Gondar University Hospital Research Articles

Seizure control and its associated factors among epileptic patients at Neurology Clinic, University of Gondar hospital, Northwest Ethiopia.

Background:Epilepsy is characterized by two or more unprovoked recurrent seizures, which often respond to available antiseizure medications. However, seizure control among epileptic patients in the developing world is low. Factors determining seizure control among epileptic patients were not evidently explored in the study setting.Objectives:This study aimed to determine the magnitude of uncontrolled seizures and associated factors among epileptic patients at the University of Gondar hospital.Methods:This cross-sectional study was conducted at the University of Gondar hospital, Northwest Ethiopia. A convenience sampling method was used to recruit study subjects. Controlled seizure was defined as seizure freedom for the past 1 year. Logistic regression analysis was used to identify factors associated with seizure control. A p-value < 0.05 was used to declare a significant association.Results:A total of 320 study subjects were included in the study. The mean (±SD) age of patients was 27.5 ± 7.6 years. More than half (182/320, 57%) of epileptic patients had uncontrolled seizures. Five or more pretreatment seizure episodes (adjusted odds ratio = 3.98, 95% confidence interval: 1.81–8.75, p = 0.001), less than 2 years on anti-seizure medications (adjusted odds ratio = 8.64, 95% confidence interval: 3.27–22.85, p < 0.001), taking 2 or more ASMs (adjusted odds ratio = 2.48, 95% confidence interval: 1.23–5.02, p = 0.011), poor adherence to ASMs (adjusted odds ratio = 9.37, 95% confidence interval: 4.04–21.75, p < 0.001), and living at a single trip distance from hospital equaled 1 h or more (adjusted odds ratio = 4.20, 95% confidence interval: 2.11–8.41, p < 0.001) were significantly associated with uncontrolled seizures.Conclusion:The dose of a preferred anti-seizure medication should be optimized before combinations of anti-seizure medications are used. Adherence to anti-seizure medications should be reinforced for better seizure control. Epilepsy care should be integrated into primary health care services in the catchment region.

Comparison of hemoglobin levels by HemoCue301+ and Sysmex KX-21N at University of Gondar Hospital, Northwest Ethiopia, 2020.

Automated hematology analyzers deliver accurate and reliable hemoglobin measurement but they are expensive to afford for most of the developing countries like Ethiopia. Point of care hemoglobin analyzer like HemoCue301+ has potential to alleviate such problems. The main aim of this study was to compare the hemoglobin concentration measured by HemoCue301+ with the Sysmex KX-21N method at University of Gondar Com-prehensive Specialized Hospital, Gondar, Ethiopia, 2020. A hospital based cross-sectional study with convenient sampling technique was employed from November to December 2020. Institutional ethics approval was obtained prior to sample utilization. A total of 147 specimens were analyzed by HemoCue301+ and Sysmex KX-21N hematology analyzer to compare the hemoglobin concentration measured by the two methods. Paired sample t-test and Bland-Altman plot were used to arrive at conclusions. SPSS version 20 and MedCalc software were used for analysis of the data. The paired sample t-test indicated the mean difference of the two measurements was 0.08299 with a standard deviation of 0.82332 and t-test: 1.222 at 146 degrees of freedom. There was no significant difference between the two measurements with a p-value of 0.224. The concordance correlation coefficient of the two methods was 0.956 (95% CI: 0.940 - 0.968, p < 0.0001). From the Bland-Altman plot, the limit of agreement was -1.50 - 1.70 g/dL with the mean difference of 0.08299 (95% CI: -0.05121 - 0.2172). There was no significant difference in the hemoglobin measurement by the HemoCue and Sysmex KX-21N (coef = -0.127, 95% CI: -0.379 - 0.634). The HemoCue301+ may be used interchangeably with Sysmex-KX-21N automated hematology analyzers.

Evaluation of Anticoagulation Control among Patients Taking Warfarin in University of Gondar Hospital, Northwest Ethiopia.

