Jimma University Hospital Research Articles

Vision Loss and Psychological Distress among Ethiopians Adults: A Comparative Cross-Sectional Study

BackgroundVision loss causes major changes in lifestyle and habits that may result in psychological distress and further reduction in the quality of life. Little is known about the magnitude of psychological distress in patients with vision loss and its variation with the normal. The aim of this study is, therefore, to investigate the psychological effects of vision loss and its determinants among Ethiopians.MethodsA comparative cross-sectional study was conducted on adults attending the Eye clinic of Jimma University Hospital. One hundred fifteen consecutive adults with visual loss at least in one eye and 115 age-and sex-matched controls with normal vision were studied. The psychological distress was measured using standardized Self-Reporting Questionnaire (SRQ-20). Chi-square test and logistic regression were carried out and associations were considered significant at P<0.05.ResultsThe overall prevalence of psychological distress was 33.4%. While psychological distress was found in 49.8% of patients who had loss of vision at least in one eye, only 18.3% of the controls had it. In the adjusted analysis, patients with vision loss had 4.6 times higher risk of suffering from psychological distress compared to patients with normal vision (AOR 4.56; 95% CI 2.16-9.62). Moreover, patients with vision loss in both eyes (AOR 4.00; 95% CI 1.453-11.015) and with worse visual acuity in the better eye (AOR 3.66; 95% CI 1.27-10.54) were significantly more likely to have psychological distress than those patients with vision loss in one eye only and good visual acuity in the better eye respectively. The cause of visual loss, pattern of visual loss, duration of visual loss and sociodemographic variables did not influence the likelihood of having psychological distress.ConclusionPrevalence of psychological distress was significantly higher in patients with visual loss compared to patients with normal vision. There is a need for integration of psychosocial care into the current medical and surgical treatment of patients with vision loss.

Retinal Detachment in Southwest Ethiopia: A Hospital Based Prospective Study

PurposeThe incidence of retinal detachment in Blacks is generally considered to be low though there are few supporting studies in Africa. This study, thus, aimed at describing the clinical profile of patients with retinal detachment in Southwest Ethiopia.MethodsA hospital-based study was done on all consecutive retinal detachment patients who presented to Jimma University Hospital over six months period. A semi-structured questionnaire was used to collect patients’ sociodemographic characteristics and clinical history. Comprehensive anterior and posterior segment eye examinations were done and risk factors were sought for. Statistical tests were considered significant if P < 0.05.ResultsA total of 94 eyes of 80 patients (1.5%) had retinal detachment (RD) and about 69% of patients were symptomatic for over a month before presentation. The mean age was 41.4 years (SD ±16.5). Fourteen patients (17.5%) had bilateral RD. At presentation, 61 eyes (64.9%) were blind from RD and 11 (13.8%) patients were bilaterally blind from RD. Rhegmatogenous RD was seen in 55 eyes (58.5%) and tractional RD in 22 eyes (23.4%). The most common risk factors were ocular trauma (32 eyes, 34.0%), myopia (23 eyes, 24.5%), posterior uveitis (13 eyes, 13.8%) and diabetic retinopathy (9 eyes, 9.6%). Most retinal breaks (25 eyes, 43.1%) were superotemporal and horse-shoe tear was the most common (19 eyes, 20.2%). Macula was off in 77 eyes (81.9%) and 38 eyes (69.1% of RRD eyes) had grade C proliferative vitreoretinopathy (PVR). Macular status was significantly associated with PVR (P=0.011), and duration of symptoms (RR=1.25, 95%CI: 1.059-1.475, P=0.040).ConclusionsA significant numbers of patients with ocular problem had retinal detachment, and nearly two third of the patients presented late. Trauma and myopia were the most important risk factors. People should be educated to improve their health seeking behavior and use eye safety precautions to prevent ocular trauma.

Genotype diversity of Mycobacterium isolates from children in Jimma, Ethiopia.

