Vol 61, No 2 (2023): APRIL 2023 VOLUME 61 NUMBER 2

Background: Acute kidney injury (AKI) is defined as a sudden decline in kidney function in 48 hours. Unless diagnosed and managed early, AKI causes significant morbidity and mortality due to the associated increased risk of renal damage with every delay in recovery. There is a paucity of information on the pattern of recovery time from AKI and its contributing factors. Hence, this study aimed to estimate the median time to recovery and identify predictors among AKI patients on dialysis at the national renal transplant center in Ethiopia.

Methods: A retrospective chart review study was conducted among 232 AKI patients on dialysis who were managed at the center from January 2018 to June 2020. Data was summarized and compared using frequency tables, median survival times, KM survival plots and Log-rank tests. To identify predictors of time to recovery from AKI, a Cox Proportional Hazard (PH) survival model was used, where Adjusted Hazard ratio (AHR), 95% CIs for AHR, and P-values were used for interpretation of results. Data management and analysis was done using SPSS software V. 25.0.

Results: From the 232 AKI patients on dialysis, 127 (54.7%, 95% CI=48.7%-61.3%) achieved recovery and the median time to recovery was 25.0 days (95% CI=22.1, 27.9). On the Cox PH model, having cardiovascular disease (AHR=0.51, 95% CI=0.28,0.93, p=0.028), sepsis (AHR=0.59, 95% CI=0.37, 0.95, p=0.031) and acute glomerulonephritis (AGN) (AHR=0.31, 95% CI=0.14,0.71, p=0.005) were found to be significant predictors of time to recovery from AKI.  

Conclusions: The median time to recovery from AKI is optimal given the high-risk nature of the studied population. However, this duration may be associated with an increased risk of both short and long-term complications from continued renal damage. Having cardiovascular disease, sepsis and AGN were found to be associated with delayed recovery from AKI. Therefore, strict monitoring of AKI patients in general, and the high-risk groups in particular, is essential for rapid recovery.

Background: Consumption of alcohol is typical in adults, and modest consumption has reported health benefits. However, daily alcohol consumption above recommended limits is an important cause of Alcoholic Liver Disease (ALD). This study aimed to assess the knowledge of ALD among alcohol consumers and screen for alcohol misuse, dependence, and disorder.
Methods: A community-based cross-sectional survey was carried out from March to December 2020 in Afikpo using a questionnaire to obtain information on alcoholic use disorder and alcohol dependence. Data were analyzed with IBM SPSS to get descriptive statistics, inferential analysis, and P-value used at 5% significance level.
Results: A total of 450 study participants were included in this study, 73.1% were males, while 48.8% had tertiary education. About 62.7% of the respondents were aged between 20 to 60 years while 24.4% were self-employed and 9.1% were farmers. About 361(80.8%) had a good knowledge about ALD. The males had more knowledge of ALD. Adolescents aged 15 to 19 had a mean audit score of 10.774, while adults above the age of 60 had a mean audit score of 12.808. Male respondents had a mean audit score of 11.395, Adolescents had a mean CAGE test score of 1.89 while adults above 60 scored 2.48. Male subjects had a mean score of 2.17 while respondent with primary education had a mean CAGE score of 2.06, however, participants with no education had the highest mean CAGE score of 2.27.
Conclusion: The residents of Afikpo community have a good knowledge of ALD though there is alcohol use disorder, alcohol misuse and dependence in the community.
Gender is the only demographic characteristics that influenced the knowledge of ALD .
Keywords: Alcoholic liver disease (ALD); alcohol dependence; alcohol misuse; alcohol disorder; audit; cage

Background: The COVID-19 outbreak response in Nigeria was challenged by the existing weak health sector and the frontline health workers for COVID-19 pandemic response are exposed to the pathogen. One militating factor undermining the control and prevention of COVID-19 in Nigeria was poor compliance to preventive measures. This study assessed the compliance with COVID-19 prevention protocols among healthcare workers in Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria.

Methods: A cross sectional study and subjects were selected through a multi-stage sampling technique. Data collection was done using interviewer-administered semi-structured questionnaire over a period of five months (June-October, 2021). Data was analyzed using IBM, Statistical Package for Social Sciences (SPSS) version 27.0 and p value was set at <0.05 as the threshold for statistical significance.

