Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15

Search results for: Tsegaye Girma Asere

15 Photocatalytic Degradation of Methylene Blue Dye Using Cuprous Oxide/Graphene Nanocomposite

Authors: Bekan Bogale, Tsegaye Girma Asere, Tilahun Yai, Fekadu Melak

Abstract:

Aims: To study photocatalytic degradation of methylene blue dye on cuprous oxide/graphene nanocomposite. Background: Cuprous oxide (Cu2O) nanoparticles are among the metal oxides that demonstrated photocatalytic activity. However, the stability of Cu2O nanoparticles due to the fast recombination rate of electron/hole pairs remains a significant challenge in their photocatalytic applications. This, in turn, leads to mismatching of the effective bandgap separation, tending to reduce the photocatalytic activity of the desired organic waste (MB). To overcome these limitations, graphene has been combined with cuprous oxides, resulting in cuprous oxide/graphene nanocomposite as a promising photocatalyst. Objective: In this study, Cu2O/graphene nanocomposite was synthesized and evaluated for its photocatalytic performance of methylene blue (MB) dye degradation. Method: Cu2O/graphene nanocomposites were synthesized from graphite powder and copper nitrate using the facile sol-gel method. Batch experiments have been conducted to assess the applications of the nanocomposites for MB degradation. Parameters such as contact time, catalyst dosage, and pH of the solution were optimized for maximum MB degradation. The prepared nanocomposites were characterized by using UV-Vis, FTIR, XRD, and SEM. The photocatalytic performance of Cu2O/graphene nanocomposites was compared against Cu2O nanoparticles for cationic MB dye degradation. Results: Cu2O/graphene nanocomposite exhibits higher photocatalytic activity for MB degradation (with a degradation efficiency of 94%) than pure Cu2O nanoparticles (67%). This has been accomplished after 180 min of irradiation under visible light. The kinetics of MB degradation by Cu2O/graphene composites can be demonstrated by the second-order kinetic model. The synthesized nanocomposite can be used for more than three cycles of photocatalytic MB degradation. Conclusion: This work indicated new insights into Cu2O/graphene nanocomposite as high-performance in photocatalysis to degrade MB, playing a great role in environmental protection in relation to MB dye.

Keywords: methylene blue, photocatalysis, cuprous oxide, graphene nanocomposite

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14 Electrochemical Response Transductions of Graphenated-Polyaniline Nanosensor for Environmental Anthracene

Authors: O. Tovide, N. Jahed, N. Mohammed, C. E. Sunday, H. R. Makelane, R. F. Ajayi, K. M. Molapo, A. Tsegaye, M. Masikini, S. Mailu, A. Baleg, T. Waryo, P. G. Baker, E. I. Iwuoha

Abstract:

A graphenated–polyaniline (GR-PANI) nanocomposite sensor was constructed and used for the determination of anthracene. The direct electro-oxidation behavior of anthracene on the GR-PANI modified glassy carbon electrode (GCE) was used as the sensing principle. The results indicate thatthe response profile of the oxidation of anthracene on GR-PANI-modified GCE provides for the construction of sensor systems based onamperometric and potentiometric signal transductions. A dynamic linear range of 0.12- 100 µM anthracene and a detection limit of 0.044 µM anthracene were established for the sensor system.

Keywords: electrochemical sensors, environmental pollutants, graphenated-polymers, polyaromatic hydrocarbon

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13 Determinants of Multidrug-Resistant Tuberculosis in Patients Who Underwent First-Line Treatment in Addis Ababa: A Case Control Study

Authors: Selamawit Hirpa, Girmay Medhin, Belaineh Girma, Muluken Melese, Alemayehu Mekonen, Pedro Suarez, Gobena Ameni

Abstract:

