Factors associated with treatment delay among newly diagnosed tuberculosis patients in Dessie city and surroundings, Northern Central Ethiopia: a cross-sectional study

Abstract Background Delayed treatment of tuberculosis (TB) cases increases the risk of death and rate of infection in the community. Early diagnosis and initiation of treatment is essential for effective TB control. The aim of this study was to assess length of delays and analyze predictors of treatment delay of newly diagnosed TB patients. Methods A cross-sectional study was conducted in Dessie city and surroundings from April1, 2016 to January 30, 2017. Fifteen health facilities of study area were selected randomly and 382 adult TB patients were included consecutively. Data were collected using a questionnaire and analyzed using SPSS version 20.0. Delay was analyzed at three levels (patient, health system and total) using median as cut-off. Logistic regression analysis was performed to investigate predictors of delays. A p-value of ≤0.05 at multivariate analysis was considered statistically significant. Results The median total, patients’ and health system’s delay was 36 [interquartile range (IQR): 24, 64], 30 (IQR: 15, 60) and 6 (IQR: 4, 8) days, respectively. About 41 and 47% of patients had prolonged patients’ and total delay, respectively. Practicing self-medication [adjusted odds ratio (AOR): 3.0; 95% CI: 1.3–5.6], having more than three family member in the household (AOR: 1.6; 95% CI: 1.02–2.50), older age (≥55 years) (AOR: 2.7; 95% CI: 1.27–5.83), being smear negative pulmonary tuberculosis (AOR: 2.3; 95% CI: 1.25–4.21) and extrapulmonary tuberculosis (AOR: 2.3; 95% CI: 1.28–4.07) were independent predictors of patients’ delay. Initial visit of general practitioners (AOR: 2.57; 95% CI: 1.43–4.63) and more than one health care visit (AOR: 2.12; 95% CI: 1.30–3.46) were independent predictors of health system’s delay. However, patients’ delay was shorter among widowed/divorced patients (AOR: 0.3; 95% CI: 0.1–0.8). Lower level of education [illiterate (AOR: 0.42; 95% CI: 0.20–0.92), grade 1–8 (AOR: 0.38; 95% CI: 0.18–0.81)] and diagnosis of TB using a chest X-ray (AOR, 0.32; 95% CI, 0.16–0.68) significantly reduce health system’s delay. Conclusion About half of TB patients delayed beyond 36 days before starting treatment, and the late patient health seeking behavior was the major contributor of total delay. Development and implementation of strategies aimed at addressing identified factors should be recognized in order to reduce TB treatment delay. Further well designed research is needed to explore additional risk factors of delayed treatment

Seroprevalence and associated risk factors of hepatitis B virus among pregnant women in southern Ethiopia: a hospital-based cross-sectional study

OBJECTIVES: Hepatitis B virus (HBV) is a major blood-borne and sexually transmitted infectious agent that is a significant global public health issue. The aim of this study was to determine the seroprevalence and risk factors of HBV among pregnant women attending the antenatal clinic of the Hawassa University referral hospital in Ethiopia. METHODS: A cross-sectional study was conducted from April to May, 2015. A total of 269 consecutive pregnant women attending antenatal consultations were enrolled. Sociodemographic information and data regarding possible risk factors were collected using a structured questionnaire. Hepatitis B surface antigen (HBsAg) screening was performed using an enzyme-linked immunosorbent assay, and the data were analyzed. RESULTS: The overall seroprevalence of HBsAg among the 269 participants enrolled in the study was 7.8% (n=21). The prevalence of human immunodeficiency virus (HIV) infection was 5.2% (n=14), of whom two participants (14.2%) were also positive for HBsAg. Study participants with no formal education (odds ratio [OR], 3.68; 95% confidence interval [CI], 1.27 to 10.68; p<0.05) were more likely to be infected with HBV than those who had completed at least secondary school. Although HBsAg was detected more often in pregnant women who had multiple exposure factors (8.8%, n=13) than in pregnant women who had not experienced possible risk factors (4%, n=1), this difference was not statistically significant (OR, 2.33; 95%CI, 0.29 to 18.63). CONCLUSIONS: A high prevalence of HBV infection was detected in the study population. Neither the type of risk factors nor exposure to multiple risk factors was significantly associated with HBV infection. Hence, screening pregnant women regardless of risk factors and improving awareness of the transmission routes of HBV within this group may reduce the risk of HBV infections

Seroprevalence and Associated Factors of Human Immunodeficiency Virus, Treponema pallidum, Hepatitis B Virus, and Hepatitis C Virus among Female Sex Workers in Dessie City, Northeast Ethiopia

