Browsing by Author "Tsegaye, Aster (PhD)"

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    Assessment of Biosafety practices in selected Public Hospital laboratories, East, South-West, and West Shoa Zones of Oromia Region, Ethiopia
    (Addis Ababa University, 2014-06) Tefera, Derese; Tsegaye, Aster (PhD)
    Background: Persons working in clinical diagnostic laboratories are exposed to many risks. The most hazardous agent in the laboratory is a microorganism that is frequently associated with laboratory infections and can be transmitted in variety of routes, especially by aerosols. Moreover, hospital and diagnostic laboratories are a challenging environment for the surrounding community. The more the laboratorians become aware of and adhere to recommended, science-based safety precautions, the lower the risk for laboratory acquired infections. The behavior patterns and attitude of individuals towards safety programs influence their involvement in laboratory accidents that put themselves and fellow workers at risk. Assessing laboratory biosafety practices will help the laboratories to identify factors that hindered laboratory personnel from practicing good laboratory biosafety measures and to determine the existing situation of the assessed laboratories so that laboratory managers can plan towards implementation of biosafety practices and hence safe working laboratory area will be created. Objective:The aim of this study was to assess biosafety practices among laboratory personnel working in selected public hospitals in the East, West and S/West Shoa zones of Oromia region. Methods: Institution based cross-sectional study was conducted between December 2013 and May 2014.The study was conducted among 45 studied laboratory personnel working in 5 selected public hospital laboratories located in East, West and S/West Shoa Adama, Bishoftu, Tulubolo, Ambo and St. Luke hospital laboratory). Datawas collected between April and May 2014 using structured questionnaire. The analysis was done by SPSS version16 statistical software using one-way ANOVA. P-values less than 0.05 wereconsidered as statistically significant. Result:Out 0f 45 participantsgreater than 37 (84%) of studied personnel were within the age range of 18-44 years. Of which the majority 23(64%) of the studied laboratory personnels’ age were aggregated within the age distribution category of 25-34. Male to female ratio of the studied participants were 3:1 with a count of male participant 34 (75.6%), and females accounted 11 (24.4%). Regarding the level of education, 23 (51.1%) of them had finished undergraduate study on medical laboratory sciences (Bachelor of sciences) and the rest 21(46.7%) were diploma holders in laboratory science. The duration of work experience in laboratory service of the studied laboratory showed that greater than 33(75%) of the group had a work experience of greater than 5years. This survey shown that the grand mean of the studied laboratory personnel for the overall biosafety practices was found to be 36.44±7.635 with a mean score range of 52%- 80%. Laboratory personnel B exceptionally scored the highest mean score of all 42.7(80%) and fall in upper moderate level which is close to high level. The mean score for laboratory D and E had shown similar results which are a mean value of38.6 (70%)and they are closed to be labeled as moderate. The rest two laboratories (A and C) found to be low level with laboratory A scored the least mean value of all 29.7 (50%), while laboratory C scored a mean value of 34.5. Conclusion: The overall biosafety practice of the studied hospital laboratories average score is 36.44±7.63 from a total score value of 55. The percent range forall studied labs is 52%-80%. Laboratory B exceptionally scored the highest mean of all with a score of 80% as a result it is in the upper moderate level category.
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    Assessment of Histopathology Services in Ethiopia
    (Addis Ababa University, 2015-06) Okbazgi, Giorgis; Tsegaye, Aster (PhD)
    Background: The scarcity of having histopathology laboratory in the nation will cause the difficulty to diagnose as well as follow up cancer diseases. Besides, the scarcity of professionals also contributes for the lack of the service in developing countries like Ethiopia. Laboratory laboratory personnel per year were 508 and 640. The lowest turnaround time (TAT) of 1 week for biopsy samples analysis was achieved by KGH and AFGH while three teaching hospitals had longer TAT of 30 days. (JUSH, HUH, ASUH) Conclusion: There is a scarcity of a histopathology laboratory set up as well as of pathologists and laboratory personnel. The available histopathology laboratories are not adequate and their distribution is concerned in Addis Ababa and major cities: besides; there is no histopathology laboratory in two regions of the country (Afar and Somali regions). Recommendation: The Federal Ministry of Health (FMoH) must give attention to the regular distribution of histopathology laboratory service to avoid unnecessary traveling to find the simplest technique FNAC by the population. Moreover, establishing a sample referral network could help address the unmet gap as cancer is on the rise. It also recommended the training of pathologists as well as histotechnologists and establishment of new histopathology laboratories at non-available areas of the country. technicians who do not have proper training and experience are active in the current histopathology laboratories in these countries. Objective: To assess the histopathology laboratory practices in Ethiopia. Method: Cross sectional study-design, and convenient sampling method were used. Data were collected by using pretested observational checklist. The Principal Investigator (PI) collected the data in April 2015 at all histopathology laboratories in Ethiopia, which practice investigation of both biopsy and cytology, Fine Needle Aspiration Cytology (FNAC) and have set up of histopathology laboratory. The number of histopathology specimen per year computed the data by the number of pathologists and laboratory personnel in that laboratory. Data was entered and analyzed using Microsoft Excel 2010 software. Result: There were 11 histopathology laboratories who set up with equipment except Afar and Somali region where no histopathology laboratories were available. The available laboratories process and diagnose biopsy as well as FNAC. About 55% of laboratories in the country owned cryostat. All laboratories own microtome, 82% of the laboratories use automatic tissue processing and embedding machine whereas the rest use manually. All facilities use manual mounting and staining method, and 36.4% owned automatic staining machine. Grossing equipment and slide warmer table or oven is available at all facilities, whereas slide and block storage cabinet is available in 54.5% of the laboratories. The number of pathologists range between one and eight where AFGH, AGHMC, GGH have one. AHRI, KGH, GUH, ASUH, HUH, and JUSH have two. EPHI /St. Paul have four, and TASH has eight pathologists: thus the highest number of biopsies per pathologist per year was received by EPHI/St. Paul (1144), GGH (1008), and TASH (813). The highest FNAC per pathologist per year was practiced by GGH (4800), ASUH (1488), AFGH (1365), HUH (1200), and GUH (1196). The overall average numbers of biopsies and FNAC per pathologist per year were 715 and 901 respectively. Whereas the respective average numbers for histopathology
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    Assessment of Immuno-Hematological changes among HIV and TB/HIV co-infected patients taking Highly Active Antiretroviral Therapy for at least six months in Menelik II Referral Hospital, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2020-06) Kasawmar, Esuyawkal; Tsegaye, Aster (PhD)
