Browsing by Author "Tsegaye, Aster(MSc, PhD)"

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    Assessment of Blood and Blood Component Utilization in Black Lion Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2011-06) Tamene, Melaku; Tsegaye, Aster(MSc, PhD); Birhanu, Asaye( BSc, MSc ); Taye, Benyam(BSc, MPH)
    Background: Assessment of blood and blood components utilization is an important tool to reduce inappropriate transfusions and helps to show the frequency of blood and blood component utilization, recipient status by pre- and post- transfusion assessments in addition improved and not improved after transfusion. However in Ethiopia the regular audit and assessment of the transfusion practice is not well studied. Objective: To assess utilization of blood and blood components for transfusion at Black Lion Specialized Hospital, Addis Ababa Ethiopia. Methods: A one year (September 2009 to August 2010) hospital based retrospective study was conducted to analyze the pattern of blood component utilization in Black Lion Specialized Hospital blood transfusion service effected from October 2010 to January 2011.There were about 4,570 transfusion episodes and 10,836 units of blood were transfused. Using estimation of single population proportion formula and systematic random sampling we selected 373 subjects and collected information from the existing blood bank log book on ABO and RH blood group, amount of transfusion episodes, and type of blood administered. In addition, data on sex, age, profession, level of education and department of the health worker, type of blood component, and amount of unit administered, prevalence of unexpected reaction, pre- and post transfusion examinations including improvement status. Data was analyzed for descriptive statistics, univariate and multivariate analysis using SPSS version 15.0 software (SPSS INC Chicago IL, USA). Results: - Of 361 transfused study subjects 856 units of blood were transfused with the mean of 2.37 units. Of the transfused 188(52.1%) were Females. The most widely used blood and blood component type in this study was whole blood 307 (85%) and the combination of two blood products were given to 27(7.5%). Plasma was transfused only for single patient (0.3%). There were no transfusion reactions after transfusion. Out of the total none improved cases, 45(66.2%) were those transfused with whole blood transfusion. The proportion of improvement after transfusion according to service ranged from 69.0% to 100%. When 95% CI for the adjusted odds ratios were calculated among these variables, significant associations were found between the overall improvement statuses of the patient with their profession of the health worker ordered the transfusion and type of blood and blood product administered. Conclusion: - The overall utilization of blood and blood components were similar to other developing countries. However, transfusion of blood components was very low and there were high rate of whole blood transfusion. The prevalence rate of patient improvement status after transfusion was high.
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    Assessment of Factors Affecting Quality of Clinical Laboratory Service in Health Facilities at South West Shewa Zone, Oromia, Ethiopia.
    (Addis Abeba University, 2021-01) Wakuma, Tamirat; Hassen, Fatuma(MPH, PhD Candidate); Molla, Habtamu(MSc, PhD candidate); Tsegaye, Aster(MSc, PhD)
    Background: A quality medical laboratory service is an important part of the health care system. Commitment of the health personnel, administration and policy makers contribute to the continuous improvement of diagnosis. In developing countries like Ethiopia, the laboratory quality system remains weak due to several factors. Therefore, assessing the factors affecting quality of medical laboratory service is highly important in order to improve service quality. Objective: To assess factors affecting the quality of medical laboratory service in South West Shewa Zone Health Facilities, Oromia, Ethiopia, January 2020 to May 2020. Methods: An institution based cross-sectional study was conducted at South West Shewa Zone Health Facilities from January 2020 to May 2020. A pretested, structured questionnaire and checklist was used to collect the socio-demographic information of the study participants and to assess factors affecting the provision of quality medical laboratory services. Data were checked for completeness, entered, and analyzed using SPSS version 24. The strength of association between the dependent and independent variables was assessed using binary and multiple logistic regression analysis. A p-value < 0.05 was considered statistically significant. Results: A total of 85 medical laboratory professionals participated in the study. Of these, 68 (80%) were males and 27 (31.8%), were laboratory technologists. Of them 78 (91.8%) were not satisfied with their salary. Thirty-two (37.6%) of the participants reported that their laboratory did not provide quality laboratory service. Lack of Quality Manual, Lack of staff recognition and not conducting Internal Quality control activitieswere the major factors significantly associated with poor quality laboratory service (p < 0.05).High work load was identified as the highest technical factor influenced the provision of quality laboratory services 56.1%, followed by Equipment Failure 20% and from administrative factors shortage of resources was rated highest 39% followed by poor staff commitment 23.4%. Conclusions:More thanOne third of the study participants reported that their laboratory did not provide quality laboratory services. Lack of quality manual, not conducting internal quality control activities and Lack of staff recognitionare the major factors associated with poor quality of laboratory services. Hence timely intervention of these factors is warranted since a third of the participants believe their laboratory does not provide quality service.