Introduction Warfarin is a widely used oral anticoagulant in clinical practice. It has variable intraindividual and interindividual dose response and a narrow therapeutic index. Therefore, it requires frequent and regular international normalized ratio (INR) determination to maintain the INR within the therapeutic range. The study evaluated parameters of anticoagulation control among patients on warfarin. Methods A cross-sectional study was conducted at University of Gondar hospital. A consecutive sampling method was used to recruit study subjects. The anticoagulation control was evaluated by determining the proportion of desired INRs and the proportion of time spent in the therapeutic range (TTR). Logistic regression analysis was used to identify associated factors with adequate TTR. A P value <0.05 was used to declare significant association. Result A total of 338 study subjects were included in the study. The mean age of patients was 48.8 (SD = 16.4) years. Atrial fibrillation was the commonest indication for warfarin therapy. One-third (33%) of study subjects achieved the desired INRs of 2.0–3.0, while about one-tenth (13%) of patients attained good INR control (TTR ≥ 65%). Multivariate logistic regression analysis revealed no significant association of sociodemographic and clinical characteristics with good TTR outcome. Conclusion The level of anticoagulation control with warfarin among study subjects was very low. The authors recommend to implement a validated warfarin-dose titration protocol and to establish anticoagulation clinics to mitigate the low anticoagulation level.

Malnutrition and contributing factors among newborns delivered at the University of Gondar Hospital, Northwest Ethiopia: a cross-sectional study

ObjectivesTo estimate the prevalence of various indicators of malnutrition (stunting, wasting, low birth weight, concurrent stunting and wasting, overweight/obesity and double burden malnutrition) among newborns and to investigate factors associated...

Hematological profiles of visceral leishmaniasis patients before and after treatment of anti-leishmanial drugs at University of Gondar Hospital; Leishmania Research and Treatment Center Northwest, Ethiopia

BackgroundVisceral leshimaniasis is a parasitic disease characterized by systemic infection of phagocytic cells and an intense inflammatory response. The progression of the disease or treatment may have an effect on hematological parameters of these patients'. Thus, the current study sought to compare the hematological profiles of visceral leishmaniasis patients before and after treatment with anti-leishmaniasis drugs.MethodAn institutional-based retrospective cohort study was conducted among visceral leishmaniasis patients admitted to the University of Gondar comprehensive specialized referral hospital leishmaniasis research and treatment centre between September 2013 and August 2018. Hematological profiles were extracted from the laboratory registration book before and after treatment. Data were entered to Epi-info and exported to SPSS for analysis. Descriptive statistics were summarized using frequency and percentage to present with the table. The mean, standard deviation, median, and interquartile range were used to present the data. Furthermore, using the paired t-test and the Wilcoxon Signed rank test, the mean difference for normally and non-normally distributed data was compared. Spearman and Pearson correlation analysis were used to describe the relationship between hematological parameters and various variables. A P value of 0.05 was considered statistically significant.ResultWith the exception of the absolute neutrophil count, all post-treatment hematological parameters show a significant increase when compared to pre-treatment levels. Prior to treatment, the prevalence of anemia, leukopenia, and thrombocytopenia was 85.5, 83.4, and 75.8%, respectively, whereas it was 58.3, 38.2, and 19.2% following treatment. Furthermore, parasite load was found to have a statistically significant negative correlation with hematological profiles, specifically with white blood cell and red blood cell parameters.ConclusionAccording to our findings, patients with visceral leishmaniasis had improved hematological profiles after treatment. The effect of treatment on parasite proliferation and concentration within visceral organs, in which the parasite load could directly affect the patient's hematological profiles, may be associated with the change in hematological profiles.

Efficacy and safety of a combined treatment of sodium stibogluconate at 20mg/kg/day with upper maximum daily dose limit of 850mg and Paromomycin 15mg/kg/day in HIV negative visceral leishmaniasis patients. A retrospective study, northwest Ethiopia.

