Emergency Medicine

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    Assessment of the Knowledge, Attitude and Practice on Universal Precaution among Emergency Medicine Professionals in Emergency Room Tikur Anbessa Specialized Hospital,AAU,Ethiopia,2013,G.C.
    (Addis Ababa University, 2013-01) Alemayehu, Afework; Seme, Assefa(MD, MPH, Ass. Professor); Azazh, Aklilu (MD, Internist, Emergency Medicine & Critical Care Physician)
    Background employing universal precautions means taking precautions with everybody. If precautions are taken with everyone, health care workers do not have to make assumptions about people's lifestyles and risk of infection. Objectives: The main objective of the study was, to assess the knowledge, attitude and practices about universal precautions among emergency medical professionals and factors associated with its practice in emergency unit. Methods: This hospital based cross sectional descriptive survey was conducted in Tikur Anbessa Specialized hospital, AAU from February through June 2013. The study was carried out using a structured questionnaire which was self-administered to all emergency medicine personnel after preliminary introduction at a plenary session. The study was use both quantitative (which was self-administered) & qualitative(to which an Observation check-list was used to observe whether or not the staff members involved in patient management is using an appropriate technique and timing as per the set guideline) methods. Data was entered, cleaned and analyzed using SPSS for Windows version 16. Frequencies, percentage and graphs was used for descriptive purposes. Study period –study period was from February 2013 to June 2013.The total budget for the accomplishing of this study was 18,465.50 ETB. Results-Only 15(24.6%) of the respondents know the presence of anti HIV prophylaxis after sustaining needle stick or sharp injuries while 46 (75.4%) didn’t know. The respondents who had perceived risk of acquiring HIV infection from their health facility waste, when disposed improperly, 2 said the risk would be for HCW, 3 for supportive staff, 40 (65.6%) for both health professionals & supportive staff and 8 said would be for Health Professionals, Supportive staff, the client / patient & the community. Among the emergency medicine professionals 36(59%) perceived that oxygen delivery materials like mask, nasal cannula & prong can be reusable whereas 25(41%) perceived as this materials can’t be reused. Concerning needle recapping after use, 51(83.6%) the respondents perceived that it should not be recapped and the remaining 10(16.4%) were said should be recapped after use. Discussion-Poor hand washing practice by emergency medicine professionals were found before and after touching the patients were found. Emergency medicine professionals were not properly handling, and disposing used Needle/sharp materials in the study area. Personal protective devices particularly mask and eye goggles, boots etc. were not available during the survey.
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    Sepsis in the Emergency Department in Tikure Anbessa Specialized Hospital Addis Ababa Ethiopia
    (Addis Ababa University, 2013-10) Zewdu, Tigist; Teklu, Sisay (Professor)
    Background: Sepsis is a medical emergency and one of the leading causes of death worldwide. It is best defined as a life threatening inflammatory disorder representing deraignment of the immune response to infection. Sepsis likely contributes to the high burden of infectious diseases morbidity and mortality in low income countries .data regarding sepsis management in sub-Saharan Africa is limited. Available data on sepsis management of adults in resource-limited settings suggest that this high mortality is associated with ineffective management including delayed and improper empiric antimicrobial therapy as well as sub-optimal fluid resuscitation [10,11]. Thus, attention to reducing the mortality from sepsis by focusing on improved management in these settings is urgently needed
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    Assessment of Knowledge, Attittud & Practice towards Safety Measures Among Workers in Fdre Metal & Engineering Corporation Metec
    (Addis Ababa University, 2014) Kebede, Mulu; Azazh, Aklilu (Associate Professor)
    Background: Accidents occurring in most industries in Ethiopia are a source of worry to everyone. Most employers fail to use adequate health and safety measures in place at their workplace to safeguard not only the employees and management but also clients and other stakeholders who might have some kind of interest in the company or institution.(3) The metal & engineering corporation is a labor intensive task. As these workers perform repetitive tasks throughout the work day, they may face several work related problems. Objective: The main objective of this study was to assess the level of knowledge, their attitudes & practices among the workers towards safety measures to prevent the above mentioned problems. Methods: A descriptive cross-sectional study was conducted in METEC in March 2014. A total of 422 study populations were randomly selected from the eight industries according to their worker number proportion. The data was collected using the structured interview questionnaires. The questionnaire was pre-tested for their accuracy and validation prior to the actual study and the necessary adjustments were done accordingly. The data were entered after being encoded and analyzed using SPSS. Results: The mean (standard deviation) age of the respondents was 33.526 (1.04) of the respondents recognized at least one safety sign. 84 (19.9%) respondents got information from health facility and 79.16% of the respondents had “High knowledge” of used PPE and 13.27% showed “Moderate knowledge” and 7.58% had ”Low knowledge. The distribution of attitudes on using PPE is 76.5% of respondents had “Positive attitude”. 6.13% of them had “Neutral attitude” While 17.37% of respondents had “Negative attitude”. Among the respondents, 89.6% had ever been using at least one kind of PPE, while 10.4% had never used any PPE. Conclusion and recommendation: The workers have high knowledge level compared to other studies. Health and safety recommendations have positive effects on both knowledge levels and safe practices. Health and safety training has positive effects on safe practice but did not impact knowledge. Health and safety recommendation should be given to the workers. Safety signs should posted at a reasonable work sites. Keywords: Safety knowledge, attitude, practice and PPE
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    Pattern of Injuries and Associated Factors in Patients Visiting the Emergency Department of Hawassa University Referral Hospital
    (Addis Ababa University, 2014) Fako, Thomas; Seyoum, Nebyou (Associate Professor)
