Butajira Hospital Research Articles

Awareness and Knowledge of Glaucoma among Health Workers in Butajira General Hospital, South Ethiopia

Raising awareness and knowledge of glaucoma is a key means of enhancing people alertness, increasing regular eye screening practice, and the chance of identifying undetected cases. Health professionals other than ophthalmologists are often the first point of contact when patients seek medical advice. However, little is known about the awareness and knowledge of glaucoma among health care professionals in Ethiopia. The objective of this study was to determine general awareness and knowledge of glaucoma among health workers in Butajira General Hospital. Hospital-based cross-sectional study was conducted at Butajira Hospital in September and October 2021 among health care providers. All health workers except those on leave and the staff in the department of Ophthalmology were included in the study. The awareness and knowledge were assessed using a self-administered questionnaire. Descriptive statistics was computed to describe the study variable, and logistic regression was conducted to see associations between dependent and independent variables. Significant associations were declared at p-values <0.05. This study showed that 184 (91.1%) had an awareness of glaucoma among the study participants, whereas 8.9% had never heard about glaucoma. Of those who were aware, only 42% have good knowledge. Professionals who had a history of eye examinations and family history of glaucoma were about 3.0 times more likely to have good knowledge. Fifty-eight percent of clinical professionals from Butajira Hospital had no awareness at all or had poor knowledge about glaucoma. Being a physician, history of eye examinations, and having a family history of glaucoma were factors related to glaucoma knowledge.

Magnitude of Preterm Birth and Its Associated Factors: A Cross-Sectional Study at Butajira Hospital, Southern Nations, Nationalities, and People's Region, Ethiopia.

Background Preterm birth infants are at a greater risk of mortality and a variety of health and developmental problems; reliable data support that this rate is increasing in almost all countries. The purpose is to find the magnitude of preterm birth and its associated factors among newborns delivered at Butajira Hospital, Southern Nations, Nationalities, and People's Region, Ethiopia. Methods This hospital-based cross-sectional study was carried out on 304 maternity cards using the systematic sampling method during May 1_21 in 2019. The data collection was performed using a structured case record form. The data were entered into EpiData software (version 3.1) and analyzed using SPSS software (version 21). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results Overall magnitude of preterm birth was observed to be 15.5%. The factors significantly associated with the preterm birth were preeclampsia (AOR = 4.0; 95% CI: 1.6-10.0), and premature rupture of fetal membranes (AOR = 4.2; 95% CI: 1.4-12.9). Conclusion Preterm birth is still public concern in the study area. The concerned administrative body should implement health education programs and improve the quality of health care delivered to pregnant mothers to control these associated factors and, consequently, promote public health in the study area.

Abstract B034: Assessment of the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia

Abstract Background: Breast cancer (BC) is the most frequently diagnosed cancer and the leading cause of cancer death among females in Ethiopia. BC screening programs are lacking and above 80% breast cancer are diagnosed at advanced stages. Ultrasound-guided fine needle aspiration (FNA) is a simple and effective approach to evaluate breast mass in resource limited countries. The aim of this study was to assess the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia. Methods: Community based cross-sectional study was conducted among 7,573 adult women, age 15 years and older from March to April 2018 in Butajira Health and Demographic Surveillance Site, South Central Ethiopia. A two stage-stratified cluster sampling method was used to select the population-based study participants. Data were collected using a pretested interviewer-administered questionnaire to inquire about breast abnormalities from eligible respondents. Further clinical assessment with history and physical examination of those reporting breast abnormalities (e.g., lump or breast pain) were assessed by experienced surgeons. If indicated, surgeons ordered the ultrasound-guided FNA performed by pathologist and cytologic analysis was done by an experienced pathologist. Women with BC were referred to Butajira Hospital for oncologic care. Data were analyzed using EPI- Info and SPSS V20. Descriptive statistics were used to summarize clinical and pathology result. Result: Out of 7,573 women surveyed, 258 (3.4%) women with breast abnormality were identified and referred to the Butajira Health Center. Only two women had visited a health facility to seek medical care before the survey was administered. Of those who reported breast abnormalities, 246 (95.3%) women had physical examinations. Forty-nine women had findings requiring ultrasound-guided FNAs. The median age of women was 30 years old with interquartile range of 25-40 years. Of the FNAs performed, 13 (26.5%) were benign lesions, 8 (16.3%) were fibroadenomas, 9 (18.4%) were reactive lymphoid hyperplasia, and 14 (28.6%) were other noncarcinoma cases. One (2%) was suspicious of BC and required excisional biopsy for diagnosis, and 4 (8.2%) ascertained non-special type carcinoma of the breast. Of BC patients, 2 patients presented with ulcerated and fungating lesion with tumor size greater than 5cm, one patient presented with ulcerating tumor measuring 3 cm, and two patients presented with a breast mass measuring 4 cm. Conclusion: A few women with self-reported breast abnormalities in a rural region of Ethiopia sought medical attention for their problem prior to our survey. We found the prevalence of women with breast abnormalities in our population-based study was similar to reports from Liberia and Rwanda. Raising awareness of health care services available to women in rural regions of Ethiopia could increase earlier detection of breast cancer and improve quality of life. Citation Format: Wondimu Ayele Manamo, Adamu Addissie Nuramo, Ahmedin Jemal, Lesley Taylor, Eva J. Kantelhardt. Assessment of the prevalence and diagnosis of breast abnormalities among adult women in rural Ethiopia [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B034.

