Ethiopian Medical Journal最新文献

{"title":"Evidence-Informed Policy Making in the Ethiopian Health System: Opportunities and Challenges","authors":"A. Workicho","doi":"10.4314/emj.v62i1.1","DOIUrl":"https://doi.org/10.4314/emj.v62i1.1","url":null,"abstract":"No Abstract","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139612562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude and Factors Associated with Catheter Associated Urinary Tract Infection, and Antimicrobial Susceptibility Profile at Hawassa, Sidama Regional State, Ethiopia: A prospective Cross-sectional Study","authors":"Marshet Kefeni, Tariku Lambiyo Anticho, Israel Tsige Tesema, Mulugeta Mengistu, Musa Mohammed Ali","doi":"10.4314/emj.v62i1.6","DOIUrl":"https://doi.org/10.4314/emj.v62i1.6","url":null,"abstract":"Introduction: The use of urinary catheter benefit patients who are unable to urinate for various medical reasons. Despite its use, a urinary catheter during its application may introduce bacteria to the urinary tract and result in Urinary tract infection (UTI). Even though  the burden of catheter-associated UTI is expected to be high in resource-limited countries, there is limited data. The aim of this study was  to determine the magnitude of culture- confirmed catheter-associated urinary tract infection (CAUTI), associated factors, and  antimicrobial susceptibility profiles of bacteria. \u0000Methods: This prospective cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital (HUCSH),  Sidama region, from May-August 2022. One hundred forty-nine catheterized patients at HUCSH were included. Socio-demographic,  clinical, and laboratory data were collected using structured questionnaire. Urine specimens were cultured on blood and MacConkey  agar. Culture-confirmed catheter-associated urinary tract infection was established if >1 X 105 colonies of bacteria per milliliters of urine  was detected. The disc diffusion method was used for antimicrobial susceptibility testing. For data analysis, SPSS version 26 was used.  Factors associated with culture-confirmed CAUTI were assessed using binary logistic regression. \u0000Results: The magnitude of culture  confirmed CAUTI was 30.2% (n=45; 95% CI=22.8−37.6). The most common bacterial isolates were Escherichia coli (n=12; 26.7%), followed  by Klebsiella species (n=10; 22.2%), and Staphylococcus aureus (n=6; 13.3%). Duration of catheterization (AOR=9.6, 95% CI=3.8−24.2) and  comorbidities (AOR=4.1, 95% CI=1.7−9.8) were significantly associated with culture-confirmed CAUTI. Most Gram- negative bacteria were  resistant to commonly prescribed antimicrobial agents. \u0000Conclusions: The magnitude of culture-confirmed CAUTI at HUCSH was high. E. coli was the leading bacteria and most of them were resistant to various types of antimicrobial agents. Duration of catheterization and  comorbidities were significantly associated with culture- confirmed CAUTI. ","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139612126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Intussusceptions in Peutz-Jeghers Syndrome Patient: A Case Report","authors":"Lee Mem Tim, W. Zainira, Othman Faeid","doi":"10.4314/emj.v62i1.10","DOIUrl":"https://doi.org/10.4314/emj.v62i1.10","url":null,"abstract":"Background: Peutz-Jeghers Syndrome is one of the hereditary gastro-intestinal cancer syndrome with characteristic mucocutaneous pigmentation and histologically distinctive hamartomatous polyps in gastro-intestinal tract. Although it is characteristically benign  hamartomatous polyp, majority of affected individuals develop symptoms starting from their second decades. We reported a known  Peutz-Jeghers Syndrome case developed recurrent polyps leading to double intussusceptions required bowel resection. Multidisciplinary  management and patient compliance to surveillance regime are important in managing PJS patients with potential gastro-intestinal tract  complications and relative high risk of developing syndrome specific cancers.