Browsing by Author "Taye, Biniam ( Assistant Professor)"

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    Assessment of Focused Antenatal Care Laboratory Services Statususing Availability, Functional Status and Clients Satisfaction at Public Health Facilities Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-06) Melese, Daniel; Taye, Biniam ( Assistant Professor)
    Back ground: Laboratory service is a key component of Focused Antenatal Care (FANC) to identify life threatening conditions of maternal and child health. Limited capacity of health facilities to provide adequate laboratory services remains a major problem for the quality of FANC service delivery. Objective: To assess the status of focused antenatal care laboratory services using availability, functional status and client satisfaction at public health facilities in Addis Ababa, Ethiopia. Methods: Institution based, descriptive cross-sectional study was conducted from April to May 2015. Both quantitative and qualitative designs were used. Four hundred and twenty two study participants interviewed on satisfaction towards FANC laboratory services by using structured questionnaire. A qualitative data was collected by In-depth interview of providers. To assess availability and functionality of the FANC laboratory, observation check list was used. Data were coded and analysed by using SPSS Version 20 software. Logistic regression model was also used to examine the effect of selected variables on clients’ satisfaction with laboratory services. P-Value less than 0.05 were taken as statistically significant. Result: Only 5(38.5%) out of 13 visited health facilities reported the availability of all types of basic FANC laboratory investigations. Comparing the availability of individual tests in the study facilities, urine dipstick, urine miscopy and stool examination were available in all institutions. However, only 7 (53.8%) of the facilities reported the availability of Hepatitis B virus screening test. Rapid syphilis/RPR test was found in 10 (76.9%) facilities. All laboratory facilities had at least one or more basic FANC laboratory tests interruption more than a day within the last one year due to shortage of reagent and electric power disruption. Additional analysis of pregnant women's satisfaction toward FANC laboratory service showed, only 56.9 % (240/422) of pregnant mothers were satisfied with FANC laboratory services. Those clients who waited less than one hour to get laboratory results were six times more likely to be satisfied than those who waited more than one hours [AOR = 6.03; CI (2.86-12.67)]. Conclusion: Majority of the health facilities reported incomplete FANC laboratory investigations. Hepatitis B screening test was the lowest available test in the study facilities. Furthermore a slightly higher maternal dissatisfaction toward FANC laboratory service was observed compared with other institutional based study in similar settings
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    Comparative Performance Between Xpert Mtb/Rif Assay, Led Fluorescence Microscopy, and Zn Light Microscopy for Detection of Mycobacterium Tuberculosis In Sputum Samples in Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-05) Dejene, Daniel; Taye, Biniam ( Assistant Professor)
    Background: In Ethiopia, the main tool used to diagnosis pulmonary tuberculosis is Ziehl- Neelsen microscopy. The emergence of drug-resistant forms of tuberculosis which needs more resources to detect, to successfully treat and effectively reduce the burden is among the top challenges in the country. Tuberculosis case detection among vulnerable population groups including children, HIV positives and other high risk groups remains low due to insensitive diagnostic tools. Due to its low sensitivity, Ziehl-Neelsen microscopy does not detect all positive TB cases among TB suspects; as a result tuberculosis transmission by false negative cases increases. Therefore, there is a need to assess the incremental value of new diagnostic tool like Xpert MTB/RIF assay and Light Emitted Diode Fluorescent microscopy for tuberculosis detection in our setting. Objective of the study: To determine the performance of Xpert MTB/RIF assay in comparison with Light Emitted Diode Fluorescent microscopy and Ziehl-Neelsen smear microscopy for detection of Mycobacterium Tuberculosis in sputum samples in Addis Ababa. Methods and Materials: A prospective cross-sectional study from December, 2013 to April, 2014 was conducted in AAHRL to compare the performance of light emitting diode fluorescent microscopy (LED-FM), Xpert MTB/RIF assay and Ziehl-Neelsen(ZN) smear microscopy in the diagnosis of pulmonary tuberculosis (PTB) Adult patients. LJ culture media was used as the gold standard for sub-samples. All data was entered into an excel spreadsheet, then transfer and analyzed using SPSS version 20. Descriptive statistics was performed and data presented in tables. McNamara’s and Kappa statistics was used for proportion and the percent agreement analysis. Results: A total of 358 pulmonary tuberculosis and MDR-TB (Multi drug resistance tuberculosis) suspected patients were enrolled from December, 2013 to April, 2014 in Addis Ababa Health research and Laboratory with mainly young adults of median age 30.5. After excluding 8 samples that were invalid by Xpert MTB/RIF assay 350 samples were analyzed statistically and The percent agreement between Light Emitted Diode Fluorescent microscopy and Ziehl-Neelsen smear microscopy, Xpert MTB/RIF assay and Light Emitted Diode Fluorescent microscopy, Xpert MTB/RIF assay and Ziehl-Neelsen smear microscopy for MTB detection showed that k=75%(95%CI,67% to 81%), p<.0005, k=81.8%(95%CI, 81% to 82.6%) p<.0005 and k=72.6%(95%CI,61.6%to82.6%), p<.0005, respectively. The percent agreement of the three tests showed that there were an overall percent agreement of 87.4%, 84.6%, and 90.9% between Light Emitted Diode Fluorescent microscopy and Ziehl-Neelsen microscopy, Xpert MTB/RIF assay and Ziehl-Neelsen microscopy, and Light Emitted Diode Fluorescent microscopy and Xpert MTB/RIF assay respectively. In the sub group study the sensitivity, specificity, PPV and NPV achieved with direct Ziehl-Neelsen microscopy, Light Emitted Diode Fluorescent microscopy and Xpert MTB/RIF using culture as a gold standard in 167(47%) samples were (76.9%, 96%, 97.8% and 64%), (81.2%, 90%, 95%, 67.2%) and (89.7%, 92%, 96.3%, 86.2%) respectively. Conclusion: Xpert MTB/RIF assay has better yield than Light Emitted Diode Fluorescent smear microscopy and Ziehl-Neelsen smear microscopy with incremental yield of 12.8% and Light Emitted Diode Fluorescent smear microscopy has better yield than Ziehl-Neelsen smear microscopy with incremental yield of 4.8% therefore Xpert MTB/RIF assay is a highly accurate diagnostic tool for MTB detection, which achieves a substantial reduction in diagnostic delay With overall performance characteristics that are superior to Light Emitted Diode Fluorescent smear microscopy and Ziehl-Neelsen smear microscopy. Keywords: Light Emitting Diode Fluorescent Microscopy (LED-FM), Ziehl-Neelsen (ZN), Xpert MTB/RIF assay