Ethiopian Journal of Health Sciences最新文献

Background: Road traffic accidents (RTAs) are among the top three global causes of death among people aged 15 to 44 years. More importantly, it is the main cause of death and permanent disability among young people aged 15 to 29 years. This study aimed to assess the magnitude of fatal traffic accidents and the factors associated with them in the North Shewa Zone, Central Ethiopia, from 2013 to 2018.

Method: An institution-based cross-sectional study was conducted in all registered RTAs from July 2013 to June 2018 that had full documentation. The data extraction tool was developed based on the daily RTA registration book format that was utilized. Data was entered into Epi-data version 3.1 and then exported to SPSS version 21 for analysis. Logistic regression analysis was used to assess the relationship between the factors and the fatality of RTA. P-values less than 0.05 were reported as statistically significant.

Results: Among 846 RTAs studied, 351 (41.5%) were found fatal, while 495 (58.5%) caused non-fatal injuries. Failure to give priority to pedestrians was 2.8 times (AOR = 2.8, 95% CI: 1.3, 5.9) more likely to cause fatal RTAs than drivers who failed to maintain distance between vehicles. Pedestrians were 2.7 times (AOR = 2.7, 95% CI: 1.1, 6.7) more likely to die in RTAs than drivers.

Conclusion: The fatality of RTA was high. Failure to give priority to pedestrians and being a pedestrian were strong predictors of death. The North Shewa Zone Traffic Police Department and police officers should focus on enforcing traffic safety laws.

Background: Malaria has been one of India's most considerable health problems since 1940. The objective of our study is to determine the status of the National Malaria Elimination Programme in India by using epidemiological indicators.

Methods and materials: The annual reports of malaria for the years 2014-2021 and monthly reports for 2020 and 2021 were collected from the official web portal and were analysed for study specific assessments.

Results: The API has shown a statistically significant reduction from 2017-2021 in all states along with category-1(P=0.003) and category-2(P=0.029) states/UTs, but there was no statistically significant reduction from 2017-2021 in category-3 (P=0.166) states/UTs. The zero indigenous cases had not been achieved in category-1 states/UTs. The overall percentage reduction in number of malaria cases in 2020 at the national level compared with 2014 was 83.6%. Despite states with strong health systems such as Gujarat, Maharashtra and Karnataka, have not shown zero indigenous cases in 2020 and the malaria cases noted were very far from reaching the targets.

Conclusions: Although we observed a significant drop in malaria incidence from 2014 to 2020, demonstrating that the country is moving nearer to malaria elimination, it is crucial to implement the strategies to reduce Plasmodium falciparum% and re-establish surveillance programmes and execute national and state programmes in order to achieve the success of the National Malaria Elimination Programme. The recategorization of states/UTs are in accordance to the API, and implementation strategies were also needed.

Background: There is only limited data in the literature showing the effect of anesthesia methods on the success of retrograd intrarenal surgery. The aim of this study was to compare and evaluate retrograd intrarenal surgery cases performed under spinal and general anesthesia in terms of effectiveness, cost, hospitalization time and complications.

Methods: A total of 337 patients who underwent retrograd intrarenal surgery due to kidney stones between 2014 and 2019 were retrospectively evaluated. In our study, the patients were divided into two groups according to the anesthesia method administered: Group 1 consisted of 172 patients who received spinal anesthesia and Group 2 comprised 165 patients administered general anesthesia. Both groups were compared in terms of demographic data, localization and size of stone, radiographic stone density, operation time, complications, need for postoperative analgesia, length of hospitalization, and stone free rate.

Results: The cost of general anesthesia was significantly higher compared to that of spinal anesthesia (p < 0.001). The analgesia application administered within the first six postoperative hours was significantly higher in the general anesthesia group (p < 0.001). In other findings, there was no statistically significant difference between the two groups.

Conclusion: Retrograd intrarenal surgery can be performed with similar safety and effectiveness under both general and spinal anesthesia. However, spinal anesthesia seems to be more advantageous due to the patients' lower need for analgesics in the early postoperative period and the lower cost of the anesthetics used.

Background: Shoulder pain is one of the most common presentations in the orthopedic clinic. Multiple factors have been found to cause shoulder pain. Radiographs and ultrasound are widely available, relatively cheap modalities in assessing shoulder pain. The aim of this study is to assess the radiographic and sonographic imaging patterns of shoulder pain.

Methods: A descriptive prospective cross-sectional hospital-based study was conducted at the Department of Radiology of Tikur Anbessa Specialized Hospital among patients with shoulder pain that came for imaging from August 2021-January 2022.