    Introduction: Injuries are major public health problem globally. Each year over 5 million people around the world die as result of injury. Injuries are ranked among the leading cause of death and disability particularly in the low income and middle income countries where they are growing in significance. In Hawassa referral hospital emergency department visited by an in average 1,500 injured patients in a year and 10% of injury is due to road traffic accident. Statement of the problem:Injury has been recognized as one of the most life threatening public problem.Injuries present 12% of the global burden of disease and the third most important cause of overall mortality. Millions of accidents occur each year and thousands of individuals lose their lives. Also the burden of injury in Ethiopia becomes one of the 3rd leading causes of death and disability. Objective ofstudy:The general objective of this research is to assess pattern of injury and associated effects in patients visiting the Emergency Department of Hawassa university referral Hospital.Study design: Retrospective cross- sectional study. Study population:All injured patients the study populations wereconsists all injured patients, who visited the adult Emergency Department of Hawassa referral teaching Hospital from February 1 up to July 1 2012. Sample size determination:All trauma patients who visited the adult emergency department in Hawassa referral hospital from February 1 up to July 1 2012 G.C. Data resource is from documentation. Result: Most injuries occurred by road traffic accident accounted for 54% and the majority 80% were male. This more injured age group was 21-30 and accounted for 41%. 62% of the injuries wereaccidental and anatomically injured part of the body was head and neck accounted for 52.2%. Conclusion:This research is crucial making to understand the problems of injury and the police maker will develop guide lines to prevent the cause of trauma and improving health care service systems in health institutions and society. Because the burden of trauma is highly damages the productive age groups
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    Prevalence of Suicidal Ideation and Attempt and Associate Factors Among People with Schizophrenia at Amanuel Mental Specialized Hospital Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-05) Aga, Jalene; Lemenh, Asnake (PhD)
    Background: The lifetime incidence of suicide for patients with schizophrenia is 10% to 13% compared to a general population estimate of about 1%.Suicidal ideation is an important phase in the suicidal process, preceding suicide attempts and completed suicide. Suicide and suicide attempts among individuals with schizophrenia often result in a significant psychological, social and financial burden upon individuals and families. Objective: The objective of this study is to assess the prevalence and associated factors of suicidal ideation and attempt among people with schizophrenia in Amanuel mental specialized hospital, Addis Ababa, Ethiopia. Method: An Institution based cross -sectional study was conducted from December 2013 to May 2014 at Amanuel Mental Specialized Hospital among people with schizophrenia. Systematic random sampling technique used to get a total of 423 samples of schizophrenic patients from outpatient department of the hospital. Thesis passed through the ethical clearance process and informed consent was obtained from study participants. Pre-tested structured questionnaire were used for interviewing the study participants. The collected data were coded, entered in to EPI-INFO software and analyzed by using SPSS version 20. The association between variables was analyzed using logistic regression analysis. Results: The prevalence of life time suicidal ideation and attempt among people with schizophrenia was found to be 27.3% and 19.3% respectively. Multiple logistic regression model of suicidal ideation and explanatory variable revealed that being single (AOR 2.18, 95%CI: =1.72).and also for suicidal attempt who attending secondary education (AOR 4.06, 95%CI: =1.50, 10.98).similarly co-morbid depression, hopelessness, poor social support, absence .of positive symptom, and a family history of suicidal were associated with both suicidal ideation and attempt. Conclusion and recommendation: This study reveals that a substantial number of people with schizophrenia have suicidal ideation and attempt .These problems were associated with socio-demographic and clinical factors. Therefore it is a significant public health issue that requires a great emphasis. In particular, modifiable factor such as depression and poor psycho social support should bemanage
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    Healthfaciltities Based Cross Sectionalstudyon Prevalence and Associted Factors of Diarrheal Morbidity Among Under-Five Childern in Armed Forces Teaching and Referral Hospital ,SIGNAL and Gofa Health Centersaddis Ababa
    (Addis Ababa University, 2014-05) Ayele, Demelash; Bacha, Tigist (Assistant professor)
    Diarrhea remains a major cause of mortality in children under 5 years of age in Sub- Saharan countries in Africa. The objective of this study was to assess the prevalence of diarrhea and associated factors among children under 5 years of age in ARFTH, Gofa and Signal health center of ministry of defense Addis Ababa,Ethiopia. A Health facility-based cross- sectional study was conducted among 348 children under 5 years of age but the sample size calculatedwas439, due to the limited duration from April 1toApril 30/2014 and non respondents, onlly348mothers were participated in thestudy.A questionnaire was used for collecting information on socio-economic characteristics, environmental hygiene and behavioral practices, and occurrence of diarrhea among children under 5 years of age.Result: the four-week prevalence of diarrhea among children under 5 years of age was 29.8%. Family income (OR =2.065, 95% CI: 1.205-3.533), Dipping water user (OR = 34.850, 95%CI: 17.996-67.489), Number of rooms (OR =2.805, 95% CI: 1.693-4.649), and Shared Latrine (OR=5.024, 95% CI; 2.997-8.422) were the major risk factors for diarrhea. This study demonstrated that diarrhea morbidity was relatively high among children under 5 years of age seen in Armed Forces Referral and Teaching Hospital, Signal health center and Gofa health center. Efforts to reduce childhood diarrhea should focus on improving household sanitation, ensure availability of private toilet facility and increasing number of rooms, construction of private toilet and avoid unsafe utilization of water. Methods; Proportional Quota sampling method based on number of patients and level of service used to obtain the study subjects from Armed Forces Referral land Teaching Hospital and Gofa,Signal health center.