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    Assessment of Knowledge, Attitude, Practice and Associated Factors towards Occupational Health and Safety among Medical Laboratory Professionals in Selected Government Health Centers in Addis Ababa.
    (Addis Abeba University, 2021-03) Habte, Walensu; Tsegaye, Aster(MSc, PhD); Nigatu, Alemayehu(MSc,MPH)
    Background:Current knowledge of laboratory workforce on safe working environment leaves much space for improvement and need to be explored further. Common laboratory risks and hazards are numerous but can be minimized with better knowledge, attitude and simple safe working practices. Worker absence due to Work related injuries is an important phenomenon across all countries, industries, and occupations. Objective: To assess knowledge, attitude, practice and associated factors towards occupational health and safety among medical laboratory professionals in selected government health centers in Addis Ababa from January to May 2020. Methods:A cross sectional study wasconducted between January to May 2020 among 333 MLPs working in selected government health centers in Addis Ababa. Data was collected using selfadministered structured questionnaire; it is also supported by in-depth interview andphysical observation checklist. Data entry, analysis was performed by SPSS version 23 software. Level of statistical significance was set at p<0.05 Results: Of the 333 participants, 171(51.4%) were female. The participant’s age ranged between 20 and 50 years. The mean knowledge score of respondents was 4.76 ± (SD 1.19) and according to this evaluation 112(33.6%) MLPs were categorized as having high level of knowledge, 161(48.3%) moderate level and 60(18%) had low level of knowledge on occupational health & safety (OHS). Mean attitude score was 17.95± (SD 3.32) and mean practice score was 26.83 ± (SD 5.64). There were strong association between training on bio-safety, work experience, marital status, monthly income, risk assessment training and knowledge score (p<0.001). Likewise, orientation on OHS (p<0.009) and risk assessment training (p<0.049) was significantly associated with attitude score .In addition, work experience (p<0.001), training on OHS (p<0.001)and risk assessment (p<0.004), monthly income (p<0.022), educational level (p<0.024) and orientation (p<0.037)were significantly associated with practice score of laboratory professionals. Conclusion: Orientation on OHSissue during first employment, Training on OHS or Bio-Safety training and risk assessment training should be given for MLPs to boost as well as get better their knowledge and practice on occupational health and safety at working environment.
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    Assessment of Platelet to Lymphocyte ratio and Neutrophil to Lymphocyte ratio as potential biomarkers in patients with rheumatoid arthritis at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2019-11) Abate, Senait; Tsegaye, Aster(MSc, PhD); Hagos, Afework(MD, Internist, Hematologist)
    Background: Rheumatoid Arthritis (RA) is a chronic, systemic autoimmune disease involving inflammation of synovial joints. The interest in the study of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio( NLR) has grown recently because they have been found to be predictive of the prognosis of patients with diverse inflammatory and ischemic conditions and these ratios are easily calculated from hematology analyzer printout. However, in Ethiopia no published study is available in this regard. Objective: This study aimed to assess platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) as potential biomarkers in patients with rheumatoid arthritis at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia from April-July, 2019. Method: This comparative cross-sectional study enrolled 61 newly diagnosed adult rheumatoid arthritis patients and 61 sex and age matched healthy controls. Blood sample was collected from all study participants using convenient sampling technique. CBC was measured using Mindray BC5300 hematology analyzer and BD sedintainer was used for ESR measurement, while RF and CRP were done based on latex agglutination method. Data analysis was done using SPSS version 20. Level of significance between groups was analyzed using independent student t-test and Mann-Whitney U test. Receiver operating characteristic (ROC) curves was used to evaluate the performance of PLR and NLR. P values less than 0.05 was taken as statistically significant. Result: The median PLR and NLR were significantly increased in RA patients compared with healthy controls 195(IQR, 150-242) vs 125(105-150), P<0.05; 2.4(1.85-3.5) vs. 1.6(1.3-1.9), P<0.05 respectively). ROC curves analysis showed that PLR had area under the curve(AUC) of 0.859 with 85.2% sensitivity and 66% specificity as a marker of rheumatoid arthritis and NLR had AUC of 0.80 with sensitivity and specificity of 78.3% and 68% respectively. Conclusion: There was a statistically significant increment in the level of Platelet to lymphocyte ratio and Neutrophil to lymphocyte ratio among new RA patients compared with healthy controls. In addition ROC curves analysis revealed a good diagnostic performance. Therefore, PLR and NLR can be added to routine diagnostic parameters as indicators in the assessment of rheumatoid arthritis patients. So, further studies with larger numbers of RA cases is needed to better understand the role of PLR and NLR in patients with RA.
