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

Prevalence of anemia and associated factors among patients living with HIV/AIDS at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Introduction Patients living with human immunodeficiency virus (HIV) face serious health problems due to associated anemia, which increases the likelihood of infection progression to state of a disease. Therefore, determining the prevalence of anemia in this vulnerable group might help to develop strategies to reduce the incidence of related cases. Material and methods Institution-based cross-sectional study was conducted from May to October, 2021 among HIV-positive patients at Mizan-Tepi University Teaching Hospital. Study subjects were selected using a simple random sampling technique, and pre-tested structured questionnaires were applied to obtain socio-demographic and clinical data. Blood samples were collected from patients for hemoglobin determination by hematology analyzer and CD4+ T-cells count. Data were entered using Epi-data manager (version 4.0.2.101) and analyzed by SPSS version 25.0. Results A total of 244 patients participated in this study. Overall anemia prevalence was 39.8% (95% CI: 33.6-46.2%), in 33 (13.5%) males and 64 (26.2%) females. Sixty-two (25.4%) patients were newly introduced to antiretroviral therapy and 35 (14.3%) patients were experienced. CD4+ T-cell of < 200/mm3 (AOR: 3.218; 95% CI: 1.401-7.387%), WHO clinical stage II (AOR: 9.060; 95% CI: 2.955-27.776%), female gender (AOR: 3.932, 95% CI: 1.878-8.233%), and body mass index of < 18.5 kg/m2 (AOR: 5.849; 95% CI: 1.824-18.752%) were among variables, which showed significant association with anemia. Conclusions The prevalence of anemia in antiretroviral therapy-experienced patients was higher as compared to naïve individuals. This study determined that anemia remains a major health threat to HIV/AIDS patients

Prevalence of biofilm producing Acinetobacter baumannii clinical isolates: A systematic review and meta-analysis.

BackgroundAcinetobacter baumannii, the first human pathogen to be designated as a "red-alert" pathogen, is on the critical priority list of pathogens requiring new antibiotics. Biofilm-associated diseases are the most common infections caused by the antibiotic-resistant bacteria A. baumannii. Multidrug-resistant strains are more easily transmitted around the world due to A. baumannii's ability to produce biofilms, which allows it to develop antibiotic resistance mechanisms and thrive in healthcare environments. As a result, A. baumannii infections are becoming increasingly common in hospital settings allover the world. As a result, a comprehensive systematic review and meta-analysis were carried out to determine the global prevalence of biofilm-producing A. baumannii clinical isolates.MethodsArticles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported into STATA version 12 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of biofilm-producing A. baumannii clinical isolates. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was done to assess the impact of a single study on pooled effect size.ResultOf the 862 studies identified, 26 studies consisted of 2123 A.baumannii clinical isolates of which 1456 were biofilm-producing. The pooled prevalence of biofilm-producing A.baumannii clinical isolates was 65.63% (95% CI = 56.70%-74.56%). There was substantial heterogeneity with an I2 value of 98.1%. Moreover, 41.34%, 33.57%, and 27.63% of isolates of strong, mild, and weak producers of biofilm. Higher prevalence was found in studies published after 2014 (66.31%); Western Pacific region (76.17%); and Asia (66.22%) followed by the African continent (57.29%).ConclusionThe pooled prevalence of biofilm-producing A. baumannii clinical isolates has risen alarmingly, posing a public health risk. This indicates the burden of biofilm-producing A. baumannii infections urges routine screening and appropriate treatment for better management of hospitalized patients, as well as effective controlling of the emergence of drug resistance. Furthermore, this finding is an alert call for the stakeholders to develop strong infection prevention and antibiotics stewardship programs for the prevention and control of biofilm-producing bacterial infections