    Background: Cytopenias are one of the most common complications in HIV and TB/HIV coinfected patients. Assessing immuno-hematological outcome is very essential for the management and care of people living with HIV and TB/HIV co-infection. Objective: To determine the Immuno-Hematological changes among HIV and TB/HIV co-infected patients taking HAART for at least six months at Menelik II Referral Hospital. Methods: This cross-sectional study was conducted on 338 HIV infected patients who have been taking HAART for at least six months. Socio-demographic, clinical, CD4+ T cells and hematological data at baseline and after at least 6 months on HAART were extracted from February to March 2019. Student t-test was used to compute the difference between baseline and current hematological and CD4+ T cells values. SPSS version 20 was used for data entry and analysis. P<0.05 was considered as statistically significant. Results: Of the total 338 individuals, 255 (75.4%) were infected with HIV only and 83 (24.6%) were TB/HIV co-infected. There was significant increase (p<0.05) in the mean CD4 (164.6 vs 317.1 cells/l), WBC (5.89 vs 6.49×10 3 /l), Hgb (13.07 vs 13.76g/dl), platelets (245 vs 265×10 /l), MCV (89.92 vs 96.13fl), MCH (30.25 vs 32.69pg) and a decrease in RBC (4.35 vs 4.25×10 /l) after six months of HAART. Compared to baseline, there was also significant decrease in the rate of Immunosuppression (CD4<350; 98.5 vs 88.5), anemia (39.9 vs 14.5%), leucopenia (22.2 vs 17.8%), neutropenia (11.5 vs 9.2%) and thrombocytopenia (16.9 vs 9.8%) after 6 months of HAART. When data was analyzed for HIV/TB co-infected patients separately, the effect of TB co-infection on HAART outcome was evident. The respective baseline and current values in this group were: CD4, 149.58 vs 294.72, WBC 5.83 vs 6.62, Hgb 12.25 vs 12.91, PLT 264.1 vs 262.9, RBC 4.22 vs 4.14, MCV 89.5 vs 92.6, MCH 29.54 vs 31.17 (P<0.05 for WBC, PLT, CD4, MCV). Rates of Immunosuppression was 98.8 vs 92.8%, anemia 51.8 vs 39.8%, leucopenia 21.7 vs 18.1%, neutropenia 10.8 vs 12.1%, thrombocytopenia 14.5 vs 12.0%. Besides, patients taking AZT based drugs had significantly higher MCV and MCH values (P<0.01) than those who did not. Conclusion: It is evident from this study that has shown significant improvements in immunohematological profiles after taking HAART for at least 6 months. The changes were more affected with TB co-infection suggesting further investigation considering HAART adherence. 3 6
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    Assessment of Knowledge, Attitude, and Practice About Bio-Medical Waste Management and Associated Factors Among Health Care Workers at Debre Markos Town Health Care Facilities, Northwest Ethiopia
    (Addis Ababa University, 2017-06) Deress, Teshiwal; Tsegaye, Aster (PhD)
    Background: Healthcare activities restore health and save lives; however, they inevitably generate wastes and by products which may be hazardous to human beings or environment. Generation and disposal of biomedical wastes has become an emerging problem worldwide. Knowledge, attitude and practice of health care workers affect outcomes of biomedical waste management and yet they are less investigated. Objectives: To assess knowledge, attitude and practice about bio-medical waste management and associated factors among health care workers at Debre Markos town health care facilities, Northwest Ethiopia. Methods: A cross-sectional study was employed from November 20, 2016 to June 12, 2017 among health care workers at Debre Markos town health care facilities. Data were collected through structured self-administered, interviewer administered questionnaires and observational checklists. Data were coded and entered into Epi-data 3.1 software and then exported into SPSS version 20 for analysis. Descriptive statistics was computed through cross tabulation. Bivariate and multivariable logistic regression analysis were computed to identify predictor variables significantly associated with the outcome variables. All variables with p value ≤ 0.2 in bivariate analysis were entered into multi-variable logistic regression model to adjust possible confounders. Variables with p value of <0.05 in the final analysis were considered to explain presence of association. Chronbach’s Alpha internal consistency reliability test was used. Result: A total of 351 health care workers were studied among 14 health care facilities. Adequate knowledge, positive attitude and adequate practice scores of health care workers’ were found to be 193(55%), 218(62.1%) and 277(78.9%) respectively. Regarding associated factors, having >10-year work experience was 4.28 times more likely contribute for adequate knowledge score than study participants with 1-5 years work experience. Working 8 and more than 8 hours per day were 7 and 6.6 times, respectively, more likely to contribute for positive attitude than working less than 8 hours per day. Similarly, presence of all three color coded bins in the department/ health care delivery sections were 4.55 times more lkkely contribute for health care professionals’ adequate practice score. Similarly, working hours per day (p= 0.014) and attitude scores (p=0.034) significantly associated with cleaners’ practice score. Conclusion and Recommendation: In this study knowledge, attitude and practice scores were low. Regular training and supervision with special emphasis for cleaners is necessary. There is should be supply of sufficient personal protective equipment. Key words: Biomedical waste, waste management, knowledge, attitude, practice, health care worker
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    Assessment of Specimen Rejection Rate and Associated Factors among Samples Referred to Addis Ababa Research and Emergency Management Core Process Laboratory, Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-02) Adugna, Berisa; Tsegaye, Aster (PhD); Molla, Habtamu(MSc, PhD candidate)
    Background: Accurate laboratory results are vital for patient safety and improving the medical diagnosis. Most errors occurred in the pre-analytic phase. Improper collection of samples can lead to sample rejection. In this case laboratory should establish rejection criteria and follow them closely. Specimen rejection may have significant consequences for patients and their clinical management. Thus, understanding the magnitude and taking appropriate action is critical for quality laboratory service provision. Objective: to assess the Specimen rejection rates and associated factors among samples referred to the laboratory of Addis Ababa Research and Emergency Management core process. Methods: cross sectional study was conducted using both primary and secondary data which assesses the rate and reason of rejection observed from June 01, 2018 to May 30, 2020 G.C. About 131,909 specimens collected at Addis Ababa Research and Emergency management core process laboratory with in the period of the study was entered and analyzed using SPSS 20. Result: a total of 131,909 specimens were sent to central reception of the Addis Ababa public health research and Emergence management core processes laboratory. The total rejection rate was 0.69%, 915. The frequencies of rejected specimens were highest in viral load 35.1%, followed by clinical chemistry which was 23.4%. The most common reason of rejection was mislabeling, 27.1%, followed by insufficient 15.8%, and clotted 15.1% specimen. Among rejected specimens, 514 specimens were rejected in the first and 401 Specimens were rejected in the second. Conclusions: The study demonstrated about 0.7% specimen rejection rate. Alongside of the efforts to minimize laboratory error, this study highlighted a complexity of pre-analytical errors to minimize them. The most commonly rejected specimens were for viral load followed by clinical chemistry samples. The most common pre analytical reason for specimens’ rejection was mislabeling, followed by insufficient and clotted specimens.
