Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study

BackgroundAnemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally.ObjectiveThe main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia.MethodsA facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant.ResultsThe proportion of postpartum anemia was 47.16%; 95% CI; 41.30–53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24–4.01), cesarean section (AOR = 4.10; 95% CI: 2.11–7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17–4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05–3.18).ConclusionThe prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia

Knowledge, Attitude and Practice Regarding Blood Donation among Graduating Undergraduate Health Science Students at the University of Gondar, Northwest Ethiopia

BACKGROUND: Blood transfusion is one of the most essential needs to manage patients suffering from various medical conditions. Nowadays, voluntary blood donors are the only source of blood in the blood banks. There is a great need to create awareness among the population at large and students about blood donation to maintain a regular blood supply. Health Science students can be used as best model to lead this initiative. Hence, the aim of this study was to assess the knowledge, attitude and practice regarding blood donation among graduating undergraduate Health Science students.METHODS: A descriptive cross-sectional study was conducted among graduating undergraduate Health Science students at University of Gondar using structured pre-tested self-administered questionnaire. Stratified sampling technique was employed to select study participants. A total of 225 students participated in the study. Data was entered into and analyzed using SPSS software version 20. Mean score was used to categorize the knowledge and attitude. Binary logistic regression model was fitted to identify factors associated with knowledge, attitude and practice regarding blood donation.RESULT: Among 255 undergraduate Health Science graduate students, 123(48.2%) and 202(79.2%) had adequate knowledge about and positive attitude regarding blood donation, respectively. About 12.5% of them had ever donated blood before. Age ≥25 years was significantly associated with practice of blood donation (AOR=4.33; 95%CI: 1.60, 11.76).CONCLUSION: Although the majority of the students had positive attitude regarding blood donation, blood donation practice was low. Age was found to be significantly associated with blood donation practice. Targeted strategies should be designed to increase awareness of health science students about blood donation. Strategies which encourage the students to donate blood voluntarily should also be designed. KEYWORDS: Knowledge, attitude, practice, blood donatio

Magnitude of Helicobacter pylori among Dyspeptic patients attending at University of Gondar Hospital, Gondar, Northwest Ethiopia

Background: Helicobacter pylori (H.pylori) infection is predominantly acquired in childhood from family members. The infection can cause dypepepsia, chronic and acute gastritis and gastric cancer. Dyspepsia is the most common illness in the Ethiopian population visiting outpatient department of health facilities, and it has also been associated with H.pylori infection. The aim of this study was to assess the magnitude of H.pylori and its associated factors among dyspeptic patients who visited University of Gondar Hospital Outpatient Department.Materials and Methods: An institutional-based cross-sectional study was conducted on 354 dyspeptic patients. A systematic random sampling technique was employed to select study participants. Data were collected by using structured questionnaire via face-to-face interview. H.pylori infection was diagnosed using stool antigen test method. The data were entered into Epi info version 3.5.3 and transferred to Statistical Package for Social Sciences version 20. Both Bivariable and  multivariable binary logistic regression analyses were performed to see the effect of independent variables on the dependent variable.Result: Of the total study participants, 201(56.8%), 195(55.1%) and 182(51.4%) were married, urban residents and females, respectively. The overall magnitude of H.pylori infection was 37.6%. In bivariable logistic regression analysis, sex and marital status were significantly associated with H.pylori infection, but in multivariable logistic regression analysis only marital status was significantly associated with H.pylori infection.Conclusion: The magnitude of H.pylori infection is high indicating that it is a public health problem in the study to area. According to this study, none of the variables were significantly associated with H.pylori infection. Hence, effective preventive, control and screening strategies need to be designed to reduce the burden of the disease.Keywords: Associated factor, Dyspepsia, Helicobacter pylor

Agreement between direct fluorescent microscopy and Ziehl-Neelsen concentration techniques in detection of pulmonary tuberculosis in northwest Ethiopia

