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Item Drug Resistance Pattern of Mycobacterium Tuberculosis and its Association with Patients` Knowledge, Attitude and Practice towards Tuberculosis in Eastern Amhara Region(Addis Abeba University, 2011-03) Esmael, Ahmed; Desta, Kassue (BSc, MSc); Ali, Ibrahim(BSc, MSc); Agonafir, Mulualem(BSc. MSc)Background: Tuberculosis (TB) remains a serious public health problem, worsened by the emergence and spread of drug resistance particularly multi-drug resistance that threat global TB control. Data obtained from KAP survey is essential to plan, implement and evaluate Advocacy, Communication and Social Mobilization (ACSM)work. Objectives: The aim of this study was to assess the magnitude of drug resistance pattern of M.tuberculosis, knowledge, perception and practice of patients` towards TB in Eastern Amhara Region, North East Ethiopia. Methods: A cross sectional survey was conducted among new and re-treatment patients (age > 18 years old) from September 2010 to February 2011. A structure and pre-validate questionnaires was used to collect data. Primary isolation and DST were carried out on egg based LJ media using indirect proportion method. Chi-Square and multivariate logistic regression was used. Results: Out of 230 study participants for DST, 165 were new cases while 65 were previously treated cases. From these, 66.5% of isolates were sensitive and 4.4% resistance to four f irst line anti-tuberculosis drugs (HRSE) while the remaining 33.5% was resistance to at least for single drug. MDR-TB was detected in 6.5 % isolates, of which 4.4% were resistance to all four first line drugs. Overall resistance to S, R, H and E was found in 27 % (62), 10 % (23), 17.8 % (41), and 6.5 % (15) respectively. Mono resistance was found in 17.4 % (40) of all isolates Among new cases primary drug resistance for one or more drugs was observed in 23.6 % (39)cases. Primary MDR-TB was found in 3 (1.81%) cases. Similarly among previously treated cases resistance to any drug was found in 58.5 % (38) cases. MDR-TB in previously treated cases was found in 18.46 % (12) Cases; the highest being in failure cases 9.23% (6). More over the mean and median knowledge score of respondents about PTB was 6.81 and 7 respectively. Majority (53.6%) of study subjects had poor knowledge score, feels not well informed about TB and had several misconceptions that need to be clarified. Majority (66.6%)ofstudy subjects heard about TB for the first time from health workers. Of study participants, 79.9% mentioned that TB transmits by respiratory droplets through coughing and sneezing and prevents by covering mouth and nose (66.6%). The four common symptoms mentioned by respondents were cough (65.6%), weight loss (33.2%), cough > = 2 weeks (32.7%) and shortness of breath (29.4%). About half of respondent not knew current free cost of TB diagnosis and treatment. Majority of respondents also worried about the disease due to it might transmits to their family, might not be cure, social interact (fear of stigma) and unable to do work. Cost (69.9 %) and difficulties in transportation (54.5 %) mentioned as the main reason for their delaines t o seeking care. Previous drug exposure and 1 + bacterial load independently contribute for the development of drug resistance TB strains. Similarly Illiteracy, rural residence, non-previous history of contracting TB, experiencing self treatment option, and delayed frequency of visit were independent predictor of low knowledge score. Conclusion: Drug resistance TB particularly MDR-TB is an emerging problem in new and retreatment patients in our study area. Majority of respondents also had poor knowledge and several misconceptions that need to be clarified. Hence, it is essential to address the problems of drug resistance through establishing good TB control program including DOTS plus service and raise KAPs` of patients through establish proper IEC pathway to indicate the level of severity and to create proper awareness about its cause, transmission, prevention and availability of service.Item 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.Item Assessment of Antiretroviral Therapy Monitoring Laboratory Services Quality in Governmental Hospitals at Addis Ababa, Ethiopia.(Addis Abeba University, 2011-06) Mindaye, Tedla; Taye, BineyamBackground: - Despite the fact that Ethiopia is accelerating its ART program, little is known about the quality of ART monitoring laboratory services in health facilities. Objective: - To assess the quality of ART monitoring laboratory services in public hospitals of Addis Ababa with emphasis on client satisfaction, providers’ views, functional & structural status of the ART monitoring laboratory service. Methods: - Hospital based, descriptive cross sectional study was conducted from October to November 2010. In this study both quantitative and qualitative design forms were used. A total of 422 clients were considered for exit interview about their satisfaction towards ART monitoring laboratory services using structured questionnaire. To assess the structural and functional aspects of ART monitoring laboratories, observation checklist was used. In-depth interview of providers were conducted to assess their views on quality of ART monitoring laboratory services. Data were coded and entered using EPI info 2002 (Centers for Disease Control and Prevention Atlanta, GA) and analyzed using SPSS version 15 software (SPSS INC, Chicago, IL, USA). Satisfaction score was calculated by giving a value of one for very satisfied. A value of two was assigned for response of satisfied; three for neutral response. Values of four and five were given for dissatisfied and very dissatisfied responses respectively. The mean, median and mode scores for the overall satisfaction were calculated. Median of the summary score of satisfaction was used to classify as satisfied and none satisfied since the distribution of summary scores was skewed. Bivariate and multivariate logistic regression models were also used to examine the effect of selected variables on patients’ satisfaction with ART monitoring laboratory services by using Odds Ratio (OR) with a 95% Confidence Interval (CI). P-Value less than 0.05 were taken as statistically significant. Variables that were found with a statistically significant association (p<0.05) at univariate logistic analysis were entered and analyzed by multiple logistic regression analysis. Results: - A total response rate of 406 (96.2%) from 422 sample size was obtained. Among those 255(62.8%) were females. The overall satisfaction rate was 47.5%. The major determinants for none satisfaction were lack of space in blood drawing room to put client personal thing (AOR= 3.377, 95% CI 1.511-7.550, P=0.00), lack of information regarding bruises following blood drawing (AOR= 2.029; CI 1.162-3.542, P=0.01 ),waiting time to get laboratory results (AOR= 4.096; CI 1.769-9.485, P=0.00), needle stick while attempting to draw blood (AOR=7.769, 95% CI 1.280-47.166, P=0.02), waiting time to get blood drawing service (AOR= 7.643, 