Immunological Markers and Hematological Parameters among Newly Diagnosed Tuberculosis Patients at Jimma University Specialized Hospital

Background: Tuberculosis (TB) is a cause of 1.2-1.5 million deaths worldwide, including deaths from TB among HIV positive people. Determining the extent of immune cells belonging to cell mediated immunity and haematological parameters is critical to maximize the potential benefit of anti-tubercular treatment and case management.Meterials and Methods: Comparative cross sectional study was conducted to determine the white blood cell (WBC) count, CD4, CD8, haemoglobin (Hgb), red blood cell (RBC) count, mean corpuscular haemoglobin (MCHC), mean corpuscular volume (MCV) between newly diagnosed TB patients and apparently healthy controls (HCs).Results: From consecutively enrolled 108 TB patients, pulmonary TB (PTB) accounted for 48(44.4%), TB lymphadenitis accounted for 48(44.4%), and disseminated/miliary TB accounted for 12(11.1%). Analysis of variance revealed that mean + SD of CD4 count of male TB patients (650 + 224cells/μl) was significantly lower than male control group (883 + 256 cells/μl) (p= 0.001). In a similar manner, the mean CD4 count of female TB patients (793 + 332cells/μl) was lower than female control group (975 + 300 cells/μl) (p=0.001). There was no statistically significant difference in CD8 counts between cases and controls for both genders. Forty (37.0%) TB patients had developed anaemia of whom 22(55%) were among PTB, 13(32.5%) from tuberculous lymphadenitis and 5(20%) from disseminated TB. Morphologically, from all anaemia among TB patients, normocytic normochromic anaemia accounted for 15(37.5%) followed by normocytic hypochromic anaemia 13(30.4%).Conclusion: CD4 lymphopenia was significant among TB patients. Granulocyte count was increased. Mild anaemia was found major haematological abnormality among newly diagnosed TB patients.Keywords: Tuberculosis, CD4 count, CD8 count, anaemia, haemoglobi

Bacterial Profile and Antimicrobial Susceptibility Pattern of Isolates Among Burn Patients at Yekatit 12 Hospital Burn Center, Addis Ababa, Ethiopia

Background: Infection is a common cause of morbidity and mortality in burn patients. Clinical diagnosis of bacteremia and/or sepsis in burn patients is difficult for a number of reasons. It could be symptomatic and/or asymptomatic as a result of immune deficiency secondary to thermal injury.Methods: A cross sectional study was conducted at Yekatit 12 Hospital Burn Center. Blood specimen and wound swab were collected from burn patients and were cultured by conventional method. Sensitivity/susceptibility pattern of the isolates was determined by disc diffusion method. Some of the risk factors of bacteremia like prior antibiotic use and total body surface area burn were also determined.Results: Fifty patients were enrolled in the study of whom 21(42%) were found bacteremic. Five different bacteria were isolated from blood specimen. Coagulase negative Staphylococci, 9(42.8%), S. aureus, 8(38.2%), Bacillus spps, 2(9.52%), K. pneumoniae, 1(4.8%), and P. aeruginosa, 1(4.8%), were frequent isolates. From wound swab, S. aureus, (34.04%), and P. aeruginosa, (31.8%), were predominant. Antimicrobial resistance was observed for Ampicillin, (77.4%), Doxycycline, (74.0), Nalidixic acid, (70.5%), Penicillin G, (68.2%), and tetracycline, (67.5%). Total body surface area of burn ≥ 15% was found as a risk factor for bacteremia.Conclusion: Bacteremia was detected at a rate of 42% among burn patients. Frequent isolates were S. aureus, (34.04%), and P. aeruginosa, (31.8%). About 82.16% of the isolates showed multiple resistances. In light of our findings, regular antibiotic resistance test has to be done for each patient in order to select an appropriate antimicrobial agent.Keywords: Bacteraemia, Burn, Sepsis, Thermal injur

Survey of Safety Practices among Hospital Laboratories in Oromia Regional State, Ethiopia

Background: Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia.Method: Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct 2011- Feb 2012. Self-administered structured questionnaire and observation checklists were used for data collection. The respondents were heads of the laboratories, senior technicians, and safety officers. The questionnaire addressed biosafety label, microbial hazards, chemical hazards, physical/mechanical hazards, personal protective equipment, first aid kits and waste disposal system. The data was analyzed using descriptive analysis with SPSS version16 statistical software.Result: All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. There were higher risks of microbial, chemical and physical/mechanical hazards.Conclusion: Laboratory safety in public hospitals of Oromia Regional State is below the standard. The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories.Keywords: laboratory safety, district hospital, Oromia Regio

Health-Related Quality of Life Among Myocardial Infarction Survivors: Structural Equation Modeling Approach

Helen Lamesgin Endalew,1 Bikis Liyew,2 Tilahun Kassew,3 Gebrekidan Ewnetu Tarekegn,4 Ambaye Dejen Tilahun,2 Tesfa Sewunet Alamneh4 1Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 4Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Bikis LiyewDepartment of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O.Box 196, Gondar, EthiopiaTel +251932731964Email [email protected]: Myocardial infarction is the fifth leading causes of disability-adjusted life years in low-income countries including Ethiopia. The aim of this study was to construct a hypothetical model to determine the factors affecting the health-related quality of life of myocardial infarction survivors at the cardiac center Ethiopia.Methods: A cross-sectional study design was employed, and 421 myocardial infarction patients were enrolled through consecutive sampling technique from the outpatient clinic at the cardiac center of Ethiopia. The World Health Organization Quality of Life-BREF-26 tool was used to assess the problem. It consists of four domains such as physical, psychological, social relationships, and environmental health domains. The structural equation modeling (SEM) analysis was employed using STATA-14 software to examine the relationship between various exogenous and endogenous or mediating variables with overall quality of life.Results: Psychological, physical, environmental health domains and sex had significant association with health-related quality of life (β=0.708, p< 0.001, β= 0.237, p=0.046, β=0.242, p=0.020, and β=0.189, p=0.017, respectively), whereas age had direct, negative association with health-related quality of life (β=− 0.007, p=0.026). Residence and level of education were not directly associated with health-related quality of life. Residence indirectly, negatively influenced health-related quality of life (β= − 0.379, p< 0.001). On the other hand, level of education indirectly, positively affects health-related quality of life (β=i0.133, p< 0.001).Conclusion: Psychological health factors had the most substantial causal effect on health-related quality of life, which was larger than the causal effects of physical and environmental health-related factors. Developing and providing comprehensive interventions are necessary to assess and manage psychological, physical, and environmental health factors and to improve the quality of life in myocardial infarction patients.Keywords: health-related quality of life, myocardial infarction, structural equation model, Ethiopi