Hospital In Southern Ethiopia Research Articles

Post-operative site infections among surgical patients at Southern Ethiopia: A prospective cohort study

ObjectiveThe current study was conducted to estimate the magnitude of SSI among surgically treated patients and identify the predictors associated with it. Backgroundsummary: Despite the fact that surgical site infection (SSI) is still a global health care-associated infection related to patients' discomfort, morbidity, and mortality, it is the most preventable nosocomial infection if all necessary measures are taken into account. MethodsAn institution-based prospective cohort study was conducted at a large teaching hospital in southern Ethiopia. Patients admitted to the surgical ward with a non-traumatic acute abdomen were participants in the study and were followed prospectively for 30 days. The collected data was entered into Epi-Data 4 and exported to STATA 16 for analysis. A logistic regression (bi-variable and multivariable) model was computed to detect the association between SSI and predictors. In the final model, variables with a p-value <0.05 were declared statistically significant. ResultsIn this study, a total of 169 patients were enrolled. More than 3/4th (78.9%) of them were male, and the mean ± SD age of participants was 42.14 ± 12.5 years. Eighteen participants (10.5%) suffered from surgical site infection (SSI). Predictors of SSI were ever smoking [AOR = 3.9; 95% CI (1.2–16.5)], American Society of Anesthesiologists score ≥3 [AOR = 8.9; 95% CI (1.7–45.5)], appendectomy [AOR = 7.7; 95% CI (1.3–45.7)], and co-morbid diabetes [AOR = 13.8; 95% CI (2.6–72.1)]. ConclusionThe magnitude of SSI was considerable in the study setting. Predictors of SSI were smoking, ASA score, appendectomy, and co-morbid diabetes. We strongly recommend that health-care professionals provide health education and patient counseling on smoking and health-seeking behaviors. Considering co-morbid conditions before surgery has paramount importance. Moreover, further large-scale studies are suggested.

Sight-threatening diabetic retinopathy and its predictors among patients with diabetes visiting Adare General Hospital in Southern Ethiopia: a hospital-based cross-sectional study

ObjectiveThe study aimed to determine the prevalence of sight-threatening diabetic retinopathy and its predictors among patients with diabetes attending Adare General Hospital in Southern Ethiopia.DesignA hospital-based cross-sectional study was conducted...

Exploring barriers to using modern contraceptives and accessing safe abortion care in women who terminated unintended pregnancies in Southern Ethiopia

BackgroundUnsafe abortion is a major medical and public health problem in Ethiopia and contributes significantly to abortion-related morbidity and mortality in the country. We explored women’s experiences with modern contraceptives and identified barriers to accessing safe abortion care and other sexual and reproductive health services.MethodsWe recruited participants from six health clinics and a public hospital in southern Ethiopia. We conducted one-on-one interviews with 34 women aged 18–49 years who sought abortion care within the past twelve months of the study. Interviews were recorded, transcribed verbatim, translated to English, and imported into Dedoose software. We analysed the data using a directed content analysis.ResultsOur findings show prevailing belief among participants that contraceptives caused infertility, abnormalities in subsequent pregnancies, and other side effects. Some of the women suggested that medical or unsafe abortions were a better alternative to using modern contraceptives for terminating unplanned pregnancies. Barriers to accessing safe abortion care included costs of services, lack of privacy, and fear of judgment from providers. Women who had negative experiences with providers were more likely to seek unsafe abortion the second time around.ConclusionProviders need to address women’s concerns about using modern contraceptives, educate their clients about the best ways to prevent unwanted pregnancies, and provide non-judgemental services. In addition, comprehensive counselling services that include contraceptive counselling should be made available to women before, during, and after abortion care. Finally, providers should strive to be facilitators of, not barriers to, safe abortion care.