95% CI 2.62722.236, P=0.00). None of the hospital laboratory had guideline for disposal of damaged or expired laboratory reagents. Equipment maintenance was one of the major problems found in almost all public hospital of the city providing ART services during in-depth interview of providers. Conclusion:-The overall satisfaction level of clients with ART monitoring laboratory services was 47.5%. Accessibility and availability of latrines, ability of phlebotomist to answer questions raised by clients and comfort of chairs in blood drawing room were considered the most significant factors for low satisfaction levels. Equipment maintenance was a major challenge in rendering ART monitoring laboratory services in public hospitals.Item Stability of Complete Blood Count and 3-part White Cell Differential Parameters with Storage Time and Temperature Variation using Cell DYN 1800 Automated Hematology Analyzer(Addis Abeba University, 2011-07) Tesema, Desalegn; Tsegaye, Aster (MSc, PhD)Background: Complete blood count (CBC) and differential white cell counts are the most commonly ordered tests in clinical practice. The standard operation procedures in the ART laboratories, which are prepared based on the instrument instruction manual of the company, recommend 8 hours storage at room temperature. However, there is no clear information as to how to handle delayed specimens in situations where delayance is unavoidable. Objective: To evaluate whole blood stability with time, storage temperature and transportation conditions using Cell-Dyn 1800, a 3-part diff hematological analyzer. Methods: A total of 45 adult participants, 19 from ART clinic of Tikur Anbessa Specialized Hospital and 26 apparently healthy Medical Laboratory Science students of Addis Ababa University were included in the study using convenient sampling methods. EDTA whole blood samples were analyzed at baseline before and after aliquoting. Each of six aliquots, for room temperature and 2-8 O C storage, one each for transporting with and without an ice box were used. After the baseline analysis of the direct EDTA tube and an aliquot, all specimens were analyzed at 8, 24, 32, 56 and 72 hours of storage. Same EDTA tube was used each time after refrigeration. Transported samples were analyzed within 8 hours and compared with baseline values. Cell-Dyn 1800 automated hematology analyzer was used following the manufacturers instruction. Results: Among the CBC parameters, WBC, RBC, Hgb, MCH were stable for 72 hours post sample collection regardless of storage temperature. These values were also unaffected during transportation. MCHC was relatively less stable. PLT counts remained stable in the direct EDTA tube samples stored at 2-8 O C for 72 hours while aliquoted samples were less stable, showing a declining trend with time. The MCV and RDW, parameters affected by change in the red cell size showed an increasing trend with time where differences were statistically significant (P<0.05) after 48 hours of storage. WBC Differential data was the least stable of all, even after 8 hours of storage, where granulocytes showed a declining trend Conclusion: The various CBC parameters showed different levels of stability at different specimen storage and handling conditions. Each parameter should be treated case by case in conditions where delayance is unavoidable.Item Evaluation of Laboratory Design and Ergonomics Workstation in ClinicalLaboratory inAddisAbaba, Ethiopia(Addis Ababa University, 2011-07) Lemma, Eshetu; Taye, Beniyam(BSc,MLT,MPH); Hassen, Fatuma(BSc, MLT, MPH)Background: Since advancement of science and technology in the area of laboratorymedicine in 21st century thedesign of laboratory should be organized into high flexibilityzones and need an open plan to support the dynamic nature lab testing by manual or semi-automated or fully automated. The most difficult issue in design of laboratory is allocationand organization of space. Although well design laboratory is in place, it will becompromised if the ergonomics workstation and workflow of laboratoryarenot designedwell. In Ethiopia there is no baseline information on laboratory design, ergonomicsworkstation, and workflow sited on literature.Objective: To evaluate the ergonomic workstation, workflow and laboratory design inclinical laboratory inAddis Ababa,Ethiopia.Method: A cross-sectional study design was used. Quantitative method and directobservationwere conducted.Result:Ergonomics: Work-related musculoskeletal complaint was strongly associated withpoor ergonomic workstation. A one year increased in work experience and age of employee,the odds in favor of compliant were estimated to be increasedby a multiplicative factor of1.374 and 0.921 respectively.A total of 117 ergonomics workstation was evaluated. Theoverall workstations mean score was 1.95 and66.6% of workstation found a mean score oftwoand belowwhich indicate poor ergonomic conditions.Workflow:A total of 28 specimen collectionworkflowand 26 chemistry laboratory workflowwere identified. A total of 8 non-valued added steps were recognized from the existedchemistry laboratory workflow.The average timeofsampleswaitingat reception prior todelivery to respective laboratorieswere decreased as moresamplescollectedwithinshorttime interval.The average cycle times of 489 blood sample drawing process were 3.58minutes and 76.5% (374) ofblood samplesweredrawnwith an average cycle time of 1.0 to5.0 minutes.Atotal of 1231.31 minutes were identified as non-value added (waste) time fromexistedworkflow of chemistry blood samples testing process and seven non-valued addedprocess stepswere recognized. Clinical chemistry laboratoryprocess cycle efficiency was56.6%. Laboratory design: The adjoining and adjacent matrix principles were notdocumented in assessed laboratories.The laboratory design didn`t show the direction ofevacuation plan during emergency situationand fire extinguisher were not strategically placed and free of obstruction. Black lion hospital laboratoriesdidnothave anymechanicalventilation system.Laboratory andnon-laboratoryactivities were not separated.Conclusion and recommendation:Hospital laboratories should aware of ergonomicsprincipleand applicationand whenevernew laboratory equipmentpurchaseorder in place itwould have beenmuch better to consider the three factors:quality, cost and ergonomicspecificationof product. Laboratory employees shall modifyorreconfigureor reposition theworkstationor equipment to fit the work to yourself not you to fit towork and by doing thispossible to prevent associated musculoskeletal disorders. Concerning the workflow,laboratories should identified non-value added process or steps or activities and byeliminating those wastes and implementinga powerfulbusiness improvement tools like leanmethod possible tomaximized customer needs.Laboratories must assess their workflowperiodically to identify wasteful practicesand focused only value-added activity to increasetheprocess cycle efficiency and productivity. Whenever laboratoryconstruction orrenovationat the stageandprior to design, identifyingthesize