Image_1_Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis.jpg

BackgroundDiabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life-threatening health problems. Although hematological parameters play a significant role in the progression and pathogenesis of diabetes, many studies have explored contradictory findings. Therefore, this evidence-based study aimed to determine the pooled mean difference of white blood cell and red blood cell parameters in diabetic patients in order to investigate hematological dysfunctions in type 1 and type 2 diabetes mellitus.MethodsArticles were extensively searched in bibliographic databases (PubMed, Cochrane library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repositories) using appropriate entry terms. For studies meeting the eligibility criteria, the first author’s name, year of publication, study design and area, type of diabetes mellitus, sample size, and mean and standard deviation of hematological parameters were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference (SMD) was determined using the random effects model, and heterogeneity was quantified using Higgins’ I2 statistics. Egger’s test and funnel plot were performed to measure bias. Furthermore, a sensitivity analysis was performed to determine the small study effect.ResultsInitially 39, 222 articles were identified. After screening of the entire methodology, 22 articles with 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) were included in this study. The pooled SMD in TLC (109/L) was 0.66 and −0.21, in T2DM and T1DM, respectively. Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, −1.59, 3.20, 0.36 and 0.26, respectively. The differences in relative differential counts (%) in T2DM were as follows: neutrophils: 1.31, eosinophils: −0.99, basophils: 0.34, lymphocytes: −0.19 and monocyte: −0.64. The SMD of differential counts of WBC (109/L) parameters; neutrophils, lymphocytes, monocytes and basophils in T1DM were −0.10, −0.69, 0.19, and −0.32, respectively. The pooled SMD in RBC parameters in T2DM were as follows: RBC: −0.57 (106/μL), Hb: −0.73 g/dL and HCT: −1.22%, Where as in T1DM RBC, Hb and HCT were −1.23 (106/μL), −0.80 g/dL and −0.29%, respectively.ConclusionPatients with T2DM had significantly increased TLC counts, absolute neutrophil, basophil, lymphocyte, monocyte counts and relative counts of neutrophils and basophils in comparison to controls. On the contrary, the absolute eosinophil count and relative lymphocyte, eosinophil and monocyte counts were decreased. In T1DM, WBC parameters were significantly decreased except monocytes. RBC parameters were found to be significantly decreased in T2DM patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated a significant alteration of WBC and RBC parameters in both diabetic patients suggesting the considerable metabolic effect of diabetes on hematologic parameters.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/export_details_pdf.php, identifier [CRD42023413486].</p

Hematological and immunological profiles of study participants for magnitude of IHA in HIV infected adults at UOGCSH during March to April 2021 (N = 358).

Hematological and immunological profiles of study participants for magnitude of IHA in HIV infected adults at UOGCSH during March to April 2021 (N = 358).</p

Table_1_Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis.docx

BackgroundDiabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life-threatening health problems. Although hematological parameters play a significant role in the progression and pathogenesis of diabetes, many studies have explored contradictory findings. Therefore, this evidence-based study aimed to determine the pooled mean difference of white blood cell and red blood cell parameters in diabetic patients in order to investigate hematological dysfunctions in type 1 and type 2 diabetes mellitus.MethodsArticles were extensively searched in bibliographic databases (PubMed, Cochrane library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repositories) using appropriate entry terms. For studies meeting the eligibility criteria, the first author’s name, year of publication, study design and area, type of diabetes mellitus, sample size, and mean and standard deviation of hematological parameters were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference (SMD) was determined using the random effects model, and heterogeneity was quantified using Higgins’ I2 statistics. Egger’s test and funnel plot were performed to measure bias. Furthermore, a sensitivity analysis was performed to determine the small study effect.ResultsInitially 39, 222 articles were identified. After screening of the entire methodology, 22 articles with 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) were included in this study. The pooled SMD in TLC (109/L) was 0.66 and −0.21, in T2DM and T1DM, respectively. Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, −1.59, 3.20, 0.36 and 0.26, respectively. The differences in relative differential counts (%) in T2DM were as follows: neutrophils: 1.31, eosinophils: −0.99, basophils: 0.34, lymphocytes: −0.19 and monocyte: −0.64. The SMD of differential counts of WBC (109/L) parameters; neutrophils, lymphocytes, monocytes and basophils in T1DM were −0.10, −0.69, 0.19, and −0.32, respectively. The pooled SMD in RBC parameters in T2DM were as follows: RBC: −0.57 (106/μL), Hb: −0.73 g/dL and HCT: −1.22%, Where as in T1DM RBC, Hb and HCT were −1.23 (106/μL), −0.80 g/dL and −0.29%, respectively.ConclusionPatients with T2DM had significantly increased TLC counts, absolute neutrophil, basophil, lymphocyte, monocyte counts and relative counts of neutrophils and basophils in comparison to controls. On the contrary, the absolute eosinophil count and relative lymphocyte, eosinophil and monocyte counts were decreased. In T1DM, WBC parameters were significantly decreased except monocytes. RBC parameters were found to be significantly decreased in T2DM patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated a significant alteration of WBC and RBC parameters in both diabetic patients suggesting the considerable metabolic effect of diabetes on hematologic parameters.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/export_details_pdf.php, identifier [CRD42023413486].</p