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    Assessment of Transfusion Transmissible Infections Among Blood Donors (A six years study) and Strategy on Direct Laboratory Testing Cost of Blood Screening at National Blood Transfusion Service of Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Edosa, Jijiga; Tsegaye, Aster (PhD)
    Background: Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis are the most serious infections transmitted during blood transfusion. In such a resource limited setting, cheaper and feasible alternative strategies for blood donations testing are specifically required. However, updated data on the transfusion transmissible infections (TTIs), and cost effective strategies of blood screening are lacking. Objective: To determine the prevalence of transfusion transmissible infections among blood donorsfrom July 2008 to July 2013and propose cost effective strategy of blood screening at National Blood Bank of Addis Ababa, Ethiopia. Methodology:A retrospective analysis of blood donors’ record covering the period from July 2008 to July 2013 was conducted. The data was collected from the National Blood Transfusion Services (NBTS) of Addis Ababa and includes category of all donors and result for TTI markers. In addition, direct laboratory costs of parallel versus sequential strategy of blood screening were compared. To compare the strategies we used the current price of the laboratory costs. Data was first exported to Excel spread sheet from the institution’s data base and then finally exported to SPSS version 16 software (SPSS INC, Chicago, IL, USA) for analysis.Data analysis was performed using scores and odds ratio using same software to look for an association between dependent and independent variables. P values less than 0.05 were considered significant. Result: A total of 173,207 consecutive blood donors were screened between 2008 and 2013.The overall seroprevalence rate ofHBV, HIV, HCV and syphilis of blood donors was 5.0%, 1.6%, 1.4% and 0.1%respectively. The HIV-HBV confection was higher among blood donors 135(41.79%) followed by HBV-HCV co-infection which accounts about 103(31.89%). Significantly increased seroprevalence of TTI’s was observed in the age groups of 17-25 and 26- 35 years. In this study, the difference in cost between the current in use strategy (Parallel) versus our proposed newly designed sequential testing algorithm was 746,773.90 ETB. Conclusion: A significant percentage of the blood donors harbor TTIs. Higher prevalence of TTIs was observed among youths and replacement donors. The direct laboratory cost analysis using current in use strategy (parallel) was higher than the newly designed sequential testing algorithm. Thus, the new strategy can be implemented to make screening of TTIs cost effective in the face of the current effort of large mobilization of voluntary blood donors in the country
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    Association of Helicobacter pylori infection with Atopy and Allergic disorders in Ziway, Central Ethiopia
    (Addis Ababa University, 2017-05) Tesfay, Mheret; Tsegaye, Aster (PhD)
    Background: Some epidemiological and experimental data point to the protective effect of Helicobacter pylori infection against the development of many extra-gastric diseases, including gastroesophageal reflux disease and its associated outcomes, childhood asthma and allergy. There is scarcity of data concerning this in Ethiopia. Objective: To assess the association of Helicobacter pylori infection with atopy and allergic disorders in Ziway, Central Ethiopia Methods and materials: Health facilities and school based cross sectional study was conducted from October 2016 to January 2017, Ziway, Ethiopia. A total of 461 children were enrolled in the study. Participant‟s socio-demographic and clinical information was collected using International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Skin prick test was done; blood and stool samples were collected from each participant. Automated WBC and manual eosinophil count were performed from EDTA blood while total serum IgE, H. Pylori stool antigen test and serum antibody test were determined using ELISA technique. Descriptive statistics were used to express the socio-demographic characteristics of the participants. Binary logistic regression was computed to assess association between variables using SPSS version 20 for windows. P < 0.05 were taken as statistically significant. Results: The overall prevalence of past and current H.pylori infection was 70.3% and 5.2%, respectively. The overall prevalence of any sensitization was 2.4%. Our result also did not show the protective effect of the bacteria. There was no association between past H.pylori infection and atopic sensitization and allergic conditions (OR 1.58, 95% CI 0.44, 5.70 (P=0.48) and OR 0.96, 95% CI 0.56, 1.62 (P=0.86), respectively) and the current infection of H. pylori was not associated with allergic conditions with OR 1.81, 95% CI 0.53, 6.22 (P=0.35). In this study the IgE levels were elevated in current H.pylori infected atopic participants. Conclusion: In this study we didn‟t find any significant association between past and current H.pylori infection with atopy or allergic conditions. Further studies with high quality longitudinal cohort are needed to map every possible correlates of the infection. Keywords: Helicobacter pylori, Atopy, Allergy, IgE
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    Association of Intestinal Helminth Infection with Atopy and Allergic Symptoms in Young Children in Batu, Ethiopia
    (Addis Ababa University, 2017-06) Walelign, Sosina; Tsegaye, Aster (PhD)
    Background: Helminths are potent immunomodulators and chronic infections may protect against allergy-related disease and atopy. They are also known for inducing allergic conditions. This study was aimed to assess the association between helminths and atopy and allergic conditions. Objective: To assess the association between intestinal helminth infection and atopy/allergic outcomes in young children in Batu, Ethiopia. Methods: Questionnaire data on allergic symptoms and a range of confounding variables was gathered in a cross-sectional study of 461 children aged from 2 to 14 years from Batu. Allergic skin sensitization to house dust mite and cockroach was measured, and a stool sample collected for qualitative and quantitative geohelminth analysis. Serum IgE using ELISA and Manual eosinophil count were measured. Data was entered and analyzed using SPSS version 20. Results: Overall sensitivity to both allergens was 2.6 %. Self - reported allergic outcomes in the last 12 months for the 461 participants had been; wheeze (3.7%), asthma (2.2%), eczema (13.2%), and hay fever (6.9%). A burden of 8.1% (36/444) was recorded for helminths. A borderline significant association was found between atopy and any allergy symptoms [OR 3.32 (95% CI: 0.99, 11.1), P = 0.052]. There was no significant association between helminths and atopy [OR 0.64 (95% CI: 0.29, 1.41) p = 0.268] and also between helminths and allergic symptoms [OR 0.64 (95% CI: 0.29, 1.41) p = 0.268]. Bivariate analysis showed keeping animas in the house associated with atopy while maternal and paternal history of allergy associated with allergic symptoms in the children. Conclusion: Contrary to the majority of related studies that reported a positive or negative association between helminths and allergy-related outcomes, we found no relation between the two. Further longitudinal studies are warranted to further elucidate the controversy. Keywords: Atopy, helminths, Allergy, IgE