The Magnitude and associated factors of Helicobacter Pylori Infection among Dyspeptic Patients at the Arba Minch General Hospital in Southern Ethiopia

Background: Infection with Helicobacter pylori (H. pylori) is a major public health problem, with a higher prevalence reported in developing countries, including Ethiopia. Persistent H. pylori infection could result in chronic gastritis, duodenal ulcers, and subsequently gastric carcinoma. However, the burden of the infection varies within and between countries. Methods: An institution-based cross-sectional study was carried out on 422 adult dyspeptic patients attended at Arba Minch General Hospital from March 1st to June 30th, 2022. Pretested structured questionnaires were used to collect socio-demographic characteristics, clinical information, and other related factors for H. pylori infection. Stool samples were analyzed using the H. pylori fecal antigen rapid test kit. The data was analyzed using SPSS version 25. The p-value &lt; 0.05 was considered statistically significant. Results: The overall magnitude of H. pylori was found to be 32.2% (136/422), with a 95% CI = (27.7-36.5). The highest proportion of H. pylori occurred in male study participants (55.1%) and in participants aged 31-40 years (42.6%). H. pylori stool antigen positivity was significantly associated with alcohol consumption [AOR = 1.87, 95% CI: (1.06-3.29)], smoking cigarettes [AOR = 2.75, 95% CI: (1.43-5.27)], and hand washing practice after the toilet [AOR = 3.02, 95% CI: (1.41-6.48)]. Conclusion: Overall, a considerable magnitude of H. pylori was identified in the setting. Alcohol consumption, smoking cigarettes, and hand washing practice after using the toilet were found to be statistically significantly associated with H. pylori infection. Health education is therefore essential, particularly regarding societal lifestyle changes and knowledge of the potential sources of infection and H. pylori transmission.

Determinants of adverse management outcomes of blunt abdominal trauma patients operated at a referral hospital in southern Ethiopia: a retrospective record review

BackgroundAbdominal trauma is one of the common reasons for emergency visits yet there is paucity of data about the subject in the horn of Africa. This study was aimed at determining the determinants of adverse management outcomes of blunt abdominal trauma among operated patients at Wolaita Sodo University Teaching and Referral Hospital, Ethiopia.MethodsThis was a three-year retrospective review conducted among 128 patient records selected using purposive sampling in which all records for the patients operated for a diagnosis of blunt abdominal trauma during the study period were included. A pretested checklist was used to extract the data relating to adverse outcomes and characteristics of the patients. A descriptive analysis followed by logistic regression was done.ResultsOf the 128 patients, adverse management outcomes related to blunt abdominal trauma occurred in 52%. Patients residing in rural areas (adjusted odds ratio 3.23, 95% confidence interval: 1.13–9.24) and those with tachycardia, (adjusted odds ratio = 3.25, 95% confidence interval: 1.19–8.83) or tachypnea (adjusted odds ratio 3.25, 95% confidence interval: 1.19–8.83) were more likely to have adverse management outcomes.ConclusionAdverse management outcomes are relatively high and associated with rural residence and deranged vital signs (tachycardia and tachypnea). Close monitoring targeting patients from rural residence and those presenting with tachycardia and tachypnea is recommended.

Incidence of Mortality and Its Predictors Among Adult Human Immune Virus Infected Patients on Antiretroviral Therapy in Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: A Retrospective Follow-Up Study.

Although the goal of ART is to have better health, extend the life of the HIV-infected patient, and decrease HIV-related death, there is a continuation of HIV-related mortality with the use of ART. This study aimed to assess the incidence of mortality and its predictors among adult HIV/AIDS patients who were on ART follow-up at Wolaita Sodo Comprehensive specialized hospital in southern Ethiopia. A retrospective follow-up study was conducted from May 1 to June 30, 2021 among adult HIV/AIDS patients with a total of 441 adult HIV/AIDS patients in this hospital included. Kaplan-Meier failure curve and Log rank test were fitted, and Cox-proportional hazards model was also used to identify the predictors of mortality. Both crude and adjusted hazard ratios (AHR) with their 95% confidence interval (CI) were calculated to show the strength of association. The proportional assumption was conducted by using a global test based on the Schoenfeld residuals. Incidence of the mortality rate was 5.61 (95% CI, 4.2-7.3) per 100 person-years observation. In the multivariable analysis, HIV/AIDS patients were widowed (aHR; 10.9 (95% CI, 3.13-37.99), poorly drug-adhered (aHR; 5.6 (95% CI, 2.4-13.2) and fair adhered (aHR; 3.53 (95% CI, 1.58-7.87), WHO clinical stage IV (aHR; 5.91, (95% CI, 1.41-24.71), history of substance use (aHR; 2.02 (95% CI, 1.01-4.06) and history of IV drug use (aHR; 2.26 (95% CI, 1.10-4.74) independently predicted the mortality of patients. In this study, incidence of mortality was relatively high. The rate of mortality may be minimized by paying particular attention to individuals with widowing, substance use at the baseline, advanced clinical stage IV, history of IV drug use at the baseline, and those with adherence problems.