Background: The sensitivity of smear microscopy for diagnosis of tuberculosis might be improved through treatment of sputum with sodium hypochlorite and application of fluorescent microscopy. This study aimed to determine the agreement between direct Fluorescent Microscopy and Ziehl-Neelsen concentration technique by their ability of detecting acid fast bacilli in resource poor settings.Methods: A cross sectional study was conducted at Gondar University Referral Hospital, Northwest Ethiopia. Three sputum specimens were collected from consecutive TB suspects. Direct and concentrated sputum smears were air-dried, heat-fixed and stained by auramine O and Ziehl-Neelsen staining techniques respectively. The stained slides were examined for acid fast bacilli using direct Fluorescent Microscopy and Ziehl-Neelsen concentration techniques.Results: Of 293 specimens, 4.4% and 2.4 % were AFB positive by direct fluorescent microscopy and Ziehl-Neelsen bleach concentrated techniques respectively. There was high percentage of tuberculosis positivity from early morning sputum samples (2.4%) compared to first spot (1.4%) and second spot (1.7%) sputum samples when using Ziehl-Neelsen sodium hypochlorite concentration technique. A moderate agreement was seen between the two methods (Kappa=0.484, P value<0.001).Conclusion: Direct fluorescent microscopy has shown high positivity rate compared to Ziehl-Neelsen concentration technique. A moderate agreement was seen between the two methods. Thus, Ziehl-Neelsen bleach sedimentation technique is recommended for detection of pulmonary tuberculosis at peripheral health service level when Fluorescent Microscopy is not availableKeywords: Agreement, Direct Fluorescent Microscopy, Ziehl-Neelsen concentration, Tuberculosis, Ethiopi

The Prevalence of Metabolic Syndrome and Its Components among Type 2 Diabetes Mellitus Patients at a Tertiary Hospital, Northwest Ethiopia

BACKGROUND: Metabolic syndrome is a cluster of risk factors that is responsible for the risk of coronary heart disease and stroke. Therefore, the aim of this study was to assess the prevalence of MetS and its components among T2DM patients.METHODS: A cross-sectional study was conducted at the Diabetes Clinic of the Hospital, from June to July, 2015. Data were entered into EPI INFO software and exported to SPSS 20 for analysis. MetS prevalence was estimated using NCEP ATPIII and IDF criteria. Anthropometric measurements, investigations of serum glucose and lipid profiles were done. Logistic regression analysis was used to evaluate associated factors. A P-value ≤ 0.05 wasconsidered statistically significant.RESULT: A total of 159 participants were included in the study; 119 (59.7%) were females with mean (±SD) age of (49.8±8.7) year. The prevalence of MetS was 66.7% in NCEP-ATP III and 53.5% in IDF definitions. The most prevalent component of MetS was elevated triglyceride (56.6% in ATPIII and 62.3% in IDF criteria), followed by abdominal obesity (61%) IDF and elevated blood pressure (55.4%) NCEP-ATPIII criteria. The regression analysis showed that increased age, being female, high BMI, having diabetes for over 5 years and poor glycemic control were significantly associated with metabolic syndrome.CONCLUSION: The prevalence of MetS and its components among T2DM patients were high, suggesting that diabetic patients are at increased risk of CVD and other complications. Efforts should be geared towards addressing these abnormalities through lifestyle modification, health awareness and medications in order to reduce this complication.

Magnitude of Anemia in Geriatric Population Visiting Outpatient Department at the University of Gondar Referral Hospital, Northwest Ethiopia: Implication for Community-Based Screening

Objective. This study is aimed at assessing the magnitude and its associated factors of anemia in geriatric population visiting outpatient department at the University of Gondar referral hospital, northwest Ethiopia. Method. A cross-sectional study was conducted among elder patients in Gondar town, North Gondar District, in May 2013. A total of 200 randomly selected geriatric population participated in the study. Summary statistics were computed and presented in tables and figure. Both bivariate and multivariable binary logistic regression were fitted to identify associated factors. A P value < 0.05 was considered as statistically significant. Result. The median age of the study participants was 65 years (Interquartile range (IQR): 8 years). The prevalence of anemia in the geriatric patients was 54.5% (n=109), of which 61.5% (n=67) were males. Mild type anemia was predominant, 55.96% (n=61). Geriatric patients with an elevated erythrocyte sedimentation rate (AOR = 9.04, 95% CI: 4.2–19.7) and who are vegetarians (AOR = 2.2, 95% CI: 1.03–4.71) were at high risk of developing anemia. Conclusion. The magnitude of anemia was high in geriatrics. Mild anemia was the predominant type. Vegetarians and geriatrics with elevated erythrocyte sedimentation rate were more likely to develop anemia. Hence, early diagnosis and management of anemia have paramount importance to prevent adverse outcomes in geriatrics