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    Association of Intestinal Helminthic Infection, Atopy and Allergic Disorder in the Setting of Mass Deworming Among Selected Government Primary School Children in Sululta Woreda, Oromia, Ethiopia
    (Addis Ababa University, 2017-11) Abera, Dessie; Tsegaye, Aster (PhD)
    Background: Intestinal helminthic infections have been suggested to play protective role from allergic sensitization and atopic diseases. There is a concern that deworming could increase the prevalence of atopic disease in endemic populations. There is inconsistent and little information about the relationship between helminthic infection and allergic disease in Ethiopia. Objective: The aim of this study was to assess the association of intestinal helminthes and atopy /allergic disorder in the setting of mass deworming among school children in Sululta, Oromia, Ethiopia. Methods: A cross sectional study was conducted among 526 school children aged 5 to 14 years from three selected government primary schools in Sululta woreda. Information on socio-demographic characteristic, associated risk factors and allergic symptoms were obtained using questionnaire. From all children, fresh stool samples were collected and processed by direct wet mount, formol-ether concentration and Kato-Katz technique and atopy was assessed by skin prick test (SPT). In addition, venous blood was collected for eosinophil count. Data was entered and analyzed using SPSS version21 statistical software. The odds ratio and 95% confidence interval was calculated to assess the strength of the association. P-value less than 0.05 were considered as statistically significant. Results: Of the total 526 school children 58.2% (306) were females. Overall 24% (n=126/526) had questionnaire based allergic symptoms while 5.1 % (n=27/526) had skin prick test reactivity, 16.9% of them (n=89/526) had intestinal helminthic infection. All helminthic infections were with low intensity level. There was no association between helminthic infection and allergic symptoms (OR=1.30, 95% CI=0.778-2.171, P=0.317). Ascaris lumbricoides infection was positively associated with skin test reactivity (AOR=4.307, 95%CI=1.143-16.222, P=0.031). Atopy was significantly associated with increased allergy symptoms (AOR=2.787, 95%CI=1.253-6.197, P=0.012). Short term deworming had no effect on atopy but has a protective effect on allergic symptom. Conclusion: Low intensity and low prevalence of helminthic infection in our findings may have contributed to the non-significant association of allergy and helminthes infection; however, Ascaris lumbricoides was positively associated with atopy. Further longitudinal study is recommended to examine the mechanism of Ascaris lumbricoides infection for the development of atopy. Keywords: Atopy, Allergy, Intestinal helminthes, School children
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    Changes in Platelet Count and Mean Platelet Volume during Infectious and Inflammatory Diseases, and their Correlation with ESR and CRP at Zewditu Memorial Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-05) Setu, Asnake; Tsegaye, Aster (PhD)
    s and inflammatory diseases have been among the major threats for public health. Many ways of diagnosing these diseases have been developed. However, there is still a need for better parameters that will help reduce the cost and increase the reliability of the diagnosis. Efforts have been undergoing to standardize the use of Platelet parameters with Erythrocyte Sedimentation Rate (ESR) and C - reactive protein (CRP). Objective: To evaluate the changes in platelet count (PLT) and mean platelet volume (MPV), and the relation between each of those markers with erythrocyte sedimentation rate (ESR) and C - reactive protein (CRP) in infectious and inflammatory diseases in Zewditu Memorial Hospital, Addis Ababa, Ethiopia from July 2015 – May 2016. Methods: A cross-sectional, hospital based study was conducted on 100 patients with infectious and inflammatory diseases and admitted in medical ward of Zewditu Memorial Hospital. PLT, MPV, ESR, and CRP were measured at hospitalization and discharge. Patients’ demographic and clinical characteristics were collected using formats. Whole blood was collected and measured using Cell Dyn 1800 Hematological analyzer for Platelet parameters (PLT and MPV). The serum level of CRP and ESR were measured using semi quantitative agglutination test and Westergren methods, respectively. Values at admission and discharge were compared using paired t-test. In addition, Pearson correlation test was used to determine the relationship between the platelet count, MPV, ESR and CRP. Data was entered and analyzed using SPSS ver.21 statistical software and P-value less than 0.05 was considered as statistically significant. Result: 48 male and 52 female adult patients with infectious and inflammatory conditions were involved in this study. Their mean PLT count changes from 258.5 ± 131.1(x 10 9/l)at admission to 279.5 ± 124.9 (x 109/l), P =0.001) at discharge.MPV increased during the same period but the difference was not statistically significant (9.6 ± 1.7flvs.10.1 ± 7.9fl,P<0.58). CRP and ESR decreased at discharge with clinical resolution of CRP 6.6 ± 9.7mg/l to 2.8±5.9 mg/l (p=0.001) and ESR 46.0 ± 40.2 mm/h to 31.5 ± 30.9 mm/h (p=0.001). PLT and MPV had a negative correlation at the time of admission (r=-0.371, p=0.001) but not at discharge (r= 0.017,p=0.863). ESR was not significantly correlated with PLT both at admission (r= 0.059, p=0.560) and discharge (r=0.077, p=0.447). Besides, ESR had no significant correlation with MPV both at admission (r= -0.096, p=0.341) and discharge (r= 0.019, p=0.849). ESR and CRP had a significant positive correlation at the time of admission (r= 0.57, p=0.0001) as well as discharge (r= 0.58, p=0.0001). Conclusion: The study demonstrated a change in PLT, ESR and CRP values of patients with infectious and inflammatory condition from the admission values. The platelet parameters were not well correlated with the known disease activity markers (CRP and ESR). Thus, further study is warranted addressing single disease so as to get convincing results before claiming them as reliable markers for assessment of infectious and inflammatory disease activity in our settings. Key words: platelet count; mean platelet volume; C-reactive protein; erythrocyte sedimentation rate and disease activity
