Assessment of Patient Satisfaction with Preoperative Anesthetic Evaluation and Assosated Factors at Menelik Referal Hospital Addis Ababa, Ethiopia

Background: Patient Satisfaction- refers to a state of pleasure or happiness with an action or service especially one that was earlier desired. Patient satisfaction is progressively appreciated measure of outcome for health care procedures and it was a measure of success in this hospitals. It was affected by anesthetist’s patient interaction, in the preoperative anesthetic evaluation. No prior study conducted in our setup. Objective: The purpose of this study was to evaluate inpatients’ satisfaction with preoperative anesthetic evaluation and associated factors at Menelik II Referral Hospital Addis Ababa Ethiopia. Methods- Institutional based cross sectional study was conducted at Menelik II Referral Hospital from Jan 6 to Feb 6, 2016, All patients who remained for elective surgery were included in the study period and interview 24 hours after operation. Data were collected using pretested standard questionnaires. All items in the structured questionnaire were scored on five point Likert scale. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Binary logistic regression was used to measure statistical significance between dependent and each independent variable. P-value 0.05 and 95% CI was used as cut off point. Results: Two hundred and seventy-five patients were operated upon under anesthesia during the study period. Of these, a total of 224 patients were included in this study with a response rate of 81.5 %, with the overall proportion of patients who said they were satisfied with anesthesia services was 72.3 %.the major factors that take patient dissatisfaction were 68.1% of patient explain anesthetist were not introduce him or herself to the patient, information on postoperative analgesia were 99.1% and postoperative nausea vomiting management were accounts 84.8%. Conclusion and recommendation: Patient satisfaction with anesthesia services was low 72.3 % in our setup compared with many previous studies, and females more dissatisfied 42.4 % than males 57.6 %. Factors that affected patient satisfaction negatively may be preventable or enhanced. Further study should be done and patient satisfaction give an emphasis

Effects of General Versus Spinal Anesthesia Over Apgar Score of Newborns Delivered by Cesarean Sections and Factors Associated with Apgar Score at Gandhi Memorial Hospital, Addis Ababa

Introduction: Apgar score is a practical method of systemically assessing newborn baby immediately after birth to identify those requiring resuscitation and to predict survival in neonatal period. It is best parameter to assess the immediate condition of the baby. Objective: To assess the effects of general versus spinal anesthesia over Apgar score of newborns delivered by cesarean sections and factors associated with Apgar score from January to March 2016 at Gandhi Memorial Hospital, Addis Ababa. Method: Institutional based comparative cross sectional study design was conducted. Systematic random sampling technique was used to select study participants. Regular supervision and follow up was made. Data was entered into Epi info version 7 by investigators and was transported to SPSS version 20 for analysis. Bivariate and multivariate analysis was used to identify factors associated with Apgar score. Result: A total of 86 study subjects were included in the study of which majority of new born baby had low Apgar score at one minute. Out of 43 mothers, who received spinal anesthesia, 15 patients (34.88%) gave birth to neonates having Apgar score >7 at one minute. On the other hand, out of 43 mothers who received general anesthesia, 7(16.3%) mothers gave birth to neonate having Apgar score ≥7at one minute. It had been found that neonates who were born under general anesthesia were three folds more likely to have low Apgar score than the other (AOR 2.768 (95% CI ((.876-8.745). Conclusion and recommendation: There was relatively a low Apgar score among newborn babies delivered under general anesthesia.  Hence, practice of spinal anesthesia was recommended

The Role of Family Planning on Economic Development at Health Centers in Halaba Special Woreda, Southern, Ethiopia

Introduction. Family planning is the mechanisms that initiate the economic development by reducing rapid population growth through providing effective use of birth controlling method. When effective family planning occurs in an environment with rapid economic development and major technological advance, it actually contributes to the national development efforts. If population growth can be slow down, each person’s share of countries resource could be greater. Objective: To assess factors influencing clinical outcomes of patients admitted to intensive care units from January 2015 to January 2016 at Nigist Eleni Mohammed Memorial Hospital, hosanna, southern Ethiopia. Method: Institutional based cross sectional study design was conducted. All health professionals working at Nigist Eleni Mohammed Memorial Hosp during the study period were included. Regular supervision and follow up was made. Bivariate analysis was used to identify factors associated with economic development. The result was interpreted using table, graph and narrative. Result: A total of 40 participants were enrolled into the study of 65 %( 26) of respondents were males. Most of respondents 37.5% (15) and 35 %( 14) were in age group of 18-25 and 26-35respectively. Over two fifth and one third of respondents have not used family planning due to lack of knowledge about family planning and lack of having communication with health care provider. Conclusion and recommendation: Family planning has a negative impact on population growth and development therefore, it was recommended that proper use of birth controlling method was strongly were recommended

