Bell’s palsy in pregnancy as a prodromal sign of preeclampsia: A report of three cases, pregnancy outcome, and literature review

Bell’s palsy is a less common neurological disorder in the general population. Its occurrence during pregnancy can be used as a predictor of adverse obstetric outcomes including preeclampsia and its complications. We report cases of three pregnant women from Botswana who presented with Bell’s palsy in the third trimester coexisting with preeclampsia and multiple complications. One of the patient was a case of maternal near-miss with multiple life threating complications including stage 3 acute kidney injury (AKI) and required hemodialysis. The second and third patients developed Bell`s palsy and preeclampsia at term, management of preeclampsia commenced with immediate delivery resulting in good maternal and neonatal outcome. In all the three patients preeclampsia and Bell`s palsy completely resolved post-delivery. Therefore, new onset Bell’s palsy in pregnancy may be used as a prodromal sign of preeclampsia. Such patients deserve close follow up for preeclampsia or gestational hypertension for a better obstetric outcome. La paralysie de Bell est un trouble neurologique moins fréquent dans la population générale. Son apparition pendant la grossesse peut être utilisée comme un prédicteur d'issues obstétricales défavorables, y compris la prééclampsie et ses complications. Nous rapportons les cas de trois femmes enceintes du Botswana qui ont présenté une paralysie de Bell au troisième trimestre coexistant avec une prééclampsie et de multiples complications. L'un des patients était un cas de quasi-accident maternel avec de multiples complications potentiellement mortelles, notamment une insuffisance rénale aiguë (IRA) de stade 3 et une hémodialyse nécessaire. Les deuxième et troisième patientes ont développé une paralysie de Bell et une prééclampsie à terme, la prise en charge de la prééclampsie a commencé avec l'accouchement immédiat, ce qui a donné de bons résultats maternels et néonatals. Chez les trois patientes, la prééclampsie et la paralysie de Bell ont complètement disparu après l'accouchement. Par conséquent, une nouvelle paralysie de Bell pendant la grossesse peut être utilisée comme signe prodromique de prééclampsie. Ces patientes méritent un suivi rapproché de la prééclampsie ou de l'hypertension gestationnelle pour un meilleur résultat obstétrica

Undiagnosed diabetes mellitus and associated factors among psychiatric patients receiving antipsychotic drugs at the University of Gondar Hospital, northwest Ethiopia

Background: Undiagnosed diabetes mellitus cases are at higher risk for diabetic related complications. In low-income African countries, patients with undiagnosed diabetes mellitus account for 75% of diabetes cases. Psychiatric disorders have a greater impact on the global burden of diseases and disability associated with chronic diseases like diabetes mellitus and cardiovascular diseases.Methods: Institution based cross-sectional study was conducted at the University of Gondar Hospital from February to April 2016. A total of 205 psychiatric patients aged above 15 years that were taking antipsychotic were included by the simple random sampling method. Fasting blood glucose, triglycerides and cholesterol level were determined from venous blood samples to evaluate diabetes mellitus based on WHO criteria.Results: Among 205 psychiatric patients taking antipsychotics, 15(7.3%) had undiagnosed diabetes mellitus. Duration of antipsychotic treatment and sex had a statistically significant association with the prevalence of undiagnosed diabetes mellitus. As the duration of antipsychotic drug treatment increased by one year, the risk of having a diabetes mellitus increase by 1.47 times (AOR: 1.47 CI: 1.021-2.125).Conclusion: The prevalence of undiagnosed diabetes mellitus among psychiatry patients taking antipsychotics was higher than the estimated diabetes national prevalence of Ethiopia. Screening of diabetes mellitus in particular, patients having a longer duration of antipsychotic treatment is mandatory to bring more undiagnosed cases for medical attention.Keywords: Diabetes mellitus, Psychiatric disorder, Antipsychoti

Prevalence and determinants of anemia among children aged from 6 to 59 months in Liberia: a multilevel analysis of the 2019/20 Liberia demographic and health survey data

