bluuebunny/crossref_metadata_2025 huggingface dataset:
Five-Year Trend Analysis of Malaria Cases in East Shawa Zone, Ethiopia
Authors: Temesgen File  , Bayissa Chala
Published: July 2024

BACKGROUND: Malaria is an infectious disease caused by Plasmodium parasites. Of the five human malaria parasites Plasmodium falciparum and Plasmodium vivax are the two coendemic predominant and widely distributed species in Ethiopia, with major public health importance. Even though enormous effort has been made countrywide to reduce the disease burden little was reported about trends of malaria transmission in the several localities of malarious areas like East Shawa Zone, Ethiopia. Thus, the present study was aimed at assessing fiveyear (2016-2020) trends of malaria transmission at Adama, Boset and Lume districts of East Shawa Zone of Oromia Regional State, Ethiopia.METHODS: Retrospective data was extracted from the central surveillance database of East Shawa Zone Health Office. The data collected was analyzed from September 2020 to December 2020 to examine trends of malaria epidemiology in three malarious districts in the Zone.RESULTS: The results of the present study showed a remarkable decrease in slide positivity rate (SPR) from 16.3 to 1.4% from 2016 to 2018 in the areas. However, a recent slight increase of malaria SPR was observed. On the other hand, as age increases more male individuals were infected with malaria compared tofemale of similar age groups. Falciparum, vivax and mixed malaria infection accounted for 53%, 41% and 6% respectively.CONCLUSIONS: Even though, an overall reduction of malaria incidence was revealed in the study areas, an increase in malaria SPR was observed in 2019 and 2020. Such inconsistency in reduction of malaria cases in the study area demands due attention of health planners.
Pneumatization Patterns of the Sphenoid Sinus in Adult Nigerians and Their Clinical Implications
Authors: Beryl S. Ominde  , Joyce Ikubor  , Patrick S. Igbigbi
Published: July 2024

BACKGROUND፡ The variant pneumatization patterns of the sphenoid sinus have significant surgical implications due to their associated inconsistent neurovascular relations. This study aimed at evaluating the pneumatization patterns of the sphenoid sinus in adult Nigerians.METHODS: This was a retrospective study conducted at the Radiology Department of a Tertiary Hospital in Nigeria after obtaining institutional ethical approval. Brain Computed Tomography images of 336 patients (137 females,199 males) aged ≥20 years were studied for the variant pneumatization patterns of the sphenoid sinus. Statistical Package for Social Sciences version 23 was used for data analysis. Chi-square test was used to assess for the association of the variants with gender and side. Pvalue was considered significant at <0.05.RESULTS: The predominant pneumatization pattern in relation to the seller turcica was the sellar type (181;53.9%) followed by the presellar type (65;19.3%), post-sellar (62;18.5%), and lastly the conchal type (28;8.3%). The most prevalent clival recess was the subdorsal type (25;7.4%) followed by the dorsal (18;5.4%), combined (7;2.1%), and lastly occipital (3;0.9%). The frequency of pneumatized anterior clinoid process, greater wing of sphenoid and pterygoid process was 76;22.6%, 60;17.9% and 141;42% respectively and these showed significant side difference (P=0.001 each). None of the pneumatization patterns showed a significant gender difference. Sphenoid sinus agenesis was not observed.CONCLUSION: The pneumatization patterns in our study varied from the findings in previous Nigerian studies and other populations. There is therefore the need for preoperative evaluation before endoscopic transsphenoidal surgical procedures.
Effect of COVID-19 on the Number of CT-scans and MRI Services of Public Hospitals in Iran: An Interrupted Time Series Analysis
Authors: Mohammad Heydarian  , Masoud Behzadifar  , Christos V. Chalitsios  , Mohammad Keshvari  , Roodabeh Omidifar  , Mahboubeh Khaton Ghanbari  , Hasan Abolghasem Gorji  , Jude Dzevela Kong  , Jianhong Wu  , Nicola Luigi Bragazzi
Published: July 2024

BACKGROUND፡ In February 2020, the Ministry of Health and Medical Education in Iran announced the first case of COVID-19. The aim of this study was to investigate the impact of COVID-19 on the number of CT-Scans and MRI services in public hospitals in western Iran.METHODS: We collected CT-scans and MRI services data from 18 public hospitals via Vice-Chancellor Office, Lorestan University of Medical Sciences from January 2017 to February 2021. Interrupted time series analysis (ITSA) was conducted to assess the impact of COVID-19 on CT-Scans and MRI services. More specifically, ITSA was conducted using ordinary least squares regression with the number of CT-Scans and MRI services per 1,000 registered persons per month as dependent variable.RESULTS: At the beginning of the observation period, the monthly rate of CT-Scans was constant (p for trend = 0.267) at 291.9 (from 95%CI 240.5 to 343.4) per 1,000 registered patients. The first case of COVID-19 coincided with an abrupt increase by 211.8 (from 95%CI 102.9 to 320.7) per 1,000 patients. Thereafter, the trend of CT-Scans did not change (p=0.576) compared to the pre-pandemic period. The rate of MRI services was 363.5 per 1,000 per registered patients per month (P = <0.0001) with a slightly decreasing trend (coefficient=-5; 95%CI, -6.9 to -3.1).CONCLUSION: The findings of this study showed that crises such as COVID-19 can affect the service delivery process. Health policymakers and decision makers should work to prevent potential reductions in health care during events such as COVID-19.
Perinatal Outcomes and Associated Factors among women with hypertensive Disorders of Pregnancy Delivered in Jimma Zone Hospitals, Southwest Ethiopia
Authors: Mesganew Amare  , Adugna Olani  , Habtamu Hassen  , Bikila Jiregna  , Nigusu Getachew  , Sena Belina
Published: July 2024