Clinical characters of study participants for the magnitude of IHA and associated factors among HIV infected adults at UOGCSH from March to April 2021.

Clinical characters of study participants for the magnitude of IHA and associated factors among HIV infected adults at UOGCSH from March to April 2021.</p

Image_3_Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis.jpg

BackgroundDiabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life-threatening health problems. Although hematological parameters play a significant role in the progression and pathogenesis of diabetes, many studies have explored contradictory findings. Therefore, this evidence-based study aimed to determine the pooled mean difference of white blood cell and red blood cell parameters in diabetic patients in order to investigate hematological dysfunctions in type 1 and type 2 diabetes mellitus.MethodsArticles were extensively searched in bibliographic databases (PubMed, Cochrane library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repositories) using appropriate entry terms. For studies meeting the eligibility criteria, the first author’s name, year of publication, study design and area, type of diabetes mellitus, sample size, and mean and standard deviation of hematological parameters were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference (SMD) was determined using the random effects model, and heterogeneity was quantified using Higgins’ I2 statistics. Egger’s test and funnel plot were performed to measure bias. Furthermore, a sensitivity analysis was performed to determine the small study effect.ResultsInitially 39, 222 articles were identified. After screening of the entire methodology, 22 articles with 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) were included in this study. The pooled SMD in TLC (109/L) was 0.66 and −0.21, in T2DM and T1DM, respectively. Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, −1.59, 3.20, 0.36 and 0.26, respectively. The differences in relative differential counts (%) in T2DM were as follows: neutrophils: 1.31, eosinophils: −0.99, basophils: 0.34, lymphocytes: −0.19 and monocyte: −0.64. The SMD of differential counts of WBC (109/L) parameters; neutrophils, lymphocytes, monocytes and basophils in T1DM were −0.10, −0.69, 0.19, and −0.32, respectively. The pooled SMD in RBC parameters in T2DM were as follows: RBC: −0.57 (106/μL), Hb: −0.73 g/dL and HCT: −1.22%, Where as in T1DM RBC, Hb and HCT were −1.23 (106/μL), −0.80 g/dL and −0.29%, respectively.ConclusionPatients with T2DM had significantly increased TLC counts, absolute neutrophil, basophil, lymphocyte, monocyte counts and relative counts of neutrophils and basophils in comparison to controls. On the contrary, the absolute eosinophil count and relative lymphocyte, eosinophil and monocyte counts were decreased. In T1DM, WBC parameters were significantly decreased except monocytes. RBC parameters were found to be significantly decreased in T2DM patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated a significant alteration of WBC and RBC parameters in both diabetic patients suggesting the considerable metabolic effect of diabetes on hematologic parameters.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/export_details_pdf.php, identifier [CRD42023413486].</p

Sociodemographic characters of study participants for the magnitude of IHA and associated factors among HIV infected adults at UOGCSH March to April 2021 (N = 358).

Sociodemographic characters of study participants for the magnitude of IHA and associated factors among HIV infected adults at UOGCSH March to April 2021 (N = 358).</p

Schematic representation of the sampling procedure of HIV positive adults on HAART at University of Gondar comprehensive specialized hospital from March to April 2021.

Schematic representation of the sampling procedure of HIV positive adults on HAART at University of Gondar comprehensive specialized hospital from March to April 2021.</p