Ethiopian Medical Journal最新文献

{"title":"Podoconiosis in Ethiopia: From Neglect to Priority Public Health Problem.","authors":"Kebede Deribe, Biruck Kebede, Belete Mengistu, Henok Negussie, Mesfin Sileshi, Mossie Tamiru, Sara Tomczyk, Fasil Tekola-Ayele, Gail Davey, Amha Fentaye","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated master plan for NTDs. An integrated lymphoedema management guideline has been developed. Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":" ","pages":"65-74"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582632/pdf/emss-73814.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35331493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADMISSION PATTERNS AND OUTCOMES IN THE MEDICAL INTENSIVE CARE UNIT OF ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA.","authors":"Seman Kedir,&nbsp;Abreham Berhane,&nbsp;Tola Bayisa,&nbsp;Tewodros Wuletaw","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of the characteristics and outcomes of critically ill patients admitted to Medical Intensive Care Unit (MICU) helps with identification of priorities and the resources required to improve care. The objective of this study was to examine admission patterns and outcomes in MICU at St. Paul’s Hospital Millennium Medical College.</p><p><strong>Materials: </strong>A retrospective review of 1256 patients’ case notes who were admitted to the MICU at St. Paul’s Hospital Millennium Medical College from 2007 to 2012 was carried out. The data was analyzed by SPSS version 18.0 to obtain descriptive and inferential measurements. P values < 0.05 were considered significant for all tests.</p><p><strong>Results: </strong>Among specific diagnoses, diabetic ketoacidosis; 187 (14.9%), was the leading cause of admission, followed by all Strokes; 103 (8.2%), and Unspecified Diseases of Circulatory System; 81 (6.4%). The overall mortality rate was 39 %. Strokes were the leading causes of death, accounting for 12.2% of total deaths. The deceased were older than the survivors by five mean age years, mean age (±SD) 41.9 (± 18.5) and 36.7 (± 17.4) years, respectively.</p><p><strong>Conclusions: </strong>Non- communicable will continue to be increasing proportion of ICU admissions in the study. The mortality in this study is also substantial, and reasons looks like late admissions and limited care in the facility. Improving the ICU infrastructure and staffing with skilled personnel might improve the quality of care.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"55 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35620535","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":"Ganglioneuroma of the Neck: A case report.","authors":"Woubedel Kiflu,&nbsp;Tihitena Negussie","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ganglioneuroma (GN) is benign tumor arising from sympathetic ganglion which commonly occurs at posterior mediastinum, retroperitoneum and adrenal gland. Rarely, it may also present in cervical region as slow growing painless neck mass. Here we present a 7 years old female child with 4 years duration of slow growing left lateral neck mass. After proper investigations the patient was prepared & taken to the operation room for complete excision of the mass. Post operation biopsy settled the definitive diagnosis as Ganglioneuroma. Thus ganglioneuroma should be considered in patients with neck mass.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"55 1","pages":"69-71"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35256987","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":"BURDEN OF TUBERCULOSIS AMONG STUDENTS IN TWO ETHIOPIAN UNIVERSITIES.","authors":"Abiyu Mekonnen,&nbsp;Beyene Petros","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis outbreaks emerge occasionally in long-term care facilities and various educational\u0000establishments. This study was designed to determine the five year overall prevalence and trend of tuberculosis\u0000and associated factors among students at Adama Science and Technology University and Addis Ababa University\u0000Sidist Kilo campus.</p><p><strong>Methods: </strong>A five-year retrospective study was conducted on students’ medical records of tuberculosis Directly\u0000Observed Treatment Short Course clinics from September 2009– July 2014. The overall prevalence and the trend\u0000of smear positive, smear negative and extra pulmonary tuberculosis cases was determined. Odds ratio with 95\u0000percent confidence interval was calculated for categorical variables using a multivariate logistic regression model\u0000to assess the strength of association.</p><p><strong>Results: </strong>A total of 112 and 263 tuberculos cases were recorded in Addis Ababa University Sidist Kilo campus\u0000and Adama Science and Technology University, respectively. The mean proportion of tuberculosis cases of all\u0000types among the total number of students enrolled at Adama Science and Technology University and Addis Ababa\u0000University Sidist Kilo campus was 1098.1 and 511.7 cases per 100,000 population, respectively. There was a statistically\u0000significant difference in prevalence of tuberculosis among students in Adama Science and Technology\u0000University compared to that in Addis Ababa University Sidist Kilo campus [adjusted odds ration: 2.881, 95% CI\u0000(1.76-4.71)]. The trend of tuberculosis prevalence showed a steady decline from the first to the last year of the\u0000study period.