Vol 55, No 2 (2017): April Issue

Introduction: Obstetric fistula is the most distressing condition in developing countries due to morbidity and loss of quality of life attributable to it. This study was conducted to determine short term complications and factors associated with these complications after repair the fistula.

Methods: This was descriptive follow up study conducted at Bugando Medical Centre from September 2014 to April 2015 involving 132 women with obstetric fistula and operated at the Centre. Social, demographic and clinical information were collected using questionnaires. Urine samples for culture and sensitivity were collected intra-operatively and data was analyzed using STATA version 11 software.

Results: The median (interquartile range) age of the participants was 23 (20-32) years. The proportion of women who developed short term complications was 42 (31.8%); with predominant complications being failed repair 18 (42.9%) and stress incontinence 10 (23.8%). Asymptomatic bacteriuria was found in 50.8% (33/65) of patients with preponderance of Gram negative bacteria. HIV seropositivity was documented in 4.1% of 123 tested patients and it was significantly associated with short term complications (p=0.002). Moreover, residing in rural areas (p=0.042); median duration of labor for more than 24 hours (p=0.002) with OR (95%CI) 4.38 (1.59 – 13.89), fistula type (p =0.005) and size (p =0.006), reduced bladder capacity (p <0.001) and urethral length (p =0.001) as well as presence of fibrosis (p =0.004) were significantly associated with short term complications among women repaired for obstetric fistulas.

Conclusion: The proportion of women developing short term complications at Bugando Medical Centre is high; with the common complications being failed repair and stress incontinence. The complications were associated with residing in rural areas, HIV seropositivity and fistula characteristics.

Keywords: Obstetric fistula repair, Short term complications, Tanzania

Background: Obstructive airway diseases are major causes of morbidity and mortality worldwide. There is  are limited published data in Ethiopia.The purpose of this study was to characterize and identify the risk factors of patients with obstructive airway diseases.Methods: A retrospective, cross-sectional review of patients seen at TASH chest clinic, between January 2013-December 2013 and all adult patients with a physician diagnosis of obstructive airway diseases were identified and their demographic and clinical data were included in the analysis.Results: During the study period, there were 144 patients seen with a clinical diagnosis of obstructive airway disease.Fifty six percent were females and 74.6% were from Addis Ababa. The mean age was 52.8±13.8 years.Among the participants, 26% and 27% had history of prior tuberculosis treatment, and prior pneumonia, respectively. Approximately 17% had ever smoked cigarettes, which was exclusively among men. Among patients who reported symptoms, 73%, 83%, and 75% presented with cough, wheezing and dyspnea respectively. Asthma was the primary diagnosis among 86% of patients; the remainder carried a diagnosis of chronic obstructive pulmonary disease (COPD). Among those who had spirometry, 55.8% of asthmatics and 63.6 % of COPD had an obstructive ventilatory defect (FEV1/FVC ratio of less than 0.7). Among COPD patients, 40% were ever smokers, and 40% were females.Conclusions: The majority are female, non-smoking and  asthmatics.Future study will incorporate bronchodilator testing.

Introduction: Information concerning the prevalence of diabetes mellitus iis sparse n Ethiopia . The study was conducted to evaluate the prevalence of diabetes mellitus among children aged 7–12 years presenting to Tikur Anbessa Specialized Teaching Hospital and identify the factors influencing its diagnosis.

Methods: A cross-sectional descriptive study was performed on children aged 7–12 years presenting with complaints other than symptoms of diabetes mellitus from July 2013 to January 2014.

Results: A total of 1,067 participants were involved; 41% were females and 59% were males. The mean age was 9.5+/- 2.5 years. 116 parents of study participants (10.87%) had appropriate knowledge of symptoms of diabetes mellitus, while 236 (22.12%) had adequate knowledge regarding its nature. 90% of parents failed to recognize that diabetes mellitus could affect children younger than 15 years. Prevalence of diabetes mellitus was 2.81/1000 cases. Impaired fasting glucose/impaired glucose tolerance was detected in 8.43/1000 cases. Parental educational level was associated with failure to recognize symptoms of diabetes mellitus and lacking knowledge of its nature.

Conclusion: There is a high prevalence of diabetes mellitus among children aged 7–12 years presenting to Tikur Anbessa Specialized Teaching Hospital. Hence, we recommend the design and implementation of community based screening and health education programs.

Key words: Diabetes mellitus, Non-communicable diseases, Child, Ethiopia

Introduction: Absolute glaucoma is the final stage of blindness in glaucoma and it is the most common reason leading to painful blind eye. This study was conducted to identify the frequency of absolute glaucoma, pain associated with glaucoma subtypes and practical treatment options for case presenting with the condition in the Ethiopian setting.

Methods: This is hospital-based cross sectional study was conducted from Sep 1,2013 to Dec 30, 2013 at Ras Desta Hospital, Department of Ophthalmology. The diagnosis of absolute glaucoma was made based on history and ophthalmic examinations. Once diagnosed, those who had pain were started on Atropine and Dexamethasone eye drops. If pain did not-resolve, retro-bulbar injection of absolute alcohol was given. Enucleation was done if the pain persisted after the injection of absolute alcohol. Data was entered on to a computer and analyzed using SPSS for windows.

