Background: Tuberculosis (TB) is a major public health challenge in developing countries. Clinical audit of treatment outcome is a major indicator of the performance of the TB control programme.

Objectives: The aim of this study was to evaluate tuberculosis treatment outcomes and associated factors among patients attending the directly observed tuberculosis short-course (DOTS) facility in a tertiary healthcare center in Nigeria.

Methods: An eight-year retrospective study of registered TB patients from October 2008 to November 2016. The treatment outcome of patients was categorized using the National TB Control programme guideline.

Results: A total of 592 complete patients’ records was reviewed. There was a slight male preponderance (322, 54.4%) and the majority of the patients were newly diagnosed of tuberculosis (537, 90.7%) especially pulmonary tuberculosis (520, 87.8%). The mean age of registered patients was 38 ± 0.6 years. More than half of the patients (339, 57.2%) had smear-positive pulmonary TB (PTB), (181, 30.6%) smear-negative PTB, while (72, 12.2%) had extra-pulmonary TB (EPTB). Four hundred and three patients (91.6%) had successful treatment outcomes (cured and treatment completed), and the predictors of TB treatment outcome were EPTB (OR 11.4 CI 2.30-57.5 p-value=0.003) and TB/HIV co-infection (OR 0.08 CI 0.025-0.24 p<0.05). TB/HIV co-infection accounted for 13% of patients and this was found to be associated with female gender (OR 2.5 CI 1.48-4.22, p-value?0.0001) and EPTB (OR 0.2 CI 0.27-12.90, p-value=0.032).

Conclusion: Satisfactory treatment outcome when compared to the global target. However, proper integration of TB/HIV programme would further improve the outcome.

Aims:  Operative management of fractures has changed significantly in the 21st century with the introduction of simple but effective devices and procedures to improve fracture care and healing outcomes. This study describes the commonest fractures treated surgically, type of fractures and operative fixation methods used for  patients seeking orthopaedic services in two hospitals in Ghana.

Methods: Review of all patients who have had operative fracture fixation at the Cape Coast Teaching Hospital and St. Joseph Orthopaedic Hospital  between January 2016 to December 2018. Operation records of 1,168 were reviewed for their age, gender, fractured bone, type of fracture, operative fixation method and devices used for fixation.

Results: A total of 1,168 fractured patients were treated operatively irrespective of age in the 3 year period reviewed. Males (817)compared to females (351) in a  ratio of 2.3:1. The 21 – 40 year age group had the highest number of fractures (50% of femur fractures, 52% of tibial and 56% of forearm fractures) managed operatively. Plate osteosynthesis was found to be the most preferred method of fixation for the major long bones; femur 360(66 %), Humerus 69(78% ), radius and ulna 81(78%). 

Conclusion: Fractures of the femur and tibial shafts represent an overwhelming majority of operatively managed long bone fractures. Plating as opposed to the gold standard of intramedullary nailing was the most commonly employed fixation method for femur and tibial fractures, so scarce resources should be channelled towards acquiring the requisite instrumentation and skill set for the fixation of these fractures.

Background

Interstitial lung diseases represent a large number of conditions that involve the parenchyma of the lung—the alveoli, the alveolar epithelium, the capillary endothelium, and the spaces between those structures—as well as the perivascular and lymphatic tissues. The causes are not known for most patients. Knowing local prevalence and associated factors will help to design preventive measures for those who are at high risk.

Objective

To determine the prevalence and characteristics of interstitial lung disease among patients visiting Ayder Comprehensive Specialized Hospital chest clinic from December 1, 2016 to November 30, 2018

Methods

A facility based retrospective cross sectional consecutive chart review was conducted on 995 patients’ charts. Those with diagnoses of interstitial lung disease were further analyzed. The data was collected using data collection format. Analysis was made on SPSS version 20 software. Descriptive statistics, frequency and proportions were utilized.

Results

From 995 patients, the top three diagnoses were Asthma, Post Tuberculosis Bronchiectasis and Interstitial Lung Disease respectively. The prevalence of interstitial lung disease was 8.4%.  Mean age was 55 years and female patients accounted for 52%.

Conclusion

Prevalence of Interstitial Lung Disease is found to be 8.4%. Interstitial Lung Disease is the third common diagnosis in chest clinic. Idiopathic Interstitial Pneumonias are the leading types.

