Medical Laboratory Sciences

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Prevalence of Hepatitis B and Hepatitis C Virus Infections and Associated Risk Factors among Sexually Transmitted Infection Syndromic Diagnosed Patients Attending at Selected Government Health Facilities, Addis Ababa, Ethiopia
(Addis Abeba Unvirsity, 0204-05-12) Beyene Demi; Mistire Wolde
Background: Hepatitis B and hepatitis C are among the main public health concerns in the world and are serious infectious diseases. In the first 6 months, the most infections with that viral hepatitis have no symptoms; therefore, diagnosis of the virus in the early stage is difficult. Syndromic approach for management is widely used to control and reduce the burden of sexually transmissible diseases; however the magnitude of viral hepatitis B and hepatitis C infections is still underreported in Ethiopia among sexually transmitted syndromic diagnosed patients. Objective: The aim of our study was to assess the prevalence of hepatitis B virus and hepatitis C virus infections and associated risk factors among sexually transmitted infection syndromic diagnosed Patients attending at Selected Government Health Facilities in Addis Ababa, Ethiopia. Methods: A health facility based cross-sectional study was conducted from January to May 2024. The socio-demographic data was taken from each study participant using pre-structured standard questioner. The 5 ml of whole blood was collected using serum separator test tube and serum sample extracted to detect the presence of HBsAg and anti-HCV antibody by using rapid test and ELISA test kits. The data was inserted into Microsoft excel and exported in to SPSS Version 23 for analysis of the result. Descriptive statistics, bivariate or multivariate analysis were used and p value lower than 0.05 were considered as statically significant. Result: A total of 355 study subjects who have sexually transmitted syndromes were participated in the study. The overall prevalence of HBsAg and HCV anti-body was 5.6% and 3.1 % respectively. History of sexually transmitted disease and blood transfusion found to be statically significant with HBV with (AOR 7.4; 95 % CI: 1.6-32.9, P= 0.009) viral infection and history of blood transfusion with HCV with (AOR of 7.4; 95%CI: 1.9-28.8, p=0.003) viral infections. Conclusion: This study showed that HBV and HCV are still public health problems which need awareness and health education on the risky behaviors and mode of transmission of HBV and HCV among individuals with Sexually Transmitted Infection syndromes. Keywords: HBV, HCV, STI/STD, syndromic patients, Addis Ababa, Ethiopia
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 ; Ali Ibrahim; Agonafir Mulualem
Background: Tuberculosis (TB) remains a serious public health problem, worsened by theemergence and spread of drug resistance particularly multi-drug resistance that threat global TBcontrol. 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 .tuberculosis, knowledge, perception and practice of patients` towards TB in Eastern AmharaRegion, 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-validatequestionnaires was used to collect data. Primary isolation and DST were carried out on egg basedLJ media using indirect proportion method. Chi-Square and multivariate logistic regression wasused. Results: Out of 230 study participants for DST, 165 were new cases while 65 were previouslytreated cases. From these, 66.5% of isolates were sensitive and 4.4% resistance to four f irst lineanti-tuberculosis drugs (HRSE) while the remaining 33.5% was resistance to at least for singledrug. 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 isolatesAmong 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 wasfound 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 7respectively. Majority (53.6%) of study subjects had poor knowledge score, feels not wellinformed 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 andprevents by covering mouth and nose (66.6%). The four common symptoms mentioned byrespondents were cough (65.6%), weight loss (33.2%), cough > = 2 weeks (32.7%) and shortnessof breath (29.4%). About half of respondent not knew current free cost of TB diagnosis andtreatment. Majority of respondents also worried about the disease due to it might transmits totheir 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 oseeking care.Previous drug exposure and 1+bacterial load independently contribute for the development ofdrug resistance TB strains. Similarly Illiteracy, rural residence, non-previous history ofcontracting TB, experiencing self treatment option, and delayed frequency of visit wereindependent 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 andseveral misconceptions that need to be clarified. Hence, it is essential to address the problems ofdrug resistance through establishing good TB control program including DOTS plus service andraise KAPs` of patients through establish proper IEC pathway to indicate the level of severityand to create proper awareness about its cause, transmission, prevention and availability ofservice.