BackgroundPaediatric tuberculosis (TB) is poorly addressed in Ethiopia and information about its magnitude and the genotype distribution of the causative Mycobacterium tuberculosis strains responsible for its spread are scanty.MethodsGastric lavage or sputum samples were collected from consecutively enrolled TB suspect children visiting Jimma University Hospital in 2011 and cultured on Middlebrook 7H11 and Löwenstein-Jensen media. Acid fast bacterial (AFB) isolates were subjected to molecular typing targeting regions of difference (RDs), 16S rDNA gene and the direct repeat (DR) region using multiplex polymerase chain reaction (mPCR), gene sequencing and spoligotyping, respectively. Molecular drug susceptibility testing of M. tuberculosis isolates was performed by Genotype®MTBDRplus line probe assay (LPA) (Hain Life Sciences, Germany).ResultsGastric lavage (n = 43) or sputum (n = 58) samples were collected from 101 children and 31.7% (32/101) of the samples were positive for AFB by microscopy, culture and/or PCR. Out of 25 AFB isolates, 60% (15/25) were identified as M. tuberculosis by PCR, and 40% isolates (10/25) were confirmed to be non-tuberculous mycobacteria (NTM) by genus typing and 16S rDNA gene sequencing. Lineage classification assigned the M. tuberculosis strains into Euro-American (EUA, 66.7%; 10/15), East-African-Indian (EAI; 2/15), East-Asian (EA; 1/15) and Indio-Oceanic (IO; 1/15) lineages. Seven M. tuberculosis strains were new to the SpolDB4 database. All of the M. tuberculosis isolates were susceptible to isoniazid (INH) and rifampicin (RIF), except for one strain (of spoligotype SIT-149 or T3_ETH family) which had a mutation at the inhA locus which often confers resistance to INH (low level) and ethionamide.ConclusionsAnalysis of the genetic population structure of paediatric M. tuberculosis strains suggested similarity with that of adults, indicating an on-going and active transmission of M. tuberculosis from adults to children in Ethiopia. There were no multidrug-resistant TB (MDR-TB) strains among the isolates.

Anti-Tuberculosis Drug Induced Hepatotoxicity among TB/HIV Co-Infected Patients at Jimma University Hospital, Ethiopia: Nested Case-Control Study

BackgroundThis study was carried out to determine the incidence and predictors of anti-tuberculosis drug induced hepatotoxicity among TB/HIV co-infected patients at Jimma University Hospital, Ethiopia.Methods/Principal FindingsA nested case-control study was conducted by reviewing charts of all TB/HIV co-infected patients who commenced anti-TB treatment from January 2008 to December 2011 at Jimma University Hospital. Patients who had developed hepatotoxicity after at least 5 days of standard doses of anti-TB drug therapy were labeled as “cases” and those without hepatotoxicity were “controls”. Each case with anti-TB drug induced hepatotoxicity was compared with 3 controls selected randomly from the cohort. From a cohort of 296 TB/HIV co-infected patients 8 were excluded from the study as the causality between anti-TB drugs and hepatotoxicity was not confirmed, 33 had developed hepatotoxicity. On bivariate logistic regression analysis, body mass index (BMI) <18.5 Kg/m2 [P = 0.01; OR (95%CI): 3.6 (1.4–9.5)], disseminated pulmonary TB [P = 0.00; OR (95%CI): 5.6 (2.2–14.6)], CD4 count ≤50 [P = 0.016; OR (95%CI): 3.6(1.27–10.23)] and WHO stage 4 [P = 0.004, OR (95%CI): 3.8 (1.68–8.77)] were significantly associated with anti-TB drug induced hepatotoxicity. Predictor variables with p-value <0.05 by bivariate analysis were analyzed using multivariable logistic regression analysis and identified disseminated pulmonary TB [P = 0.001; AOR (95%CI) = 5.6 (2.1–15.0)] and BMI <18.5 [P = 0.014; AOR (95%CI) = 3.6 (1.3–10.1)] as independent predictors of anti-TB drug induced hepatotoxicity.ConclusionsThe incidence of anti-TB drug induced hepatotoxicity was 11.5%. The results suggest that in the presence of disseminated pulmonary TB and/or BMI <18.5 Kg/m2, TB/HIV co-infected patients should be closely followed for the occurrence of hepatotoxicity during the intensive phase of TB treatment to prevent morbidity and mortality.

Determinants of glycemic control among insulin treated diabetic patients in Southwest Ethiopia: hospital based cross sectional study.