BackgroundAnemia is a serious worldwide public health issue that happens at any stage of life but primarily affects young kids and pregnant mothers. Although anemia has a significant impact on child health, its magnitude and associated factors in children aged 6–59 months have not been yet studied in Liberia. Therefore, the aim of this study was to identify the prevalence and determinants of anemia in children aged 6–59 months in Liberia.MethodsThe data was extracted from Liberia Demographic and Health Survey, conducted from October 2019 to February 2020. The sample was obtained using a stratified two-stage cluster sampling technique. An overall weighted sample of 2,524 kids aged 6–59 months was involved in the final analysis. We used Stata version 14 software for data extraction and analysis. A multilevel logistic regression model was employed to identify factors associated with anemia. Variables with a P-value of <0.2 in the bivariable logistic regression analysis were selected as candidates for multivariable analysis. In multivariable analysis, the adjusted odds ratios (AOR) with the 95% confidence interval (CI) were declared as the determinants of anemia.ResultsThe prevalence of anemia in children aged 6–59 months in Liberia was 70.8% [95% CI: 68.9%, 72.5%]. Of these, 3.4% were severe anemia, 38.3% were moderate anemia and 29.1% were mild anemia. Children aged 6–23 and 24–42 months, being stunted, children from households with unimproved toilet facilities, children from households with unimproved water sources, and lack of media (television) exposure were significantly associated with higher odds of anemia. However, using mosquito bed nets, living in the Northwestern and Northcentral region were significantly associated with lower odds of anemia among children 6–59 months.ConclusionIn this study, anemia in kids aged 6–59 months in Liberia was a main public health issue. Age of the child, stunting, toilet facility, water source, exposure to television, mosquito bed net use, and region were significant determinants of anemia. Therefore, it is better to provide intervention for the early detection and management of stunted children. Similarly, interventions should be strengthened to address unimproved water sources, unimproved toilet facilities, and lack of media exposure

‘Mothers moving towards empowerment’ intervention to reduce stigma and improve treatment adherence in pregnant women living with HIV in Botswana: study protocol for a pragmatic clinical trial

Background With high rates of HIV and multiple vulnerable subgroups across diverse settings, there is a need for culturally based, HIV stigma reduction interventions. Pregnant women who are living with HIV are especially in need of services to protect not only their own but also their children’s lives. Uptake of HIV services worldwide is hindered by stigma towards persons living with HIV/AIDS. While cultural context plays a key role in shaping HIV stigma, these insights have not yet been fully integrated into stigma reduction strategies. By utilizing the “What Matters Most” stigma framework, we propose that an intervention to counter culturally salient aspects of HIV stigma will improve treatment adherence and other relevant outcomes. A pragmatic clinical trial in Botswana will evaluate the “Mothers Moving towards Empowerment” (MME) intervention, which seeks to address HIV stigma in Botswana and to specifically engage pregnant mothers so as to promote antiretroviral therapy (ART) adherence in the postpartum period. Methods This study will test MME against treatment as usual (TAU) among pregnant mothers diagnosed with HIV and their infants. Outcomes will be assessed during pregnancy and 16 weeks postpartum. Women who meet eligibility criteria are assigned to MME or TAU. Women assigned to MME are grouped with others with similar estimated delivery dates, completing up to eight intervention group sessions scheduled before week 36 of their pregnancies. Primary outcomes among mothers include (i) reducing self-stigma, which is hypothesized to mediate improvements in (ii) psychological outcomes (quality of life, depression and social functioning), and (iii) adherence to antenatal care and ART. We will also examine a set of follow-up infant birth outcomes (APGAR score, preterm delivery, mortality (at < 16 weeks), birth weight, vaccination record, and HIV status). Discussion Our trial will evaluate MME, a culturally based HIV stigma reduction intervention using the “What Matters Most” framework, to reduce stigma and improve treatment adherence among pregnant women and their infants. This study will help inform further refinement of MME and preparation for a future large-scale, multisite, randomized controlled trial (RCT) in Botswana. Trial registration ClinicalTrials.gov NCT03698981 . Registered on October 8, 201