BackgroundVisceral leishmaniasis (VL) is one of the most neglected tropical infectious diseases. It is fatal if left untreated. The objective of this study was to assess the efficacy and safety of 17-day injections of combined regimen of sodium stibogluconate and paromomycin (SSG/PM) in HIV-negative VL patients.MethodsA retrospective analysis of medical records of VL patients treated in the University of Gondar Hospital during period 2012–2019 was carried out.ResultsA total of 2836 patients were treated for VL from 2012 to 2019. Of these 1233 were treated with SSG-PM, and 1000 of them were included in the study. Initial cure was achieved in 922 (92.2%) patients. The frequency of treatment failure, treatment interruptions, default and deaths respectively were 30 (3%), 20 (2%), 13 (1.3%) and 15 (1.5%). Among 280 patients who completed 6-month follow up, the final cure was 93.9% (263/280), 4 (1.4%) relapsed and 13 (4.6%) developed post-kala-azar dermal leishmaniasis (PKDL). The most common adverse events (AEs) were raised liver transaminases (35.1%; 351 patients), injection site pain (29.1%, 291 patients) and raised serum alpha-amylase (29.1%, 291 patients). Factors associated with poor treatment outcomes were sepsis, pneumonia, and adverse events.ConclusionA combination of SSG at 20mg/kg with upper daily maximum dose of 850mg and PM was effective for achieving initial cure at end of treatment and safe for treatment of HIV negative VL patients in northwestern Ethiopia. Our data are consistent with previous reports and confirms effectiveness of SSG/PM treatment regimen in the Eastern African countries. Efficacy at 6-months (93.9%) was estimated on data derived from patients who completed follow up and needs to be interrogated by future studies.

Magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, Ethiopia

BackgroundUndernutrition and cardiac disease are interconnected in a vicious cycle. Little is known about the effect of undernutrition on cardiac disease among children in low- and middle-income countries (LMICs). This study aimed to assess magnitude of undernutrition and associated factors among children with cardiac disease at University of Gondar hospital, northwest Ethiopia.MethodThis hospital-based cross-sectional study included children with cardiac disease presenting to the pediatric outpatient clinic at University of Gondar Hospital, Ethiopia. A self-administered questionnaire was administered to participating families, and medical records were reviewed. All participants who fulfill the inclusion criteria were included. Anthropometric measurements were made and the presence of malnutrition was diagnosed according to the WHO criteria. Associated factors of undernutrition analyzed by using binary logistic regression model. Variables with p-value ≤0.2 in bivariate analysis were fitted to the final multivariable analysis and those variables with p-value ≤0.05 were considered as having statistically significant association to the outcome variable. AOR and 95% confidence interval was calculated to assess the strength of association between the variables.ResultA total of 269 patients participated in the study. 177 (65.7%) were undernourished, of whom 96 (54.5%) were underweight, 70 (39.7%) were stunted, and 95 (53.9%) were wasted. Pulmonary hypertension (adjusted odds ratio [AOR] = 3.82, 95%CI 1.80–8.10), NYHA/modified Ross class III and IV heart failure (AOR = 4.64, 1.69–12.72) and cardiac chamber enlargement (AOR = 2.91, 1.45–5.66) were associated with undernutrition.ConclusionUndernutrition is common among children with cardiac disease in northern Ethiopia. Children with pulmonary hypertension, high-grade heart failure, and cardiac chamber enlargement may warrant close follow-up for malnutrition.

Stereoacuity Among Patients with Refractive Error at University of Gondar, Northwest Ethiopia.

