Debre Markos Referral Hospital Research Articles

Laboratory specimen rejection rate and associated factors among referred specimens at Debre Markos Referral Hospital, Ethiopia: prospective cross-sectional study.

laboratory errors mostly emerge from the pre-analytical phase, mainly those related to collection, handling, transportation, and storage of diagnostic specimens. Specimen rejection due to improper sample collection, may lead to poor patient outcomes, such as incorrect diagnosis, inappropriate treatment, and death. This study aimed to assess the specimen rejection rate and associated factors among referred specimens at Debre Markos Referral Hospital. a prospective cross-sectional study design was applied from January 2020 to April 2020 to investigate specimen rejection rate and associated factors among referred specimens. The study population was all laboratory specimens referred for viral load, CD4 count, gene expert, and early infant diagnosis to the Debre Markos Referral Hospital laboratory. The statistical analysis was done with Statistical Package for Social Sciences version 20.0 software. of the total of 2750 specimens submitted to the laboratory from January 2020 to April 2020, 37 (1.34%) specimens were rejected due to different reasons like insufficient volume, hemolysis, and an inappropriate specimen container. Specimen collector training status and experience had a significant association with the specimen rejection rate. the results of our study show that the specimen rejection rate among referred specimens was high, indicating that more interventions are required to decrease the specimen rejection rate.

The impact of exercise modalities on blood glucose, blood pressure and body composition in patients with type 2 diabetes mellitus

BackgroundPhysical activity has been recommended as an important non-pharmacological therapeutic strategy for the management of type 2 diabetes mellitus (T2DM). The aim of this study was to investigate the effects of 12 weeks of strength, aerobic, and a combination of aerobic and resistance training on blood glucose level, blood pressure, and body composition in patients with T2DM.MethodsFrom Debremarkos referral hospital, 40 subjects with T2DM (mean age 42.45 years, 29 men, 11 women) were randomly assigned to one of three intervention groups or the control group. The following variables were measured: body mass index (BMI), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and body fat percentage (BFP). Paired sample T-test and one-way ANCOVA were applied whilst controlling for diet, gender, and age.ResultsAll intervention groups showed improvement in a mean difference of FBG − 13.03 (t =-5.55, df = 39, p < 0.001), SBP − 21.63 mmHg − 17.6 mmHg (t =-6.51, df = 39, p < 0.001), DBP − 11.86 mmHg (t = -5.47, df = 39, p < 0.001) and BFP − 9.14 (t = -7.49, df = 39, p < 0.001). There was a significant difference in mean BMI reduction when diet, gender, and age were controlled in a one-way ANCOVA (F (3, 33) = 11.79, p < 0.001), SBP (F (3, 33) = 13.383, p < 0.001), DBP (F (3, 33) = 7.830, p < 0.001), FBG (F (3, 33) = 6.337, p < 0.001), BFP (F (3, 33) = 24.29, p < 0.001) between the exercise intervention groups and control group. Additionally, the estimated marginal means indicate that the combined strength and aerobic exercise intervention group experienced the greatest improvements.ConclusionBody composition, blood pressure, and fasting blood glucose were significantly lower in the combined (aerobic plus strength) treatment than in the individual treatment, indicating that the combined exercise intervention was more successful in altering these parameters.

Seroprevalence and risk factors for Toxoplasma gondii infection among pregnant women at Debre Markos Referral Hospital, northwest Ethiopia.

To assess the seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women at the Debre Markos Referral Hospital, northwest Ethiopia. A facility-based cross-sectional study was undertaken among pregnant women from March 2020 to May 2021. Sociodemographic and clinical data were collected from randomly selected participants. Five millilitres of blood was collected and an enzyme-linked immunosorbent assay kit was used to test for T. gondii immunoglobulin G (IgG) antibodies. A logistic regression model was computed to identify the risk factors. The adjusted odds ratio (aOR) was estimated along with the 95% confidence interval (CI). A statistically significant association was defined as p<0.05. T. gondii IgG antibody positivity was found in 38.8% (n=132) of 340 pregnant women. Contact with cats (AOR 2.5 [95% CI 1.5 to 4.2]), eating raw/undercooked meat (AOR 5.7 [95% CI 3.2 to 10.3]), consuming unwashed vegetables (AOR 4.1 [95% CI 2.1 to 8.0]), a history of abortion (AOR 1.9 [95% CI 1.1 to 3.3]) and drinking water sources (AOR 2.5 [95% CI 1.2 to 5.2]) demonstrated a statistically significant association with T. gondii infection. Toxoplasmosis was found to be fairly common in pregnant mothers. Proper cat excreta disposal, not eating raw/undercooked meat, maintaining hand cleanliness and following environmental sanitation protocols could be important to decrease T. gondii infection.

