Ethiopian Journal of Health Sciences最新文献

Background: Diagnostic autopsy has been in use for long to determine the cause of death. Since recently however 'Minimally Invasive Tissue Sampling' (MITS) is introduced to determine definitive cause of neonatal death. This study describes locally established facilitators to introduce MITS procedures to determine cause of neonatal death in Ethiopia.

Methods: Exploratory study was conducted in Butajira community where twenty-two key informants representing community opinion leaders' health care workers, five in depth interviews with parents who recently lost neonates and eight FGDs with community members were completed to generate evidences in line with the research question. Interviews and discussions were audio recorded, transcribed verbatim and analysed facilitated by open-code software. Thematic analysis was applied to identify and interpret patterns of the evidences.

Results: In Butajira, ANC and delivery in health facilities was found to have improved over the years. Yet, child death remains an outstanding problem. While different factors were identified to cause the death of a child, relatively few participants choose to accept newborn death as a natural occurrence or will of the creator. Majority of the study participants expressed interest to know definitive cause of death using MITS. Yet, awareness about MITS and how it works was unanimously desired. It was found that husbands and wives are key to authorize MITS procedure while community opinion leaders including religious leaders were identified as key to influence parental decisions for the procedure.

Conclusion: Building awareness of the community members and engagement of opinion leaders is critical to introduce MITS.

Background: Urology is one of the most rapidly evolving and technologically advanced surgical specialties. However, training programs in Sub-Saharan Africa (SSA) face unique challenges. This study aimed to assess the current status of urology training in SSA and identify areas for improvement, providing crucial insights into the strengths and limitations of these programs.

Methods: A 24-discrete items online survey was developed with "Google Forms" in English and French. The questionnaire was composed of two parts. The first part assessed general information about the urology training, and the second part evaluated the consultant's or department head's ability to perform and teach endourology procedures.

Result: A total of 25 responses were received from 18 countries. The oldest training center is the University of Cape Town, South Africa; the program started in 1950. The number of consultants in the department ranges from 1 to 12, with an average of 4.79. Twenty of the training sites have a compulsory general surgery clinical attachment in their program. Fourteen of the training sites stated that research is mandatory in their curriculum. Fourteen of the centers reported providing laparoscopic urology surgery. Cystoscopy is the most mastered procedure and percutaneous nephrolithotomy (PCNL) is the most difficult procedure to gain any experience with by residents.

Conclusion: Urology training in sub-Saharan Africa started late but is increasing in number through time. Urology training in Africa faces multiple challenges, including inadequate number of experts, limited availability of advanced equipment and simulation-based training sites. Training institutions should be encouraged to facilitate research and basic urological skills training.

Background: Fatigue is a pervasive and debilitating symptom among hemodialysis patients, severely impacting their quality of life and ability to participate in social activities. Dialysis nurses are pivotal in alleviating these effects through physical exercise. This study aims to evaluate the effectiveness of an integrated dialysis nursing intervention in reducing fatigue among hemodialysis patients.

Methods: A quasi-experimental time series design was employed, involving 295 hemodialysis patients (148 in the experimental group and 147 in the control group) selected through consecutive sampling from two dialysis units in Chennai. Baseline fatigue was assessed in both groups. The experimental group received the integrated dialysis nursing intervention, including 15-minute sessions of aerobic exercises three times a week for eight weeks. The control group continued with routine care. Fatigue levels were reassessed at the end of the fourth and eighth weeks. Data were analyzed using SPSS version 20.

Results: The study revealed a significant reduction in fatigue scores in the experimental group compared to the control group, with p < 0.001 in post-test I and II. The experimental group showed greater improvement than the control group, with p < 0.05.

Conclusions: The integrated dialysis nursing intervention significantly reduced fatigue in hemodialysis patients. Incorporating this approach into routine intradialytic care can enhance fatigue management and improve patients' quality of life.

Background: Access to safe drinking water remains a critical challenge in Sub-Saharan Africa, driven by a complex mix of environmental, political, social, economic, and infrastructural factors. This scoping review aims to map the literature on water access in Sub-Saharan Africa over the past decade.

Methods: We conducted a comprehensive search of academic databases and grey literature from January 2013 to the present. We included peer-reviewed quantitative, qualitative, and mixed-methods research, as well as reviews and reports focusing on factors influencing water access and related interventions in Sub-Saharan Africa. Data were extracted on study characteristics, key determinants, proposed solutions, and outcomes.

Results: A total of 137 studies were included. Commonly reported determinants included droughts, climate change, conflict, governance, gender, wealth, education, poverty, and inadequate infrastructure. Identified potential interventions included infrastructure development, water quality monitoring, climate adaptation, governance reforms, decentralized management, targeted subsidies, and integrated water resources management. However, most studies described barriers rather than evaluating solutions.

Conclusions: Persistent inequities in water access are driven by interconnected factors such as poverty, governance, gender, and infrastructure. Implementing integrated solutions is crucial, with a shift from problem identification to evaluating contextualized interventions across sectors. Dedicated implementation research is needed to translate knowledge into action, advancing water security and achieving Sustainable Development Goal 6 in the region.

Background: Transcatheter closure and surgical ligation of patent ductus arteriosus (PDA) are management options for PDA that have not spontaneously closed. However, studies reported the presence of complications and residual shunts in both Transcatheter closure and surgical ligation of PDA by themselves. In this study, the immediate outcomes of transcatheter closure of PDA versus surgical ligation of PDA were compared.

