Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study

Abstract Background Delayed treatment of tuberculosis (TB) cases increases the risk of death and rate of infection in the community. Early diagnosis and initiation of treatment is essential for effective TB control. The aim of this study was to assess length of delays and analyze predictors of treatment delay of newly diagnosed TB patients. Methods A cross-sectional study was conducted in Dessie city and surroundings from April1, 2016 to January 30, 2017. Fifteen health facilities of study area were selected randomly and 382 adult TB patients were included consecutively. Data were collected using a questionnaire and analyzed using SPSS version 20.0. Delay was analyzed at three levels (patient, health system and total) using median as cut-off. Logistic regression analysis was performed to investigate predictors of delays. A p-value of ≤0.05 at multivariate analysis was considered statistically significant. Results The median total, patients’ and health system’s delay was 36 [interquartile range (IQR): 24, 64], 30 (IQR: 15, 60) and 6 (IQR: 4, 8) days, respectively. About 41 and 47% of patients had prolonged patients’ and total delay, respectively. Practicing self-medication [adjusted odds ratio (AOR): 3.0; 95% CI: 1.3–5.6], having more than three family member in the household (AOR: 1.6; 95% CI: 1.02–2.50), older age (≥55 years) (AOR: 2.7; 95% CI: 1.27–5.83), being smear negative pulmonary tuberculosis (AOR: 2.3; 95% CI: 1.25–4.21) and extrapulmonary tuberculosis (AOR: 2.3; 95% CI: 1.28–4.07) were independent predictors of patients’ delay. Initial visit of general practitioners (AOR: 2.57; 95% CI: 1.43–4.63) and more than one health care visit (AOR: 2.12; 95% CI: 1.30–3.46) were independent predictors of health system’s delay. However, patients’ delay was shorter among widowed/divorced patients (AOR: 0.3; 95% CI: 0.1–0.8). Lower level of education [illiterate (AOR: 0.42; 95% CI: 0.20–0.92), grade 1–8 (AOR: 0.38; 95% CI: 0.18–0.81)] and diagnosis of TB using a chest X-ray (AOR, 0.32; 95% CI, 0.16–0.68) significantly reduce health system’s delay. Conclusion About half of TB patients delayed beyond 36 days before starting treatment, and the late patient health seeking behavior was the major contributor of total delay. Development and implementation of strategies aimed at addressing identified factors should be recognized in order to reduce TB treatment delay. Further well designed research is needed to explore additional risk factors of delayed treatment

Feco-prevalence and risk factors of Helicobacter pylori infection among symptomatic patients at Dessie Referral Hospital, Ethiopia

Abstract Background Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection in the world. It can result in various upper gastroduodenal diseases. The prevalence varies among countries, population groups within the same country and testing methods. The aim of the study was to determine feco-prevalence and risk factors of H.pylori infection among symptomatic patients in Amhara region, Northeast Ethiopia. Methods A cross sectional study was conducted in a total of 342 new consecutive outpatients with upper abdominal complaints at Dessie Referral Hospital from May to July, 2016. A structured questionnaire was used to collect the socio-demographic, lifestyle and environmental data. Stool samples were used to detect H. pylori specific antigen. Blood samples were assessed for anti-H. pylori IgG and ABO blood types. SPSS version 20.0 statistical software package was used for data analysis. Chi-square test and logistic regression were used in the analysis and P-value ≤0.05 was considered as statistically significant. Results H. pylori stool antigen and serum anti-H.pylori IgG detection rate was 30.4 and 60.5% respectively with kappa measure of agreement of 0.271. Antigen detection was significantly associated with family size (> 3) [AOR = 1.83, 95% CI: 1.10–3.05, p = 0.02], more persons (> 3) sharing the same bed room in the household [AOR = 2.91, 95% CI: 1.39–6.11, p = 0.005], alcohol consumption (> once a week) [AOR = 2.70, 95% CI: 1.49–4.89, p = 0.001] and individuals’ blood type: group O [AOR = 8.93, 95%CI: 1.79–44.48, p = 0.008] and group A [AOR = 5.53, 95%CI: 1.08–28.36, p = 0.040]. Gender, age, marital status, occupation, educational level, residence, smoking as well as coffee, tea, fruits and vegetables consumption were not statistically associated with H. pylori antigen detection (p > 0.05). Conclusion The overall H. pylori stool antigen and anti-H. pylori IgG detection rate was 30.4 and 60.5%, respectively. The test agreement was not strongly convincing and needs further evaluation. Alcohol consumption, overcrowding and ABO blood group were significantly associated with H. pylori antigen detection