Job Satisfaction and Associated Factors Among Anesthetists at Government Hospitals of Addis Ababa, Ethiopia

Background: Anesthetic practice is always at high risk in medical profession. Job satisfaction level of Anesthetist can be affected by different factors. An investigation to retain anesthetists in the profession to meet the increasing demands of the healthcare system has a great importance. This study was aimed to determine the level of job satisfaction and associated factors among anesthetists working in government hospitals of Addis Ababa. Methods: A cross-sectional study conducted on sampled 101 anesthetists. Simple random sampling method was used to obtain the study participants. Data were collected using a structured questionnaire, comprised two main parts; demography and job satisfaction. Respondent rated 18 factors related to job satisfaction using six point Likert scale. A descriptive analysis using Proportion and frequency were used. A‘chi square’ test were used to assess statistical significance of association and P-values less than 0.05 were considered as statistically significant. Results: Among 101 anesthetists respondent, 57% were male, the majority of respondents were below the age of 30 years 58.4% and 59.4% of the respondents were single. A 53% of the respondents were satisfied and the highest dissatisfaction rate was in the age group of below thirty.  Satisfaction in helping others, responsibilities and freedom to choose method of working were significantly associated with job satisfaction. The major reasons reported for their dissatisfaction were inadequate salary, lack of public awareness about the role of anesthetists and professional hazard. Conclusion: There is a low level of job satisfaction among anesthetists who are working in government hospitals of Addis Ababa. Therefore, improving satisfaction level of anesthetist by solving major reasons of dissatisfaction is strongly recommended. Keywords: Anesthetists , satisfaction , dissatisfaction , government hospitals DOI: 10.7176/JHMN/94-05 Publication date:October 31st 2021

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Full-dose hepatitis B virus vaccination coverage and associated factors among health care workers in Ethiopia: A systematic review and meta-analysis.

IntroductionThe hepatitis B vaccine is the backbone of hepatitis B prevention. All health care workers must receive a full-dose (3-dose vaccine series) to achieve >90% protection against hepatitis B virus. There is limited evidence available on vaccination coverage of HBV among health care workers in Ethiopia. Therefore, the objective of this study was to estimate the national full-dose hepatitis B vaccination coverage and the associated factors among health care workers in Ethiopia.MethodsStudies were retrieved from PubMed, EMBASE, Web of Science, SCOPUS, CINAHL, and Google Scholar by using a combination of search terms with Boolean operators. The quality of each study was evaluated independently by three authors using the modified Newcastle-Ottawa Scale (NOS) for cross-sectional studies. Statistical analyses were performed using STATA™ Version 14 software. Meta-analysis was carried out using a random-effects (DerSimonian and Laird) method. The heterogeneity test was conducted by using I-squared (I2) statistics. Leave-one-out sensitivity analysis was performed.ResultsA total of 15 articles with 5734 participants were included in this systematic review and meta-analysis. The pooled prevalence of full-dose hepatitis B virus vaccination coverage among health care workers in Ethiopia was 20.04% (95% CI: 13.83, 26.26); I2 = 98.9%). Being male sex (p = 0.002), having work experience of less than 5 years (p ConclusionThe national full-dose hepatitis B vaccination coverage among health care workers was low. Training of health care workers in infection prevention, particularly in hepatitis B and testing and providing hepatitis B vaccination for newly recruited staff and every 5 years for those long-term workers were recommended to increase the uptake of the vaccine

Predictors of Neonatal Sepsis in Hospitals at Wolaita Sodo Town, Southern Ethiopia: Institution-Based Unmatched Case-Control Study, 2019

Background. Neonatal sepsis plays a significant role in neonates’ mortality in developing countries accounting for 30-50% of total deaths each year. Gaining insight into neonatal sepsis predictors will provide an opportunity for the stakeholders to reduce the causes of neonatal sepsis. This research is aimed at determining the predictors of neonatal sepsis at Wolaita Sodo University Teaching Referral Hospital and Sodo Christian General Hospital, Ethiopia, April-July 2019. Method. This study employed an institution-based unmatched case-control study by selecting neonates in selected hospitals through consecutive sampling technique. The cases of this study are neonates diagnosed with sepsis. The study used a pretested structured questionnaire for a face-to-face interview to collect data from index mothers. Besides, the review of the record was done using checklists. The data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences version 24.0 for analysis. The study used descriptive, bivariate, and multivariate analyses. The odds ratio with 95% confidence interval was used to measure the association’s strength. p<0.05 was the cut-off point for declaration of statistical significance for the multivariate analysis. Results. Factors significantly associated with neonatal sepsis among neonates were maternal age of 15-20 years and 21-30 years, mothers with low income/wealth, history of urinary tract infections/sexually transmitted infections, presence of intrapartum infections, antenatal care follow‐up<3 visits, Apgar (Appearance, Pulse, Grimace, Activity, and Respiration) score<7, low birth weight, and the time in which breastfeeding started after delivery<60 minutes. Conclusion. Maternal age, wealth/income, maternal urinary tract infections/sexually transmitted infections, intrapartum fever, antenatal care visit≤3 times, Apgar score<7, low birth weight, and starting time of breastfeeding were independent predictors of neonatal sepsis. Therefore, maternal health education during antenatal care visits, perinatal and newborn care, and early initiation of breastfeeding might decrease neonatal mortality and morbidity due to sepsis