and nature of laboratory test being performed,laboratory workflow,number and sizeof laboratory equipments needed, type and numberof ergonomicscasework and countertops,number of sinks available, aisles betweenworkstation andequipments, position of utilitycords,plumbing fixtures, location of safety station, emergency evacuation plan, number andsize of doors and windows, access control areas, and the like should be identified andcalculatedin detailearly in planning and programming phases of laboratory design. Furthermore, Laboratory proximity programming and functional relationship betweenlaboratories and reception should be determined early in design process and laboratorymoduleunit space size determinationand open plan laboratorytogether with lean laboratorydesign should be consider in design process. Finally, laboratory manager, engineer,architecture, hospital administrator, other relevant individual must be part of laboratorydesign construction and renovation team.Item 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.Item Antiretroviral Treatment Associated Hyperglycemia and Dyslipidemia among HIV Infected Patients at Burayu Health Center, Addis Ababa, Ethiopia, 2012(Addis Abeba University, 2012-06) Abebe, Molla; Kinde, Samuel; Dr.Tegbaru, BeleteIntroduction: Development of HAART has brought significant suppression of viral replication, decreasing morbidity and mortality and dramatically transforming HIV into chronic disease. Unfortunately, the prospect of maintaining patients on HAART for long term may be restricted by a heterogeneous collection of unexpected metabolic abnormalities, including dysregulation of glucose metabolism, dyslipidemia and lipodystrophy. Objective: To assess antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia. Methodology: A cross-sectional study was conducted on adult HIV infected individuals at Burayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equal number of HAART naïve and HAART initiated patients (n=126 each) were included in the study. Demographic data were collected using a well-structured questionnaire. TC, TG, HDL-C, LDL-C and glucose were determined using COBAS INTERGA 400 chemistry analyzer. The data were analyzed using SPSS version 19 software. Chi-square, student-t-test and logistic regression were used to assess association between variables. P value < 0.05 was considered as statistically significant. Result: Of 252 study participants, 72.2% were females, mean age was 35.3 years; mean BMI was 21.4; mean time with the virus was 20.6 months; 62.7% were married; 48.4% were at primary educational level; 52.4% were house wives; 15.5% were TB-HIV co-infected and 43.7% were categorized as WHO stage one. The prevalence of hyperglycemia, hypertriglyceridemia, hypercholesterolemia, decreased HDL-C and increased LDL-C was 7.9%, 22.8%, 42.1%, 50.8% and 23% in HAART initiated and 5.6%, 10.3%, 11.1%, 73% and 7.1% in non-HAART groups, respectively. ART regimens observed as a first line were only containing 2 nucleoside backbones (from AZT/D4T/3TC/TDF) with either NVP or EFV. Serum TG level ≥200 mg/dl was more common among patients who received D4T based than those with AZT based antiretrovirals (34% versus 16.4%, P = 0.029). Conclusion: First-line HAART is associated with potentially atherogenic lipid profile levels in patients with HIV infection compared to untreated patients in our setting. This indicates glucose and lipid profile levels need to be monitored regularly in HIV infected patients taking antiretroviral treatment.Item Evaluation of Same Day Diagnosis of TB Microscopy in Comparison to the Spotmorning-spot method and Knowledge, Attitude and Practice of Health Personnel towards the Use of the Same Day Diagnosis of TB in Selected Health Institution in Addis Ababa, Ethiopia.(Addis Abeba University, 2012-06) kebede, Sisay; Desta, Kassu(BSc,MSc); Ali, Ibrahim(BSc, MSc); Agonafir, Mulualem(BSc,MSc)Back ground: the need to collect serial sputum specimens over multiple patient visits results in a protected diagnostic process with rates of patients with high rates of patient dropout. Recent studies on SMS method of examination PTB reported that the first two specimens have high smear positivity in line with this WHO changed its policy to minimize the number of sputum specimens from three to two. Objective: The main objective of this study was to evaluate the same day diagnosis of TB microscopy in comparison to the spot-morning-spot methods and KAT of lab personnel, GP, HO and Nurse to wards the use of the same day diagnosis of TB in selected health institutions in Addis Ababa. Material and method: Across sectional study were conducted in 16 conveniently selected private clinics, governmental health centers, public hospitals and private hospitals, federal police and armed force hospital from September – December 2012.All patients who were avail themselves in the selected health institutions for the diagnosis of MTB and those health personal who were worked in each health facility. The diagnosis was performed using ZN sputum smear microscopy and light-emitting diodes fluorescent microscopy (LED-FM) technique. A structure and pre-validate questionnaires was used to collect data for KAP survey. Chi-square was used to assess the associations’ different variables of techniques and health personals KAP study. Result: A total of 209 participant enrolled, 43(21%) were identified culture positive,39 (18.7%) were detected by the same day approach and 40(19.1%) by the standard approach (p>0.05).on the other hand LED-FM and ZN microscopy were identified 39(18.1%) and 48(23%) respectively. Sensitivity was (88.4%) for ZN microscopy and (95.3%) for LED-FM, it was (99.4%) and (95.9%) for specificity. More over the mean and median knowledge, practice and attitude score of laboratory personal about the same day diagnosis was 4.07, 5.96, 7.67 and 5, 5, 8 respectively. Majority (61%),(73%) and (97%) of Laboratory personal had good knowledge, practice and positive attitude while the mean and median knowledge score was 4.7 and 4 respectively, but the mean and median attitude and practice was 6.65, 6.4 and 8.7 respectively .majority (57.7%),(63.4%) and (72.4%) of other health personal had poor knowledge, positive attitude and good practice respectively. using same day approach together with LED-FM would increase the smear detection rate, reduce work load, TAT, patient and health facility cost and transmission of TB. Hence, it is essential to address the advantages and dis advantages of the conventional approaches, LED-FM and same day diagnosis of TB to raise KAPs` of health personnel. Therefore it is necessary to give in-service and off service training for health personnel towards the use of LED-FM, conventional approach and the same day approach in the diagnosis of TBItem Effect of Maternal Iron Deficiency Anemia on Iron Store of Term Newborns(Addis Abeba University, 2012-06) Terefe, Betelihem; Tsegaye, Aster (BSc, MSc, PhD); Birhanu, Asaye (BSc, MLT, MSc)Background: Iron deficiency anemia (IDA) is a severe form of iron deficiency. It most commonly