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At least 19 recordsLinked to original sources

PubMed2001

Diarrhoeal morbidity among young children in Eritrea: environmental and socioeconomic determinants.

Diarrhoeal diseases are still a major cause of morbidity and mortality among children in many developing countries, particularly in sub-Saharan Africa. In Eritrea, diarrhoeal disease is one of the most frequent causes of illness and a major contributor to mortality among children. Yet, except for some descriptive reports by the National Statistics Office of Eritrea, no systematic study of the factors that influence the prevalence of diarrhoeal morbidity among young children in Eritrea was carried out. This study examined the effects of some environmental and socioeconomic factors that were associated with childhood diarrhoea in Eritrea. The study used data collected by the Demographic and Health Survey (DHS) in Eritrea in 1995. Results of the study showed that the environmental and socioeconomic conditions of the population were significant predictors of diarrhoeal morbidity. The study also found an important association of diarrhoeal morbidity with the age and the number of children, particularly with high prevalence of diarrhoea at the age of weaning and in households with a large number of children.

Age Factors↗

PubMed2006

Traditional risk-sharing arrangements and informal social insurance in Eritrea.

In Eritrea neither the state nor the market is effective in providing health insurance to low-income people (in rural and informal job sector). Schemes intended for the informal sector are confronted with low and irregular incomes of target populations and consequently negligible potential for profit making. Because of this there, are no formal health insurance systems in Eritrea that cover people in the traditional (or informal) sector of the economy. In the absence of formal safety nets traditional Eritrean societies use their local social capital to alleviate unexpected social costs. In Eritrea traditional risk-sharing arrangements are made within extended families and mutual aid community associations. This study reveals that in a situation where the state no longer provides free public health services any more and access to private insurance is denied, the extension of the voluntary mutual aid community associations to Mahber-based health insurance schemes at the local level is a viable way for providing modern health services.

Cross-Sectional Studies↗

PubMed1999

Emergency medicine in Eritrea: rebuilding after a 30-year war of independence.

Eritrea became a member of the United Nations in 1993, after a devastating 30-year war of independence with Ethiopia. Although Eritrea suffers from many of the problems beset by the developing world, the people are determined to rebuild their country. Emergency medical care and emergency services are in their infancy, yet the signs of progress are already visible in the capital city of Asmara. This report describes the current state of the prehospital system and emergency medical care in Eritrea.

Communicable Disease Control↗

PubMed2005

Surgical management of complex obstetric fistula in Eritrea.

OBJECTIVES: To evaluate the incidence of and demographic characteristics associated with obstetric fistula in Eritrea. To determine the outcomes of surgical repair of complex fistula in Eritrea by a visiting surgical team. METHODS: A surgical team comprising expert gynecologic surgeons traveled to Eritrea in September 2004. We evaluated 50 patients with genitourinary fistula and performed surgical repairs of these fistulas on 37 women via both vaginal and abdominal approaches. Demographic and basic medical data were obtained at the time of evaluation, and follow-up questionnaires were completed at 4 weeks postoperative. RESULTS: The majority of the women had fistulas related to obstructed labor at their first pregnancy unattended by any healthcare professional. The average duration of labor was 3 days, and more than half had resulted in stillbirths. The rate of successful repair in women with primary vesicovaginal fistulas (VVF) was 63%, and that in women with recurrent vesicovaginal fistulas was 61%. Two women required urinary diversion procedures because of the severity of the damage to the genital tract. Urethral reconstruction in women with urethrovaginal fistulas (UVFs) was successfully accomplished in 77% of patients. The rate of successful repair of rectovaginal fistulas (RVFs) was 87%. CONCLUSIONS: We have demonstrated that a team of specialized surgeons can successfully accomplish surgical procedures and repairs of very complex urinary tract fistulas in a very short mission to a resource-poor nation.

Adult↗

PubMedDate not supplied

Population genetic structure of Anopheles arabiensis mosquitoes in Ethiopia and Eritrea.