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    Assessment of Quality Management System Implementation and its Associated Factors in Public Hospitals of Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-03) Amenu, Senbeto; Tsegaye, Aster(MSc, PhD); Nigatu, Alemayehu(MSc,MPH)
    Background: A Quality Management System is the organizational structure, processes, procedures, and resources needed to implement, maintain and continually improve the management of quality. The federal ministry of health of Ethiopia has chosen quality management system (QMS) as a comprehensive and applied strategy to achieve administrative development and improve the quality of health care services including the medical laboratory in order to respond to the needs and expectations of the clients on quality of services provided for them. Objective: To assess current implementation status of quality management system and its determinant factors in public hospitals of Addis Ababa Ethiopia, from February to August 2020. Methods: The study was used cross-sectional study design. It also used both quantitative and qualitative data to assess the implementation status of QMS and associated factors in all public hospitals in Addis Ababa Ethiopia. Data was entered and analyzed by SPSS version 23. Binary and Multivariable logistic regression analysis was done to identify predictive factors. Results: The outcome of this study shows that the implementation status of quality management system of public hospitals found in Addis Ababa was 56.7% and also indicates that implementation was better in specialized hospitals based on professional’s perception. Five variables found significantly associated with QMS in hospitals(p<0.05) were presence of hospital quality mission, availability of established and functional quality committee, presence of specified budget for quality improvement, perceived significance of quality by professionals and presence of well aware professionals on quality management system. Conclusion and Recommendation: This study found that the current quality management implementation status was found 56.7% based on perception of professionals. The quality management was more successfully implemented in specialized hospitals than general hospitals. The hospital management should focus on the quality mission of the hospital and the significance of QMS, allocate specified budget for quality improvement activities, strengthening quality committees to accomplish the QMS implementation.
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    Comparison of Microhematocrit Methods (Commercial versus Window Clay Sealant) and Automated Hematology Analyzer (Sysmex XT-4000i) for Determination of Hematocrit and Mean Cell Volume (MCV) at Tikur Anbessa Specialized hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2019-10) Birhanu, Haymanot; Tsegaye, Aster(MSc, PhD); Negash, Mikiyas(MSc, PhD Fellow)
    Background: Due to several sources of imprecision and inaccuracy of HCT and RBC Indices measurement in manual and automated methods difference in values may impact the clinical decision. Therefore, it would be essential to compare the three methods. Objective: To compare of Microhematocrit (Manual) Methods and Automated Hematology Analyzer (Sysmex XT-4000i) for determination of Hematocrit and Mean Cell Volume at Tikur Anbessa Specialized Hospital, Addis Ababa. Method: A hospital based comparative cross-sectional study was conducted in Tikur Anbessa Specialized Hospital (TASH) from January to March 2019 on 240 left over blood samples for Complete Blood Count (CBC) analysis. Hematocrit and MCV were determined Microhematocrit (Manual) using commercial and window clay sealant and Sysmex XT-4000i automated methods. The data obtained from the three methods were entered and analyzed using Statistical Package for SPSS version 23 software for windows. Standard deviation and mean were determined and Independent Student t-test was used to compare mean difference between the three methods on p-value of 0.05. Additionally, precision, correlation coefficient and Bland Altman plot were used to assess correlation and agreement between the tests. Also figures and tables were used for the description of the data. Result: The mean ±SD for three methods as follow as: HCT values were 40.9±14.91, 40.1±14.84 and 40.3±14.98 for automated, manual methods using commercial sealant and window clay respectively, MCV values were 85.7±9.18, 83.7±10.6 and 83.9±10.12 for automated, manual methods using commercial sealant and window clay respectively. There was no statistically significant difference between the automated and both manual methods (p>0.05) for the mean values of HCT. There was statistically significant difference in the mean values of MCV between automated and both manual methods (p<0.05), but no statistically significant difference between manual methods. HCT values of automated and manual methods using commercial sealant (positively correlated (r=0.984) and limit of agreement range (95%)) and window clay sealant (positively correlated (r=0.992) and limit of agreement range (96.25%)) and the manual methods each other had also positive correlation (r=0.988) and limit of agreement range of (95.75%). Conclusion: since there is good performance agreement for HCT, the results of automated method could be checked by both manual methods. Also the two manual methods interchangeably could be used for hematocrit determination in the case of inadequate sample.