occurs in pregnant women and infants. One of the causes of IDA in early childhood is the acquisition of lower than the normal amount of iron store at birth. The stored iron of the newborn babies, which is the main source of iron during the first six months of their age, is endowed from the maternal circulation. Therefore, knowledge of the effect of maternal IDA on the iron stores of term newborns will be relevant for better management of IDA in infancy. Objective: The aim of this study was to assess the effect of maternal iron deficiency anemia on iron store of term newborns. Methodology: A cross-sectional study was conducted from December 13, 2011 to February 20, 2012 in Obstetrics and Gynecology departments of St. Paul’s hospital, Selam and Gulelie health centers. A total of 95 pregnant women and their respective newborns that fulfilled the inclusion criteria were included in the study. Blood samples were collected from the mothers and cord of newborns and analyzed for complete blood count and serum ferritin levels using Cell-dyn 1800 and Cobas e 411 analyzers, respectively. Women were classified into three groups as: iron deficient anemic, iron deficient non anemic and non iron deficient non anemic based on hemoglobin and serum ferritin values. All pre-analytical, analytical and post-analytical quality aspects were thoroughly controlled. For statistical analysis MedCalc® software Version 12.1.4 was used. Result: The median hemoglobin and serum ferritin levels for the pregnant women were 12.2g/dl and 42.1ng/ml, respectively. The median hemoglobin and serum ferritin levels for the newborns were 16.1g/dl and 187.6ng/ml, respectively. Newborns of iron-deficient anemic pregnant women (152.6ng/ml) had significantly lower levels ( p = 0.0008) of serum ferritin than non iron deficient non anemic pregnant women (225.9ng/ml). Besides, newborns ferritin and hemoglobin levels have significant correlation with hemoglobin ( r s = 0.256, p = 0.0122; r = 0.226, p = 0.0279), and ferritin (r s = 0.366, p = 0.0003; r s s = 0.268, p = 0.0086) levels of the mothers. Maternal age had an effect on the ferritin status of newborns, where newborns delivered from younger mothers (< 24 years) had higher serum ferritin values than the others (> 24 years). Conclusion: The study demonstrated that maternal iron deficiency anemia has a significant impact on the iron store levels of their newborn.Item Pattern of Lipid and Lipoproteins among Thyroid Dysfunction Patients Referred To Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia(Addis Abeba University, 2012-06) Nigussie, Paulos; Wolde, Mistere(BSc, M.Sc); Ayana, Gonfa(M.Sc)ABSTRACT Introduction: The relationship between thyroid hormones and lipids has long been studied, having been first described more than 70 years ago. Since then, much new information has been discovered, which justifies a reevaluation of the relationship between thyroid pathology, dyslipidemia and further cardiovascular disease rick. Relations between thyroid function and lipid status remain incompletely understood in Ethiopia. Besides the emerging concern of stroke and hypertension, goiter is one of the highly endemic and prevalent noninfectious diseases in the country. Moreover, the country health policy and strategy mainly focus on prevention of communicable diseases and physicians may fail to manage lipid and lipoprotein abnormalities, and cardiovascular risks while treating their patients for thyroid dysfunctions. Objective: To determine the relationship between thyroid dysfunction versus serum lipid profile and risk of cardiovascular disease among patients referred to the Ethiopian Health and Nutrition Research Institute. Methods: Correctional with Control study was conducted from September, 2011 to May 2012. A total of 212 participants, 106 of them referred for thyroid function laboratory investigation or on follow-up and the rest 106 sex and age matched apparently healthy control group were consented, considered for exit interview and physical examination about their antropometrical, medication, nutritional status, and for sine and symptom of thyroid disfunction with trained nurses. The laboratory investigation includes lipid and lipoprotein panels, and thyroid functional test using COBAS Integra-400, and COBAS e-411analyzers. Data entry was done using Microsoft Excel 2007. Data analysis wsbe performed using Chi-square, Student-t-test and odds ratio, using SPSS version 19 and STATA version 8 were used to assess association between variables. p value <0.05 was considered as statistically significant. Result: Of 212 study participants, 89.6% were females, mean age, mean age was 39.2 years; mean BMI was 23.4±4.9 among cases and 22.1±2.6 among control subjects. BP was statistically significantly higher among control than cases p<0.0001. Majority of the subjects were euthyroid (54.7%), followed by hyperthyroidism (23%) in which 9.4%, 6.1%, and 7.6% account for overt hyperthyroid, sub-clinical hyperthyroid, and T3 toxicosis, respectively. The rest 22.2% were hypothyroid in which 2.8%, 19.3%, account for overt hypothyroid and sub-clinical hypothyroid, respectively and 37% of the subjects have elevated thyrogloblin. However, sub-clinical hypothyroids 12.7%. Lipids and lipoproteins (TC, TRI, LDL, Apo-A, and Lp-A) were significantly elevated in hypothyroid condition than control subjects whereas HDL decreased significantly. And the reverse condition happens in hyperthyroid subjects. 47.3% of the case where taking medication for their thyroid dysfunction. Of this 21.1 % of them became euethyroid subjects after medication with L-thyroxin. And there lipid and lipoprotein profiles seem normal. Conclusion: Thyroid dysfunction is associated with higher BP, higher BMI, and lipid and lipoprotein profile. Apparently healthy subjects may became sub-clinical hypothyroid and had higher thyrogloblins; this indicate below optimum iodine supplement. L-hhyroxine may help in the optimization of lipid and lipoproteins.Item Seroepidemiology of Toxoplasma Gondii infection and its risk factors in women of child-bearing age in selected health institutions of central Ethiopia(Addis Abeba University, 2012-06) Hailu, Anteneh; Desta, Kassu (MSc); Dr.Sisay, Tesfaye(PhD); Zewda, Endras(PhD Candidate)Background: Toxoplasmosis is an important zoonotic parasitic disease worldwide.Congenital transmission of T. gondii during pregnancy has been regarded as a risk factor for the health of newborn infants.Prevalence and risk factors of toxoplasmosis in women of childbearing age in Ethiopia are unknown. Objective: Estimating the seroprevalence and potential risk factors in acquiring T. gondii infection by women of child-bearing age in Central Ethiopia. Methods A cross-sectional study was conducted from May 2011 to January 2012 in child bearing age women of sample size of 425 in central Ethiopia. Indirect ELISA IgG and IgM test in parallel structured questionnaire was used to assess possible risk factors and knowledge and perception of health professionals about the disease. The data was cleaned, coded using Microsoft