Pre-labor rupture of membranes and associated factors among pregnant women admitted to the maternity ward, Northwest Ethiopia.

Pre-labor rupture of membranes (PROM) is the rupture of fetal membranes before the onset of labor. PROM is found in 3-15% of all pregnancies and 30-40% of preterm labor worldwide. The most serious complications are neonatal and prenatal mortality, which is higher in Africa, including Ethiopia. Despite a paucity of evidence on the magnitude and factors affecting PROM after 28 weeks of gestation but before the onset of labor (including both term and preterm PROM). Hence, the purpose of this study was to determine the magnitude and identify associated factors of the pre-labor rupture of membranes. An institutional-based cross-sectional study was conducted among 315 pregnant women from April 10, 2019 to June 30, 2019 at Debre Markos Referral Hospital. The samples were chosen using a systematic random sampling method among admitted pregnant women. The data were entered using EpiData entry version 4.2 and cleaned and analyzed using Stata/SE version 14.0. In binary logistic regressions, variables with a p-value <0.20 are selected for multivariable analysis. A multivariable logistic regression model with a 95% confidence interval and a p-value <0.05 was used to identify associated factors. In this study, the magnitude of PROM was 19%. Maternal monthly income ≤1000 birr [AOR: 3.33 (95%CI: 1.33, 8.33)], gestational age <37weeks [AOR: 3. 28 (95%CI: 1.53, 7.02)], multiple pregnancy [AOR: 4.14 (95%CI: 1.78, 9.62)], polyhydramnios [AOR: 5.06 (95%CI: 2.28, 11.23)] and history of abnormal vaginal discharge [AOR: 6.65 (95%CI: 2.62, 16.72)] were found significant associated factors. In conclusion, the magnitude of the pre-labor rapture of the membranes was higher than in previous studies. Hence, health professionals should strengthen counseling, early diagnosis, and treatment of infections, as well as focus on women with pregnancy-related risks, to reduce pre-labor rupture of membranes and improve fetal and perinatal health.

Incidence and Predictors of Inpatient Mortality Rate After Cases Started Care in the Intensive Care Unit in Debre Markos Referral Hospital.

The intensive care unit (ICU) is a separate area in which potential health care services for patients who are in critical condition with detailed observation, monitoring, and advanced treatment than other units. This study aimed to assess the incidence and predictors of inpatient mortality after inpatient treatment was started in Debre Markos Comprehensive Specialized Hospital. A facility-based retrospective cohort study was employed among 384 ICU-admitted patients from December 30, 2020 to January 1, 2022. The collected data were entered into Epi Data version 4.2 and exported to STATA 14.0 for further analysis. The Cox proportional hazard regression model was fitted after checking using the Schoenfeld residual and log-log plot test. A categorical variable with an adjusted hazard ratio of 95% CI was claimed for predictors. Overall, 384 admitted adult patients were included in the final analysis with a mean (±SD) age of 42.1 (±17.1) years. At the end of the follow-up period, 150 (39.06%) cases died in the ICU. The overall incidence of the mortality rate was 16.9 (95% CI: 13.7-19.55) per 100 person per day. Epidemiologically, 347 (90.36%) cases were medical illness, 25 (6.51%) surgical, and 12 (3.13%) were obstetric cases, respectively. The median length of inpatient stay was found to be 4.9 (IQR ± 2.8) days. In multivariable analysis; being (+) for human immunodeficiency virus (AHR = 0.59, 95% CI: 0.39-0.91), age ≥65yearas (AHR = 1.61, 95% CI: 1.11-2.32), and admission on weekend-time (AHR = 1.48, 95% CI: 1.06-2.06) were predictors of inpatient death. The overall in-hospital mortality rate was significantly higher than in the previous study in this hospital with a short median survival time. The inpatient mortality rate was significantly associated with age ≥65 years, being HIV positive, and admission during weekend time. Therefore, effective intervention strategies should be highly needed for ICU team members for early risk factors prevention.