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    Determination of Common Hematological Parameters Reference Intervals among Apparently Healthy Pregnant and Non-Pregnant women of South Wollo Zone, Amhara region, Northeast Ethiopia.
    (Addis Ababa University, 2019-12) Fiseha, Mesfin; Tsegaye, Aster(MSc, PhD); Tamir, Zemenu(MSc, PhD candidate); Negash, Mikias(MSc, PhD candidate)
    Background: The physiology of a normal pregnancy involves major alterations in the hematological parameters. However, hematological parameters reference intervals currently being used in Ethiopia is derived from western populations, even though significant variations are reported previously. Objective: To determine hematological parameters reference intervals among apparently healthy pregnant and non-pregnant women of South wollo zone, Amhara region, Northeast Ethiopia. Method: A community based cross-sectional study was conducted among 600 pregnant and nonpregnant women in South Wollo Zone, Amhara Region, Northeast Ethiopia from June to August 2019. Medical history, physical examination and laboratory screening were performed for each study participant. Socio-demographic and other important data were collected using a structured questionnaire. 4ml of Whole blood was collected and Mindary BC-3000 plus hematology analyzer was used to measure hematological parameters following standard procedures. Data were entered and analyzed using SPSS version 23. The mean, median, and 2.5th percentile and 97.5th reference intervals limits with 90% CI were determined for the hematological parameters. P-value <0.05 was considered statistically significant. Result: The established reference intervals (2.5th–97.5th percentile) for pregnant women were: WBC: 4.0-13.2x103/ul; Lymph %: 12.9-38.13 %; Gran %: 50.45-81.54 %; MID %: 4.24-11.64; RBC: 3.45-4.67x106/ul; Hgb: 10.1-13.67 g/dl; HCT: 33.49-46.52 %; MCV: 84.76-103.52 fl; MCH: 27.5-33.0 pg; Platelet count: 131.7-373.15x103/ul; MPV: 7.24- 10.16 fl. A statistical significant difference between pregnant and non-pregnant was noted in all hematological parameters except MCHC. The mean and median value of WBC count, absolute granulocyte count and percentage, MCV, MPV and PDW increased, whereas mean values of HCT and Platelet count decreased as gestational period advance. Conclusion: The findings of this study indicated that pregnant women hematological parameters reference intervals differ from other studies in Ethiopian and other countries pregnant women reference intervals. Hence, this would signify the necessity for such determinations of local reference intervals for different populations and the health facilities found in south wollo zone should utilized the currently established reference intervals for pregnant women for better care.
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    Determination of Hematological Parameters Reference Interval for Adults of Dire Dawa Population, Dire-Dawa, Ethiopia
    (Addis Ababa University, 2019-06) Mengistu, Teklay; Tsegaye, Aster(MSc, PhD); Tibebu, Melatwork(MSc, PhD candidate)
    Background: Reference interval (RI) for hematological parameters are used for a comparative decision-making process by the treating physician, for diagnosis, management and monitoring of hematologic disorders. Manufacturers’ package inserts RI, which is western population based, is the most frequently external source of hematologic parameters. However, many factors like gender, age, environmental, lifestyle, and ethnicity influence hematological parameters. Objective: To establish hematological parameters reference interval for adults of Dire Dawa Population, Dire-Dawa. Methods: A cross sectional study design was employed for hematologic reference interval determination in Dire Dawa City Administration from January to May 2019. The study participants were from strata of adults (18-65 ages of both sexes) and pregnant women. After obtaining informed written consent, data was conveniently collected using a well-defined questionnaire that covers exclusion criteria. Fresh whole blood of 5ml was collected and 2ml poured into K3EDTA and analyzed by Mindray BC-3000plus hematology analyzer and 3ml for serology tests. Data was analyzed using SPSS version 24, the 95% reference intervals for each hematological parameters were calculated. Statistical significance was determined at p< 0.05. Result: A total of 472 individuals, aged 18 to 65 years for adult groups of both gender and 15 to 49 years for pregnant women were the final study participants in this study. Their mean ± SD age was 30.93±9.34 years. The respective 95% reference intervals for males, females and pregnant women were for WBC: 3.5-10.3x103/μl, 3.8-10.2x103/μl and 3.6-11.8 x103/μl; for Hgb: 12.40-17.50gm/dl, 10.78-15.25gm/dl and 9.5-13.50gm/dl; for RBC: 4.46-6.15x106/μl, 3.81-5.49 x106/μl and 3.67-5.07x106/μl; for HCT: 43.8-58.5%, 37.48-52.08% and 32.20-46.03%; for PLT: 164.0-447.00x103/μl, 177.0-442.27x103/μl and 157.5-421.5x103/μl. A statistically significant difference was observed between males and females for almost all hematologic parameters. Conclusion: There was a significant difference for most hematologic parameters based on genders and between pregnant and non-pregnant women. The RI obtained in this study is different from the values currently practiced in Dire Dawa town underscoring the need for locally appropriate intervals.