Detection of dengue virus infection in children presenting with fever in Hawassa, southern Ethiopia

Dengue fever is a mosquito-borne viral infection, with rising incidence globally. Eastern Ethiopia has had dengue fever outbreaks in recent years. However, the extent to which the infection contributes to hospital presentation among children with fever in southern Ethiopia is unknown. We examined 407 stored plasma samples collected to investigate the aetiology of fever in children aged at least 2 months and under 13 years presenting to the outpatient of the largest tertiary hospital in southern Ethiopia. We analyzed samples for dengue virus non-structural 1 antigen using enzyme-linked immunosorbent assay. The median (interquartile range) age of the 407 children examined was 20 (10–48) months, and 166 (40.8%) of the children were females. Of 407 samples analyzed, 9 (2.2%) were positive for dengue virus non-structural 1 antigen, of whom 2 were initially treated with antimalarial drugs despite having negative malaria microscopy, and 1 of the 8 patients had a persistent fever at the seventh day of follow-up time. The presence of active dengue virus infection in the study area highlights the need for studies at the community level as well as the integration of dengue diagnostics into fever-management strategies. Further research to characterize circulating strains is warranted.

Frailty status and associated factors among older PLHIV in Southern Ethiopia.

Studies addressing frailty are limited in the global south, including Ethiopia. We estimated the prevalence of frailty and associated factors among older people living with HIV (PLHIV) attending a large Comprehensive Specialized Hospital in southern Ethiopia. A systematic sample of 187 PLHIV and 187 HIV-negative controls > 50 years old were recruited between October 1 and November 30, 2021. Data on socio-demographic, behavioural and clinical characteristics were collected using a structured questionnaire. Frailty assessments were completed using the brief frailty instrument (B-FIT-2), which consists of 6 components. Scoring 5-6 points was frail, 2-4 points were pre-frail and below 2 was considered as non-frail. Logistic regression model was used to measure association between variables. Median (IQR) age was 53 (50, 80) for PLWH and 59 (55-66) for controls. Prevalence of frailty was 9.1% for PLHIV Versus 5.9% for controls. A significant proportion of PLHIV was pre-frail; 141 (75.4%) compared to controls 110 (58.8%). Pre-frailty status was associated with HIV diagnosis (adjusted odds ratio (aOR) 4.2; 95% CI 1.8-9.9), low age (aOR 0.3; 95% CI 0.1-0.6), lower educational attainment (aOR 2.2; 95% CI 1.0-4.9), being farmer (aOR 3.2; 95% CI 1.0-10.2) and having high or low body mass index (BMI) (aOR 11.3; 95% CI 4.0-25.8). HIV diagnosis (aOR 9.7; 95% CI 1.6-56.8), age (aOR 0.2; 95% CI 0.1-0.7), lower educational attainment (aOR 5.2; 95% CI 1.5-18.2), single status (aOR 4.2; 95% CI 1.3-13.6), farmer (aOR 19.5; 95% CI 3.5-109.1) and high or low BMI (aOR 47.3; 95% CI 13.8-161.9) predicted frailty. A high proportion of frailty and pre-frailty was observed in a cohort of older PLHIV attending care in Southern Ethiopia. Future research should focus on interventions targeting factors associated with frailty.