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    Precipitating Factors and Clinical-Laboratory Features of Diabetic Ketoacidosis (DKA) at Tikur Anbesa Specialized Hospital Emergency Department, Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Bogale, Helina; Kebede, Sofia (Assistant Professor)
    Background:-Diabetic ketoacidosis is potentially fatal metabolic disorder commonly present in emergency department.It is a life threating complication of diabetes.If it misdiagnosed or mistreated it is 100% fatal. Purpose:- To study precipitating factors and clinical-laboratory features of diabetic ketoacidosis (DKA) atatTikurAnbesa Specialized Hospital Emergency department, Addis Ababa Ethiopia. DESIGN:- A prospective study by reviewing medical charts. SUBJECTS: A sampled 103 Adult patients aged 12 years and above with known or previously unknown diabetes presentingin the emergency department from January 2011 to January 2013 with a diagnosis of diabetic ketoacidosis. .. RESULTS: Mean (SD) age was 30.9 (12.11) years for males and 28.4 (14.4) for females. Majorityof patients 77(74.8%) were type I and 23(22.3%) were newly diagnosed. Infection was the leading precipitating factors 36(45%)and 24(30%) was due to treatment non adherence. Infection sites includegenito-urinary system, respiratory system and acute febrile illness. Only 11.1% had altered level of consciousness, when 8% were in coma and 35.9% had dehydration. More than half (52.7%) patients hadleukocytosis and 31.4% were hypokalemic. CONCLUSION and RECOMMENDATION Diabetic ketoacidosis commonly seen in TikurAnbesa hospital emergency department. It was a major cause of morbidity and mortality. The main precipitant factors of DKA were infections and missed insulin injections. These factors are preventable in order to improve outcomes of diabetic patients to not to complicate to DKAby improving patient education and access to care. Key words: Diabetic ketoacidosis, precipitating factors, clinical and laboratory feature, TikurAnbesa
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    Magnitude, Associated Factors and Maternal Outcome of Postpartum Hemorrhage at Black Lion Specialised Hospital From Jan.1, 2009 To Dec.30, 2013 G.C
    (Addis Ababa University, 2014-06) Abera, Kebebush; Teklu, Sisay (Professor)
    Back Ground: Postpartum hemorrhage (PPH) continues to be the leading direct cause of maternal mortality worldwide. Objective: To determine maternal and perinatal outcomes in mothers who had postpartum hemorrhage. Methods: A facility based retrospective cross-sectional study was conducted on all women who came to Black Lion Hospital, with a diagnosis of PPH during the five years, from Jan.1, 2009 to Dec.30, 2013 GC. Data were collected using a structured questionnaire from the mothers and their neonate’s charts and labor ward reporting log book .Data were collected by the principal investigator and trained labor ward nurses. Results: There were 12,995 deliveries at TASH during the five year. Generally there were 185 cases of PPH who delivered in Black Lion Hospital as well referred from other health facilities which makes the magnitude of 1.4% during the five year. However, 160 cases of PPH whose medical charts were retrieved were used for its completeness. The maternal age of the study population was ranging between 17 and 44 years with mean age of 28.56 years. Most of the post partum women who had PPH, 105(65.6%) were from AA and the remaining were out of AA. Conclusion The magnitude of PPH was 1.4% during the study period and it was associated with significant maternal and perinatal complications. Retained placenta or conceptus material was the most leading cause for PPH in this study which accounts for 37.5%. Shock and severe anemia were the most common complications they were encounters.