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    Effect of Specimen Handling on Quantitative HIV-1 Viral Load Measurement at Saint Paul Hospital Millennium Medical College, Addis Ababa
    (Addis Ababa University, 2019-11) Gutema, Gadissa; Tsegaye, Aster(MSc, PhD); Tola, Habteyes(MSc, PhD Fellow)
    Background: Proper specimen handling prior to quantification of plasma HIV-1 RNA viral load is important, since some reports suggest that variations in specimen handling may affect detection and quantification of plasma RNA. However, there is limited evidence on the effect of time of plasma separation, storage, freeze-thawing and dilution on the HIV-1 RNA viral load. Objective: To determine the effect of sample management on HIV-1 RNA viral load measurement in St. Paul Hospital Millennium Medical College from April to July 2019. Methods: Experimental study design was conducted in St. Paul Hospital Millennium Medical College from April to July 2019 GC in people living with HIV. Whole blood sample was collected into two EDTA test tubes from 88 eligible participants. The viral load test was done by Abbott m2000sp/rt analyzer. Data was entered into Microsoft excel and analyzed by SPSS version 20. Repeated measure analysis of variance was used to compare HIV RNA viral load mean difference between different time of plasma separation, storage, freeze-thawing and dilution. Post-hock analysis was employed to locate the place of significant difference. Level of significance was set at 5%. Results: There was significant HIV-1 RNA viral load log mean difference between plasma separation time at 6 hours (hrs) and 24hrs (p<0.001). Similarly, there was significant HIV- 1 RNA viral load log mean difference between plasma tested within 6hrs, stored at 2-80c for 6 and 15 days (p = 0.006 and <0.001). HIV-1 RNA viral load log mean difference was not observed when plasma was stored at 2-80c for 6 days (p= 0.999) and at - 200c for either 30 (p = 0.899) or 60 days (p = 0.999). There was significant log mean difference between plasma that exposed to 4th cycle of freeze-thawing in -200c when compared with plasma tested within 6hrs (p = 0.013). For the three dilution proportions (1:2, 1:3 and 1:5) there was no significant difference on mean RNA copies when compared to each other and tested within 6hrs (p = 0.999). Conclusion and recommendation: Only plasma separated at 24hrs, stored at 2-8oc for 15days and freeze-thaw 4th cycle had statistically significant effect on HIV RNA viral load variation. Though the differences were not clinically significant at a cut-off viral load level of 0.5 log10, therefore focusing on these factors could improve the result quality and ultimately improve patient care.
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    Establishment of community based Hematological Reference Intervals among apparently healthy adolescents aged 12-17 years in Mekelle city, Tigrai, Northern Ethiopia; a Cross Sectional Study Design From December, 2018 – May, 2019
    (Addis Ababa University, 2019-06) H/slassie, Hagos; Tsegaye, Aster(MSc, PhD)
    Background: Hematological reference ranges are important in clinical and diagnostic management for the assessment of health and disease conditions. Hematological reference intervals are better to be established based on sex and age differences as these are among the main factors affecting them. Objective: The aim of this study was to establish hematological reference intervals among adolescents aged, 12-17 years in Mekelle, Tigrai, and Northern Ethiopia, 2019. Study area: conducted in Mekelle city Study design and period: using a cross sectional study design conducted from December 2018 to May 2019 G.C. Method: A community-based cross-sectional study was conducted in 249 adolescents aged 12-17 years from December 2018 to May 2019. About 4ml of blood sample was collected using vacutainer tube containing di-potassium Ethylenediamine tetra-acetic acid. Hematological parameters were measured by Sysmex KX-21N hematology analyzer (Sysmex Corporation Kobe, Japan). The data were entered and analyzed by SPSS version 23 statistical software. The 97.5th percentile and 2.5th percentile were the upper and lower reference limit for the study population. Result: A total of 249 adolescents consisting of 122 (49%) males and 127 (51%) females with the median age of 15.31 (range 12 to 17) years were recruited. The median, mean and 95% percentile ranges of hematological values were determined. The 95% RI values were: Red blood cells (1012/Liter), 4.6-5.9 (Males) and 4.28-5.75 (Females); White blood cells (109/Liter), 2.9-9.6 (Males) and 3.4-10.2 (Females); Hemoglobin (g/dl), 12.6-17.6 (Males) and 12-15.4 (Females); Platelets(109/Liter), 138-364 (Males) and 150.6-461.8 (Females). Almost all of the hematological parameters showed significant differences (p<0.05) across the gender. Conclusion: This study concluded that there were statistically significant higher values of WBC count, MCV, platelet count, lymphocyte count, and neutrophil percent in females than males. However the value of RBC count, hemoglobin, hematocrit, MCHC, RDW CV (%), mixed count, and mixed percentage were statistically significant higher in males than females.
