Vol 60, No 01 (2022): 60th Anniversary Regular Issue

Introduction: Determining the tuberculosis (TB) case notification rate (CNR) at Zonal and Woreda level administration is very important for programmatic management.

Methods: Routine case notifications data archived between 1 July 2014 and 30 June 2018 were extracted from the regional health management information system (HMIS) database. The CNR of all forms of TB was calculated by dividing notified cases by the total population. The proportion of extra-pulmonary TB (EPTB) and TB/HIV co-infection were calculated by dividing the number of EPTB and TB/HIV against the total notified TB cases, respectively. The regional and zonal CNR of all forms of TB, TB types and TB/HIV co-infection were plotted using line and bar graphs. The Woreda TB, EPTB, and TB/HIV co-infection rate were mapped using ArcGIS 10.3.

Results: During the four-year period, 90,248 TB cases were registered in the database. The regional annual TB CNR was 113/100,000 population. Among the total notified cases, 47.5% were EPTB which have West-East belt characteristics. Proportionally, EPTB is higher among females than males; and in rural Woreda than urban Woreda. The proportion of regional TB/HIV co-infection rate was 8%. However, it was much higher in big towns such as Dessie (21%), Gondar (20%) and Bahir Dar (16%). Many Woredas found to be hotspots of TB and TB/HIV co-infection across the study period.

Conclusion: TB and TB/HIV co-infection showed heterogeneous variation among Zones and Woredas. To better understand driving factors for TB in Amhara Region, hotspot versus cold spot ecological study is desirable.

Introduction: Syphilis is an important public health problem worldwide. Female commercial sex workers are disproportionately affected by syphilis. There is scarce data on the prevalence of syphilis among female sex workers in Ethiopia. The objective of this study was to identify the seroprevalence of syphilis and associated factors among female commercial sex workers.

Methods: Institution-based cross-sectional study was conducted in Hawassa city among 381 female Commercial sex workers from July 5 to November 25, 2018. Background data were collected using a structured questionnaire. Blood samples were collected from participants; plasma was prepared and tested for the antibody produced against T. pallidum using the syphilis test strip. Data were analyzed using SPSS version 21. A logistic regression model was used to assess factors associated with seroprevalence of syphilis.

Results: Most of the participants belong to the age group 20‒24 years; most of them were single and reside in an urban area, Seroprevalence of syphilis among female commercial sex workers was 4.2% ( 95% CI: 2.4-6.3). None of the factors assessed were significantly associated with the seroprevalence of syphilis.

Conclusions: Relatively low seroprevalence of syphilis was found in the present study requiring large-scale study to identify whether the low rate is a reflection of the global trend or program-related success involving this marginalized segment of society.

Background: Rheumatic heart disease (RHD) has remained a substantial public health challenge in low and middle-income countries. We aimed to determine the prevalence and associated factors of RHD among patients who received echocardiographic examinations.

Methods: A total of 849 patients who underwent echocardiography examinations were included in the study. Descriptive statistics and logistic regression analysis were performed.  The odds ratio with 95% confidence interval, and p-values were used to determine the presence of associations.

Results: A total of 849 cardiac disease suspected cases were included in the analysis, of which 406 (47.8%) had a definite cardiac disorder. RHD is responsible for 76(18.2%) of the total cardiovascular disorders. The prevalence of RHD was 76(9.0%) among the total study population.  The sex and age of the patients showed associations with rheumatic heart disease. The odds of having RHD among females was nearly three times that of male counterparts (AOR= 2.9, 95%CI: 1.6-5.4). Besides, the odds of having RHD among younger than 24, and from 25 to 35 was seventeen times that of respondents older than 50 years of age (AOR=17.2, 95%CI: 7.2-41.5, & AOR= 17.1, 95%CI: 7.3-40.0) respectively.  

Conclusions: One-half of the cardiac disease suspected individuals had a definite cardiac disease, and RHD accounted for 18.2% of the total cardiac diseases. Younger age and female in gender were associated with greater likelihood of having RHD. Therefore, interventions should be tailored to the magnitude of the problem; females and younger age groups should be the focus of concern.

Background: Amblyopia is a unilateral or bilateral condition which results in visual reduction whilst the eye seems to be healthy. The main purpose of this study was to determine the prevalence and etiology of amblyopia in school children.