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    Assessment of Knowledge Attitude and Practice of Residents About Pre Hospital Care in Addis Ababa
    (Addis Ababa University, 2014-06) Abebe, Asmamaw; Enquselassie, Fikirie (PhD)
    Background: In Ethiopia pre hospital care is not well developed. Apart from some governmental and non-governmental institutions, the pre hospital care is not well known by the community Objective to assess the knowledge, attitude and practice of residents about pre hospital care In Addis Ababa Methodology: household based cross sectional study was conducted using multi stage random sampling technique from March to April, 2014. The data was collected through structured self- administered questionnaire and interviewing technique among 422 participants. Data was entered, analyzed, and interpreted by using SPSS Software version20. Result: The findings of this study shows that majority of the respondents 364 (86.3%) knew the presence of pre hospital care, most respondents 405(96%) believed that pre hospital care is important and 160 (37.9%) individuals had encountered in different levels of pre hospital care provision. 411(97.4%) respondents believed that pre hospital care should be strengthened by increasing number of ambulances (23.7%), by training health professionals (18.7%), by teaching the community about pre hospital care (26.1%) and a combination of the above methods (31.5%). Regarding the assessment of their practice the common care givers during mass casualty were bystanders 102(24.2%) and the least care givers were paramedics being 18(4.2%).The common emergent problems that occurred in Addis Ababa fall down accident 72(29.2%) and followed by road traffic accident 59(24.1%). Conclusion: Knowledge, Attitude and Practice investigations provide helpful insight into the level of understanding and utilization of services within the community .The findings show that high proportions of respondents have good knowledge (76.5%) and, positive attitude (69.9%) of pre hospital care, however, less than half of them have practiced pre hospital care in mass casualty. Unfortunately 58.8% and 65.2% of the respondents did not know the phone number of Red Cross and fire & emergency dispatch center respectively. Recommendation: The city administration should teach the community to improve awareness about the advantages of pre hospital care, ambulance transportation and early visit to a hospital so as to decrease morbidity and mortality of trauma patients. The Red Cross and fire and emergency dispatch center should advertise their phone number to the public and respond immediately to community call and formulate a decision with policy makers about safe and rapid transportation despite the barriers Concerned authorities should be concerned about increasing the number of paramedics and the available Paramedics should actively participate in mass casualty incidents. Based on this study no identified barriers about pre hospital care so that there should be another study by taking other variables
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    Evaluation of the Risk Factors of Hypertension in Patients Visiting Adult Emergency Outpetient Departmet of Tikur Anbessa Specialized Hospital, Ethiopia
    (Addis Ababa University, 2014-06) Hussien, Seid; Kebede, Sofia (Assistant Professor)
    Hypertension is a growing public health problem in many developing countries including Ethiopia and if left untreated can cause a major risk factor for heart failure, renal failure, stroke and even death. However, its prevention and control has not yet established payable attention. The aim of this study was to assess the main risk factors of hypertension among patients visiting in Adult emergency department of Black lion Specialized Hospital by using risk assessment form that contains 39 structured close-ended questionnaires. It is a descriptive cross-sectional study conducted over a period of three months. Participants aged >18 years were recruited using convenience sampling technique and data was collected by face-to-face interview after verbal informed consent. Additionally, weight, height and Blood Pressure (BP) of participants were measure following standard procedures. Hypertension was defined as having BP ≥ 140/90 mmHg or reported use of regular anti-hypertensive medications. Data was collected by investigator assisted with clinical nurses and then entered into a computer using EPI Info version 3.5.1 and exported to SPSS version 21 for analysis. The study data was analyzed by using statistics such as mean, average and percentages. In this study 254 subjects consisting of 159(62.6%) men and 95(37.4%) women had hypertension. In this study from non modifiable risk factors age, gender, ethnicity, family history, and from modifiable risk factors smoking, alcohol drink, excessive salt intake, Khat chewing, DM,BMI, Physical inactivity, and Psychosocial stressors were observed. In which smoking 35(13.8%) and alcoholic 108(42.5%) might be considerable risk factors only seen in men. Moreover, psychological stressful condition, excessive salt food intake, physical inactivity and BMI were the mainly seen modifiable risk factors in both gender. By this study we concluded that more number of male was observed in the risk factors of hypertension than female and as the age is coming increasingly the probability of the magnitude of risk factors also increase in both gender and mostly avoidable risk factors was observed in high magnitude
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    Assessment of knowledge, Attitude and practice Toward First aid related to Road Traffic Accidents Among Traffic Police in Lideta, Kirkos and Arada Sub City of Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Cherkos, Adugna; Girma, Biruk (Assistance professor)
    Introduction: - In Ethiopia comprehensive Pre-hospital emergency medical system is practically non-existent. A comprehensive emergency medical system includes not only a health facility based care for emergency cases but also a functional pre-hospital care that gives primary care for injuries at the accident scene and while transferring victims to health facilities. Traffic police personnel are the first respondent to road traffic accidents. The objective: - Assessment of Knowledge, Attitude and Practice to ward first aid related to road traffic accidents among traffic police in LIDETA, KIRKOS and ARADA sub city of Addis Ababa Ethiopia. Method: A cross-sectional quantitative study was carry out among traffic police working in LIDETA, KIRKOS and ARADA sub city of Addis Ababa, Ethiopia from February 3-18, 2014, using a convenient sampling technique. 150 police traffic was participated and responded for open- ended and close- ended questions and 120 were analyzed. Result: Participants were 120 (92.3%) male and 10(7.7%) female with an average age of 27 ±7.42 (SD) with a range from 23 to 50 years. One hundred and eleven (85.4%) were trained previously on first aid from different institution. Forty two (32.1%) were identified noisy breathing which is a sign of air way obstruction. Most participants‘ first action during first aid was only transfer to near hospital, furthermore 128(98.5%) believed that it is necessary to give first aid immediately for RTA victims, but some them had not willingness to give first because of fear infection, shortage of materials and didn‘t had full skill. Conclusion and recommendation: In This study identified baseline knowledge, practice and perspective of first aid related to road traffic accident of traffic polices who are working in ARADA, LIDETA and KIRKOS sub city of Addis Ababa Ethiopia, and showed that there was gap on knowledge and practice of first aid for RTA victims, on the other hand respondents gives a positive believe related to application of first aid at scene. Would been providing continuous training and demonstration of moderate level of knowledge, attitude and practices towards first aid related to firs aid further collaboration with governmental and non-governmental institutions