Prevalence, associated factors and rifampicin resistance pattern of pulmonary tuberculosis among HIV-positive patients attending antiretroviral treatment clinic at East Gojjam Zone, Ethiopia: An institution-based cross-sectional study

BackgroundDrug-resistant tuberculosis (TB) threatens global TB care and prevention, and it remains a major public health concern in many countries particularly in sub-Saharan countries. Pulmonary TB is the most common serious opportunistic infection on HIV-positive patients and it is the leading cause of death among HIV-positive patients in developing countries. Ethiopia is one of the high TB burden countries with high morbidity and mortality. ObjectiveTo determine the prevalence, associated factors and rifampicin resistance of pulmonary TB among HIV-positive attending antiretroviral treatment clinic at East Gojjam. MethodsHospital-based cross-sectional study was conducted at Debre Markos Referral Hospital, from February to June 2019. A total of 112 HIV-positive TB suspected patients were included using convenient sampling techniques and a bacteriological confirmation test for tuberculosis was performed using Gene-Xpert MTB/RIF assay from a spot sputum sample. Viral load was determined by using a quantitative real-time polymerase chain reaction (RT-PCR) from the blood sample. Socio-demographic and clinical data were collected by face-to-face interview using a semi-structured questionnaire. The data were analyzed by using Statistical Package for Social Sciences (SPSS) software (version 24). ResultOut of the 112 study participants, the prevalence of Pulmonary TB was 11.6 %. Among TB positives 23.1 % were rifampicin resistant. Rifampicin resistance was 100 % among female patients. Having family members treated for pulmonary TB (P = 0.003, [AOR = 4.5; 95 % CI = 3.59–58.8]), cigarette smoking (P = 0.039, [AOR = 2.18; 95 %CI = 1.17–40.5]), being on WHO HIV disease clinical stage II (P = 0.024, [AOR = 1.81; 95 %CI = 1.50–30.99]), and having viral load (1000–9999) RNA copies/ml (P = 0.031, [AOR = 1.54; 95 %CI = 1.32–31.41]) were found to be significantly associated with pulmonary TB. ConclusionThe prevalence of pulmonary TB and rifampicin resistance was high among HIV patients. Having family members treated for Pulmonary TB, history of cigarette smoking, WHO HIV clinical stage, and high viral load were associated risk factors for TB. Therefore, strengthening awareness creation on TB transmission, drug resistance, and treatment adherence are essential. Moreover, early screening and treatment are vital for preventing the transmission and occurrence of drug-resistant TB among study populations.

Prevalence of undernourishment and associated factors among adults with major depressive disorder at two public hospitals in Northwest Ethiopia: a cross-sectional study

ObjectiveUndernourishment is overlooked in people with major depressive disorder (MDD); however, it could have huge impacts on recovery, functioning and quality of life. This study aimed to assess the prevalence...

Health-related quality of life and associated factors among type 2 diabetic adult patients in Debre Markos Referral Hospital, Northwest Ethiopia

Health-related quality of life (HRQOL) is a multifaceted concept that is strongly impacted by Type II diabetes in developing countries. The majority of studies indicate diabetes mellitus prevalence without looking at people's quality of life.This study was conducted using an Institution-based cross-sectional design in Debre Markos Referral Hospital from March 03 to March 31, 2020. We evaluated HRQOL using the WHO quality of life BREF and data were obtained through face-to-face interviews. We used a systematic random sampling technique to select study participants. Data were entered into Epi data version 3.1 and exported to STATA version 14.0. Candidates for multivariable analysis were variables with a P-value less than 0.25 in the bivariable analysis and P-value less than 0.05 were considered to declare a statistically significant association. The final model was tested for its goodness of fit using Hosmer and Lemeshow's statistics.The analysis included a total of 368 adult individuals with type II diabetes and 206 (56%) had a good HRQOL. Being male (AOR = 4.28, 95%CI:2.36, 7.78), having duration of disease of more than 59 months (AOR = 2.93, 95%CI:1.61, 5.34), doing a physical exercise (AOR = 2.33,95%CI:1.34, 4.05) and got counseling (AOR = 3.33; 95%CI:1.82, 5.94) were directly associated with good HRQOL whereas the presence of diabetic complications (AOR = 0.46, 95%CI:0.26, 0.80), comorbidity (AOR = 0.45; 95%CI:0.25, 0.84) and drinking alcohol (AOR = 0.27, 95%CI:0.16, 0.48) had an inverse relationship with good HRQOL.More than half of type 2 diabetic adult patients had a good HRQOL. Being male, drinking alcohol, getting counseling, doing physical exercise, absence of diabetic complications, and comorbidity and long duration of disease were predictors of good HRQOL. Therefore, avoiding drinking alcohol and promoting physical exercise and counseling should be encouraged.

