Depuis 2008, les infrastructures de Djibouti ont accueilli et fourni annuellement des services a plus de 300 navires militaires. Avec l’accroissement de
la seule base militaire americaine et chinoise sur le continent et la reforme de la presence militaire francaise, ainsi que l’etablissement de structures italienne, japonaise et autres, Djibouti est devenue une plateforme maritime internationale ou de nouvelles methodes de cooperation et de coordination y sont developpees. Cependant, l’instabilite regionale et la recente emergence des violences au Yemen et en Somalie ont conduit la Republique de Djibouti et ses infrastructures portuaires a instaurer des mesures garantissant la securite et la surete maritime. Cette volonte est plus que jamais necessaire etant donne que le pays prevoit de mettre en place de nouveaux projets de developpement qui vont accroitre le risque de criminalite du pays tout en permettant une croissance economique continue.
On March 13, 2020, Ethiopia reported the first confirmed case of COVID-19 in Addis Ababa. COVID-19 is likely to overwhelm an already-fragile health care delivery system and reduce the availability of essential health services. This analysis of data from the Somali Region of Eastern Ethiopia on health care workers' (HCWs) knowledge, attitudes, and practices regarding the prevention and control of COVID-19 may be used in planning health education programs about the emerging viral disease.This study aimed to investigate the knowledge, attitudes, and practices of HCWs regarding COVID-19 infection.This cross-sectional study was conducted among HCWs in three public health facilities in the Somali Region, Eastern Ethiopia. A self-administered questionnaire was shared with all HCWs working at the public health facilities. A total of 15 knowledge questions were scored as 1 or 0 for correct or incorrect responses, respectively. A total of 14 practice questions were scored on a 3-point scale from 1 ("always") to 3 ("never"). A total of six attitude questions were rated on a 5-point Likert scale, in a negative dimension, as follows: 1 ("strongly agree"), 2 ("agree"), 3 ("neutral"), 4 ("disagree"), and 5 ("strongly disagree"). Mean scores were calculated and used as a cut point to dichotomize the outcome variables (>13.7 indicated good knowledge, <18.8 indicated good practices, and ≤10.5 indicated favorable attitudes). We used t tests and analyses of variance (ie, F tests) to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores.Of the 686 HCWs approached, a total of 434 HCWs responded (63.3% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 13.7 (SD 2.6), and 73.3% (318/434) of participants had sufficient knowledge. The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 18.8 (SD 5.8), and 61.5% (267/434) of the participants practiced precautionary measures to prevent COVID-19. There was a negative correlation between knowledge and attitude scores (r=-0.295, P<.001) and between knowledge and practice scores (r=-0.298, P<.001).The overall levels of knowledge and practice were relatively better than the attitude level. This highlights the need to implement strategies that enhance the positive attitudes and safe practices of the HCWs for better containment of the pandemic and supporting of essential health care services.
In many low-resource countries, progress toward reducing neonatal mortality is slow. This scenario is particularly prevalent in Sub-Saharan Africa and Ethiopia. Neonates who nearly died due to severe complications during birth or the neonatal period constitute neonatal near-miss cases. However, no pooled data exists to quantify the magnitude of neonatal near-misses in Ethiopia. As a result, the goal of this study was to identify national burden of NNM and associated factors in Ethiopia. This systematic review and meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was registered on PROSPERO (CRD42022303477). A comprehensive search of literature was carried out using PubMed/Medline, HINARI, African Journal Online, Science Direct, and Google Scholar. From 2010 to 2020, all lists of eligible studies' references were also identified and retrieved. The pooled estimate with a (95% CI) was calculated using a random-effects model in STATA 14.1-version. I2and meta-bias statistics were used to assess heterogeneity of the included studies. From those included studies, (9 articles) with a total of 6437 neonates were included in the meta-analysis. The pooled prevalence of NNM in Ethiopia was 14% (95% CI: 13–15). Neonates who were born by Caesarean section, neonates whose mothers had pregnancy-induced hypertension and premature ruptured-membranes had higher odds of NNM. In Ethiopia, one out of every seven neonates suffers from NNM. Cesarean section, Pregnancy-induced hypertension and premature ruptures of the membrane are risk factors for NNM. Improving maternal health-care utilization would reduce the burden of NNM.