Assessment of Antiretroviral Therapy Monitoring Laboratory Services Quality in Governmental Hospitals at Addis Ababa, Ethiopia.
(Addis Abeba University, 2011-06) Mindaye Tedla; Taye Bineyam
Background: - Despite the fact that Ethiopia is accelerating its ARTprogram, little is known about the quality of ART monitoring laboratoryservices in health facilities. Objective: - To assess the quality of ART monitoring laboratory services inpublic hospitals of Addis Ababa with emphasis on client satisfaction,providers’ views, functional & structural status of the ART monitoringlaboratory service. Methods: - Hospital based, descriptive cross sectional study was conducted from October to November 2010. In this study both quantitative andqualitative design forms were used. A total of 422 clients were considered forexit interview about their satisfaction towards ART monitoring laboratoryservices using structured questionnaire. To assess the structural and functional aspects of ART monitoring laboratories, observation checklist wasused. In-depth interview of providers were conducted to assess their viewson quality of ART monitoring laboratory services. Data were coded andentered using EPI info 2002 (Centers for Disease Control and PreventionAtlanta, GA) and analyzed using SPSS version 15 software (SPSS INC,Chicago, IL, USA). Satisfaction score was calculated by giving a value of onefor very satisfied. A value of two was assigned for response of satisfied; threefor neutral response. Values of four and five were given for dissatisfied andvery dissatisfied responses respectively. The mean, median and mode scoresfor the overall satisfaction were calculated. Median of the summary score ofsatisfaction was used to classify as satisfied and none satisfied since thedistribution of summary scores was skewed. Bivariate and multivariatelogistic regression models were also used to examine the effect of selectedvariables on patients’ satisfaction with ART monitoring laboratory services byusing Odds Ratio (OR) with a 95% Confidence Interval (CI). P-Value less than0.05 were taken as statistically significant. Variables that were found with astatistically significant association (p<0.05) at univariate logistic analysiswere entered and analyzed by multiple logistic regression analysis. Results: - A total response rate of 406 (96.2%) from 422 sample size wasobtained. Among those 255(62.8%) were females. The overall satisfactionrate was 47.5%. The major determinants for none satisfaction were lack ofspace 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 followingblood 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 whileattempting 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% CI2.62722.236,P=0.00). None of the hospital laboratory had guideline for disposalof damagedor expired laboratory reagents. Equipmenm aintenance wasone ofthemajor problemsfound inalmost allpublichospital of thecity providingARTservicesduringin-depthinterviewofproviders. Conclusion:-Theoverall satisfactionlevelof clientswithART monitoringlaboratoryservices was 47.5%.Accessibilityand availability of latrines,abilityofphlebotomistto answerquestionsraisedby clientsandcomfort ofchairsinblooddrawingroomwereconsideredthemost significantfactors forlowsatisfactionlevels.Equipmentmaintenancewasa major challengeinrendering ART monitoring laboratory services in public hospitals.
Assessment of Blood and Blood Component Utilization in Black Lion Specialized Hospital, Addis Ababa, Ethiopia
(Addis Abeba University, 2011-06) Tamene Melaku; Tsegaye Aster; Birhanu Asaye; Taye Benyam
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 bloodcomponent utilization, recipient status by pre- and post- transfusion assessments in additionimproved and not improved after transfusion. However in Ethiopia the regular audit andassessment of the transfusion practice is not well studied. Objective: To assess utilization of blood and blood components for transfusion at Black LionSpecialized Hospital, Addis Ababa Ethiopia. Methods: A one year (September 2009 to August 2010) hospital based retrospective studywas conducted to analyze the pattern of blood component utilization in Black LionSpecialized Hospital blood transfusion service effected from October 2010 to January2011.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 weselected 373 subjects and collected information from the existing blood bank log book onABO and RH blood group, amount of transfusion episodes, and type of blood administered. Inaddition, 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 unexpectedreaction, pre- and post transfusion examinations including improvement status. Data wasanalyzed for descriptive statistics, univariate and multivariate analysis using SPSS version15.0 software (SPSS INC Chicago IL, USA). Results: - Of 361 transfused study subjects 856 units of blood were transfused with the meanof 2.37 units. Of the transfused 188(52.1%) were Females. The most widely used blood andblood component type in this study was whole blood 307 (85%) and the combination of twoblood 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 ofimprovement 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 associationswere found between the overall improvement statuses of the patient with their profession ofthe 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 otherdeveloping countries. However, transfusion of blood components was very low and therewere high rate of whole blood transfusion. The prevalence rate of patient improvement statusafter transfusion was high.
