Browsing by Author "Atnafu Abay"

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    Combined Use of Cytopathological Diagnosis with Molecular Tests Performed on Concentrated Fine Needle Aspirate Samples to Improve the Lab Diagnosis for Tuberculous Lymphadenitis Suspected Patients
    (Addis Abeba University, 2021-09) Atnafu Abay; Desta Kassu; Araya Shamble ; Bobosha Kidist; Wassie Liya
    Background: Tuberculosis lymphadenitis (TBLN) is a granulomatous infection of lymph nodes and the most frequent form of extra pulmonary Tuberculosis in Ethiopia. Issues arising in thecytopathological diagnosis of TBLN suspected patients include the inconclusive result and lackof easily accessible diagnostic tests. In both instances, considerable consequences are observedconcerning clinical management, economical perspective, and time. The fate of TBLN suspectedpatients with an inconclusive cytopathological result will be either taking other antibiotics or beon anti-TB treatment empirically. Though both approaches are targeted towards the benefit of thepatient, they may either lead to inappropriate treatment outcome or cause the patient to suffermore from the disease. This is mainly resulted in due to lack of concrete affirmative laboratorydiagnostic tools that support the cytopathological diagnostic method. Objective: To investigate the combined use of cytopathological diagnosis with molecular testsperformed on concentrated FNA sample in the detection of TBLN cases. Methods: A cross sectional study was conducted at ALERT Hospital and the Lab work wasperformed at AHRI, Addis Ababa from Sept 2020 – April 2021. Using consecutive samplingtechnique, 96 participants suspected of having TBLN were enrolled in this study. The sensitivity,specificity, positive and negative predictive values including their 95% confidence intervals (CI)was calculated by using the culture results as the "gold standard". Cohen’s Kappa value was usedto measure interrater variability and level of agreement. All statistical tests were consideredsignificant when having a two-sided P-value of <0.05. Result: Out of the 96 participant, ZN, AO, Cytopathology, Xpert, RT PCR and LJ cultureprevailed 12 (12.5%), 27 (28.1%), 51 (53.1%), 43 (44.7%), 51 (53.1%), 36 (37.5%) positiveresult respectively. The sensitivity of Xpert, RT PCR, and FNAC were 91.7%, 97.2%, and97.2%, and the specificity were 83.3%, 73.3%, and 68.3% respectively. GeneXpert and RT PCRwhen combined with Cytology detected 61 (63.5%) positive and culture being gold standard, thesensitivity reached 100% while the specificity drops to 58.3%. Conclusion: Combination of molecular test, performed on concentrated sample, withcytopathology shown increased sensitivity, particularly geneXpert with FNAC provides anelevating alternative in case detection rate of Tubercular lymphadenitis patients with improved specificity. It also providesaffirmative results and hence aid in alleviating issues withinconclusive results.
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    Factors Affecting Channel Conflict in Multi-dimensional Distribution System of Total Automotive Lubricants in Addis Ababa Market
    (Addis Ababa University, 2019-06) Atnafu Abay; Workneh Kassa
    One of the most effective ways to achieve a sustainable competitive advantage is through implementing an effective marketing channel strategy. It is perhaps the most complex and demanding of all marketing mix alternatives in distribution system. To the contrary conflict is considered inevitable in the distribution system because of conflicting goals and other incompatibilities between distributions members. Channel Conflicts arising from goal incompatibility, ambiguous roles and perception difference and communication barriers are mainly due to change in construct of trust between the channel members. The purpose of this study is to assess the impact of change due to construct of trust on channel conflict within multi-dimensional distribution channel of TOTAL automotive lubricants in Addis Ababa market. The study applied an explanatory research design and quantitative approach with a sample size of 305 respondents selected out of population of 757.The findings indicated that variables such as goal incompatibility; roll ambiguity and perception difference have significant positive impact on channel conflict in multi-dimensional distribution channel of automotive lubricants markets in Addis Ababa. The finding also revealed that the relationship between communication barriers and dependence of intermediaries on company has positive but week impact for the contribution of channel conflict. The result of regression analysis showed goal incompatibility, roll ambiguity, and perception difference were significant predictors of channel conflict. The researcher recommends therefore, since the model could only explain 48.6% in variance of the channel conflict within the distribution channel of TOTAL automotive lubricant market in Addis Ababa and hence further study has to be carried out comprising of other factors which were not part of model of this research. It is recommended that the company should focus on insuring the compatibility of goals of the company and its distributors work on reduction of roll ambiguity, perception deference, communication barriers to avoid or reduce channel conflict in automotive lubricant market.