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    Pattern of Neurologic Emergencies in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Gebrezgabiher, Selemon; Kebede, Sofia (Assistant Professor)
    Neurological emergencies are a frequent presentations and often times with devastating short and long term consequences. Neurological disorders are increasingly prevalent in Sub- Saharan Africa with the paucity of data on adult neurological emergencies in the region. The objective of the study was to determine the pattern of neurologic emergencies in TASH, Addis Ababa, Ethiopia. Medical records of 311 adult patients presented to Tikur Anbessa Specialized University Hospital from February 1, 2013 to January 31, 2014 were reviewed retrospectively. The mean age of the patients was 44.681.1 years. Males outnumbered Females giving a sex ratio (M: F) of 1.22:1. Neurological emergencies accounted for 5.27% of the total medical emergencies. The most common neurologic emergencies were cerebrovascular disorder (54%), neurologic complications of HIV/AIDS (9%), meningitis (8.7%) and seizure disorder (7.7%). Hemiparesis, altered mental status and convulsion were the common presenting features accounting 44%, 19.3% and 13.1%, respectively. The overall mortality rate of neurologic emergencies was 27.3% with the highest case fatality rate from Encephalopathy 53.8% followed by Tetanus 50%, neurologic complications of HIV/AIDS 39.3%, meningitis 37% and cerebrovascular disorder 27.4%. It will be very useful for health care policy makers if they focus on planning for better management and prevention of common neurologic emergencies. II
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    Assessment of Completeness of Documentation of Referral Papers and Reasons for Referral Among Referred Patients to Tash Ed.
    (Addis Ababa University, 2014-06) Taye, Mulunesh; Azazh, Aklilu (Associate Professor)
    INTRODUCTION: In the referral process, referral papers are the standard and typically the sole method of communicating information between general practitioners and hospital specialists. Sub-optimal referral letter can be a source of poor continuity of care (delayed diagnosis, multiple medication, multi-drug resistance, high litigation risk, unnecessary testing and extra-medical costs) and therefore, decrease the quality of care. Referral papers of high quality are an essential part of good clinical care and act as the interface between health care professionals in primary, secondary and tertiary care. OBJECTIVE: The aim of this study is to assess the quality of documentation on referral papers of patients referred to Tikur Anbessa Specialized Hospital Emergency adult, pediatrics and gynecology and obstetrics departments. METHODOLOGY: This study was conducted at TASH EDs from December- June 2014 by implementing a retrospective cross sectional study design. A total of 1011 patient referral papers were recruited by simple random sampling method. Data was collected from patients’ individual folders retrospectively. For collecting relevant information, data was collected by using dummy tables and analyzed using SPSS version 20.0. RESULTS: All 1011 eligible referral letters from Tikur Anbessa Specialized Hospital Emergency Department were systematically assessed in this study. The result shows that the name of the patient featured in all of referral letter (100%, n=1011). Only 29.8% of referral letters bearing the patient’s address while 70.3% of referral letters contain history of present illness; 30.3% of referral letter contain physical examination and 19.4% of referral letters contain all the vital signs. The histories of allergies were reflected in none of the referral letters. About 12.2% referral letters were not entirely legible. CONCLUSION: Most of the socio-demographic data except the address were documented in the referral papers. The clinical information section (the most important part) of the referral paper was strikingly deficient especially history of allergy, vital signs, physical examination findings, chief complaint(s), results of basic investigations, treatment given. Only the working diagnosis and reason for referral were documented in most referral papers. In a quarter of referral papers assessed, the receiving unit was not mentioned, of which more than half wrote to any hospital. Signature of the referring clinician rather than name or qualification was documented
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    Assessment of knowledge, Attitude and practice Among Health Care workers regarding needle Stick and Sharp Object injuries in Army Force Referral and Teaching Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Jemaneh, Lemessa; Azaje, Aklilu (Associate Professor)
    Objective: This study aimed to assess the knowledge, attitude and practices among health care workers on needle stick injuries. Methods: Hospital based cross-sectional descriptive survey was conducted among HCWs in army force referral and teaching hospital AA, Ethiopia. Pre tested structured questionnaire were administered to health care workers on other hospital in the same professional. Data was entered in to a computer using EPI-3 Info version 5.4 and Data was analyzed using SPSS version 16.0 Result The response rate of the survey was 99.3% and the results showed maximum participant were in the age group of 20-53 years. 97.2% of health care workers were aware of the fact that hepatitis B, hepatitis C, and HIV could transmitted by needle-stick injuries. 82(57.3%) had participated in any training related to infection prevention program. 40(27.9%) and 38(26.6%) were exposed blood /body fluids and had needle stick or sharp injuries in the last one year’s respectively. 104(72.8%) were of the impression that needle should be recapped after used. 24 (16.8%) had been vaccinated against hepatitis B. The prevalence of NSSIs was highest among nurses21 (55.5%) and injuries had occurred while sudden movement of the patient was the most common source of NSSIs. Conclusion; The survey revealed that over all knowledge of health care workers about the risk associated with needle-stick injuries and use of preventive measures was adequate, however, the domains of attitude and practices need to be improved.