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    Clinical Utility of Red Cell Distribution Width in the investigation of Non-Hematological Disorders from May till August 2015, at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Case Control Study
    (Addis Ababa University, 2015-08) Tibebu, Melatwork; Tsegaye, Aster (PhD)
    Background: Red cell distribution width (RDW) is a measurement of the degree of anisocytosis, or the degree of red cell size variability present in a blood sample. RDW has been reported as a significant diagnostic as well as prognostic lab marker for many non-hematological disorders. A study conducted in Addis Ababa showed that RDW was one of the less recognized and underutilized laboratory marker in clinical practice. Objective: To describe the clinical utility of RDW in the investigation of non hematological disorders at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A Case-control and questionnaire based study was conducted at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A convenient sampling technique was employed and a total sample size of 150 ( 100 cases and 50 apparently healthy controls) and 100 clinicians non hematological diseases yet failed to utilize it. Reason behind it is yet to be identified but the habit of utilizing RDW in the investigation of diseases other than anemia should be urged and encouraged. Key words: RDW, clinical utility, non-hematological disease were included from May to August, 2015. Cases were adult patients diagnosed with heart, liver and kidney diseases. RDW was determined using Sysmex XT-2000i Automated Hematology Analyzer. The data were entered in to Excel spread sheet and imported for analysis to SPSS version 19 software (SPSS INC, Chicago, IL, USA). Frequency, mean distribution, paired t test and chi square was calculated P values less than 0.05 were considered statistically significant. Result: Half of the clinicians had the Knowledge that elevated RDW could be an indication of non hematological diseases. However, 68% (68/100) of them rated that they rarely or never use RDW in the investigation or follow up of patients having non hematological diseases. Paired t test revealed mean difference of 2.53± 4.3 existed between the cases and control groups with a confidence interval of 1.314-3.76 (p<0.001). The association between the three diseases and elevated RDW was found to be statistically significant (P<0.05) with 95% confidence interval (0.000-0.030). The clinical laboratory method course for medicine students was rated as inadequate by the majority of them. Conclusion: RDW's clinical utility by clinicians at TASH in the investigation or follow up of patients with non hematological diseases was insufficient indicating that awareness should be created. Half of the clinicians had the knowledge that elevated RDW could be an indication of
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    Comparative Cross-Sectional Study on Prevalence and Associated Factors of Anemia in HAART Naïve and HAART Experienced Adult HIV Patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-03) Alemu, Rahel; Tsegaye, Aster (PhD)
    Background: Hematological abnormalities are manifested in human immunodefieicincy virus patients as a result of progressive damage to the body’s immune system. They are documented to be the second most common causes and strong independent predictor of mortality and morbidity in people living with HIV/AIDS. Objective: To determine prevalence and associated factors of anemia in highly active antiretroviral therapy (HAART) naïve and HAART experienced adult HIV positive individuals. Methodology: A hospital based comparative cross sectional study was conducted from April to November, 2015 at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. A total of 340 HIV infected adult individuals, 170 HAART naïve and 170 HAART experienced, were enrolled in the study. Participant’s socio-demographic and clinical information were collected using pre-tested structured questionnaire. Blood and stool specimen were collected from each participant. Blood was examined for full blood count, CD4 and hemoparasite. Stool samples were screened to detect intestinal parasites. Descriptive statistics were used to express the socio-demographic characteristics of the participants. Binary and multiple logistic regressions were computed to assess association between variables using SPSS version 20. P value less than 0.05 was taken as statistically significant. Result: - The overall all prevalence of anemia was 15.44%. The prevalence of anemia in HAART Naïve and HAART experienced patients was 24.71% and 7.1% respectively. Advanced WHO clinical stage (AOR= 9.63, 95% CI= 1.07-86.95), low CD4+ T cells count (<200) (AOR= 7.57; 95% CI= 2.17- 27.01), and body mass index <18.5 (AOR= 7.56; 95% CI= 2.12-27.01) were found to be predictors of anemia in HAART naïve patients. On the other hand, none of the variables was found to be independently associated with anemia in HAART Experienced patients. Conclusion: -Anemia is the common manifestation both in HAART naïve and HAART experienced patients. However, Prevalence of anemia is higher in HAART naïve HIV individuals than those on HAART. Therefore; further longitudinal study should be conducted to map every possible correlates of anemia and compare its burden in HAART Naïve and HAART experienced adult HIV patients. Keywords: Anemia, HAART-naïve, HAART- experienced, Risk Factors
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    Comparative study on Changes in Hematological Parameters during the First 6 month of Antiretroviral Therapy initiation Among HIV infected pregnant and non-Pregnant women at Zewditu Memorial Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-06) Aschalew, Jenber; Tsegaye, Aster (PhD)