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139613576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Silico-Tuberculosis","authors":"K. Gebrehiwot, T. Gebremariam","doi":"10.4314/emj.v62i1.8","DOIUrl":"https://doi.org/10.4314/emj.v62i1.8","url":null,"abstract":"No Abstract","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139613943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Tuberculosis Mimicking a Lung Cancer: a Case Series","authors":"Mahader Nigussi, Genet Hagos, Mahlet Alemayhu, Meron Yafet, Selome Tarekegn, Tseganesh Mekonnen, Azmera Gissila, Melaku Taye, D. K. Huluka","doi":"10.4314/emj.v62i1.11","DOIUrl":"https://doi.org/10.4314/emj.v62i1.11","url":null,"abstract":"Tuberculosis (TB) is an infectious disease that is caused by Mycobacterium tuberculosis. Despite TB being a preventable and curable disease, it still remains to be one of the leading causes of mortality worldwide and continues to be prevalent. TB can manifest in multiple  systems, but its primary target is the lungs. Pulmonary TB can present differently depending on the patient's immune status and  comorbidities. One atypical presentation of TB is lung mass, which can mimic lung malignancy and cause diagnostic delays.In this case  series, we report on four cases in which TB was initially suspected to be lung malignancy. All four patients had lung masses on diagnostic  imaging; microbiological testing was positive in only two of the patients and bronchoscopic abnormalities were seen in two of those. In  two of the four cases, caseating granulomas were present on biopsy. All four patients attained clinical and radiologic resolution.In  conclusion, despite years of knowledge and the prevalence of TB, atypical presentations can still cause diagnostic delays and unnecessary  interventions. This case series provides examples of TB mimicking lung cancer, so considering TB as a differential diagnosis  for patients presenting with a lung mass is crucial. ","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139613259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Neurocognitive Impairment in Treatment Experienced HIV+ Adults from a Tertiary Care Center in Ethiopia","authors":"Biniyam Alemayehu Ayele, Kiran T. Thakur, W. Amogne","doi":"10.4314/emj.v62i1.4","DOIUrl":"https://doi.org/10.4314/emj.v62i1.4","url":null,"abstract":"Background: Given the improvement in life expectancy of people living with HIV (PLWH) in sub-Saharan Africa, the risk of asymptomatic HIV-associated neurocognitive disorder (HAND) has increased. The study objectives were to investigate the prevalence of HAND and  associated factors among treatment experienced adults in Ethiopia.Methods: A single-center observational cross-sectional study was conducted between December 2019 and June 2020 to investigate  HAND. International HIV dementia scale (IHDS) was used to screen for the disorder. Both descriptive and analytical statistics were used to  analyze the data.Results: Total of 324 PLWH (63% females) who were on combination antiretroviral therapy for median of 144 months (IQR: 108-168) were  investigated. The mean age was 42.5 years (1SD=12.2). The prevalence of HAND was 75.3% and the difference was significantly more in  those above 40 years of age (65.8% vs. 80.7%, p=0.003). Age is the only risk factor identified with multivariable logistic regression analysis.  A linear decrement in the total score of cognitive performance was observed as the patient’s age increase; age was responsible  for 9.4% variation observed in IHDS score (r= -0.31, R2=0.094, p<0.0001). Although statistically not-significant, the trend for  cardiometabolic and behavioral risk factors (hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol and khat use) was higher in  the group diagnosed with HAND.Conclusion: The occurrence of neurocognitive impairment was more pronounced in individuals aged 40 years and above who were HIV  positive, compared to those below 40 years. Age was found to be an independent predictor of HAND. Cardiovascular and behavioral risk  factors were observed more among patients with HAND compared to no-HAND.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139612713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonohysterography Assessment of the Structural Abnormalities of the Uterus in Women with Infertility in Ethiopia","authors":"Mahlet Yigeremu, T. Kebede, Asefa Getachew, Melaku Biruk","doi":"10.4314/emj.v62i1.5","DOIUrl":"https://doi.org/10.4314/emj.v62i1.5","url":null,"abstract":"Background: Female factor infertility is associated with a high incidence of the uterine cavity and fallopian tube pathology in developing  countries with a high prevalence of STDs, therefore various methods are available for structural evaluation of the female reproductive  system, among them is saline infusion sonohysterography (SISHG). The study aimed to assess the role of SISHSG in female infertility  evaluation in areas where the gold standard investigating modalities are not readily available. \u0000Methods: A hospital-based cross-sectional study was carried out in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia,  between January 2019 to August 2019 G.C. SISHSG consists of instillation of saline into the endometrial cavity with simultaneous pelvic  ultrasonography (US). Fifty consecutive female patients referred to the Radiology Department for SISHSG are included in the study.  