Abstract

Background: Upper gastrointestinal bleeding (UGIB) is a common medical emergency associated with significant morbidity and mortality. At present, there is limited epidemiological data on UGIB and associated mortality in Ethiopia.

Aim: to assess the pattern, management and outcome of GIB patients admitted to St. Paul’s Hospital Millennium Medical College

Methods and materials: A cross-sectional retrospective study was done. out of 208 patients who presented to Saint Paul’s Hospital Millennium Medical College with gastrointestinal bleeding(GIB) in one-year period, 128 patients fulfill the inclusion criteria. using a structured questionnaire demographic data, endoscopic diagnosis and outcome of GI bleeding patients was assessed. Data was analyzed by using SPSS version 23 and Statistical analysis was performed by using chi-square test and P-value < 5% is considered as significant.

Result: The mean age of patients was 35 ± 14.37. Majority were males (83.6%) with a male to female ratio of 5:1. Varices is the most common cause of UGIB seen in 46.1% (59), followed by peptic ulcer disease 24.2%(31), esophagitis 3.9%(5), gastritis 6.3%(8), Duodenitis 3.1%(4) and malignancy 4.7%(6). Ten patients (7.8%) had both varices and ulcer.  The mortality rate in this study was 17.2%. variceal cause of bleeding, malignancy, sepsis, hepatic encephalopathy and transfusion requirement are predictors of mortality.

Conclusions: In the present study, variceal bleed was the most common cause of UGIB, followed by peptic ulcer bleed. Overall mortality was 17.2% of cases; there was significant association between cause of bleeding and mortality.

Abstract

Background

Acute lower respiratory infections (ALRI) is a major cause of deaths in children worldwide. In ALRI hypoxemia is the most common fatal complication. The WHO definition of hypoxemia  does not take into account the altitude The objective of this study is to determine the oxygen saturation value in apparently healthy under-five children who permanently reside at moderate altitude, Addis Ababa, Ethiopia using pulse oximetry. 

Methods

The study was a cross sectional design. The location of the study was at 2 health facilities in Addis Ababa. The SpO₂ was measured among apparently healthy under-five year children using Nellcor N-10 self-calibrating pulse oximetry between May and July, 2017. A structured questionnaire was used to collect socio-demographic and clinical data. Data were entered and analyzed using SPSS version 20 statistical software.

Results

The mean SpO₂ was 93.59% (95% CI 93.06%, 94.11%) with a median of 94.67%.  The 2.5^th centile threshold of SpO₂ for hypoxemia is 82%. Using suggested formula for hypoxemia threshold for the altitude of Addis Ababa is 90%. A significant difference was observed in SpO₂ between infants and older children, although the difference was not demonstrable when sleeping subjects were excluded. Activities affect SpO₂ whereby sleep and bottle or breast feeding had a lowering effect on SpO_2.

Conclusions

This study provided a reference range of SpO₂ values for healthy children under-five years of age. To determine the threshold for hypoxemia needs further clinically relevant cutoff.

Key words:

• Moderate altitude, oxygen saturation, children under-five-year

Abstract  

Background: Neurological and musculoskeletal disorders can affect different body parts and anatomical structures. Physiotherapy is used in musculoskeletal and neurological disorders.

Objective: To assess the anatomical profile of neurological and musculoskeletal disorders among patients.

Material and Method: Institution based retrospective cross sectional study was carried out at Tikur Anbessa Specialized Hospital (TASH). The sample size was 355. Data were obtained from charts of Patients presented to physiotherapy unit. The study participants were neurological and musculoskeletal patients visiting physiotherapy unit of TASH. The data were analyzed using SPSS 21. A statically significant association was declared at p-values <0.05.

Result: There were 342 participants among them 192 (56.1 %) were male and 150 (43.9 %) were female. Most 84 (24.6%) of patients, were between 45 and 59 years. In this study, prevalence of neurological disorders and musculoskeletal disorders were 55.3% and 38.6%, respectively. Lower limb 109 (31.9%), Back 67 (19.6%) and upper limb 59 (17.3 %) were the most affected anatomical regions. Inter Vertebral Disc (IVD) 88 (27.9%), Bone 66 (19.3 %) and joint 55 (17.5%) were the most affected structures. Among traumatic causes of disorders Road Traffic Accident (RTA) (45%) was the leading cause, followed by falling (19%).