BackgroundGood glycemic control reduces the risk of diabetic complications. Despite this, achieving good glycemic control remains a challenge in diabetic patients. The objective of this study is to identify determinants of glycemic control among insulin treated diabetic patients at Jimma University Hospital, Southwest Ethiopia.MethodsHospital-based cross-sectional study was conducted on systematically sampled 284 insulin-treated diabetic patients with a regular follow up. Data was collected by interviewing patients during hospital visits and reviewing respective databases of September 2010 to December 2011. Data collection took place from February 20 to May 20, 2012. Poor glycemic control was defined as fasting blood sugar (FBS) ≥126 mg/dL. Binary logistic regression analysis was conducted to identify predictors of poor glycemic control.ResultsPatients had a mean age of 41.37 (±15.08) years, 58.5% were males, the mean duration of insulin treatment was 4.9 (±5.1) years, 18.3% achieved good glycemic control (FBS≤126 mg/dL), 95% self-reported repeated use of disposable insulin syringe-needle and 48% correctly rotating insulin injection sites. Most (83.1%) of study participants had one or more complications. On multivariable logistic regression analyses, body weight of >70 Kg (AOR = 0.21; P<0.001), total daily dose of insulin ≤35 IU/day (AOR = 0.26; P<0.001), total daily dose variation without checking glycemic level (AOR = 3.39; P = 0.020), knowledge deficit about signs and symptoms of hyperglycemia (AOR = 3.60; P = 0.004), and non-adherence to dietary management (AOR = 0.35; P = 0.005) were independent predictors of poor glycemic control.ConclusionsThe proportion of patients with poor glycemic control was high, which resulted in the development of one or more complications regardless of duration on insulin treatment. Hence, appropriate management of patients focusing on the relevant associated factors and independent predictors of poor glycemic control would be of great benefit in glycemic control.

Glaucoma Subtypes in Ethiopian Clinic Patients

Until population-based data become available in Ethiopia, hospital-based studies may reflect the distribution of the subtypes of glaucoma in certain parts of the country. The main aim of this study was to determine the subtypes of glaucoma in Jimma University Hospital, Ethiopia. A facility-based cross-sectional study was conducted in Jimma University Hospital from April 1, 2007 to March 30, 2008. The study population consisted of 335 consecutive new and follow-up patients with glaucoma diagnosed based on strict objective criteria. The mean (SD) age of the study patients was 57.0 (12.7) years (range, 8 to 90 y). The male to female ratio was 2.7:1. The 2 most common subtypes of glaucoma found were exfoliation glaucoma (35.2%) and primary open angle glaucoma (32.8%). Primary angle closure glaucoma was diagnosed in 18.5% of patients. The finding of exfoliation glaucoma as the most common subtype of glaucoma in the present clinic-based study is interesting. Such observation has never been reported from anywhere in Africa. We recommend community-based surveys to define the real distribution of the glaucoma subtypes in Ethiopia.

Predictors of antiretroviral treatment-associated tuberculosis in Ethiopia: a nested case-control study

Little is known about the predictors of antiretroviral treatment (ART)-associated tuberculosis (TB) in developing nations. The objective of this study was to determine predictors of ART-associated TB in adults with HIV infection at Jimma University Hospital, Ethiopia. A nested case-control study was conducted in October 2009. The study population consisted of adults with HIV infection (aged >14 years) who developed active TB in the first six months since ART initiation and controls that did not develop active TB. Data were collected using a structured and pretested questionnaire. Cox proportions hazards analysis was done to determine predictors of ART-associated TB. A total of 357 patients (119 cases and 238 controls) participated in the study. After six months of follow-up, cumulative incidence of ART-associated TB was 5.2% (123/2355). Forty (33.6%) cases were lost to follow-up after they developed ART-associated TB and 11 (9.2%) died. Fifty-one (21.4%) controls interrupted ART and 11 (4.6%) died. A CD4 lymphocyte count increase >0.5/μL/day (adjusted hazard ratio [AHR] = 19.80, 95% confidence interval [CI]: 9.52, 41.12, P < 0.001), a base-line CD4 lymphocyte count <200 cells/μL (AHR = 9.59, 95% CI: 2.36, 39.04, P = 0.002), World Health Organization (WHO) clinical stage 3 or 4 (AHR = 3.04, 95% CI: 1.62, 5.69, P < 0.001), night sweats during ART initiation (AHR = 1.53, 95% CI: 1.06, 2.21, P < 0.001) and high ART adherence (AHR = 1.30, 95% CI: 1.13, 1.50, P < 0.001) were independent predictors of ART-associated TB. HIV-infected adults with these risk factors should be followed cautiously for the development of ART-associated TB. Good ART adherence and a good immunological response during ART were associated with ART-associated TB, most likely because of an immune reconstitution inflammatory syndrome unmasking the TB.