This study examined the population genetic structure of the major malaria vector, Anopheles arabiensis mosquitoes, in Ethiopia and Eritrea. Ethiopia and Eritrea have great geographical diversity, with high mountains, rugged plateaus, deep gorges, and rolling plains. The plateau is bisected diagonally by the Great Rift Valley into the Northwestern Highlands and the Southeastern Highlands. Five A. arabiensis populations from the Northwestern Highlands region and two populations from high-altitude sites in the Great Rift Valley were genotyped using six microsatellite markers to estimate the genetic diversity and population genetic structure of A. arabiensis. We found that A. arabiensis populations from the Northwestern Highlands and the Great Rift Valley region showed a similar level of genetic diversity. The genetic differentiation (F(ST)) of the five mosquito populations within the Northwestern Highlands region was 0.038 (P <.001), while the two populations within the Great Rift Valley showed little genetic differentiation (F(ST) = 0.007, P <.01). The degree of genetic differentiation between the Northwestern Highlands region and the Great Rift Valley region was small but statistically significant (F(ST) = 0.017, P <.001). The population genetic structure of A. arabiensis in the study area did not follow the isolation-by-distance model (r(2) = 0.014, P >.05). The low F(ST) estimates for A. arabiensis populations in Ethiopia and Eritrea are consistent with the general population genetic structure of this species in East Africa based on other molecular markers.

Animals↗

PubMed2006

A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and 2004: the effect of combination of control methods.

BACKGROUND: Malaria is a huge public health problem in Africa that is responsible for more than one million deaths annually. In line with the Roll Back Malaria initiative and the Abuja Declaration, Eritrea and other African countries have intensified their fight against malaria. This study examines the impact of Eritrea's Roll Back Malaria Programme: 2000-2004 and the effects and possible interactions between the public health interventions in use. METHODS: This study employed cross-sectional survey to collect data from households, community and health facilities on coverage and usage of Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS), larvicidal activities and malaria case management. Comparative data was obtained from a similar survey carried out in 2001. Data from the Health Management Information System (HMIS) and reports of the annual assessments by the National Malaria Control Programme was used to assess impact. Time series model (ARIMA) was used to assess association. RESULTS: In the period 2000-2004, approximately 874,000 ITNs were distributed and 13,109 health workers and community health agents were trained on malaria case management. In 2004, approximately 81% households owned at least one net, of which 73% were ITNs and 58.6% of children 0-5 years slept under a net. The proportion of malaria cases managed by community health agents rose from 50% in 1999 to 78% in 2004. IRS coverage increased with the combined amount of DDT and Malathion used rising from 6,444 kg, in 2000 to 43,491 kg, in 2004, increasing the population protected from 117,017 to 259,420. Drug resistance necessitated regimen change to chloroquine plus sulfadoxine-pyrimethamine. During the period, there was a steep decline in malaria morbidity and case fatality by 84% and 40% respectively. Malaria morbidity was strongly correlated to the numbers of ITNs distributed (beta = -0.125, p < 0.005) and the amount (kg) of DDT and Malathion used for IRS (beta = -2.352, p < 0.05). The correlation between malaria case fatality and ITNs, IRS, population protected and annual rainfall was not statistically significant. CONCLUSION: Eritrea has within 5 years attained key Roll Back Malaria targets. ITNs and IRS contributed most to reducing malaria morbidity.

Adult↗

PubMed2002

Humanitarian assistance in UN operations: laboratory and consultative support of a local hospital in Eritrea.

The United Nations Mission to Eritrea and Ethiopia deployed to monitor a cease-fire in a mutually agreed upon Temporary Security Zone. Support for the United Nations (UN) troops included a Field Dressing Station supplied by the Dutch Navy, augmented by Canadian personnel. As with most missions of this type, the health of the deployed Canadian and Dutch soldiers is such that there is time to provide some medical support to local civilian institutions. This article describes this interaction in Eritrea through the illustration of the diagnosis and management of a specific illness through the cooperative use of high-technology laboratory equipment coupled with what we believe to be common sense. Although there was no specific United Nations Mission to Eritrea and Ethiopia humanitarian medical assistance mandate, the expanded use of CIMIC# projects was employed to allow this activity. The guiding principle of sustainability once UN facilities leave is also illustrated in the approach taken to provide this assistance.

Adult↗

PubMed2004

Ethnobotanical survey and testing of plants traditionally used against hematophagous insects in Eritrea.

An ethnobotanical study was conducted to find plants traditionally used against nuisance insects in three regions of Eritrea: highland, eastern escarpment and wet lowland. Six plants were collected, two of them were reported to be used against mosquitoes (Ocimum forskolei, Lamiaceae and Nicotiana glauca, Solanaceae), two others against fleas (Salvia shimperi, Lamiaceae and Otostegia integrifolia, Lamiaceae) and Neorautanenia mitis (Fabaceae) and Calpurnea aurea (Fabaceae) against animal lice. The effect of fresh leaves and shoots of O. forskolei hanging on walls at the head and foot of beds was tested in Eritrea against Anopheles arabiensis and 53% reduction in mean number of mosquitoes per house was achieved. Blood meals of mosquitoes collected from houses and pit shelters were analysed to determine whether biting diversion occurred due to the use of plants in the houses. No diversion of biting was observed to goats, which are abundant in the test area. Hot water distillates of N. glauca, S. schimperi and O. integrifolia were tested against An. gambiae s.s. in the laboratory using a Hemotek membrane blood feeder with pig skin replacing the parafilm membrane. The approximate doses in microl/cm(2) for 50% repellency with the extracts of S. schimperi, N. glauca and O. integrifolia were 0.97, 1.72 and 2.44, respectively. Even though the plants only achieved partial protection, they have a potential for widespread use as a complement to other control methods.