Worldwide, there were 650,000 multi-drug resistant tuberculosis (MDR-TB) cases in 2010. Ethiopia is 15th among the 27 MDR-TB high-burden countries. A case control study was conducted at St. Peter Hospital and five health centers in Addis Ababa. Cases were MDR-TB patients who were in treatment at St. Peter Hospital during the study period. Controls were patients who were on first-line anti-TB treatment and were registered as cured or having completed treatment in the period 9 April 2009– 28 February 2010, in five health centers. A structured interview questionnaire was used to assess factors that could potentially be associated with the occurrence of MDR-TB. Factors that were significantly associated with MDR-TB: drug side effects during first-line treatment (adjusted odds ratio (AOR): 4.5, 95% CI; 1.9 - 10.5); treatment not directly observed by a health worker (AOR = 11.7, 95% CI; 4–34.3); and retreatment with the Category II regimen (P = 0.000).

Keywords: adherence to TB treatment, MDR-TB, TB treatment, TB treatment regimens

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12 Architecture for Multi-Unmanned Aerial Vehicles Based Autonomous Precision Agriculture Systems

Authors: Ebasa Girma, Nathnael Minyelshowa, Lebsework Negash

Abstract:

The use of unmanned aerial vehicles (UAVs) in precision agriculture has seen a huge increase recently. As such, systems that aim to apply various algorithms on the field need a structured framework of abstractions. This paper defines the various tasks of the UAVs in precision agriculture and models them into an architectural framework. The presented architecture is built on the context that there will be minimal physical intervention to do the tasks defined with multiple coordinated and cooperative UAVs. Various tasks such as image processing, path planning, communication, data acquisition, and field mapping are employed in the architecture to provide an efficient system. Besides, different limitation for applying Multi-UAVs in precision agriculture has been considered in designing the architecture. The architecture provides an autonomous end-to-end solution, starting from mission planning, data acquisition, and image processing framework that is highly efficient and can enable farmers to comprehensively deploy UAVs onto their lands. Simulation and field tests show that the architecture offers a number of advantages that include fault-tolerance, robustness, developer, and user-friendliness.

Keywords: deep learning, multi-UAVs, precision agriculture, UAVs architecture

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11 Beyond the 'Human Rights and Development' Discourse: A Quest for a Right to Sustainable Development in International Human Rights Law

Authors: Roman Girma Teshome

Abstract:

The intersection between development and human rights has been the point of scholarly debate for a long time. Consequently, a number of principles, which extend from the right to development to the human rights-based approach to development, have been adopted to understand the dynamics between the two concepts. Despite these attempts, the exact relationship between development and human rights has not been fully discovered yet. However, the inevitable interdependence between the two notions and the idea that development efforts must be undertaken by giving due regard to human rights guarantees has gained momentum in recent years. On the other hand, the emergence of sustainable development as a widely accepted approach in development goals and policies makes this unsettled convergence even more complicated. The place of sustainable development in human rights law discourse and the role of the latter in ensuring the sustainability of development programs call for a systematic study. Hence, this article seeks to explore the relationship between development and human rights, particularly focusing on the place given to sustainable development principles in international human right law. It will further quest whether there is a right to sustainable development recognized therein. Accordingly, the article asserts that the principles of sustainable development are directly or indirectly recognized in various human rights instruments, which provides an affirmative response to the question raised hereinabove. This work, therefore, will make expeditions through international and regional human rights instruments as well as case laws and interpretative guidelines of human rights bodies to prove this hypothesis.

Keywords: sustainable development, human rights, the right to development, the human rights-based approach to development, environmental rights, economic development, social sustainability

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10 Energy Analysis of Sugarcane Production: A Case Study in Metehara Sugar Factory in Ethiopia

Authors: Wasihun Girma Hailemariam

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Energy is one of the key elements required for every agricultural activity, especially for large scale agricultural production such as sugarcane cultivation which mostly is used to produce sugar and bioethanol from sugarcane. In such kinds of resource (energy) intensive activities, energy analysis of the production system and looking for other alternatives which can reduce energy inputs of the sugarcane production process are steps forward for resource management. The purpose of this study was to determine input energy (direct and indirect) per hectare of sugarcane production sector of Metehara sugar factory in Ethiopia. Total energy consumption of the production system was 61,642 MJ/ha-yr. This total input energy is a cumulative value of different inputs (direct and indirect inputs) in the production system. The contribution of these different inputs is discussed and a scenario of substituting the most influential input by other alternative input which can replace the original input in its nutrient content was discussed. In this study the most influential input for increased energy consumption was application of organic fertilizer which accounted for 50 % of the total energy consumption. Filter cake which is a residue from the sugar production in the factory was used to substitute the organic fertilizer and the reduction in the energy consumption of the sugarcane production was discussed