    Background: The use of ARV prophylaxis during pregnancy can dramatically reduce the risk of vertical transmission of HIV infection. Currently, limited studies have documented the effect of ART in decreasing the risk of opportunistic infection as well as improving survival of HIV infected pregnant women and fetus. However, little is known about its impact on hematological parameters in resource limited settings like Ethiopia. Objective: To assess changes in hematological parameters after 6 months of ART initiation among HIV infected pregnant and non-pregnant women at Zewditu Memorial Hospital ART clinic, Addis Ababa, Ethiopia. Methodology: A retrospective comparative study was conducted among HIV infected pregnant women who received ART between September 2008 and January 2014 at ART clinic of Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Data conveniently collected from 384 pregnant women on ART was compared with that obtained from 384 non pregnant women who are on ART as controls. Demographic, clinical and hematological parameters data were collected between November and December 2016 carefully from the existing ART logbook and antenatal follow up cards. Data collected through a standardized format were entered into Excel spread sheet and transported into and analyzed by SPSS Version 20 software. Dependent variable frequencies, mean, standard deviation and range were calculated. Mean change of different hematological values during follow up time from the base line were compared using paired t-test. P value <0.05 was considered as statistically significant. Results: The results of the study indicated significant difference in RBC Count, Hb, HCT, MCV, MCH,MCHC PLT counts were statistically significantly lower, while CD4 count was significantly higher in HIV infected pregnant women compared to non pregnant women. There was no statistically significant difference between the two groups for PLT and total WBC. Prevalence of anemia, leucopenia, thrombocytopenia and CD4+ T lyphocytopenia at baseline and 6 months of follow up were 49.5% vs 54.4%, 20.7% vs 4.9% , 20.8% vs 18.8% and 88.8% vs 69.8% for HIV infected pregnant women, respectively. The respective values in HIV infected non pregnant women were 37% vs 18% , 8.6% vs 5.8% ,38% vs 7.8% and 58.6% vs 34.1.Microcytic hypochromic anemia was the dominant type in the pregnant women while normocytic hypochromic was the commonest followed by microcytic hypochromic anemia in the non-pregnant women. Thus, monitoring of all hematological parameters (not only Hb) is warranted. Conclusion: Comparison of hematological parameters of HIV infected pregnant with non pregnant significant changes. Since these parameters are strongly influenced as a result of pregnancy. Key words: Pregnant women, Hematological parameters, anemia, thrombocytopenia, CD4+ T cells and ART
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    Comparision of Hemocue301+ With Sysmex-Kx21n and Celldyn1800 Automated Hematology Analyzers for Measurement of Hemoglobin Levels in Patients at Stt. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2015
    (Addis Ababa University, 2016-10) Samue, Mesfin; Tsegaye, Aster (PhD)
    Background:Hemoglobin concentration is measured routinely using automated hematology analyzers. Even if these automated hematology analyzers are very accurate and reliable, they are expensive and transport of the samples to the laboratory delays the process which may delay treatment. Point of care hemoglobin analyzer like Hemocue301+ has potential to solve such problems. Although method comparison experiment has to be conducted when new instrument are installed, this practice is not common in our country. Objective:To compare hemoglobin determined by Hemocue301+, with Sysmex-kx21N and Cell-Dyn1800 methods using patients’ blood sample at St Paul’s Specialized Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methods:A facility based cross sectional study with convenient sampling method was conducted at St. Paul’s specialized teaching hospital starting from May 15 to June 2 2015. A total of 117specimens for agreement study and 3 specimens for precision study were analyzed on Hemocue301+, Sysmex-Kx21N, and cell-Dyn1800 hematology analyzers to compare their Hemoglobin results. This study includes patients of all age group. One sample t-test and bland and Altman plot with limit of agreement were used to make inference. Data analyses were performed using SPSS version 20 Software. Result:The precision experiment showed within run normal range CV% for Hemocue301+, SysmexKx21N and Cell-Dyn1800 (1.7%, 1.3%, 1.8%, respectively). The one sample t-test showed a non-significant p-value of 0.10 for Hemocue301+ and Sysmex-Kx21N and the limit of agreement from Bland and Altman plot for 95% was (-1.07, 1.25)g/dl with only 1.7% of the cases were out of the limit of agreement. For Hemocue301+ and Cell-Dyn1800, a non-significant p- value of 0.46 and the Bland and Altman plot limit of agreement for 95% was (-1.22, 1.31)g/dl with only 1.7%of the case were out of the limit of agreement.Hemocue301+was agreed with SysmexKx21N and Cell-Dyn1800 within 1 g/dl which was considered as clinically important limit for Hemoglobin measurement. Conclusion: The Hemocue301+ maybe used interchangeably with Sysmex-Kx21N and Cell- Dyn1800 automated Hematology analyzers in St Paul’s Specialized Hospital Millennium Medical College Hematology laboratory
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    Comparison of Manual Platelet Estimates and Automated Platelet Count at Tikur Anbessa Specialized Hospital, Addis Ababa
    (Addis Ababa University, 2017-05) Bisrat, Elias; Tsegaye, Aster (PhD)
    Background: The accuracy of automated platelet counts can be compromised when measuring severely thrombocytopenic samples. This is especially of concern because current clinical guidelines lowered the prophylactic platelet transfusion threshold to 10 × 109/L for patients without additional risk factors. This count is a threshold for background count of many hematological analyzers, thus making validation of the automated platelet count a crucial step. Objective: To compare manual platelet estimates and automated platelet count by Sysmex KX 21N at Tikur Anbessa Hospital (TASH). Methods: A hospital based cross-sectional comparative study was conducted in Tikur Anbessa Specialized Hospital from January to March 2017 on 320 blood samples. Platelet count was enumerated by sysmex KX 21 and by manual method. Number of platelets/1000 RBC in PBS was multiplied by automated RBC count in 106/uL to get an estimate of platelet count in 103/uL and the average number of platelet/10 oil emersion field (OIF) was multiplied by 20,000. The data were entered and analyzed using SPSS version 20 and interpreted accordingly. Statistical significance was determined at 95% confidence interval. Pearson correlation coefficient was used to determine correlation between the methods. Bland Altman plot was used to assess agreement between tests. Figures and tables were used for the description of the data. Result: For normal platelet count the Paired t-test showed non-significant difference between automated and PLT estimated from average platelets/10 OIF (p>0.05), were positively correlated (r=0.994) and in the limit of agreement range (95%). For severe thrombocytopenic samples the two platelet estimation methods did not show significant difference when tested by paired t-test (p>0.05), were positively correlated (r=0.869) and in the limit of agreement range (97.5%). Conclusions: The mean PLT count by automated and PLT estimated from PLT:RBC ratio for normal count did not show significant difference so the two methods could give the same PLT count result. The mean PLT count for severe thrombocytopenic patient samples did not show significant difference when analyzed by the two manual platelet estimation methods. Key words: Peripheral blood smear, Platelet count, Platelet: red blood cell ratio, platelet estimate