PurposeThis study aimed to assess the level of stereopsis, proportion of poor stereopsis, and factors influencing stereopsis in adults with refractive error.MethodsThis was a cross-sectional, descriptive study conducted on 153 adults with refractive error at Gondar University Hospital Tertiary Eye Care Center from April 08 to June 07, 2019. Structured questionnaires and ophthalmic instruments (Retinoscope, Worth Four Dot test and TNO Stereo plates) were used to collect the data. Data were entered and analyzed with Statistical Package for Social Sciences (SPSS) version 20. The result was summarized using summary statistics such as mean. Chi-squared test of association was applied between stereopsis and independent variables.ResultsThe level of stereopsis after correction of refractive error ranged from 1.89 to 2.65 log arc second. Before correction of refractive error, poor stereopsis was observed in 46.4% of the participants, while after correction, it dropped to 39.8% (CI: 95%: 31.1%–47.8%). Stereopsis after correction had a significant association with age, best visual acuity, type of refractive error, and fusional status at distance with a p value < 0.05.ConclusionGiven refractive error corrected, the mean stereopsis in patients with refractive error was 2.42 log arc second. Proportion of poor stereopsis was noted in 39.8% of the participants corrected for refractive error. Age, best corrected visual acuity, type of refractive error, and fusional status had a significant association with stereopsis. Further studies on stereoacuity on a large scale are recommended.

Prevalence and Associated Factors of Depression among Pregnant Mothers Who Had Intimate Partner Violence during Pregnancy Attending Antenatal Care at Gondar University Hospital Northwest Ethiopia in 2020.

Background Antenatal depression is the major obstetric problem that led to significant maternal and perinatal morbidity and mortality worldwide, especially in the third world. However, in Ethiopia this prevalence and association were not studied, as result, this study investigated the prevalence and associated factors of antenatal depression among pregnant mothers who had intimate partner violence during pregnancy. Methodology. An institution-based cross-sectional study was done among 409 pregnant mothers who had intimate partner violence during pregnancy from May to July 2019 at Gondar University Hospital. All pregnant mothers who came for ANC follow-up during the study period approached for screening of intimate partner violence during pregnancy using standard and validated screening method and instrument of the WHO multicountry study on women's health and domestic violence to evaluate intimate partner violence, and we use EPDS for the evaluation of antenatal depression validated in Ethiopia with a cut point of 13. Result Prevalence of depression among pregnant mothers who had any form of intimate partner violence during pregnancy was 35%: physical abuse (AOR = 1.8; 95% CI: 1.19, 3.30), more than one type of abuse (AOR = 10.18; 95% CI: 7.10, 16.18), poor social support (AOR = 5.81; 95% CI: 1.12, 13.12), and pregnant mothers whose partner drunk for the past twelve months (AOR = 7.16; 95% CI: 183, 8.00) were significantly associated with antenatal depression. Conclusion High prevalence of antenatal depression among pregnant mothers who had intimate partner violence during pregnancy was highly associated with physical abuse, more than one type of abuse, lack of social support, and partner of pregnant mothers who is a drunk. Hence, this is important to create a screening program and prevention strategy of intimate partner violence during pregnancy at the time of antenatal follow-up to prevent and early identify its morbidity and mortality.

Miltefosine for the treatment of cutaneous leishmaniasis-A pilot study from Ethiopia.

BackgroundCutaneous leishmaniasis (CL) in Ethiopia, caused by Leishmania aethiopica, is often severe and hard to treat compared to CL caused by other species elsewhere. Miltefosine is the only oral anti-leishmanial drug, with a favorable side-effect profile compared to routinely available sodium stibogluconate (SSG), but evidence about its use for L. aethiopica is lacking.Methodology and principal findingsIn an observational cohort study, treatment outcomes, safety and adherence among CL patients who required systemic treatment and received miltefosine for 28 days in Boru Meda Hospital and University of Gondar Hospital were studied. Patient cure was defined as 100% flattening for non-ulcerated lesions and 100% flattening and 100% re-epithelization for ulcerated lesions. Outcomes were documented for day 28, 90 and 180, both per site, and pooled, adjusting for site as a fixed effect with effect coding. Among 94 included patients (32 in Gondar, 62 in Boru Meda), median lesion duration was 12 months, median size six cm, and mucosal involvement (46.8%) and diffuse (30.9%) lesions were common. Adherence to miltefosine was good, and side-effects were tolerable. Initial outcomes at day 28 were promising, with 68.8% and 94.0% of patients having good improvement or cure in Gondar and Boru Meda respectively. In Boru Meda, outcomes were good with 72.7% and 72.9% cure at day 90 and day 180 respectively. In Gondar, results were less promising, with only 12.5% and 26.7% cure at day 90 and day 180, although confidence intervals were wide. In pooled estimates, 48.7% of patients reached cure at day 180, and 32.3% relapsed. Outcomes were better in Boru Meda Hospital, for smaller lesions and for mucosal lesions.Conclusions/SignificanceBased on miltefosine’s good initial response, tolerable side-effects, tablet-form, we propose to include miltefosine for future clinical trials using extended treatment schedules, combination therapy, or targeting specific subgroups.Trial registrationClinicalTrials.gov NCT04004754.

Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients Attending the Diabetic Clinic of the University of Gondar Hospital, Northwest Ethiopia.

Objective To investigate the level of diabetic retinopathy in type 2 diabetes (T2DM) patients attending the University of Gondar Hospital (UGH) Diabetic Clinic, Northwest Ethiopia. Methods An audit was carried out involving a total of 739 T2DM patients attending at the diabetic clinic of UGH. They represented approximately 90% and 50% of all T2DM patients under regular review at the urban and rural diabetic clinics of UGH, respectively. All were supervised by the same clinical team for a long period. Eye examinations were performed for visual acuity, cataract, and retinal changes (retinal photography and slit-lamp biomicroscopy). Body mass index (BMI) and HbA1c levels were measured. The presence or absence of hypertension was recorded. Results Men constituted 41.5% of the group, the mean age at diagnosis of T2DM was 50.4 years, and 50.2% were hypertensive. The BMI was 25.0 ± 4.1 kg/m2, and HbA1c was 7.75 ± 1.63% (61.2 ± 17.8 mmol/mol) (mean ± SD, for BMI and HbA1c)). Severe visual impairment/blindness was reported in 10.6%, 15.2% had cataract, 16.0% had retinopathy, and 11.1% had maculopathy. The prevalence of retinopathy increased with time from diagnosis of T2DM (chi-square for trend, p < 0.001) and with increasing HbA1c level (chi-square for trend, p=0.03). Conclusion These results compare well with the most recent results in well-equipped, wealthier regions of the world and show the importance of stable healthcare infrastructure for chronic-disease management.

A Ten-Year Trend of Cutaneous Leishmaniasis at University of Gondar Hospital, Northwest Ethiopia: 2009-2018.

Background Cutaneous leishmaniasis (CL), which is one form of leishmaniasis, may show variations over years across regions, and epidemiological studies are crucial to estimate the cases of the disease status over a long time. This study is aimed at determining the trend of CL among patients at the University of Gondar Leishmaniasis Research and Treatment Center, northwest Ethiopia between 2009 and 2018 years. Methods A ten-year data were extracted retrospectively. We included all patients who were visiting the center for CL diagnosis during the last ten years. Giemsa-stained skin slit microscopy was used to diagnose the disease. A chi-square test was used to compare the proportions of patients infected across years, seasons, months, sex, and age groups. Result During the 10 years, a total of 1079 samples were requested for the diagnosis of CL. The cumulative average annual prevalence was found to be 55.4% (598/1079). The highest and lowest proportions of CL cases were recorded in 2014 (69.5%) and 2018 (35.4%), respectively. However, the percentage of CL cases did not show any significant differences over the study period. The number of suspected patients was significantly increased over the years (being lowest in 2009 and highest in 2017). The proportion of CL cases showed a remarkable difference across months but not seasons. CL was the highest within 15-49 years of age and males. Conclusion The prevalence of CL did not show any significant differences over the last ten years. However, a remarkable increase of CL suspected cases was observed across the years. The disease showed significant association with age, sex, and months, but not seasons.

Magnitude of Phenotypic and MTBDRplus Line Probe Assay First-Line Anti-Tuberculosis Drug Resistance Among Tuberculosis Patients; Northwest Ethiopia.

