Authors:Desie Kasew, Ashenafi Abebe, Ufaysa Munea, Tekalign Deressa, Yalewayker Tegegne, Martha Alemayehu, Mulugeta Melku Abstract: Background: Helicobacter pylori (H.pylori) infection is predominantly acquired in childhood from family members. The infection can cause dypepepsia, chronic and acute gastritis and gastric cancer. Dyspepsia is the most common illness in the Ethiopian population visiting outpatient department of health facilities, and it has also been associated with H.pylori infection. The aim of this study was to assess the magnitude of H.pylori and its associated factors among dyspeptic patients who visited University of Gondar Hospital Outpatient Department. Materials and Methods: An institutional-based cross-sectional study was conducted on 354 dyspeptic patients. A systematic random sampling technique was employed to select study participants. Data were collected by using structured questionnaire via face-to-face interview. H.pylori infection was diagnosed using stool antigen test method. The data were entered into Epi info version 3.5.3 and transferred to Statistical Package for Social Sciences version 20. Both Bivariable and multivariable binary logistic regression analyses were performed to see the effect of independent variables on the dependent variable. Result: Of the total study participants, 201(56.8%), 195(55.1%) and 182(51.4%) were married, urban residents and females, respectively. The overall magnitude of H.pylori infection was 37.6%. In bivariable logistic regression analysis, sex and marital status were significantly associated with H.pylori infection, but in multivariable logistic regression analysis only marital status was significantly associated with H.pylori infection. Conclusion: The magnitude of H.pylori infection is high indicating that it is a public health problem in the study to area. According to this study, none of the variables were significantly associated with H.pylori infection. Hence, effective preventive, control and screening strategies need to be designed to reduce the burden of the disease. Keywords: Associated factor, Dyspepsia, Helicobacter pylori PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Birkneh Tilahun Tadesse, Byron Alexander Foster, Mulugeta Sitot Shibeshi, Henok Tadele Dangiso Abstract: Background: Bacterial meningitis is a significant cause of morbidity and mortality in the developing world. However, limited research has focused on the diagnosis and management of meningitis in resource-limited settings. Methods: We designed a prospective case series of children admitted to a large, academic referral hospital with acute meningitis syndrome. Data were collected on age, time of presentation, prior antibiotics, cerebrospinal fluid (CSF) parameters, antibiotic and steroid prescription, and clinical outcome. Results: Data on 99 patients were collected and analyzed. Most of the patients were males, n=69 (70%), and were from a rural area, n=83 (84%). Incomplete vaccination was common, n=36 (36%) and many have evidence of malnutrition, n=25 (38%). Most patients, n=64 (72%), had received antibiotics prior to admission with a mean duration of symptoms of 4.9 days prior to admission. The CSF white blood cell (WBC) count was higher in those who had not received prior antibiotics though it was elevated in both groups. The CSF WBC count was not associated with survival; malnutrition and length of symptoms prior to admission were both associated with decreased survival. Conclusions: While use of antibiotics prior to obtaining CSF in patients with acute meningitis syndrome may decrease their CSF WBC count, it is not clinically significant. Many patients had a significant delay in presentation that had an effect on survival, This is a potentially modifiable risk factor despite the resource-limited setting. Keywords: bacterial meningitis, children, antibiotics, glucocorticoids PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Rozina Ambachew Geremew, Beyene Moges Agizie, Abate Assefa Bashaw, Mengistu Endris Seid, Addisu Gize Yeshanew Abstract: Background: Sexually transmitted infection (STI) is a major global cause of acute illness, infertility, long-term disability and death, with serious medical and psychological consequences to millions of men, women and infants. Moreover, in Ethiopia, epidemiological studies on STI among STI clinic clients are limited. Therefore, the aim of this study was to determine the prevalence and associated risk factors of sexually transmitted infection (STI). Methods: A cross sectional study was conducted between April and August 2014 among STI clinic clients in Gondar Town hospitals and health centers. One hundred twenty study participants who fulfill the criteria were included. Different laboratory methods and techniques were applied to identify the possible microorganisms. Data were entered and analyzed using SPSS version 20. Logistic regression was used to determine risk factors for STI and P values < 0.05 was considered statistically significant. Results: The overall laboratory test confirmed that STIs prevalence was 74.1% with 32.5% being Candida spp., 30% T. palladium, 20.8% N. gonorrhoeae and 14.2% T. vaginalis. Two or more organisms were isolated in 20% of the study subjects. Risk factors for