The epidemiology of smear positive pulmonary tuberculosis at Felege Hiwot Referral Hospital, Northwest Ethiopia: A five year retrospective study

Background: Globally, tuberculosis (TB) continues to cause considerable morbidity and mortality. Ethiopia is among the 22 high TB burden countries reported. Currently, data regarding the magnitude of TB and associated factors have been released at different health facilities as part of service auditing. However, such data are not universally available that this study was carried out to determine the prevalence of smear positive tuberculosis and its associated risk factors at FelegeHiwot Referral Hospital (FHRH) over a period of five years.Methods: We analyzed all the records of 12,442 presumptive TB patients registered at FHRH from 2011 to 2015. Data on patient’s sex, age, residential address and sputum smear microscopy results were extracted from laboratory registration logbook. All data were entered, cleaned and analyzed using SPSS version 22 for windows. The proportion and trend of smear positive TB over the five years period was calculated and the overall prevalence of TB in these years was determined. Logistic regression model was used to analyze the association between TB positivity and potential associated variables; p < 0.05 was considered to be significant.Results: TB suspected patients were found to be characterized as male 7052 (56.7%), within the age group of 15-29 years of age 4105 (33.0%) and were from rural settings7841 (63.0). The number of presumptive TB patients visiting FHRH over the five years period was quite variable. However, the prevalence of smear positive TB in each year was almost consistent, ranging from 4.2% to 6.5%. The prevalence of smear positive TB among new and follow up patients was at 5.2% and 4.5%, respectively. The proportion of overall burden of smear positive pulmonary TB was estimated at 5.2% and was found significantly associated with age group between 15-29 (AOR: 0.45, 95% CI, 0.23-0.77), 30-44 (AOR:0.22, 95% CI, 0.15-0.32) and 45-59 (AOR:0.38, 95% CI, 0.26-0.56).Conclusions: In the studied area high prevalence of smear positive TB was documented over the five years period; which implies inconsistent measures being taken to reduce the burden of the disease. Hence, interventions to decrease prevalence of TB and thereby its impacts need to be evaluated and strengthened. [Ethiop. J. Health Dev. 2017;31(3):155-160]Keywords: TB, Trend, Felege Hiwot Referral Hospita

The relationship between facility delivery and infant immunization in Ethiopia

ObjectiveTo determine whether facility delivery is related to compliance with recommended infant immunizations, particularly those that occur weeks or months after delivery.MethodsIn a retrospective analysis, multivariate logistic regression was used to assess data from the 2011 Ethiopia Demographic and Health Survey (EDHS) to determine the strongest correlates of facility delivery. These correlates were then used, along with facility delivery itself, to determine the relationship between facility delivery and infant immunization.ResultsIn total, 3334 women delivered a newborn 12–24 months before the 2011 EDHS: 90.2% (3007) delivered at home, and 9.8% (327) delivered in a facility. Education, wealth status, urban residence, and number of children under 5 years living in the household were the factors most strongly associated with facility delivery. When facility delivery and its strongest correlates were entered into multivariate logistic regression models with infant immunizations as the outcome, facility delivery was significantly associated with increased likelihood of DPT‐HepB‐Hib, polio, and measles vaccination, and increased likelihood of being fully immunized (all P < 0.01). Facility delivery was the strongest single factor associated with infants being immunized, doubling the odds of full immunization.ConclusionThe impact of facility delivery on health outcomes transcends the immediate delivery and postpartum period.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135167/1/ijgo217.pd

Antimicrobial resistance and ESBL profile of Uropathogens among pregnant women at Edna Adan Hospital, Hargeisa, Somaliland

BACKGROUND: The emergence and spread of antimicrobial resistance (AMR) among uropathogens is increasing, especially in resource limited settings due to a number of reasons. The production of Extended Spectrum β-Lactamase (ESBL) by some strains of E. coli and methicillin resistant Staphylococcus species, limits the choice of antimicrobials in the treatment of urinary tract infection (UTI) globally. However, little is known about the type of uropathogenes and their current AMR profile among pregnant women in Hargeisa, Somaliland.METHODS: Clean-catch mid-stream urine samples were collected and processed for bacteriological culture and antimicrobial sensitivity testing (AST). Ceftazidime (30μg) and Cefotaxime (30μg) disks were used for ESBL screening as per CLSI guideline and each ESBL screening positive isolate were phenotypically confirmed by a combination disk test.RESULTS: Among 376 study participants, 79 (21.0%) had significant bacteriuria (SBU). Majority at 58(73.4%) of the isolates were Gram-negative. The most predominant isolate was E.coli, 36(45.6%) followed by K. pneumonea 16(20.3%) and S. aureus at 9(11.4 %). The proportion of ESBL producing isolates was 25(32.9%). Gram-negatives showed high level resistance to ampicillin, amoxicillin, cefotaxime, and cephalexin at 87%, 85%, 57%, and 52%, respectively. Previous history of UTI, monthly income, educational status and having dysuria were significantly associated with SBU (p&lt;0.05).CONCLUSION: Relatively high prevalence of uropathogens and an increased level of drug resistance were documented. Therefore, continued surveillance on the type of uropathogens and their AMR pattern is needed to ensure appropriate recommendations for the rational empirical treatment of UTI and for policy input

Reproductive health providers' willingness to provide comprehensive abortion services and knowledge of the abortion law in Addis Ababa, Ethiopia