BackgroundMycobacterium tuberculosis (Mtb) drug resistance is a key challenge in ending TB.ObjectiveThe study aimed to determine anti-TB drug resistance and compare the discordance between phenotypic and genotypic drug-susceptibility testing (DST).MethodsProspective enrollment and sputum collection from patients suspected of active pulmonary TB from May 2018 to December 2019 at the University of Gondar Hospital. Phenotypic DST study for streptomycin, isoniazid, rifampin, and ethambutol was done by MGIT 360 SIRE Kit. Genotypic resistance for isoniazid and rifampin was performed by MTBDRplus v2 line probe assay (LPA) and compared to phenotypic drug resistance.ResultsA total of 376 patients, median age 32 years, and 53.7% male were enrolled. Mtb was isolated from 126 patients. 106/126 (84%) patients were newly diagnosed with TB and 20 patients with prior TB treatment. Seventy (66.0%) were susceptible to all anti‐TB drugs tested. Twenty-five (19.8%) of the isolates were resistant to isoniazid, 12 (9.5%) to rifampicin and six (5%) were multidrug resistant. Among previously treated TB patients, 4 (20.0%) and 5 (25.0%) were mono-resistant and poly-resistant, respectively. The sensitivity and specificity of LPA resistance for isoniazid were 94.4% and 100%, and for rifampin was 75.0% and 100%, respectively.ConclusionThe frequency of mono- and poly-drug resistance among both newly diagnosed and previously treated TB patients was high to the rest of the nation. MTBDRplus showed excellent concordance for isoniazid and rifampin. We concluded that DST should be performed for all patients to improve management and decrease spread of drug-resistant Mtb strains in the community.

Annular Pancreas in an Eleven-year-old Male Ethiopian Child at the University of Gondar Hospital; A Case Report

Annular Pancreas in an Eleven-year-old Male Ethiopian Child at the University of Gondar Hospital; A Case Report

Assessment of Total Serum IgE Level and Associated Factors among Asthmatic Patients at University of Gondar Hospital, Gondar, Northwest Ethiopia

Background: Asthma is a chronic respiratory disorder having both genetic and environmental underlying risk factors. Immunoglobulin E (IgE) is known to play a critical role in asthma pathogenesis and has also main function in immune response to parasites such as helminths. In this research, we aimed to assess total serum IgE level and associated factors among asthmatic patients at the University of Gondar Hospital, Gondar, Northwest Ethiopia. Methods: A comparative cross-sectional study was conducted from June to August 2019 at the University of Gondar Hospital among asthmatic patients. A structured questionnaire was used to collect socio-demographic characteristics of patients. Venous blood was collected from asthmatic patients to determine total IgE and cholesterol levels. A stool examination was also done among the patients. Stored serum sample from blood donors was used as control. Data was analyzed using SPSS version 20. ANOVA, Kruskal Wallis test, spearman’s correlation, chi-square, and binary logistic regressions were used in data analysis. P-value ≤ 0.05 was considered statistically significant. Results: A total of 88 study subjects were included. The geometric mean of total IgE level was 366.6 ± 5.4 IU/ml and 52.2 ± 3.6 IU/ml for patients and controls respectively (p<0.001). The geometric mean total IgE levels of patients with positive and negative helminth infection were 1282.9 ± 3.6 IU/ml and 294.4 ± 5.6 IU/ml respectively (p=0.237). The geometric mean total IgE level for moderate-severe groups of asthmatics was 367.4 ± 5.6 IU/ml and intermittent-mild groups were 321.2 ± 5.4 IU/ml (p=0.803). The association of cholesterol level and total IgE level among patients was found to be negative and non-significant (with an odds ratio of 0.995 and 95% confidence interval (CI) of 0.982-1.009) (p=0.507). Conclusion: This study showed significantly higher total IgE levels in asthmatics than controls. Hence, assessment of total IgE level in asthmatics is a direct measurement of airway inflammation and estimation of total IgE level should be included in routine practice. Non-significant differences and associations were found between total IgE levels and associated factors among patients.

