Objective: Chronic empyema is a serious problem and is often difficult to manage. Its incidence has dropped worldwide, but continues to pose health problems in low and middle income countries. This study has been conducted to assess the outcome of open thoracic window in patients with neglected chronic thoracic empyemain Ethiopian patients.

Methods: A six-year (June 2008 to October 2014) retrospective study was conducted on thirty five patients (ten females and twenty five males, age ranging from 30-70 years). Open window thoracostomy was performed on these patients for chronic empyema with residual lung tissue and with or without bronchopleural fistula who failed to respond to the conventional methods of treatment.

Results: The etiology was primary empyema in 16 patients, post-traumatic in 12 patients, and post-thoracotomy in seven patients. Spontaneous closure was achieved in 12 patients; simple closure was done on 18 patients; and closure with muscle flap in five patients. In all patients, the cavity cleared from secretions in two to three weeks and the residual space narrowed in seven to nine months. All patients gained weight following the surgery.

Conclusion: Our result has revealed that open thoracic window is still an alternative method for the treatment of chronic empyema when the conventional method of treatment fails.

Key words; Chronic Empyema, Open window thoracostomy, Bronchopleural fistula

Background: The treatment response of HCV infection is dependent on genotype and stage of the disease. However, genotype pattern and treatment outcomes of HCV infection among Ethiopian patients has not been studied so far.

Objectives: To evaluate the common HCV genotypes and treatment outcomes among Ethiopian adult patients.

Method: Adult patients aged 18 and above with HCV infection referred from various regions of the country were included in the study after written informed consent. As there was no free or insurance coverage for treatment of HCV infection in the country, those who could afford to pay for treatment with PEG Interferon and Ribavirin were recruited during January 1, 2008 through December 31,2013 at United Vision, Adera, Old Airport, and Mexico referral higher clinics in Addis Ababa. Patients with decompensated cirrhosis and pregnant ladies were excluded from the study. The patients were counseled on treatment options, cost, treatment outcomes, adverse drug effects, and possible complications. Data were collected on demographic features, clinical characteristics, viral genotypes, and treatment outcomes during follow up visits until six months after completion of recommended standard treatment. Data were analyzed using SPSS software.

Results: A total of 200 adults with chronic HCV infection were treated with PEG -Interferon and Ribavirin (for 24 or 48 weeks according to the genotypes) during the study period. Of the 200 patients enrolled in the study, 120(60%) were male, 90% were from Addis Ababa, and the median age was 48 years. Sixty per cent of the patients were infected with genotype 4,17% with genotype 1, 13.5% with genotype 2 and 9.5% with genotype 3.

Eighty percent of the patients had end of treatment response; of these, 74.4% had undetectable HCV RNA at6^th month after end of treatment. The end of treatment response was noted to be close to 90% for patients with HCV genotypes 2 and 3 infections.

Conclusion: This study indicates that genotype 4 is the prevalent HCV genotype followed by 1,2, and 3 among Ethiopian patients. Treatment with interferon and ribavirin was well tolerated and provided a very good response.

Key words: HCV, genotypes, treatment, Ethiopia.

ABSTRACT

Background: Physiological range of clinically important hematological parameters and lipid profiles of healthy population in Ethiopia is not well assessed.

Objective: Objective of this study is to determine hematologic and lipid parameters of healthy blood donors in Addis Ababa.

Methods: Red Cross Society located in Addis Ababa was selected as a study area. 336 donors; age range between 18-58 years participated. Venous blood sample was collected by tube containing K₃ EDTA for hematology test and sterile tube for lipid test. After centrifugation serum was extracted for lipid test and transported to SPHMMC within 5-8hrs of sample collection. IBM.SPSS version 21 was used for data analysis, P< 0.05 is assumed as significant and 95% CL was accepted.

Results:  RBC, MCV, Platelet and TG were significantly higher in the present study than the reference range; while RBC indices, WBC, Hgb, Hct, HDL, LDL and TC were found to be higher in reference range used in clinical practice; Significantly higher (RBC p=0.000, HGB with p=0.000, HCT p=0.000 and MCHC p=0.009) was observed in male. Significantly higher platelet count and HDL was observed among females (p=0.001, p=0.001 respectively). No significant change in hematological parameters and lipid profiles across age groups was seen.

Conclusion: It is evident from the study that hematological and lipid variables obtained were significantly different from the one’s used as reference range in clinical practice

Keyword: Hematology, Lipid Profile, Normal Values, Addis Ababa.

Background: An outbreak of a chronic liver disease of unidentified cause, known as “Unidentified Liver Disease (ULD)” by local communities was first observed in a rural village in Tigray, northern-Ethiopia in 2001. Little was known about the geographical extent, trend, and epidemiology of the disease.

Methods: The Ethiopian Public Health Institute (EPHI) by then Ethiopian Health and Nutrition Research Institute (EHNRI), Centers for Disease Control and Prevention, World Health Organization, and Tigray Regional Health Bureaue established the ULD surveillance system in 2009 to characterize and monitor trends for this emerging disease and to identify cases for treatment and follow up. A large-scale official training was provided to the surveillance staff on case identification, management and reporting.  In absence of a confirmatory test, the system used simple case definitions that could be applied by frontline staff with varying clinical training. To maximize resources, health extension workers already conducting household visits in affected communities identified cases and increased community awareness about the disease.  A team was placed in Shire, in close proximity to the outbreak region, to provide support and collect reports from health facilities and district health offices.

Results: As of September 2011, a total of 1,033 cases, including 314 deaths were identified. Contamination of locally produced grains with several pyrolizidine alkaloid producing plants was identified cause of the disease. Staff interviews identified that shortage and turnover of trained staffa major challenge.

Lessons learned: Long term dedication by frontline staff, using simple case definitions to identify cases, and active collection of missing reports were critical for surveillance of this chronic non-infectious disease of unknown cause in a rural, resource-limited setting.

Keywords: Surveillance, Pyrolizidine, Liver  Disease, PA, Tigray, Ethiopia)