Evaluation of Laboratory Design and Ergonomics Workstation in Clinical Laboratory in Addis Ababa, Ethiopia
(Addis Ababa University, 2011-07) Lemma Eshetu; Taye Beniyam; Hassen Fatuma
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 strategicallyplaced 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.
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
Background: Complete blood count (CBC) and differential white cell counts are the mostcommonly ordered tests in clinical practice. The standard operation procedures in the ARTlaboratories, 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 tohow to handle delayed specimens in situations where delayance is unavoidable. Objective: To evaluate whole blood stability with time, storage temperature andtransportation 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 SpecializedHospital and 26 apparently healthy Medical Laboratory Science students of Addis AbabaUniversity were included in the study usingconvenient sampling methods. EDTA wholeblood samples were analyzed at baseline before and after aliquoting. Each of six aliquots, forroom temperature and 2-8OC storage, one each for transporting with and without an ice boxwere used. After the baseline analysis of the direct EDTA tube and an aliquot, all specimenswere analyzed at 8, 24, 32, 56 and 72 hours of storage. Same EDTA tube was used each timeafter refrigeration. Transported samples were analyzed within 8 hours and compared withbaseline values. Cell-Dyn 1800 automated hematology analyzer was used following themanufacturers instruction. Results: Among the CBC parameters, WBC, RBC, Hgb, MCH were stable for 72 hours postsample collection regardless of storage temperature. These values were also unaffected duringtransportation. MCHC was relatively less stable. PLT counts remained stable in the direct EDTAtube samples stored at 2-8OC for 72 hours while aliquoted samples were less stable, showing adeclining trend with time. The MCV and RDW, parameters affected by change in the red cellsize 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 8hours of storage, where granulocytes showed a declining trend Conclusion: The various CBC parameters showed different levels of stability at differentspecimen storage and handling conditions. Each parameter should be treated case by case inconditions where delayance is unavoidable.
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; Tegbaru Belete
Introduction: 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 restrictedby a heterogeneous collection of unexpected metabolic abnormalities, including dysregulation ofglucose metabolism, dyslipidemia and lipodystrophy. Objective: To assess antiretroviral treatment associated hyperglycemia and dyslipidemia amongHIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia. Methodology: A cross-sectional study was conducted on adult HIV infected individuals atBurayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equalnumber of HAART naïve and HAART initiated patients (n=126 each) were included in thestudy. 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. Thedata were analyzed using SPSS version 19 software. Chi-square, student-t-test and logisticregression were used to assess association between variables. P value < 0.05 was considered asstatistically significant. Result: Of 252 study participants, 72.2% were females, mean age was 35.3 years; mean BMIwas 21.4; mean time with the virus was 20.6 months; 62.7% were married; 48.4% were atprimary 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 morecommon 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 inpatients 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.
Effect of Maternal Iron Deficiency Anemia on Iron Store of Term Newborns
(Addis Abeba University, 2012-06) Terefe Betelihem; Tsegaye Aster ; Birhanu Asaye
Background: Iron deficiency anemia (IDA) is a severe form of iron deficiency. It mostcommonly occurs in pregnant women and infants. One of the causes of IDA in early childhood isthe acquisition of lower than the normal amount of iron store at birth. The stored iron of thenewborn babies, which is the main source of iron during the first six months of their age, isendowed from the maternal circulation. Therefore, knowledge of the effect of maternal IDA onthe 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 oniron 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 healthcenters. A total of 95 pregnant women and their respective newborns that fulfilled the inclusioncriteria were included in the study. Blood samples were collected from the mothers and cord ofnewborns and analyzed for complete blood count and serum ferritin levels using Cell-dyn 1800and Cobas e 411 analyzers, respectively. Women were classified into three groups as: irondeficient anemic, iron deficient non anemic and non iron deficient non anemic based onhemoglobin and serum ferritin values. All pre-analytical, analytical and post-analytical qualityaspects were thoroughly controlled. For statistical analysis MedCalc® software Version 12.1.4was used. Result: The median hemoglobin and serum ferritin levels for the pregnant women were 12.2g/dland 42.1ng/ml, respectively. The median hemoglobin and serum ferritin levels for the newbornswere 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 deficientnon anemic pregnant women (225.9ng/ml). Besides, newborns ferritin and hemoglobin levelshave significant correlation with hemoglobin (rs = 0.256, p = 0.0122; r= 0.226, p = 0.0279),and ferritin (rs = 0.366, p = 0.0003; rs 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.