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    Establishment of hematological reference intervals for apparently healthy adult residents in Asella town, southeast Ethiopia
    (Addis Abeba University, 2019-06) Tadesse, Solomon; Tsegaye, Aster(MSc, PhD); Alemu, Jemal(MSc, PhD candidate)
    Background: About 70% of medical decisions made by physicians are based on the information presented by laboratory results. However, test results by themselves are valueless unless reported with the appropriate reference interval or medical decision limit. Currently, Ethiopia use reference intervals adopted from textbooks that refer mainly to Caucasian subjects. The country having heterogeneous population, there is a need to establish locally derived hematological reference interval that could be used in Asella town, Arsi zone, Ethiopia. Objective: To establish hematological reference intervals for apparently healthy adults in Asella town, southeast, Ethiopia. Methods: A cross sectional study was conducted from January to March 2019 on apparently healthy individuals in Asella town aged from 18-60 years. Predesigned and structured questionnaire was used for collection of data on socio-demographic characteristics and dietary pattern of the reference population. Systematic random sampling technique was used. About 3ml of EDTA whole blood was collected and analyzed using Sysmex KX 21N automated hematology analyzer which analyses 60 tests per hour. The data was entered and analyzed by appropriate statistical software (Epi Info and SPSS) and interpreted using non-parametric methods, by which central 95% of the measured values was included in the intervals. Result: a total of 494 participants were recruited and 424 participants were involved in this study with the median age of 28 years. Except WBC (3.4 to 10.1 x10 9 /L) which showed no significant difference, other men and non-pregnant women reference intervals are: RBC (4.77 to 6.07 x10 /L; 4.18 to 5.29 x10 12 /L), HGB (14.7 to 18.1 gm/dL; 12.7 to 15.7gm/dL), HCT (42.1 to 51.3%; 37.1 to 44.4%) and PLT (159 to 336 x10 9 /L; 177 to 376 x10 9 /L), respectively. Pregnant women’s WBC, RBC, HGB and PLT are (4.9 to 13.2 x10 9 /L, 3.58 to 4.9 x10 12 /L, 11.0 to 14.6gm/dL and (138 to 368 x10 9 /L), respectively. Conclusion: most of the hematological RI of this study was significantly different from currently in use in Asella referral and teaching hospital laboratory. The difference was also observed in studies of other African countries as well as studies from different parts of Ethiopia. 12
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    Establishment of reference intervals for the common renal and liver function clinical chemistry parameters among apparently healthy pregnant and non-pregnant women in South wollo zone, Amhara National Regional State, northeast Ethiopia.