BACKGROUND፡ Hypertensive disorders of pregnancy are multisystem diseases that increase the risk of adverse perinatal outcomes worldwide. It Led to early and late serious health consequence on the baby, with a significant proportion occurring in low-income countries. Hence the objective of this study was to determine perinatal outcomes and associated factors among women with hypertensive disorders of pregnancy delivered in Jimma zone hospitals.METHOD: A Facility based cross-sectional study design was employed from March to May 2020 on 211 hypertensive women delivered in the four randomly selected hospitals. The data were collected by reviewing medical record and face to face interview using consecutive sampling technique. Binary and multivariable logistic regression was performed to identify association.RESULT: Ninety-one (43.1%) of fetuses developed unfavorable perinatal outcome. Inability to read and write (AOR=2.5; 95% CI:1.03-6.17), being primipara (AOR=4.6; 95% CI:1.6-13.2) and multi-para (AOR=3.1; 95% CI:1.09-9.17), Lack of antenatal care visit (AOR=4.2; 95% CI:1.2-15.01), having preeclampsia (AOR=4.2; 95% CI:1.1-16.6) and eclampsia (AOR=5.8; 95%CI:1.2-26.2) and late provision of drug (AOR=3.9;95% CI:1.9-7.9) were independent factors.CONCLUSION: Pregnancy complicated with hypertensive disorders was associated with increased unfavorable perinatal outcomes. Preeclampsia and eclampsia, inability to read and write, primipara and multipara, lack of antenatal care and late provision of drug were factors associated with unfavorabl perinatal outcomes.
Bacterial Uropathogens, Antimicrobial Susceptibility Profile and Associated Factors among Pediatric Patients in Bahir Dar, Northwest Ethiopia
Authors: Girma Zerefaw  , Senait Tadesse  , Awoke Derbie
Published: July 2024

BACKGROUND: Urinary tract infection (UTI) in the pediatric group may lead to end-stage renal dysfunction later in life. Tracking the type of the isolates and their antimicrobial resistance pattern would impact the management of UTI in these group. The aim of this study was to describe the distribution of bacterial uropathogenes, their antimicrobial susceptibility profile and factors associated with significant bacteriuria (SBU) among pediatric patients at selected facilities in Bahir Dar, Northwest Ethiopia.METHODS: A cross-sectional study was conducted from 1st February to 30th June 2020. About 5-10ml of urine samples were collected from pediatrics presumptive for UTI and a urine sample was considered positive for SBU if a single organism was grown at a concentration of >104cfu/ml. Antimicrobial sensitivity testing was performed using the Kirby-Bauer disc diffusion technique. Logistic regression was used to identify factors associated with SBU and statistical significance was set at p-value < 0.05.RESULTS: Of the total 299 study participants, the majority 173 (57.9%) were females. The mean age of the participants was 6.6 years. The proportion of significant bacteriuria was at 49(16.4%). Most, 37 (75.5%) of the isolates were Gram-negative. The most predominant isolate was E. coli, 21(42.9%) followed by P. aeruginosa, 6(12.2%) and coagulase negative staphylococci, 6(12.2%). The level of multi-drug resistance among Grampositive and Gram-negatives was at 50% and 78.4%, respectively. Participants’ sex, circumcision status, having a flank pain and being malnourished were statistically associated with significant bacteriuria.CONCLUSION: Actions to minimize antimicrobial resistance should be strengthened to reduce the impact of UTI among the pediatric group.
Addressing the Impact of Noncommunicable Diseases and Injuries (NCDIs) in Ethiopia: Findings and Recommendations from the Ethiopia NCDI Commission
Authors: Solomon Tessema Memirie  , Wubaye Walelgne Dagnaw  , Mahlet Kifle Habtemariam  , Alemayehu Bekele  , Dejuma Yadeta  , Amsalu Bekele  , Wondu Bekele  , Molla Gedefaw  , Mathewos Assefa  , Mieraf Taddese Tolla  , Awoke Misganaw  , Neil Gupta  , Gene Bukhman  , Ole F. Norheim
Published: July 2024

BACKGROUND: Noncommunicable diseases and injuries (NCDIs) are the leading causes of premature mortality globally. Ethiopia is experiencing a rapid increase in NCDI burden. The Ethiopia NCDI Commission aimed to determine the burden of NCDIs, prioritize health sector interventions for NCDIs and estimate the cost and available fiscal-space for NCDI interventions.METHODS: We retrieved data on NCDI disease burden and concomitant risk factors from the Global Burden of Disease (GBD) Study, complemented by systematic review of published literature from Ethiopia. Cost-effective interventions were identified through a structured priority-setting process and costed using the One Health tool. We conducted fiscal-space analysis to identify an affordable package of NCDI services in Ethiopia.RESULTS: We find that there is a large and diverse NCDI disease burden and their risk factors such as hypertension and diabetes (these conditions are NCDIs themselves and could be risk factors to other NCDIs), including less common but more severe NCDIs such as rheumatic heart disease and cancers in women. Mental, neurological, chronic respiratory and surgical conditions also contribute to a substantial proportion of NCDI disease burden in Ethiopia. Among an initial list of 235 interventions, the commission recommended 90 toppriority NCDI interventions (including essential surgery) for implementation. The additional annual cost for scaling up of these interventions was estimated at US$550m (about US$4.7 per capita).CONCLUSIONS: A targeted investment in cost-effective interventions could result in substantial reduction in premature mortality and may be within the projected fiscal space of Ethiopia. Innovative financing mechanisms, multi-sectoral governance, regional implementation, and an integrated service delivery approach mainly using primary health care are required to achieve these goals.
Knowledge, Perception and Preparedness Related to COVID-19 among Adult Rural Population in Konso, Southern Ethiopia
Authors: Girma Gilano  , Serawit Lakew  , Tadiwos Hailu  , Be’ement Tekabe  , Sewunet Sako  , Tesfaye Feleke
Published: July 2024