Result: Of the 73 patients with shoulder pain included in the study, 67% were females while 33% males. The mean age was 51.7 years. Radiographs found pathology in 53% of the cases. Acromioclavicular joint osteoarthritis, greater tuberosity degenerative changes, rotator cuff calcification were common radiographic findings. Ultrasound detected pathologies in 87% of the cases. The common pathologies were rotator cuff pathologies, biceps tendon pathologies, acromioclavicular joint degeneration, greater tuberosity degenerative changes, subacromial subdeltoid bursitis, and adhesive capsulitis. There was a significant association between greater tuberocity degenerative changes and supraspinatous pathologies with age, greater tuberocity degenerative changes with supraspinatous pathologies, acromiohumeral distance of <7mm with supraspinatous pathology.

Conclusion: Radiographs and ultrasound are valuable imaging modalities for shoulder pain. Low acromiohumeral interval, greater tuberosity degenerative changes, and acromioclavicular joint osteoarthritis are associated with rotator cuff tears. Rotator cuff pathologies are the most common pathologies observed in ultrasound. We recommend ultrasound to be second step after radiograph due to its low cost and wide availability.

Background: Promotion and use of family planning in countries with high birth rates have the potential to avert a third of all maternal deaths and nearly a tenth of childhood deaths. To support government efforts in creating wider access to comprehensive contraceptive methods, EngenderHealth has contributed to the government of Ethiopia's long-term goal of improving maternal health outcomes through its Access to Better Reproductive Health Initiative project.

Methods: Difference-in-Difference approach is the main methodology in this analysis to estimate the "contribution" or "effect" of the ABRI intervention by comparing the changes in family planning outcomes from 2005 to 2016 between the ABRI and non-ABRI areas. This analysis was based on pooled data from the 2005 and 2016 Ethiopian Demographic and Health Surveys. To track temporal changes in the family planning indicators in the ABRI and non-ABRI areas, we employed simple trend analysis.

Results: The results show that overall contraceptive prevalence rate, use of injectables, women's knowledge of Long-Acting Reversible Contraception (LARC) methods, and their exposure to family planning information/messages from health workers all significantly improved in the ABRI intervention areas beyond what occurred in the non-ABRI areas. The greatest increase in the use of modern contraception was among adolescents aged 15-19 years, with a DID estimate of 22.4% (p=0.007), ABRI areas compared to no-ABRI areas.

Conclusion: In the ABRI areas, family planning indicators recorded positive and significant changes. EngenderHealth has contributed its part in improving access to the uptake of comprehensive contraception and supporting government programs.

Background: Functional Gastrointestinal Disorders (FGIDs) and their risk factors vary from region to region. Therefore, this study aimed to determine the prevalence of abdominal pain of FGIDs in different dietary diversity score (DDS) and its determinant factors among adults in Jimma City, Southwest Ethiopia.

Methods: A community-based cross-sectional study was conducted from July 17 to October 27, 2019. The study included systematically selected healthy adults aged ≥ 18years. Data were collected on gastrointestinal symptoms (Rome III), and DDS (24-dietary recall).

Results: Of 865 healthy adults, the prevalence of abdominal pain symptoms co-occurrence was 168(19.4%), dyspepsia, 152(17.6%) and IBS, 133(15.4). Similarly, the co-occurrence was distributed as 81(9.4%) in middle, 64(7.4%) in high and 23(2.6%) in low DDS groups. Although this distribution was different in the DDS groups, it is not significantly associated. With potential confounders adjusted, the behavioral factors associated with the co-occurrence with an AOR (95% CI) were khat chewing: 7.37 (1.76 - 30.87), drinking alcohol: 3.24 (1.15 - 9.18), sedentary life: 12.28 (3.19 - 48.40) and less physical activity: 4.44 (1.43-13.75). Moreover, elevated TAG: 5.44 (2.78 - 8.10), elevated LDL: 4.26 (1.61-11.29), central obesity: 2.78 (1.08 -7), low HDL 5.89 (2.22-15.60), positive H.pylori stool test: 2.7 (1.86 -7.72), being diabetic: 2.7 (1.79 -7.79) and hypertensive: 2.79 (1.08 - 7.14) were associated with the co-occurrence.

Conclusion: Abdominal pain and FGIDs had significant distribution among adults in Jimma City. Therefore, early screening and managing FGIDs in the community is recommendable.

Multisystem inflammatory syndrome in children (MIS-C) is a rare post-infectious complication associated with COVID-19. This case report presents a detailed account of a paediatric patient diagnosed with MIS-C who developed dilated cardiomyopathy as a significant complication. This report aims to enhance our understanding of the rare potential cardiovascular implications of MIS-C and highlights the importance of prompt recognition and management.