Methods: A school based prospective cross-sectional study design was employed. A total of 1,226 school children aged between 7 and 15 years were screened. Best corrected visual acuity and detailed ophthalmic evaluation were performed in all participants. A diagnosis of amblyopia was based on a best-corrected visual acuity of 6/12 or less in one or both eyes, or a bilateral difference of at least two best- corrected visual acuity lines.

Results: Prevalence of amblyopia was 5.14 % (95% CI: 3.9%-6.4%) and the majority of them were from public schools (82.5%). There was statistical association between students from public school and amblyopia (p=0.003). A total of 44 (41.9%) children had severe amblyopia. Underlying amblyogenic causes were anisometropia (49.2%), isometropia (36.5%), sensory deprivation (11.1%) and strabismus (3.2%).

Conclusion: In this study, the prevalence of amblyopia among school children was 5.14%. Refractive error is a major risk factor for amblyopia. We found significant statistical difference in amblyopia prevalence between public and private school children.

Background: Status epilepticus is a neurological emergency which may occur in people with epilepsy. Ascertaining the incidence of status epilepticus in the community is wrought with many challenges and few reports exist in sub–Saharan Africa, a region with a high burden of epilepsy.

Objective: The aim of this study was to describe reported incidence of status epilepticus among epilepsy patients attending neurology outpatient clinic in Enugu.

Methods: This was cross-sectional study carried out in the medical out-patient clinics in Enugu Nigeria. Data were collected using a semi-structured questionnaire. Informants were patients and their caregivers. Status epilepticus defined as seizures based on International League Against Epilepsy criteria.

Results: Data of 154 patients were reviewed and analysed. A total of 56(36.4%) confirmed that they had experienced seizures that could be described as status epilepticus (males (36.3%) and females (36.5%)).  P=0.98.  About 54.5% of those with stroke and 47.9% of patients who had cluster seizures reported a history of status epilepticus. Factors that correlated with having status epilepticus were history of cluster seizures, family history of epilepsy and having no past history of seizure related admissions.

Conclusions: The reported incidence of status epilepticus among epilepsy patients attending tertiary hospital clinics in Enugu is high. Factors that may account for this includes, non-adherence, or greater seizure severity. Careful patient education will improve emergency management of epilepsy to reduce the morbidity related to epilepsy in the community.

Background: Studies on the incidence and risk factors for anastomotic leak (AL) related to gastrointestinal (GI) surgery are mainly from the developed world. Incidences of AL range from 1.0% to 41.0%, varying widely according to the site, definition, and type of GI resection. Multiple risk factors have been identified. AL typically manifests clinically around the seventh postoperative day. It increases morbidity, mortality, hospital stay and extra costs irrespective of improvements in surgical techniques.

Objective: To identify the pattern, risk factors, and mortality rate related to GI anastomotic leaks after GI resection and anastomosis. 

Methods: A retrospective descriptive study of medical records of 352 patients for ALs following GI tract resection and anastomosis at four university hospitals in Addis Ababa during January 1, 2017 to December 31, 2018 was done. Data were analyzed using SPSS version 23 package. Descriptive statistics and logistic regressions were used to analyze the data. A p-value of <0.05 was used to define statistical significance.

Results: The overall rate of AL was 9.9 %. Low preoperative serum albumin and emergency procedure had statistically significant association. The mean hospital stay was 12 days. Anastomotic leak-associated death rate was 48%.

Conclusion: In this study, most patients had elective surgeries involving the colon. Most of them developed enteroenteric ALs with longer hospital stays, and higher death rates, affirming that AL significantly increases morbidity, mortality and cost.

Background: Professional satisfaction is a key factor in delivering quality medical care. However, the level of professional satisfaction of radiologists, among others, in Ethiopia has not been assessed so far. In light of this, this study hopes to determine the Level of Professional Satisfaction in Ethiopian Radiologists.

Methods: The study is a cross-sectional survey of the level of professional satisfaction among Ethiopian practicing radiologists who have at least 2 years of experience.  We compiled the list of participants that came for the 2017 annual conference to the Radiological Society of Ethiopia (RSE) meeting and used a self-administered structured questionnaire.