In Ethiopia, the maternal mortality ratio is 676/100,000 live births with complications from unsafe abortion being the leading cause. The current study was conducted to assess the knowledge of reproductive health practitioners of the law governing abortion in Ethiopia, the willingness of providers to perform abortion procedures, and current comprehensive abortion care (CAC) practice patterns of physicians, midwives, and nurses at one teaching hospital in Addis Ababa, Ethiopia. All currently practicing obstetric/gynecologist faculty and residents, midwives, and nurses working on the obstetrics and gynecology ward at one public teaching hospital in Addis Ababa were invited to participate in this cross-sectional survey. A total of 50 participants completed the survey. 68% of the sample, reported being willing to provide abortion services, if offered the appropriate training. Participants who believe unsafe abortion is a large contributor to poor health of Ethiopian women are almost seven times more likely to be willing to provide CAC services, and physicians are more likely than non-physicians to report being comfortable currently providing CAC services. Obstetric and gynecological providers at St. Paul’s are supportive of providing abortion services, if they are trained in the procedure. Ensuring proper clinical training, as well as sensitization to the recent law change and the burden of unsafe abortion, is of the upmost importance to ensure Ethiopian women have access to safe abortions, as allowed by law.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151763/1/Rominski et al 2015.5 (3).pdfDescription of Rominski et al 2015.5 (3).pdf : Main articl

Correction to: Prevalence, antimicrobial susceptibility profile and predictors of asymptomatic bacteriuria among pregnant women in Adigrat General Hospital, Northern Ethiopia

Following publication of the original article [1], the authors reported that one of the authors’ names was spelled incorrectly. In this Correction the incorrect and correct author name are shown. The original publication of this article has been corrected

Prevalence, antimicrobial susceptibility profile and predictors of asymptomatic bacteriuria among pregnant women in Adigrat General Hospital, Northern Ethiopia

Abstract Objective Approach to asymptomatic bacteriuria among pregnant women in Ethiopia is mainly based on clinical grounds and urine strip and microscopy tests. On top of this, the treatment is also on an empirical basis which may leads to an increased antimicrobial resistance. The aim of this study was to assess the prevalence, antimicrobial susceptibility profile and associated factors of asymptomatic bacteriuria among pregnant women attending antenatal clinic in Adigrat Hospital, Northern Ethiopia. Results Out of 259 pregnant women included in the study, the prevalence of asymptomatic bacteriuria was at 55 (21.2%). Gram negative bacteria, specifically Escherichia coli were the predominant isolates followed by Klebsiella species and Proteus mirabilis. Of the Gram positive identified bacteria, Staphylococcus aureus was main isolate. Age of the mother (18–25 years old) with [AOR = 8.5, 95% CI (2.2, 32.9)], family income (< 1000 ETB) with [AOR = 7.5, 95% CI = (2.4, 23.1)] and gestational period at 1st trimester [AOR = 11.9, 95% CI (4.4, 32.4)] and 2nd trimester [AOR; 5.6, 95% CI (2.0, 15.5%)] were predictors significantly associated with asymptomatic bacteriuria. All Gram negative isolates were found 100% resistance to Ampicllin. Moreover, all Gram positive isolates were found sensitive to Vancomycin at 100%

Prevalence of Methicillin-Resistant Staphylococcus aureus and Associated Risk Factors among Patients with Wound Infection at Referral Hospital, Northeast Ethiopia

Background. The spectrums of infections due to methicillin-resistant Staphylococcus aureus are manifold and are associated with worse outcomes. A study on the prevalence of these pathogens and their sensitivity patterns will give updated information which is very helpful for health personnel responsible in the management of patients and timely monitoring of the emergence of resistant bacteria. Hence, the study aimed at assessing the prevalence of methicillin-resistant Staphylococcus aureus and associated factors among patients with wound infection at Dessie Referral Hospital. Method. A cross-sectional study was conducted among 266 patients at Dessie Referral Hospital from February to May 2016. Wound swab samples were collected aseptically using Levine’s technique and transported to Dessie Regional Laboratory by using brain-heart infusion transport media. Isolation of Staphylococcus aureus was done based on cultural and biochemical profiles. Drug susceptibility test was performed using the disc diffusion technique as per the standard and interpreted based on the Clinical and Laboratory Standards Institute guidelines. The data were entered and analyzed by using SPSS version 20. Result. Staphylococcus isolates from 266 processed wound swabs were 92 (34.58%). Of these, 26 (28.3%) were identified as methicillin-resistant S. aureus and 66 (71.7%) were methicillin-sensitive S. aureus. The overall prevalence of methicillin-resistant S. aureus among the study population was 9.8%. The isolated methicillin-resistant S. aureus showed full resistance to penicillin (100%) followed by erythromycin and ciprofloxacin (16, 61.5%) and cotrimoxazole and gentamicin (14, 53.8%). From the total S. aureus isolates, 20 (21.7%) of them showed multidrug resistance. Of these methicillin-resistant S. aureus, 18 (69.8%) showed high multidrug resistance. Patients who are farmers in occupation (AOR = 6.1, 95% CI (1.086–33.724)), admitted in the hospital (AOR = 3.56, 95% CI (1.429–8.857)), and have low BMI (<18.5) (AOR = 13.89, 95% CI (4.919–39.192)) were among the risk factors significantly associated with wound infection due to methicillin-resistant S. aureus. Conclusion. All methicillin-resistant S. aureus isolates were 100% resistant to penicillin and showed high multidrug resistance. Therefore, antibiotic susceptibility test should be performed prior to treatment