Ethiopian Journal of Health Sciences最新文献

Background: Despite health education efforts, pregnant women still face major health problems.The aim of this study was to assess the knowledge and attitudes of pregnant women on measures to prevent mother-to-child transmission of the human immunodeficiency virus in a context of social vulnerability.

Methods: This is a cross-sectional survey of 384 pregnant women randomly selected from the 20 health districts in the province of Essaouira. This study was carried out from January 2022 to June 2022. A questionnaire was used, and bivariable logistic regression analyses were done to identify factors associated with knowledge and attitudes of pregnant women about mother-to-child transmission of the human immunodeficiency virus.

Results: Low knowledge (75.8%) and negative attitudes (72.7%) about preventing mother-to-child transmission of HIV were observed in study participants. The knowledge and attitudes of pregnant women about the prevention of mother-to-child transmission of HIV varied by education level, number of children, and source of information. There was a very significant correlation between knowledge and attitude (p=0.000).

Conclusion: A significant number of pregnant women have incomplete knowledge and attitudes about preventing mother-to-child transmission of HIV. Actions to increase the knowledge of pregnant women are essential. The capacity of healthcare providers should also be strengthened to improve the quality of care.

Background: Accommodation and Vergence disorder are diverse visual anomalies which can interfere with a child's school performance and impair one's ability to function efficiently. Its association with refractive error and its intervention were studied less in Indian myopia children; hence, there is a need for research in such setting.

Method: One hundred and fifty Indian adolescents aged 10 to 17 years were divided into three refractive error groups (high, moderate, and low myopia). Baseline vision examination and a comprehensive binocular vision assessment were performed on all eligible adolescents. Vision therapy was provided to participants whose parents gave consent on behalf of the children. Chi-square analysis was utilized to look at the association between the groups of refractive errors. To compare the mean constants of the experimental and control groups, a two-way RM ANOVA was performed.

Results: The most common dysfunction found in low myopia (75.3%), and moderate myopia (54%) was convergence insufficiency. High myopes (62.8%) were found to have combined convergence and accommodative insufficiency followed by accommodative dysfunction (14%) and basic exophoria (6%). In moderate myopia, a significant relationship was found between this dysfunction and refractive error. The experimental group in the overall sample showed statistically significant improvement after vision therapy (P<0.001), in comparison to the control group.

Conclusion: Refractive error is linked to accommodative and convergence insufficiency. Thus, vergence and accommodative impairment must be tested for all myopic children, and vision therapy should be advised along with spectacle prescription for efficient binocular vision.

Background: Human infection with Enterobius vermicularis occurs worldwide. The most common clinical manifestation of a pinworm infection is an itchy anal region. This parasite is incidentally found in appendicitis. This study aims to characterize and genotype this parasite from different samples inferred by mt-DNA.

Methods: Forty appendectomies for acute clinical appendicitis, 40 positive scotch-tape samples, and 10 adult females worm isolated from patients. Genetic differentiation, haplotype differences, and isolates population structure were analyzed based on the cytochrome c oxidase subunit I (cox1) gene.

Results: It has been demonstrated that all isolations in the appendectomies specimens are similar, and the genetic difference divergence is seen in adult worm specimens. The neutral indices of the samples did not show a significant difference and show that there is no intra-specific and population distribution diversity.

Conclusion: Our results show different haplotypes in the B type of E. vermicularis population and add new information about genotyping of these parasites in Iran. In comparison with other studies, intra-specific variation of this parasite from Iran was observed.

Background: Appropriate self-management (SM) is crucial in controlling epilepsy and improving self-efficacy, medication adherence and avoidance of seizure triggers in patients with epilepsy (PWE. The aim of this study was to evaluate SM and its predictors among adult PWE in Iran.