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; Ayana Gonfa
Introduction: The relationship between thyroid hormones and lipids has long been studied, having beenfirst described more than 70 years ago. Since then, much new information has been discovered, whichjustifies a reevaluation of the relationship between thyroid pathology, dyslipidemia and furthercardiovascular disease rick. Relations between thyroid function and lipid status remain incompletelyunderstood in Ethiopia. Besides the emerging concern of stroke and hypertension, goiter is one of thehighly endemic and prevalent noninfectious diseases in the country. Moreover, the country healthpolicy and strategy mainly focus on prevention of communicable diseases and physicians may fail tomanage lipid and lipoprotein abnormalities, and cardiovascular risks while treating their patients forthyroid dysfunctions. Objective: To determine the relationship between thyroid dysfunction versus serum lipid profile and riskof cardiovascular disease among patients referred to the Ethiopian Health and Nutrition ResearchInstitute. Methods: Correctional with Control study was conducted from September, 2011 to May 2012. A total of212 participants, 106 of them referred for thyroid function laboratory investigation or on follow-up andthe rest 106 sex and age matched apparently healthy control group were consented, considered for exitinterview and physical examination about their antropometrical, medication, nutritional status, and forsine and symptom of thyroid disfunction with trained nurses. The laboratory investigation includes lipidand 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 assessassociation 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 BMIwas 23.4±4.9 among cases and 22.1±2.6 among control subjects. BP was statistically significantly higheramong control than cases p<0.0001. Majority of the subjects were euthyroid (54.7%), followed byhyperthyroidism (23%) in which 9.4%, 6.1%, and 7.6% account for overt hyperthyroid, sub-clinicalhyperthyroid, 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 haveelevated 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 whereasHDL decreased significantly. And the reverse condition happens in hyperthyroid subjects. 47.3% of thecase where taking medication for their thyroid dysfunction. Of this 21.1 % of them became euethyroidsubjects 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 lipoproteinprofile. 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 andlipoproteins.
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 ; Sisay Tesfaye; Zewda Endras
Background: Toxoplasmosis is an important zoonotic parasitic disease world wid.Congenitaltransmission gondii during pregnancy has been regarded as a risk factor for the health ofnewborn 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. gondiiinfection by women of child-bearing age in Central Ethiopia. Methods A cross-sectional study was conducted from May 2011 to January 2012 in childbearing age women of sample size of 425 in central Ethiopia. Indirect ELISA IgG and IgM testin parallel structured questionnaire was used to assess possible risk factors and knowledge andperception of health professionals about the disease. The data was cleaned, coded usingMicrosoft 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 samplesof 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 factorsinvestigated, univariable logistic regression showed significant association of T. gondii infectionwith study area, age, pregnancy status, raw vegetable consumption, source of water, presence ofcat 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 ofcats and toxoplasmosis. From health professionals, 63% (63) of them had knowledge oftoxoplasmosis. Among health professionals 47.3% didn’t knew the importance of testingtoxoplasmosis during pregnancy and (93%) do not screen pregnant women but 78% of them hadan 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 inwomen of child-bearing age in central Ethiopia is high. Study area, pregnancy and raw vegetableconsumption are risk factors to acquire T.gondii infection. Educational program, antenatalscreening of pregnant women and further epidemiological studies to uncover the economic andhealth impact of toxoplasmosis are suggested.
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; Medhin Girmay; G/Yohannes Asfawesen; Aseffa Abraham
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.
