Vol 53 (2015): Sup.2: Special Issue on MEPI: Improving Medical Education Quality, Faculty Retention and Research Capacity in Ethiopia

Back ground:As one of the countries in Sub-Saharan Africa with a low physician to population ratio, Ethiopia has sought to mitigate the problem by increasing the number of students enrolling in the existing medical schools. 

Objective: To describe the process of introducing Simulationbased medical education at Addis Ababa University College of Health Sciences, school of medicine.

Methods: Two rounds of intensive training was given by John Hopkins in collaboration withMEPI to the core clinical educators to introduce them the six-step model of curriculum development for medical education and standardized patient (SP) techniques with the ultimate aim of introducing SPs in the teaching and learning process for medical students. 

Results: There were total of  22 faculty members  participated in the first group ,the majority of whom had no prior training in curriculum development or SBME and were skeptical of the value of SBME, as evidenced in their survey responses.( 3.42/5 in Likert scale 1= least  5= most) at the end of the course  the participant were comfortable with the concept of curriculum development the rating increased  to 4.45/5(P< 0.0001) and they embraced more favorable attitudes regarding the feasibility and desirability of simulationwith Likert Scale 4.01/5 to 4.51 (P<0.0001).

Conclusion: Training courses at CHS were successful for generating enthusiasm about simulation, and improving participant attitudes regarding the usefulness and feasibility of this educational method.

Keyword: Simulation: medical education: standardized patients

Background: Cervical cancer is the second commonest type and third cause of cancer death among women in low-income countries. Women with HIV/AIDS are at greater risk of developing cervical cancer. The study is aimed at identifying determinants for suspected precancerous cervical lesions among HIV- positive women at Mekelle Hospital .

Methods: An unmatched case-control study was conducted among randomly selected HIV positive women in Mekelle hospital in 2014. Visual inspection with acetic acid (VIA) is done in HIV positive women by trained nurses routinely. A number of 116 cases, who had suspicious findinsgs on VIA, and 232 HIV-positive controls without suspicious findings on VIA were randomly selected and enrolled into the study. The determinants for precancerous cervical lesion were analyzed using multiple logistic regression and described as adjusted odds ratio (AOR).

Results: HIV positive women who had CD4 counts less than  350/mm³ were two times more likely to have precancerous cervical lesion compared to those with CD4 cells above 350/mm³. Women with two (AOR=3.6; 95% CI: 1.7, 7.7)   and three (AOR=2.5; 95% CI: 1.2, 5.4) sexual partners were four and three times more likely to have precancerous cervical lesions, respectively,as compared to those who had one sexual partner. Age, History of STI  and duration of ART had no influence on presence of VIA positive lesions in HIV positive women.

Conclusion: CD4 count cells and number of sexual partners were predictors of VIA positivecervical lesion among HIV positive women.

Key words: Precancerous cervical lesion, VIA, HIV positive women, determinants, Tigray.

Background: Teenage pregnancy is directly related to high incidence of pregnancy related complications contributing to maternal morbidity and mortality and social problems. There are no enough data on teenage pregnancy and related complications in Ethiopia and in Benishangul Gumuz region in particular.

Objective: To investigate the magnitude and factors associated with teenage pregnancy among teenage females visiting Assosa general hospital for health care services.

Methods: Facility-based quantitative cross-sectional study was carried out among 783 randomly selected teenage females using structured and pre-tested questionnaire from January to April 2014.

Results: Teenage pregnancy is estimated at 20.4% in this study. The median age of subjects at first sexual intercourse and at first marriage being 16 and 17 years respectively. High proportion of (46.8%) teenagers had engaged in premarital sex. Among sexually active teenage females, 46.7% experienced their first sexual encounter by coercion. Being young [AOR= 0.21, 95%CI= 0.06-0.67], single [AOR= 0.06, 95%CI= 0.03-0.12], housemaid [AOR= 3.93, 95%CI=1.71-9.04] and use of family planning [AOR= 2.39, 95%CI= 1.20-4.75] have statistically significant association with teenage preganancy.

Conclusions and Recommendations: A range of factors including age, marital status, level of education, occupational status, average family income and use of family planning have influence on teenage pregnancy in the study area. Behavioral change communication, strengthening school health program, empowering young women specifically the rural women, and promoting parent-children discussion on sexuality is recommended.

Key words: Teenage females, Teenage pregnancy, Risk factors, Assosa General Hospital.

Background: Leprosy is a chronic infectious disease affecting the skin and peripheral nerves. Early diagnosis and full course treatment are critical for preventing lifelong neuropathy and disability to minimize the occurrence of disability. There is not enough study on prevalence of disability and its determinants.

Objective: The objective of this study is to assess the magnitude of disability and associated factors among leprosy patients after treatment in Boru Meda Hospital.

Methods: Facility based cross sectional study was conducted among 128 leprosy patients registered at BoruMeda Hospital from January 1, 2010 to December 31, 2012. Data was collected from charts, entered, cleaned, edited using EPI Info Version 3.53 for windows and analyzed by SPSS.

Results: Five patients (4%) had Grade 2 disability at discharge; 123 (96%) were discharged with either disability grading 0 or disability grading 1, which are considered to be normal disability grading. Males and rural people were more affected by the diseases: 72% and 92% respectively. Sixty percent of disability occurred due to type one reaction. The mean age of patients and treatment duration were 39.3 years and 60 days respectively. Among the factors type of reaction was significantly associated with disability grading (P=0.02).

Conclusion and recommendation: Rural people and males are more affected by leprosy and the prevalence of disability is decreasing. Awareness creation on rural people and patients with leprosy to see healthcare providers as early as possible is warranted.

Key words:  Leprosy, Grade 2 disability, Multi drug therapy 

Background:  Hypertensive Disorders of Pregnancy (HDP) represent the most common medical complication in pregnancy associated with significant maternal and perinatal morbidity and mortality worldwide. Identification of common maternal and perinatal morbidities associated with HDP is important for policy makers to plan to alleviate the problem.

Objective: To assess the patterns of HDP and associated factors from September 2011- August 2014 in Debre Berhan Referral Hospital. 

Method: Institution-based retrospective cross sectional study was conducted by reviewing logbooks and patients charts.

Result: HDP complicate 3.9% of pregnancy. The prevalence of HDP shows an increasing trend from 1.8% in 2011 to 5.7% in 2014. Preeclampsia accounts for 67.4% of all case followed by eclampsia which account for 27.8%. In this study, HDP was associated with 35.4% preterm delivery, 30.8% fetal death, 39.4% low birth weight, 38.4% low APGAR score and 8.5% IUGR. About 15.8% of newborns born from mothers with HDP needed resuscitation and 40.1% ICU admission. Maternal death occurs in 2.5% mothers who had HDP with the case fatality rate for eclampsia being 6.67%. HDP contributed for 35% of all maternal deaths. Of all mothers with HDP, 58% were primi-gravida ladies.

Conclusion: the prevalence of HDP shows an increasing pattern over the last years. Preeclampsia and eclampsia together take the lion-share of HDP. Primi-gravida women are affected more frequently than multi-gravida women with hypertensive disorders of pregnancy. HDP was associated with major adverse perinatal and maternal outcome

Key words: Preeclampsia, eclampsia, Hypertensive disorders of pregnancy (HDP), Maternal and perinatal mortality, Apgar score.