Magnitude of sepsis and its predictors among neonates admitted to neonatal intensive care unit at Hawassa University comprehensive specialized hospital in Southern Ethiopia 2022

Background: Neonatal sepsis is a leading cause of neonatal death across the globe, which accounted for 15% and 30% of neonatal mortality in low and middle-income countries and developing countries including Ethiopia, respectively. Despite various efforts have been made by the Ethiopian government to prevent neonatal mortality and morbidity, sepsis-related to neonatal mortality is still high. So the objective of this study was to assess the magnitude and affecting factors of neonatal sepsis among neonates admitted to neonate intensive care units in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia. Methods and materials: Facility based cross-sectional study was conducted from January to February 2022 at Hawassa university comprehensive specialized hospital, Southern Ethiopia. A total of 216 neonate-mother pairs who were admitted to the intensive care unit was included in the study and a systematic random sampling technique was used to select study participant. A structured questionnaire was used to collect data. The data was entered into EPI Data 3.1 version and transported to SPSS version 25 for data analysis. Multi regression analysis was done for predictor variables associated at p-value &lt;0.05 with the dependent variable. Result: A total of 74 (34.3%) neonates were admitted with neonatal sepsis. A surgical procedure is done before sepsis (AOR=2.9, 95% of CI(1.5 to5.6), last pregnancy wanted (AOR=2.8, 95% of CI(1.0 to 7.3), more frequent per-vaginal examination (AOR=2.6, 95% of CI (1.3 to 5.3), educational level unable to read and write(AOR=5.4, 95% of CI(1.0 to 27.7), low birth weight (AOR=5.4, 95% of CI(3.0 to 9.8), and getting care from unskilled health workers(AOR=2.7, 95% of CI(1.5 to 4.9) were significantly associated with neonatal sepsis at multivariable with less than 0.05 p values. Conclusion: This study indicated that the prevalence of neonatal sepsis was still high. Thus, immediate action should be taken before it leads to neonatal mortality and further complications. The study used only physician diagnosis to confirm neonatal sepsis, which may affect its prevalence and needs further investigation.

Satisfaction status and its associated factors on delivery service provided among women who gave birth at hawassa university comprehensive specialized hospital in southern Ethiopia 2022

Background: Despite the Ethiopian federal ministry of health implementing compassionate, respectful, and caring as one of the health sector transformation agendas to increase health service utilization, the level of maternal satisfaction with institutional delivery is still low and varies from region to region. In addition, no previous study was conducted in this study area. Therefore, the main objective of the study was to assess the level of women's satisfaction with institutional delivery services and associated factors among mothers who gave birth at Hawassa University's comprehensive specialized Hospital. Methods and Materials: Institutional based quantitative cross-sectional study was employed from April to May 2022 at Hawassa University's comprehensive specialized hospital. A total of 265 women who came to delivery service were included in the study and systematic sampling techniques was used to select study participant. A semi-structured questionnaire was used to collect data. The data was entered into EPI Data 3.1 version and transported to SPSS version 25 for data analysis. Binary and multi-regression were done for predictor variables associated at p-value &lt;0.05 with the dependent variable. Result: A total of 265 mothers fully responded, making a response rate of 95.3%. This study found that 63% of study participants were satisfied and 37% of them were unsatisfied with the delivery and labor service. Participants' occupation, last pregnancy wanted, health conditions of the mother during and after delivery, media exposure to institutional delivery, total duration of labor, a surgical procedure done for women, the provider gives periodic updates on the progress of labor and explained what is being done and that to be expected were statistically associated with satisfaction status. Conclusion: The study showed that the overall satisfaction of the women with the delivery service provided by health care providers in the study area was relatively low. Therefore, all stakeholders should take immediate and appropriate action on those identified factors.