</p><p><strong>Conclusion: </strong>The number of tuberculosis cases observed among university students in this study was high. Governmental\u0000and nongovernmental agencies involved in tuberculosis control must consider higher education institutions\u0000as focal points for prevention and elimination of tuberculosis in Ethiopia.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 4","pages":"189-96"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683725/pdf/nihms914616.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35235543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ART EXPERIENCED PATIENTS FOR TACKLING ATTRITION FROM HIV CARE: A MULTI-SITE COHORT STUDY.","authors":"Alula Meressa Teklu,&nbsp;Kesetebirhan Delele Yirdaw","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Retention of patients on anti-retroviral treatment in Ethiopia is a challenge. Use of anti-retroviral treatment experienced patients to prepare and re-engage them when they miss follow-ups is recommended, but evidence on its effectiveness is limited. This study evaluated its effectiveness.</p><p><strong>Methods: </strong>: A retrospective cohort study in 10 randomly selected health facilities was conducted to compare outcomes before and after initiation of the adherence supporters program in HIV care and treatment from September 2001 to August 2013. Data analysis involved Kaplan-Meier survival and Log-rank test analysis on STATA statistical software Version 12 to compare survival experiences.</p><p><strong>Results: </strong>Of 18,835 records that were available, 938 (4.36%) records with missing values were excluded and data from the remaining 17,897 was analyzed. The incidence of first instance lost to follow-up was 22.2 per 100 person-years (95% confidence interval 21.7-22.7). The risk of missing follow-ups after initiation of the program was high (Hazard Ratio –1.22, P < 0.001). The incidence of restarting after missed follow-ups was 23 per 100 PY (95% CI 22.2-24.0). The likelihood of restarting after missed follow-ups was four times higher during the period adherence supporters were present (P<0.001). Patients who stayed longer in care before missing follow ups were more likely to restart (5.7 times the chance of restarting treatment for those whose first lost to follow-up occurred at≥12 months compared to <3 months, P< 0.001).Time to restarting treatment was shorter after the initiation of the adherence supporters program (median 37 vs. 115 days). The risk of recurrence of being lost to follow-up in the presence of adherence supporters was significantly higher than when there were no adherence supporters; 38.8 (95% CI 36.3-41.6) per 100 PY vs. 26.1 (95% CI 19.8-34.4) per 100 PY, respectively.</p><p><strong>Conclusion: </strong>Adherence supporters were effective in improving re-engagement of patients in treatment and care after they were lost to follow-up. Yet, prevention of lost to follow-up cases has remained a challenge to the program.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 4","pages":"197-205"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35235545","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":"THREE SIBLINGS WITH ANDROGEN INSENSITIVITY SYNDROME.","authors":"Sisay Teklu,&nbsp;Jakob Schneider,&nbsp;Zewdu Terefework,&nbsp;Benadam Shimeles,&nbsp;Shemsu Abraham,&nbsp;Endalk Bonsa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Genetic, gonadal, phenotypic and psychological genderis the basis for gender assignment to an individual. Derangement\u0000in genetic makeup, under or over exposure to sex hormones and problems related to sex hormone receptors\u0000will lead to abnormal development of the external and internal genitalia. Failure to respond for the endogenous\u0000androgen, Androgen Insensitivity Syndrome is one of the common causes of genital ambiguity and intersex.\u0000In this case series we have presented three girls from a family of seven children visited Tikur Anbassa Specialized\u0000Hospital (TASH) with a complaint of primary amenorrhea and diagnosed to have androgen insensitivity syndrome.\u0000Their clinical presentation, relevant laboratory and histopathologic findings, karyotype and genetic analysis\u0000results are summarized. Potential causes and treatment options are discussed.