excel sheet and transferred to SPSS soft ware’s version 20 for data analysis. Results: The study revealed that anti-T. gondii antibodies were detected in 81.4% of the samples of which 69.4% were positive for only IgG and 12.0% positive for both IgG and IgM antibodies. Of the 213 pregnant women 57 (26.8%) were IgM reactive. Out of 17 potential risk factors investigated, univariable logistic regression showed significant association of T. gondii infection with study area, age, pregnancy status, raw vegetable consumption, source of water, presence of cat at home, contact with cat, HIV status and precaution during cats’ feces cleaning (P≤0.05). Almost all child bearing age women had no awareness or information regarding health risk of cats and toxoplasmosis. From health professionals, 63% (63) of them had knowledge of toxoplasmosis. Among health professionals 47.3% didn’t knew the importance of testing toxoplasmosis during pregnancy and (93%) do not screen pregnant women but 78% of them had an exposure of toxoplasmosis in patient and all of them didn’t gave health education. Conclusion: Results of current study showed that the seroprevalence of T. gondii infection in women of child-bearing age in central Ethiopia is high. Study area, pregnancy and raw vegetable consumption are risk factors to acquire T.gondii infection. Educational program, antenatal screening of pregnant women and further epidemiological studies to uncover the economic and health impact of toxoplasmosis are suggested.Item External Quality Assessment on CD4 + T-Cell count using In-house Proficiency Testing Panels for CD4 count Laboratories in Addis Ababa, Ethiopia.(Addis Abeba University, 2013-03) Kidanu, Natnael; Dr. Wolday, Dawit; Kinde, Samuel; Mulugeta, GebruBack ground: A CD4+ T-cell count External Quality Assessment (EQA) program is important for the evaluation of performance of CD4 count laboratories. Objective: The purpose of the present study is to assess the quality of CD4 count laboratory performance using in-house Proficiency Testing (PT) panels that perform routine CD4 counts in Addis Ababa, Ethiopia. Methods: Voluntary sampling technique was employed and 20, 23, and 25 laboratories were participated in trials 1, 2, 3 respectively. In-house prepared fresh whole blood samples both with 68 “normal” and 68 “low” CD4 count materials were sent according to WHO guidelines to participating laboratories. The percentage and absolute counts of CD4+ T-lymphocytes were done using their routine procedures. The data were analyzed using Microsoft Excel , sigma plot version 12.3, and Graph Pad® Prism version 5 for each trial, for each participant which included; the trimmed mean, standard deviation (SD), the percent coefficient of variation (%CV), the residual, and the standard deviation index (SDI) values for both the absolute counts and percentages of CD4+ lymphocytes (%CD4). Feedback was provided to each respective participant within one month of result submission in each trial. Results: Most participating laboratories produced results that were within 2SD of the mean (Mean ± 2SD). The average inter-laboratory precision (trimmed %CV) was 10.87% and 5.14% for CD4 absolute counts and CD4% of Lymphocytes respectively. For the normal level CD4 EQA material, the trimmed mean %CV (between-laboratory precision) was 9.59% and 3.23% for CD4 absolute counts and %CD4 respectively. For the low level CD4 EQA material, the trimmed mean %CV (between-laboratory precision) was 12.15% and 7.05% for CD4 absolute counts and %CD4 respectively. The percentage outlier rate of absolute CD4+ counts and % CD4 for all trials were 4.3% and 4.1% respectively. Conclusion: CD4 EQA program using In-house PT panels was found to help facilities in early identifying their gaps with regard to their CD4 count performance. In-house prepared PT panels was helpful in avoiding the challenges encountered during participation in external EQA providers like the high cost, transportation problem, feedback delay, CD4 laboratory coverage. TMItem Patients’ and Health Professionals’ Perception and Satisfaction on Malaria Diagnostic Service in Awi Zone; Amhara Nation Regional State, North West Ethiopia(Addis Ababa University, 2014) Likie, Agajie; Tsegaye, Aster (PhD)Background: Correct diagnosis of malaria is crucial for proper treatment of patients and surveillance of the disease. However, there are various limiting factors including inadequate infrastructure and consumables. Furthermore, inappropriate perception and inadequate satisfaction of health service providers and users are suggested as significant challenges in the utilization and the quality of laboratory malaria diagnostic services in other African countries. Objective: To assess perceptions and satisfactions of patients and health professionals about malaria diagnostic service in Awi Zone, Amhara National Regional State, North West Ethiopia. Methods: Health facility based cross sectional study was conducted from November to December 2013. The patient sample size was determined by using single population proportion. Interview and self administered structured questionnaires were employed to collect information from laboratory personnel, clinicians and patients. Data were collected from 304 patients, 99 clinicians, 26 laboratory professionals and 11 key informants. Data was entered using Epi-Info 3.5.3, further analysis was done by SPSS version 20. Chi-square test was used to determine association between the main out come and associated factors. The strength of association between covariates and the main outcome was identified by using odds ratio in binary logistic regression, and also multiple logistic regression was utilized to crosscheck confounders for those associated variables. Values less than 0.05 and 95% CI were taken as significant level. Result: Overall 52.6% of patients, 50% of laboratory professionals, and 61.2% of clinicians were satisfied with malaria diagnostic service in their health facility laboratories. Ethnicity, residence, knowing malaria diagnosis after consulting clinician, and time period to receive malaria result were independent predictors for patient satisfaction (p< 0.05). Lack of benefit, training or professional development and insufficient duty payment besides unequal workload were some of the factors significantly affected lab professionals level of satisfaction (p<0.05). Request for laboratory malaria diagnosis on the basis of clinical signs and symptoms of patients and trust for malaria diagnostic result were important predictors for clinician satisfaction (p<0.05). Conclusion and Recommendation: Based on the finding, patients and health professionals level of satisfaction on malaria diagnosis service was in the range of 50% to 61.2%. Lab constraints were the main factors that mimic satisfaction for health professionals, and these in turn might cause negligence of professionals towards patients and prolonged waiting time that presented dissatisfaction for patients. Thus, the regional government should focus on those constraints that compromise the quality of malaria