Non adherence to treatment and the associated factors in patients with epilepsy in Southern Ethiopia

Adherence to antiepileptic drug therapy in people with epilepsy is critical for seizure control. Poor adherence to epilepsy treatment, on the other hand, is recognized as a worldwide problem, particularly in developing countries such as Ethiopia. As a result, the current study seeks to ascertain patients’ adherence to antiepileptic medications and the factors that influence it at Hawassa University Comprehensive Specialized Hospital in Southern Ethiopia. From February 1 to October 15, 2017, 187 people with epilepsy who were on followup at Hawassa University Comprehensive Specialized Hospital underwent a hospitalbased retrospective medical review. Adherence was measured using Morisky Medication Scale-8. Data was entered and analyzed using the soft ware Statistical package for social sciences version 20. The results were summarized using cross-tabulations and frequency tables. While binary logistic regression was used to analyze factors associated with adherence to antiepileptic drug therapy, significance was declared at p&lt;0.05. According to the findings of the current study, about nineteen percent of the study participants were nonadherent to their treatment. Compared to patients with monthly income of less than 1000.00 ETB, those who earn&gt;3000.00 ETB [AOR=0.164, 95% CI (0.038: 0.702)] and those with monthly income between 2000 and 3000 ETB [AOR=0.110, 95%CI (0.026:0.461)] [AOR=0.110, 95% CI (0.026:0.461)] are less likely associated with non-adherent to antiepileptic drugs (P&lt;0.05). Likewise, patients who perceived epilepsy as psychiatric disorder [AOR= 0.250, 95%CI (0.087: 0.716)] compared to those who perceive it as neurologic, and those patients with seizure free period of less than one year [AOR= 0.206, 95%CI(0.076:0.562)] compared to those with seizure free period of more than one year are found to be less non adherent (p&lt;0.05).

Magnitude of Malaria-Typhoid Fever Coinfection in Febrile Patients at Arba Minch General Hospital in Southern Ethiopia.

Coinfection with malaria and typhoid fever is a major public health issue in developing countries. In endemic areas, including Ethiopia, people are at risk of acquiring both malaria and typhoid fever at the same time. Therefore, this study aimed to determine the magnitude of malaria-typhoid fever coinfection in febrile patients attending hospital at Southern Ethiopia. A hospital-based cross-sectional study was carried out on 416 febrile patients attending Arba Minch General Hospital from 1st October to 30th December 2021. The data was collected using a pretested structured questionnaire. Capillary and Venus blood samples were collected for assessing malaria and typhoid fever, respectively. Blood smear, culture, and biochemical tests were performed based on standard parasitological and microbiological methods. The P-value ≤ 0.05 was considered statistically significant. The magnitude of malaria, typhoid fever, and their coinfections was 26.2% (109/416), 6.5% (27/416), and 3.1% (13/416), respectively. Among the confirmed malaria cases, about 66% of infections were Plasmodium falciparum. The malaria-typhoid fever coinfection showed a statistically significant association with a clinical presentation of a continuous pattern of fever (AOR = 5.84; 95% CI: 1.44-23.71, P = 0.014) and chills (AOR = 3.94; 95% CI: 1.04-14.89, P = 0.044). About 29.6% of Salmonella isolates were multidrug-resistant (MDR). The total rate of coinfection with malaria and typhoid fever was comparable to that of previous studies. With the consideration of higher prevalence of drug resistance of Salmonella spp. and higher prevalence of malaria-typhoid fever coinfection, proper diagnostic procedure should be implemented for proper use of drugs.

Quality Assurance with Reference Quality Control Strains in Antimicrobial Susceptibility Testing: Need for Quality Antimicrobial-Resistant Research [Letter

Letter for the article Bacteriological Profiles, Antimicrobial Susceptibility Patterns, and Associated Factors in Patients Undergoing Orthopedic Surgery with Suspicion of Surgical Site Infection at Arba Minch General Hospital in Southern Ethiopia

Birth-Related Perineal Tear and Its Associated Factors Among Mothers Who Delivered in Atat Hospital