Compliance, Barriers, and Facilitators to Social Distancing Measures for Prevention of Coronavirus Disease 2019 in Northwest Ethiopia, 2020

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic is the defining global health crisis of our time. To date, there is no curative treatment for COVID-19, and with vaccines only recently being rolled out predominantly in wealthy countries, prevention still remains the main strategy. Social distancing has been proven to mitigate the epidemic and limit disease spread. As is the case in many other countries, the Ethiopian government has declared a state of emergency and taken several measures to impose social distancing. The level of compliance with social distancing measures in Ethiopia is unknown.ObjectiveThe aim of this study was to assess the compliance, barriers, and facilitators to social distancing measures for the prevention of COVID-19 in Northwest Ethiopia.MethodsA cross-sectional survey using telephone interview triangulated by a qualitative study was conducted over a period of 1 month from April 20 to May 20, 2020, at the University of Gondar Hospital in Gondar, Ethiopia. A total of 401 randomly selected participants, and 12 key representative informants selected by convenience were included for the quantitative and qualitative studies, respectively. Information on sociodemographic factors, knowledge about COVID-19, and practices concerning preventive measures––particularly social distancing––was collected. Respondents were asked what they believed were the barriers and facilitators of social distancing during in-depth face-to-face interviews. Data were entered and analyzed using Epi-data and Stata software, respectively. Frequencies and odds ratios were analyzed. P values < 0.05 were considered statistically significant, and a confidence level of 95% strength of association was used.ResultsA total of 425 potential participants were approached and 401 responded positively (response rate = 94.4%). Of the 401 study participants, 55.4% (95% CI, 50.4%–60.2%) reported poor compliance with social distancing measures. The mean (SD) age of participants was 36.4 (11.8) years. The majority of participants (63.84%) reported that they went to crowded places without putting on a face mask. Of the participants, 243 (60.6%) and 306 (76.3%) had good knowledge of COVID-19 transmission and prevention, respectively. Multivariate logistic regression analysis revealed that only age (adjusted odds ratio = 1.02; 95% CI, 1.00–1.04) was significantly associated with social distancing measures, with older persons more likely than younger to comply with social distancing guidelines.ConclusionsThe majority of the study's participants reported poor compliance with social distancing measures set by the government and health authorities for prevention of COVID-19. Reported compliance with social distancing measures increased with increasing age. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX) © 2021 Elsevier HS Journals, Inc.

HIV Co-Infection Among Presumptive Tuberculosis Cases and Asthmatic Patients at University of Gondar Hospital, Northwest Ethiopia.

Tuberculosis and Human Immunodeficiency Virus (HIV) have been closely linked since the emergence of Acquired Immunodeficiency Syndrome (AIDS). Several studies have suggested an increased incidence of asthma among HIV positive individuals. This study aimed to determine the prevalence of Mycobacterium tuberculosis (MTB) and HIV infection among presumptive tuberculosis cases and asthmatic patients. A hospital-based, cross-sectional study was conducted on 424 study participants from October 2018 - June 2019. Sociodemographic data and sputum samples were collected and investigated by Ziehl-Neelsen microscopy, Gene Xpert MTB/RIF assay, and culture. The nutritional status of the patients was assessed by body mass index. Finally, data was entered, cleared, and checked using Epi-info version 7 and exported to SPSS version 20 for analysis. Logistic regression was used for statistical association. p-value < 0.05 at 95% CI was considered statistically significant. The overall prevalence of MTB and HIV infection was 3.86% and 5.4%, respectively. The prevalence of MTB infection among presumptive tuberculosis (TB) cases was 4.4%, but none among asthmatic patients. The prevalence of HIV infection among presumptive TB cases and asthmatic patients was 5.2% and 6.6%, respectively. The overall prevalence of malnutrition was 30%. The prevalence of malnutrition among culture-positive TB patients was 31.25% and that of HIV positive cases was 43.5%. The proportion of MTB infection among HIV positive patients was 12.5%. Marital status of the study subjects significantly associated with culture positive MTB infection. Occupation and previous history of tuberculosis infection had a statistically significant association with HIV infection. This study showed a high prevalence of HIV among asthmatic patients compared to presumptive TB cases. So, regular large-scale surveys should be conducted to assess the burden and intervene accordingly.