Neuroendocrine differentiation in a case of cervical cancer

Neuroendocrine neoplasms may occur in the uterine cervix, although rarely; it accounts for 0.5-1% of all malignant tumors of the uterine cervix. A case report of an Ethiopian female presented at the Gynecology Out-Patient Clinic at Jimma University Hospital, complaining from irregular vaginal bleeding over the previous three months. Clinically there was a cauliflower cervical mass; histopathologically it was formed of sheets of small cell tumor; that further showed neuroendocrine differentiation, as demonstrated by chromogranin-A positivity. It is important to differentiate small cell carcinoma from other malignant tumors of the uterine cervix. Morphological features play an important role in making a diagnosis and the immunohistochemistry study can offer an additional useful assistance.

The ‘jimma exchange’ and audit of obstetric outcomes at jimma university hospital, ethiopia

BackgroundAs part of the ‘Jimma Exchange Scheme’, staff from Nottingham University Hospitals NHS Trust travelled to Jimma, Ethiopia to observe working practices in the Obstetrics department of the University Hospital...

Multidrug resistant Salmonella Concord is a major cause of salmonellosis in children in Ethiopia

S. Concord in Ethiopia. The objective of this study was to determine the aetiology of febrile and diarrhoeic illness in Ethiopian children focussing on Salmonella. Paediatric patients (n = 1,225) presenting with diarrhoea or fever from the paediatric outpatient department of Tikur Anbessa University Hospital, Addis Ababa (n = 825), and Jimma University Hospital, South West Ethiopia (n = 400), were investigated for pathogens from January to August 2006. Parasites were detected in 337 cases, Salmonella in 65, and Shigella in 61. Serotyping of Salmonella (including 48 stored isolates) demonstrated the dominance of S. Concord: S. Concord (85), S. Typhimurium (7), S. Paratyphi B (2), S. Haifa (1), S. Typhi (2), S. Enteritidis (4), S. Butantan (2), S. Infantis (1), S. Pomona (1), Salmonella group M (28:y:-) (1), and S. Oskarshamn (1). Six isolates in serogroups B and D were untypeable. Of 81 S. Concord isolates, 30% were invasive, most (86.5%) were positive for ESBL production by E-test and 70% were multiply resistant to trimethoprim-sulphamethaxole, ceftriaxone, chloramphenicol and gentamicin, of which over one quarter (27%) also showed reduced susceptibility to ciprofloxacin. Multi-drug resistant S. Concord was the major cause of salmonellosis in two regions of Ethiopia. The strain isolated was highly invasive, highly antibiotic-resistant, and represents a threat to heath care globally.

Mycobacterial, bacterial and fungal pathogens causing pulmonary complications in patients with HIV infection

Background To describe the socio-demographic profile of HIV patients, who are clinically suspected to have lower respiratory tract infections (LRTI) and to estimate the prevalence and types of mycobacterial, bacterial and fungal pathogens in these patients. Materials and methods Sputum samples were collected from ninety-four subjects attending at Jimma University Hospital, Ethiopia and examined microbiologically. Results Ninety-two pathogens were isolated from eighty-nine patients of the total ninety-four patients. Out of all isolates, 45.6% of the isolates constitute bacteria, 38% were Mycobacterium tuberculosis and 16.3% belong to different fungal classes. Mixed infection was identified in two cases. Klebsiella pneumonia and Candida albicans were the most common bacterial and fungal pathogens isolated respectively. Conclusion This study demonstrates that there is a difference in the incidence rates of bacterial and fungal isolates of this study and of other studies conducted within Africa and outside Africa.

Different mutation patterns of Plasmodium falciparum among patients in Jimma University Hospital, Ethiopia

BackgroundThe emergence of drug resistance is a major problem in malaria control. Combination of molecular genotyping and characterization of mutations or single nucleotide polymorphisms (SNPs) correlated with drug resistance can provide information for subsequent surveillance of existing and developing drug resistance patterns. The introduction of artemether/lumefantrine (AL) as first-line treatment, never used before in Ethiopia, allowed the collection of baseline data of molecular polymorphisms before a selection due to AL could occur.Method97 patients with uncomplicated falciparum malaria were recruited from April to June 2006 and treated with either AL, quinine (Q) or atovaquone/proguanil (AP) in Jimma University Hospital, Ethiopia. Mutations or SNPs associated with resistance to these drugs were analysed by RFLP (pfdhfr, pfmdr1) and sequencing of the target genes (pfcytb, pfserca ).ResultsSNPs previously reported to be associated with resistance to the study drugs were identified in recrudescent and treatment sensitive isolates. A total of seven recrudescences were obtained. The pfmdr1 N86Y mutation was found in 84.5% of isolates. The triple mutation 51I,59R,108N of the pfdhfr gene occured in high frequency (83.3%) but no pfcytb mutation was detected. Sequencing showed a variety of previously described and new mutations in the pfserca gene.ConclusionThe prevalence of mutations was in accordance with the expected patterns considering recent drug regimens. The broad introduction of AL and the cessation of former drug regimens might probably change the current distribution of polymorphisms, possibly leading to decreased sensitivity to AL in future. Continuous surveillance of molecular patterns in this region is, therefore, recommended.

