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| 2. |
- Feigin, Valery L., et al.
(författare)
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Global, regional, and national burden of stroke and its risk factors, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019
- 2021
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 20:10, s. 795-820
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Tidskriftsartikel (refereegranskat)abstract
- Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12.2 million (95% UI 11.0-13.6) incident cases of stroke, 101 million (93.2-111) prevalent cases of stroke, 143 million (133-153) DALYs due to stroke, and 6.55 million (6.00-7.02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11.6% [10.8-12.2] of total deaths) and the third-leading cause of death and disability combined (5.7% [5.1-6.2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70.0% (67.0-73.0), prevalent strokes increased by 85.0% (83.0-88.0), deaths from stroke increased by 43.0% (31.0-55.0), and DALYs due to stroke increased by 32.0% (22.0-42.0). During the same period, age-standardised rates of stroke incidence decreased by 17.0% (15.0-18.0), mortality decreased by 36.0% (31.0-42.0), prevalence decreased by 6.0% (5.0-7.0), and DALYs decreased by 36.0% (31.0-42.0). However, among people younger than 70 years, prevalence rates increased by 22.0% (21.0-24.0) and incidence rates increased by 15.0% (12.0-18.0). In 2019, the age-standardised stroke-related mortality rate was 3.6 (3.5-3.8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3.7 (3.5-3.9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62.4% of all incident strokes in 2019 (7.63 million [6.57-8.96]), while intracerebral haemorrhage constituted 27.9% (3.41 million [2.97-3.91]) and subarachnoid haemorrhage constituted 9.7% (1.18 million [1.01-1.39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79.6 million [67.7-90.8] DALYs or 55.5% [48.2-62.0] of total stroke DALYs), high body-mass index (34.9 million [22.3-48.6] DALYs or 24.3% [15.7-33.2]), high fasting plasma glucose (28.9 million [19.8-41.5] DALYs or 20.2% [13.8-29.1]), ambient particulate matter pollution (28.7 million [23.4-33.4] DALYs or 20.1% [16.6-23.0]), and smoking (25.3 million [22.6-28.2] DALYs or 17.6% [16.4-19.0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.
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| 3. |
- Adane, A, et al.
(författare)
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Exploring data quality and use of the routine health information system in Ethiopia: a mixed-methods study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:12, s. e050356-
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Tidskriftsartikel (refereegranskat)abstract
- A routine health information system (RHIS) enables decision making in the healthcare system. We aimed to analyse data quality at the district and regional level and explore factors and perceptions affecting the quality and use of routine data.DesignThis was a mixed-methods study. We used the WHO toolkit for analysing data quality and interviewed staff at the point of data generation and along with the flow of data. Data were analysed using the Performance of Routine Information System Management framework.SettingThis study was performed in eight districts in four regions of Ethiopia. The study was nested within a 2-year programme of the Operational Research and Coaching for government Analysts.ParticipantsWe visited 45 health posts, 1 district hospital, 16 health centres and 8 district offices for analysis of routine RHIS data and interviewed 117 staff members for the qualitative assessment.Outcome measuresWe assessed availability of source documents, completeness, timeliness and accuracy of reporting of routine data, and explored data quality and use perceptions.ResultsThere was variable quality of both indicator and data element. Data on maternal health and immunisation were of higher quality than data on child nutrition. Issues ranged from simple organisational factors, such as availability of register books, to intricate technical issues, like complexity of indicators and choice of denominators based on population estimates. Respondents showed knowledge of the reporting procedures, but also demonstrated limited skills, lack of supportive supervision and reporting to please the next level. We saw limited examples of the use of data by the staff who were responsible for data reporting.ConclusionWe identified important organisational, technical, behavioural and process factors that need further attention to improve the quality and use of RHIS data in Ethiopia.
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| 4. |
- Adane, Abyot, et al.
(författare)
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Routine health management information system data in Ethiopia : consistency, trends, and challenges
- 2021
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector.Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys.Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources.Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions.Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions.
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| 5. |
- Gebresenbet, Girma, et al.
(författare)
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A concept for application of integrated digital technologies to enhance future smart agricultural systems
- 2023
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Ingår i: Smart Agricultural Technology. - : Elsevier. - 2772-3755. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Future agricultural systems should increase productivity and sustainability of food production and supply. For this, integrated and efficient capture, management, sharing, and use of agricultural and environmental data from multiple sources is essential. However, there are challenges to understand and efficiently use different types of agricultural and environmental data from multiple sources, which differ in format and time interval. In this regard, the role of emerging technologies is considered to be significant for integrated data gathering, analyses and efficient use. In this study, a concept was developed to facilitate the full integration of digital technologies to enhance future smart and sustainable agricultural systems. The concept has been developed based on the results of a literature review and diverse experiences and expertise which enabled the identification of stat-of-the-art smart technologies, challenges and knowledge gaps. The features of the proposed solution include: data collection methodologies using smart digital tools; platforms for data handling and sharing; application of Artificial Intelligent for data integration and analysis; edge and cloud computing; application of Blockchain, decision support system; and a governance and data security system. The study identified the potential positive implications i.e. the implementation of the concept could increase data value, farm productivity, effectiveness in monitoring of farm operations and decision making, and provide innovative farm business models. The concept could contribute to an overall increase in the competitiveness, sustainability, and resilience of the agricultural sector as well as digital transformation in agriculture and rural areas. This study also provided future research direction in relation to the proposed concept. The results will benefit researchers, practitioners, developers of smart tools, and policy makers supporting the transition to smarter and more sustainable agriculture systems.