BACKGROUND: According to the world health organization, the COVID-19 outbreak has currently affected millions of people worldwide. Since the start of the pandemic in China, everything countries have thrown at the virus turned unsuccessful. As there is no established vaccine to halt the virus transmission, it might be very difficult for developing countries like Ethiopia even after vaccine development. Thus, focusing on improving knowledge, perception, and preparedness related to the virus might be very vital.METHODS: A community-based cross-sectional survey was conducted using the questionnaire applied in most countries which is suitable to apply in the Konso zone in South Nations Nationalities Region (SNNPR) from April.2020 to July 2020. Data were collected, cleaned, coded, checked, and entered into Epi Info and then exported and analyzed in STATA 15. We fitted a binary logistic regression model. Categorical variables were presented using figure tables, and proportion and for continuous variables, mean and standard deviation were used. The results were also presented using Adjusted Odds Ratio (AOR) with 95% CI.RESULTS: From 636 respondents expected, 615(97%) were participated and possessed the knowledge of 39%, and 64% perception and preparedness each. Measurements related to the policy and interventions like restrictions to movement, selfisolation, wearing a face mask, & the need for more tests was notsupported by most participants.CONCLUSION: The poor knowledge, perception, and preparedness were correlated with the unavailability of water and electricity, less education, and informal source of information which could be improved through area appropriate health education interventions.
A Case Report of Huge Lymphangioma over the Chest Wall: A Rare Presentation of a Newborn
Authors: Netsanet Workneh Gidi  , Basazin Tasew  , Gersam Abera
Published: July 2024

BACKGROUND፡ Lymphangioma is a rare benign tumor of lymphatic system that is often diagnosed in the first few years of life. The presentation and complications depend on the site and the size of the lesion.CLINICAL DESCRIPTION: This was a term male newborn weighing 3230g born to a 38 year old para IIV mother. Delivery was spontaneous and uneventful. The neonate was active, had no gross dysmorphic feature except the huge, 20cm by 28cm cystic, non-tender mass over the left lateral chest area. Diagnosis: Lymphangioma was diagnosed based on chest ultrasound, there was a large multiloculated cystic lesion over left lateral chest, and the cyst had no communication with spinal canal, and had no solid component. Therapy: The patient was observed for complications, otherwise not needing intervention in the first few days.OUTCOMES: He developed superinfection of the mass, for which intravenous antibiotics administered, infection was controlled and surgery was postponed until a few months. However, the patient was presented with severe malnutrition at the age of three months and subsequently lost to follow up.CONCLUSION: Huge lymphangiomas at neonatal age are likely to get superinfected; a close observation for signs of complications is needed. Though surgical intervention could be postponed until the baby grows to avoid the complications of surgery, adequate counseling is needed to reassure the parents about the benign and treatable nature of the disease. And individualized decision on earlier surgical intervention has to be considered with adequate postoperative care whenever follow up is not guaranteed.
Evaluation of Cheek Edema in an Infant Reveals Langerhans Cell Histiocytosis
Authors: Asimakis D. Asimakopoulos  , Eugene Panosetti  , Alexandra Papoudou-Bai  , Chrissa Sioka
Published: July 2024

BACKGRAOUND: Langerhans cell histiocytosis is a rare hematological disorder. Skin rash is the typical early feature, and bony involvement is the second most common presentation.METHODS: We present a case of a 5-month-old female infant with left hemifacial swelling, initially treated for infection with antibiotics. However, due to persistence of swelling and new onset fever, further evaluation with ultrasonography, CT scan, FDG PET/CT and eventually biopsy was performed.RESULTS: Imaging methods revealed mandibular osteolysis indicative of either osteomyelitis or histiocytosis X. Tissue biopsy was diagnostic for Langerhans cell histiocytosis.CONCLUSION: Langerhans cell histiocytosis may present in infancy with a variety of symptoms, included an isolated bony lesion. Langerhans cell histiocytosis, despite its rarity, should be included in the differentiated diagnosis, when bone osteolysis is found.
Attitudes and Satisfaction toward the Taken Procedures to Tackle COVID-19 Pandemic in Palestine
Authors: Samer Abuzerr  , Kate Zinszer  , Amira Shaheen  , Abdel Hamid El Bilbeisi  , Alshaarawi Salem  , Ali Aldirawi  , Osama Jabr Emad  , Ayman Al Haj Daoud  , Rima Naser  , Kamal Eldeirawi
Published: July 2024