Adult↗

PubMed1998

Prevalence of infection with HIV, hepatitis B and C viruses, in four high risk groups in Eritrea.

BACKGROUND: Little is known about the prevalence of infections in different population groups in Africa, and about the influence of living conditions on the spread of infections. This study is the first of its kind in the state of Eritrea and is expected to serve as an evaluation of the situation in the country. OBJECTIVE: A serosurvey for human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) was carried out during the summer of 1995 in Massawa, a small sea port in Eritrea (East Africa) in four groups considered to be at risk for these infections. STUDY DESIGN: The study subjects were former Guerrilla Fighters, Female Sex Workers, Truck Drivers, and Port Workers. Participants from a tribe called Rashaida were believed to be at low risk, and thus served as a control. RESULTS: The Female Sex Workers had the highest incidence of HIV-1 infection, 29%, compared to 10% for Port Workers, and 3% for Guerrilla Fighters. On the other hand presence of HBsAg, indicating a high prevalence of hepatitis B carrier status, was highest in the Guerrilla Fighters, followed by the Rashaidas, and lowest in the Female Sex Workers. The Female Sex Workers were further tested for antibodies against HBV and the results revealed that 53% of them, 5%, had antibodies against HBcoreAg. Excluding the possibility of an acute infection at sampling time, three of them became HBsAg carriers. Surprisingly, our group of Truck Drivers did not show HIV-1 infection, and no HIV-2 infections were seen in the whole cohort. CONCLUSION: The study shows that the described groups have different prevalences of infection with HIV, hepatitis B and C which can partly be explained by their living conditions.

Acquired Immunodeficiency Syndrome↗

PubMed2000

The effects of water supply and sanitation on childhood mortality in urban Eritrea.

Child mortality differentials according to water supply and sanitation in many urban areas of developing countries suggest that access to piped water and toilet facilities can improve the survival chances of children. The central question in this study is whether access to piped water and a flush toilet affects the survival chance of children under five in urban areas of Eritrea. The study uses data collected by the Demographic and Health Survey (DHS) project in Eritrea in 1995. The results show that while the unadjusted effect of household environment (water supply and toilet facility) is large and statistically significant during the post-neonatal and child periods, it is relatively small and statistically insignificant during the neonatal period. The effect of household environment remains substantial during the post-neonatal and child periods, even when other socioeconomic variables are held constant. However, the household environment effect totally disappears during the neonatal period when the socioeconomic factors are controlled for.

Child, Preschool↗

PubMed2005

Use of 'sense of coherence (SOC)' scale to measure resilience in Eritrea: interrogating both the data and the scale.

An adapted 'sense of coherence' scale short form (SOC-13) was administered in nine languages of Eritrea with a total of 265 participants (162 women and 103 men) in order to assess 'resilience' in quantitative terms. Statistical analysis yielded significant differences in SOC scores between the displaced and non-displaced: mean=54.84 (SD=6.48) in internally displaced person (IDP) camps, compared with mean=48.94 (SD=11.99) in urban and rural settlements (t=3.831, p<0.001). Post-hoc tests revealed that the main difference is between IDP camp dwellers and urban (non-displaced) residents. Those in rural but traditionally mobile (pastoralist or transhumant) communities scored more or less the same as the urban non-displaced - i.e. significantly higher than those in IDP camps (p<0.05). Analysis of variance showed that displacement has a significantly negative effect on women compared with men (RR=0.262, p<0.001). Repeating the analysis for the three groups confirmed that urban and pastoralist/transhumant groups are similar, while women in IDP camps are lower scoring (RR=0.268, p<0.001), Hamboka women being worst affected due to their experience of serial displacement. These findings are interpreted and discussed in the light of qualitative information gleaned from the study participants' interrogation of the content of the SOC scale; and in the wider context of historical, socio-political and cultural characteristics of Eritrea. The study's implications for humanitarian and public health policy are considered.