Opportunistic And Other Intestinal Parasitic Infections In Aids Patients, Hiv Seropositive Healthy Carriers And Hiv Seronegative Individuals In Southwest Ethiopia

Human Immunodeficiency Virus (HIV) infection leads to acquired immunodeficiency syndrome (AIDS) and major causes of morbidity and mortality of such patients are opportunistic infections caused by viral, bacterial, fungal and parasitic pathogens. To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among AIDS patients and HIV positive carrier individuals. Cross-sectional study was conducted among AIDS patients, HIV positive healthy carriers and HIV negative individuals in Jimma University Hospital, Mother Theresa Missionary Charity Centre, Medan Acts Projects and Mekdim HIV positive persons and AIDS orphans' national association from January to May, 2004. Convenient sampling technique was employed to identify the study subjects and hence a total of 160 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of the patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration, oocyst concentration and modified Ziehl-Neelsen staining technique. Out of 160 persons enrolled in this study 100 (62.5%) (i.e. 65 male and 35 female) were infected with one or more intestinal parasites. The highest rate 36 (69.2%) of intestinal parasites were observed among HIV/AIDS patients, followed by HIV positive healthy carriers 35 (61.4%) of and HIV negative individuals (29 (56.9%). Isospora belli 2 (3.9%), Cryptosporidum parvum 8 (15.4%), Strongyloides stercoralis 6 (11.5%) and Blastocystis 2 (3.9%) were found only in HIV/AIDS groups I. belli, C. parvum, S. stercoralis and Blastocystis are the major opportunistic intestinal parasites observed in HIV/AIDS patients. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients with diarrhoea.

A primary healthcare approach to the management of chronic disease in Ethiopia: an example for other countries

Chronic non-communicable diseases such as epilepsy, diabetes, cardiac disease and hypertension represent a growing but neglected burden in developing countries. Rural sufferers, distant from health facilities, bear this most acutely. In response, a community care programme has been developed at Jimma University Hospital and its allied health centres in rural southwest Ethiopia. This involves general duty nurses at rural health centres being trained to provide care for chronic disease patients, with regular supervision from the hospital physicians. The programme allows treatment to be provided away from the main hospital so that those who cannot afford to travel can access care near their homes. Improved access increases the request for care, and helps to address the large unmet need for chronic disease treatment. This is a good model in which rural healthcare delivery through a team can bring widespread benefit. In this article chronic disease care is discussed with a particular focus on diabetes and epilepsy. The model can be replicated in more or less developed countries and may also be relevant for HIV care.

Prevalence and determinants of low birth weight in Jimma zone, Southwest Ethiopia

To assess the prevalence and determinants of low birth weights (LBW). A cross-sectional descriptive study. Four health centers (Jimma, Agaro, Asendabo and Shebe) within 5-50 km radius from Jimma University and Jimma University hospital from September 1, 2002 to March 30, 2003. Mothers with newborns delivered in the above institutions and those delivered at home and received care within the first 24 hours after delivery in the above health care settings. A total of 145 (22.5%) of the newborns were LBW. Mothers residing in the urban setting had higher risk of delivering LBW babies and the difference was statistically significant (p = 0.00). Analysis of maternal obstetric history revealed that those mothers who delivered before 37 weeks of gestation, had weight loss, and who did not receive additional diet during pregnancy had higher risk of delivering LBW babies and the difference was statistically significant (p = 0.01, 0.00, 0.00) respectively. Similarly, those who had multiple gestations had a higher risk of delivering LBW babies and the difference was statistically significant (p = 0.00). Despite the fact that the method of sampling used in this study has its own limitation, the prevalence of LBW in this study was relatively higher than the reported current estimate of LBW in Ethiopia. Therefore, it is recommended that special attention should be given to adequate rest and additional diet during pregnancy and making antenatal services available and accessible to all pregnant women.