Results: Eighty radiologists participated in the study of which 2/3^rd was males, and 53.9% were younger than 45yrs of age, with an overall satisfaction rate of 62.8%. Male radiologists (p = 0.01) aged 35-44 (P-value =0.02) and working in large cities outside Addis (P = 0.01), as well as radiologist in clinical practice were found to be somewhat or extremely satisfied (p= 0.03). Meanwhile, radiologists of younger age, females, and those working in small towns (p= 0.001), were more dissatisfied.  In addition, only 32% of the radiologist are either very satisfied or extremely satisfied with their monthly income which was significantly associated with the overall level of job satisfaction (p=0.001)

Conclusions: The survey demonstrated a comparable level of professional satisfaction of Ethiopian radiologists with those of other countries. Professional satisfaction is associated with work arrangement, gender, and age group in addition to years of experience, and place of work.  It was also able to determine that income has a major influence on professional satisfaction.

Background: The clinical features and endoscopic findings of dyspepsia are not well studied in Ethiopia. Dyspepsia is the predominant presentation of patients to Gastrointestinal (GI) Clinics in our country and Endoscopic findings are not routinely recommended to patients. Yet, identifying which patients need an urgent Endoscopy diagnosis is important to diagnose organic causes at an earlier stage.  This study assessed the prevalence of dyspepsia, associated factors, and clinically significant endoscopic findings and alarm symptoms in referral GI clinic in Ethiopia.

Methods: A retrospective cross-sectional record review was conducted among adults who came with complaints of dyspepsia from September 1, 2015, to August 31, 2017 at St Paul hospital millennium medical college GI clinic. SPSS version 23 was utilized for data analysis. Descriptive data are presented as frequencies and percentages for categorical variables. To see the effect of each independent variable on the outcome, binary logistic regression was used, and the strength of the association was assessed by computing odds ratio. A P value of <0.05 was considered statistically significant.

Results: From 3542 patients seen at GI clinic, dyspepsia was diagnosed in 418 i.e. in 21.6% of cases. The endoscopic diagnosis showed a high prevalence of gastric cancer of 8.8%. Functional dyspepsia was diagnosed in 15.5% and a high prevalence of non-specific Gastro-duodenitis were reported, especially in younger cases with no associated alarm symptoms. Anemia and weight loss were independent predictors for organic causes.

Conclusion: Weight loss and anemia were important predictor of gastric cancer and should alarm physicians for an early endoscopy in these patients. The study also supports to restrict upper GI endoscopy in individuals <45 years of age and no alarm symptoms.

Introduction: People are more likely to die due to biological impairment than chronological aging. Diabetes is a public health problem, whereby diagnosing proves challenging for health providers.  Likewise, the prevalence of undiagnosed diabetes in west Ethiopia is unnoticed.

Aim: To investigate the magnitude and associated factors of undiagnosed diabetes mellitus among middle aged adult urban populations in west Ethiopia.

Methods: A community based cross-sectional study was conducted from 01 March 2019 -August 2019 on 266 undiagnosed middle aged urban residents. Data was collected using questionnaires, anthropometric measurements, and biomarkers as per WHO steps. Fasting blood glucose ≥ 126mg/dl in the morning was taken as diabetes and FBS>100-125mg/dl, pre-diabetes (impaired FBS). SPSS version 24 multivariable logistic regression analysis was applied, and associated factors were considered statistically significant at 95%CI with p <0.05.

Results: The overall magnitude of newly diagnosed raised fasting blood sugar was 7.14% among urban residents in west Ethiopia. Of this, 2.25% was had diabetes and the remaining 4.89 % was pre-diabetes. Having a sleep disorder, sedentary lifestyle, increased: waist circumference, waist to height ratio, BMI, triglycerides, and blood pressure were significantly associated with elevated fasting blood glucose. On multivariable logistic analysis, having a high BMI and elevated blood pressure were four (AOR: 4.87; p=0.049), and five (AOR: 5.22; p=0.005) times more associated with diabetes mellitus, respectively. Sleep apnea (p=0.023) was also shown to have significant association with diabetes.

Conclusions: This study revealed undiagnosed diabetes was prevalent and associated to common risk factors in west Ethiopia. Therefore, age targeted community-based education and early detection are significant to reduce its burden.