Sensitivity, specificity, positive and negative predictive values were calculated for 26 patients who had both SISHSG and conventional HSG. \u0000Result: The majority of the patients were in the age group of 35-40(38%) and 34 (68%) had secondary infertility. The commonest  abnormalities detected were uterine myoma 10(20%), Asherman syndrome/cervical stenosis 7 (14%), and tubal blockage 6(10%). The  sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SISHSG in normal study, Asherman  syndrome/cervical stenosis and chronic endometritis was 100%, as compared to the gold standard conventional HSG. For bilateral tubal  blockage the SISHSG had 50% sensitivity, 90% specificity, 66.7% PPV and 81.8% NPV, however, for unilateral tubal blockage SISHSG had  low sensitivity 33%. \u0000Conclusion: SISHSG is readily available, easy-to-do, safe and radiation-free procedure and has high sensitivity and specificity in detecting  uterine cavity abnormality. We advocate its use as a first step of investigation modality in the evaluation of female infertility. ","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139612860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors and Determinants of Pulmonary Function Impairments in Chronic Respiratory Diseases in Ethiopia: A Hospital-based Cross-Sectional Study","authors":"A. Binegdie, T. Gebremariam, Aschalew Worku, E. K. Etissa, Shifa Hamid, Adursemed Awol, Addisu Belay, H. Meme, A. El Sony, L. Zurba, M. Lesosky, John Balmes, P. Burney, Graham Devereux, Kevin Mortimer","doi":"10.4314/emj.v62i1.2","DOIUrl":"https://doi.org/10.4314/emj.v62i1.2","url":null,"abstract":"Introduction: Chronic respiratory diseases (CRDs) are diseases of the airways and lung parenchyma. Although they are leading causes of  morbidity and mortality globally, chronic respiratory diseases have received relatively little public attention. This study aimed to  characterize the common chronic respiratory diseases, along with their lung function and possible determinants in symptomatic patients  attending clinics at Bishoftu General Hospital, Ethiopia. \u0000Methods: A cross-sectional study was conducted at the outpatient department of Bishoftu Hospital from June 2019 to March 2020.  Consecutive adult patients aged 18 and above with chronic respiratory symptoms (lasting more than 8 weeks) and no evidence of active  tuberculosis were recruited. Questionnaires were used to collect data on demographics, symptoms, diagnoses, and potential risk factors.  Lung function was measured by spirometry. Allergic status was assessed through allergen skin prick testing with standard allergens.   \u0000Results: A total of 170 participants were recruited, with the majority being female (102, 60.0%). The mean age was 49 years (SD=16). The  most common symptoms reported were wheezing in the last twelve months 156 (91.8%), cough 138 (81.2%) and severe exertional  breathlessness 137 (80.6%). Thirty-nine (22.9%) participants were either active or passive smokers. Half of the patients (50.3%) were  exposed daily to vapors, dust, gases, or fumes and 58 (34.3%) were exposed to biomass smoke. In total, 138 (81.2%) had a positive  allergen skin prick test. Chronic bronchitis (49.1%) and asthma (36.1%) were the most common clinical diagnoses. Classification of lung function revealed 23 (15%) normal, 29 (19%) obstructive, 36(23.5%) restrictive and 61(39.9%) mixed obstructive/ restrictive patterns.  