Factors Associated with Apgar Score among Newborns Delivered by Cesarean Sections at Gandhi Memorial Hospital, Addis Ababa

Background. Newborns can be assessed clinically using the Apgar score test to quickly and summarily assess the health of newborn physical condition immediately after delivery and to determine any immediate need for extra medical or emergency care. This study is aimed at assessing factors associated with Apgar score among newborns delivered by cesarean sections and factors associated with Apgar score. Method. Institutional-based cohort study design was conducted. All eligible study participants were included. Training was given for data collectors and supervisors. Regular supervision and follow-up was made. Data was entered into Epi Info version 7 computer software by investigators and was transported to SPSS version 20 computer program for analysis. Bivariate and multivariate analysis was used to identify factors associated with Apgar score. Result. A total 354 newborn babies were included into the study. Majority of baby had low Apgar score at one minute and high Apgar score at five minutes. About 30.2% of newborn baby had Apgar score below seven minutes. On the other hand, about 12.8% of all newborns had low Apgar score at five minutes. It had been found that those neonates who were born when skin incision to delivery time is greater than three minutes were about fourfolds more likely to have low Apgar score than those who were born when skin incision to delivery time is less than three minutes (AOR 3.645) (95% CI (0.116-26.421)). Conclusion. Newborn babies have a low Apgar score at one minute as compared to five minutes. But low Apgar score at five minutes has long-term sequel. Therefore, it is very important to reduce factors associated with low Apgar score at both minutes

Effect of Laryngeal Mask Air Way Insertion versus Endotracheal Intubation over Hemodynamic Responses in Pediatrics Patient Who Underwent Ophthalmic Surgery at Menelik II Hospital, Addis Ababa: A Prospective Observational Study Design

Background. The airway of an anesthetized child is usually maintained with an endotracheal tube or laryngeal mask airway. However, both are related with some level of pressor response which may be risky in several groups of patient. Methods. An institutional-based prospective observational study design was employed. A systematic random sampling technique was used to select study participants. Data were entered into Epi info version 7 and transported to SPSS version 20 for analysis. Normality of the data was checked using Shapiro–Wilk tests. An independent t test was used to determine the mean differences between the two groups while the paired sample t test was used to determine the mean differences within the groups. A p value of less than 0.05 was used as a cut-off point for the presence of association. Results. The changes in systolic and diastolic blood pressure were returned to baseline values at five and three minutes in both groups, respectively. However, the changes in the heart rate and mean arterial pressure returned to baseline values in five minutes in the ETT group and three minutes in the LMA group. At baseline, the difference in systolic blood pressure between the two groups was not statistically significant (p=0.328). Conclusions. A significant hemodynamic pressor response was observed after the insertion of both LMA and ETT groups. However, the LMA group has less hemodynamic change as compared to the ETT group. Therefore, the practice of LMA insertion was strongly recommended

Changing prevalence and factors associated with female genital mutilation in Ethiopia: Data from the 2000, 2005 and 2016 national demographic health surveys.

SettingFemale genital mutilation (FGM) is a traditional surgical modification of the female genitalia comprising all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for cultural or nontherapeutic reasons. It can be harmful and violates girls' and women's human rights. FGM is a worldwide problem but mainly practiced in Africa. FGM is still widely practiced in Ethiopia despite being made a criminal offence in 2004.ObjectiveUsing data from three Ethiopian Demographic Health Surveys (EDHS) conducted in 2000, 2005 and 2016 the objective was to assess changes in prevalence of FGM and associated factors among women of reproductive age and their daughters.MethodsEDHS datasets for the three surveys included data on FGM prevalence and socio-demographic factors. After weighting, the data were analysed using frequencies, proportions and the chi square test for trend. Categorical variables associated with FGM in 2016 were compared using OpenEpi and presented as prevalence ratios (Pr) with 95% Confidence Intervals (CI). Levels of significance were set at 5% (PResultsThere was overall decline in FGM prevalence (from 79.9% to 74.3% to 65.2%, P95%, lack of school education, coming from rural areas and living in less wealthy households.ConclusionAlthough progress has been slow, the prevalence of FGM in Ethiopia has declined over time. Recommendations to quicken the trajectory of decline targeting integrated interventions to high prevalence areas focusing on mothers, fathers, youngsters, religious leaders and schools and ensuring that all girls receive some form of education