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    Diagnostic Utility of Immunophenotyping by Flow Cytometry for Diagnosis and Classification of Acute Leukemias in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-11) Tegegn, Metasebia; Tsegaye, Aster (PhD)
    Background: Immunophenotypic characterization of acute leukemia is an important clinical application of flow cytometery and has become a powerful tool contributing to proper diagnosis and classification. Objective: To phenotype and classify acute leukemias by flow cytometry using commonly used markers for leukemia diagnosis. Method: A total of 40 pediatric and adult patients diagnosed with acute leukemia were evaluated by flow cytometry with 17 surface and cytoplasmic markers known to be useful in discriminating different types of acute leukemia. Results: 21 of 40 patients (52.5%) were classified as Acute Myeloblastic leukemia (AML) while 19 (47.5%) were identified as Acute lymphoblastic leukemia (ALL). Of all the ALL cases, 10 of the 19 (52.6%) were B-ALL and 47.4% (9/19) were T-ALL. Markers of immaturity HLA-DR and CD34 antigens were co expressed in 61% of AML cases, and 33% of T-ALL cases, whereas CD34 was expressed in 50% of the B-ALL cases. MPO and CD13 were the most commonly expressed markers of AML, whereas CD19 and cCD79a were present in all cases of B-ALL. Cytoplasmic CD3 and CD7 were the most sensitive markers for T-ALL. Discrimination of AML from ALL patients by flow cytometry was 80% concordant with traditional morphology. Notable discrepancies occurred in cases where leukemia cells expressed markers for more than one lineage. Conclusion: Immunophenotyping by flow cytometry provides useful information to confirm diagnoses of standard morphology methodology, to provide classifications where morphology is indeterminate, and to provide further lineage and maturation information for ALL not obtainable by morphology is needed for ALL cases. It thus represents an important tool among many in leukemia classification and is realistic in the resource limited settings. Key words: Leukemia, ALL, AML, Flow cytometry, Immunophenotyping
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    Effects of Low Dose Ionizing Radiation on the Hematological Parameters in Medical Imaging and Therapeutic Technologists Working in Selected Governmental Hospitals, Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-06) Giragn, Eden; Tsegaye, Aster (PhD)
    Background: Exposure to ionizing radiations including x-rays and gamma rays leads to abnormal hematological findings, cancer (including leukaemia), birth defects in the future children of exposed parents, and cataracts. There is no published report in Ethiopia addressing the effect of low dose radiation on hematological parameters. Objective: To compare the hematological profile such as (RBCs count, RBC indices, Hb, Hct levels, WBCs, platelets count and peripheral morphology) of medical imaging and therapeutic technologists and controls of selected Governmental Hospitals in Addis Ababa, Ethiopia Method: A comparative cross-sectional study with 182 participants in the period October 2015 to June 2016 was carried out. Of them, 91 were radiation exposed and 91 were controls. Hematological parameters were analyzed using Sysmex XT-2000i. Peripheral blood morphology was done from a stained smear. Data was entered, cleaned and analyzed using SPSS version 21. Student t-test was used to compare the hematological parameter means between the two groups, the exposed and the control. Bivariate correlation statistics was used to draw association between the dependent and independent variables. P values ≤ 0.05 were considered statistically significant. Data was cleaned, entered and analysed using SPSS 21. Result: Mean values of White Blood Cells, Mean Cell Hemoglobin, Mean Platelet Volume, Platelet Distribution Width, Platelet Large Cell Ratio, Lymphocytes, Monocytes and Basophils have shown significant difference from the control group. The mean MCH, PDW, P-LCR were higher while WBC, MPV, LYMPH, MONO, and BASO were lower in the exposed group. Atypical lymphocytes were significantly higher in the exposed group; 65/91 of the exposed and only 7 of the non-exposed group have such abnormal picture. There were larger effects on the lymphocyte of exposed workers with high number of atypical lymphocytes. A smaller but not negligible effect was noted on white blood cells and medium effects on mean cell haemoglobin, platelet distribution width, mean platelet volume, platelet large cell ratio, Basophil and monocytes. Conclusion: It is not deniable that low dose ionizing radiation is imposing impact on the haematological as well as immunological system of medical imaging and therapeutic technologists as there are larger effects on the lymphocyte and basophil subsets of exposed workers. Key words: ionizing radiation, hematological parameters, atypical lymphocyte
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    Evaluation of Erythrocyte Sedimentation Rate measurement by Iria Automated Method and Westergren manual method at Myungsung Christian Medical Center, Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-06) Tsegaye, Dawit; Tsegaye, Aster (PhD)