INTRODUCTIONBirth-related perineal tear or laceration(s) are related to vaginal delivery. Perineal laceration(s) can results in serious maternal morbidity and even mortality in low and middle-income countries, including Ethiopia. The prevalence and determinants of birth-related perineal tear have not been well studied in Ethiopia, particularly in the study area of this research. Therefore, the aims of this research were to determine the prevalence and determinants of birth-related perineal tear among mothers who delivered in Atat Hospital in southern Ethiopia. It was another aim of this study to design an evidence-based intervention and prevention strategies for the reduction of a BPT in the study area and the country based on analysis of data acquired in this research.METHODSA hospital-based cross-sectional study was conducted at Atat Hospital from March 1 to August 30, 2021. A total of 422 mothers were included. A systematic random sampling procedure was used to select the study participants. Chart review and interviewer-administered questionnaires were used to collect data. Data entry and analysis were done by using Epi info 7 and SPSS version 20. The strength of associations was assessed by using an adjusted odds ratio with a 95% confidence interval (CI) and statical significance was considered at p-value of less than (&lt;) .05.RESULTThe prevalence of perineal tears in Atat Hospital was 152 (38.4%) among 396 delivered mothers (95% CI 33.8, 43.4%). Variables found to be related to perineal tear(s) included an episiotomy, (AOR, 2.145,95% CI 1.051, 4.378), fundal pressure (AOR, 7.409, 95% CI 3.157, 17.384), augmentation, (AOR, 4.608,95% CI 2.139, 9.927), and neonatal head circumference (AOR, 3.427,95% CI 2.377, 4.923). These four variables were significantly associated with the perineal tear (p &lt; .05).CONCLUSIONThe prevalence of perineal trauma in this study was high may be be minimized with the use of indicated episiotomy and the lack of fundal pressure. Fundal pressure, augmentation, an episiotomy, and neonatal head circumference were significantly associated factors with the occurrence of perineal tears.

Clinical management and outcomes of acute febrile illness in children attending a tertiary hospital in southern Ethiopia

BackgroundThe management of febrile illnesses is challenging in settings where diagnostic laboratory facilities are limited, and there are few published longitudinal data on children presenting with fever in such settings. We have previously conducted the first comprehensive study of infectious aetiologies of febrile children presenting to a tertiary care facility in Ethiopia. We now report on clinicians’ prescribing adherence with guidelines and outcomes of management in this cohort.MethodsWe consecutively enrolled febrile children aged 2 months and under 13 years, who were then managed by clinicians based on presentation and available laboratory and radiologic findings on day of enrolment. We prospectively collected outcome data on days 7 and 14, and retrospectively evaluated prescribing adherence with national clinical management guidelines.ResultsOf 433 children enrolled, the most common presenting syndromes were pneumonia and acute diarrhoea, diagnosed in 177 (40.9%) and 82 (18.9%), respectively. Antibacterial agents were prescribed to 360 (84.7%) of 425 children, including 36 (34.0%) of 106 children without an initial indication for antibacterials according to guidelines. Antimalarial drugs were prescribed to 47 (11.1%) of 425 children, including 30 (7.3%) of 411 children with negative malaria microscopy. Fever had resolved in 357 (89.7%) of 398 children assessed at day 7, and in-hospital death within 7 days occurred in 9 (5.9%) of 153 admitted patients. Among children with pneumonia, independent predictors of persisting fever or death by 7 days were young age and underweight for age. Antibacterial prescribing in the absence of a guideline-specified indication (overprescribing) was more likely among infants and those without tachypnea, while overprescribing antimalarials was associated with older age, anaemia, absence of cough, and higher fevers.ConclusionOur study underscores the need for improving diagnostic support to properly guide management decisions and enhance adherence by clinicians to treatment guidelines.

Bacteriological Profiles, Antimicrobial Susceptibility Patterns, and Associated Factors in Patients Undergoing Orthopedic Surgery with Suspicion of Surgical Site Infection at Arba Minch General Hospital in Southern Ethiopia.