Abstract B103: Community-based uptake of self-sampling for HPV DNA-based testing for cervical cancer screening in Ethiopia: Preliminary findings of a cluster randomized trial

Abstract Background: Cervical cancer (CC) remains a leading cause of morbidity and mortality of all cancers among women residing in low-income countries, including Ethiopia. In Ethiopia, although the standard method of CC screening is using Visual Inspection with Acetic Acid (VIA), service accessibility is limited and the uptake by eligible women is very low. Self-sampling for human papillomavirus (HPV) DNA testing might improve the uptake of targeted women for CC screening, especially for hard-to-reach population in Ethiopia. We investigated whether self-collection of cervicovaginal samples for HPV DNA tests would be associated with increased uptake of screening compared with VIA. Methods: A community-based randomized controlled trial has been conducted in Butajira, one of the Health and Demographic Surveillance Sites (HDSS) of Ethiopia. A total of 55 clusters comprising 2,356 women aged 30-49 were randomized in two arms. Community-based sensitization was conducted using the local community workers at their vicinity. Following the community mobilization women were invited to go to the local health post for self-collection-based HPV DNA testing (arm A) or to Butajira Hospital for VIA screening (arm B). We compared the uptake of screening between the two arms. Results: In the HPV arm, of the total 1,213 sensitized women, 1,020 (84.1%) (P&amp;lt;0.0001) accessed the health post for HPV screening. In the VIA arm, 575 of 1,143 (50.5%) visited the hospital. Among the women who accessed the health post for HPV DNA testing, 892 of 1,020 (87.5%) (p=0.0007) provided samples, while 466 of 575 (81%) underwent VIA screening. The residual was excluded due to eligibility criteria in both arms. Conclusion: This preliminary finding of the trial demonstrated better community acceptability and uptake of self-collection-based CC screening at the health post compared to VIA at the hospital. Self-collection-based CC screening can be done at the local health facility and may significantly improve the uptake of CC screening in Ethiopia. Citation Format: Muluken Gizaw, Friederike Ruddies, Adamu Addissie, Alemayehu Worku, Tamrat Abebe, Brhanu Teka, Andreas M. Kaufmann, Eva Kantelhardt. Community-based uptake of self-sampling for HPV DNA-based testing for cervical cancer screening in Ethiopia: Preliminary findings of a cluster randomized trial [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B103.

Prevalence and Associated Factors of Adverse Birth Outcome Among Deliveries at Butajira Hospital, Southern Ethiopia

Prevalence and Associated Factors of Adverse Birth Outcome Among Deliveries at Butajira Hospital, Southern Ethiopia

Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia

BackgroundIntestinal parasitic infections and HIV/AIDS have been the major public health problems and remain a vital cause of morbidity and mortality in developing countries. Both problems are linked in a vicious cycle. The magnitude of intestinal parasites was prevalent among people living with HIV/AIDS even in the HAART era. However, the pertinent risk factors associated with intestinal parasites among HIV/AIDS patients were not well investigated in Ethiopia particularly at Butajira town. Therefore, the aim of this study was to determine the prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients on HAART in Butajira, Ethiopia.MethodA cross-sectional study was conducted, and a total of 323 study subjects was involved in the study. A systematic random sampling technique was used to select each participant during data collection. Stool specimen was collected and processed using direct wet mount, formol-ether concentration technique, and modified Ziehl-Neelson staining techniques to identify both common and opportunistic intestinal parasites. Structured questionnaire was used to collect socio-demographic, environmental, clinical, and nutritional data. Both bivariate and multivariate logistic regression analyses were used to assess the association of various explanatory factors on intestinal parasites. P value ≤0.05 at 95% CI was considered statistically significant.ResultsThe overall prevalence of intestinal parasites was 35.9% (95% CI 31.0–40.9%). Protozoa’s (Entanmoeba histolytica/dispar trophozoite, E. histolytica/dispar cyst, Giardia lamblia trophozoite, and G. lamblia cyst), helminths (Tanea species, Ascaris lumbricoides, Strongyloid stercoralis, Hookworm species and H. nana), and opportunistic intestinal parasites (Cryptosporidium parvum, Isospora belli) were observed in 57 (17.1%), 46 (14.4%), and 28 (8.7%) study participants respectively. Multivariate logistic regression analysis revealed that the presence of animals (AOR 6. 14; 95% CI 3.13, 12.0); using river water (AOR 4.87; 95% CI 1.14, 20.7); undernutrition (AOR 2.59; 95% CI 1.36–4.95); and level of immunosuppression (AOR 4.02; 95% CI 1.78–9.05 and AOR 2.84; 95% CI 1.37–5.89) were significantly associated with intestinal parasites.ConclusionsThe prevalence of intestinal parasites found to be higher among HIV/AIDS patients receiving HAART at Butajira Hospital, southern Ethiopia. Presence of animals, using river water, lower CD4 T cell count, and undernutrition were significant factors affecting intestinal parasites. Therefore, consistent detection of intestinal parasites and deworming of patients should be performed as well as improving health education on personal hygiene, avoiding contact with pit or domestic animals, and using safe or treated water. Furthermore, improving nutritional support and household food access are recommended.

The Impact of Demographic and Risk Behavioural Factors on the Prevalence of HIV/AIDS in Butajira, Ethiopia

The study aims at describing the impacts of some demographic and risk behavior factors. The data for this study were taken from Butajira Hospital and data were analyzed using SPSS. In this study, chi square test of association is employed to test the association between determinant factors and the prevalence of HIV/AIDS in Butajira, Ethiopia. The result indicates all the proposed variables have significant association with prevalence of HIV/AIDS. Finally a binary logistic regression model is adopted for the analysis of the impact of demographic and HIV related risk factors on client’s status with HIV/AIDS. The result revealed that, client’s age, marital status, education level, occupation, suspected exposure time and condom use found to be significant at 5% significance level, indicating strong effects on prevalence of HIV/AIDS. The probability that an adult in this age groups 24-31, 32-45 and more than 46 years are 1.26 times (odds=1.26), 2.864 times (odds=2.864) 3.945 times (odds=3.945) more likely than those individuals aged between 16 and 23. Educational levels of clients have a significant influence on HIV infection (p value <0.05), as the result individuals who enrolled in secondary education level are more affected than those other individuals (i.e. Odds =1.227). It was also observed that those clients who had no sexual practices in the past are less likely to be infected by HIV/AIDS than those clients had sexual practice before (odds 0.453).

Prevalence of malnutrition and its associated factors among adult people living with HIV/AIDS receiving anti-retroviral therapy at Butajira Hospital, southern Ethiopia

Malnutrition and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) are highly prevalent in Sub-Saharan Africa, and they are linked in a vicious cycle. Intestinal parasite co-infection worsens the effect of malnutrition among HIV patients. However, the magnitude of malnutrition and its determinant factors among people living with HIV/AIDS are not well understood in Butajira in particular and Ethiopia in general. The aim of this study was to determine the prevalence of malnutrition and its associated factors among adult people living with HIV/AIDS and receiving anti-retroviral therapy (ART). Institution-based cross-sectional study was conducted, and systematic random sampling technique was used to select study subjects. A total of 305 study subjects were enrolled in the study. Structured and pre-tested questionnaire was used to collect demographic data. From each sampled patient, anthropometric and laboratory data were also collected. Both bivariate and multivariate logistic regression analyses were used to assess the effect of the various factors on the level of malnutrition. A P value ≤0.05 at 95% CI was considered statistically significant. The overall prevalence of malnutrition was 25.2% of which 49, 19, and 9 patients were mildly, moderately, and severely malnourished, respectively. Multivariate logistic regression analysis revealed that living in rural area, anemia, and intestinal parasitic co-infection were significantly associated with malnutrition (AOR = 1.98, 1.9, 2.85, respectively). The prevalence of malnutrition among HIV/AIDS patients receiving ART in Butajira was high and intestinal parasite co-infection was found as an important risk factor associated with malnutrition.

