Acute isovolemic haemodilution in elective prostatectomy: An Ethiopian study

Background: Major surgical procedures often produce significant haemorrhage that may require transfusion of blood in order to maintain an adequate circulation. This study was aimed at comparing the effect of Acute Isovolemic Haemodilution (AIH) with use of Homologous Blood Transfusion during elective major surgery.Methods: This was a study prospective undertaken in the sub regional hospital at ArbaMinch, Ethiopia over a 15 month period and involved 34 patients admitted for prostatectomy. The patients were divided into two groups, the control group who when indicated received homologous blood, and an AIH group who received some if not all of their own ‘freshly drawn blood’ which had been taken in the operation room immediately before surgery.Results: There were no differences between the postoperative Haematocrit levels in the two groups, but there were less complications and a shorter hospital stay in the AIH group than in the control group.Conclusion: This relatively small study showed that Acute Isovolemic Haemodilution is a safe technique, which should be used widely in Ethiopia and in other ‘developing countries’. AIH avoids the risks of using homologous blood for transfusion

Married women’s empowerment and associated factors on achievement of their ideal number of children in Dilla Zuria woreda, Gedeo zone, Southern-Ethiopia: a community based cross sectional study

Background: Women’s empowerment in health care decision has been recognized as an important dimension to their access to reproductive health service and for better maternal and child health outcomes. However, the effect of women’s empowerment on achievement of their ideal number of children remains relatively unexplored in the context of Ethiopia. Hence, this current study aimed to explore the impact of women empowerment on their ability to achieve their ideal number of children among married women.Methods: Community based cross-sectional study was conducted from January 1 to February 1, 2015 among married women aged 15-49 years in Dilla Zuraia Woreda, Gedeo Zone. Systematic sampling technique was used to select a total of 592 study participants. Pre-tested structured questionnaires were used for gathering data. Bivariate and multivariate logistic regression analyses were performed using SPSS version 20.0 statistical package.Results: This study demonstrates that 82.8% of women achieved their ideal number of children that they need to have in their whole life. About (69.4%) of married women had empowerment to achieves their ideal number of children. Women’s empowerment as measured by household decision making and attitude towards gender role were positively associated with women’s ideal number of children. The finding that empowerment as measured by household decision-making and gender role attitudes was less influential in predicting achievement of ideal fertility than husband‘s desires of children. Our study also suggests education was associated with a smaller ideal number of children.Conclusions: Our study documents showed low empowerment, but strong association between women empowerment and achievement of their ideal number of children. The findings suggest different targeting strategies to improve women’s status, as well as men’s awareness and involvement in sexual issues via women’s empowerment

Assessing the Practice of Birth Defect Registration at Addis Ababa Health Facilities

BACKGROUND፡ Birth defects are conditions that exist at birth and cause structural changes in one or more parts of the body. In order to plan proper management and design preventive activities of these conditions, accurate tracking, registration and analyses of the registered data are important. We assessed the practice of birth defect registration at Addis Ababa health facilities.METHODS: We retrospectively checked the existence of a separate birth defect registry book and assessed the delivery room registration book for completeness in registering birth defects. We also assessed the total number of birth defects registered during 2010-2015.RESULTS: We assessed the practice of birth defect registration at 37 delivery service providing health facilities in Addis Ababa, 20 public and 17 private institutions. Of the 37 health institutions assessed, 23 registered birth defects (3 of them used a separate birth defect registry books, and 20 used a regular registration book to register birth defects). The remaining 14 did not register any congenital anomaly. Of the institutions that do not register congenital anomalies, 10 are private and four are public.CONCLUSION: Only three delivery providing health facilities had a dedicated birth defect registry book which is close to ideal for a birth defect registration. There is a need for others to do the same until an electronic birth defect registration is established. This registration will serve as a resource for clinical governance and studies into quality of life, quality of care, etiology and prevention

The Role of Environmental Factors in the Etiology of Nonsyndromic Orofacial Clefts