    Background: - Erythrocyte sedimentation rate (ESR) is still a widely used hematological parameter as indicator of disease condition. Westergren method is the standard method based on International committee for Standardization in Hematology (ICSH) recommendation for measuring ESR. But nowadays different automated instruments are available with reduced turnaround time, which increase the quality by reducing bio-hazard risk for the laboratory professionals. However, there is no method comparison study conducted in Ethiopia and still the old method is used in many health facilities. Objective: -Evaluation of Erythrocyte Sedimentation Rate measurement by IRIA automated method and Westergren manual method at Myungsung Christian Medical Center, Addis Ababa. Method: -A prospective cross sectional study was conducted at Myungsung Christian Medical Center from February to May 2017 GC. By doubling the ISCH recommendation the samples were tested in 3 different groups of values and the total sample size was 240. Every ESR ordered sample was analyzed using both manual and automated methods. Result was entered and analyzed using SPSS version 20. Linear regression, correlation and Bland Altman analysis were carried out to determine agreement between the reference and the new method was carried out. Agreement was considered acceptable when the difference is lying between mean + two standard deviation (Mean+1.96SD) for 95% and above of cases in the Bland and Altman plot. Result: The comparison between the conventional Westergren and IRIA automated method showed very good correlation in the two methods and agree well for ESR level between 1-20 mm/hr with r=0.934, Mean bias 0.663, SD 2.629,LoA(5.815, -4.490), and ESR level between 21- 60 mm/hr r=0.917, Mean bias 0.1875, SD 3.7924 LoA (7.621,-7.246). However, for ESR level greater than 60, it showed good correlation r=0.890 but poor agreement in the Bland-Altman analysis as the mean difference is lying between the limit of agreement for less than 95% of cases Mean difference 1.388, SD 11.346,LoA (23.625,-20.849). Conclusion: For ESR level below 60 mm/hr, the two instruments can be used interchangeably. However, for ESR level greater than 60mm/hr the result of the automated machine must be confirmed with the conventional westergren method before using it for clinical propose. Key words: - Erythrocyte Sedimentation Rate, Westergren, IRIA, ESR automated
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    Evaluation of Hematological and Lipid Profiles in Pulmonary Tuberculosis Patients: A case control Study at Metema and Gondar Referral Hospitals, North West Ethiopia
    (Addis Ababa University, 2017-08) Yesuf, Mohammed; Tsegaye, Aster (PhD)
    Background: Tuberculosis is one of the first most common causes of deaths in the world alongside HIV/AIDS, causing more than 9.6 million new cases and 1.5 million deaths globally in 2014 alone. This infection also accompanied by hematological and lipid profile alterations. The hematological and lipid alteration related to the disease is not yet well determined and has variation in different studies. Objective: This study aimed at evaluating hematological and lipid profiles in pulmonary tuberculosis patients in Metema hospital and Gondar referral Hospital, North West Ethiopia. Materials and methods: A case control study design was implemented from January to July 2017. One to one case to control ratio was used and a total of 88 blood samples were collected. There were 44 samples from tuberculosis patients and 44 samples from apparently healthy individuals. Collected bloods were tested using Hematology analyzer (sysmex) and Mindray chemistry analyzer for hematological and lipid profiles, respectively. Results: The mean + SD of hemoglobin, hematocrit and red blood cell count of the pulmonary tuberculosis patients were significantly lower than control groups (P < 0.05). However, platelet counts, total white blood cell counts, and erythrocyte sedimentation rate were significantly increased as compared with control groups (p<0.05).The mean serum levels of triglyceride, total cholesterol, high density lipoprotein and low density lipoprotein were significantly lower than their respective control groups (p=0.001). Body mass index had significant positive associations with RBC counts, HGB, and HCT and serum levels of TC and LDL (P < 0.05). Conclusion: Pulmonary Tuberculosis patients in this study had hematological and lipid profile abnormalities. RBC count, HCT and HGB were significantly reduced. However, TWBC count, thrombocyte, and ESR of TB patients were significantly elevated than control group. Total Cholesterol, HDL, LDL and TG concentrations were significantly reduced as compared with control groups. The factors associated with hematological and Lipid profiles also due attention to prevent further complication. Keywords: Case, Control, Lipid profile, Hematological profile, Tuberculosis.
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    Evaluation of Phlebotomy Services in Clinical Laboratory Setting in Addis Ababa Public
    (Addis Ababa University, 2014-06) Liknaw, Wondimeneh; Tsegaye, Aster (PhD)
    Background: Phlebotomy being a critical part of the pre analytical phase of laboratory testing is the most neglected procedure in health care. About 70% of quality of test is affected during phlebotomy and other pre analytical services. However, little is known about the practice of phlebotomy services in developing countries like Ethiopia. Objectives: To assess the practice of phlebotomists and to identify the major sources of errors during venous blood collection in public hospitals in Addis Ababa. Methodology: Hospital based, cross sectional study was conducted from April 15 to May 10, 2014. The study followed 40 phlebotomists while each of them were collecting 5 different venous blood collections (giving a total of 200 phlebotomies). Well structured questionnaires and checklists were used to collect data. Data was entred on EPI-Data version 3.1and statistical analysis was performed with SPSS version 20. Descriptive statistics were employed and Chi square test was used for compairing major errors observed. Result: Almost all laboratory phlebotomy sites had no SOPs available in collection sites and most of collection sites were not well ventilated. The major errors identified were use of single glove for more than one client 139 of 200 (69.5%), inappropreate cleaning practice of vein puncture sites 180 of 200 (90%), collecting blood before the disinfectant alcohol is air dried 139 of 200 (69.5%), incorrect tube collection sequences 107 of 200 (53.5%), unnecessarly applying of tourniquets after blood started flowing in to the collection tubes and syringes 170 of 200 (85.0%) and applying tourniquets before locating and selecting approperate site for venous blood collection 175 of 200 (87.5%). Conclusion and Recommendation: - Many errors were identified in the phlebotomy practice during the observational study. As the quality of blood specimen influences patient result: emphasis should be given on phlebotomy training to improve the practices for phlebotomists and ensure safety as well as quality during blood collections for laboratory analysis. Keywords: phlebotomy, venous blood collection, Quality, tourniquet, phlebotomist, preanalytical errors