Mapping child growth failure across low- and middle-income countries

Child growth failure (CGF), manifested as stunting, wasting, and underweight, is associated with high 5 mortality and increased risks of cognitive, physical, and metabolic impairments. Children in low- and middle-income countries (LMICs) face the highest levels of CGF globally. Here we illustrate national and subnational variation of under-5 CGF indicators across LMICs, providing 2000–2017 annual estimates mapped at a high spatial resolution and aggregated to policy-relevant administrative units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the World Health 10 Organization’s ambitious Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and rates of progress exist across regions, countries, and within countries; our maps identify areas where high prevalence persists even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where subnational disparities exist and the highest-need populations reside, these geospatial estimates can support policy-makers in planning locally 15 tailored interventions and efficient directing of resources to accelerate progress in reducing CGF and its health implications

Subnational mapping of HIV incidence and mortality among individuals aged 15–49 years in sub-Saharan Africa, 2000–18 : a modelling study

Background: High-resolution estimates of HIV burden across space and time provide an important tool for tracking and monitoring the progress of prevention and control efforts and assist with improving the precision and efficiency of targeting efforts. We aimed to assess HIV incidence and HIV mortality for all second-level administrative units across sub-Saharan Africa. Methods: In this modelling study, we developed a framework that used the geographically specific HIV prevalence data collected in seroprevalence surveys and antenatal care clinics to train a model that estimates HIV incidence and mortality among individuals aged 15–49 years. We used a model-based geostatistical framework to estimate HIV prevalence at the second administrative level in 44 countries in sub-Saharan Africa for 2000–18 and sought data on the number of individuals on antiretroviral therapy (ART) by second-level administrative unit. We then modified the Estimation and Projection Package (EPP) to use these HIV prevalence and treatment estimates to estimate HIV incidence and mortality by second-level administrative unit. Findings: The estimates suggest substantial variation in HIV incidence and mortality rates both between and within countries in sub-Saharan Africa, with 15 countries having a ten-times or greater difference in estimated HIV incidence between the second-level administrative units with the lowest and highest estimated incidence levels. Across all 44 countries in 2018, HIV incidence ranged from 2 ·8 (95% uncertainty interval 2·1–3·8) in Mauritania to 1585·9 (1369·4–1824·8) cases per 100 000 people in Lesotho and HIV mortality ranged from 0·8 (0·7–0·9) in Mauritania to 676· 5 (513· 6–888·0) deaths per 100 000 people in Lesotho. Variation in both incidence and mortality was substantially greater at the subnational level than at the national level and the highest estimated rates were accordingly higher. Among second-level administrative units, Guijá District, Gaza Province, Mozambique, had the highest estimated HIV incidence (4661·7 [2544·8–8120·3]) cases per 100000 people in 2018 and Inhassunge District, Zambezia Province, Mozambique, had the highest estimated HIV mortality rate (1163·0 [679·0–1866·8]) deaths per 100 000 people. Further, the rate of reduction in HIV incidence and mortality from 2000 to 2018, as well as the ratio of new infections to the number of people living with HIV was highly variable. Although most second-level administrative units had declines in the number of new cases (3316 [81· 1%] of 4087 units) and number of deaths (3325 [81·4%]), nearly all appeared well short of the targeted 75% reduction in new cases and deaths between 2010 and 2020. Interpretation: Our estimates suggest that most second-level administrative units in sub-Saharan Africa are falling short of the targeted 75% reduction in new cases and deaths by 2020, which is further compounded by substantial within-country variability. These estimates will help decision makers and programme implementers expand access to ART and better target health resources to higher burden subnational areas

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