Establishment of immunohematological reference values among HIV sero-negative pregnant women at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia

Background: Normal pregnancy is characterized by profound changes in almost every organ and system. Immunohematological parameters are important in clinical practice for the assessment of health and disease. Therefore, this study was aimed to establish immunohematological reference range among HIV sero-negative pregnant women. Methods: A cross-sectional study was conducted among HIV sero-negative pregnant women at St. Paul’s Hospital Millennium Medical College  (SPHMMC), Addis Ababa, Ethiopia, from 20/1-30/6/ 2016. Whole blood was collected and immunological and hematological parameters were measured  following the standard procedure. Data were entered in to Epi Info version 3.5, checked for completeness and exported to SPSS version 20 software for  analysis. The mean ± SD and 95% Confidence Interval (95% CI) values were calculated for different immunohematological parameters. Results: A total of 400 women with mean age ±SD (27.3 ±4.7) ranging from18-40 years were enrolled. The mean ± SD reference value of white blood cells count with 95% CI was 8.3 ±2.3 (8.1-8.6) x109 cells/L and for CD4+, CD8+, and CD4to CD8 ratio cells absolute count with 95% CI were 906 ±404 (867-946), 698± 378 (662-736) cell/μl, and 1.5±0.9 (1.4-1.6), respectively. The mean ± SD reference values for red blood cells count with 95% CI was 4.5±0.5(4.4-4.5) 1012/L, for hemoglobin 14±7.2(13.3-14.7) gm/dl, and for hematocrite was 39.5± 4(39-39.9). Conclusions: These values were lower than the one from developed countries but not lower than the one from other African studies. It suggests the need for further large study.  Keywords: Immunohematological References, Pregnant Women, Reference Value

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Intention, magnitude and factors associated with bottle feeding among mothers of 0–23 months old children in Holeta town, Central Ethiopia: a cross sectional study

BACKGROUND: World Health Organization (WHO) recommends that bottle feeding should be avoided for infant and young child feeding since it has an impact on optimal breastfeeding, appropriate complementary feeding and bottles with a nipple are prone to contamination. The objectives of this study were to determine intention, magnitude and factors associated with bottle feeding among mothers of 0–23 months infants and children. METHODS: Community based cross sectional study was conducted from February to May 2016. A total of 422 mothers who had children 0–23 months were included in the study. Systematic random sampling was used to select the study subjects. Data were collected using a pre-tested interviewer administered structured questionnaire. The data were cleaned, coded, entered in to EPI-INFO version 3.5.4, and transferred and analyzed using SPSS. Odds ratio was calculated with 95% CI to identify factors associated with bottle feeding practice. P-values less than 0.05 were considered as statistically significant. RESULTS: The prevalence of bottle-feeding in this study was 19.6% and another 27.6% mothers have intention of bottle feeding. Being infant age of 0–5 months [AOR = 0.27;95% CI:(0.12,0.62)] and being a housewife [AOR = 0.37;95% CI:(0.21,0.67)] were negatively associated while having three under five children [AOR = 2.77;95% CI:(1.07,7.14)], not attending PNC follow-up [AOR = 2.13;95% CI:(1.19,4.97)], lower age of mothers [AOR = 3.38;95% CI:(1.48,7.73)] and not counseled on bottle feeding [AOR = 2.18;95% CI:(1.24,3.83)] were positively associated with bottle feeding. CONCLUSION: The prevalence of bottle feeding in the study area was high compared to the national prevalence of bottle feeding. Working outside home, lower maternal age, older age of children, having more than one under five children in the household, not attending PNC follow-up and not counseled on bottle feeding were found to be risk factors associated with bottle feeding practice in the study area

Clinical chemistry laboratory errors at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia

Abstract Objective This study was aimed to determine the magnitude of errors in clinical chemistry laboratory tests at different phases of the assay of clinical chemistry laboratory unit. Results From the total 1633 clinical chemistry laboratory tests done, overall, 541 (33.1%) errors occurred which accounts that 392 (72.3%), 45 (8.3%), and 104 (19.2%) were pre analytical, analytical and post analytical phases of errors, respectively. Incomplete clinical data of patient was observed on 1185 (72.6%) of CLL tests. Name, gender, and age of patients were missed on 8 (0.5%), 190 (11.6%), and 257 (15.7%) forms of the requests, respectively. The physician’s name existed only on 248 (15.2%) and signature on 1137 (69.6%) of the request forms. An essential patient data were incomplete, which needs emphasis on awareness creation. Such practice improves laboratory data interpretation and thereby prevent misdiagnose and mistreatment of patients

Errors in the Hematology Laboratory at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract Objective The objective of this study was to determine the magnitude of pre-analytical, analytical and post-analytical laboratory errors in hematology tests. Results A total of 2606 hematology requests were studied. Out of the total, 562 (21.6%) pre-analytic, 14 (0.5%) analytical and 168 (6.4%) post-analytical errors were recorded which contribute a total frequency of 75.5, 1.9 and 22.6%, respectively. The name of the physician requesting the test was not provided on 2215 (85%) of request forms and 1827 (70.1%) of the request forms were unaccompanied with proper clinical details of the patient. Essential information required on the request forms was often missed. Close communication between clinicians and laboratory personnel is the key to improve laboratory quality in general