Zoonotic tuberculosis in a high bovine tuberculosis burden area of Ethiopia

BackgroundTuberculosis (TB) is a major cause of ill health and one of the leading causes of death worldwide, caused by species of the Mycobacterium tuberculosis complex (MTBC), with Mycobacterium tuberculosis being the dominant pathogen in humans and Mycobacterium bovis in cattle. Zoonotic transmission of TB (zTB) to humans is frequent particularly where TB prevalence is high in cattle. In this study, we explored the prevalence of zTB in central Ethiopia, an area highly affected by bovine TB (bTB) in cattle.MethodA convenient sample of 385 patients with pulmonary tuberculosis (PTB, N = 287) and tuberculous lymphadenitis (TBLN, N = 98) were included in this cross-sectional study in central Ethiopia. Sputum and fine needle aspirate (FNA) samples were obtained from patients with PTB and TBLN, respectively, and cultures were performed using BACTEC™ MGIT™ 960. All culture positive samples were subjected to quantitative PCR (qPCR) assays, targeting IS1081, RD9 and RD4 genomic regions for detection of MTBC, M. tuberculosis and M. bovis, respectively.ResultsTwo hundred and fifty-five out of 385 sampled patients were culture positive and all were isolates identified as MTBC by being positive for the IS1081 assay. Among them, 249 (97.6%) samples had also a positive RD9 result (intact RD9 locus) and were consequently classified as M. tuberculosis. The remaining six (2.4%) isolates were RD4 deficient and thereby classified as M. bovis. Five out of these six M. bovis strains originated from PTB patients whereas one was isolated from a TBLN patient. Occupational risk and the widespread consumption of raw animal products were identified as potential sources of M. bovis infection in humans, and the isolation of M. bovis from PTB patients suggests the possibility of human-to-human transmission, particularly in patients with no known contact history with animals.ConclusionThe detected proportion of culture positive cases of 2.4% being M. bovis from this region was higher zTB rate than previously reported for the general population of Ethiopia. Patients with M. bovis infection are more likely to get less efficient TB treatment because M. bovis is inherently resistant to pyrazinamide. MTBC species identification should be performed where M. bovis is common in cattle, especially in patients who have a history of recurrence or treatment failure

Impacts of land use and land cover change on ecosystem service values in the Afroalpine area of Guna Mountain, Northwest Ethiopia

Ecosystem service changes caused by land use and land cover change (LULCC) is an important indictor and early warning of ecological changes. However, few attempts have been made to evaluate the effects of LULCC on ecosystem services in the Afroalpine highlands of Northwestern Ethiopia. Therefore, this study aimed to analyze the impacts of LULCC on ecosystem services values in the afro-alpine area of Guna Mountain, Northwestern Ethiopia. Image classification was carried out using Landsat imageries of 1995, 2008, and 2020 following Random Forest algorithm with Google Earth Engine(GEE) based on filtered sample points. A modified benefit transfer method was used to evaluate ecosystem service value (ESV) changes in response to LULCC. The results revealed that the most notable feature of LULCC in the afro-alpine area of Guna Mountain was the expansion of cropland and built-up areas at the expense of grassland, forest, and shrubland. The overall ESV of the study site was estimated at USD 46.97 × 106 in 1995, USD 36.77 × 106 in 2008, and USD 37.19 × 106 in 2020. The net ESVs of the study site declined by USD 9.78 × 106 between 1995 and 2020. The regulating service values accounted for the greatest share, accounting for over 42% in all periods, followed by provisioning and supporting service values, which accounted for over 29% and 13%, respectively, while cultural services accounted for the smallest amount of the total ESV. The ecosystem service value of food production experienced the highest increase. However, the values of the remaining 16 types of ecosystem services declined with varying degrees of reduction over the study periods. The results of this study is necessary for land-use planners and decision-makers who require site-specific information on impacts of LULCC on ecosystem service

Trend analysis of hydro-climate variables in the Jemma sub-basin of Upper Blue Nile (Abbay) Basin, Ethiopia

Article Highlights The annual precipitation of the sub-basin has shown an increasing trend. A considerable upward trend in the annual average temperature was found. The observed rainfall and temperature trends are associated with the hydro-climate trends

Routine health information use among healthcare providers in Ethiopia: a systematic review and meta-analysis