Glycemic control and its associated factors in type 2 diabetes patients at Felege Hiwot and Debre Markos Referral Hospitals.

Poor glycemic control is a main public health problem among type 2 diabetes mellitus (T2DM) patients and a significant cause of the development of diabetic complications. This study aimed to assess the glycemic control status and its associated factors among type 2 diabetes patients in Felege-Hiwot and Debre Markos Referral Hospitals. A retrospective cohort study was conducted at Felege-Hiwot and Debre Markos Referral Hospitals from December 2014 to December 2015. We have reviewed the chart of these patients until January 2020. Type 2 diabetic patients on follow-up at Felege-Hiwot and Debre Markos Referral Hospitals who fulfilled the inclusion criteria of the study were included. The primary outcome was the level of blood glucose during the study period. Good glycemic control was defined as patients whose average fasting blood glucose measurement for three consecutive visits was between 70 and 130 mg/dL. A generalized linear mixed autoregressive order one model was used to identify the determinants of glycemic control. A total of 191 patients with 1740 observations were included in the study. The overall prevalence of good glycemic control was 58.4% (95% CI: 57.159.7%). The factors associated with good glycemic control at 95% confidence level adjusted odds ratio were being residing in rural (CI: 0.454, 0.614), negative proteinuria (CI: 1.211, 1.546), diastolic blood pressure < 90 (CI: 1.101, 1.522), systolic blood pressure < 140 (CI: 1.352, 1.895), serum creatinine (CI: 0.415, 0.660), duration per visit (CI: 0.913, 0.987), duration since diagnosis (CI: 0.985, 0.998), weight ≥ 78 kg (CI: 0.603, 0.881). Age 38–50, 51–59 and 60–66 years (CI: 1.267, 1.776), (CI: 1.057, 1.476) and (CI: 1.004, 1.403), respectively. The overall prevalence of poor glycemic control was high at Debre Markos and Felege Hiwot Referral Hospital. Living in a rural area, older age (≥ 67 years), positive proteinuria, higher weight (≥ 78 kg), higher serum creatinine levels, higher duration per visit, higher time duration of T2DM since diagnosis, and developing hypertension (SBP ≥ 140, DBP ≥ 90) were the predictors of lower good glycemic control achievements of T2DM patients. In response to this finding, an aggressive intervention that targets improving glycemic control is required.

Predictors of blood glucose change and microvascular complications of type 2 diabetes mellitus patients in Felege Hiwot and Debre Markos referral hospital, North West Ethiopia

BackgroundMicrovascular complications lead to disability, dependency, and accelerated morbidity and mortality. This study aimed to identify predictors of blood glucose change and time to microvascular complications among patients with type 2 diabetes.MethodsA retrospective cohort study was conducted among type 2 diabetes mellitus patients enrolled between December 2014 and December 2015 at Felege Hiwot and Debre Markos Referral Hospital. A total of 318 T2DM patients were included in the study. Joint modelling of longitudinal and survival analysis was employed to identify predictors of Blood Glucose Change and Microvascular Complications in Type 2 Diabetes Mellitus Patients.ResultsThe prevalence of microvascular complications in Type 2 diabetes patients was 26.3%, 95%confidence interval(CI):(21.5, 31.1). Of which, half of the patients developed a microvascular complication after 30 months from the onset of the follow-up. The significant predictors of developing microvascular complication were positive proteinurea (adjusted hazard ratio (AHR) = 1.418, 95%CI: 1.080, 1.861), Serum creatinine (AHR = 3.704, 95%CI: 1.992, 6.887), Weight (AHR = 1.058, 95%CI: 1.023, 1.094), and log fasting blood glucose(log(FBS))(AHR = 1.013, 95%CI: 1.010, 1.015). The predictors of fasting blood glucose progression were higher baseline FBS(est(estimate) = 0.002,95%CI:0.0018, 0.0022), Systolic blood pressure (SBP) (est = 0.003, 95%CI: 0.002, 0.004), diastolic blood pressure (DBP) (est = 0.002, 95%CI: 0.0002, 0.004), and age (est = 0.003, 95%CI: 0.001, 0.004).ConclusionThe progression of the fasting blood glucose level for rural patients was faster than for urban patients. Patients having higher baseline FBS, previous hypertension history, higher SBP, higher DBP, older age, and fewer visits to the hospital have a relatively more progressive change in blood sugar levels. Patients having higher triglyceride levels, positive proteinuria, higher fasting blood sugar, higher weight, and a lesser number of hospital visits have a higher risk of developing a complication. In response to this finding, an aggressive intervention that targets to prevent microvascular complications is required.