Food Insecurity and its Associated Factors among People Living with HIV/AIDS Receiving Anti-Retroviral Therapy at Butajira Hospital, Southern Ethiopia

Background: Food insecurity and HIV/AIDS are common problems in resource limited setting particularly Sub- Saharan countries. Both are intertwined and worsening one another in a vicious cycle through a mixture of various factors. However, the magnitude of food insecurity and its associated factors among People Living with HIV/AIDS are not well studied in Ethiopia. Objective: The aim of this study was to assess the prevalence of food insecurity and its associated factors among adult people living with HIV/AIDS receiving HAART. Methods: Institution based cross-sectional study was conducted. A total of 338 study subjects were enrolled in the study and systematic random sampling technique was used to select the study participants. Structured and pre-tested questionnaire was used to collect socio-demographic, clinical and nutrition related data. Both bivariate and multivariate logistic regression analyses were used to assess the effect of the various factors on food insecurity. P-value ≤ 0.05 at 95% CI was considered statistically significant. Results: The overall prevalence of food insecurity among PLWHA receiving HAART at Butajira hospital was 78.1% (95% CI: 73.7%-82.8%). Mild, moderate and severe food insecurity was observed on 4.4%, 32.0% and 41.7% participants respectively. Multivariate Logistic regression analysis revealed that living in rural area (AOR=1.94; 95% CI: 1.11, 3.38), low monthly income (AOR=7.80; 95% CI: 7.80 (3.55-17.1) and inadequate household dietary diversity (AOR=14.4; 95% CI: 4.90, 42.6) were significantly associated with food insecurity. Conclusion: Food insecurity is high among PLWHA receiving HAART at Butajira Hospital, Southern Ethiopia. Living in rural area, low monthly income, under-nutrition and inadequate household dietary diversity were the significant factors for food insecurity.

Helicobacter pylori infection and its association with anemia among adult dyspeptic patients attending Butajira Hospital, Ethiopia.

BackgroundHelicobacter pylori infection is associated with anemia. Understanding the magnitude of H.pylori infection and its association with anemia is important in the management of anemic patients. The aim of this study was to assess the association between H.pylori infection and anemia among dyspeptic patients.MethodsA cross-sectional study was conducted in Butajira Hospital, Southern Ethiopia among 401 systematically dyspeptic patients. A structured questionnaire was used to collected data about the patient characteristics. Blood samples were analyzed for red blood cell parameters. Stool samples were assessed for the presence of H.pylori antigens and the presence of intestinal helminthes. Data were summarized in frequencies (%) and mean (SD) as appropriate. Chi-square test, logistic regression and independent t-tests were used in the analysis as needed. In all cases P-value <0.05 was considered as statistically significant.ResultsThe overall prevalence of H. pylori infection was 52.4% and it was significantly associated with age, presence of intestinal parasites, smoking habit, alcohol drinking habit and body mass index. The prevalence of anemia among H.pylori infected patients (30.9%) was significantly (P < 0.001) higher than uninfected patients (22.5%). The mean (SD) values of HGB, MCV, MCH, MCHC, HCT and RBC count was significantly different between H.pylori infected and uninfected patients.ConclusionThis study showed high prevalence of H.pylori infection among dyspeptic patients and this was associated with age and some behavioral characteristics of the patients. H.pylori infected patients showed high rate of anemia prevalence as compared to their H.pylori unifected counter parts. From this study it can be recommended that intervention activities related to the behavioral characteristics and prevention of intestinal parasitic infections should be in place. The cross sectional nature of the study has a limitation to show cause and effect associations and hence association between H.pylori infections with anemia need to be investigated in cohort type studies.

Chronic kidney disease and underdiagnosis of renal insufficiency among diabetic patients attending a hospital in Southern Ethiopia.