Prevalence and associated risk factors of intestinal parasitic infections among asymptomatic food handlers in Wollo University student’s cafeteria, Northeastern Ethiopia

Abstract Objective Intestinal parasitic infections (IPIs) are among the major public health and socioeconomic problems in developing countries like Ethiopia. Food-handlers that directly deal with production and distribution of foods between societies are one of the most important sources to transmit parasitic infections to humans. The aim of this study was to assess the prevalence and associated risk factors of intestinal parasites among asymptomatic food-handlers working in students’ cafeteria of Wollo University, Northeastern Ethiopia. Result A cross-sectional study was conducted among 200 asymptomatic food handlers at Wollo University from January 1 to February 20, 2018. Among the total participants 30 (15%) were infected with at least one intestinal parasites. The dominant parasite was E. histolytica (5.5%) followed by A. lumbricoides (4%) and then G. lamblia (3%). Finger nail trimming (p = 0.002, AOR: 4.35, 95% CI 1.71–11.04), medical checkup (p = 0.012, AOR: 4.01, 95% CI 1.37–12.25) and residence (p = 0.014, AOR: 3.16, 95% CI 1.26–7.95) were independent predictors of intestinal parasitic infection among the food handlers

Magnitude and associated factors of cytopenias among antiretroviral therapy naïve Human Immunodeficiency Virus infected adults in Dessie, Northeast Ethiopia.

BackgroundHematologic abnormalities involving peripheral blood cell cytopenias are strong predictors of morbidity, mortality and poor antiretroviral therapy (ART) outcomes of HIV infected individuals. However, limited studies are conducted in resource-limited settings of sub-Saharan Africa that have addressed the magnitude and associated factors of cytopenias. This study aimed to investigate the magnitude and associated factors of cytopenias among ART naïve HIV infected adult Ethiopians.Materials and methodsA cross-sectional study was conducted among ART naïve HIV infected individuals attending at ART unit of Dessie Referral Hospital between November 01, 2015 and April 30, 2016. A total of 402 adults were included using consecutive sampling. Socio-demographic, clinical and laboratory data of patients were collected. The data were entered to Epi Info version 3.4.3 and analyzed using SPSS version 20 software (SPSS INC, Chicago, IL, USA). Factors associated with cytopenias were analyzed first using bivariate and then multivariate logistic regression models. An odds ratio with 95% confidence interval was used to measure the strength of association. For all statistical significant tests, the cut-off value was set at PResultsIn this study, the overall magnitude of any cytopenia, anemia, leucopenia and thrombocytopenia were 63.4%, 43.5%, 24.4% and 18.7%, respectively. In multivariate logistic regression analysis, severe immunosuppression and WHO clinical stage IV HIV disease were significantly associated with increased prevalence of cytopenias. In addition, older age and younger age showed significant association with increased prevalence of anemia and leucopenia, respectively.ConclusionFrequent occurrence of cytopenias was independently associated with severe immunosuppression and WHO clinical stage IV HIV disease. Further longitudinal multicenter studies are recommended to bolster the findings of this study in order to suggest the need of routine assessment and management of hematological abnormalities for optimal choice of initial antiretroviral agents and prevention of further morbidities

Uninvestigated dyspepsia and associated factors of patients with gastrointestinal disorders in Dessie Referral Hospital, Northeast Ethiopia

Abstract Background Dyspepsia is a common problem in the community and clinical practice with symptom(s) considered arising from the gastroduodenal region. Dyspepsia burden and associated factors vary from country to country. The aim of this study was to determine the prevalence of uninvestigated dyspepsia (UD) using Rome III criteria, associated risk factors and self-reported dyspepsia symptoms’ correlation with H. pylori infection. Methods A cross-sectional study was conducted among randomly selected 318 out patients with gastrointestinal complaints during the period from September 1 to December 30, 2015. All patients completed a questionnaire for collecting data regarding sociodemographic, lifestyle and functional gastrointestinal disorders. Diagnosis of dyspepsia was made according to the Rome III criteria. H. pylori infection was assessed using stool antigen test. SPSS version 20.0 statistical software package was used for data analysis. Results From a total of 318 patients, 48.4% had UD according to Rome III criteria; with 42.1% symptoms of epigastric pain/burning, 26.1% postprandial fullness and 22.6% early satiation. Epigastric pain/burning (AOR = 1.92, 95% CI 1.07–3.43), early satiation (AOR = 2.68, 95% CI 1.38–5.20) and belching (AOR = 4.7, 95% CI 1.54–14.40) were significantly correlated with H. pylori infection. H. pylori infection (AOR = 4.33, 95% CI 2.41–7.76) and aspirin/NSAIDs consumption (AOR = 5.29, 95% CI 2.82–9.93) were independent risk factors for UD. However, consumption of raw fruits/ vegetables at least once a week (AOR = 0.48, 95% CI 0.24–0.98) and taking two or more cups of tea a day (AOR = 0.339, 95% CI 0.17–0.70) were inversely associated with UD. Conclusions UD is highly prevalent among adults with gastrointestinal complaints. H. pylori infection is significantly associated with UD and correlates with its symptoms. Individuals with epigastric pain/burning, early satiation and belching should be primary focus of H. pylori infection diagnosis and treatment. The role of consumption of tea, raw fruits and vegetables on dyspepsia needs further large scale study