diagnostic service.Item Lipids as Indirect Biomarkers of Pulmonary Tuberculosis in Patients with and Without Hiv Infection in Addis Ababa, Ethiopia(Addis Ababa University, 2014-02) Amare, Yemane; Kassa_, Desta (PhD)Background: - Even though some studies have shown that lipids could be indirect markers of pulmonary tuberculosis (TB), there is no sufficient data from Ethiopia which characterize the level of these markers during TB disease and infection. Nonetheless, the effect of HIV co-infection and its treatment on the level of these makers is not well investigated. Objective: - to determine whether lipids are indirect biomarkers of pulmonary TB in pts with or with out HIV infection. Methods: - fasting plasma samples collected from 159 untreated adults visiting various health institutions in Addis Ababa (44 HIV+/TB+, 49 HIV-/TB+, 17 HIV+/TST+, 24 HIV-/TST+ and 25 HIV-/TST-) at baseline, from 88 (30 HIV+/TB+, 47 HIV-/TB+ and 11 HIV+/TST+) groups after 6 month of ATT and ART and from 31 (20 HIV+/TB+ and 11 HIV+/TST+) groups after 18 months of ART and stored for five years at -80 0C until analyzed for total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) using Cobas Integra 400 plus. We used stata version 11 for statistical analysis. Results: -at baseline, mean level of TC, LDL-C and HDL-C were significantly lower in HIV-TB+, HIV+TB+ and HIV+TST+ as compared to HIV-TST+ and HIV-TST-. TG was also significantly lower in HIV+/TB+, HIV-TB+ and HIV+/TST+ than in HIV-TST-. Patients with HIV-/TB+ were also significantly different from HIV-/TST+ groups for TG levels. On the other hand HIV-TB+, HIV+TB+ and HIV+TST+ did not differ significantly from each other for most lipid profiles except for HDL-C that was markedly lower in HIV+/TB+ than HIV-/TB+ and HIV+/TST+ groups. After 6 month of ATT for HIV-/TB+ groups, significant increases were observed in TC, LDL-C and HDL-C. Proportion of patients with abnormal high TC, TG and LDL-C after ATT was very few (≈ 4%). For HIV+/TB+ patients, After 4 months of ART and 6 month of ATT, significant increases were observed in TC, TG and HDL-C levels. At 18 months, the proportion of patients with TC levels ≥ 200 mg/dl had increased significantly, from 0 to 20 % and TG levels > 150 mg/dl from 0 to 30 %. However, the proportion of patients with HDL-C levels < 40 mg/dl decreased significantly, from 95 % to 50 %. For HIV+/TST+ patients, After 6 months of ART, no significant change in all lipid levels. However, after 18 months of treatment, TC levels significantly increased by a mean of 61 mg/dl and LDL-C increased by 37 mg/dl Conclusion and recommendations: In addition to cardiovascular risk prediction, if confirmed in further studies with larger sample size and combined with other prognostic clinical and laboratory markers, measurement of plasma lipids may allow clinicians and investigators to target patients with pulmonary TB in whom microscopy is most likely to yield a pathogen. Key words: TB, TB/HIV co-infection, biomarker, lipids, ATT, ARTItem Frequency of Specimen Rejection and Associated Factors at St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia(Addis Ababa University, 2014-04) Molla, Habtamu; Tsegaye, Aster (PhD)Introduction: Laboratory testing is an integral part of the clinical decision-making process, and results of laboratory testing often strongly influence medical diagnoses and therapies. Quality of specimen is an important factor that affects the accuracy and usefulness of laboratory results. The problem is high in resource poor countries like our country, Ethiopia. Identifying the types, frequency and associated factors influencing the quality of clinical samples is important for designing appropriate interventions to prevent their generation and Serology departments. Compared with the respective frequency with which they collect the specimen, laboratory personnel had significantly fewer rejected specimens than Nonlaboratory personnel. The proportion of specimens that were rejected in emergency department and inpatient services were twice more than for the outpatient services. Conclusion: Our finding shows the problems of specimens in the preanalytic phase and the factors involved in rejection of specimens, particularly with respect to specimen collections performed outside the laboratory walls by Nonlaboratory personnel who are not under the direct control of the laboratory; moreover, the finding shows that the rates of specimen rejection are higher for inpatients and ED than outpatients, owing to the performance of outpatient procedures by personnel under direct laboratory control. and hence improving the quality of laboratory service. Different literatures showed that more than 70% of errors in the laboratory occur in the pre analytical phase. Objective: The purpose of the study is to determine the frequency of specimen rejection and associated factors of specimens submitted for different tests to the St. Paul hospital millennium medical college, Addis Ababa, Ethiopia. Methods: Cross sectional study design was applied at St. Paul hospital millennium medical college medical laboratory. A total of 8063 specimens were collected during the study period. The quality of all specimens submitted to laboratory during data collection period were checked and inappropriate specimens were recorded in data collection checklist format. The data was entered and analyzed using SPSS version 16.0 software. Result: Of 8063 total specimens submitted for testing to the laboratory of St. Paul hospital millennium medical college during the data collection period, 116(1.4%) were rejected. The most frequent reason for rejection was hemolysis of specimen, which occurred much more frequently than the second most cited reasons, clotted specimens and unlabelled specimens. Compared with their respective frequency of rejection of specimens by type of requested laboratory service, significantly more rejected specimens occurred in HematologItem Assessment of Knowledge, Attitude and Practices of Medical laboratory professionals on use of Internal Quality Control (IQC) for Clinical Laboratory Tests among Selected Health Centers in Addis Ababa, Ethiopia(Addis Ababa University, 2014-05) Mamuye, Dereje; Hassen, Fatuma (PhD)Background: Internal quality control (IQC) is designed to detect, reduce, and correct deficiencies in a laboratory's internal analytical process prior to the release of patient results, in order to improve the quality of the results reported by the laboratory. As different studies indicated, 5% to 10% of laboratories are deficient in IQC practices, including IQC frequency, use of appropriate material, and statistical processing. Understanding what medical laboratory professionals know about IQC, their thinking about it and their actual practice of what they know will help to design solutions for improving quality of medical laboratory service. Objective: To assess Knowledge, altitude and practices (KAP) of medical laboratory professionals on the use of IQC for laboratory tests among selected Health centers. Methods: Cross sectional study design