BackgroundIn the thoughts of all orthopedicians, the emergence of drug-resistant and biofilm-forming bacterial infections at orthopedic surgical sites is the most feared problem. Thus, this study aimed to determine the bacteriological profiles, antimicrobial susceptibility patterns, and biofilm forming ability of isolates, as well as factors associated with orthopedic surgical site infections (OSSIs).MethodsAn institution-based cross-sectional study was conducted from March 1st, 2021, to February 30th, 2022 at Arba Minch General Hospital. About 245 suspected orthopedic patients with surgical site infection were enrolled and structured questionnaires were used to collect the required information. Wound swabs or pus aspirates were aseptically collected. The frequency and type of bacterial pathogen(s), antimicrobial susceptibility pattern, and biofilm formation were used to determine and characterize the magnitude of OSSIs. SPSS version 25 was used to analyze factors associated with OSSIs.ResultsThe overall magnitude of symptomatic OSSIs was 29.4% (72/245). External fixation [AOR = 4.761, 95% CI: (1.108–20.457)], implant use [AOR = 3.470, 95% CI: (1.460–8.246)], length of time for surgery [AOR = 3.225, 95% CI: (1.545–6.731)], and post-operative hospitalization [AOR = 4.099, 95% CI: (2.026–8.293)] were all statistically significant. Staphylococcus aureus was the most frequently isolated bacteria, accounting for 76%. Methicillin-resistant was observed in 57.9% and 40% of isolated S. aureus (MRSA) and coagulase-negative staphylococci (CoNS), respectively. One-third of the isolated E. faecium was vancomycin-resistant (VRE). Overall, 67.1% (51/76) of isolates were multidrug-resistant (MDR). About 27.6% (21/76) of isolates were found to be strong biofilm producers.ConclusionOSSIs were shown to be caused by a significant number of drug-resistant and biofilm-producing bacterial isolates. To mitigate the problem, aseptic surgical practice and conventional wound management, as well as constant observation of antimicrobial resistant patterns, should be followed.

Maternal Near-Miss and Maternal Death Associated with Abdominal Ectopic Pregnancy: Case Series from a Tertiary Hospital in Southern Ethiopia

Maternal Near-Miss and Maternal Death Associated with Abdominal Ectopic Pregnancy: Case Series from a Tertiary Hospital in Southern Ethiopia

Predictors of mortality among neonates hospitalized with neonatal sepsis: a case control study from southern Ethiopia

BackgroundNeonatal sepsis, which resulted from bacterial, viral, and fungal invasions of the bloodstream, is the major cause of neonatal mortality and neurodevelopmental impairment among neonates. It is responsible for more than one-third of neonatal deaths in Ethiopia. Frequently neonates referred to health facilities are at high risk of death. Hence, assessing and preventing the predictors of mortality in neonatal sepsis helps to reduce the burden of neonatal mortality.ObjectivesTo determine predictors of mortality among neonates admitted with sepsis at Durame general hospital, southern Ethiopia, 2020.MethodsInstitution-based unmatched case-control study was carried out from March 8 to 30, 2020, among 219 neonates in Durame general hospital in southern Ethiopia. Neonates admitted with sepsis and died were considered as cases and neonates admitted with sepsis and survived (discharged alive) as controls. Cases were selected by taking the deaths of neonates consecutively among those neonates admitted with the diagnosis of neonatal sepsis. The next immediate three corresponding controls were selected by lottery method from the Neonatal Intensive Care Unit (NICU) case registration book. Data was collected by using structured pretested checklists from neonates’ records and then entered into Epi data version 3.1 and exported to SPSS version 20. Logistic regression was used to identify the predictors of mortality. Statistical significance was declared at P < 0.05.ResultsA total of 55 cases and 164 controls were included in this study. More than three quarters (81.8%) of cases had early onset sepsis. The multivariable logistic regression analysis showed that predictors of mortality in this study were; poor feeding [AOR = 4.15; 95% CI (1.64, 10.49)], respiratory distress [AOR = 2.72; 95% CI (1.31, 5.61)], estimated gestational age less than 37 weeks [AOR = 4.64; 95% CI (2.17, 9.91)], and convulsion [AOR = 3.13; 95% CI (1.12, 8.76)].ConclusionThis study showed that prematurity, convulsion, poor feeding, and respiratory distress were the predictors of sepsis-related neonatal mortality. It is important to pay attention to septicemic babies with any of the identified predictors to reduce sepsis-related mortality.