Methods: This cross-sectional study was conducted in 2021. The participants were 335 adult PWEs that were selected from healthcare settings in Hamadan, Iran. Epilepsy Self-Management Scale (ESMS) was used to measure patients' self-management behaviors. Data were analyzed using the independent samples t-test, Pearson's and Spearman's correlation analyses and multiple linear regression analysis.

Results: The mean score of SM was 114.37±11, indicating moderate level of SM, and the mean scores of SM in the medication management, seizure management, and safety management subscales were significantly more than the mean scores of the other subscales (P < 0.05). Age, place of residence, marital status, seizure type, seizure frequency, and epilepsy duration significantly predicted 53% of the variance of SM (adjusted R square = 0.532).

Conclusion: PWEs have moderate SM and need SM-related education, particularly about lifestyle management and information management. Predictors of SM should be considered to boost SM practice.

Background: Neurocysticercosis (NCC) is considered the most common central nervous system (CNS) helminthic infection. The prevalence of NCC cases in the Middle East has increased in recent years. Thirty-nine cases of NCC were reported between 2003-2011 in the Arabian Peninsula, among, five cases being from the kingdom Saudi Arabia (KSA). Most of the cases reported from the KSA were presented with seizures, and they belonged to expatriate workers or their related contacts. In this case series, we presented three cases of colloidal/calcified NCC.

Cases: Our patients were diagnosed with NCC based on epidemiologic exposure, clinical features, and typical radiological findings. Stool samples for ova and parasites were negative in all three cases. Among these cases, two patients were immigrants and belonged to endemic areas, and third case who is the youngest in this series was a Saudi, without any history of exposure to any source.

Results: The first and the third cases were treated with Albendazole and Dexamethasone. We did not offer any medication regarding NCC in the second case as he had asymptomatic NCC and the disease was inactive so did not mandate anti-helminth medication.

Conclusion: NCC in KSA, like in non-endemic countries, is not a rare or unusual infection anymore, presenting with seizures or incidental findings in an asymptomatic state. Vigilant diagnostic protocols with efficient diagnostic tools are required for detecting carriers of the adult form of the parasite. Timely detection of these carriers can avoid further spread and its related complications in the Saudi population.

Background: Diabetes mellitus is among the most prevalent and costly chronic diseases in the world. Unfortunately, immediate prospects for a cure are not available. We aimed to determine the in vivo antidiabetic activity, histologic, and biochemical effect of Balanites aegyptiaca fruit extract on alloxan-induced diabetes in Wistar rats.

Methods: Thirty-six Wistar rats were allotted into six groups (n=6). Group I was normal control. Group II was induced with diabetes but not treated.Groups III-V were induced with diabetes and treated with 100, 200, and 300 mg/kg extracts while Group VI was treated with Metformin once daily for 14 days. Animals were euthanized, and blood samples were collected for biochemical assays. The liver, kidney, pancreas, and testis were excised and processed by the paraffin wax method.

Result: Oral administration of BA extract significantly (P<0.05) reduced blood glucose, liver enzymes, and creatinine levels in diabetic animals. The extract also improved the body weights of diabetic animals and microscopic anatomy of the pancreas, testis, liver, and kidney parenchyma compared to the control.

Conclusion: Balanites aegyptiaca phytochemicals reduced blood glucose level and improved the histology of the liver, kidney, pancreas, and testis. Further study is recommended to identify the phytochemicals and mechanism of action.

Background: Increased renal echogenicity is a nonspecific ultrasound finding. It may be a normal variation or suggestive of various underlying conditions like renal amyloidosis, chronic kidney disease, sickle cell disease and HIV associated nephropathy (HIVAN).

Objective: To study maternal renal echogenicity in normal pregnancy, and explore its relationship with maternal baseline characteristics in our subregion.