Evaluation of Lipid Profile and Inflammatory Marker in Patients with Gastric Helicobacter pylori Infection, Ethiopia.

IntroductionH. pylori are gram-negative, microaerophilic helical-shaped bacteria with multiple flagella and commonly exist in the stomach. This infection may cause significant mucosal inflammation and damage, leading to ulcers in the stomach. It can also affect organ systems external to the gastrointestinal tract. To assess cardiovascular risk factors and to predict cardiovascular disorders, we are evaluating and comparing lipid profile and inflammatory marker between H. pylori-positive and negative patients.ObjectiveTo evaluate and compare lipid profile (TC; TG; LDL; HDL) and inflammatory marker (hs-CRP) in dyspeptic patients with and without H. pylori infection.MethodsComparative cross-sectional study was conducted from September 2020 to January 2021 at Debre Markos Referral Hospital, Debre Markos Health Center, and Hidassie Health Center, Ethiopia. Each of 50 H. pylori-positive and negative dyspeptic patients were studied. The data were checked for completeness and analyzed by SPSS version 25.0 Software. A p-value < 0.05 was considered statistically significant.ResultsSerum mean high-density lipoprotein (HDL) values were 37.54 ± 7.98 mg/dL and 43.12 ± 7.86 mg/dL (p < 0.05) for H. pylori-positive and negative dyspeptic patients, respectively, and median serum high sensitive C reactive protein (hs-CRP) levels were 6.29 mg/L (1.66–41.34) and 3.35 mg/L (0.39–10.01) (p < 0.05) for H. pylori-positive and negative dyspeptic patients, respectively.ConclusionH. pylori infection significantly alters serum high-density lipoprotein (HDL) and high sensitive C reactive protein (hs-CRP) levels in dyspeptic patients, as a result, increase the potential risk of cardiovascular diseases.

Mortality Rate and its Predictors Among Adult Tuberculosis Patients in Debre Markos Referral Hospital, North West Ethiopia

Mortality Rate and its Predictors Among Adult Tuberculosis Patients in Debre Markos Referral Hospital, North West Ethiopia

Health-related quality of life and associated factors among HIV-positive individuals on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia

Health-related quality of life and associated factors among HIV-positive individuals on antiretroviral therapy at Debre Markos Referral Hospital, Northwest Ethiopia

Nutritional status of Human Immune virus-infected under-five children in North West Ethiopia

BackgroundGlobally, malnutrition affects nearly one-third of the 8 million deaths of under 5 years children. Malnutrition associated with the Human Immune virus (HIV) infection is a complex medical condition. The co-occurrence of malnutrition and HIV increase the rate of morbidity and mortality of children significantly. ObjectiveThis study aimed to assess nutritional status and associated factors of HIV-infected under-five children before antiretroviral therapy initiation in North West Ethiopia. MethodsAn institution-based cross-sectional study was conducted among 270 records of HIV-infected children who were visiting Debre Markos referral hospital and Felege Hiwot referral hospital from 2015 to 2017 in North West Ethiopia. Malnutrition was assessed among the participants using the World Health Organization Z-score charts. Data were entered using Epi-Data version 3.1 and analysis was done using STATA 14 statistical software. The multivariable logistic regression model was fitted for each explanatory variable. Odds ratio with its 95% confidence interval with p-values < 0.05 were used to measure statistically significant association. ResultThe overall burden of malnutrition among HIV-infected under-five children was 27%; 10.7%, 17.8 %, and 15.9 % of wasting, stunting, and underweight respectively. Of all participants, 40% of them had a CD4 count below the threshold, 37.8% were in advanced stages of the disease and 17.8% of children had developed anemia. Seventeen percent of HIV-infected under-five children had opportunistic infections of which tuberculosis, pneumonia, and Kaposi’s sarcoma were highly observed. Age of children was significantly associated with malnutrition; older children were less likely to develop malnutrition as compared to infants (AOR: 0.15, 95% CI (0.07, 0.32)). ConclusionThe magnitude of malnutrition among HIV-infected children remains high in the study area. Therefore, measures should be strengthened in promoting nutritional education for HIV-positive children.