BACKGROUND: Since the beginning of the COVID-19 pandemic, there have been differences in the mitigation strategies implemented by governments worldwide. In addition, people's acceptance and adherence to these strategies, such as avoiding large gatherings and shelter in place, varied. The current studyaims to assess the attitude and satisfaction with the procedures to tackle COVID-19 in Palestine.METHODS: This cross-sectional descriptive study was conducted in the Palestinian territories, including, Gaza Strip, West Bank, and East Jerusalem, between April 29, 2020, and June 5, 2020, using a validated online questionnaire. The questionnaire included three sections: socio-demographic characteristics, attitude towards the measures and behaviors to avoid COVID-19 infection and its consequences, and level of people satisfaction with the response of the community and local authorities to combat the COVID-19 pandemic. A convenience sampling method was used to select participants. Statistical analysis was performed using SPSS version 26.
RESULTS: A total of 570 adults aged ≥18 years (56.3% males and 43.7% females) were included in the study. The mean positive attitude score (average % agree or strongly agree) was 94.22%; 95.24%, 95.18%, and 92.18% in the Gaza Strip, West Bank, and East Jerusalem, respectively. While, the mean satisfaction score was 44.26%, distributed as 47.16%, 46.1%, and 39.22% in the Gaza Strip, West Bank, and East Jerusalem, respectively. Additionally, there were statistically significant variations by most attitude and satisfaction variables across the governorates included in the study (p < 0.05). The current study demonstrated high levels of positive attitude but suboptimal level of satisfaction toward the taken procedures to tackle COVID-19 in Palestine.CONCLUSIONS: Varied implementation strategies to improve the levels of satisfaction toward the approaches to combat the COVID-19 pandemic are recommended.
Comparison of Cardiac Risk Scores among the East Mediterranean and South Asian Population
Authors: Tahani Saud Samar Alenazi  , Alanoud Abdullah Slamah Alhuiti  , Palanisamy Amirthalingam  , Ahmed Mohsen Hamdan  , Osama Salih Mohammed  , Mostafa A. Sayed Ali
Published: July 2024

BACKGROUND: Cardiovascular disease (CVD) is a global burden particularly in developing countries necessitates the periodical monitoring for these vulnerable population. This study aimed to compare four tools to measure the CVD risk between the East Mediterranean and South Asian population.METHODS: This retrospective analysis included 139 patients from East Mediterranean (n=90) and South Asians (n=49) ethnicity who were admitted during the one-year period in a multi-specialty tertiary care hospital located in Tabuk, Saudi Arabia. Four different tools currently in use across the world were used to analyses the CVD risk.RESULTS: Atherosclerotic Cardiovascular Disease (ASCVD) from American College of Cardiology/American Heart Association (ACC/AHA) was found to be significant (P=0.0000) than World Health Organization/International Society of Hypertension (WHO/ISH) and Framingham Risk Score (FRS) European SCORE (Systematic Coronary Risk Evaluation) memo card from European Society of Cardiology risk prediction charts. Meanwhile, FRS looks equally good as it detects 44.89% of South Asian study population with >10% CVD risk while ACC/AHA detects 46.93%.CONCLUSION: The present study recommends ACC/AHA cardiac risk estimator to identify the CVD risk in East Mediterranean population. However, the South Asian population needed a population-based tool to assess the accurate CVD risk.
Illness Representation and Associated Factors among Hypertensive Patients in Central Ethiopia
Authors: Daniel G/Tsadik  , Yemane Berhane  , Alemayehu Worku
Published: July 2024

BACKGROUND: Illness representation is an implicit belief system about an illness constructed by an individual to give meaning to their illness. An individual’s belief about his/her illness, treatment, and own control are known to influence an individual’s ability to cope with the illness and sustain the health-related quality of life. However, how Ethiopians perceive hypertension has not been studied well. This study aimed to assess illness representation and associated factors among hypertensive patients in Central Ethiopia.METHOD: A facility-based cross-sectional study was conducted in four public hospitals in Central Ethiopia. A total of 989 patients participated in the study. The revised Illness Representation Questionnaire was used to collect relevant data. Data were analyzed using the Generalized Estimating Equation with an ordinal logistic regression model and exchangeable working correlation matrix. A P-Value of less than 0.05 was indicated statistical significance.RESULTS: Overall, 64.3% (95% CI: 61.3, 67.4) of the respondents reported low to moderate Illness representation about their hypertension. Respondents who were housewife [AOR: 1.48, 95% CI= 1.05, 2.08], in older age category 50-64 years [AOR: 1.92, 95% CI= 1.19, 3.09] and ≥ 65 years [AOR: 2.38, 95% CI= 1.43, 3.96], and had no family support [AOR: 1.98, 95% CI= 1.44, 2.73] showed a significant association with Illness Representation.CONCLUSION: This study revealed that about two-thirds of hypertensive patients in Central Ethiopia perceived hypertension as a low to moderately threatening illness. Such low illness representation undermines initiation of treatment and effective control of blood pressure. Health care providers need to strengthen strategies that increase their patient’s illness representation.
Magnitude of Anxiety and Depression and Associated Factors among Palliative Care Patients with Cancer at Tikur Anbessa Specialized Hospital, Ethiopia
Authors: Bantalem Tilaye Atinafu  , Tefera Mulugeta Demlew  , Fetene Nigussie Tarekegn
Published: July 2024

