Bridging the gap in respiratory medicine: How a pulmonologist from other continent can help African children who “can’t breathe?” The story of a European professor and his African trainee

An European pediatric pulmonologist successfully organized a 2-year in-house pediatric pulmonology training with simultaneous establishment of the first pediatric pulmonary center in Ethiopia. Collaboration of the local institution with a non-governmental organization (NGO) facilitated the realization of the program. Training cost was significantly low compared to the expected out of country training, with extra financial benefit enabling purchase of equipment for the center. Our experience shows that specialists from developed countries can be instrumental to establishing cost-effective training programs and founding of specialized services in low-income countries by training subspecialists in their own setting. NGOs and leading international professional societies can support such programs to relieve the suffering of the child who “can’t breathe” because s/he is born in a low income country

Unilateral pulmonary vein atresia presenting with recurrent hemoptysis and bronchial varices in an Ethiopian adolescent: a case report

Abstract Background Congenital unilateral pulmonary vein atresia is a rare anomaly resulting from failure of the pulmonary vein to incorporate in the left atrium. It is a very rare cause of recurrent respiratory infections and hemoptysis requiring a high index of suspicion for proper diagnosis and management in early childhood. Case presentation We report a 13-year old Anuac (Ethiopia, Region of Gambela) male adolescent with a delayed diagnosis of isolated atresia of the left pulmonary veins despite early childhood presentation with recurrent chest infections, hemoptysis and exercise intolerance. Contrast enhanced CT of thorax with reconstructed planes confirmed the diagnosis. He underwent pneumonectomy for severe and recurrent symptoms and did well on subsequent follow ups after 6 months of pneumonectomy. Conclusion Although a rare anomaly, congenital unilateral pulmonary vein atresia should be considered in the differential diagnosis of a child presenting with recurrent chest infections, exercise intolerance and hemoptysis to facilitate early appropriate diagnosis and treatment

Quality of nursing care and nurses’ working environment in Ethiopia: Nurses’ and physicians’ perception

Background: Nurses play critical roles as patient advocate, regulating quality of care and improve health care values. Data are scarce regarding quality of nursing care in Ethiopia. Objective: To assess quality of nursing care and convenience of the nurse working environment to provide quality of nursing care in a tertiary hospital in Ethiopia. Methods: Data was collected prospectively using Quality of Nursing Care Questionnaires of Safford & Schlotfeldt and Practice Environment Scale of Nursing Work Index (PES-NWI). One hundred seventeen nurses and 51 physicians were included and data was analyzed using SPSS for windows version-20. Result: Four of the five PES-NWI variables had mean score less than 2.5, suggesting the nursing environment and management was unfavorable to assure quality care. All nursing care performances were low. The highest score was in nurse carryout orders (66.7%) and lowest in nurse-physician collaboration (24.8%). Conclusion: The quality of nursing care is substandard. Favorable environment and nurse physician relationship must be established to provide quality care. Keywords: Quality-nursing care, Perception, Physician, Nurse work-environment, Ethiopi

Knowledge and attitudes about genetic counseling in patients at a major hospital in Addis Ababa, Ethiopia

Previous work at St. Paul’s Hospital Millennium Medical College (SPHMMC) in Addis Ababa, Ethiopia, demonstrated a need for genetic counseling (GC) services, with 4% of pediatric, neonatal intensive care, and prenatal patients identified as having indications for genetic evaluation (Quinonez et al, 2019). The aim of this study was to investigate SPHMMC patients’ familiarity with, knowledge of, and attitudes toward GC services. Surveys were adapted from previous work in North America populations (Riesgraf et al, 2015 and Gemmell et al, 2017) and administered to 102 patients, and results were compared to North American populations using Student’s t test. 30% of respondents reported at least some familiarity with GC, primarily via the media or healthcare providers. Patients had generally positive attitudes toward GC, reporting they would trust information provided by a genetic counselor and that GC is in line with their values. Knowledge of GC showed similar trends overall when compared to results from North American populations. Our work indicates limited exposure to GC in this population, but generally positive feelings toward GC. Patients’ attitudes toward GC were comparable to rural North American populations surveyed using the same tool on most items; however, cultural differences including views on abortions and directiveness of healthcare providers could account for discrepancies and are important considerations when implementing genetic services globally.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167515/1/jgc41340_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167515/2/jgc41340.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167515/3/jgc41340-sup-0001-Supinfo.pd

Impact of COVID-19 infection on lung function and nutritional status amongst individuals with cystic fibrosis: A global cohort study

International audienceBackground: Factors associated with severe COVID-19 infection have been identified; however, the impact of infection on longer-term outcomes is unclear. The objective of this study was to examine the impact of COVID-19 infection on the trajectory of lung function and nutritional status in people with cystic fibrosis (pwCF).Methods: This is a retrospective global cohort study of pwCF who had confirmed COVID-19 infection diagnosed between January 1, 2020 and December 31, 2021. Forced expiratory volume in one second percent predicted (ppFEV 1 ) and body mass index (BMI) twelve months prior to and following a diagnosis of COVID-19 were recorded. Change in mean ppFEV 1 and BMI were compared using a t-test. A linear mixed-effects model was used to estimate change over time and to compare the rate of change before and after infection.Results: A total of 6,500 cases of COVID-19 in pwCF from 33 countries were included for analysis. The mean difference in ppFEV 1 pre-and post-infection was 1.4 %, (95 % CI 1.1, 1.7). In those not on modulators, the difference in rate of change pre-and post-infection was 1.34 %, (95 % CI -0.88, 3.56) per year (p = 0.24) and -0.74 % (-1.89, 0.41) per year (p = 0.21) for those on elexacaftor/tezacaftor/ivacaftor. No clinically significant change was noted in BMI or BMI percentile before and after COVID-19 infection.Conclusions: No clinically meaningful impact on lung function and BMI trajectory in the year following infection with COVID-19 was identified. This work highlights the ability of the global CF community to unify and address critical issues facing pwCF