Predictors of extrapulmonary tuberculosis among diabetic patients at Debre Markos compressive specialized hospital, Ethiopia, 2021: A retrospective cohort study

BackgroundExtrapulmonary tuberculosis is an emerging public health problem among diabetic patients. Diabetes, which causes immunosuppression, is increasingly being recognized as an independent risk factor for tuberculosis, and the two often coexist and impact each other. Therefore, this study aimed to investigate the incidence and predictors of extra pulmonary tuberculosis among diabetic patients at Debre Markos referral hospital, Northwest Ethiopia. MethodsThis institutionally-based retrospective cohort study was undertaken among 433 diabetic patients of Debre Markos compressive specialized hospital between January 2016 to December 2020. All eligible diabetic patients who full filled the inclusion criteria were included in the study. Data were entered using Epi-data Version 3.1 and analyzed using STATA Version 14. The survival time of diabetic patients was estimated using the Kaplan-Meier survival curve, and the survival time between different categorical variables was compared using the log rank test. Both bi-variable and multivariable Cox-proportional hazard regression models were fitted to identify independent predictors of tuberculosis among diabetic patients. ResultsAmong a cohort of 433 diabetic patients at Debre Markos compressive specialized hospital, 17(3.9%) developed extra pulmonary tuberculosis during the follow-up time. The total time allotted to follow up the study participants was 1101.5 person-years (PY). The overall extra pulmonary tuberculosis incidence rate was 1.5 per 100 PY with 95% CI. Using the multivariable Cox-regression analysis, age (AIR 4.8 (95% CI (1.2–20.7), 0.03), diabetic medication (AIR 1.4 (95% CI(1.24–16), 0.03), having past history of PTB before diabetic follow up initiation (AID 1.5(95% CI (3.2–6.9),0.01) and having history of alcohol (AIR (95%CI (4(1.2–13),0.02) were significantly increased the risk of extra pulmonary tuberculosis while BMI (18.5–25) AIR(95% CI (0.22 (0.06–0.76), 0.02) was associated with a rate reduction for the incidence of extra pulmonary tuberculosis. ConclusionsIn this study, we found a high rate of extra pulmonary tuberculosis among diabetic patients. Factors significantly linked with increased risk of extra pulmonary tuberculosis included: age, using insulin as hypoglycemic medication, having past history of PTB before diabetic follow up initiation and alcoholic history while BMI was associated with a rate reduction of EPTB. Early screening and treatment for extra pulmonary tuberculosis is highly recommended at diabetes mellitus follow up for patients with the above risk factors.

Multistate Models for the Analysis of Time to Type II Chronic Diabetic Complications in Debre Markos Referral Hospital, Northwest Ethiopia

Introduction: Diabetes is a chronic, non-communicable disease characterized by elevated blood glucose levels. The purpose of this study was to jointly model the transition of diabetic patients in a series of clinical states and to assess the relationship between each state and different patient characteristics. Methods: A hospital-based retrospective study was conducted on 524 patients with type II diabetes, aged 18 years or older, who attended their medication between January 1, 2005, and December 31, 2017. Multistate models with different assumptions were considered to explore the effects of different prognostic factors on the transition intensity of type II diabetes mellitus patients. Results: During a median follow-up time of 7.4 years (Inter-Quartile Range=4.01), 54.8% of diabetic patients developed either microvascular or macrovascular complications, and 10.5% of them experienced both microand macrocomplications, and 16.66% of diabetes patients died. The assumption Markov was assessed by using the likelihood ratio test showed that Markov assumption was not held just for the transition. The transition rate of patients from the macrovascular state to the death state was affected by the residence of the patients (P=0.05) and age at diagnosis (p=0.01). The transition rates of patients with microvascular complications to death were significantly affected by baseline triglyceride level (P&lt;0.001), age at first diagnosis (P=0.01), baseline glucose level (P=0.03, and baseline serum creatinine level (P=0.04). Conclusion: The semi-Markov model fitted the data well and could be used as a convenient model for the analysis of time to diabetes-related complications or death.

Incidence and Predictors of Mortality among Preterm Neonates Admitted to the Neonatal Intensive Care Unit at Debre Markos Referral Hospital, Northwest Ethiopia.