STI had knowledge about STI and alcohol consumption. Conclusion: The prevalence of N. gonorrhoeae, T. pallidum, T. vaginalis, and Candida spp. in the study area was high. It needs health education programs, promotes condom utilization and more comprehensive community based STI studies.Keywrds: STI, Candida spp., N. gonorrhoeae, T. pallidum, T. vaginalis PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Tsegaye Tewelde Gebrehiwot, Fessahaye Alemseged Tesfamichael Abstract: Background: Window opening during bus transportation is recommended as a tuberculosis prevention strategy.Yet, drivers are affected by lack knowledge and risk perception of passengers and assistants. Boosting knowledge of and notifying the high risk of tuberculosis transmission for every passenger could be too costly. However, strategies targeting bus drivers as key agents unlike targeting all passengers might be less costly for window opening. Method: Data were collected from November 18/2014 to December 21/2014 in inter-region bus stations of Addis Ababa using cross sectional study design. Samples of 306 participants were selected using simple random sampling, and data were collected through face-to-face interview. Data were entered into Epi-data version 3.1 andanalyzed using IBM SPSS version 21. Result: From a sample of 306 bus drivers, 303 were interviewed. Nine in ten and nearly half of participants believed in the need for opening all windows and avoiding overcrowding of passengers as TB preventive measures respectively. Few bus drivers (7.3%) believed that bus drivers and their assistants could be at risk of tuberculosis. The majority (85.7%) of bus drivers opened side window the whole day without precondition. Hearing tuberculosis related information from radio was a promoting factor for tuberculosis preventive measures among bus drivers. Conclusion: Tuberculosis preventive practices and knowledge of bus drivers seempositive (opportunities), despite their low risk perception (challenge). Using the opportunity, further empowering bus drivers to persuade passengers and assistants to open all the rest of the windows is needed. Keywords: Tuberculosis, Knowledge, prevention practices, bus drivers, Ethiopia PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:James Ogunmodede, Philip Kolo, Ibraheem Katibi, Ayodele Omotoso Abstract: Background: HAART has improved survival of HIV patients. Its contribution to the development of new cardiovascular abnormalities has generated much interest. This study aimed at determining the prevalence of QTc prolongation among HIV patients and determining the influence if any of the use of HAART on the QTc and on the risk of having QTc prolongation.Materials and Methods: One hundred and fifty HIV positive subjects comprising 76 HIV positive subjects on HAART (Group A), 74 who were HAART- naïve (Group B), and 150 age and sex-matched healthy controls (Group C) were studied. All subjects had electrocardiography, and QTc duration was calculated.Results: Mean QTc was significantly different among the three groups (P <0.001), highest in Group B > Group A > Group C. Frequency of QTc prolongation was highest in Group B (32%)>, Group A (17.3%)> Group C (4.7%) (P<0.001). Mean QTc was significantly longer among patients with CD4 count <200 cells/mm3 than among those with >200 cells/mm3 0.445 + 0.03secs vs 0.421 + 0.03secs (P<0.001). QTc prolongation was commoner among individuals with CD4 count <200 cells/mm3 50% vs 20.5% (P<0.001). On binary logistic regression, none of the HAART medications used by our patients was predictive of the occurrence of QTc prolongation.Conclusion: The QTc is longer, and QTc prolongation occurs more frequently in HAART-naïve HIV patients than patients on HAART and healthy controls. None of the HAART medications used by our patients was predictive of the development of QTc prolongation. Keywords: QTc prolongation, HIV/AIDS, Highly Active Anti-Retroviral Therapy (HAART) PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Clarence S. Yah Abstract: Background: Despite the shift in antiretroviral therapy (ARVs) eligibility cascade from CD4 ≤ 200 to CD4 ≤ 350 to CD4 ≤ 500 mm3, HIV related morbidity and mortality continue to escalate annually, as do HIV infections. The new paradigm of treatment for all HIV positives individual irrespective of CD4 count may significantly reduce HIV and related illnesses. The author assumes that all HIV infected partners should be eligible for HIV treatment and care, irrespective of CD4 count. A second assumption is that high risk HIV negative partners have free access to continuum of HIV pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PEP) and other prevention packages. Methods: A literature review search was used to extract evidence-based ARVs-HIV treatment and prevention interventions among HIV positives and high risk partners respectively. Only articles published in English and indexed in journal nuclei were used for the study. The information was used to nurture understanding of HIV treatment and prevention approaches as well as HIV incidence multiplier effect among HIV serodiscordant partners. The imputed HIV incident reference was assumed at 1.2 per 100 person-years (2). This was based on the imputation that retention in