Zone (previous Dirashe and Konso Special Woreda), and in south-east Ethiopia (Bale Zone and the southern part of Somali Region). See Map.
The project’s aims to strengthen the antenatal services so the health extension workers can help normal deliveries, and identify and refer women in need of help during delivery to health institutions. The project shall enable health centres and hospitals to practise safe delivery. Particular attention is on intrapartum care.
The Centre for International Health at the University of Bergen runs a research school for PhD students. Please visit the Blog for the research school to get for information about PhD training at this institution.
Norway is a peaceful and harmonious society, and is very open. On July 22, this was shattered by a massacre at a youth camp at Utøya, and a bombing in the capital, Oslo. At least 76 people were killed in the attacks, many were injured and some are still missing.
On May 17th, 1940, after the start of war in Norway, the famous Norwegian poet Nordahl Grieg wrote: “Vi er så få her i landet, Hver fallen er bror og venn” My English translation is: “We are so few in this country, Every fallen is a brother and a friend”.
The worst atrocity in Norway since World War II was done by a 32 year old Norwegian.
Norway after July 22 will be different from what is was before this national tragedy. In the days after this national tragedy, many hundred thousand people in Norway have in public expressed their deep sorrow. All are defiant, and are determined that this national tragedy won’t undermine the values our country stands for: peace, democracy, solidarity, openness and tolerance.
I have for many years known Hans Rosling. He is a professor in Stockholm. He started working in rural Africa, described the Konzo nutritional disorder, and is now a not only an excellent teacher, but also global educator.
Please visit his homepage http://www.gapminder.org/ and download some of the very good software that he has developed. This software is free, and the teaching materials are useful tools to learn both students and professionals.
Now, please watch the film from YouTube (BBC Four):
Statistics come to life when Swedish academic superstar Hans Rosling graphically illustrates global development over the last 200 years.