Authors:Mirgissa Kaba , Alemseged Abdissa , Nega Jibat , Kalkidan Solomon , Alemayehu Bekele Abstract: Consideration of community engagement to scientific inquiry is a relatively recent development. In scientific inquiry, there have been major shifts to make the development of science and knowledge building the collective responsibility of researchers, research participants and other stakeholders (1). In the past century, we witnessed the evolution of different epistemologies – positivist, neo-positivist, postmodernist and constructivist, in particular (2). More recently there are widespread calls to move from disciplinary to transdisciplinary research and guidance by One Health approach to benefit science, knowledge building and problem solving from multiple perspectives. PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Kassu Desta , Mistire Wolde , Gizachew Taddesse , Aster Tsegaye Abstract: Background: Since the emergence of COVID-19 (SARS-CoV-2) in China, in December 2019, the pandemic has continued to be a major public health threat. According to the World Health Organization, on March 02, 2021, there were113,989,973 confirmed cases of COVID-19 globally, and 2,531,542 reported deaths. In Ethiopia on the same period, there were159,072 confirmed cases and 2,365 reported deaths. Efforts have been made in Ethiopia to make COVID-19 Biochemical and immuno-hematological tests available; however, the role of private diagnostic laboratories with this perspective has not been assessed. This study aims to address the role of private diagnostic laboratories as service providers of various laboratory tests that can help with the management of COVID-19 patients. Materials and methods: A cross-sectional survey was carried out with seven standalone laboratories in Addis Ababa. A questionnaire and observation checklists – adopted from the World Health Organization, were used to prepare a structured questionnaire and on-site evaluations of the availability of biochemical and immuno-hematological tests in the city. The data collection tool also assessed whether the diagnostic laboratories had back-up instruments for common biochemical and immuno-hematological tests. The data entry and analysis were conducted using SPSS software version 20. Results: Among the 7 private diagnostic laboratories participated in this study majority of them have professionals who are males (N=20/33, 60.6%). Most of the laboratory professionals in the private laboratories had Bachelor of Science degrees in medical laboratory sciences (15/33, 45.5%). Almost all of them provide organ function tests including liver and renal functions. However, some important tests like D-dimer were not available. All the laboratories claimed that they had adequate stock for conducting hematological tests, although none had GeneXpert® MTB/RIF assays for detection Mycobacterium tuberculosis and testing for rifampin resistance. Conclusions: Private diagnostic laboratories that offer clients most clinical chemistry, hematological and immuno-hematological tests are to be welcomed, particularly during the COVID-19 pandemic, when public health diagnostic laboratories could be overburdened, and the stock of reagents might be low or unavailable. There should be a means to strengthen public-private partnerships and both patients and clinicians could benefit a lot by availing diagnostics as needed. Further detailed study is required to understand the role of private diagnostic laboratories during outbreaks and pandemics situation. [Ethiop. J. Health Dev. 2021; 35(1):3-8] Key words: Private laboratory, biochemical tests, hematological tests, COVID-19 PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Bekele Belayihun , Mengistu Asnake , Yeowndwossen Tilahun , Habtamu Zerihun, Adeba Tasissa, Zerihun Tilahun, Fisseha Moges , Atsede Taddelle, Wondimagegnehu Workneh Abstract: Background: Maternity waiting homes within primary health care facilities are ideal platforms to reach women with family planning education and counselling. Maternity waiting home users interact with health care providers on a regular basis throughout their waiting period and can prepare to initiate the family planning method of their choice immediately after childbirth. To date, there has been no clear evidence about the use of maternity waiting homes to increase the uptake of immediate postpartum family planning. The aim of this study is to assess the contribution of maternity waiting homes to increase the uptake of immediate postpartum family planning among women who deliver in primary health care facilities in Ethiopia. Methods: A comparative cross-sectional study design was conducted to collect quantitative data from women who gave birth within 12 months prior to the study. Multi-stage random sampling procedures were employed to select 884 women. Descriptive summaries and logistic regressions with 95% confidence intervals were conducted using Stata version14 to analyze the data. Results: The prevalence of immediate postpartum family planning use among women who used maternity waiting homes was 44%, while among those who did not use maternity waiting homes it was 36%. The use of maternity waiting homes