care, adherence and other predetermined factors are functions of an effective health care delivery system. Result: The model showed a reduced HIV transmission from 1.2 per 100 person-years to 1.032 per 100 person-years in 6 months. The average threshold period of HIV suppressed partners on ARVs to an undetectable level. The combined multiplier protective-effect probability of transmitting HIV from HIV positive partners on ARVs-suppressed viremic load to HIV negative partners on PrEP/PEP-prevention was detected at 86% Conclusion: The model showed a significant reduction in HIV incidence. Placing serodiscordant sexual partners in HIV treatment and prevention plays a significant role in reducing and controlling HIV infection. Therefore, the policy of enrolling all HIV positives irrespective of CD4 count on ARVs and high risk partners on prevention if adopted and sustained may underpin reduction and control of HIV genotype and HIV related morbidity, mortality and opportunistic infections. Keywords: HIV, test and treat, linkage to care, prevention, incidence PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Binalfew Tsehay, Mekbeb Afework, Metasebia Mesifin Abstract: Background: Greulich and Pyle standards are the most widely used age estimation standards all over the world. The applicability of the Greulich and Pyle standards to populations which differ from their reference population is often questioned. This study aimed to assess the reliability of Greulich and Pyle (GP) method for determination of age of children at Debre Markos Referral Hospital, East Gojjam Zone, Ethiopia. Subjects and Methods: Hospital based cross sectional study design was applied to children who came to Debre Markos Referral Hospital from May to October 2015 and fulfilled the inclusion criteria of the study. The data was analyzed using SPSS version 20 and medcalc version 15 softwares. Significance was set at α = 0.05. Results: A total of 108 radiographs were analyzed. Chronological age in most of the children was under estimated. The mean under-estimation was 11.8 months in the female sample and 8.7 months in the male sample. Greulich and Pyle method became inapplicable for the sample at 16 years for females and 16.5 years for males and later. Delay in skeletal maturation was observed in both sexes, but the females in the sample matured earlier than the males. Conclusion: The findings of this study suggest against the applicability of GP atlas which were not directly applicable to an East Gojjam Zone population. Large scale studies should be planned and nationwide guideline, and atlas which can easily be used throughout the country should be developed. Keywords: Chronological age, bone age, Greulich and Pyle PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Addisu Gize Yeshanew, Yeshwondm Mamuye GebreSilasie, Hirut Tadesse Mengesha Abstract: Background: Normal pregnancy is characterized by profound changes in almost every organ and system. Immunohematological parameters are important in clinical practice for the assessment of health and disease. Therefore, this study was aimed to establish immunohematological reference range among HIV sero-negative pregnant women. Methods: A cross-sectional study was conducted among HIV sero-negative pregnant women at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, from 20/1-30/6/ 2016. Whole blood was collected and immunological and hematological parameters were measured following the standard procedure. Data were entered in to Epi Info version 3.5, checked for completeness and exported to SPSS version 20 software for analysis. The mean ± SD and 95% Confidence Interval (95% CI) values were calculated for different immunohematological parameters. Results: A total of 400 women with mean age ±SD (27.3 ±4.7) ranging from18-40 years were enrolled. The mean ± SD reference value of white blood cells count with 95% CI was 8.3 ±2.3 (8.1-8.6) x109 cells/L and for CD4+, CD8+, and CD4to CD8 ratio cells absolute count with 95% CI were 906 ±404 (867-946), 698± 378 (662-736) cell/μl, and 1.5±0.9 (1.4-1.6), respectively. The mean ± SD reference values for red blood cells count with 95% CI was 4.5±0.5(4.4-4.5) 1012/L, for hemoglobin 14±7.2(13.3-14.7) gm/dl, and for hematocrite was 39.5± 4(39-39.9). Conclusions: These values were lower than the one from developed countries but not lower than the one from other African studies. It suggests the need for further large study. Keywords: Immunohematological References, Pregnant Women, Reference Values PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Ali Janati, Mohamad Ali Sarabchian, Bahram Mohaghegh, Naser Aghmohamadzadeh, Hesam Seyedin, Masumeh Gholizadeh, Edris Hasanpoor Abstract: Background: Type 2 Diabetes is a main concern of public health in contemporary world with remarkable mortality, delayed complications and health costs. Governments are obliged to improve the quality of health care and consider appropriate strategies to reduce the costs. An alternative strategy for hospital services is care at home. Therefore, this study was aimed to evaluate the cost-effectiveness of home-based and hospital-based diabetes care. Methods: A quasi-experimental, pre-test and post-test design was conducted in Northwest Iran. Sixty subjects who were