BackgroundDiabetic patients with chronic kidney disease (CKD), as defined by a reduced glomerular filtration rate (GFR), are at greater risk for cardiovascular and renal events and mortality. The aim of this study was to determine the prevalence of CKD among diabetic patients attending a hospital in southern Ethiopia, and to assess underdiagnosis of renal insufficiency among those with normal serum creatinine.MethodsA total of 214 randomly selected diabetics attending the follow-up clinic at Butajira hospital of southern Ethiopia participated in this study during the period from September 1 to October 31, 2013. All patients completed an interviewer-administered questionnaire and underwent clinical assessment. The simplified Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault (C-G) equations were used to estimate GFR (eGFR) from serum creatinine.ResultsCKD, defined as eGFR < 60 ml/min/1.73 m2, was present in 18.2% and 23.8% of the study participants according to the MDRD and Cockcroft-Gault (C-G) equations, respectively. Only 9.8% of the total participants, and 48.7% (for the MDRD) and 37.3% (for C-G) of those with eGFR <60 ml/min/1.73 m2 had abnormal serum creatinine values, i.e. > 1.5 mg/dl. Normal serum creatinine was observed in 90.2% of participants attending the hospital. A large proportion of participants ranging from 38.9-56.5% have shown to have mild to moderate renal insufficiency (stage 2–3 CKD) despite normal creatinine levels. CKD, eGFR < 60 ml/min/1.73 m2, was found in 10.4 and 16.9% of participants with normal serum creatinine using the MDRD and C-G equations, respectively.ConclusionCKD is present in no less than 18% of diabetics attending the hospital, but it is usually undiagnosed. A significant number of diabetics have renal insufficiency corresponding to stages 2–3 CKD despite normal creatinine levels. Therefore, GFR should be considered as an estimate of renal insufficiency, regardless of serum creatinine levels being in normal range.

Prevalence of Chronic Kidney Disease and Associated Risk Factors among Diabetic Patients in Southern Ethiopia

Background: Chronic kidney disease (CKD) in diabetes is associated with an increased risk of premature mortality, kidney failure and cardiovascular disease. No studies are available on the prevalence of CKD among diabetics in Ethiopia. The aim of this study was to determine the prevalence of CKD and its associated risk factors among diabetic adults attending Butajira hospital of Southern Ethiopia based on estimated glomerular filtration rate (GFR). Methods: A facility based cross sectional study was conducted in Butajira hospital, southern Ethiopia among 214 randomly selected diabetic adults. Demographic, clinical, and laboratory data were collected from September 1, 2013 to October 31, 2013. The simplified Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault (CG) equations were used to estimate GFR (eGFR) from serum creatinine value. SPSS 20.0 Software was used for data analysis. Results: 39 (18.2%) and 51 (23.8%) of the study participants were found to have CKD, as defined by eGFR < 60 ml/min/1.73 m2, according to the MDRD and Cockroft-Gault equations, respectively. Of these; 17.3 and 22.9% have stage 3 CKD, and 0.9% have stage 4 CKD, respectively. Significant risk factors for CKD in the study subjects when using either the MDRD or C-G equation were older age, longer duration of diabetes, family history of kidney disease, and poor glucose control (P < 0.05). Additionally, female sex (P < 0.008) and obesity (P < 0.038) were independent risk factors for CKD when defined by the MDRD, and type 2 diabetes was when defined by C–G (P < 0.03). Conclusion: CKD was present in not less than 18.2% diabetic adults attending the follow up clinic at Butajira hospital, in southern Ethiopia. Risk factors for CKD were similar to those reported in developed country studies. Using the MDRD equation led to a lower prevalence of CKD and a better risk categorization than did by C-G equation, thus contributing to better management of clinical outcomes in diabetic care.

Identification and genotyping of the etiological agent of tuberculous lymphadenitis in Ethiopia

In Ethiopia, little has been done to assess how Mycobacterium bovis has contributed to human tuberculosis, though the population routinely consumes unpasteurized milk and raw meat. The aim of this study was to determine the proportion of M. tuberculosis and M. bovis as etiological agents of tuberculous lymphadenitis (TBLN). Patients with lymphadenopathy (n = 171) were included in a cross-sectional study at Butajira Hospital, Southern Ethiopia. Lymph node biopsies were cultured. Patients' HIV status was identified. DNA from positive cultures was tested by PCR to identify M. bovis and M. tuberculosis. Isolates were genotyped by multiplex ligation-dependent probe amplification (MLPA) assay. Among 171 patients, 156 had culture results. Of these, 107 (69%) were positive for M. tuberculosis complex (MTC). Six of the 10 HIV-positive patients were culture positive. M. tuberculosis specific sequences were identified in the DNA of each of 100 samples as assessed by RD10 targeted PCR, and each of the 95 isolates exhibited the M. tuberculosis specific TbD1 deletion by MLPA analysis. No M. bovis was identified. These results indicate that all the isolates were modern M. tuberculosis strains. Furthermore, MLPA studies confirmed that 42% of the isolates showed the Haarlem genotype and 12% displayed sequences compatible with INH resistance. No mutations conferring resistance to ethambutol or rifampicin were detected. Our data showed that M. tuberculosis strains had common characteristics with strains causing pulmonary TB, which appears to be the main etiological agent of TBLN.