Introduction Healthcare policy formulation, programme planning, monitoring and evaluation, and healthcare service delivery as a whole are dependent on routinely generated health information in a healthcare setting. Several individual research articles on the utilisation of routine health information exist in Ethiopia; however, each of them revealed inconsistent findings.Objective The main aim of this review was to combine the magnitude of routine health information use and its determinants among healthcare providers in Ethiopia.Methods Databases and repositories such as PubMed, Global Health, Scopus, Embase, African journal online, Advanced Google Search and Google Scholar were searched from 20 to 26 August 2022.Result A total of 890 articles were searched but only 23 articles were included. A total of 8662 (96.3%) participants were included in the studies. The pooled prevalence of routine health information use was found to be 53.7% with 95% CI (47.45% to 59.95%). Training (adjusted OR (AOR)=1.56, 95% CI (1.12 to 2.18)), competency related to data management (AOR=1.94, 95% CI (1.35 to 2.8)), availability of standard guideline (AOR=1.66, 95% CI (1.38 to 1.99)), supportive supervision (AOR=2.07, 95% CI (1.55 to 2.76)) and feedback (AOR=2.20, 95% CI (1.30 to 3.71)) were significantly associated with routine health information use among healthcare providers at p value≤0.05 with 95% CI.Conclusion The use of routinely generated health information for evidence-based decision-making remains one of the most difficult problems in the health information system. The study’s reviewers suggested that the appropriate health authorities in Ethiopia invest in enhancing the skills in using routinely generated health information.PROSPERO registration number CRD42022352647

Beliefs About Body Weight and Practices of Regulating Food and Physical Exercise Patterns of Children Among Parents in Southern Ethiopia

Bewunetu Zewude,1 Getahun Siraw,2 Belayneh Melese,3 Tewodros Habtegiorgis,1 Ashenafi Hizkeal,1 Mihret Tadele1 1Department of Sociology, College of Social Sciences and Humanities, Wolaita Sodo University, Wolaita Sodo town, Ethiopia; 2Department of Sociology, College of Social Sciences and Humanities, Dilla University, Dilla town, Ethiopia; 3Department of Civics and Ethical Studies, College of Social Sciences and Humanities, Wolaita Sodo University, Wolaita Sodo town, EthiopiaCorrespondence: Bewunetu Zewude, Email [email protected]: The problem of childhood obesity is often associated with cultural values of body weight which includes the belief that voluptuous body size is a sign of good health status and better parental care. We examined the beliefs and behaviors of parents pertaining to preferred body weight of children, including practices of management of feeding and physical exercise patterns of children in southern Ethiopia.Methods: Using cross-sectional survey study design, a structured questionnaire was distributed to randomly selected parents. Quantitative data were collected from 215 respondents, inserted into SPSS software, and analyzed by frequency and percentage distributions, charts, and multinomial logistic regression techniques.Results: Most (59.1%) respondents want their child’s body weight to be normal/neither fat nor thin. In addition, 58.2% of the study participants held the opinion that average body size is an indication of good health status. Furthermore, 72.6% of respondents revealed that they control the amount of food their child consumes with the aim of preventing obesity/overweight. Moreover, 79.5% of respondents encourage their children to sometimes walk on foot, instead of always relying on vehicles while 87% of them replied that they regulate the amount of time their children spend watching TV. Above all, parents’ preference of voluptuous body size of children is significantly associated with age (OR=61.52.448, P < 0.001, 95%C.I: 57– 66.14), educational status (OR = 35.605, P < 0.001; 95%C.I: 6.050– 209.524), sex (OR = 0.237, P < 0.05; 95%C.I: 0.078-0.724) and grownup area (OR = 2.869, P < 0.05; 95%C.I: 1.062– 7.749).Conclusion: Parents not only have adequate level of awareness regarding the health risks of children’s heavy body weight but also engage in the body weight management practices of their children such as by regulating the food consumption patterns of children, encouraging them to undertake physical exercises, and by being role models while doing physical exercises for themselves.Keywords: childhood obesity, body weight, food consumption, physical exercise, regulatio