Introduction. Sexually transmitted infections (STIs) are prevalent in Ethiopia and elsewhere among different population groups particularly among female sex workers (FSWs). Because of their work and their behavior, FSWs are at high risk to acquire STIs. The aim of the study was to assess the seroprevalence and associated factors of HIV, HBV, HCV, and T. pallidum among FSWs in Dessie City, Northeast Ethiopia. Methods. This cross-sectional study was conducted in Dessie City, Amhara Region, Northeastern Ethiopia, from November 2017 to April 2018. A total of 360 FSWs whose age is greater than or equal to 18 years and who are willing to participate were recruited by simple random sampling technique. Interview-based questionnaire was administered, and 5 ml of venous blood from each participant was drawn under aseptic conditions. The rapid test was performed to obtain the result of the four STIs (HIV, T. pallidum, HBV, and HCV). The collected data were entered and analyzed by SPSS version 20.0. From the bivariable analysis, variables having P value < 0.2 were retained into multivariable analysis. From the multivariable analysis, variables with P value < 0.05 were affirmed as statistically associated factors. Adjusted odds ratios and their 95% confidence intervals were used as indicators of the strength of association. Results. Majority of study participants were urban dwellers, 10 (2.8%) respondents were married, 61 (16.9%) have more than two children, and more than half of them were at the age range between 18 and 27 years. Any infection with STIs was 84 (23.3%), whereas 27 (7.5%), 47 (13.1%), 2 (0.6%), and 45 (12.5%) study participants were positive for laboratory test of HIV, HBV, HCV, and T. pallidum, respectively. Marital status, sharing of sharp materials, breakage of condom, number of customers per week, genital discharge, and pain had significant association with any STI. Conclusions. In comparison with different research works in Ethiopia and abroad, the prevalence of any STI, HIV, HBV, and T. pallidum was found to be relatively high. Preventive approach and appropriate treatment of STIs should be developed. Concerned body should work together to alleviate the problem by counseling and recruiting them on other productive job sectors in the country

Assessment of Extrapulmonary Tuberculosis Using Gene Xpert MTB/RIF Assay and Fluorescent Microscopy and Its Risk Factors at Dessie Referral Hospital, Northeast Ethiopia

Background. Tuberculosis is a major public health problem and extrapulmonary tuberculosis (EPTB) accounts for a significant proportion of tuberculosis cases worldwide. Objective. To determine the magnitude of EPTB, associated risk factors, and agreement of diagnostic techniques at Dessie Referral Hospital. Methods. A cross-sectional study was conducted on consecutive presumptive EPTB cases from March 1 to June 30, 2017. Sociodemographic characteristics and other variables were collected using a structured questionnaire. Clinical specimens were collected and processed using fluorescent microscopy and Gene Xpert assay. Data was analyzed using SPSS version 20. Chi-square test and logistic regression were done and a P value of ≤0.05 was taken as statistically significant. Results. From a total of 353 presumptive EPTB cases the overall prevalence of Gene Xpert assay and smear confirmed patients was 8.8% and 2.5%, respectively. Tuberculosis lymphadenitis was the predominant (33.3%) type followed by pleural (11.9%) and peritoneal (6.7%) tuberculosis. Previous history of pulmonary tuberculosis was significantly associated with extrapulmonary infection (AOR:2.8; 95%CI: 1.05-7.54; p=0.04); however, other variables such as age, residence, sex, marital status, occupation, level of education, and monthly income did not show any association. Conclusion. High proportions (71%) of Gene Xpert assay confirmed EPTB patients were smear-negative. Sensitivity of microscopy should be enhanced in resource limited countries like Ethiopia where Gene Xpert machine is not easily accessible

Prevalence of intestinal parasitic infection among children under 5 years of age at Dessie Referral Hospital: cross sectional study

Abstract Objective Intestinal parasitic infection is a serious public health problem throughout the world particularly in developing countries. Like other countries in sub saran region epidemiological data regarding prevalence of intestinal parasites and their associated factors were limited in Ethiopia. So, the main objective of this study was to determine the prevalence of intestinal parasites and associated factors among under five children in Dessie Referral Hospital from August 1, 2017 to December 20, 2017. Results In this research a total of 232 under five children were involved. Out of these study subjects 36 (15.5%) were infected with at least one intestinal parasites. A total of five intestinal parasites were examined and the dominant parasite was E. histolytica 15/232 (6.5%) followed by H. nana 11/232 (4.7%). All age groups were affected by intestinal parasites but children who were at the age of below 2 years and at the age between 2 and 3 years were 4.7 times and 2.6 times at risk of acquiring infection with intestinal parasites in comparison at the age of 3–5 years children