BACKGROUND: Little is known regarding the severity of anxiety and depression among palliative care patients with cancer. As a result, this study aimed to assess the magnitude of anxiety and depression and its associated factors among palliative care patients with cancer.Methods: A cross-sectional study was conducted at the Black Lion Specialized Hospital oncology center on palliative care patients with cancer who had follow up. Interviews and chart reviews were used. Descriptive statistics and Chi-square were done. Multivariate analysis was done.RESULT: A total of 171 palliative care patients with cancer were involved in the study. The magnitude of anxiety and depression was found at 64.9% and 47.4%, respectively. Those palliative care patients with cancer whose age >64 years (AOR: 7.1; CI: 1.59-68.0; P =0.029), unable to write and read (AOR: 0.2; CI: 0.03-0.73;P = 0.017), secondary school (AOR: 0.3; CI: 0.11-0.83; P = 0.022) were significant factors for anxiety. Breast cancer (AOR: 0.1; CI:0.01-0.85; P = 0.021), surgery plus radiation (AOR: 0.2; CI: 0.02-0.91: P=0.024) others (radiation and surgery (AOR: 0.1; CI: 0.02-0.8: P = 0.036) were found to be significant factors for depression.Conclusion: the magnitude of anxiety and depression was 64.9% and 47.4%, respectively. Greater than 64-year-old age, unable to write and read secondary school were significant factors for anxiety. Breast cancer, surgery plus radiation, others (radiation and surgery) were found to be significant factors for depression.
Knowledge of Emergency Physicians about the Management of Traumatic Dental Injuries: A Cross-sectional Study in Northern Iran
Authors: Touraj Assadi  , Mahmood Moosazadeh  , Pouya Akbari  , Salma Omidi
Published: July 2024

BACKGROUND: Dental trauma is a common dental public health problem among the children and adults. As the emergency departments are usually the first contact point for patients after a trauma, this study aimed to evaluate the level of knowledge of emergency medicine specialists or residents and general practitioners (GPs) working in the emergency departments about the management of traumatic dental injuries.METHODS: In this descriptive cross-sectional study, all emergency medicine specialists or residents and GPs working in the emergency department of hospitals affiliated to Mazandaran University of Medical Sciences were evaluated. Data were collected using a questionnaire comprising questions on demographic information and physicians' knowledge of how to deal and manage different dental injuries. The information was analyzed using t-test and chi-square statistical test.RESULTS: The level of knowledge was good in 71.5% of emergency medicine specialists and average in 75% of the residents and 93.4% of GPs. None of the participants had low level of knowledge about management of traumatic dental injuries. There was a statistically significant association between physicians' knowledge and their job position (P<0.001). Moreover, there were no statistically significant differences between gender and the history of participating in dental trauma courses with the level of physicians' knowledge (P>0.05).CONCLUSION: The results of present study highlights the need for training programs to raise the knowledge of emergency medicine residents and GPs about how to effectively manage the traumatic dental injuries in patients presenting to the emergency department.
Appropriateness of Head CT Scans at Tikur Anbessa Specialized Hospital, Ethiopia
Authors: Etsehiwot Demeke  , Abebe Mekonnen
Published: July 2024

BACKGROUND: Overutilization of advanced diagnostic imaging modalities strains health care systems, especially in resource limited setups. The aim of this study is to identify magnitude of inappropriate Head Computed Tomography scans at Tikur Anbessa Specialized Hospital.METHODS: Retrospective cross-sectional study was conducted at Tikur Anbessa Specialized Hospital, Radiology department, among patients getting Head Computed Tomography examinations in the period of August 2018- November 2018. Appropriateness of each scan was assessed using the American College of Radiology Appropriateness Criteria.RESULT: Of the 443 Head Computed Tomography scans assessed, 61.6% were done for male patients and the mean age of patients scanned is 35. Children younger than 14yrs of age constituted 17.2%. No contrast was used in 63.9% of the scans and 64.3% were initial imaging with no prior study for similar indication. Out of the scans evaluated, 11.7% were inappropriate. Headache (38.5%), Seizure (23.1%) and Head trauma (23.1%) were the commonest indications for inappropriate scan. Scans done for cerebrovascular disease were 240 times more likely to beappropriate. Large number of inappropriate scans were requested from central triage (33.3%) and adult emergency (26.2%). Pediatric department requested inapproprieate scans in 11.9% of the cases. Residents requested majority of inappropriate scans (82.3%). Inappropriateness was associated with use of contrast agent and having only incidental outcomes.CONCLUSION: A large number of inappropriate Head Computed Tomography scans are being done. Mechanisms such as preauthorization by radiologists, increasing awareness by medical students, physicians, radiology residents and radiologists and preparing customized imaging appropriateness guidelines should be implemented.
Molecular Detection of Plasmodium Infection among Anophelinae Mosquitoes and Differentiation of Biological Forms of Anopheles Stephensi Collected from Malarious Areas of Afghanistan and Iran
Authors: Vahideh Moin-Vaziri  , Navid Dinparast Djadid  , Helen Hoosh-Deghati  , Hoda Atta  , Abbas Ali Raz  , Seyyed Javad Seyyed-Tabaei  , Naseh Maleki- Ravasan  , Sedigheh Zakeri
Published: July 2024

BACKGROUND: Updated information on the vectorial capacity of vectors is required in each malarious areas as well in Iran and its neighboring countries such as Afghanistan. The aims of this study were to investigate the potential infection of about 800 specimens collected from malarious areas of Afghanistan and Iran, and to differentiate biological forms of Anopheles stephensi.Method: Two molecular markers, 18S RNA gene subunit and AsteObp1 intron I, were used respectively for investigation Plasmodium infection and identifying the biological forms of An. stephensi.RESULTS: Plasmodium infection was detected in 4 pools of Afghanistan specimens, including An. stephensi, collected from Nangarhar. Individually examination showed infection in 5 An. stephensi (infection rate: 1.25), to P. falciparum (2), P. vivax (2) and a mix infection. Out of five infected specimens, three were intermediate forms and two were mysorensis. No infection was found in specimens collected from Iran (Chabahar County), probably due to the active malaria control program in south-east of Iran.CONCLUSION: The key role of An. stephensi, as a known Asian malaria vector, was re-emphasized in Afghanistan by the results achieved here. The fauna of vectors and the pattern of biological forms of An. stephensi are similar in both countries that urge regional investigations to provide evidence-based and applied data for decision-maker in malaria control.
Magnitude of Preeclampsia and Associated Factors Among Women Attending Delivery Service in Debre Tabor Specialized Hospital
Authors: Alemu Degu Ayele  , Zemenu Alemu Tilahun
Published: July 2024