Conclusion: In this study, lower limb and back were the most affected anatomical regions. IVD and bone were the most affected anatomical structures. RTA and Falling were among the common traumatic causes of musculoskeletal and neurologic disorders.

Keywords: Musculoskeletal, Neurological disorder, Tikur Anbessa specialized hospital, Ethiopia

Background: COVID-19 is an acute respiratory illness caused by a novel human coronavirus (SARS-CoV-2), which causes higher mortality in people aged ?60 years and in people with underlying medical conditions.

Objective: To describe the Knowledge, attitudes, and practices towards COVID-19 among health professionals in selected hospitals of Addis Ababa, Ethiopia.

Methods: this is a cross-sectional survey conducted in selected Addis Ababa Hospitals during April and May 2020. A standardized, well-structured questionnaire was used to collect the data. Descriptive statistics was used to summarize the study and outcome variables. Chi-square test and odds ratios were used to test the differences and observing and quantifying the association between categorical outcomes respectively.

Result: A total of 526 health professionals participated in the study. 227(43.2 %) were from Tikur Anbesa Specialized Hospital, 110 (20.9 %) from Yekatit 12 Hospital 87 (16.5 %), and 102 (19.4 %) from Ghandi and Zewditu Memorial Hospitals respectively. Among this 283 (53.8 %) were female and mean age was 32.5 + 8.9. 204 (38.8 %) physician and 82 (15.6 %) were nurses. Age groups > 50 years were more knowledgeable than the reference age group 20-30 years AOR 8.76 with 95% CI (2.47-30.99). Being Pharmacist and laboratory technician had a good knowledge than the reference group nurses with AOR 2.72 (1.25-5.94) and 1.98 (1.00-3.94) 95% CI respectively.

Conclusion: The study identified that there was a huge knowledge gap on the asymptomatic transmission of the disease and measures should be taken to fill the knowledge gap.

Introduction: Radiology practices are facing unprecedented challenges during COVID-19 pandemic not only in how they are providing care to patients but also in how to continue to educate the next generation of radiologists. Education is one of the area challenged markedly by the pandemic.  This survey is mainly trying to analyses the impact of COVID 19 on radiology residency in Ethiopia and look into alternative innovative options that radiology departments are using in order to maintain the trainging program.

Methodology; an online survey was distributed through a social media platform to all radiology resident trainees. Questionnaire contains learning and teaching activities before and after COVID 19 pandemic.

Result: Of the total 211 radiology residents who are training radiology residency in Ethiopia 119 residents fulfilled the inclusion criteria,  Of which 93 (78.2%) are males and 26 (21.8%) are female. Nearly half 52(43.3%) of residents are in their third year, while 45(37.5%), and  21(17.5%) in their second and first year of training resoectively. Seminar and daily image viewing sessions are the most common ways of radiology teaching activities accounting for 93.3% and 91.6% respectively. More than half (50.4%) of respondents state that the activities are compromised with some activities replaced by alternative models. Use of open source video conferencing (74.4%) is the most commonly used alternative method.

Conclusion and Recommendation:COVID-19 pandemic dictates that traditional ways of teaching which mandates face-to-face discussions will no more be the choice so using alternative methods should be encouraged. 

Abstract

Aim: The purpose of this study was to determine the levels of competence and predictors to lead, manage, and govern among the health system workforce.

Methods: A cross-sectional study was carried out in northwest Ethiopia. Eight hundred thirteen workforce were participated in the study. Competence to lead, manage, and govern was computed from 20 items. It was also leveled into four categories. Ordinal logistic regression analysis was conducted to identify predictors of this competence.

Results: From 813 participants, 396 (48.7%) and 582 (71.6%) were females and service owners respectively. The estimates for low, moderate, high and very high levels of competence to lead, manage and govern were 41.3%; 42.7%; 13.5% and 2.5% respectively. Sex (p = .031) and responsibility (p = .019) were identified as main predictors.

Conclusions: Competence to lead, manage and govern among the health system workforce in northwest Ethiopia is inadequate. Policymakers, program planners and researchers need to take action giving due attention to females and service owners. Feature research could be conducted considering hierarchical variables.