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| 6. |
- Hailu, Beyene Zewdie, et al.
(författare)
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Patterns and drivers of fungal disease communities on Arabica coffee along a management gradient
- 2020
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Ingår i: Basic and Applied Ecology. - : Elsevier BV. - 1439-1791 .- 1618-0089. ; 47, s. 95-106
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Tidskriftsartikel (refereegranskat)abstract
- Plants, including those managed by humans, are often attacked by multiple diseases. Yet, most studies focus on single diseases, even if the disease dynamics of multiple species is more interesting from a farmers’ perspective. Moreover, most studies are from single management systems, although it is valuable to understand how diseases are distributed across broad management gradients, especially in cases where less intensive management also provides biodiversity values in the landscape. To understand the spatial dynamics and drivers of diseases across such a broad management gradient, we assessed the four major fungal diseases on Arabica coffee (Coffea arabica) at 60 sites in southwestern Ethiopia along a gradient from only little managed wild coffee in the forest understory to intensively managed coffee plantations. We found that environmental and management factors related to disease incidence and severity differed strongly among the four fungal diseases. Coffee leaf rust (Hemileia vastatrix) and Armillaria root rot (Armillaria mellea) were more severe in intensively managed sites, whereas coffee berry disease (Colletotrichum kahawae) and wilt disease (Gibberella xylarioides) were more severe in less managed sites. Among sites, incidence and severity of the four fungal diseases poorly correlated with each other. Within sites, however, shrubs that were severely attacked by coffee leaf rust also had high levels of berry disease symptoms. A better understanding of disease dynamics is important for providing management recommendations that benefit smallholder farmers, but also to evaluate possibilities for maintaining biodiversity values in the landscape related to shade cover complexity and wild coffee genetic variation.
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| 7. |
- Nurihun, Biruk Ayalew, 1983-, et al.
(författare)
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Impact of climate and management on coffee berry disease and yield in coffee's native range
- 2024
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Ingår i: Basic and Applied Ecology. - 1439-1791 .- 1618-0089. ; 76, s. 25-34
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Tidskriftsartikel (refereegranskat)abstract
- Climate change might increase plant diseases, reduce crop yields and threaten the livelihoods of millions of smallholder farmers globally. It is thus important to understand the relationships between climate, disease levels and yield to improve management strategies for sustainable agroforestry in a changing climate. One of the major threats to coffee production in Africa is the coffee berry disease (Colletotrichum kahawae). To investigate the effects of climatic and management variables on coffee berry disease (CBD) incidence and yield, we recorded minimum and maximum temperature and relative humidity, as well as CBD and yield, along a broad environmental and management gradient in southwestern Ethiopia during two consecutive years. CBD was affected by several climatic and management variables. For example, CBD incidence increased with minimum temperature during the fruit expansion stage, and decreased with minimum temperature during the endosperm filling stage. CBD incidence was negatively affected by the proportion of resistant cultivars, whereas the coffee structure index (pruning) had no effect on disease incidence. Coffee yield decreased with increasing minimum temperature during the flowering period in 2018 and maximum temperature during the fruit developmental period in 2019. Coffee yield was negatively affected by canopy cover and positively affected by the coffee structure index in both years. Our findings highlight that CBD and yield were affected by different climatic and management variables. Yet, managing for low disease levels and high yield is practically difficult due to season -dependent effects of several climatic variables. One way to break the correlation of climatic variables between seasons might be to take advantage of differences among shade trees in the presence or timing of leaf drop. To reduce CBD incidence, using resistant cultivars is an effective strategy, but this might threaten the wild coffee genetic reservoir.
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| 8. |
- Nurihun, Biruk Ayalew, 1983-, et al.
