Pattern of Vascular Diseases at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

BACKGROUND: Vascular diseases are evolving fast in sub-Saharan Africa, but its management is challenged by lack of expertise and infrastructure. In the light of the prevailing challenge, this study was done to see the pattern of vascular disease and its treatment in a tertiary referral hospital.METHODS: A prospective cross-sectional study was done over a period of one year (February 9, 2016 to February 8, 2017) at Tikur Anbessa specialized hospital (TASH) at Addis Ababa, Ethiopia.RESULTS: A total of 386 patients were seen at the surgical OPD. Of these, 78(20.2%) were admitted and operate on. The male to female ratio was 1.3:1. The mean age affected was 39 +/- 10 (Range 12-91 years). On the other hand, 132 (34.2%) patients came with PAD. Of them, 46(34.8%) presented with either frank Gangrene or pre-gangrene stage. The rest 86(65.1%) had claudication pain. The other diseases seen are Varicose Vein, 100(25.9%), Carotid body tumors, 60(15.4%), Aneurysmal diseases, 36(9.1%), Vascular malformations, 34(8.7%), and Vascular injuries, 22(5.6%). During the study period, 28(35.9%) PAD, 22(28.2%) trauma patients, 8(10.2%) Chemodectomas, 8(10.2%) aneurysms, 6(7.7%) hemangiomas, 4(5.1%) varicose vein and 2(2.6%) AV fistula patients were operated.CONCLUSION: The pattern of vascular disease in Ethiopia is becoming a challenge. The gap created due to limited vascular surgeons, poor infrastructure and absent supply chain system has significantly compromised the number and type of operated-on patients. These challenges result in preventable morbidity and mortality

Indirect child mortality estimation technique to identify trends of under-five mortality in Ethiopia

Background: In sub-Saharan African countries, the chance of a child dying before the age of five years is high. The problem is similar in Ethiopia, but it shows a decrease over years.Methods: The 2000; 2005 and 2011 Ethiopian Demographic and Health Survey results were used for this work. The purpose of the study is to detect the pattern of under-five child mortality overtime. Indirect child mortality estimation technique is adapted to examine the under-five child mortality trend in Ethiopia.Results: From the result, it was possible to see the trend of under-five child mortality in Ethiopia. The under-five child mortality shows a decline in Ethiopia.Conclusion: From the study, it can be seen that there is a positive correlation between mother and child survival which is almost certain in any population. Therefore, this study shows the trend of under-five mortality in Ethiopia and decline over time.Keywords: EDHS, under-five mortality, parity, indirect technique, CEB, children survivin

Evaluation of Ethiopian Tax Administration System: emphasis on taxpayer compliance

Voluntary compliance with tax laws of taxpayers is believed to be shaped by two major streams of factors: economic and social-psychological. Many countries of the world including Ethiopia try to emphasize the economic deterrence approach in which the belief is that taxpayers pay taxes only because they fear audit and the subsequent sanctions. The social-psychology approach to taxation, on the other hand, takes the position that taxpayers’ (non)compliance decision is influenced by justice perception, how they value government expenditure, how they feel they are treated by the revenue authority, and so on. In this study we concisely went over the historical evolution of taxation in Ethiopia, assessed the culture of voluntary compliance, looked at how taxpayers perceive service delivery by the revenue authority, and evaluated the fairness perception of the Ethiopian tax system. Data for the study were gathered primarily through questionnaire distributed to 200 (162 usable ones returned) taxpayers and unstructured interview with selected officials from the revenue authority. Secondary sources such as journal articles, reports of the World Bank, IMF, and MoFED were also consulted. We used descriptive data analysis method. Both economic and social-psychological factors are found to influence taxpayers’ (non)compliance decision in so far as those respondents’ responses indicate.Keywords: Tax administration, Voluntary compliance, Taxpayers’ services, Tax system fairnes

Mechanical property characterization of water hyacinth and glass fiber reinforced hybrid composite

While composites of natural fibers have got more attraction because of their advantages, there are some limitations. Therefore, hybridization is a way to minimize some of the limitations of natural fibers composite. This article reports on the study conducted to investigate the mechanical properties of a hybrid glass/water hyacinth reinforced polymer composite using five different forms of volume fractions. The hybrid composite was prepared by hand lay-up method according to ASTM D3410 and ASTM D3039 standards for compression and tensile tests, respectively. The material properties of the composite were analyzed to explore the influence of fiber volume fraction. The results indicate that the mechanical properties change as a function of the volume fraction. Thus, the addition of glass fibers influenced the results of both tensile and compressive properties.publishedVersio

Pattern of surgical admissions to Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A five-year retrospective study

