Browsing by Author "Tsegaye, Aster(PhD)"

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    Assessment of FunctionalityStatus of Medical Laboratory Equipmentand Factors affecting their functionalityamong Public Hospitals in Addis Ababa.
    (Addis Ababa University, 2019-06) Abebe, Negussu; Hassen, Fatuma(MPH, PhD fellow); Desale, Adino(MSc); Tsegaye, Aster(PhD)
    Strengthening the health system of developing countries requires a well-functioning laboratory. In this regard, properly functioning medical laboratory equipment is one of the critical components. However, there is a great concern that the laboratory equipment maintenance is a critical bottleneck for strengthening health systems in sub-Saharan Africa. BACKGROUND: OBJECTIVE: To assessfunctionality status of Medical Laboratory Equipment and reasons for their malfunction among Public Health Hospitals in Addis Ababa, 2018. METHODS: Facility basedcross-sectional study design was employed at14public hospitals in Addis Ababa from September to November, 2018.A convenient sampling method was used to include 14 public hospitals in Addis Ababa. Quantitative data collection tool with pretested interviewer administered questionnaire and checklist was used to collect pertinent data on equipment management system. Data were entered and analyzed by using SPSS version 20.0 (SPSS Inc., Chicago, IL, USA). The results were presented by using tables and graphs. Frequencies for all variables were counted and cross tabulated using percentages. Result:A total of 115 medical laboratory equipment were assessed in this study from 14 public hospitals in Addis Ababa. Almost one-third 33% (38) of laboratory equipment were chemistry machines with different model and country of origin. The overall functionality status of medical laboratory equipment was 58.3% (67/115). Unavailability of spare parts is the primary reason for malfunction of medical laboratory equipment among public hospitals in Addis Ababa. Lack of spare parts accounts about 39.6% (19/48) ofthe non-functionality of medical laboratory equipment during the study period followed by installation problem 14.6% (7/48) and unavailability of reagents 12.5% (6/48). Conclusion:This study has shown that a large proportion of medical laboratory equipment were non-functional among public hospitals in Addis Ababa. The study also has shown that the main reason for non-functionality of medical laboratory equipment was lack of spare parts followed by installation problem. Based on our findings, we recommend laboratories should follow manufacturer instructions to install laboratory equipment, capability building the biomedical engineers, avail necessary spare parts and reagent to utilize the most out of them.
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    Establishment of Community based Reference Interval for Common Clinical Chemistry Parameters among Adolescents and Children in Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-06) G/Egzeabher, Letebrhan; Wolde, Mistire (PhD); Tsegaye, Aster(PhD)
    Back ground: Establishment of Reference Intervals (RI) is one of the expected activities of medical laboratories which enable interpretation of the laboratory results according to the existing local setups. Company derived values are being used to interpret results in health facilities of Addis Ababa by the absence of locally RI. Objective: To establish RI for common clinical chemistry parameters among apparently healthy adolescents and children in Addis Ababa, Ethiopia from April to October, 2019 Methods: A community based cross sectional study was conducted on a total of 516 apparently healthy children (5-11 years) and adolescents (12-17 years) randomly selected from Addis Ababa, Ethiopia from April to October, 2019.After interviewing the health status of participants, socio demographic, nutritional status and life style data were collected using structured questionnaire. Blood (5 ml), urine (5ml) and stool (about 5 grams) samples was taken and examined. Serum levels of selected clinical chemistry parameters were determined using Cobas C501. Data were entered, cleaned and analyzed by SPSS version 21. After the exclusion of outliers using turkey method, Kolmogorov-Sminorv test was used to check its normality. The 95% RI with 90% CI was determined using non-parametric method (2.5 and 97.5 th percentile).The difference between children and Adolescent values was evaluated using Mann-Whitney test and P-value of <0.05 claimed the presences of stastically significant difference. Results: There was stastically significant variation between children and Adolescents in both sex and age for level of AST, ALP, TP, TBIL, DBIL, Cr, and UA, but ALT and ALB by age and Urea by sex. The established RI includes: Gluc 61-91 and 57-97 mg/dl, ALT 1.3-13.0 and 1.6-14.0 U/L, AST 12.3-26.7 and 8.0-27.0U/L, ALP 143-375 and 47-452U/L, DBIL 0.01-0.20 and 0.01-0.27mg/dl, TBIL 0.09-0.46 and 0.16-0.71mg/dl, TP6.4-7.8 and 6.48.3g/dl, ALB 4.1-5.1 and 4.1-5.2g/dl, UA1.4-4.9 and 1.5-6.8mg/dl, Cr 0.29-0.58 and 0.040.64mg/dl and Urea 9-30 and 8-31mg/dl for children and Adolescents, respectively for each test. Conclusion: The study identified variations with the currently utilized RIs; therefore, establishment and use of local reference ranges should be encouraged because it enhances patient care and health research. th
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    Proficiency Testing and Onsite Assessment of HIV Rapid Testing sites at Health Facilities enrolled in HIV Rapid Test Quality Improvement Initiative (RTQII) in Ethiopia
    (Addis Abeba University, 2020-06) Yenealem, Dereje; Tsegaye, Aster(PhD); Desta, Kassusta (MSc,PhD candidate)
    Background: HIV rapid testing services must ensure that appropriate quality assurance programs and well understood testing algorithms are implemeted to obtain accurate and reliable test results. Proficiency testing programs are important for improving HIV rapid testing quality while conducting an onsite evaluation provides a chance to observe the overall testing situation and support on identified gaps. Objective:To assess the performance of HIV Rapid testing sites in Rapid Test Quality Improvement Initiative(RTQII) enrolled health facilities through proficiency testing and onsite evaluation. Method:Health facility based cross sectional study was conducted from August to December 2019on 159 HIV testing sites (HTS) in 41 Health facilities (HFs) in five administrative regions and two city administrations in Ethiopia. Characterized HIV dried tube specimen (DTS) PT panels were prepared and verified at the Ethiopian Public Health Institute (EPHI) and distributed to the sites. Also onsite evaluation, accompanied by checklists with structured interviews, was conducted. The collected data was analyzed by SPSS version 23 and chi square test was applied to identify the association between acceptable performance and different factors.Testing sites whose PT scores matched 100% with the expected result together with adherence to the National HIV Testing Algorithm(NHTA) were considered acceptable. Results: The overall acceptable performance (100% PT score with the correct algorithm followed) was found to be 62% while 12% scored 80% and 11% scored between 20 to 60%. The rest 15 % were not considered as acceptable due to failure to adhere to the NHTA.Testing sites that participated in External Quality Assessment/Proficiency Testing(EQA/PT) schemes has shown better performance than those that did not participate in PT schemes with 70% and 56% performance, respectively (p=0.057). Though adherence to the NHTA, Training on HIV rapid testing, following SOP, were all positively associated with HIV rapid testing performances, all of them were not statistically significant. Conclusion:Expansion of HIV diagnostic services at different points of care must ensure that appropriate quality assurance programs has been put in place. The lower level of PT performance together with problems observed during onsite evaluations calls for regular supervision, strong EQA programmes, adequate hands on training, and proper assignment of testing personnel.