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    Assessment of the Knowledge, Attitude and Practice of Fourth, Fifth And Sixth Year Medical Students On Standard Precaution In Tash, Addis Ababa, Ethiopia, 2014
    (Addis Ababa University, 2014-06) Tarko, Shambel; Azazh, Aklilu (Associate Professor)
    Background; employingstandard precautions means taking precautions with everybody. If precautions are taken with everyone, health care workers do not have to make assumptions about people's lifestyles and risk of infection. Objectives: The main objective of the study is to assess the knowledge, attitude and practices of medical students on Standard precautions. Methods: This cross sectional health institution based survey was conducted in TASH, Addis Ababa University,among medical students who are 4th, 5th and 6th year. The study uses quantitative methods. Statistical significance was determined by computing mean variations using logistic regression. Result:The total knowledge score showed the level that 118(54.6%) had fair knowledge 71(32.9%) has good knowledge and 27(12.5%) had poor knowledge. Total knowledge score of respondents range from 6 to 18 out of 18 the mean knowledge score 13.37 with sd of+2.42.The knowledge level on standard precaution132 (61.1%) had good knowledge, 25(11.6%) fair and 59(29.6%) poor knowledge.Attitude score of the respondents showed that 180(83%) scored above half. Overall practice score showed that 117(53.9%) had fair practice while 15(6.9%) had good practice and 85(39.2%) had poor practice. Practice score standard precaution showed that 125(56.8%) had fair 69(32.6%) poor and 23(10.6%) good practice. Hand hygiene practice showed that 12.9% had good practice while 21% fair and 66.1% poor practice.Weak association was found between knowledge and attitude (r = 0.354; P<0.001); knowledge and practice to UP standards (r=0.201; P<0,001); attitude and practice towards UP (r=0.425; P<0.001). Conclusion: Medical students had a better Knowledge and acceptable level of attitude towards standard precaution but Medical students had poor knowledge and practice towards hand hygiene, overall they had poor practice to all components Strengthen and integrate standard precaution with the routine services through providing training for medical students in the Hospitals and health centers they are attached. Keywords: standard precaution, medical students, standard precaution related
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    Assessment of Knowledge Attitude and Practices of Military Personnel Regarding First Aid Measures in Northern Command 21 st Division
    (Addis Ababa University, 2014-06) Mebrahtu, Legese; W/Tsadik, Assefu (PhD)
    Back ground: First aid is the initial treatment or help given to sick particularly injured individual before professional medical care becomes available with the materials at hand. Such intervention aims in reducing the situations that threaten the victim until a professional arrives or the sick individual is brought to health facility. The first minutes after a serious injury represent only a short time during which potentially lifesaving measures can be initiated. Many deaths from blocked airways or external bleeding can be avoided with quick action such as opening a blocked airway, assisting breathing and applying direct pressure to a wound to reduce bleeding. Objective: to assess knowledge, attitude and practices of military personnel regarding first aid measures. Method: The study site was northern command, 21st division military personnel. Descriptive cross-sectional study design was employed on sample size of 375 military personnel from February 20 - 30, 2014 G.C study period. Results: A total of 375 military personnel‟s, all were males and the response rate was 100%. The mean ± SD age of the study participants was (26.7 ± 7.14) years and with majority rank was Private 162 (43.2%).From the participant 160 (42.7%) attended FA training. Most of them had trained on the military training center. Priorities to respiratory problem causality giving FA 272 (72.5%) have correct answer. Majority knew fractured FA and 365(96.8%) knew one or more than one bleeding control methods. Attitude to first aid was thought to be positive, majority of the respondents were ready to be trained and 312(83.2%) were interest to give FA to others, but 375(48.5%) of them thought that FA could be performed by any person. Conclusion The study participant‟s (military personnel) are expected to know first aid measures more because of their mission. But the result showed that there were gabs on preferable position of unconscious patients, FA of penetrating objects on the abdomen, FA of chemical burn, FA of penetrating eye injury, FA of priority, FA of protruded intestine, seizure, choking, cardiac arrest, fractured. Also half of the participants believed FA activity was performed only by health workers. So it is important to evaluate the first aid training programs of military training center to improve knowledge, practice and attitude of the military personnel‟s regarding basic life support.