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Co-infection of intestinal parasites and Helicobacter pylori among upper gastrointestinal symptomatic adult patients attending Mekanesalem Hospital, northeast Ethiopia

Abstract Objective Intestinal parasites and H. pylori are well-known for their high prevalence worldwide. Thus, the objective of this study waste assess risk factors and co-infection of intestinal parasites and H. pylori among adult patients with upper gastrointestinal complaints. A hospital-based cross sectional study was conducted among 363 consecutive adult patients from December 10, 2015 to February 30,2016. Stool and venous blood were collected for analysis of Intestinal parasites and H. pylori infection, respectively. Data was analyzed using SPSS version 16 and logistic regression analysis was carried out to assess predictors of co-infection. A p ≤ 0.05 was considered as statistically significant. Results Helicobacter pylori IgG and intestinal parasites were detected in 70.25–38.3% of participants, respectively while G. lamblia accounted 22.3%. G. lamblia prevalence was significantly higher among H. pylori infected participants (COR: 2.76; 95% CI: 1.46–5.23), but E. hystolytica/dispar infection didn’t show significant variation (p = 0.15). H. pylori and intestinal parasites concomitant co-infection was associated with male sex (AOR: 1.61; 95% CI: 1.01–2.56), consumption of river water (AOR: 1.85; 95% CI: 1.11–3.07) and ground/spring water (AOR: 4.10; 95% CI: 1.97–8.52). Thus, besides H. pylori investigation, upper gastrointestinal symptomatic patients should be screened for G. lamblia infection and other intestinal parasites

Assessment of Extrapulmonary Tuberculosis Using Gene Xpert MTB/RIF Assay and Fluorescent Microscopy and Its Risk Factors at Dessie Referral Hospital, Northeast Ethiopia

Background. Tuberculosis is a major public health problem and extrapulmonary tuberculosis (EPTB) accounts for a significant proportion of tuberculosis cases worldwide. Objective. To determine the magnitude of EPTB, associated risk factors, and agreement of diagnostic techniques at Dessie Referral Hospital. Methods. A cross-sectional study was conducted on consecutive presumptive EPTB cases from March 1 to June 30, 2017. Sociodemographic characteristics and other variables were collected using a structured questionnaire. Clinical specimens were collected and processed using fluorescent microscopy and Gene Xpert assay. Data was analyzed using SPSS version 20. Chi-square test and logistic regression were done and a P value of ≤0.05 was taken as statistically significant. Results. From a total of 353 presumptive EPTB cases the overall prevalence of Gene Xpert assay and smear confirmed patients was 8.8% and 2.5%, respectively. Tuberculosis lymphadenitis was the predominant (33.3%) type followed by pleural (11.9%) and peritoneal (6.7%) tuberculosis. Previous history of pulmonary tuberculosis was significantly associated with extrapulmonary infection (AOR:2.8; 95%CI: 1.05-7.54; p=0.04); however, other variables such as age, residence, sex, marital status, occupation, level of education, and monthly income did not show any association. Conclusion. High proportions (71%) of Gene Xpert assay confirmed EPTB patients were smear-negative. Sensitivity of microscopy should be enhanced in resource limited countries like Ethiopia where Gene Xpert machine is not easily accessible

Analysis of sociodemographic characteristics with knowledge and practice, at college of medicine and health sciences, Wollo University, Northeast Ethiopia, 2017. (n = 408).

<p>Analysis of sociodemographic characteristics with knowledge and practice, at college of medicine and health sciences, Wollo University, Northeast Ethiopia, 2017. (n = 408).</p

Correct preventive of medicine and health sciences students towards hepatitis B and C at Wollo University, Northeast Ethiopia, 2017. (N = 408).

<p>Correct preventive of medicine and health sciences students towards hepatitis B and C at Wollo University, Northeast Ethiopia, 2017. (N = 408).</p