Background: Nonsyndromic orofacial clefts (NSOFCs) represent the most common congenital anomalies in the head and neck region. Multiple factors contribute to the occurrence of this anomaly. The etiology of NSOFCs in the Ethiopian population has not been investigated prior to this study.Aims of the Study: To assess the role of maternal environmental factors in the occurrence of NSOFCs in the Ethiopian Population.Methods: The authors used unmatched case control study design and evaluated the role of environmental factors to the occurrence of NSOFCs in the Ethiopian population. The participants were recruited from the same institution (Yekatit 12 Hospital Medical College). The authors studied 760 mothers (359 mothers of children born with NSOFCs and 401 mothers of children born without any congenital anomalies). Univariate and multivariate logistic regression analyses were used to calculate relative risk by odds ratio and 95% confidence interval.Results: Mothers who gave history of bronchial asthma and mothers who were admitted for threatened abortion had a higher risk of delivering a child with NSOFCS P value=0.013; AOR=0.194, 95% CI [0.053-0.712], P value &lt;0.001; AOR= 0.179, 95% CI [0.091-0.352] respectively. Higher number of children with NSOFCs were born to mothers who were exposed to diagnostic X-ray investigation during early pregnancy than those who were not exposed P value 0.048; AOR=0.375, 95% CI [0.142-0.990].Conclusion: Maternal exposure to diagnostic x-ray, maternal chronic illness like bronchial asthma and threatened abortion were found to be associated with the occurrence of NSOFCS in the studied population.</p

Oral Health-Related Quality of Life of Children Born With Orofacial Clefts in Ethiopia and Their Parents

Objective: To assess the oral health–related quality of life (OH-RQoL) using a translated standardized measure in an understudied population of Ethiopian children born with orofacial clefts (OFCs) and their parents. Methods: Using a descriptive study design, we assessed the OH-RQoL of 41 patients with OFCs between the ages of 8 and 17 years and their parents. Participants received multidisciplinary cleft care from 2008 to 2016. They completed an Amharic translation of the Child Oral Health Impact Profile (COHIP). Results: There was strong internal reliability with the translated COHIP for parents and patients. Parents’ COHIP scores ranged from 67 to 186, and patients’ scores were 78 to 190. The mean for patients and parents was 155, indicating good OH-RQoL. Conclusion: The Amharic translation of the COHIP appears appropriate for use with families in Ethiopia. Both parents and patients reported OH-RQoL at similar levels as other international populations. </jats:sec

Early outcome of facial reconstructive surgery abroad: a comparative study

Every year, many medical missions are undertaken in the developing world but there is almost a universal lack of outcome data on the quality of these missions. The present study compares early clinical outcome and complication rate in two consecutive missions (facial reconstruction) undertaken to Ethiopia in 2007 and 2008. The object was to establish if measures adopted following feedback from the first mission led to improvement of the results. A significant improvement was observed in early clinical outcome and there were less severe complications in the 2008 compared to the 2007 mission. On both occasions, significantly more complications were experienced after complex compared to simple procedures. Despite improved outcome in 2008, 50% of the complex cases had an unfavourable clinical result. The data suggest that early outcome studies are a useful method of critically evaluating the quality of surgical mission. The unsatisfactory outcome of complex procedures underlines the need for feedback on the quality of these missions

Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research

BACKGROUND: A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort.METHODS: Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis.RESULTS: Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI.CONCLUSIONS: Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.</p

Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research

BACKGROUND: A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort.METHODS: Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis.RESULTS: Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI.CONCLUSIONS: Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.</p

Multidisciplinary approach to genomics research in Africa:the AfriCRAN model

This article is an outcome of the African Craniofacial Anomalies Research Network (AfriCRAN) Human Hereditary and Health (H3A) grant planning meeting in 2012 in Lagos, Nigeria. It describes the strengths of a multidisciplinary team approach to solving complex genetic traits in the craniofacial region. It also highlights the different components and argues for the composition of similar teams to fast track the discovery of disease genes, diagnostic tools, improved clinical treatment and ultimately prevention of disease