significantly contributed to an increase in the immediate uptake of postpartum family planning (OR = 0.69, 95% CI = 0.51-0.95, p<0.022). Conclusions and recommendations: This study showed that maternity waiting homes significantly contributed to improved uptake of immediate postpartum family planning within 10 minute or 48 hours after delivery. Developing a comprehensive package of maternal care services in maternity waiting homes has the potential to improve the uptake of family planning among postpartum women. [Ethiop. J. Health Dev. 2021; 35(1):9-17] Key words: Ethiopia, family planning, immediate postpartum, maternity waiting home, primary health care facilities PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Yohannes Zenebe , Tazeb Molla, Laway Beza , Daniel Mekonnen Abstract: Background: Neonatal sepsis is a life-threatening medical condition that occurs when host and pathogen interaction leads to organ/tissue damage. Determining the bacterial profile and the antimicrobial susceptibility pattern, and associated factors, in certain geographic regions is vital for rapid empirical medical decisions. Objective: To assess the bacterial profile, antimicrobial susceptibility pattern, and factors associated with neonatal sepsis, in Felege-Hiwot Referral Hospital, Ethiopia. Methods: A facility-based cross-sectional study was conducted from April 2018 to July 2018. A total of 412 neonates were included in the study. Socio-demographic and clinical data were collected using a structured and pre-tested questionnaire. About 2ml of blood sample was withdrawn from each participant, and processed for bacterial identification and susceptibility testing, following 2017 Clinical and Laboratory Standards Institute guidelines. Data were analysed using Statistical Package for the Social Sciences version 23. Logistic regressions were used to determine the association between independent variables and dependent variables in relation to bacterial profiles and antimicrobial susceptibility patterns. Odds ratios, and their 95% confidence intervals, were calculated, and the results were considered statistically significant at a p-value less than 0.05. Results: Of the 412 neonates who were enrolled, 41.3% (170/412) were positive for blood culture. Klebsiella pneumoniae, 28.2% (48/170) was the predominant isolate, followed by Staphylococcus aureus, 24.7% (42/170). The majority of the isolates developed resistance to ampicillin and penicillin. The overall proportion of multidrug resistance was 78.2% (133/170). Preterm (<37 weeks) [AOR = 2.049; 95% CI: 1.151, 3.647], low birth weight (<2,500gm) [AOR = 2.357; 95% CI: 1.352, 4.109], prolonged rupture of membrane (≥18 hours) [AOR = 4.282; 95% CIL: 1.615, 11.354], and caesarean section modes of delivery [AOR = 2.826; 95% CI: 1.618, 4.936] showed statistical association with bacteriologically confirmed neonatal sepsis. Conclusions: The majority (78.2%) of presumptive neonatal sepsis cases tested positive for blood culture. Klebsiella pneumoniae and Staphylococcus aureus were the leading isolates recovered from neonatal sepsis cases. Most of the bacterial isolates from NS cases were resistant to multiple classes of antibiotic. Auspiciously, majority of these isolates were susceptible to ciprofloxacin; as such this replication inhibitor antibiotic could be a choice of physicians for empirical treatment decision. Since it is a single facility based study, further study is recommended. [Ethiop. J. Health Dev. 2021; 35(1):18-28] Key words: Bacteria; neonate; early-onset neonatal sepsis; late-onset neonatal sepsis PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Mesfin Haile kahissay , Solomon Ahmed Mohammed, Birhanu Demeke Workneh Abstract: Background: As the means of storing and transporting vaccines while maintaining their potency, cold chain storage is the most critical element of immunization. This study explores factors that contribute to vaccine wastage in public health facilities in Oromia Special Zone, Ethiopia, and focuses on how this knowledge can empower public health governors’ efforts in relation to effective vaccine cold chain management. Methods: A phenomenological study design was employed with key informants (n=13). Data-driven coding was used and content analysis was performed using NVivo 11 plus. A narrative strategy was also employed. Results: The present study identified a range of factors that contribute to vaccine wastage related to logistics, immunization practices, vial size, health professionals, and institutions. The presence of one these factors may trigger the appearance of another. The identified factors should be considered as complementary, and the notable consensus among key informants made the results generic and relevant to vaccination service around the world. Conclusions: Various factors contribute to vaccine wastage. The contributing factors for vaccine wastage identified in this study should be considered by health professionals and public health governors when drafting and implementing intervention strategies for improving vaccine cold chain management for similar health facilities operating around the world. [Ethiop. J. Health Dev. 2021; 35(1):29-37] Key words: Vaccine wastage, contributing factors, cold chain management. PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Zewdie Birhanu , Argaw Ambelu , Abraraw Tesfaye , Negalign Berhanu, Wondwossen Kassahun, Teferi Daba , Kifle Woldemichael Abstract: Background: Food security is a central component of the development agenda in pastoralist communities, especially among those who reside in drought-prone areas. Objective: This study measured the prevalence of household food insecurity and associated factors among pastoralist communities of Borana, Ethiopia. Methods and materials: A community-based cross-sectional study was conducted between July and August 2015 in two pastoralist communities in Borana Zone, Oromia, Ethiopia. Data were collected from 1,058 randomly sampled households through an interviewer-administered structured questionnaire. The data were analysed using SPSS version 21.0. Results: The mean household food insecurity score was 18.21 (value range: 0.00-27.00). Overall, 82.33% of the households were severely food insecure, with 14.56% moderately food insecure. Ownership of private farming land, reliance on crop farming as the main economic activity (β=1.47, p=0.016), and one-way walk time to water sources (β=0.01, p=0.001) were significantly associated with household food insecurity (p<0.05). Likewise, increased family size (β=0.49, p=0.001) and lack of education (β=1.41, p=0.025) were significantly associated with food insecurity. In contrast, dependence on small business (petty trade and shop) as the main economic activity (β=5.14, p=0.001); ownership of milking cow (β=-0.25, p=0.001), bull/heifer (β=-0.16, p=0.002), goat (β=-0.14, p=0.001) or pullet (β=-1.17, p=0.001); ownership of various assets, such as forage (β=-2.50, p=0.009); and participation in village-level saving schemes (β=-1.41, p=0.044) were all significantly associated with reduced household food insecurity. Conclusions: Household food insecurity was widespread in the pastoralist communities of Borana, Ethiopia, affecting a high number of households in all domains: food anxiety, food quality, and quantity of food at the household level. As there were factors that were linked to food insecurity in the study pastoralists, evidence-based innovative interventions via a combination of measures in a medium-to-long-term development plan are vital for sustained household food security. [Ethiop. J. Health Dev. 2021; 35(1):38-49] Keywords: Pastoralist, resilience, food resiliency, food insecurity, Borana, Ethiopia PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Beyene Dobo , Aberash Fekadu, Melese Birmeka Abstract: Background: Malaria infections in Ethiopia are a significant health problem that varies across regions. Malaria’s public health and socio-economic impact is huge and contributes significantly to the country’s poverty and underdevelopment. The aim of this study was to determine the five-year trend of malaria (2012-2016), and to assess the prevalence and associated risk factors of malaria infection among patients visiting Goljota Health Center from September to December 2017. Methods: The present study is a retrospective and an institution-based cross-sectional study on the prevalence of malaria. For the cross-sectional study, blood samples collected from 422 patients were processed using thin and thick blood film methods. Also, five years of retrospective data were collected to determine the trend of malaria prevalence. Socio-demographic factors were assessed and logistic regression analyses were employed to determine the independent risk factors for malaria infection. Results: The prevalence of malaria was 14.8% in 2012, 21.4% in 2013, 14.2% in 2014, 12.9% in 2015 and 13.2% in 2016. The majority of malaria positives were male, with Plasmodium vivax accounting for most infections. The highest number of infections were in the ≤10-year-old age group. The overall prevalence of malaria infection in the cross-sectional study was 13% in Heben Arsi Woreda (District). Being male (AOR 1.5, 95% CI: 1.06-2.2, p<0.02), using bed nets when sleeping (AOR 0.36, 95% CI: 0.22-0.60, p<0.01), implementing indoor residual spraying in the past five months (AOR 0.06, 95% CI: 0.03-0.10, p<0.01), home not close to breeding site (AOR 0.54, 95% CI: 0.29-0.98, p<0.04), and the absence of an opening/hole in an external house wall (AOR 0.49, 95% CI: 0.27-0.92, p=0.026) showed a negative significant association with malaria infection. So, these factors are protective in relation to malaria infection. Using thatched roof material (AOR 1.64, 95% CI: 1.0-2.7, p<0.02) and having an income of <500 Ethiopian birr per month (AOR 3.1, 95% CI: 1.24-7.9, p=0.02) had a positive significant association with malaria infection. Conclusions: A strong relationship exists between malaria infection and socio-demographic risk factors. There was a decreasing malaria trend from 2013 to 2015, followed by a small increase in 2016. To further decrease the prevalence rate, intervention strategies should be designed and implemented to address current and local malaria-associated health problems that could help to reduce the problem of malaria among the population in the study area. [Ethiop. J. Health