Browsing by Author "Mekonen Eshete"

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    Prevalence and Determinants of Emotional and Behavioral Problems in Children with Sleep Disordered Breathing
    (Addis Ababa University, 2024-12-23) Dagmawi Geremew; Mekonen Eshete
    Background: Bilateral cleft lip is a common problem that mandates intervention. However, the surgery has a high learning curve and is technically demanding, which requires a delicate skill with an understanding of the complex three-dimensional anatomy of the lip and the nose. More recently, cleft surgery simulators have been developed and proposed as potential solutions for challenges facing cleft surgery education. Trainings using a simulator were shown to significantly improve the competence and proficiency of trainees. The first simulator-based bilateral cleft lip repair training was conducted at ALERT Hospital in Addis Ababa, Ethiopia. Weevaluated the impact and effectiveness of the training in this study. Objective: The main purpose of this study was to evaluate and assess the efficacy and impact of the first simulator-based bilateral cleft lip repair training in Ethiopia, which was conducted at ALERTHospital in Addis Ababa, Ethiopia. Methods: Asimulator-based bilateral cleft lip repair workshop was delivered to plastic and reconstructive surgery attendings and trainees in Addis Ababa, Ethiopia. Before the workshop, all participants received a supplementary video on the subject matter. A didactic lecture followed by a simulation session was delivered during the workshop. Both pre- and post-workshop, participants completed an online survey, which was entered into the Smile Train database. The data was retrieved from the Smile Train database, entered into the latest version of SPSS, and analyzed. Paired t-test was conducted to assess a statistical effect on impact and efficacy of the training. Outputs were summarized into different charts, figures and table formats. Results: A total of 18 participants (18/20) had finished the training. A significant improvement in their level of confidence after the workshop was declared. Before the training, only 38.9% had had excellent confidence. However, this figure rose to 67% after the training. Two-thirds (66.67%) of the participants strongly agreed on the training’s relevance, content, usefulness, and educational value. About 55.56% strongly believed in the training content and would irecommend the workshop to their colleague. More than three-fifths (61.11%) strongly believed the workshop covered relevant surgical contents, and two-thirds (66.67%) agreed on the realistic simulation of the workshop. The paired t-tests indicated an efficacy was changed with an adjusted mean difference (-4.39±SD 3.24 (-2.78,-5.99), p < 0.000). Conclusion and recommendations: Simulator-based bilateral cleft lip repair training is very vital for a trainee’s efficacy improvement, so we recommend such training on a larger scale. Therefore, curriculum developers and stakeholders, including non-government organizations, should consider engaging in providing simulator-based training to surgical trainees to be skilled at bilateral cleft lip repair. Keywords: Assessement, Impact, Efficacy, Simulator, Bilateral Cleft Lip Repair, Ethiopia .
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    Prevalence of Burn Injury, Patterns, and its Associated Factors among Burn Patients Attending Yekatit 12 Hospital Medical College and AaBET Hospitals. A Two-year Retrospective study
    (Addis Ababa University, 2026-01-21) Melkamu Tewabe; Soresa Abebe; Mekonen Eshete
    Background: Burn is an injury to the surface layers of the body caused by agents such as fire, scald, electricity, chemicals, sunlight, or nuclear radiation. Burn injuries remain a major health concern, especially in low-resource settings with high morbidity and mortality rates. Comprehensive burn patterns and epidemiology data in developing countries like Ethiopia are limited. Thus, this study reflects the recent patterns of burn injuries at Yekatit 12 Hospital Medical College and Addis Ababa Burn, Emergency, and Trauma hospitals in Addis Ababa. Objective: To evaluate the prevalence, patterns, and associated factors of burn injury among burn inpatients admitted at Addis Ababa Burn, Emergency, and Trauma hospital and Yekatit 12 Hospital Medical College from April 1st, 2023, to March 31st, 2025. Method: A hospital-based retrospective cross-sectional study was conducted using a stratified sampling technique. Data was gathered using a systematic checklist that was taken from the national burn patient medical record formats. EpiData version 3.1 was used to enter the data, while SPSS version 27 was used for analysis. The factors linked to burn injuries were described using logistic regressions, chi-square tests, and descriptive statistics. The results were represented using the Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) with a 95% confidence interval (CI) Results: Among trauma patients, the prevalence of burn injuries was 15.92%, with 45.3% being hospitalized. Most patients were aged<15 years (55.5%) and male (54.7%). Hot fluids/Scald (56.9%) and flame (21.9%) burns were the commonest causes, frequently affecting the upper extremities (60%). Second-degree burns (60.6%) and injuries involving <10% total body surface area (48.2%) were the most common clinical findings. By Multivariate regression analysis, burn depth (AOR=0.011 for second-degree, p<0.032) and total burned body surface area (AOR≈0 for <30%, p<0.0001) were identified as significant predictors of complications. Among 137 burn patients, 73% discharged without complications, while 14.6% had scar of contracture, 8% disability, and 4.4% mortality. Conclusion: Burn injuries unevenly affect children and are mostly caused by preventable household incidents. The extent and depth of burns significantly predict the severity of complications, indicating the need for targeted prevention programs and enhanced care capacity. These results recommend improved burn care protocols and public education to decrease the burden of burn-related morbidity
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    The Role of Genetic and Environmental Factors in the Etiology of Orofacial Clefts in the Ethiopian Population.