    (Addis Ababa University, 2019-11) Assen, Miftah Mohammed.; Kindie, Samuel(MSc, PhD candidate); Tsegaye, Aster(MSc, PhD)
    Background: Physiological changes during pregnancy causes alterations in biochemical analytes concentration. Thus, pregnancy specific reference intervals (RI) are important for accurate diagnosis and treatment of cases. In Ethiopia, clinical laboratory test results are usually interpreted using values established on western population. Objective: To establish RIs for common renal and liver function clinical chemistry parameters among apparently healthy pregnant and non- pregnant women in South wollo zone, Amhara National Regional State, northeast Ethiopia. Methods: A community based cross sectional study was conducted on a total of 378 apparently healthy study participants randomly selected from south wollo zone, Ethiopia from April to June 2019. Data like medical history, physical examination and sociodemography were collected by using well organized questionnaire. After the exclusion of outliers using quartile method, Kolmogorov–Sminorv test was used to check its normality. The 95% RI with 95% confidence interval was established using the non-parametric method. The significance of differences between pregnant and non-pregnant women was evaluated using Mann–Whitney U test. Result: There was statistically significant variation between pregnant and non-pregnant women in values of Albumin, T.Protein, ALP, urea and Creatinine but not for AST, ALT, bilirubin(direct) and bilirubin(total). Reference intervals established for pregnant women includes: albumin 26.14–42.87g/l, total protein 48.52–74.71 g/l, AST 2.4–43.6 U/L, ALT 0.94–28.35 U/L, ALP 21.2–337 U/L, bilirubin(direct) 0.03-0.32 mg/dl, bilirubin(total) 0.26- 0.94 mg/dl, creatinine 0.29–0.87 mg/dl, urea 7.17–20.82 mg/dl. Albumin: 32.81–47.87, total protein: 56.71–83.9 U/L, AST: 4.2–37.1 U/L, ALT: 2.69–41.18 U/L, ALP: 3.22–278.7 U/L, bilirubin(direct) 0.1-0.51mg/dl, bilirubin(total) 0.24-1.06mg/dl, creatinine 0.44–1.00 mg/dl, urea 8.07–27.87 mg/dl for non-pregnant women. Conclusion: The RIs provided by this study are decisive in interpreting clinical laboratory results for medical decision making and other health-related conditions. Physiological adaptations of pregnancy should be taken into account when interpreting LFT and RFT in a pregnant woman.
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    Long term immune recovery of adult HIV infected patients taking highly active antiretroviral therapy as measured by CD4+ T cell counts in ALERT hospital, Addis Ababa Ethiopia
    (Addis Abeba University, 2012-06) Gizaw, Geremew; Tsegaye, Aster(MSc, PhD); Medhin, Girmay(MSc, PhD); G/Yohannes, Asfawesen(MD, Internist); Aseffa, Abraham (MD, PhD)
    BACKGROUND: More than five years have elapsed since free ART has been available to PLWHA in Ethiopia. The Ethiopian ART guideline follows the ART recommendations for resource limited countries forwarded by WHO in 2006. There are more than 280,000 PLWHA in Ethiopia who have ever been started with ART. The response to treatment is followed using a six monthly determination of CD4+ T cells. However, there is scarcity of information regarding the degree of immune recovery among PLWHA in Ethiopia who have been on ARV since 2005. OBJECTIVE: To assess immune recovery of adult HIV infected patients who have been on ART from 1-6 years and factors influencing it. METHOD: A retrospective study was conducted in ALERT hospital, Addis Ababa, Ethiopia on adult HIV infected patients who have been taking antiretroviral therapy for more than six months. Data was collected from pre-ART, ART and follow up formats and analyzed using SPSS version 20 and GraphPad Prism 5. RESULT: Among the total of 4419 reviewed medical records, 61.6% were females and the median age for all study participants was 35 years (IQR, 29-40). The mean (95% CI) weight at baseline was 53(SD=10.4) Kilogram; 57.7 (SD=10.3) for males and 50(SD=9.5) for females (p=0.000). The median CD4 at baseline was 135(IQR, 72-201); 120 (IQR, 62-186) for males and 144 (IQR, 79-209) for females (p=0.000). At baseline, 16.0%, 59.0%, and 25.0% participants had a CD4 cell/ µl of ≤50, 51-200 and ≥201, respectively. Among the total OIs and co-morbidities, Herpes zoster was the most frequently observed one (20.7%). There was a dramatic increment of CD4 cells/ µl across all age groups during the first six months of follow up period. Particularly, the age group 15-24 years had the highest (21.8 cells/µl /month) rate of CD4 cells/ µl increment. The overall rate of increment during the 72 months follow up was 4.4 cells/µl /month. Patients who start antiretroviral treatment with ≤50 cells/ µl had the highest rate (21.2 cells/µl /month) during the first six month of treatment. At the end of the 72 months, the median CD4 difference from the baseline was 314 cells/µl and the overall mean weight increment was 6.2 Kg. CONCLUSION: The study has shown CD4 increment which is comparable with other developed and developing countries, especially in the first 6 months. In this study, females and younger age groups (15-24 years) have shown a better immune recovery.