BACKGROUND: Preeclampsia is among the leading causes of maternal and perinatal morbidity and mortality, and it continues as a global health concern. Therefore, this study was aimed to assess the magnitude of pre-eclampsia and its determinant factors among women attending delivery services in Debre Tabor Comprehensive Specialized Hospital Northwest Ethiopia.METHODS: Institutional-based cross-sectional study was conducted among 261 women from January 1- 30, 2021. A systematic sampling technique was applied. Data were collected using a structured and pre-tested questionnaire. The collected data were entered using Epi-data version 4.2 and analyzed by statistical package for social science (SPSS) version 23. A significant association was declared at a p-value of < 0.05 with a 95% Confidence interval.RESULTS: Overall 15,7% of women had preeclampsia. Age at menarche (10-15 years) (AOR=4.79; 95% CI: 2.07-15.27), unwanted pregnancy (AOR:1.29; 95% CI: 1.59-8.44), history of chronic hypertension (AOR:2.93; 95% CI: 1.00-6.20), BMI ≥ 30 Kg/m2 (AOR:1.79; 95% CI: 1.06-3.65), and alcohol consumption (AOR:2.12; 95% CI: 4.00-14.14) were significantly associated with preeclampsia.CONCLUSION: This study showed that the magnitude of preeclampsia was significantly high compared with previous national reports. Early menarche age, the status of current pregnancies, history of chronic hypertension, BMI, and alcohol consumption were significantly associated with preeclampsia. Therefore, the government and respective stakeholders should be strengthening antenatal care services to early identify and manage women with preeclampsia. Besides, health education and promotion should be strengthened regarding the maintenance of appropriate body weight and alcohol intake before pregnancy.
Mass Hysteria among Beneficiary Students of the School-Feeding Program in Addis Ababa, Ethiopia
Authors: Solomie Jebessa  , Handsome Deksiso  , Muluwork Tefera  , Yonas Bahretibeb
Published: July 2024

BACKGROUND: Mass hysteria is described as the rapid spread of conversion disorder without organic basis among a group of people. Mass hysteria can occur in work place and commonly in schools. There are usually some factors attributable to the episode; however, the lack of a pathogen upon investigation is a fundamental characteristic. We are reporting an episode of mass hysteria from two schools in Addis Ababa, Ethiopia.METHODS: Clinical record, laboratory investigation, toxicology study from the food and psychiatric evaluations.RESULTS: On November 25, 2019 a total of 113 students were brought from two schools in Addis to Tikur Anbessa Specialized Hospital. Most were between the ages of 10 and 15 years and were female students. Their school breakfast of bread and marmaladewas attributed as the cause of the episode; however only 49% of the students brought in had eaten the food. The majority complained of nausea and vomiting but most had normal physical finding; and their symptoms were resolved without treatment. The laboratory investigation on samples of blood and stool were negative for bacterial growth and food culture and toxicology were non-revealing. Most were reassured and few were given symptomatic treatment.CONCLUSION: This mass hysteric episode is similar to episodic reports from other school feeding programs in some Asian and African countries. The finding of this report is important for health care practitioners to consider mass psychogenic illness in case they face similar mass presentation without objective finding; and will help to avoid unnecessary costly investigations.
COVID-19 Vaccination and Disability in Ethiopia: Ensuring No One is Left Behind
Authors: Abubeker Alebachew Seid
Published: July 2024

Letter to the editor.
Admission Pattern and Treatment Outcome in Pediatric Intensive Care Unit, Tertiary Hospital, Addis Ababa, Ethiopia
Authors: Gemechu Edae  , Atnafu Mekonnen Tekleab  , Melaku Getachew  , Tigist Bacha
Published: July 2024

BACKGROUND: Knowledge of the clinical profile and outcomes of critically ill children admitted to Pediatric Intensive Care Unit (PICU) in developing countries aids with the identification of priorities and the resources needed to improve the outcome of critically ill patients. This study aimed to assess the admission pattern, outcomes, and associated factors of patients admitted to the PICU of St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.METHODS: Institutional-based cross-sectional study was done. Data was collected through chart abstraction from patients admitted to the PICU between January 2017 and December 2018. SPSS 20.0 was used to analyze the data. Descriptive statistics, cross-tabulations, and logistic regressions were used.RESULTS: A total of 260 pediatric patients were analyzed. The mean age at admission was 48.13 ± 53.65 months, with M: F ratio of 1.4:1. The mean and median duration of PICU stay was 7.26±6.87 days, and 6.0 days respectively. The most commonly affected organ systems were the central nervous system (79, 33.2%) and respiratory system (55, 23.1%). Mechanical ventilation and admission after cardiopulmonary resuscitation (p< 0.001) were independent predictors of mortality. Infectious causes of illnesses were the leading causes of admission and death in the PICU.CONCLUSION: The mortality rate of our PICU was 21.1 %. In this study, post-cardiopulmonary resuscitation admission and use of mechanical ventilation were statistically significant predictors of mortality indicating the need for well equipping and staffing the PICU to improve the outcome of such critically sick patients.
Risk Factors of Birth Asphyxia among Newborns at Debre Markos Comprehensive Specialized Referral Hospital, Northwest Ethiopia: Unmatched Case-Control Study
Authors: Yoseph Merkeb Alamneh  , Ayenew Negesse  , Yared Asmare Aynalem  , Wondimeneh Shibabaw Shiferaw  , Mihretie Gedefew  , Melkamu Tilahun  , Yidersal Hune  , Abtie Abebaw  , Yalemgeta Biazin  , Tadesse Yirga Akalu
Published: July 2024