Methods: This descriptive, cross-sectional study was conducted in the Obstetrics and Radiology Units of the two tertiary health facilities, one secondary facility and one radio-diagnostic facility, all in Bayelsa State, South-South Nigeria, between March-August 2022. The relationships between maternal renal echogenicity and age, parity and gestational age were explored using Chi-square test of proportion, while with an analysis of variance (ANOVA), the mean difference of age, weight and height between the grades of renal echogenicity was investigated. Kruskal Wallis test was deployed to examine parity in the grades of renal echogenicity. The level of significance was set at p<0.05.

Results: The study participants that had Grade 0, 1 and 2 renal echogenicity were 160 (39.7%), 403 (58.3%) and 8 (2.0%), respectively. There were statistically significant relationships between maternal renal echogenicity and maternal age (χ²=36.94; p=0.001), parity (χ²=64.29; p=0.001), gestational age (χ²=16.03; p=0.003) and body mass index (BMI) (χ² = 45.15; p - 0.001).

Conclusion: Our study revealed a significant relationship between maternal renal echogenicity in normal pregnancy and maternal baseline characteristics (age, parity, gestational age and weight).

Background: Depression and burnout are common among healthcare workers (HCWs) and negatively affect their well-being and the quality of the service they provide. However, the burden of depression and burnout among health extension workers (HEWs) in Ethiopia and their relationship has not been documented well.The objective of this study was to estimate the prevalence of depression and burnout among HEWs in Ethiopia and to investigate the relationship between these conditions.

Materials and methods: We used a cross-sectional study design and collected data from 584 rural and 581 urban HEWs in Ethiopia, as part of the 2019 national health extension program assessment. The Patient Health Questionnaire (PHQ-9) and Burnout Self-Test were used to screen HEWs for depression and burnout, respectively. We used descriptive statistics to estimate the magnitude of depression and burnout, and logistic regression to examine their relationship.

Result: Based on PHQ-9 cutoff scores of 10, the prevalence of major depression was 16.5% among rural and 8.9% among urban HEWs, whereas burnout risk was 39.8% among rural and 12.6% among urban HEWs. The odds of having depression among HEWs with burnout risk was relatively higher compared to those without burnout risk [For rural HEWs, the adjusted odds ratio (AOR) is 11.88 at a 95% confidence interval (CI; 5.27, 26.80), and for urban HEWs, the AOR is 11.49 at a 95% CI (5.35, 24.63)].

Conclusion: The prevalence of depression and burnout is high among HEWs in Ethiopia, with a significant rural-urban difference, and burnout is a significant predictor of depression. Mental health interventions that enable prevention, early detection, and management are needed especially for rural HEWs who are in charge of preventive health service delivery for the disadvantaged rural communities.

Background: The Health Extension Program (HEP) was introduced in 2003 to extend primary health care services by institutionalizing the former volunteer-based village health services. However, this program is not comprehensively evaluated.

Materials and methods: The 2019 comprehensive national assessment of HEP involved (1) assessment through quantitative and qualitative primary data, (2) a thorough systematic review of the HEP literature, and (3) a synthesis of evidence from the two sources. The assessment included household survey(n=7122), a survey of health extension workers (HEWs) (n=584)_, and an assessment of health posts (HPs)(n=343) and their supervising health centers (HCs)(n=179) from 62 randomly selected woredas. As part of the comprehensive assessment.

Output and results: The outputs were (a) full and abridged reports, (b) 40 posters, (c) seven published, three under review scientific papers and (d) seven papers in this special issue. During the one-year period preceding the study, 54.8% of women, 32.1% of men, and 21.9% of female youths had at least a one-time interaction with HEWs. HPs and HEWs were universally available. There were critical gaps in the skills and motivation of HEWs and fulfillment of HP standards: 57.3% of HEWs were certified, average satisfaction score of HEWs was 48.6%, and 5.4% of HPs fulfilled equipment standards.

Conclusions: The findings informed policy and program decisions of the Ministry of Health, including the design of the HEP Optimization Roadmap 2020-2035 and the development Health Sector Transformation Plan II. It is also shared with global community through published papers.