Results: The study involved a total of 111 patients with absolute glaucoma. The majority of absolute glaucoma patients, 79(71.2%), had no pain. The remaining 32(28.8%) had pain and 21(65.6%) of them had got relief with topical steroid and atropine eye drops. For non-respondents, retrobulbar absolute alcohol injection was given and 7(21.9%) improved. Finally, the remaining 4(12.5%) patients eye were enucleated to relief intractable pain.

Conclusion: -Management of painful absolute glaucoma in our setting should be started with topical steroid and atropine eye-drops. If this fails, the next step is retrobulbar injection of absolute alcohol, and finally if pain is intractable, enucleation is recommended.

Key words: - Absolute glaucoma, pain, Management, no light perception, Ethiopia

Background: In hypospadias repair in the past 15 years, there has been a trend favoring procedures that incorporate the urethral plate into the neourethra.

Objective: This is to indicate that tubularized incised plate hypospadias repair is a versatile operation with potential applicability to wide spectrum hypospadias conditions.

Methods: From Sept. 1/2012 to August 30/2015, a retrospective review of all patients with hypospadias was done to assess the technique for repair and evaluate the treatment outcomes. Descriptive analysis was carried out using numbers, percentages and tables.

Results: There were 67 patients who underwent repair of hypospadias, all in Mekelle hospital. The age ranged from 8 months to 32 years of life.  Most 42 (62.7%) patients had distal hypospadias. TIP (tubularized incised plate) repair technique was carried out in most 58 (86.6%) of the cases, Mathieu procedure in 7 (10.4%) and MAGPI repair in 2 (3.0%) of our cases. The overall morbidity encountered was in 9 (13.3%) but in only 7 (12.1%) of the cases with TIP hypospadias repair technique, mainly due to urethrocutaneous fistula, partial/complete neourethral dehiscence and neourethral stricture.

Conclusion: Patient satisfaction rate that exceeded 87.9% was achieved in this study ensuring that TIP repair technique is the best treatment option for wide spectrum of hypospadias conditions.

Key word: Hypospadias, Technique,Outcomes,Mekelle

Background:This study aimed at determining the prevalence of bacterial agents causing upper respiratory tract infections and their susceptibility patterns to commonly used antibiotics among outpatients in Kitui District Hospital.

Methods: A total of 237 throat swabs were collected between November, 2012 to April, 2013 and innoculated onto Blood agar, MacCkonkey agar and Chocolate agar then incubated at 37 ^oC for 24 hours. Colony morphology and standard biochemical tests were  performed for identification and confirmation of the isolates based on their Gram staining and cultural characteristics. Antimicrobial sensitivity patterns of the bacteria to antibioticswas determined byKirby-Bauer disc diffusion technique. P values of ? 0.05 were considered to have clinical and epidemiological significance.

Results: Pathogens were isolated in 95.4 % of the samples collected’ out of this, 5% were mixed cultures involving Candia albicans and either viridans group streptococci or Staphylococcus aureus. Bacteria isolated were S. aureus with the highest prevalence (44.3%), followed by viridans group streptococci (32.5 %) and Streptococcus pyogenes (13.5%). Resistance of bacterial pathogens to antibiotics in Kitui district hospital was highest in viridans group streptococci (48.2 %) followedby Staphylococcus aureus (40.5%) whileStreptococcus pyogenes had the least resistance (28.1 %) and there were no cases of multi-drug resistance.

Conclusion: The rate of antibiotic resistance was significantly high and proper interventions shouldbe put in place by the relevant government ministry to prevent these infections and their complications.

Key words: Prevalence, susceptibility, antibiotic resistance, multi-drug resistance, URTIs

Background: Sexually transmitted infections (STIs) are major health problems often affecting young people, particularly adolescents. Information about the magnitude of STIs among school students in Ethiopia is scarce. The aim of this study was to assess the prevalence and predictors of self-reported STIs among students attending school in Bahir-Dar town.

Methods: Cross-sectional data was collected from 520 high school students in Bahir-Dar, northwest Ethiopia. Stratified two-stage cluster sampling was used to select the study participants. The effect of risk factors on the presence of STIs was analyzed using multiple logistic regressions.

Result: The prevalence of self-reported STIs was 13.1% (95% CI: 11.4-14.8). The statistically significant predictors for acquiring STIs were: being students of higher grades (AOR=5.0, 95% CI:3.2-8.9), having multiple sexual partners (AOR=2.5, 95% CI:1.4-4.1), having practiced substance abuse (AOR=4.6, 95% CI:2.8-6.4), and non-participation in school sexual and reproductive health clubs/activities (AOR=10.6, 95% CI:6.8-14.7). Predictors which had a significant protective effect from acquiring STIs included not having experienced sexual violence (AOR=0.12, 95% CI: 0.03-0.58) and having good knowledge on the transmission mode as well as consequences of STIs (AOR=0.18, 95% CI: 0.05- 0.7).

Conclusions: The prevalence of self-reported STIs among the high school youth was high. Having multiple sexual partners, indulging in substance abuse, having poor knowledge of STIs and their transmission mode and exposure to sexual violence were among the significant predictors for acquiring STIs.  In view of this, promotion of peer and school sexual education and encouraging parental guidance were some of the suggested recommendations.

Keywords: STIs, Northwest Ethiopia, Prevalence, Self-reported, Predictors, School youth