(författare)
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Impact of climate on a host-hyperparasite interaction on Arabica coffee in its native range
- 2024
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Ingår i: Journal of Applied Ecology. - 0021-8901 .- 1365-2664. ; 61:3, s. 538-550
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Tidskriftsartikel (refereegranskat)abstract
- Natural enemies of plant pathogens might play an important role in controlling plant disease levels in natural and agricultural systems. Yet, plant pathogen–natural enemy interactions might be sensitive to climatic changes. Understanding the relationship between climate, plant pathogens and their natural enemies is thus important for developing climate-resilient, sustainable agriculture.To this aim, we recorded shade cover, daily minimum and maximum temperature, relative humidity, coffee leaf rust and its hyperparasite at 58 sites in southwestern Ethiopia during the dry and wet season for 2 years.Coffee leaf rust severity was positively related to the maximum temperature. Hyperparasite severity was higher when the minimum temperature was low (i.e. in places with cold night temperatures). While canopy cover did not have a direct effect on rust severity, it reduced rust severity indirectly by lowering the maximum temperature. Canopy cover had a direct positive effect on the hyperparasite severity during one surveying period.Synthesis and applications. Our findings highlight that coffee leaf rust and its hyperparasite are both affected by shade cover and temperature, but in different ways. On the one hand, these niche differences lead to the worrying prediction that levels of coffee leaf rust will increase, and its hyperparasite will decrease, with climate change. On the other hand, these niche differences between coffee leaf rust and its hyperparasite provide opportunities to develop strategies to manage the environment (such as shade cover and microclimate) in such a way that the rust is disfavoured and the hyperparasite is favoured.
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| 9. |
- Nurihun, Biruk Ayalew, et al.
(författare)
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The impact of shade tree species identity on coffee pests and diseases
- 2022
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Ingår i: Agriculture, Ecosystems & Environment. - : Elsevier BV. - 0167-8809 .- 1873-2305. ; 340
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Tidskriftsartikel (refereegranskat)abstract
- The multifunctional role of shade trees for conservation of biodiversity and ecosystem services in natural forests and agroforests is well documented, yet we lack insights into the impact of shade tree species identity on pest and disease dynamics on agroforestry crops such as coffee and cacao, and its implications for management. We conducted two surveys on the impact of shade tree species identity and canopy cover on pests, diseases and a fungal hyperparasite on Arabica coffee in southwestern Ethiopia, which is one of the areas of origin of Arabica coffee. One survey was in a commercial plantation, and the other along a management gradient from only little managed coffee growing in the natural forest to intensively managed commercial plantations. To link these findings to current shade tree selection criteria, we complemented these surveys by interviews with farmers and managers. Shade tree species identity left a weak imprint on insect pest levels, and insect pests levels differed strongly in the strength and direction of their response to canopy cover. In contrast to the insect pests, the incidence of coffee leaf rust and its hyperparasite, as well as coffee berry disease, differed among shade tree species, with particularly high levels of coffee leaf rust and the hyperparasite underneath the canopy of the shade trees Acacia abyssinica and Croton macrostachyus, and coffee berry disease underneath the canopy of Acacia abyssinica and Polyscias fulva. Smallholder farmers used many criteria for selecting shade trees, such as leaf traits and competition for soil moisture, but low priority is given to the effect of shade tree species identity on pests and diseases. Our findings help to understand spatial variation in pest and disease dynamics in natural forests and agroforests, and may inform the selection of shade tree species by coffee producers and thereby contribute to ecologically-informed pest and disease management. Importantly, our finding highlight the potential for using tree identity for the sustainable management of pests and diseases, with relevance for global agroforestry systems.
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| 10. |
- Nurihun, Biruk Ayalew, 1983-, et al.
(författare)
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Using local knowledge to reconstruct climate-mediated changes in disease dynamics and yield-A case study on Arabica coffee in its native range
- 2024
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Ingår i: Plants, People, Planet. - 2572-2611.
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Tidskriftsartikel (refereegranskat)abstract
- Societal Impact StatementAdapting agriculture to climate change requires an understanding of the long-term relationship between climate, disease dynamics, and yield. While some countries have monitored major crop diseases for decades or centuries, comparable data is scarce or non-existent for many countries that are most vulnerable to climate change. For this, a novel approach was developed to reconstruct climate-mediated changes in disease dynamics and yield. Here, a case study on Arabica coffee in its area of origin demonstrates how to combine local knowledge, climate data, and spatial field surveys to reconstruct disease and yield time series and to postulate and test hypotheses for climate-disease-yield relationships.Summary While some countries have monitored crop diseases for several decades or centuries, other countries have very limited historical time series. In such areas, we lack data on long-term patterns and drivers of disease dynamics, which is important for developing climate-resilient disease management strategies.We adopted a novel approach, combining local knowledge, climate data, and spatial field surveys to understand long-term climate-mediated changes in disease dynamics in coffee agroforestry systems. For this, we worked with 58 smallholder farmers in southwestern Ethiopia, the area of origin of Arabica coffee.The majority of farmers perceived an increase in coffee leaf rust and a decrease in coffee berry disease, whereas perceptions of changes in coffee wilt disease and Armillaria root rot were highly variable among farmers. Climate data supported farmers' understanding of the climatic drivers (increased temperature, less rainy days) of these changes. Temporal disease-climate relationships were matched by spatial disease-climate relationships, as expected with space-for-time substitution.Understanding long-term disease dynamics and yield is crucial to adapt disease management to climate change. Our study demonstrates how to combine local knowledge, climate data and spatial field surveys to reconstruct disease time series and postulate hypotheses for disease-climate relationships in areas where few long-term time series exist.
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