Keywords: energy analysis, organic fertilizer, resource management, sugarcane

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9 Analysis of the Impact of Climate Change on Maize (Zea Mays) Yield in Central Ethiopia

Authors: Takele Nemomsa, Girma Mamo, Tesfaye Balemi

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Climate change refers to a change in the state of the climate that can be identified (e.g. using statistical tests) by changes in the mean and/or variance of its properties and that persists for an extended period, typically decades or longer. In Ethiopia; Maize production in relation to climate change at regional and sub- regional scales have not been studied in detail. Thus, this study was aimed to analyse the impact of climate change on maize yield in Ambo Districts, Central Ethiopia. To this effect, weather data, soil data and maize experimental data for Arganne hybrid were used. APSIM software was used to investigate the response of maize (Zea mays) yield to different agronomic management practices using current and future (2020s–2080s) climate data. The climate change projections data which were downscaled using SDSM were used as input of climate data for the impact analysis. Compared to agronomic practices the impact of climate change on Arganne in Central Ethiopia is minute. However, within 2020s-2080s in Ambo area; the yield of Arganne hybrid is projected to reduce by 1.06% to 2.02%, and in 2050s it is projected to reduce by 1.56 While in 2080s; it is projected to increase by 1.03% to 2.07%. Thus, to adapt to the changing climate; farmers should consider increasing plant density and fertilizer rate per hectare.

Keywords: APSIM, downscaling, response, SDSM

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8 Establishment of Reference Interval for Serum Protein Electrophoresis of Apparently Healthy Adults in Addis Ababa, Ethiopia

Authors: Demiraw Bikila, Tadesse Lejisa, Yosef Tolcha, Chala Bashea, Mehari Meles Tigist Getahun Genet Ashebir, Wossene Habtu, Feyissa Challa, Ousman Mohammed, Melkitu Kassaw, Adisu Kebede, Letebrhan G. Egzeabher, Endalkachew Befekadu, Mistire Wolde, Aster Tsegaye

Abstract:

Background: Even though several factors affect reference intervals (RIs), the company-derived values are currently in use in many laboratories worldwide. However, little or no data is available regarding serum protein RIs, mainly in resource-limited setting countries like Ethiopia. Objective: To establish a reference interval for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted on a total of 297 apparently healthy adults from April-October 2019 in four selected sub-cities (Akaki, Kirkos, Arada, Yeka) of Addis Ababa, Ethiopia. Laboratory analysis of collected samples was performed using Capillarys 2 Flex Piercing analyzer, while statistical analysis was done using SPSS version 23 and med-cal software. Mann-Whitney test was used to check Partitions. Non-parametric method of reference range establishment was performed as per CLSI guideline EP28A3C. Result: The established RIs were: Albumin 53.83-64.59%, 52.24-63.55%; Alpha-1 globulin 3.04-5.40%, 3.44-5.60%; Alpha-2 globulin 8.0-12.67%, 8.44-12.87%; and Beta-1 globulin 5.01-7.38%, 5.14-7.86%. Moreover, Albumin to globulin ratio was 1.16-1.8, 1.09-1.74 for males and females, respectively. The combined RIs for Beta-2 globulin and Gamma globulin were 2.54-4.90% and 12.40-21.66%, respectively. Conclusion: The established reference interval for serum protein fractions revealed gender-specific differences except for Beta-2 globulin and Gamma globulin.