Dev. 2021; 35(1):50-57] Key words: Malaria, health, risk factors, prevalence, south central Ethiopia PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Mukanda Gedeon Kadima , Manimbulu Nlooto Abstract: Background: Antimicrobial resistance in South Africa is driven by many factors, such as the careless use of prescribed antimicrobial medicines and the use of traditional medicines, with the result that there is always the danger of misadministration, interaction, and toxicity. This study was conducted in two different public healthcare facilities in iLembe District, KwaZulu-Natal Province, South Africa to determine whether any interaction occurred among patients attending outpatient departments in selected healthcare facilities in terms of the concurrent use of traditional medicines and prescribed antimicrobial medicines. Methods: This study was a cross-sectional descriptive study using medical chart reviews. Antimicrobials prescribed alone or in association with traditional medicines were assessed and reported using descriptive statistics. Where applicable, associations were carried out; a p-value ˂0.05 was estimated as statistically significant. Results: A total of 400 outpatients’ medical records were documented from two different municipalities, revealing that many participants had viral infections (194/400, 48.5%). Overall, 12% of participants (48/400) had documented adverse effects (30/48) and interactions (18/48). A few participants (15/400) used traditional medicines in conjunction with prescribed medicines. After adjustment, negative clinical outcomes namely adverse effects and interactions were significantly more likely due to the use of traditional medicines (AOR=0.01, 95% CI:0.001-0.05) and (AOR=0.21, 95% CI: 0.37-1.23), respectively. Conclusions: Traditional medicine was used sparingly in conjunction with prescribed antimicrobials for infectious diseases. However, adverse effects and interactions, such as herbal intoxication, persistent rashes, and treatment failure, were documented in a few medical records. Further studies are needed to investigate the effects of the concurrent use of traditional medicine with antimicrobials or other prescribed medicines from the perspectives of traditional healers and biomedically healthcare professionals. [Ethiop. J. Health Dev. 2021; 35(1):58-71] Key words: Concomitant use, prescribed antimicrobials, traditional medicine, antimicrobial resistance, treatment failure, adverse effects PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
Authors:Xi Jia-xi , Zhang Hua-jun, Chen Xiao-yu, Ye Dong-mei, Lan Bi-quan, Chen Ying, Su Heng-hai Abstract: Background: Worldwide, non-small cell lung cancers have the highest incidence and mortality rates of all cancers. Gemcitabine (2’,2’-difluoro-2’-deoxycytidine or dFdC, C9H11F2N304) is widely used as the first-line chemo-reagent for lung cancer patients whose tumors have been diagnosed to be at an advanced stage and are therefore unresectable. Objective: The objective of this systematic study was to establish the correlation between the plasma concentration of gemcitabine and short-term clinical efficacy and adverse reactions in patients with advanced squamous cell carcinoma of the lung using liquid chromatography-mass spectrometry. Material and methods: In total, 53 patients were given the chemotherapy medications, gemcitabine and cisplatin, every 3 weeks. Plasma concentrations of gemcitabine were determined using liquid chromatography-mass spectrometry. A modified methodology of the liquid chromatography-mass spectrometry system was verified and performed to detect plasma concentrations of gemcitabine. The clinical endpoints – short-term clinical efficacy and adverse reactions – were evaluated after two cycles. Results: The plasma concentration range of gemcitabine in 53 patients was 1.58-28.70μg/ml (mean 14.37±8.63μg/ml), with 28 patients in the >15μg/ml group (mean 21.76±3.45μg/ml), and 25 patients in the ≤15μg/ml group (mean 6.09±3.57μg/ml). The clinical benefit rate (CBR) of the >15μg/ml group was significantly higher than that of the 15μg/ml group (p<0.05). The incidences of leukopenia and neutropenia, thrombocytopenia and grade III-IV gastrointestinal reactions in the >15μg/ml group were significantly higher than in the ≤15μg/ml group (p<0.05). There was no statistical difference between the two groups in terms of the incidences of reduced hemoglobin, liver and kidney function damage, allergic reaction and rash (p>0.05). The analysis of the plasma concentration of gemcitabine and the percentage of reduction in neutrophil count (NEUT) (r2 = 0.3212; p<0.05) and platelet (PLT) (r2 = 0.6439; p<0.05) showed a significant positive correlation. Conclusions: In patients with advanced non-small cell lung cancer, a high plasma concentration of gemcitabine can improve the short-term clinical efficacy of treatment, but increase the incidence of grade III-IV adverse reactions. [Ethiop. J. Health Dev. 2021; 35(1):72-82] Key words: Non-small cell lung cancer, gemcitabine, plasma concentration, short-term efficacy, adverse reactions PubDate: 2021-03-04 Issue No:Vol. 35, No. 1 (2021)
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