Adaptation, Psychological↗

PubMed2006

The prevalence of hypertension and its relationship with obesity: results from a national blood pressure survey in Eritrea.

The prevalence of cardiovascular diseases has been shown to be on the increase in Africa based on hospital-based information and limited national surveys. A recent report on analysis of data from Health Information Management Systems (HIMS) highlighted an increasing burden of noncommunicable diseases (NCDs) in Eritrea, with the incidence of hypertension doubling in a space of 6 years. HMIS data are only a proxy of national prevalence rates, necessitating the conduct of national surveys. The WHO STEPwise approach to surveillance of NCDs was used for the national NCD risk factor survey in 2004. This report focuses on blood pressure (BP) and obesity (body mass index (BMI) > 30 kg/m2) as NCD risk factors in Eritrea. A total of 2352 people in age groups 15 to 64 years participated in the survey. The prevalence of hypertension defined as BP > 140/90 mmHg was 15.9% in the general population, with 16.4% in urban and 14.5% in rural areas, 17% of whom were males while 15% were females. BMI was positively associated with systolic (SBP), diastolic and mean arterial pressure. Although the prevalence of obesity (3.3%) was higher in females, the effect of BMI on BP was higher in males than in females (regression coefficient 0.64 and 0.38, respectively, P < or = 0.05), especially in those >45 years. BMI did not have a significant effect on BP in lean people (BMI < 19) and in those with high BMI, but was positively correlated to SBP in those with normal BMI (P < or = 0.02). BMI and age appear to play a synergistic role in creating a strong association with BP.

Adult↗

PubMed2004

Prevalence of Giardiasis due to wastewater reuse for agriculture in the suburbs of Asmara City, Eritrea.

A study was undertaken to assess the health impact of utilization of the raw domestic sewage for vegetable cultivation in the suburbs of the capital city of Asmara, Eritrea. Standard techniques were adopted for the analysis of the samples. Results showed heavy contamination of vegetables by faecal coliforms as well as with Giardia cysts. Stool samples of 75 farmers who were occupationally exposed revealed that 45% of them were harbouring giardia cysts. The dietary intake of raw salads (lettuce, cabbage) grown on the raw sewage appear to be a causative factor of Giardiasis in the farming community as well as in the town of Tsadachristian located on the suburbs of the capital city of Asmara. The hospital data of the affected town is compared with other towns of Eritrea. The result indicates agriculture reuse of untreated wastewater is a major cause for the increase in Giardasis.

Adolescent↗

PubMed2006

Rolling out insecticide treated nets in Eritrea: examining the determinants of possession and use in malarious zones during the rainy season.

OBJECTIVE: This paper describes determinants of insecticide treated net (ITN) ownership and use in malarious areas of Eritrea. With ITN distribution and re-treatment now free for all living in these areas, we examine barriers (other than cost) to access and use of ITNs. We explore the differences between use of an ITN as a proportion of all households in the survey (the roll back malaria indicator), and use of an ITN as a proportion of those households who already own an ITN. METHODS: A modified two-stage cluster design was used to collect data from a sample of households (n = 2341) in the three most malarious administrative zobas (zones or provinces). Logistic regression was used to analyse the data. RESULTS: Our findings suggest environmental heterogeneity among zobas (including program effects specific to each zoba), perception of risk, and proximity to a clinic are important predictors of ITN possession and use. Among households with at least one ITN, 17.0% reported that children under five were not under an ITN the night before the survey, while half of all such households did not have all occupants using them the night before the survey. The number of ITNs, as well as zoba, was also significant determinants of use in these households with at least one ITN. CONCLUSION: Current efforts to disseminate ITNs to vulnerable populations in Eritrea are working, as suggested by high ITN ownership and net-to-person ratios inside households. However, the gap between ITN ownership and use, given ownership, is large, and may represent lost opportunities to prevent infection. Closing this gap requires concerted efforts to change behaviour to ensure that all household members use ITNs as consistently and correctly as possible during and following the rains.

Attitude to Health↗

PubMedDate not supplied

Health effects of wastewater reuse for agriculture in the suburbs of Asmara city, Eritrea.

The health impact of utilization of raw domestic sewage for vegetable cultivation in the suburbs of Asmara, Eritrea, was assessed. Results showed heavy contamination of vegetables by fecal coliforms and Giardia cysts as well as other pathogenic bacteria such as Shigella and Salmonella. Stool samples from 75 occupationally exposed farmers revealed that 45% of them were harboring Giardia cysts. Dietary intake of raw greens (lettuce, cabbage) grown on the raw sewage appears to cause giardiasis, amebiasis, and diarrhea in the farming community as well as in the surrounding area. Comparison of hospital data from the affected area with data from other areas of Eritrea indicated that agriculture use of untreated wastewater was the major cause of the increase in giardiasis and other gastrointestinal diseases.