English

Tenofovir Disoproxil Fumarate a nucleotide reverse transcriptase inhibitor that was introduced as a preferred first line antiretroviral therapy in Ethiopia as of 2008. However, routine renal function assessment is recommended as it is known to cause renal failure and renal tubular dysfunction. To assess the practice of renal function monitoring of patients on TDF based ART regimen. The magnitude of renal dysfunction and its associated factors are also assessed. Institutional based retrospective record review was carried out to determine the magnitude of renal dysfunction and associated factors among HIV positive individuals who have been on TDF based ART regimen in Gondar university hospital. A total of 406 records were reviewed and 96.21% were found complete. From a total of 290 patients with Creatinine determination, renal dysfunction was found in 25.2%. Patients aged between 30-41years had AOR of 2.75(95%CI 1.18, 6.37), while those aged 42-53 years had AOR of 3.10 (95%CI 1.12, 8.55) as compared to those aged less than 30 years. Low body mass index (AOR 4.39(95%CI 2.24, 8.61), low CD4 (AOR 5.87(95%CI 2.73, 12.62)) were associated with increased risk of renal dysfunction. However Advanced WHO stages (stages 3 and 4), were associated with a lower incidence of renal dysfunction. About one fourth of patients who were on TDF regimen developed renal dysfunction. Twenty nine percent of participants had no renal function monitoring. Factors which influence the renal dysfunction in patients with TDF regimen in this study are age, low body mass index, low CD4 count and advanced WHO stage. Key words: Renal dysfunction, Tenofovir, antiretroviral therapy (ART) regimen, Gondar University Hospital

Hematological reference intervals among full-term newborns in Ethiopia: a cross-sectional study

BackgroundHematological reference intervals are used for medical decision tools for interpretation of numerical test results. Establishing of hematological interval among newborn babies is very important for the diagnosis of malignancy, anemia, bleeding disorders, and various infections. There are no locally established hematological reference intervals in Ethiopia. Thus, the aim of this study is to establish locally determined hematological reference interval among full-term newborns.MethodsA cross-sectional study was conducted from May 15 to July 30 2019 among 151 apparently healthy full-term newborns at Gondar University Hospital. About 3 ml of cord blood was obtained for analysis of Hematological parameters and determined by using Sysmex KX-21N (Sysmex Corporation Kobe, Japan) automated analyzer. Median, 2.5th and 97.5th percentile were computed.ResultMale to female ratio was almost equal. All hematological parameter had no statistically significant difference between males and females. The delivery types were not influenced its hematological values. The reference interval of white blood cells, red blood cells, platelets, hemoglobin, hematocrit, mean cell volume, and mean cell hemoglobin were (7.64–22.16) x109/l, (3.69–5.47)x1012/l, (132.74–413.4) x109/l, (13.32–19.64) g/dl and (39.42–58.06)%, (91.6-113.22)fl, and (30.48–38.02 pg), respectively.ConclusionsAll hematological reference intervals were established from full-term newborns at University of Gondar hospital was different from other studies in Nigeria, Iraq, Pakistan, Nepal, Saudi Arabia and Iran. Therefore, own determined reference value is very important for the clinicians to correctly diagnosis the patients at health facility levels.

Factors associated with knowledge and attitude towards adult cardiopulmonary resuscitation among healthcare professionals at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: an institutional-based cross-sectional study

ObjectiveThis study was conducted to assess the factors associated with knowledge and attitude towards adult cardiopulmonary resuscitation (CPR) among health professionals at the University of Gondar Hospital, Northwest Ethiopia.Study designAn...