Factors predisposing to low birth weight in Jimma Hospital South Western Ethiopia

Low birth weight continues to remain a major public health problem in Ethiopia in contrast to what is observed in many developing countries. To assess some of the predisposing factors to low birth weight among deliveries in Jimma hospital. Cross-sectional case referent study. Maternal and child health clinic and maternity ward of Jimma University Hospital, Ethiopia. One hundred and forty seven mothers who gave birth to low birth weight (LBW) babies between June 1999 and July 2000 were identified. Normal and low birth weight. The incidence of LBW was found to be 11.02%. Mothers younger than 20 years and > or =35 years, short stature (< or =150 cm), late first antenatal visit and complications during pregnancy were significantly associated with LBW (p<0.001). However, parity showed a negative association with LBW. Attention to nutritional education, early antenatal care interventions and strengthening of maternal and child health assists in combating LBW in the area.

HIV Seroprevalence and Factors Affecting Prevention of Vertical Transmission of HIV Among Antenatal Care

Patients and Methods A cross-sectional survey was conducted among antenatal care attendants of Jimma university hospital from Jan. 25, 2004 to Feb 25, 2004 using a structured questionnaire. At the same time unlinked anonymous blood sample was taken during routine ANC investigations. The sera were tested for HIV antibody using rapid test algorithm. In addition, full VCT service was given for volunteers. The data was analyzed by using SPSS 12th edition and chisquare and binary logistic regression were used to see associations and p-value less than 0.05 was taken as cut of point for significance.

Detection and differentiation of two morphologically identical species of &lt;i&gt;Entamoeba&lt;/i&gt;

Background: Infection with Entamoeba histolytica is a worldwide public health problem. Diagnosis of this parasite by conventional microscopy is almost impossible, because it is morphologically indistinguishable from E. dispar, which is non pathogenic. Objective: To detect and differentiate E. histolytica from E. dispar by PCR technique and to determine the prevalence of trophozoites and cysts of E. histolytica /E. dispar by microscopy of fresh stool specimen among out patients of Jimma University Hospital to provide baseline data for further study. Method: A cross-sectional study was conducted from Feb. 24 – Mar. 23, 2003 in Jimma University Hospital among patients with clinical signs and symptoms of intestinal complaints. The stool samples were examined microscopically and by PCR and Solution Hybridization Enzyme Linked Immuno assay (SHELA). Results: Out of 228 stool specimens collected, 30(13.2%) E. histolytica/E. dispar were observed by microscopic examination of which 6(2.6%) were trophozoite and 24 (10.5%) were cysts. From the total 30(13.2%) microscopically observed E. histolytica /E. dispar, PCR-SHELA detected 28(12.3%) E.dispar while no E.histolytica DNA was found. Infections with one or more intestinal parasites were common, 151 (66.2 %). By far the most common intestinal parasitic infection was Ascaris lumbricoides, 87 (38.2%) followed by Trichuria trichiura, 53(23.3%). Conclusion: Infection with E. histolytica was not found in all the stool samples examined. Neither the trophozoites nor the quadrinucleated cysts reported by microscopy were those of E. histolytica. Our finding suggests that among the patients studied, the commonly reported trophozoites and cysts belong to the non-pathogenic E. dispar, which requires no treatment at all. Therefore, the commonly reported complaints of diarrhea require alternative explanation since the routine diagnostic microscopy of amebiasis is unsatisfactory. [Ethiop.J.Health Dev. 2004;18(2):121-124]

Pancytopenia of Unknown Cause in Adult Patients Admitted to a Tertiary Hospital in Ethiopia: Case series.

Over the past few years, we have witnessed a dramatic increase in the number of patients presenting with severe pancytopenia to Jimma University Hospital. We now present sociodemographic and clinical characteristics of adult patients admitted with pancytopenia of unknown cause to Jimma University Hospital during the period of March 2015 to June 2016. Complete blood count and other diagnostic tests were done for all patients to uncover underlying causes. Out of 65 cases admitted with pancytopenia during the specified period, 40 were excluded for various reasons. The rest 25 patients were included in this review. The mean age was 32.1 years (SD=14.9); 14 were younger than 30 years of age. The mean hemoglobin level, white cell count and platelet count were 48.6 g/L (SD=1.9), 1,918 /µL (SD=879.8) and 36,200 /µL (SD=26,131) respectively. The major presenting symptoms were generalized malaise and fever. No geographic or seasonal clustering of the cases was seen. The number of cases with pancytopenia of unidentified cause seen at the hospital over the specified period is alarmingly high and deserves great attention. The hematologic alteration in most of the patients was found to be severe with poor clinical outcome. This calls for large scale community based investigation to uncover the root cause of the problem.