Background: Temporal bone fracture is usually a sequel of significant blunt head injury. Fracture of the temporal bone is mainly classified according to the orientation of the fracture plane and whether there is involvement of the otic capsule. Despite its frequent occurrence, there is limited research on the frequency and pattern of temporal bone fractures in our setup.

Methods: Retrospective cross-sectional hospital - based study of 60 patients who underwent computed tomography of the head for head trauma at Tikur Anbessa Specialized Hospital during the study period from October 2020 - October 2022.

Results: Among the 60 patients enrolled in the study, the mean age of presentation was 31.1 years with a male-to-female ratio of 4:1. There were 69 temporal bone fractures, 9(15%) were bilateral and 51(85%) unilateral The longitudinal fracture pattern was the most common fracture pattern, occurring in 40(78.4%) of unilateral cases, 15(83.3%) of bilateral cases. Otic capsule sparing fractures accounted for 49(96.07%) of unilateral fracture cases, and all patients with bilateral involvement had an otic capsule sparing fracture. Among the 42 patients for whom data regarding post-traumatic hearing outcome was available, 4 patients had post-traumatic hearing impairment. Anatomically, the squamous portion of the temporal bone was involved in 30(43.5%) of cases.

Conclusions: Fractures affecting the squamous portion of the temporal bone, longitudinal fracture patterns, and otic capsule sparing were the most frequent forms. The majority of temporal bone fractures were associated with other bone fractures and intracranial injuries.

Background: Gangrenous sigmoid volvulus has a significant impact on morbidity and mortality. This study was conducted to compare sigmoid resection and primary anastomosis (RPA) with sigmoid resection and end colostomy (Hartmann's procedure) for gangrenous sigmoid volvulus.

Methods: A systematic review and meta-analysis study design was employed to summarize retrospective cohort, prospective cohort, and randomised control trial studies published from inception to march 31, 2023. Searching was performed on Medline, CINAHAL, Web of Science, Google Scholar, the Cochrane Library, and ClinicalTrials.gov to locate eligible articles. Data searching, selection and screening, quality assessment of the included articles, and data extraction were done by two separate reviewers. RevMan 5.4 software with a fixed-effect Mantel-Haenszel model and Stata version 14 were used to analyze the data. The protocol registered on PROSPERO registration website (CRD42023413367).

Results: Ten cohort studies and one randomised control trial with 724 patients were found; all of them were rated as being of moderate quality. The overall mortality after RPA was 15% (95%CI: 11-19%), and after Hartmann's procedure it was 19% (95%CI: 15-23%). Resection and primary anastomosis (RPA) for gangrenous sigmoid volvulus had slightly lower mortality rate than stoma (OR=0.98(95%CI: 0.68-1.42), p=0.07, I²=43%), which had no statistically significant difference. Resection and primary anastomosis (RPA) had a slightly higher morbidity rate than Hartmann's procedure (OR=1.01(95%CI: 0.66-1.55), p=0.30, I²=18%), which had no statistically significant difference.

Conclusion: Sigmoid resection and primary anastomosis (RPA) and Hartmann's procedure had no significant differences in mortality and morbidity for the treatment of gangrenous sigmoid volvulus. Choice of the intervention for gangrenous sigmoid volvulus should be individualized with consideration of different detrimental factors.

Background: X-ray Computed Tomography dose levels have been varying among modalities and scanning body regions due to the absence of incessant routine follow-up. Thus, the study aimed to compute the dose index discrepancies in Ethiopia for the most recurring scan protocols (head, chest, abdomen, and pelvis).

Methods: A purposive sampling method was employed to select the hospitals due to the rare existence of functional CT scanners in Ethiopia. From the selected hospitals, a total of 1,385 (249 heads, 804 chests, 132 abdomens, and 200 pelvis) were collected in terms of standard dose metric values in the period of December 2019-March 2020. Patients' DLP was computed into mean value using IBM SPSS Statistics 20 software. From the mean DLP, we can compute the effective dose.

Results: Patients' dose level disparity was observed in this study though it is below the ICRP standard level for all body regions except for pelvis DLP (593.37 mGy-cm) at Black Lion. The dose level for the head and chest are computed within the recommended level at all hospitals. Effective doses for the pelvis at four hospitals (Teklehaimanot, Black Lion, ALERT, Paul's, and Ayder hospitals) were computed as 6.45, 8.90, 5.08, 6.54, and 6.84 mSv respectively, and the effective doses for abdomen at Ayder Hospital was obtained to be 8.90 mSv, which is above the recommended value.

Conclusion: X-ray CT scanners are somewhat properly functioning although some sort of justification and optimization for pelvis and abdomen examinations are strongly recommended to implement as low as reasonably achievable principle.