Keywords: serum protein electrophoresis, reference interval, Addis Ababa, Ethiopia

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7 Women's Use of Maternal Health-Care Services in Hawassa Zuriya Worda: A Qualitative Study of Women's Childbearing Preference Location

Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

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Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

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6 The International Constitutional Order and Elements of Human Rights

Authors: Girma Y. Iyassu Menelik

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“The world is now like a global village!” so goes the saying that shows that due to development and technology the countries of the world are now closely linked. In the field of Human rights there is a close relationship in the way that rights are recognised and enforced. This paper will show that human rights have evolved from ancient times through important landmarks such as the Magna Carta, the French Declaration of Rights of Man and of the Citizen and the American Bill of Rights. The formation of the United Nations after the Second World War resulted in the need to codify and protect human rights. There are some rights which are so fundamental that they are found in international and continental instruments, national constitutions and domestic legislation. In the civil and political sphere they include the right to vote, to freedom of association, speech and assembly, right to life, privacy and fair trial. In the economic and social sphere you have the right to work, protection of the family, social security and rights to education, health and shelter. In some instance some rights can be suspended in times of public emergency but such derogations shall be circumscribed by the law and in most constitutions such limitations are subject to judicial review. However, some rights are so crucial that they cannot be derogated from under any circumstances and these include the right to life, recognition before the law, freedom from torture and slavery and of thought, conscience and religion. International jurisprudence has been developed to protect fundamental rights and avoid discrimination on the grounds of race, colour, sex, language or social origin. The elaborate protection system go to show that these rights have become part of the international order and they have universal application. We have now got to a stage where UDHR, ICCPR and ICESCR and have come to be regarded as part of an international bill of rights with horizontal and vertical enforcement mechanisms involving state parties, NGO’s , international bodies and other organs.

Keywords: rights, international, constitutional, state, judiciary

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5 Optimization of Alkali Assisted Microwave Pretreatments of Sorghum Straw for Efficient Bioethanol Production

Authors: Bahiru Tsegaye, Chandrajit Balomajumder, Partha Roy

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The limited supply and related negative environmental consequence of fossil fuels are driving researcher for finding sustainable sources of energy. Lignocellulose biomass like sorghum straw is considered as among cheap, renewable and abundantly available sources of energy. However, lignocellulose biomass conversion to bioenergy like bioethanol is hindered due to the reluctant nature of lignin in the biomass. Therefore, removal of lignin is a vital step for lignocellulose conversion to renewable energy. The aim of this study is to optimize microwave pretreatment conditions using design expert software to remove lignin and to release maximum possible polysaccharides from sorghum straw for efficient hydrolysis and fermentation process. Sodium hydroxide concentration between 0.5-1.5%, v/v, pretreatment time from 5-25 minutes and pretreatment temperature from 120-2000C were considered to depolymerize sorghum straw. The effect of pretreatment was studied by analyzing the compositional changes before and after pretreatments following renewable energy laboratory procedure. Analysis of variance (ANOVA) was used to test the significance of the model used for optimization. About 32.8%-48.27% of hemicellulose solubilization, 53% -82.62% of cellulose release, and 49.25% to 78.29% lignin solubilization were observed during microwave pretreatment. Pretreatment for 10 minutes with alkali concentration of 1.5% and temperature of 1400C released maximum cellulose and lignin. At this optimal condition, maximum of 82.62% of cellulose release and 78.29% of lignin removal was achieved. Sorghum straw at optimal pretreatment condition was subjected to enzymatic hydrolysis and fermentation. The efficiency of hydrolysis was measured by analyzing reducing sugars by 3, 5 dinitrisylicylic acid method. Reducing sugars of about 619 mg/g of sorghum straw were obtained after enzymatic hydrolysis. This study showed a significant amount of lignin removal and cellulose release at optimal condition. This enhances the yield of reducing sugars as well as ethanol yield. The study demonstrates the potential of microwave pretreatments for enhancing bioethanol yield from sorghum straw.