Prematurity is the most frequent cause of neonatal death and the second leading cause of under-five mortality. Preterm related complications accounts for 35 % of neonatal deaths within the first week after birth. So far, most studies done in Ethiopia have focused on estimating the prevalence and determinant factors of premature neonatal death. The current study aimed to assess the incidence and predictors of mortality among preterm neonates admitted to neonatal intensive care unit at Debre Markos Referral Hospital. An institution-based retrospective follow up study was conducted among premature neonates admitted to Neonatal Intensive Care Unit at Debre Markos Referral Hospital from July 2019 to October 2019. Around 498 patients were selected randomly. A multivariable cox proportional hazards model was fitted to identify predictors of mortality. A total of 498 preterm babies were followed, and the mean age for follow up at the time of admission to NICU was 15 hours ± 38 SD. Death rate in preterm was estimated to be 27.11% (95% CI: 23.3%, 31.1%). Preterm neonates with gestational age of less than 32 weeks (AHR=1.51; 95% CI: 1.02, 2.24), respiratory distress syndrome (AHR=1.49; 95% CI: 1.03, 2.17), perinatal asphyxia (AHR=1.74, 95% CI: 1.01, 2.76) and congenital malformation (AHR=3.38, 95% CI: 1.21, 8.77) were statistically significant predictors of mortality among preterms. The incidence of death in preterm neonates is relatively low. Gestational age less than 32 weeks, perinatal asphyxia, respiratory distress syndrome and congenital malformation were found as predictors.

Magnitude of anemia and associated factors among children aged 6\u201359\u2009months at Debre Markos referral hospital, Northwest Ethiopia: a hospital-based cross-sectional study

BackgroundAnemia, the most common micro-nutrient deficiency disorder, is the world’s second leading cause of morbidity and morbidity, affecting 24.8% of the population, of which 47.4% are under-five children. The prevalence of anemia ranges from 44 to 56% in Ethiopia. Although its magnitude has shown decreases across regions; it continues to be a significant public health problem, particularly in developing countries including Ethiopia. Despite this evidence, the magnitude and associated factors of anemia was not systematically explored and there is a limited information or limited evidences in the study area. Hence, the aim of this study was to assess the magnitude and associated factors of anemia among children aged 6–59 months attending at Debre Markos Referral Hospital, Northwest Ethiopia.MethodsA hospital-based cross-sectional study was conducted at Debre Markos referral hospital Northwest Ethiopia from September 30 to December 30, 2019. Data on socio-demographic and socio-economic factors, health and nutritional features of children and their mothers were obtained using pre-tested structured questionnaires in a face-to-face interview with child care providers. Blood samples and stool examination for intestinal parasites were performed. Hemoglobin level was analyzed using the HemoCue device (HemoCueHb 301). The collected data were coded, cleared and entered into Epi-Data version 3.1, and analyzed using Stata version 14 software. To identify candidates and predictor variables, bivariate and multivariate logistic regressions were applied respectively. The significance level was determined at a confidence interval of 95% at p-value < 0.05.ResultsOf the total of 341 participants planned to be participated, about 310 mother-child pairs participated in the study, giving a response rate of 91%; and data were collected from children as well as their parents or guardians.In this study, the magnitude of anemia was 11.9% (95% CI, 8.5, 16.2%). Poor dietary diversity (AOR = 2.3; 95% CI: 1.12, 5.14), food-insecure households (AOR = 3.24; 95% CI: 1.85, 4.52), complementary feeding initiation time (AOR = 3.20; 95% CI:1.23, 6.61), intestinal parasites infection (AOR = 3.20; 95% CI:1.23, 6.61) and family income (AOR = 2.87; 95% CI:1.57, 5.0) were found to be factors significantly associated with anemia.ConclusionOverall, anemia is considered a public health problem among children aged 6–59 months attending at Debre Markos referral hospital, based on the cut-off point of the World Health Organization. Poor dietary diversity, complementary feeding initiation time, household food insecurity, intestinal parasite infection and family income were significantly associated with childhood anemia. Thus, it needs for proven interventions in public health such as food diversification, anti-helmintic drug provision and household food security. In addition, educating women about nutrition and diet diversification, as well as involving them in alternative sources of income-generating activity, can be vital in the study area.

Predictors of recovery rate among undernourished HIV-positive adults treated with ready-to-use therapeutic food at Debre Markos Comprehensive Specialized Hospital: A retrospective cohort study.