    (Addis Ababa Universty, 2018-05) Mekonen Eshete; Wakgari Deressa
    Background: Orofacial clefts (OFCs) are the commonest craniofacial birth defects with a worldwide birth prevalence of 1/700 live birth. It varies from 1/2500 to 1/500 births depending on the geographic origin, racial and ethnic backgrounds, and socioeconomic status. The incidence of this anomaly in Ethiopia is not known and the etiology has never been studied. We investigated the contribution of previously reported candidate genes and chromosomal loci to the risk of non-syndromic orofacial clefts (NSOFCs) in the Ethiopian population, which is important for improving the management and prevention. It is also of paramount importance in parental counseling and intervention. We investigated the role of environmental factors in the occurrence of NSOFCs in the Ethiopian population. The quality of life of children affected and their parents was also assessed. Objectives: The main objective of this study was to investigate the role of genetic and environmental factors in the etiology of NSOFCs in the Ethiopian Population Methods: We assessed the epidemiology, etiology and quality of life of those affected and the perception of their parents. The epidemiology of OFCs was assessed using the Ethiopian 2007 sensus retrived from the Federal Ministry of Health (EFMH) and the Smile Train (ST) databases. The data was collected from June 2007 to December 2013. ST is a charity organization, which supports cleft care in Ethiopia.We used data collected from November 2012 to January 2016 on maternal and child demographic data, maternal illness, medication, lifestyle and exposures. Saliva samples collected from the participants (Cases, Case mothers, controls and Control Mothers) for analysis using Oragne saliva collection kits and sponges. The collected saliva samples were sent to University of Iowa, USA for DNA processing. We collaborated with similar projects in Ghana and Nigeria to perform the genetics part of this investigation. We selected &genotyped 48 single-nucleotide polymorphisms (SNPs) on 701 non-syndromic cleft lip and or palate (NSCL/P)&163 non-syndromic cleft palate only (NSCPO) cases, 1070 unaffected relatives &1078 unrelated controls. The association of these SNPs with NSOFCs in Asian and European population was confirmed through Genome-wideassociation (GWAS)& candidate gene (CG) studies. We conducted association analyses for each population using the cleft-type cohorts described above, and a meta-analysis of the three subpopulationsThe role of environmental factors in the etiology of NSOFCS was assessed using the data collected on maternal demographic data, maternal illness, maternal medication use, lifestyle and exposure before and during pregnancy. We interviewed 359 mothers of children born with NSOFCs and 401 mothers of children born without any congeneital anomaly.We assessed the oral health related quality of life (OHRQoL) of children born with NSOFCS &the perception of their parents using the child oral health impact profile (COHIP) questionnaire. In this study 41 children born with NSOFCs and treated from December 2008 to December 2016 and equal number of parents participated. Results: We determined the incidence/prevalence of OFCs in Ethiopia using the ST database, which was collected from June 2007-December 2013. During this time 18,073 patients with cleft lip and or palate (CL/P) were operated, out of the total operated patients with OFCs 8,232 are under seven years old. The total number of live births during this period was 18,811,316. This gives an incidence of 44/100,000 live births of orofacial clefts in Ethiopia. The prevalence was estimated using the total number of Cleft patients operated from June 2007 to December 2013 (N=18,073) as a numerator and the total number of population (N= 88,703,914) in 2013 as a denominator. It is estimated to be 20/100,000 populations. We confiremed that SNPS, which were found to be associated withn the occurrence of NSOFCs in European population, were found to be associated with the occurrence of NSOFCs in our study populations. In the Ethiopian subpopulation PAX7 (rs742071, P = 0.005574,OR=1.329 and 95%CI 1.087-1.626), IRF6 (rs642961, P =0.01508;OR= 1.442; 95% CI 1.072-1.94), DYSF (rs2303596, P = 0.00231;OR= 0.6854; 95%CI 0.5371-0.8747), 8q24 (rs987525, P =0.000782; OR= 1.413; 95%CI 1.154-1.73), were found to be Nominally associated with the occurrence of NSCL/P. SNPS in NTN1 (rs8081823, P= 0.03251; OR=0.4905, 95% CI 0.216-1.114) were also found to be nominally associated with NSCPO in the Ethiopian population.The role of maternal environmental factors and diseases in the occurrence of NSOFCs was assessed and revealed that mothers who lived outside Addis Ababa during their pregnancy time had a higher risk of delivering a child with NSOFCs and mothers who gave history of threatened abortion and Bronchial Asthma were having a higher risk of delivering a child with NSOFCs. Mothers who had exposure to diagnostic X-Ray were also at higher risk of having a child with NSOFCs No significant differences were found for overall and subscales COHIP scores between the patients and their parents. The maximum overall score parents obtained on the COHIP was 186 and the patients was 190. The mean overall score of the patients and parents was 155. This indicates good OHRQoL of children born with NSOFCs. Conclusion and Recommendations: The prevalence 20/100,000 populations found in this study are lower than the previous studies done in many parts of Africa including the study done in Addis Ababa. Loci, which contributed to the occurrence of NSOFCs in European and Asian population, were found to contribute to the occurrence of NSOFCs in sub-Saharan populations (Ethiopia, Ghana and Nigeria). We found out that the affected children who received multidisciplinary cleft care had good OHRQoL and the responses of the affected children and their parents did not differ.We recommend community based prospective study to find out the true incidence of OFCs. We also recommend conducting a prospective case control study to better understand the contribution of environmental factors and the gene environment interaction in the occurrence of birth defects in general and OFCs in particular. Finally, we recommend that the child oral health impact profile (COHIP) questionnaire should be modified to fit the cultural beliefs of various populations and society around the world.