Adult↗

PubMed2003

Larval habitat diversity and ecology of anopheline larvae in Eritrea.

Studies on the spatial distribution of anopheline mosquito larvae were conducted in 302 villages over two transmission seasons in Eritrea. Additional longitudinal studies were also conducted at eight villages over a 24-mo period to determine the seasonal variation in anopheline larval densities. Eight anopheline species were identified with Anopheles arabiensis predominating in most of the habitats. Other species collected included: An. cinereus, An. pretoriensis, An. d'thali, An. funestus, An. squamosus, An. adenensis, and An. demeilloni. An. arabiensis was found in five of the six aquatic habitats found positive for anopheline larvae during the survey. Anopheles larvae were sampled predominantly from stream edges and streambed pools, with samples from this habitat type representing 91.2% (n = 9481) of the total anopheline larval collection in the spatial distribution survey. Other important anopheline habitats included rain pools, ponds, dams, swamps, and drainage channels at communal water supply points. Anopheline larvae were abundant in habitats that were shallow, slow flowing and had clear water. The presence of vegetation, intensity of shade, and permanence of aquatic habitats were not significant determinants of larval distribution and abundance. Larval density was positively correlated with water temperature. Larval abundance increased during the wet season and decreased in the dry season but the timing of peak densities was variable among habitat types and zones. Anopheline larvae were collected all year round with the dry season larval production restricted mainly to artificial aquatic habitats such as drainage channels at communal water supply points. This study provides important information on seasonal patterns of anopheline larval production and larval habitat diversity on a countrywide scale that will be useful in guiding larval control operations in Eritrea.

Animals↗

PubMed2003

Maternal psychosocial well-being in Eritrea: application of participatory methods and tools of investigation and analysis in complex emergency settings.

OBJECTIVE: To establish the context in which maternal psychosocial well-being is understood in war-affected settings in Eritrea. METHOD: Pretested and validated participatory methods and tools of investigation and analysis were employed to allow participants to engage in processes of qualitative data collection, on-site analysis, and interpretation. FINDINGS: Maternal psychosocial well-being in Eritrea is maintained primarily by traditional systems of social support that are mostly outside the domain of statutory primary care. Traditional birth attendants provide a vital link between the two. Formal training and regular supplies of sterile delivery kits appear to be worthwhile options for health policy and practice in the face of the post-conflict challenges of ruined infrastructure and an overstretched and/or ill-mannered workforce in the maternity health service. CONCLUSION: Methodological advances in health research and the dearth of data on maternal psychosocial well-being in complex emergency settings call for scholars and practitioners to collaborate in creative searches for sound evidence on which to base maternity, mental health and social care policy and practice. Participatory methods facilitate the meaningful engagement of key stakeholders and enhance data quality, reliability and usability.

Anxiety↗

PubMed2003

Distribution of anopheline mosquitoes in Eritrea.

The spatial distribution of anopheline mosquito species was studied throughout Eritrea during the 1999-2001 malaria transmission seasons from October to December for the highlands and western lowlands and February to April for the coastal region. Of the 302 villages sampled, 59 were visited in both the first and second year. Overall, 13 anopheline species were identified, with the Anopheles gambiae complex predominating during the first year (75.6%, n = 861) and the second year (91.9%, n = 1,262). Intrazonal variation accounted for 90% of the total variation in mosquito distribution. Polymerase chain reaction results indicated that 99% (n = 1,309) of the An. gambiae s.l. specimens were An. arabiensis, indicating that this was the only member of the gambiae complex present. There was a high degree of aggregation of anophelines within zones and villages, with more than 80% of the total anophelines being collected from less than 20% of the villages and from only 10% of the houses sampled. At least 80% of the anopheline mosquitoes were collected from grass-thatched Agudo-type housing. Vector abundance showed an inverse relationship with elevation, with highest densities in the low-lying western lowlands. Multiple regression analysis of log-transformed mean density of An. arabiensis with rainfall and the normalized difference vegetation index (NDVI) (average NDVI, minimum NDVI, and maximum NDVI) showed that these independent variables were not significantly associated with mosquito densities (R2 = 0.058). Our study contributes to the basic understanding of the ecology and distribution of malaria vectors with respect to species composition and spatial heterogeneities both that could be used to guide vector control operations in Eritrea.

Animals↗