Background: Blood transfusion is a mandatory therapeutic maneuver that provides life-saving benefits to patients who are suffering from severe anemia due to medical disorders. Purpose: this study was aimed to determine HBV infection and associated factors among blood donars in Jigjiga zone Somali region. Methods: A facility-based cross-sectional study design was conducted among a sample blood donor in Jigjiga city Blood Bank Somali regional state of Ethiopia. A standardized questionnaire using Epidata was used. A bivariate and multivariate logistic regression was used to assess the independent predictors association (pvalue<0.25) in bivariate as candidate of multivariable logistic regression model-A significant (pvalue<0.05) was considered as statistical significance. Results: A total of 323 blood donars participated with a response rate of 95.5%. The overall prevalence of hepatitis B virus infection was (7.1%) (95% CI: 4.3-10.2)After adjusted analysis, marital status being single (AOR=5.3 CI: 1.018-27.859), unsafe therapeutic drug injections (AOR=10.1 CI: 2.791-36.566) unprotected sex (AOR4.6=CI: 1.533-14.116), razor and sharp material sharing (AOR=5.5 CI: 0.852-16.530), having poor knowledge on hepatitis B virus infection (AOR=3.4 CI: 1.107-10.485) were identified as statistically significant associated with hepatitis virus infection. Conclusion: Overall prevalence of the study was 7.1%, which needs intervention by the government and other stakeholders.
Abstract Background : Unintended pregnancies commonly occur in low and middle-income countries during the twelve months of post-partum. The World health organization recommends an interval of 24 months or more to reduce adverse outcomes for the mother and the child. But most women, especially in the postpartum period, have little or no understanding of fertility. Ethiopia’s mini demographic and health survey in 2019 showed only 41% of married women use modern contraceptives. In the Somali region, modern contraceptive use is reported as low as 3%. There is limited evidence on the effectiveness of post-partum and post-abortion family planning integration with reproductive, maternal, neonatal, child, and adolescent health and nutrition services (RMNCAN) to guide program efforts and policy action on health services. Therefore, this study aims to assess the challenges, opportunities, and enablers of delivery model integration of post-partum and post-abortion family planning with RMNCAN services in selected primary healthcare facilities in the Somali Region of Ethiopia. Methodology : This formative assessment was done in eight primary healthcare settings of the Fafan and Jarar zones of the Somali Region, using qualitative research methods. Ethical clearance was obtained from the Institutional Review Board of the College of Health Sciences at Addis Ababa University, respondents were informed about the purpose of the study, confidentiality considerations were properly made and their consent was obtained. Key Informant interviews (KII), In-depth interviews (IDIs), and Focus group discussions (FGDs) were used to collect data. OpenCode 4.03 software was used to analyse the data. Result: The post-partum and post-abortion family planning (PPPAFP) services uptake remains poor and key barriers such as limited PPPAFP service to health facilities, limited information, poor supply chain management of PPPA, poor community acceptance and low awareness of PPPAFP services and poor participation of women in health care budget allocation are negatively reinforcing the awareness, access, and utilization of FP service. Evidences also show that deviated decision-making of available assets and resources; mostly men, limited female participation in leadership roles and responsibilities, and negative cultural norms, and attitude towards family planning services in general were found to impede the services delivery. Conclusion and recommendations: It is noted that there is limited information regarding the availability of family planning services. In addition, there is poor supply chain management and poor community acceptance, and low awareness of PPPAFP. Therefore, the government and other stakeholders should facilitate the availability and accessibility of all FP methods and their information at the community, household, and individual levels; women empowerment should be in place to augment service uptake. Drawing from these findings, we also recommend Health education and counselling, availability & accessibility of family planning facilities and supplies, and community support groups for improving postpartum and post-abortion family planning use.
Abstract Background Immunization is one of modern medicine’s greatest achievements in the last three decades. Annually it can prevent nearly 2 to 3 million deaths. Understanding the determinants of effective immunization coverage is a critical undertaking. Accordingly, we set out to check the best available evidence of outstanding predictors of immunization coverage among children aged 12–23 months in Ethiopia. Method Electronic databases including PubMed, Google Scholar, HINARI, and SCOPUS, Web of Science, African Journals Online, Ethiopian Medical Journals were searched. The search process, study selection, critical appraisal, and data extraction were done independently by two reviewers using Joanna Briggs Institute Meta-analysis for Review Instrument (JBI-MAStARI). The difference between reviewers was resolved with a third person. The risk of bias was assessed by the Newcastle Ottawa Tool for observational studies. Data were extracted using the Microsoft Excel checklist and exported to STATA 13. Heterogeneity was assessed using I 2 , Funnel plot and Egger’s test was used to check for publication bias . Results We identified 26 studies with 15,042 children with mothers/caretakers to assess factors associated with immunization coverage and significant factors were: maternal formal education, (OR = 2.45; 95% CI: 1.62–3.72), paternal formal education, (OR = 1.01; 95% CI: 0.27–3.77), residence, (OR = 2.11; 95% CI: 1.00–4.45), birth at health facility (OR = 1.86; 95% CI: 0.99–3.49), family size less than four, (OR = 1.81; 95% CI: 1.16–2.84), knowledge on age of immunization to be completed (OR = 6.18;95% CI: 3.07–12.43), knowledge on immunization schedule (OR = 2.49; 95% CI: 1.35–4.59), time to travel to health faculties, (OR = 1.74; 95% CI: 0.62–4.89), antennal care, (OR = 3.11; 95% CI: 1.64–5.88), and tetanus toxoid vaccination, (OR = 4.82; 95% CI: 2.99–7.75). Conclusion Our findings showed that literacy, residence, awareness, family size, maternal health services use, and proximity of the health facilities were factors associated with full immunization. This implies that there is a need for primary health service expansion and health education to “hard to reach areas” to improve immunization coverage for children aged 12–23 months.