was employed from December 2013 to May, 2014 to assess KAP of IQC for laboratory tests on 175 medical laboratory professionals working in 30 selected health centers in Addis Ababa. The data was entered and analyzed using SPSS version 19.0 soft ware. Descriptive statistics was computed for most of the study variables. Logistic regression analysis was used to determine associations with dependent and independent variables; crude and adjusted odds ratios were used to see the strength of the association and control for confounder‟s effect. P values less than 0.05 were taken as statistically significant. Result: From a total of 175 study participant majorities (81.7 %) had better Knowledge about preparing in house made IQC and 18.3 % have no knowledge about it.. All in all 98 (68.5%) of the study participants did not face failed result for IQC while 45 (31.5%) had faced failed result. And their decision for failed IQC result was 21(46.6%) immediately reject whereas 24 (53.3 %) of them would repeat the test before rejecting the result. When study participant's feeling was classified as bad, good, very good and excellent, 4 (2.3%) had bad, 79(45.1%) had good, 38 (21.7%) had very good and 54(30.9%) have excellent attitude towards IQC. About 32 (18.3%) of the study participants had never performed IQC while 143(81.7%) of them declared that they perform IQC. However, only 49.1% had documented their IQC result and the remaining 50.9% have no document. Regarding frequency of IQC, 64 (57.6%) of them perform IQC per batch, 24 (21.6%) daily, 6 (5.4 %) monthly and 17(15.3%) claimed performing IQC weekly. And over all 53(47.8%) of the respondents accepted this frequency Major reason for not performing IQC for laboratory tests in this study were work load, difficulty of IQC materials to prepare for some routine tests, cost of IQC materials, lack of supply, lack of staff members. The major factors for good IQC practice in this study were educational level, work experience, participation in SLMTA program. Taking LQM training, however, had no significant association both with Knowledge as well as IQC practice. Conclusion: The study demonstrates good IQC knowledge and attitude which is not translated into an equivalent practice as demonstrated by poor documentation. Working in a laboratory which participates in SLMTA has a positive association while LQM training has no significant association with IQC knowledge and practice. Hence, practice focused training as well as motivation activities are needed to promote the use IQC and reduce rate of error for laboratory resultsItem Prevalence of Bacterial isoLates from Cerebrospinal Fluid, their Antimicrobial Susceptibility Pattern and Associated Risk factors with Special Emphasis on Streptococcus Pneomoniae Among Pediatrics suspected meningitis patients at Tikur Anbessa and Yekatit 12 Specialized Hospitals, Addis Ababa, Ethiopia(Addis Ababa University, 2014-05) Hassen, Mulu; Mulugeta, Gebru (PhD)Background: Bacterial meningitis remains a major cause of mortality and morbidity in neonatology and pediatrics patients in many countries of the world including Ethiopia. Information on prevalence of bacterial meningitis, susceptibility of the causative microorganism to rationalize treatment and associated risk factors is scare among pediatrics groups. Objective: To isolate bacteria’s from CSF specimen, determine antimicrobial susceptibility pattern and to assess associated risk factors with special emphasis on Streptococcus pneumoniae among pediatrics suspected meningitis patients attending pediatrics clinic at Tikur Anbessa and Yekatit 12 specialized hospitals, Addis Ababa, Ethiopia. Methodology: A hospital based cross sectional study was conducted at Tikur Anbessa and Yekatit 12 specialized hospitals, from September, 2013 to January, 2014. A consecutive sampling technique was used. Three hundred eighty five pediatrics patients attending the hospital at pediatrics ward that were gave CSF samples for diagnostic purpose were enrolled in the study. Samples were taken from them and analyzed according to standard microbiological (culture) procedures, antimicrobial susceptibility pattern were determined using disc diffusion technique and serological (BinaxNOW streptococcus pneumoniae antigen test) procedure was also done. Datas were double entered with EPI INFO version 3.5.3 and analyzed using SPSS version 21 software. Binary logistic regression was used to identify the association between variables. Sensitivity, specificity, PPV and NPV were used to see the performance of the ICT. Result: Bacterial pathogens were isolated from 17 patients showing an isolation rate of 4.4%.Among these, 58.8% and 41.2% were gram negative and gram positive organisms respectively. The most commonly isolated bacteria were S.pneumoniae (35.3%), followed by Neisseria meningitidis (11.8%). Among all risk factors assessed, none of them were statistically significant with suspected meningitis cases (p>0.05). The antimicrobial sensitivity remained high for third generation cephalosporins for most of the isolates. The ICT increased the detection of pneumococcus over culture. Conclusion The prevalence of bacterial isolates in this study was 4.4%. Antigen detection (BinaxNOW S.pneumoniae test in our study) is a better adjuvant to culture. Frequency of single as well as multiple drug resistance was very high among the bacterial isolates. Area specific periodic evaluation of antimicrobial susceptibility test will be importantItem Prevalence and Antimicrobial Resistance of Bacterial Isolates With Special Emphasis on Enterobacteriaceae Among Children Suspected for Septicemia And Urinary Tract Infection in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia(Addis Ababa University, 2014-05) Hailu, Melese; Asrat, Daniel (PhD)Background: Blood stream and urinary tract infections are a major cause of mortality and morbidity of the pediatric population. Extended spectrum beta-lactamase (ESBL) producing and carbapenem resistant enterobacteriaceae is the challenge for controlling now days. Assessing the prevalent bacteria and their antibiotic resistance helps to provide effective therapies, develop rational prescription programs and make policy decisions. Objective: To determine the prevalence and antimicrobial resistance of bacterial isolates with special emphasis on enterobacteriaceae among children suspected for septicemia and urinary tract infection in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Method: A cross sectional study was conducted from January 10 to March 30/2014 at Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. A total of 322 study participants who were suspected for septicemia and/or UTI were recruited. All blood and urine samples were cultured on Blood and MacConkey agar. All culture positives were characterized by colony morphology, Gram stain and biochemical tests using the standard procedure. Significant bacteriuria was determined for all culture positive urine samples. Antimicrobial susceptibility test was performed for all bacterial isolates using Kirby-Bauer method. ESBL