Evaluation of Limited Joint Mobility of the Hand and Associated Factors among Diabetic and Non Diabetic Patients in a Tertiary Care Hospital in Southern Ethiopia: A Case-control Study

Introduction: Limited Joint Mobility (LJM) is one of the long- term complications of Diabetes Mellitus (DM). It is a widespread problem among patients with DM, affecting more than two- thirds of diabetic patients. It is known that LJM predominantly affects the mobility of upper limb joints, especially those of the hand, and is often neglected until hand deformity is severe enough to interfere with daily life. Even though various studies in developed countries have revealed a significantly higher rate of LJM among diabetic patients, there is limited evidence in developing countries, specifically in Ethiopia. Aim: To assess LJM of the hand and associated factors among diabetic and non diabetic patients. Materials and Methods: A hospital-based, case control study was conducted on 240 participants in Arba Minch General Hospital, Southern Ethiopia from November 2018 to May 2019. The range of flexion and extension motions of individual hand joints {wrist, Metacarpophalangeal (MCP), first Interphalangeal (IP), Proximal Interphalangeal (PIP), and Distal Interphalangeal (DIP)} were measured by using a Goniometer. The collected data was entered into Epi (Epidemiological) Info version 3.2 and transferred to Statistical Package for Social Sciences (SPSS) version 20.0 for analysis. An independent t-test was conducted to compare the mean and standard deviations of hand joint motions among diabetic and non diabetic groups. Logistic regression was used to assess the association between the dependent and independent factors. The p-value &lt;0.05 was considered as statistically significant. Results: A total of 234 participants (response rate of 97.5% ,117 diabetic cases and 117 non diabetic controls) were included in the study. The magnitude of LJM among diabetic cases was 17.1%, whereas in non diabetic controls, it accounted for 4.3%. The composite score mean (±SD) of hand flexion in diabetic patients was 1088.75±860, which is significantly lower (p&lt;0.05) than in non diabetic patients, 1117.75±82.880, and hand extension in diabetic patients was 227.98±87.220, which was significantly lower than in non diabetic patients, 276.96±78.180. Age &gt;50 years (AOR: 3.9 (1.14-13.36) with p=0.03) and co- morbidity with hypertension {AOR: 3.26 (1.02-10.41) with p=0.04} were identified as significant associated factors for LJM in diabetic patients. Conclusion: In diabetic patients, flexion and extension movements of hand joints were significantly reduced compared to those of non diabetic patients. Advanced age and co- morbidity with hypertension were significantly associated with LJM in the current study.

Factors associated with preventive practices of COVID-19 among health care workers in Dilla University Hospital, Southern Ethiopia

Implementation of prevention measures is essential for decreasing COVID-19 morbidity and mortality. In health care settings, wearing face masks, avoiding handshakes and spitting, and thoroughly washing hands with soap and water or using an alcohol-based hand rub have been recommended as preventive measures to reduce the risk of COVID-19 transmission. Therefore, this study aimed to assess factors associated with COVID-19 prevention practices among health care workers at Dilla university hospital in Southern Ethiopia. An institutional-based cross-sectional study was conducted among 238 health care workers in Dilla university hospital from June 13, 2021- July 12, 2021. A stratified random sampling techniques were used to select study participants. Data were collected by using pre-tested structured self-administered questionnaires. A binary logistic regression analysis was used to identify factors related to COVID-19 prevention practice among health care professionals. For statistical significance factors with p-value less than 0.05, an Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was calculated and interpreted. One hundred thirty-four participants [56.3%, 95% CI: 50 - 60.3%] had good COVID-19 prevention practices. Being a frontline worker [AOR=12.6, 95% CI: 3.9–41.6], being female [AOR= 0.7, 95% CI: 0.35–0.84], being a nurse [AOR= 8, 95% CI: 2.4–27], and implementation of Infection Prevention and Control (IPC) guideline [AOR = 4.0, 95% CI: 1.56–10.08] were all factors associated with good COVID-19 prevention practice. COVID-19 prevention practices were low among healthcare professionals in the study settings. Being frontline worker, being a nurse, being female, and implementation of IPC guidelines were all associated with COVID-19 preventive measures practices among health care workers. Health care workers may need to improve the way and habit of practicing prevention methods towards COVID-19.