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; Ali Ibrahim; Agonafir Mulualem
Back ground: the need to collect serial sputum specimens over multiple patient visits results in aprotected diagnostic process with rates of patients with high rates of patient dropout. Recentstudies on SMS method of examination PTB reported that the first two specimens have highsmear positivity in line with this WHO changed its policy to minimize the number of sputumspecimens from three to two. Objective: The main objective of this study was to evaluate the same day diagnosis of TBmicroscopy in comparison to the spot-morning-spot methods and KAT of lab personnel, GP, HOand Nurse to wards the use of the same day diagnosis of TB in selected health institutions inAddis Ababa. Material and method: Across sectional study were conducted in 16conveniently selectedprivate clinics, governmental health centers, public hospitals and private hospitals, federal policeand armed force hospital from September – December 2012.All patients who were availthemselves in the selected health institutions for the diagnosis of MTB and those health personalwho were worked in each health facility. The diagnosis was performed using ZN sputum smearmicroscopy and light-emitting diodes fluorescent microscopy (LED-FM) technique. A structureand pre-validate questionnaires was used to collect data for KAP survey. Chi-square was used toassess 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).onthe 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 personalabout 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 positiveattitude while the mean and median knowledge score was 4.7 and 4 respectively, but the meanand 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 practicerespectively. 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 isessential to address the advantages and dis advantages of the conventional approaches, LED-FMand 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 towardsthe use of LED-FM, conventional approach and the same day approach in the diagnosis of TB
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; Wolday Dawit; Kinde Samuel; Mulugeta Gebru
Back ground: A CD4+ T-cell count External Quality Assessment (EQA) program isimportant for the evaluation of performance of CD4 count laboratories. Objective: The purpose of the present study is to assess the quality of CD4 count laboratoryperformance 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 wereparticipated 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 toparticipating laboratories. The percentage and absolute counts of CD4+ T-lymphocytes weredone using their routine procedures. The data were analyzed using Microsoft Excel, sigma plotversion 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), theresidual, and the standard deviation index (SDI) values for both the absolute counts andpercentages of CD4+ lymphocytes (%CD4). Feedback was provided to each respectiveparticipant 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 CD4EQA 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, thetrimmed mean %CV (between-laboratory precision) was 12.15% and 7.05% for CD4 absolutecounts and %CD4 respectively. The percentage outlier rate of absolute CD4for all trials were 4.3% and 4.1% respectively. Conclusion: CD4 EQA program using In-house PT panels was found to help facilities in earlidentifying their gaps with regard to their CD4 count performance. In-hoprepared PT panels was helpful in avoiding the challenges encountered during participation in external EQAproviders like the high cost, transportation problem, feedback delay, CD4 laboratory coverage. TM
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
Background: Correct diagnosis of malaria is crucial for proper treatment of patients andsurveillance of the disease. However, there are various limiting factors including inadequateinfrastructure and consumables. Furthermore, inappropriate perception and inadequatesatisfaction of health service providers and users are suggested as significant challenges in theutilization 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 toDecember 2013. The patient sample size was determined by using single population proportion.Interview and self administered structured questionnaires were employed to collect informationfrom laboratory personnel, clinicians and patients. Data were collected from 304 patients, 99clinicians, 26 laboratory professionals and 11 key informants. Data was entered using Epi-Info3.5.3, further analysis was done by SPSS version 20. Chi-square test was used to determineassociation between the main out come and associated factors. The strength of associationbetween covariates and the main outcome was identified by using odds ratio in binary logisticregression, and also multiple logistic regression was utilized to crosscheck confounders for thoseassociated 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 clinicianswere satisfied with malaria diagnostic service in their health facility laboratories. Ethnicity,residence, knowing malaria diagnosis after consulting clinician, and time period to receivemalaria result were independent predictors for patient satisfaction (p< 0.05). Lack of benefit,training or professional development and insufficient duty payment besides unequal workloadwere 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 patientsand 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 levelof satisfaction on malaria diagnosis service was in the range of 50% to 61.2%. Lab constraintswere the main factors that mimic satisfaction for health professionals, and these in turn mightcause negligence of professionals towards patients and prolonged waiting time that presenteddissatisfaction for patients. Thus, the regional government should focus on those constraints thatcompromise the quality of malaria diagnostic service.