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    Magnitude, Clinical Presentation, and Outcome of Pediatric Burn Injuries at Yekatit 12 Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Tadele, Achamyelesh; Bacha, Tigist (Assistant professor)
    Back ground: Burn injuries are a global public health problem, accounting for an estimated 195 000 deaths annually. The majority of these occur in low- and middle-income countries and the rate of child deaths from burns is currently over seven times higher in low- and middle-income countries than in high-income countries. Burn injuries are largely considered as being preventable. However, one needs to know the patterns, causes and outcomes of burn injuries if intervention measures are to be effective.. Objective: the aim of this study was to determine the magnitude, clinical presentation and outcome of pediatric burn patients seen in Yekatit 12 hospital from January 2012 – January 2014. Methodology: This study was conducted at Yekatit 12 hospital from December- June 2014 by implementing a retrospective cross sectional study design. A total of 422 burn patients were recruited by simple random sampling method. Data was collected from patients’ medical record cards retrospectively. SPSS version 20 for widows was used for data entry and analysis. Descriptive statistics and logistic regression were used to analyze the data. Result: Burn accounted for 6.4% of patients who had visited the pediatric department of Yekatit 12 hospital during the study period. Children less than 3 years of age had the highest proportion of patients (53.3%) and the median total body surface area (TBSA) burned was 11% with a range of 1-95% . The most frequent burn injuries were scalds, followed by flame burns, electrical burns , contact burns with hot solid object and chemical burns with 60%,32.9%, 3.8%, 2.4% and 0.9% respectively. Most of the burns ( 49%) healed with no or minor sequelae and 7.85% of patients died in the study period. Cause of burn has statistically significant association with death (P= 0.027). Conclusion and recommendation: The leading causes of burn are scalds which are preventable. Children should not be allowed in the kitchen and they should be kept in their beds or in their room while their mothers are doing housework chores. The most effective way to prevent burns is public education. Key words/phrases: pediatric burn injuries, scald, partial thickness burn, full thickness burn, TBSA
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    A Study on Assessment of Knowledge, Attitude and Practice of Teachers About First Aid Service Provison in Governmental Preparatory and High School, Addis Abeba, Ethiopia. 2017
    (Addis Ababa University, 2014-06) Ashagrie, Abebe; Sultan, Menbeu (Assistance Professor)
    Background: First aid is the treatment of any injury or sudden illness before professional medical help can be provided. The aim is to prevent the condition getting worse, ensuring fast recovery and preserving the precious human life. This study will contribute to identify the gap on Knowledge, attitude and practice of first aid among high schools and preparatory teachers of kolfe keranio Sub City in Addis Ababa, Ethiopia. Objective: - To assess knowledge, attitude and practice of first aid among high school and preparatory teachers in kolfe keranio Sub City, Addis Ababa, Ethiopia, 2017. Method: - A cross-sectional quantitative study was conducted from December 2016 to July 2017 in governmental high school and preparatory teachers of kolfe keranio Sub City in Addis Ababa City. The study was conducted on 3 samples from 8 selected high schools. Data was collected by using pretested, structured self-administer questionnaire consisting knowledge, attitude and practice questions. Result: -: About 163(95.9%) knew about first aid, their source of information was 62.2% from media, and poor knowledge about From a total respondents were poor knowledge about first aid 37(21.8%) of chocking, 39(22.9%) neck and back injury, 42(24.7%) fracture, 43(25.5%) human/animal bite,49(28.8%) swallowed poison, 61(35.9%) breathing difficulty, 65(38.2%) nose bleeding,74(43.5%) burning and 76(44.7%)epilepsy. Out of 74 (43.5%) who faced child with breathing difficulty, 42 (24.7%) has breath slowly and deeply, 39(22.9%) they encourage the student to calm down and sit quietly, 38 (22.4%) contacted responsible school authority and parent, while 26(15.3%) called ambulance. About 123(72.3%) had faced child with fainting. Eighty three (48.8%), of respondents kept the child on the flat position, 63 (37.1%), contacted responsible body, 55 (32.4%), loosen clothing around the neck and waist 41 (24.1%), had given nothing by mouth and 34(20.0%), called ambulance. Above half of the respondents (58.2%) felt good attitude towards giving and learning first aid. Most of the respondents (63.5%) strongly agreed that learning first aid is fair and few respondents (5.3%) strongly agreed that ministry of health give first aid training only few teachers. Conclusions: The study revealed practices knowledge and attitude toward first aid were limited, especially with cause, and management. Moreover, there were statistically significant differences between respondents with and without training of first aid. Keyword:-first aid KAP of high school teachers in kolfe keranio sub city