was detected using combination disk & double disk synergy methods on Muller Hinton agar. Carbapenemase were detected by Modified Hodge method using Meropenem. All demographic & laboratory data were entered to EPI INFO & exported to SPSS version 20 for analysis. Result: The overall prevalence of bacteria isolates from blood and urine cultures was 17.1%. From 177 blood samples 13.0% (n=23/177) and from 145 urine samples 22.1% (n=32/145) were culture positives. Coagulase negative Staphylococci & Klebsiella ozaenae were the predominate bacteria isolated in blood and urine cultures respectively. Most of them 89.1% (n=49/55) developed multidrug resistance (MDR≥2 drugs) to most commonly used antibiotics. Multiple resistances were observed in 71.42% of Gram positive and 95.11% Gram negative isolates. Prevalence of ESBL producing and carbapenem resistant enterobacteriaceae was 78.57% and 12.12% respectively. Conclusion: The choice of drugs in the treatment of bacteria isolates from blood and urine is quite narrow today due to the wide scale resistance to common antibiotics. The emergence of MDR calls for continuous monitoring & reviewing of antimicrobial policy in hospitals and the country at large. Key terms: Septicemia, UTI, Bacterial isolates, antimicrobial resistance pattern, ESBL, Carbapenem resistance, Tikur Anbessa University Hospital, Addis Ababa, EthiopiaItem Assessment of Biosafety Practice and Associated Factors in Clinical Laboratory Workers Among Government Hospitals in Addis Ababa, Ethiopia(Addis Ababa University, 2014-05) Seyoum, Alexsander; Worku, Walelegn (PhD)Background: Biosafety is an important practice in all laboratory settings especially in developing countries where standard operating procedures are lacking. There is only limited information about biosafety practices in government hospital laboratories in Addis Ababa. Objective: To assess the situation of biosafety practice and associated factors in clinical laboratory workers among government Hospitals in Addis Ababa, Ethiopia Method: Cross-sectional study design was conducted from March to May 2014; in all government Hospitals of Addis Ababa. A total of 290 laboratory professionals were participated about their biosafety practice and its associated factors using structured questionnaire to assess the structural and functional aspects of Biosafety Practice of laboratories. Data were coded and entered by Epi Info and Exported to SPSS V.20 for analysis. Bivariate and multivariate analysis were also used to identify factors that affect the outcome variable and to examine the effect of selected variables on laboratory personnel practice toward biosafety practice by using Odds Ratio (OR) with a 95% Confidence Interval. P- Value less than 0.05 were taken as statistically significant. Variables that were found with a statistically significant association (p<0.05) at bivariate logistic analysis were entered and analyzed by multiple logistic regression analysis. Results: - In this study a total of 290 laboratory professionals were involved. Out of those subjects the biosafety practice rates of protective barrier were 76.2%. The major factor for biosafety practice were practice of performing a written procedure for the clean-up of spills (AOR=2.31; CI 1.21-4.42), those who were practice of decontamination and wastes before disposal (AOR=2.69; CI 1.49-4.86) and those who got information in Participating a biosafety practice (AOR=5.07; CI 1.66-15.52) Conclusion: - This study revealed that there is an achievement of a minimum requirement of biosafety practice among studied laboratory personnel. Practice of performing clean-up of spills, practice of decontamination and wastes before disposal and information in participating a biosafety practice are a significant association with biosafety practice.Item Prevalence of Smear Negative Pulmonary Tuberculosis Among Ptb Suspected Patients at Adama Referral Hospital, Adama, Ethiopia(Addis Ababa University, 2014-05) Belew, Adugna; Desta, Kassu (Assistant Professor)BACKGROUND: Tuberculosis is a communicable disease caused by infection with Mycobacterium tuberculosis complex group and infects almost one third part of the world population and kills around two million people worldwide each year. Much attention has recently been paid to the problem of smear-negative pulmonary tuberculosis. Quite appropriately, the discussion has focused on low-income countries, home to the vast majority of individuals with tuberculosis and HIV and where the ability to culture diagnostic specimens may be lacking. In particular, smear-negative pulmonary TB (SNPTB) has become an increasing important clinical and public health problem, especially in areas that are affected by the dual infection of tuberculosis and Human immunodeficiency Virus, such as sub-Saharan Africa including Ethiopia. OBJECTIVE: The aim of the study is to determine the prevalence of smear negative pulmonary tuberculosis using standard culture methods and clinical algorithm among PTB suspected patients at Adama Referral Hospital, Adama, Ethiopia . METHODS: A cross sectional study was conducted among suspected pulmonary tuberculosis patients (age >18 years old) visiting at Adama referral hospital in Eastern oromia Region from June 2013 to December 2013. The study subjects were all smear negative pulmonary tuberculosis patients and a consecutive sampling technique was used. A sputum sample was collected from patients who had smear negative result by Zihel Neelson method/technique. All smear negative pooled sputum samples was processed for culture using conventional Lowenstein-Jensen solid medium at the Adama regional laboratory. Descriptive statistics was computed. P < 0.05 will be statistically significance and multivariate logistic regression will be used for analysis of the result. RESULTS: Of 232 AFB smear-negative patients, 130(56 %) were males. The mean age of the respondents was 40.2 ranging from 19 to 77 years old. Of 232 AFB smear-negative patients, 28 (12.1) were MTB culture positive. Among adults PTB suspected patients; smear-negative TB culture positive was less prevalent (10.7%) in age group 41-50 years. Majority (71.4%) of smear- negative TB culture positive was observed in male The majority of patients came with a combination of symptoms and the entire patient had chronic cough more than two weeks. Of the study participants, 116(50.0%) had abnormal chest x-ray finding. The binary- logistic regression identified that Productive cough (OR (95%CI)= 0.82(0.81-0.91)), Haemoptysis (OR (95%CI)= 2.43(1.04-5.68)), night sweats (OR (95%CI)= 6.85(2.00-23.39)), Unexplained weight loss (OR (95%CI)= 3.44(1.53-7.72)), the presence of typical X-ray Findings (OR (95%CI)= 2.81(1.18-6.68)), and being HIV patients or positive(OR (95%CI)=4.92(2.1- 11.5)) were independently associated with confirmed SNPTB. But in Multivariate regression analysis, Productive cough (OR (95%CI)= 0.82(0.81-0.91)), night sweats (OR (95%CI)= 8.27(2.27-30.1)), and being HIV patients or positive(OR (4.16(1.45-11.96)) were significantly associated with confirmed SNPTB.