Results: Majority (60.1%), of the respondents got information on COVID-19 protocols through seminars and workshops.  However, more than a quarter (28.8%) of the respondents said the use of available PPE was suboptimal. More than one-third, (35.8%), of respondents believe the protocols are too strict. There is, however, good perception (93.3%), but relatively lower compliance (58.7%) of COVID-19 protocols among the staff. Age, marital status and sex were associated with compliance towards COVID-19 protocols in this study (P<0.05). Identified significant predictors (p<0.05) of compliance include age (AOR=1.944), female sex (AOR=7.829).

Conclusion:  Most respondents had good knowledge of availability, perception of effectiveness, but relatively lower compliance with the COVID-19 protocols in this facility.  The government or hospital authority make sure that necessary steps to further boost compliance are taken.

Background: Seizure‐related injuries (SRI) constitute one of the major areas of concern in managing people with epilepsy. Of those, the ones with generalized tonic‐clonic seizures and drop attacks, are prone to sustain motor vehicle accidents, falls, burns, drowning, fractures, soft tissue and head injuries. Hence, this study aimed to assess the magnitude and associated factors of SRI among patients seen at Amanuel Specialized Mental Hospital, Ethiopia.

Methods: A cross‐sectional study was conducted at a regular seizure follow up clinic. A total of 298 patients above 15 years of age were included in this study. Patients’ socio-demographic and clinical data were collected based on interview and record review. Descriptive statistics were done and multivariable logistic regression was used to determine independent predictors of SRI with adjusted odds ratio and corresponding confidence interval. A p-value <0.05 was considered as statistically significant.

Results: A total of 298 patients were included in this study. Of these, 34.9% were reported to have SRI. Lacerations (54.2%), burn (19.8%) and dental-loss (15.8%) were the most common type of injuries. There was a 2.2-fold increase in the odds of SRI among those in grades 1-6 educational levels (AOR=2.19, 95% CI (1.04-4.54)), and a lower risk of SRI was found among those who could read and write (AOR=0.11, 95% CI (0.13-0.86)).

Conclusions: The study documented significant level of SRI among the study population with varied levels of severity. To minimize SRI ,it is essential to target the above predictors through proper surveillance system in the follow-up clinics with continuous advocacy work to the family and working environment.

Background: Hypertension is a major public health problem in both developing and developed nations because it is highly prevalent and is associated with complications. Numerous environmental and genetic variables are linked to the occurrence of the disease. It may be influenced by the renin-angiotensin-aldosterone system, which preserves bodily homeostasis. The angiotensinogen gene M235T polymorphisms that has an effect on the activity of the renin-angiotensin-aldosterone system are  related to the high hypertension risk. The aim of this study was to find out the association between angiotensinogen M235T gene polymorphism and the risk of developing hypertension.

Methods: A total of 306 samples - 153 patients with hypertension and 153 age- and sex-matched healthy controls were selected using a simple random sampling technique. Clinical and biochemical variables were measured to assess the associated risk factors. Blood samples from the patients and matched controls were used to isolate deoxyribonucleic acid. The AGT M235T genotypes were identified using polymerase chain reaction and analyzed by agarose gel electrophoresis. Logistic regression with a 95% confidence interval (CI) was employed to assess the risk correlations of AGT gene M235T polymorphisms with hypertension.

Results: Our analysis showed that the AGT-TT genotype (odds ratio [OR] = 3.11, 95% CL = 1.67–5.79, P< 0.001) and T allele (OR = 2.18, 95% CL = 1.56–3.04, P< 0.001) are considerably higher in hypertensive patients than in healthy controls. Our study also identified the clinical risk factors for hypertension, such as, total cholesterol, triglycerol, low density lipoprotein-cholesterol, and high density lipoprotein-cholesterol levels, which were significantly higher in patients compared to controls (P< 0.001).

Conclusion: The AGT M235T genes of the TT genotype and the T allele are associated with an increased risk of hypertension among the Ethiopian patients. A population-based epidemiological study is needed corroborate the association between AGT and HTN.