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
Background: - Even though some studies have shown that lipids could be indirect markers ofpulmonary tuberculosis (TB), there is no sufficient data from Ethiopia which characterize the level ofthese markers during TB disease and infection. Nonetheless, the effect of HIV co-infection and itstreatment 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 without HIV infection. Methods: - fasting plasma samples collected from 159 untreated adults visiting various healthinstitutions in Addis Ababa (44 HIV+/TB+, 49 HIV-/TB+, 17 HIV+/TST+, 24 HIV-/TST+ and 25HIV-/TST-) at baseline, from 88 (30 HIV+/TB+, 47 HIV-/TB+ and 11 HIV+/TST+) groups after 6month of ATT and ART and from 31 (20 HIV+/TB+ and 11 HIV+/TST+) groups after 18 months ofART 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) usingCobas 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 lowerin HIV+/TB+, HIV-TB+ and HIV+/TST+ than in HIV-TST-. Patients with HIV-/TB+ were alsosignificantly 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-Cthat was markedly lower in HIV+/TB+ than HIV-/TB+ and HIV+/TST+ groups. After 6 month of ATTfor HIV-/TB+ groups, significant increases were observed in TC, LDL-C and HDL-C. Proportion ofpatients 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, TGand HDL-C levels. At 18 months, the proportion of patients with TC levels ≥ 200 mg/dl had increasedsignificantly, from 0 to 20 % and TG levels > 150 mg/dl from 0 to 30 %. However, the proportion ofpatients 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 oftreatment, 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 infurther studies with larger sample size and combined with other prognostic clinical and laboratorymarkers, measurement of plasma lipids may allow clinicians and investigators to target patients withpulmonary TB in whom microscopy is most likely to yield a pathogen. Key words: TB, TB/HIV co-infection, biomarker, lipids, ATT, ART
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
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 oflaboratory results. The problem is high in resource poor countries like our country, EthiopIdentifying the types, frequency and associated factors influencing the quality of clinicalsamples is important for designing appropriate interventions to prevent their generationand Serology departments. Compared with the respective frequency with which they collectthe specimen, laboratory personnel had significantly fewer rejected specimens thanNonlaboratory personnel. The proportion of specimens that were rejected in emergencydepartment and inpatient services were twice more than for the outpatient services. Conclusion: Our finding shows the problems of specimens in the preanalytic phase and thefactors involved in rejection of specimens, particularly with respect to specimen collectionsperformed outside the laboratory walls by Nonlaboratory personnel who are not under thedirect control of the laboratory; moreover, the finding shows that the rates of specimenrejection are higher for inpatients and ED than outpatients, owing to the performance ofoutpatient procedures by personnel under direct laboratory control.and hence improving the quality of laboratory service. Different literatures showed thatmore 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 rejectionand associated factors of specimens submitted for different tests to the St. Paul hospitalmillennium medical college, Addis Ababa, Ethiopia. Methods: Cross sectional study design was applied at St. Paul hospital millennium medicalcollege medical laboratory. A total of 8063 specimens were collected during the studyperiod. The quality of all specimens submitted to laboratory during data collection periodwere checked and inappropriate specimens were recorded in data collection checklistformat. 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 hospitalmillennium medical college during the data collection period, 116(1.4%) were rejected. Themost frequent reason for rejection was hemolysis of specimen, which occurred much morefrequently than the second most cited reasons, clotted specimens and unlabelledspecimens. Compared with their respective frequency of rejection of specimens by type ofrequested laboratory service, significantly more rejected specimens occurred in Hematolog
Comparison of Hematological Parameters determined by SYSMEXXT-2000I and Cell DYN 1800 in Tikur Anbessa Specialized Hospital in Addis Ababa Ethiopia.