Background: Tikur Anbessa specialized hospital (TASH) is Ethiopia’s largest tertiary teaching and referral hospital admitting and treating surgical patients under various specialties. This study aims to analyze the magnitude and pattern of surgical admissions to this facility. Methods: A five-year Cross sectional retrospective analysis was done on all adult surgical admissions to TASH from Sept. 2010 to Sept. 2015. Results: There were a total of 8,698 surgical admissions of which, 4471 (51.4%) were male and 4227 (48.5%) were female with male to female ratio of 1.06:1. Their age ranged from 13 to 95, with mean age being 38.8 ± 16.2 years. Three thousand two hundred twenty two (46.5%) patients were from Addis Ababa. Of all admissions, 4706 (54.1%) were elective ones of which obstructive uropathy, 997(21.1%), esophageal diseases, 716(15.2%) and Urolithiasis, 573(12.2%) respectively are the top three. The rest, 3992 (44.9%), were emergency admissions, the top three ones being trauma, 1435(35.9%), appendicitis 281(7%) and Intestinal obstruction, 190(4.7%) respectively. General surgical (gastrointestinal, endocrine and vascular) cases account for 3414 (39.25%) of all admissions followed by urosurgical cases, 2114 (25.31%), cardiothoracic surgical cases, 1942 (22.33%), and neurosurgical cases, 1139 (13.1%). There were a total of 280 deaths with an overall mortality rate of 4% of which, 3.2% were from elective admissions and 5.2% from emergency ones. Mortality rate was the highest among neurosurgical patients being 6.3% followed by 4.3%, 3.8% and 3.5% in cardiothoracic, general surgical and urosurgical cases respectively. Conclusions: The admission pattern indicates quite a big number and diversity of cases though the bed capacity is limited. There are significant number of cases that could be treated at other secondary level hospitals. Trauma is the leading cause of emergency admissions and significant cause of mortality. We recommend increasing the number of beds, organizing separate trauma center and admitting only cases requiring tertiary level care. Keywords: pattern of surgical diseases; surgical admissions; Tikur Anbessa Specialized Hospital

Factors affecting child malnutrition in Ethiopia

Background: One of the public health problems in developing countries is child malnutrition. An important factor for children’s well-being is good nutrition. Therefore, the malnutrition status of children under the age of five is an important outcome measure for children’s health. This study uses the proportional odds model to identify risk factors associated with child malnutrition in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data.Methods: This study uses the 2016 Ethiopian Demographic and Health Survey results. Based on weight-for-height anthropometric index (Z-score) child nutrition status is categorized into four levels namely- underweight, normal, overweight and obese. Since this leads to an ordinal variable for nutrition status, an ordinal logistic regression (OLR)proportional odds model (POM) is an obvious choice for analysis.Results: The findings and comparison of results using the cumulative logit model with and without complex survey design are presented. The study results revealed that to produce the appropriate estimates and standard errors for data that were obtained from complex survey design, model fitting based on taking the survey sampling design into account is better. It has also been found that for children under the age of five, weight of a child at birth, mother’s age, mother’s Body Mass Index (BMI), marital status of mother and region (Affar, Dire Dawa, Gambela, Harari and Somali) were influential variables significantly associated with underfive children’s nutritional status in Ethiopia.Conclusion: This child’s age of a child, sex, weight of child at birth, mother’s BMI and region of residence were significant determinants of malnutrition of children under five years in Ethiopia. The effect of these determinants can be used to develop strategies for reducing child malnutrition in Ethiopia. Moreover, these findings show that OLR proportional odds model is appropriate assessing thedeterminants of malnutrition for ordinal nutritional status of underfive children in Ethiopia.Keywords: BMI, Ethiopian Demographic and Health Survey (EDHS), malnutrition, proportional odds model

Indirect child mortality estimation technique to identify trends of under-five mortality in Ethiopia.

Background: In sub-Saharan African countries, the chance of a child dying before the age of five years is high. The problem is similar in Ethiopia, but it shows a decrease over years. Methods: The 2000; 2005 and 2011 Ethiopian Demographic and Health Survey results were used for this work. The purpose of the study is to detect the pattern of under-five child mortality overtime. Indirect child mortality estimation technique is adapted to examine the under-five child mortality trend in Ethiopia. Results: From the result, it was possible to see the trend of under-five child mortality in Ethiopia. The under-five child mortality shows a decline in Ethiopia. Conclusion: From the study, it can be seen that there is a positive correlation between mother and child survival which is almost certain in any population. Therefore, this study shows the trend of under-five mortality in Ethiopia and decline over time

Modelling CD4 counts before and after HAART for HIV infected patients in KwaZulu-Natal South Africa

Background: This study aims to make use of a longitudinal data modelling approach to analyze data on the number of CD4+cell counts measured repeatedly in HIV-1 Subtype C infected women enrolled in the Acute Infection Study of the Centre for the AIDS Programme of Research in South Africa. Methodology: This study uses data from the CAPRISA 002 Acute Infection Study, which was conducted in South Africa. This cohort study observed N=235 incident HIV-1 positive women whose disease biomarkers were measured repeatedly at least four times on each participant. Results: From the findings of this study, post-HAART initiation, baseline viral load, and the prevalence of obese nutrition status were found to be major significant factors on the prognosis CD4+ count of HIV-infected patients. Conclusion: Effective HAART initiation immediately after HIV exposure is necessary to suppress the increase of viral loads to induce potential ART benefits that accrue over time. The data showed evidence of strong individual-specific effects on the evolution of CD4+ counts. Effective monitoring and modelling of disease biomarkers are essential to help inform methods that can be put in place to suppress viral loads for maximum ART benefits that can be accrued over time at an individual level