Background: Measles is a highly contagious, serious respiratory viral disease characterized by fever, and maculopapular erythematous rash. Before widespread vaccination in 1980, measles was responsible for an estimated 2.6 million deaths worldwide each year. Objective: of this study was to investigate the magnitude of measles outbreak and identify factors that contributed its incidence in Kabridahar District. Methods: A descriptive and unmatched case control study for 33 cases and 66 controls was conducted in Kabridahar district. Structured questionnaire was used for data collection from cases and controls. Data was analyzed by using Microsoft excel and SPSS 20. Result: A total of 33 cases and 66 controls were recruited for this outbreak investigation data collection. The overall attack rate was 0.4/1,000 with zero case fatality. From the total cases, 17 (51%) were male and 16 (49%) were female. 18 (55%) out of the total cases were reported from the age group 5-14 years. 13 (39%) from the total 33 cases were reported from Elhar kebele, 7 km from Kabridahar town. The mean age of cases and controls were 7.6±4.6 SD and 7.5±4.8 SD respectively. 20 (61) of the cases and 16 (24%) of the controls didn’t ever receive vaccination for measles. Cases that had contact history with another confirmed measles case (AOR=3.5, 95% CI (5.9, 21.4)); presence of measles case (s) in the neighboring household and or within the household (AOR=14.5, 95% (3.0, 7.0)) and (AOR=9.5, 95% CI (1.8, 4.8)) respectively and not vaccinating children from measles virus (AOR=5.6, 95% CI (1.3, 2.4)) were significantly associated with the outbreak. Conclusion: History of contact with measles case (s), presence of case (s) in the neighboring household and or within the household and not vaccinating children timely were independent risk factors for this outbreak.
Abstract The Somali Region of Ethiopia has been affected by drought for several years. Drought conditions have led to food and water scarcity and a humanitarian crisis in the region. In January 2017, an outbreak of acute watery diarrhea (AWD) was declared in the region. AWD prevention and control activities include strengthening water, sanitation, and hygiene (WASH) services. Access to safe drinking water is critical in preventing transmission of AWD and chlorine is an effective chemical to disinfect water supplies. The US Centers for Disease Control and Prevention collaborated with the WASH Cluster and the United Nations Children's Fund, Ethiopia, to provide technical assistance to the Somali Regional Water Bureau to improve chlorination of drinking water supplies and quickly assess water quality improvements in Jijiga town, Fafan Zone. Timely sharing of surveillance and case investigation data allowed for the identification of gaps within the water supply system in Jijiga and implementation of centralized and decentralized chlorination interventions and monitoring systems. Pilot use of a rapid assessment to determine residual chlorine levels at various points in the city helped improve chlorination intervention impact. This work illustrates that rapid community-level water quality improvements can be implemented and assessed quickly to improve interventions during outbreaks.
Abstract Objective The aim of this study is to investigate the food safety knowledge and practices of food handlers in the context of covid-19. Result A total of 384 food handlers were approached and all of them responded (response rate = 100%). Majority of the participants were under 40 years of age (n = 369, 96.1%). Of the total participants, 50.8% were male with a mean age of 32.1 (SD: 4.8). Majority of the participants were under 40 years of age (n = 369, 96.1%). Female, younger adults, married, educated and those with prior food safety training had better food handling practice than their counter parts.
BACKGROUND To maintain the safety of our food supply during the Covid-19 pandemic, it is crucial to emphasize the significance of food safety in relation to good hygiene practices. OBJECTIVE The aim of this study is to investigate the food safety knowledge and practices of food handlers in the context of covid-19. METHODS A cross-sectional study was conducted in Jigjiga in May 2020 and data was collected using questionnaire and observation checklist on employees’ knowledge of food safety and their practices in the context of covid-19. RESULTS A total of 384 food handlers were approached and all of them responded (response rate = 100%). Less than 50% of the respondents had sufficient knowledge. Female, younger adults, married, educated and those with prior food safety training had better food handling practice than their counter parts. CONCLUSIONS Food handlers with prior food safety training practiced more than their counterparts. As a result, researchers, food safety communicators, the media, and all other related sectors should work to educate food handlers to advance their health and food safety training.
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