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    Magnitude of Anemia and Associated Factors in Children Aged 6-59 Months at Keranyo Health Center, Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-02) Jiru, Zewdu; Tsegaye, Aster(MSc, PhD); Alemu, Jemal(MSc)
    Background: Anemia impairs physical capacity and work performance in all age groups. In children, anemia affects cognitive and motor development because of the need for adequate oxygen carrying capacity during the critical first few years of life when mental and physical growth are occurring at their fastest. In Ethiopia, Anemia among children aged 6-59 months children categorized as severe public health problem. Regular monitoring of the magnitude anemia and its predicting factors is helpful for appropriate intervention. Objective: To assess the magnitude of anemia and associated factors in children aged 6-59 months at Keranyo health center, Addis Ababa, Ethiopiafrom January 01 to February 30, 2020. Method: A cross sectional health facility based study wasconducted among 427 children aged 6 to 59 months. Convenient sampling technique was used to include the participants. Pretested and structured questionnaire was used to collect socioeconomic and demographic characteristics of the family and child. Data on nutritional status and capillary blood sample was collected from each child. Multivariate logistic regression was used to calculate adjusted odds ratios with the corresponding 95% confidence intervals.P-values less than 0.05 was also used to declare statistical significance. Result: Of the total 427 children, 210 (49.2%) were males. The overall prevalence of anemia among children aged 6-59 months was 177(41.5%) (95% CI: 36.8% - 45.9%). Of the anemic under-five children, 14(3.3%) had mild, 149(34.9%) moderate and 14(3.3%) had severe anemia. Children whose maternal education is below elementary((AOR=3.82, 95% CI = (1.66, 8.77)), children who had fever in the last 2 weeks (AOR=2.13; 95% CI: (1.33, 3.42)), who consumed tea (AOR=2.17; 95% CI: (1.20, 3.93)) and with mothers who was not supplemented with iron during their last pregnancy (AOR=3.02; 95% CI: (1.40-6.55)) were more likely to become anemic. Conclusion: This study confirmed thatthemagnitude of anemia in children aged 6-59 months in Keranyo health centeris in the severe public health category. Educational and occupational status of the mother, child history of fever in the last two weeks, child tea consumption and maternal iron supplementation during pregnancy were factors associated with anemia in those children (659 months).Therefore, strengthening awareness and bringingbehavioural change in order to increase the knowledge of reproductive women about anemia is warranted.
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    Magnitude of Vacuolating Cytotoxin A (VACA) in Helicobacter pylori stool antigen and blood antibody-positive asymptomatic young children in Ziway, Ethiopia
    (Addis Ababa University, 2019-12) Dawit, Negusu; Desta, Kassu(MSc, PhD candidate, Associate Professor); Tsegaye, Aster(MSc, PhD); Taye, Bineyam(MPH, PhD)
    Background: Vacuolating Cytotoxin A (VacA) is the major H.pylori toxin that affects multiple cellular activities including cell membrane channel formation, disruption of endosomal /lysosomal function, and detachment of epithelial cells from the basement membrane. The toxin also, interferes with the process of antigen presentation, apoptosis and inhibition of activationinduced proliferation of T lymphocytes. In Ethiopia, information regarding VacA antigen is insufficient. Objective: To determine the magnitude of VacA toxin production in H.pylori positive asymptomatic children at Ziway, Oromia Region, Ethiopia Methods: A cross-sectional study was conducted in young children from selected schools and health facility in Ziway town. A convenient sampling technique was employed to include study participants who met the inclusion criteria. A structured questionnaire was used to collect sociodemographic and health status data of the study participants. Concentration of circulating VacA was determined by using the BG competitive ELISA antigen detection test kit. Information from the laboratory analysis and questionnaires were entered and analyzed using SPSS version 20. Categorical variables were compared using the chi-square test method. Pearson correlation was made between VacA positivity and test method, gender and age of the children. P < 0.05 was considering being statistically significant. Result: A total of 21 H. pylori stool antigen (Ag) positive and 42 antibody (Ab) positive children aged 4-14 years were recruited (33 male, 30 female).The overall prevalence of VacA was 44.4% (28/63); 18 (64.28%) were male and 10 (35.7%) were female, 60.7% (17/28)of them were in the age group of 9-14 years. VacA positivity rate from stool antigen positives was 10/21 (47.6%) and from blood antibody positives 18/42 (42.9%).In this study there was no statistically significance between VacA prevalence and test method (stool Ag or serum Ab detection), age and sex. Conclusion: The magnitude of H. pylori VacA toxin among asymptomatic children in Ziway, Ethiopia is high and there was no significant association between VacA positivity and age, sex and laboratory test method. Further large scale longitudinal studies should be conducted.