eligible insulin-treatment type 2 diabetes mellitus were randomly assigned into two equal groups to receive home-based or conventional hospital-based care. Data on glycosylated hemoglobin (HbA1c), hypoglycemia episodes, time needed to achieve glycemic control level, diabetes treatment satisfaction, diabetes knowledge and costs during three months were collected. Results: The cost of home-based care in insulin therapy diabetes was 61% less compared with the hospital-based methods. The former strategy was cost-effective in terms of reduction in HbA1C and the time needed to achieve glycemic control. The patients in home care group were more satisfied and knowledgeable. Conclusions: The care at home approach for type 2 diabetic patients can be introduced and supported as a cost-effective care method in the country. Keywords: Cost-effectiveness, type 2 diabetes, insulin therapy, home care, hospital care PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Ali Janati, Edris Hasanpoor, Sakineh Hajebrahimi, Homayoun Sadeghi-Bazargani Abstract: Background: Evidence-based management (EBMgt) has been developed as a management framework for improving the quality of management decisions. To use that, we need to identify the source of evidence in decision-making. Therefore, the purpose of this study was to identify the sources of evidence in managing hospitals. Methods: Qualitative methods were used to explore the sources of evidence and to identify hospital managers’ attitudes towards evidence-based management. A series of semi-structured interviews (n=48), with a purposive sample of 48 participants, were conducted in 2016. Also, four focus group discussions (FGDs) were conducted with health managers and specialists in the field of management. A questionnaire was used for collection of demographic characteristics and managers’ perspectives. Results: Six main themes emerged from the interviews including: scientific and research evidence, facts and information of hospital, political-social development plans, managers’ professional expertise and ethical-moral evidence. Also, the results showed that the majority of participants believed to use the evidence-based hospital management (95.83%). Conclusions: Our study suggested that a full evidence-based hospital manager someone who is using all the sources of evidence for making hospital decisions. Using hexagon of evidence sources, managers can identify the best available evidence for hospital decisions and to make the best decision in the process of evidence-based decision making. Keywords: Evidence-based management, management decisions, hospital managers, health sector
Authors:Akinlolu G. Omisore, Grace M. Babarinde, Damilola P. Bakare, Esther O. Asekun-Olarinmoye Abstract: Background: The Sustainable Development Goals (SDGs) is a globally accepted developmental agenda, and it is expected that everyone everywhere in the world would be aware, knowledgeable and be willing to contribute to its attainment. This study aims to assess the level of awareness, knowledge of, and attitudes towards the SDGs among members of a university community. Methods: A cross-sectional survey was conducted on 450 students and staff of Osun State University, Southwestern Nigeria, selected from three of its six multi-campuses via multi-stage sampling. Data were collected by means of semi-structured questionnaire. Data were analysed using SPSS version 20.0. Results: The mean age for the respondents was 26(10.2) years. Only 43% of the respondents were aware of the SDGs and only 4.2% had good knowledge of the SDGs. However, 56.3% had positive attitude towards it. More respondents with good knowledge of the SDGs were either acadenic staff or those have been enlightened via personal study of the SDGs or through other means. Similarly having a positive attitude was associated with being an academic staff/ high level of education as well as belonging to the middle age group. (p<0.05). Conclusion: The awareness of and attitudes towards the SDGs was just fair. However, the level of knowledge was abysmally low, and this has serious negative implications for SDGs attainment. Pertinent individual and population-level methods of enlightening people about the SDGs must be put in place in educational settings; curricular changes are imperative. Keywords: Attitudes, Awareness, Knowledge, MDGs, SDGs, University PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
Authors:Tinsae Alemayehu, Wondwossen Ergete, Workeabeba Abebe Abstract: Background: Pediatric nervous system tuberculomas are usually infra-tentorial and multiple. A frontal lobe location is rare. Case Details: We report a 10 year-old boy who presented with a chronic headache and episodes of loss of consciousness. He had no signs of primary pulmonary tuberculosis and a diagnosis of frontal tuberculoma was made upon a post-operative biopsy. He improved following treatment with anti-tubercular drugs.Conclusion: Tuberculosis should be considered in children with a chronic headache or focal neurologic deficit and a supra-tentorial intracranial mass in endemic countries like Ethiopia.Keywords: Tuberculoma, Tuberculosis, Frontal lobe, Ethiopia PubDate: 2017-11-06 Issue No:Vol. 27, No. 6 (2017)
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