Airflow obstruction (FEV1/FVC ratio) was independently associated with increasing age (p<0.05), exertional breathlessness (p<0.001),  previous history of asthma (p<0.05), BMI (p<0.05), and doctordiagnosed chronic obstructive pulmonary disease (p<0.001) and asthma  (p<0.05). \u0000Conclusion: This study demonstrated a high burden of abnormal lung function in patients attending clinics due to chronic respiratory  symptoms. Increasing age, exertional breathlessness, prior diagnosis of asthma, BMI, and clinically diagnosed COPD and asthma were  independently associated with obstructed lung function. These find ings highlight the critical need for spirometry services to identify lung  abnormalities in patients with chronic respiratory symptoms. Epidemiology, and the findings should be factored into clinical  decision making and program design for disease prevention, screening, and treatment. It also calls for further prospective research to  learn more about the conditions in the context of additional relevant personal and clinical characteristics. ","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139612835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnesium Toxicity Presented as Quadriparesis in Postpartum Period: Case Report","authors":"Zekewos Demissie, Seyfemichael Getachew, S. Teklu, Abraham Demile, Bezawit Endeshaw, Amanuel Hintsa","doi":"10.4314/emj.v62i1.9","DOIUrl":"https://doi.org/10.4314/emj.v62i1.9","url":null,"abstract":"Quadriparesis may result from numerous neurologic diseases. Any of the causes could occur in the postpartum period. However, some  conditions have increased prevalence during peripartal period, such as cerebral venous thrombosis, eclampsia itself, or its treatment with  magnesium sulfate causing neuromuscular dysfunction in case of toxicity. Herein, we report a case of magnesium toxicity in a 34- year-old mother in the early postpartum period. This case signifies the importance of magnesium toxicity in patients with decreased  renal clearance.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139612720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary practice and its association with glycemic control among individuals with type 2 diabetes mellitus in Ethiopia: A multi-center cross-sectional study","authors":"Firegenet Asnake Kitaw, Muluken Zeleke Megiso, Indris Ahmed Yesuf, Bersabel Hilawi Tewodros, Yohannes Shiferaw Shaweno, Blen Solomon Teklu, Mefthe Fikru Berhanu, Edengenet Solomon Weldesenbet","doi":"10.4314/emj.v61i4.2","DOIUrl":"https://doi.org/10.4314/emj.v61i4.2","url":null,"abstract":"Background: Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder that needs a comprehensive management plan. The integral role of nutrition therapy in diabetes management is getting special attention in guidelines though the practice is in a primitive stage, especially in resource limited settings where lifestyle modifications have a large role in the overburdened healthcare system. Understanding the current dietary practice and its effect on disease control in settings where a tertiary level care is provided is a critical step in providing targeted intervention. Therefore, the aim of the study was to assess dietary practice and its association with level of glycemic control among individuals with T2DM who were on follow-up at two large tertiary hospitals in Ethiopia.Methods: A hospital based cross-sectional study was conducted from January to March 2023 among 314 systematically selected individuals with T2DM who were on follow-up at diabetes clinics of St. Paul’s Hospital Millennium Medical College and Tikur Anbessa Specialized Hospital. Data was collected using a pre-tested structured questionnaire and summarized using frequency and median (interquartile range). To examine the association of dietary practice with level of glycemic control, a binary logistic regression model was run at 5% level of significance where Adjusted Odds Ratio (AOR) and 95% CI for AOR were used to interpret the results.Results: From the 314 participants, 146 (46.5%) patients had adequate knowledge regarding the recommended dietary practices and only 42 (13.4%) of the individuals practiced a healthy diet. A total of 107 (34.1%, 95% CI=29.0%-39.2%) had optimal glycemic control. Poor dietary practice (AOR=7.93, 95% CI=2.63-23.89, p<0.001), obesity (AOR=2.74, 95% CI=1.05-7.18%, p=0.04), and taking combination oral anti-diabetic drugs (AOR=6.22, 95% CI=3.05-12.69, p<0.001) were significantly associated with suboptimal glycemic control.Conclusions: Dietary knowledge and practice among individuals with T2DM were very low, as is the level of glycemic control, which are similar to studies conducted years back, indicating a lack of improvement in the desired behavior over time. Poor dietary practice in turn was associated with suboptimal glycemic control. It is important to target interventions that enhance the understanding and application of dietary practice in these individuals.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136057647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}