Methods: Comparative cross-sectional study conducted on children under 18 years of age who underwent transcatheter closure and surgical ligation of PDA at a cardiac center in Ethiopia from January 1, 2012, to January 1, 2022, by retrospectively reviewing the records from October 1, 2023, to November 1, 2023. 664 patients who underwent PDA closure, (n = 316) in the transcatheter closure group and (n = 348) patients in the surgical ligation group were included in this study.

Result: The surgical ligation group patients were younger, and more proportion of patients had severe pulmonary hypertension. Overall complications were significantly higher with surgical ligation compared with transcatheter closure ((112 (35.4% vs 286 (71.9%)), p-value = 0.001)). Total mechanical ventilation time, intensive care unit(ICU) stay, and hospital stay were higher in the surgical ligation group with a p-value of 0.001 each.

Conclusion: Transcatheter closure of PDA has lower overall complications and shorter mechanical ventilation time, lower ICU stay, and lower hospital stay. Given the lower number of overall complications, transcatheter closure of PDA has to be considered for selected patients.

Background: The basilar artery (BA) is a crucial vessel in the posterior cerebral circulation, supplying blood to the occipital lobes, cerebellum, and brainstem. Variations in BA diameter can be indicative of pathological conditions and may serve as a predictive marker for cerebrovascular events. Despite the importance of these measurements, data on the normal BA diameter in the Black African population is limited. This study aims to establish baseline values for BA diameter in healthy adults in Enugu, southeast Nigeria, and to examine any potential gender differences.

Methods: A cross-sectional study was conducted on 298 subjects (150 males, 148 females) at the University of Nigeria Teaching Hospital Ituku/Ozalla, Enugu State. Participants, referred for brain CT, had normal radiologist reports. Contrast-enhanced brain CT scans were performed using a 64-slice Brilliance Philips scanner. BA diameter was measured on axial images at the midpons level.

Results: The participants had a mean age of 49.4 years (±14 years). The BA diameter ranged from 3.1mm to 5.5mm, with a mean of 4.2mm (±0.5mm). Males had a significantly larger BA diameter compared to females (p<0.05). Diameter increased with age in both genders.

Conclusions: This study provides reference values for BA diameter in a Nigerian population, highlighting a gender difference and age-related increase in diameter. These findings contribute to the understanding of BA geometry in Black Africans and can assist in diagnosing and managing cerebrovascular conditions.

Background: Global population aging has sparked research into frailty and falls given their impact on older adults. This study provides a bibliometric analysis of frailty and fall literature to identify publication trends, leading contributors, impactful works, and conceptual themes.

Methods: Frailty and fall publications were retrieved from Scopus and Web of Science databases without date restrictions. Data was analyzed using ScientoPy, and VOSviewer to generate statistics, visualizations, and maps based on temporality, productive countries, institutions, citations, subject categories, and keyword occurrences.

Results: After pre-processing, 345 publications remained (84.6% Web of Science, 15.4% Scopus). The literature has grown steadily since 1990, led by the United States, China, and Japan. Prolific institutions were identified, including Pittsburgh University. Highly cited impactful studies were published across journals like the Journal of the American Geriatrics Society. Geriatrics/gerontology was the dominant subject category. Keyword co-occurrence analysis revealed clusters focusing on geriatric physical health, cardiovascular health, cognition, interventions, and mortality.

Conclusions: This bibliometric analysis synthesizes a comprehensive overview of frailty and fall research, identifying rising publication and citation trends, leading global contributors, impactful studies, and thematic focuses. The findings can inform resource allocation, international collaboration, impactful evidence utilization, and future research planning to advance frailty science and clinical care for older populations. Ongoing investigation is warranted into frailty mechanisms, assessment, management, and multidomain interventions.

Background: Salvia officinalis (Common Sage) plant, is used as herbal medicine. The study was aimed at investigating the antimalarial potential and liver function profiles of the Methanol Extract of Salvia officinalis.

Methods: Mice infected with Plasmodium berghei were treated (p.o) with the extract in the curative, suppressive, and prophylactic antimalarial models at doses of 250mg/kg, 500mg/kg, and 1000mg/kg. The positive control drug used was artemether/lumefantrine (7mg/kg A/L) while the negative control was 10mk/kg of Tween 80.

Results: The curative stage showed a significant (p < 0.001) dose-dependent antiplasmodial effect (of the methanol extract of S. officinalis leaf) compared with the negative control (Group 1). At doses of 250, 500, and 1000mg/kg, the Salvia officinalis extract produced parasite suppression of 37.13%, 57.18% and 66.80% respectively. While the positive control group produced parasite percentage suppression of 74.38%. There was a significant chemo-suppressive effect (p < 0.001) at all doses of the methanol extract of Salvia officinalis leaf. The leaf extracts demonstrated a prophylactic significant (p < 0.001) activity. There was no significant effect (p > 0.05) on packed cell volume at doses of 250 and 500mg/kg while 1000mg/kg body weight showed a significant (p < 0.05) effect. There was a reduction in the level of activity of the enzymes and other parameters in the liver function tests with an increase in the dosage of the leaf extract.

Conclusion: The methanol extract of Salvia officinalis possesses in vivo antiplasmodial activities and could be a lead plant in the development of antiplasmodial agents.