Nutritional support is becoming more widely acknowledged as a crucial component of the key package of care for HIV/AIDS patients. This nutritional support is exceptionally important for patients in sub-Saharan Africa, including Ethiopia, where HIV/AIDS is very prevalent. However, there is a lack of evidence on the recovery rate and predictors at the study site and at large in Ethiopia. Therefore, this study will give some insight into the recovery rate and its predictors among under-nourished HIV-positive adults treated with Ready to Use Therapeutic Food (RUTF) attending at Debre Markos referral hospital. Moreover, the findings of this study will be used by both governmental and non-governmental organizations to allocate more resources to mitigate the nutritional problems for people living with HIV. An institution-based retrospective cohort study was conducted among 453 under-nourished HIV positive adults treated with RUTF at Debre Markos referral Hospital from the 1st of July, 2015 to the 31st of December, 2017. The study participants were selected using a simple random sampling technique. Data were extracted from patient charts using a standardized data extraction checklist. Data were entered into Epi-Data Version 4.2 and analyzed using Stata Version 14. The Kaplan-Meier survival curve was used to estimate the time to recovery. Log-rank test was used to compare the recovery time between different baseline categorical variables. The bivariable and multivariable Cox-proportional hazard regression models were fitted for potential predictors of recovery time. Adjusted hazard Ratios (AHRs) with 95% CIs were used to measure the strength of association and test statistical significance. A total of 453 undernourished HIV-positive adults were included in the final analysis. About 201, 44.4% (95%CI: 38.9, 49.0%) patients participating in the RUTF program were recovered based on predetermined exit criteria with incidence of 10.65 (95% CI: 9.28, 12.23) per 100 person-month observations. Being moderately undernourished (AHR: 11.0, 95% CI: 5.3, 23.1), WHO clinical stage (I or II) (AHR:1.8, 95% CI: 1.2, 2.6), and working functional status at baseline (AHR = 2.34, 95%CI: 1.01,5.45) were predictors of recovery time. This study concluded that the overall nutritional recovery rate was below the acceptable minimum requirement which at least 75% of patients should recovered. Mild to moderate undernutrition at baseline, WHO clinical stage I or II at enrolment, and working functional status were found to be predictors of recovery time in HIV/AIDS patients treated with the RUTF. As a result, special attention should be paid to severely malnourished patients, WHO clinical stages III or higher, and patients who are bedridden or ambulatory during treatment.

Methicillin and Vancomycin Resistant Staphylococcus aureus and Associated Factors from Surgical Ward Inpatients at Debre Markos Referral Hospital, Northwest Ethiopia.

IntroductionStaphylococcus aureus is a well-known superbug and leading causes of wound infections. The clinical epidemiology of methicillin resistant S. aureus (MRSA) and vancomycin resistant S. aureus (VRSA) is not well documented in Ethiopia. The aim of this study was to determine the proportion of MRSA, VRSA and associated factors from surgical inpatients in Debre Markos Referral Hospital (DMRH), Northwest Ethiopia.MethodsA facility-based cross-sectional study was conducted from February to April 2020 at DMRH. A structured questionnaire was used to gather demographic and clinical data. Wound swab was collected from inpatients and then inoculated on blood agar and mannitol salt agar. The presence of MRSA and VRSA was determined using the cefoxitin (30 μg) antibiotic disk diffusion and vancomycin E-test methods, respectively. The data were analyzed using SPSS 20. Data were analyzed using bivariate and multivariate logistic regression analysis. A P-value <0.05 was considered statistically significant.ResultsA total of 242 wound cases were enrolled and the majority of them were males 172 (71.1%). Among the total enrolled cases, S. aureus was identified from 71 (29.3%) of the admitted patients. The proportion of MRSA was 32 (13.22%) and that of VRSA was 4.1%. The proportion of vancomycin intermediate S. aureus (VISA) was gauged at 4.5%. Hospital stay over 72 hrs, wound depth, current antibiotic use, and previous history of wound infection showed statistically significant association with MRSA. On the contrary, VRSA did not showed any significant association against the analyzed variables.ConclusionHigh proportions of S. aureus isolates became MRSA; resistant to all β-lactam antimicrobial agents excluding newer cephalosporin. In addition, the proportion of VRSA/VISA was also high. Multiple variables demonstrated significant associations with MRSA. Hence, intervention measures for MRSA risk groups must be in place. Furthermore, hospital infection control and an antibiotic stewardship program should be strengthened.