(Addis Abeba University, 2014-05) Hailu Lulit; Tsegaye Aster; Alemu Jemal
Antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolated from Pediatric Patients at Yekatit 12 Hospital Medical College
(Addis Ababa University, 2014-05) Merga Yamirot; Bitew Adane
Background: Urinary tract infection (UTI) is considered as the most commonbacterial infectious disease seen among the pediatric patients. Objective:This study was carried out in order to determine the antimicrobialSusceptibility Profile of Bacterial Uropathogens Isolates from Pediatric Patients at Yekatit 12Hospital Medical College Materials and Methods Clean voided mid-stream urine specimens were obtained frompatients in sterile universal bottles. Urine collected from each patient was inoculated ontoCLED and blood agar plats using calibrated inoculating loop with a capacity of 0.001ml,Inoculated plates were incubated for 24- 48 hours at 37°C at inverted position aerobically.Bacterial isolates were characterized/ indented by gram stain and by using an array ofstandard routine biochemical test. Antimicrobial susceptibility test was carried out by usingthe Kirby Bauer disc diffusion. Result: The data was analyzed by using SPSS, version 17. Descriptive statistics wascomputed for most of the study variables and Frequency distribution tables were used todescribe the findings. In this study a total of 384 pediatric patients (199 males and 185females) aged between 0 years to 15 years from whom urine sample were collected wereenrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36(19.5%) have positive cultures while 25 (12.6%) of the 199 males had significant bacteriuriaand the largest number of study subjects were below age 3 years and the largest positiveculture was obtained from this age group, accounting 35 (57.4%.) out of 61 positive culture.Bacterial species belonging to six generawere isolated and identified from 61 positivecultures and the genera were Escherichiai, Klebsiella, Staphylococcus, Proteus, Acnitobacterand Entrococcus. and E. coli was isolated in 28 cases (28/61, 49.5 %), followed by Klebsillaspp. in 17 cases (17/61, 27.9%), Staphylococcus spp. in 5 patients (5/61, 8.2%.) ( S. aureus inone and coagulase negative staphylococci in 4 case), Entrococcus in 7 case (7/61, 11 5%),Proteus spp. in 3 cases (3/61, 4.9%) ) and Acenitobacte in one case (1/61,1.6%). Of bacterialisolates E. coli was found out to be the most common pathogen followed by Klebsiella spp..Furthermore E. coli and klebsiella spp. were the most common pathogen in female patientsaccounting 71. 4% and 64.7% respectively. percentage resistance of Klebsilla spp was muchhigher when compared to E.coli. Eighty eight percent of Klebsiell spp. were resistant tocefotaxim, ceftazidim, trimetroprimsulfamethoxazole and cefuroxime. Acentobacter spp. was100% resistances to gentamicin,trimetroprimsulfamethoxazole , agumentin, and nalidixicacid . But they were 100% susceptible to ciprofloxacin, cefuroxime , norfloxacine,cefotaxim,chloramphenicol and ceftazidim . On the other hand, proteus spp. were 100%sensitive to all drugs except nitrofurantion. Species of Entrocuccus were resistance of 71.4%to chloramphenicol and 85.7% to both trimetroprimsulfamethoxazole and ErythromycinS .aurueswas100%susceptibletociprofloxacin,cefuroxime,gentamicin, trimetroprimsulfamethoxazole, chloramphenicol, Clindamycine and Ceftriaxone while coagulase negative staphylococci were resistance to all of the above drugs except Clindamycine and gentamicin . Multidrug resistance to two or more drugs was observed in73.7% of bacterial isolates. Conclusion: This study determines the antimicrobial Susceptibility Profile of BacterialUropathogen Isolates from Pediatric Patients and highlighted the majorbacterial uro-pathogens involved in UTI up to my knowledge for the first time in the country. Furthermore,species bacterial pathogens and their frequency was consistent with the usually reportedpattern, with E. coli being the most common organism isolated followed by Klebsiella. Spp.In this study Majority of gram negative species were susceptible to ciprofloxacin,norfloxacine and nitrofurantion (exceptproteus spp) and gram positive species weresusceptible to ciprofloxacin Clindamycine and gentamicin so this drugs can be used to treatUTI in children however Most of bacterial isolates were multidrug resistant and it is thereforesuggested that appropriate antimicrobials should be administered to reduce the risk of multidrug resistant organisms developing and avert ineffectiveness of antibiotics
Prevalence of Hepatitis B, Hepatitis C and Hiv Among Chronic Liver Disease Patients in Selected Hospitals, Addis Ababa, Ethiopia
(Addis Ababa University, 2014-05) Mohammed Yacob; Ali Ibrahim