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 4","pages":"229-36"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35532862","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":"HIGH PREVALENCE OF ATRIAL FIBRILLATION IN STROKE PATIENTS ADMITTED TO UNIVERSITY OF GONDAR HOSPITAL, NORTHWEST ETHIOPIA.","authors":"Ermias Shenkutie Greffie,&nbsp;Taddese Mitiku,&nbsp;Seid Getahun","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Even though atrial fibrillation is a common risk factor of stroke which contributes to poor outcome, data concerning this association is scarce in African countries. This study assessed the prevalence of confirmed atrial fibrillation and its effect on outcome in stroke patients admitted to University of Gondar Hospital.</p><p><strong>Methods: </strong>Hospital based cross-sectional study by record analysis was done from December 2014 to February 2015. All adult stroke patients with documented head CT scan and ECG results admitted to university of Gondar hospital during June 2010 to May 2013 were included. Relevant data including sociodemographics, type of stroke, and presence of atrial fibrillation was collected from patient charts using a data extraction form.</p><p><strong>Results: </strong>A total of 94 patients with mean age of 67.4±12.4 years and Female to male ratio of 1.13:1 were analyzed. The prevalence of AF was 28.7%. It occurred in 34% and 14% of ischemic and hemorrhagic strokes respectively. The in hospital case fatality of stroke associated with and without atrial fibrillation was 22.2% and 8% respectively while the rate of improvement at discharge was 34% and 68% respectively. Atrial fibrillation was associated with a low rate of improvement at discharge (OR= 0.28 CI: 0.1-0.78).</p><p><strong>Conclusion: </strong>Atrial fibrillation is common in stroke patients in our hospital, especially in the elderly population. It is associated with low rate of improvement at discharge. Appropriate screening and treatment of atrial fibrillation is invaluable for the primary and secondary prevention of stroke.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 4","pages":"207-12"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35235546","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":"TO SHARE KNOWLEDGE, NOT TUBERCULOSIS","authors":"Abraham Aseffa","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 4","pages":"179-80"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35235539","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":"CORRIGENDUM.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 4","pages":"241"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35533764","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":"REFERRAL OF EMERGENCY SURGICAL PATIENTS IN A\u0000TERTIARY HOSPITAL, ADDIS ABABA, ETHIOPIA.","authors":"Engida Abebe,&nbsp;Henok Teshome,&nbsp;Mahteme Bekele","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Referral is part of patient care when done appropriately. Common reasons for referral include seeking\u0000expert advice, technical examination and/or intervention, care beyond the facility’s capacity.\u0000Objectives: Determine the rate, reason for and type of cases referred among patients seen at surgical Emergency\u0000Room of SPHMMC during May to July 2015.</p><p><strong>Patients and methods: </strong>Cross sectional study was done at St. Paul’s Hospital Millennium Medical College Emergency\u0000Room, including all surgical patients seen in three months period. Data was collected from the individual\u0000patient’s medical records, records of the ER and the liaison office and Interns morning reporting book. Data was\u0000analyzed with SPSS version 20.</p><p><strong>Results: </strong>Total of 2,492 patients were seen. The mean number of patients seen per day was 27.7 with a range from\u000013 to 51. Trauma made 70% (1746) of all cases seen. Cases that needed admission made 30.1% (755), but only\u000049.5 % (374) of them were admitted. The overall referral rate was 15.3%. The referral rate in patients who needed\u0000admission was 50.5 % (381). Trauma made 77.4% (295) of the referrals, mainly orthopedic, 54.6% (161) and\u0000neuro-traumas, 38% (112). Among non trauma cases acute abdominal conditions tops, 75% (56). Lack of inpatient\u0000beds was the main reason for referral 65.6% (250). Specialist care need was the reason for referral in 34.5%\u0000(131) of cases. Among patients referred only 14.4% (55) left the hospital at the time of referrals. Four percent (13)\u0000of the kept patients died in the ER waiting for referrals.</p><p><strong>Conclusions: </strong>The rate of referral from St. Paul’s Hospital Millennium Medical College Emergency Room is high.\u0000It is higher in trauma cases, specifically orthopedic and neuro-traumas. Main reason for referrals was lack of bed.\u0000The capacity of the hospital and other hospitals in AA in absorbing traumas, specifically orthopedic and neurotraumas\u0000need to be evaluated and necessary policy adjustments should be implemented. Further study at each hospital\u0000and the whole city gives better picture of referrals among hospitals in Addis Ababa.</p>","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 4","pages":"221-8"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35585553","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}