BACKGROUND፡ Despite a global decline in under-five deaths, the neonatal mortality rate remains slow in developing countries and birth asphyxia remains the third cause of neonatal deaths. Globally, neonatal deaths accounts for 45% of under-five deaths, birth asphyxia causes 23-40% of neonatal deaths in Ethiopia. There is limited data on risk factors of asphyxia in Ethiopia, particularly in the study area. Therefore, this study aimed to identify the risk factors of birth asphyxia among newborns.METHODS: This research followed a hospital-based unmatched case-control study design at Debre Markos comprehensive specialized referral hospital, Northwest Ethiopia, among 372 newborns (124 cases and 248 controls). Data were collected by interviewing index mothers and chart review using a pre-tested questionnaire. Then it was entered in Epi-data version 3.1 and transferred to STATA version 14.0 for analysis. Bivariate and multiple variable logistic regression were carried out to the possible risk factors. Finally, statistical significance was declared using adjusted odds ratio with 95% CI and p-value <0.05.RESULTS: Prolonged labor >12, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, noncephalic presentation, comorbidity, birthweight<2500grams were found to be significant factors of birth asphyxia.CONCLUSION: In this study, Prolonged labor >12 hours, meconium-stained amniotic fluid, assisted vaginal delivery, gestational age < 37 weeks, non-cephalic presentation comorbidity, fetal distress, birthweight<2500grams were found to be risk factors of birth asphyxia were risk factors of birth asphyxia. Therefore, to reduce neonatal mortality associated with birth asphyxia, attention should be given to holistic pregnancy, labor and delivery care, and post-natal care. Moreover, interventions aimed at reducing birth asphyxia should target the identified factors.
Catastrophic Health Expenditure and Impoverishment from Non- Communicable Diseases: A comparison of Private and Public Health Facilities in Ekiti State, Southwest Nigeria
Authors: Ipinnimo Tope Michael , Durowade Kabir Adekunle
Published: July 2024

Background: Catastrophic health expenditure and impoverishment are the outcomes of poor financing mechanisms. Little is known about the  prevalence and predictors of these outcomes among non-communicable disease patients in private and public health facilities.
Methods: A health facility-based comparative cross-sectional study was conducted among 360 patients with non-communicable diseases (180 per  group) selected through multistage sampling. Data were collected with a semi-structured, intervieweradministered questionnaire and analyzed with  IBM SPSS for Windows, Version 22.0. Two prevalences of catastrophic health expenditure were calculated utilizing both the World Bank (CHE1)  and the WHO (CHE2) methodological thresholds.
Results: The prevalence of CHE1 (Private:42.2%, Public:21.7%, p<0.001) and CHE2 (Private:46.8%, Public:28.0%, p<0.001) were higher in private  health facilities. However, there was no significant difference between the proportion of impoverishment (Private:24.3%, Public:30.9%, p=0.170). The  identified predictors were occupation, number of complications and clinic visits for catastrophic health expenditure and socioeconomic status for  impoverishment in private health facilities. Level of education, occupation, socioeconomic status, number of complications and alcohol predicted  catastrophic health expenditure while the level of education, socioeconomic status and the number of admissions predicted impoverishment in  public health facilities.
Conclusion: Catastrophic health expenditure and impoverishment were high among the patients, with the former more prevalent in private health  facilities. Therefore, we recommend expanding the coverage and scope of national health insurance among these patients to provide them with  financial risk protection. Identified predictors should be taken into account by the government and other stakeholders when designing policies to  limit catastrophic health expenditure and impoverishment among them.
The Status of Facility Based Emergency Care in Public Hospitals of Ethiopia Using WHO Assessment Tool
Authors: Menbeu Sultan  , Woldesenbet Waganew  , Lemlem Beza  , Yemene GebreMedihin  , Mulu Kidane
Published: July 2024

BACKGROUND: The availability of emergency care contributes to half of the total mortality burden in a low and middle income countries. The significant proportion of emergency departments in LMICs are understaffed and poorly equipped. The purpose of this study is to examine the status of emergency units and to describe the facilitators and barriers to the provision of facility-based emergency care at selected Ethiopian public hospitals.
METHODS: A mixed-methods explanatory design was used. Ten hospitals were purposively selected due to their high number of patients and referral service. A WHO facility assessment tool was used to quantitatively assess the facilities, and an in-depth interview with hospital and emergency room leadership was conducted. The quantitative results were descriptively analyzed, and the qualitative data was thematically analyzed.
RESULT: This survey included a total of ten hospitals. Three of the facilities were general hospitals, and seven were tertiary level hospitals. They all were equipped with an emergency room. All of the studied hospitals serve a population of over one million people. In terms of infrastructure, only 3/10 (30%) have adequate water supply, and alf (5/10) have telephone access in their ED. The qualitative resultshowedthat the most common barriers to emergency care delivery were prolonged patient stays in the emergency room, inadequate equipment, and a shortage of trained professionals.
CONCLUSION: The status of emergency care in Ethiopia is still developing, and hospital care as a whole should improve to alleviate the high burden of care in emergency rooms and reduce morbidity and mortality.
Practice of Postoperative Pain Management in Under-Five Children in A Tertiary Hospital: A Prospective Crossectional Study
Authors: Belachew Dejene Wondemagegnehu  , Mekdelawit Mesfin Tadess
Published: July 2024