Keywords: cellulose, hydrolysis, lignocellulose, optimization

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4 A Systematic Categorization of Arguments against the Vision Zero Goal: A Literature Review

Authors: Henok Girma Abebe

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The Vision Zero is a long-term goal of preventing all road traffic fatalities and serious injuries which was first adopted in Sweden in 1997. It is based on the assumption that death and serious injury in the road system is morally unacceptable. In order to approach this end, vision zero has put in place strategies that are radically different from the traditional safety work. The vision zero, for instance, promoted the adoption of the best available technology to promote safety, and placed the ultimate responsibility for traffic safety on system designers. Despite Vision Zero’s moral appeal and its expansion to different safety areas and also parts of the world, important philosophical concerns related to the adoption and implementation of the vision zero remain to be addressed. Moreover, the vision zero goal has been criticized on different grounds. The aim of this paper is to identify and systematically categorize criticisms that have been put forward against vision zero. The findings of the paper are solely based on a critical analysis of secondary sources and snowball method is employed to identify the relevant philosophical and empirical literatures. Two general categories of criticisms on the vision zero goal are identified. The first category consists of criticisms that target the setting of vision zero as a ‘goal’ and some of the basic assumptions upon which the goal is based. Among others, the goal of achieving zero fatalities and serious injuries, together with vision zero’s lexicographical prioritization of safety has been criticized as unrealistic. The second category consists of criticisms that target the strategies put in place to achieve the goal of zero fatalities and serious injuries. For instance, Vision zero’s responsibility ascription for road safety and its rejection of cost-benefit analysis in the formulation and adoption of safety measures has both been criticized as counterproductive. In this category also falls the criticism that Vision Zero safety measures tend to be too paternalistic. Significant improvements have been recorded in road safety work since the adoption of vision zero, however, for the vision zero to even succeed more, it is important that issues and criticisms of philosophical nature associated with it are identified and critically dealt with.

Keywords: criticisms, systems approach, traffic safety, vision zero

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3 The ICC, International Criminal Justice and International Politics

Authors: Girma Y. Iyassu Menelik

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The international community has gone through indescribable atrocities resulting from acts of war. These atrocities turned Europe and Africa into a wilderness of bloodshed and crime. In the period 1960- 1970s Africa witnessed unprecedented and well-documented assaults on life and property. This necessitated the adoption, signing and ratification of the International Criminal Court, establishment of the International Court of Justice which is a great achievement for the protection and fulfilling of human rights in the context of international political instability. The ICC came as an important opportunity to advance justice for serious crimes committed in violation of international law. Thus the Rome statute has become a formidable contribution to peace and security. There are concerns that the ICC is targeting African states. However, the ICC cannot preside over cases that are not parties to the Rome statute unless the UN Security council refers the situation or the relevant state asks the court to become involved. The instable international political situation thus deals with criminal prosecutions where amnesty is not permissible or is strongly repudiated. The court has become important justice instruments for states that are unable or unwilling to fulfill their obligation to address legacies of massive human rights violations. The ICJ as a court has a twofold role; to settle legal disputes submitted to it by states, and to give advisory opinions on legal questions referred to it by duly authorized United Nations organs and specialized agencies. All members of the UN are ipso facto parties to the statute of the ICJ. The court gives advisory opinion on any legal question. These courts are the most appropriate fora to pronounce on international crimes and are in a better position to know and apply international law. Cases that have been brought to the courts include Rwanda’s genocide, Liberia’s Charles Taylor etc. The receptiveness and cooperation of the local populations are important to the courts and if the ICC and ICJ can provide appropriate protections for the physical and economic safety of victims then peace and human rights observance can be attained. This paper will look into the effectiveness and impediments of these courts in handling criminal and injustices in international politics as while as what needs to be done to strengthen the capacity of these courts.

Keywords: ICC, international politics, justice, UN security council, violence, protection, fulfilling

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2 Reducing Road Traffic Accident: Rapid Evidence Synthesis for Low and Middle Income Countries

Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede

Abstract:

Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.

Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident

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1 Psychosocial Challenges of Multi-Drug Resistant Tuberculosis (MDR-TB) Patients at St. Peter TB Specialized Hospital in Addis Ababa

Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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