Introduction; Hepatitis B virus (HBV) and hepatitis C (HCV) virus is hepatotropic virus spreadmainly through contaminated blood and blood products, sexual contact and contaminatedneedles. Chronic infection by these viruses leads to slow progressive liver disease that over aperiod of up to 30 years may result in cirrhosis, chronic liver failure and hepatocellularcarcinoma (HCC). HIV, HBV, and HCV infection share similar transmission routes andtherefore co-infection is common. These viruses are prevalent in different parts of the worldincluding Ethiopia there for this study shows the burden of these viruses in Ethiopia. Objective: To determine the prevalence of HBV, HCV and HIV infection among clinicallydiagnosed chronic liver disease patients visited at Black Lion, St. Paul and Armed force hospitalAddis Ababa, Ethiopia. Method: Hospital based cross-sectional study was conducted in three selected hospitals of AddisAbaba over a period of 3 months (March2014- May 2014) on clinically diagnosed chronic liverdisease patients. By using questionnaire brief history and risk factors was taken from eachvolunteering patient. Serum samples from each volunteering patients was screened for thepresence of HBsAg and anti-HCV by ELISIA test kit and HIV by national test algorism. Result: A total of 117 participants who have chronic liver disease participated in the study,where 82 of them were males and the remaining 35 were females. The age distribution rangeform 18-78 years and the median age was 39 years. The overall prevalence of HBsAg, HCV andHIV was 34.2%, 18.8% and 9.4 respectively. The study participants had combined HBV/HIV,HCV/HIV and HBV/HCV infection which is possible because of their common modes oftransmission. History of multiple sexual partner and blood transfusion also found staticallysignificance with HBV and HCV virus infection respectively. Conclusion: The prevalence of HBV and HCV is high where as HIV is moderate amongchronic liver disease patients and history of blood transfusion and multiple sexual partners wasstatistically associated with HCV and HBV infection respectively
Prevalence of H.Pylori Infection in Pediatric Patients Who is Clinically Diagnosed for Gastroenteritis in Beham Specialized Children S Higher Clinic, Addis Ababa, Ethiopia
(Addis Ababa University, 2014-05) Kemal Ahmed; Mulugeta Geberu
Background: The public health impact of Helicobacter pylori (HP) infection is graduallybecoming obvious, the bacterium now being implicated as an aetiologic agent in a variety ofgastric diseases. In developing countries, Hp infection is markedly more prevalent at youngerages than in developed countries. According to World Gastroenterology Organisation (WGO)2010 the prevalence of HP in Ethiopia was 48% in age between 2 4, 80% at the age of 6and95% in adult s population. Objective: To determine the prevalence of H.pylori infection among paediatric patients who sclinically diagnosed for gastroenteritis. Method: A cross sectional study was conducted to determine the prevalence of H.pyloriinfection among pediatric patient in private pediatric clinic, Addis Ababa Ethiopia. The study was conduct from March 3rd to May 11th 2014. Non-probability convenient sampling techniquewas used to collect the data. The stool samples were tested according to the manufactureinstruction and procedure. Information from the laboratory analysis and questionnaires wereentered into SPSS, version.17 and odd ratio, 95%CI were calculated to measure the degree ofrelationship between risk factors for H. pylori infection. Result: A total of two hundred twenty one paediatric patients having upper gastrointestinal symptoms because of a suspicion of H. pylori infection participated in this prospective study at Beham specialized children s higher clinic between March 2014 and May 2014.Among the study subjects 114(51.6%) were girls and 107 (48.4%) were boys aged from 9months to15years with the mean age of 6.29 [95% CI 5.9-6.7]. Helicobacter pylori antigens weredetected in 57 of the 221children giving an overall prevalence of 25.8% (95%CI 18.8-31),27.2% in female and 24.3% in male children. The frequency of H. pylori colonization washigher in females than in males. Of the 114 females enrolled in the study, H. pylori antigen wasdetected in the stools of 31 (27.2%) against 26 (24.3%) of the 107 males (OR = 0.8595%CI=0.46-1.57). Age of acquisition was one year and five month. Conclusions:The prevalence of H. pylori infection is 25.8%. This is high among children in the study area.Infection also is acquired at very early age. Household crowding is one of the factors thatenhance the infection.

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