BACKGROUND: Despite advancements in pain management, children have remained undertreated for postoperative pain. Data regarding the practice of post-operative pain management in paediatric patients remains less available in the developing world. This study was aimed at evaluating practice of postoperative pain management in under five children.
METHODS: A prospective cross sectional one-year study was conducted on all paediatric patients who underwent major paediatric surgical procedures from February 1, 2020 to January31, 2021, at a tertiary hospital in Addis Ababa, Ethiopia.
RESULT: A single type of analgesic medication was used in 67.1% patients. Analgesic medications were administered on standing base only in 64.4% of patients. Patients’ charts had no documentation of pain assessment both in the neonatal intensive care units and wards.32.89 % of assessed patients had moderate to severe pain record.
CONCLUSION: Significant number of patients suffer from post-operative pain because of absence of proper pain assessment and inadequate administration of analgesic medication.
Lactate for Predicting the Prognosis of Multi-Drug Poisoned Patients
Authors: Durdu Mehmet Uzucek  , Dervis Yildiz  , Ahmet Burak Urfalioglu  , Satuk BugraYapici  , Kemal Sener  , Akkan Avci  , Sadiye Yolcu
Published: July 2024

BACKGROUND: We aimed to compare serum lactate levels of multi-drug poisoned patients to determine whether knowing the level may help emergency clinicians in predicting the patients’ prognoses.
METHODS: The patients were divided into two groups according to the number of kinds of drugs taken (Group 1: patients took 2 kinds of drugs; Group 2: patients took 3 or more kinds of drugs). The groups’ initial venous lactate levels, lactate levels before discharge, lengths of stay in the emergency department, hospitalisation units, clinics, and outcomes were recorded on the study form. These findings of the patient groups were then compared.
RESULTS: When we evaluated the first lactate levels and lengths of stay in the emergency department, we found that 72% of the patients with initial lactate levels ≥13.5 mg/dL stayed more than 12 hours in the emergency department. Twenty-five (30.86%) patients in the second group stayed ≥12 hours in the emergency department, and their mean initial serum lactate level was significantly related (p=0.02, AUC=071). The mean initial serum lactate levels of both groups were positively related with their lengths of stay in the emergency department. The mean initial lactate levels of patients who stayed ≥12 hours and those who stayed <12 hours in the second group were statistically significant, and the mean lactate level of the patients who stayed ≥12 hours in the second group was lower.
CONCLUSION: Serum lactate levels may be helpful in determining a patient’s length of stay in the emergency department in the case of multi-drug poisoning.
Ceftaroline Susceptibility among Isolates of MRSA: A Comparison of EUCAST and CLSI Breakpoints
Authors: Arun Sachu
Published: July 2024

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important bacterial pathogen causing a number of community-acquired and nosocomial infections. Ceftaroline fosamil is a fifth generation cephalosporin, approved for the treatment of infections caused by MRSA. The main objective of this study was to estimate the susceptibility of ceftaroline among isolates of MRSA by using CLSI and EUCAST breakpoints.
MATERIALS AND METHODS: Fifty non-duplicate isolates of MRSA were included in the study. Ceftaroline susceptibility was done using E-strip test and interpreted using CLSI and EUCAST breakpoints.
RESULTS: Susceptible isolates were equal (42%) by both CLSI and EUCAST, while resistant isolates were more commonly seen in EUCAST (50%). Ceftaroline MIC ranged from 0.25- >32μg/ml. All the isolates were sensitive to Teicoplanin and Linezolid.
CONCLUSION: Resistant isolates were less (30%) while using the CLSI 2021 criteria probably due to the inclusion of SDD category. Our study showed that Fourteen isolates (28%) had Ceftaroline MIC >32μg/ml, which is an alarming finding. The high percentage of Ceftaroline resistant isolates in our study probably suggest a hospital spread of Ceftaroline resistant MRSA emphasizing the need for stringent infection control precautions.
Intraductal Carcinoma of the Parotid Gland as a Rare Neoplasm: A Case Report and Literature Review
Authors: Eugénie Delaine  , Andrea Avagnina  , Stéphane Yerly  , Sara Fontanella  , Abderrahmane Hedjoudje  , Bassel Hallak  , Salim Bouayed  , Asimakis D. Asimakopoulos
Published: July 2024

BACKGROUND: Intraductal carcinoma is a rare low grade neoplasm of salivary glands with an excellent prognosis. It most frequently occurs in the parotid gland. Ectopic localizations are quite rare.
METHODS: This case report describes a man in his 60’s who was referred to ear, nose and throat outpatient department with 1-month history of painless swelling of the right parotid region.
RESULTS: Ultrasound-guided fine-needle aspiration unveiled a cytologic specimen judged as “suspicious for malignancy” and patient underwent a partial superficial parotidectomy. Immunohistochemistry confirmed diagnosis of intraductal carcinoma of right parotid gland.
CONCLUSION: There are few reported cases concerning this clinical entity following thorough review of the literature and recent developments with reference to the contribution of cytology and histopathology will probably modify its classification and management.