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    Patternes of Ocular Trauma Patients Seen at the Departemnt of Ophtalmology Menelik Iihospital
    (Addis Ababa University, 2014-06) Habtesilassie, Martha; Bejiga, Abebe (PhD)
    Background: Ocular injury is one of the major causes of monocular visual impairment and blindness worldwide with significant socioeconomic impact. Objective: To evaluate the incidence, causes and visual acuity at presentation of ocular trauma cases presented to Menelik II Hospital over two months period. V Methods: A prospective cross sectional hospital-based study was conducted at Menelik II Hospital in Addis Ababa from April to June 2014. All consecutive emergency patients with ocular trauma who presented to the hospital were examined. A structured questionnaire was used to evaluate the causes, type of injury and visual acuity at presentation of trauma cases. The collected data were cleaned and analyzed using SPSS for Windows version 20. Result: Out of a total of 2765 patients seen at the department during the study period, 204 were emergency ocular trauma cases making the incidence of ocular trauma to be8 per 100ocular patients over two months. There were 147(72.1%) males and 57(27.9 %) females, the male to female ratio being 2.6.Sixty seven (32.8%) cases of ocular injury were among the 21-30 year age group followed by those in the age group 11-20 year which occurred in 46(22.5%) cases. Professionally, construction workers, farmers and welders sustained trauma to the eye in 38 (18.6%), 34 (16.7%) and 32 (15.7%) cases respectively. Unilateral involvement was seen in 190 (93.1%) of the cases while bilateral ocular trauma occurred in 14 (6.9%) patients. Blunt injury constituted 116 (56.9%) patients and penetrating injury occurred among 71 (34.8%) cases. Regarding patient arrival for treatment, 180 (88.2%) came for medical care after 24 hours have elapsed. Twenty patients (9.8%) were blind in the involved eye. Conclusion: The incidence of ocular trauma was 7.3%.Ocular trauma was more prevalent in males and productive age groups. The common cause of ocular trauma was foreign body followed by fighting. Of 204 cases half of them were accidental. This study was able to provide a better understanding of the cause and incidence of ocular trauma. Our study showed that the patients with ocular injury need urgent medical treatment. Health education about proper use of eye goggle and prompt medical management can prevent the permanent visual loss. Education about proper use of eye goggle and prompt medical management can prevent the permanent visual loss from ocular injury
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    Pattern of Congestive Heart Failure at Adult Emergency Medicine Department, Tikur Anbessa Specialized Hospital,Aau, Aa, Ethiopia
    (Addis Ababa University, 2014-08) Ataro, Demelash; Azazh, Aklilu (Associate Professor)
    Background: Rheumatic heart disease is the commonest cause of cardiac disease in general and Congestive Heart Failure in most sub-Saharan African countries, followed by hypertensive heart disease which is rising along with other non-communicable diseases. However the pattern of congestive heart failure in our setting is not known (1). Therefore the objectives of this study were to assess the common causes of heart failure, common precipitating factors, ED stay of patients admitted with CHF, ED mortality of Patients admitted With CHF and predictors of ED mortality and common clinical presentations of patients with CHF. METHODS: A prospective cross-sectional study was conducted on 128 patients who were admitted to adult emergency medicine department of Tikur Anbbesa specialized hospital, Addis Ababa university, Addis Ababa, Ethiopia with diagnosis of CHF. The study population was 128 patients who were admitted with the diagnosis of CHF, during four Months period, Dec 1/2013 to March 31/2014. The patients condition on discharge or admission to ward was followed. The data were collected using structured pretested data collection tools and analyzed using SPSS for windows version 20.0. Results: During the data collection time frame 128 patients, 75 (58.6%) female and 53 (41.4%) male, with CHF were admitted to the emergency department. Fifty percent of patients were within the age range of 12 to 29 years. CRVHD was the most common ECHO finding in 67 (52.3%) of the patients followed by DCMP 14(10.9%), Corpulmonale 10 (7.8%), IHD 8 (6.3%), HHD 4 (3.1%) and peripartal cardiomyopathy 2 (1.6%). The most common precipitating factor identified was pneumonia 46 (35.9%) followed by arrhythmias 29 (22.7%), discontinuation of CHF therapy 20 (15.6%) and natural course of the disease or refractory CHF in 10 (7.8%) of the patients. Shortness of breath was the commonest symptom 121(94.5%) of patients and tachypnea was the commonest sign 104 (81.3%). Only 38 (29.7%) of patients were disposed from the ED within the first 24 hours. Four patients (3.1%) died at ED and statistically significant predictors of mortality could not be identified. Conclusion and recommendations: The most common cause of CHF at TASH, Ethiopia is CRVHD, which accounts for more than fifty percent of the causes. The most common precipitating factor is pneumonia. Concerned body should focus on prevention, diagnosis and treatment of CRV