Medical Laboratory Sciences

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    Agreement Between Enzyme Linked Immunosorbent Assay with Rapid Plasma Reagin and Treponemapallidumhaem Agglutination Assay for Screening and diagnosis of syphilis at National Blood Bank Service in Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-08) Afework, Ejigayehu; Hussein, Mintewab (PhD)
    Background: Serological diagnosis of syphilis is based on demonstration of specific treponemal antibody and non treponemal antibodies (reagin) in body fluids. Accurate and reliable testing is a critical step in ensuring the diagnosis of syphilis and the safety of blood transfusion service. Performance agreement between syphilis tests is not documented well in Ethiopia. Objectives: To determine agreement between Enzyme Linked Immunosorbent Assay with Rapid Plasma Reagin and TreponemapallidumHaemagglutination Assay for screening and diagnosis of syphilis. .Methods:Laboratory based Cross sectional study was carried out from January 2016 to June 2016 at National Blood Bank Service Addis Ababa, Ethiopia. All positive (One hundred and ninety) and 190 negative samples were used which stored in NBBS (National Blood Bank Service) laboratory from July 2015 to Dec 2015 (total 380 samples). Systematic random sampling method was used to select negative samples .The data was analyzed by SPSS version 20 software. The percentage agreement and κ value were compared; the sensitivity, specificity, positive predictive value and negative predictive value of the ELISA and RPR were calculated. P value less than 0.05 were taken as statistical significant. Results:From 190 ELISA positive sera, 151 (80%) were confirmed as positive by TPHA, 39 (20 %) were found to be false positive. 59 (39%) of samples were positive and 92 (61%) were false negative by RPR. From 190 ELISA negative sera all were negative by RPR and TPHA. The sensitivity, specificity, PPV and NPV of ELISA was 99.9%, 85%, 79 % and 100% respectively. While RPR was 62%, 99 %, 100% and 63 % respectively. Percent agreement of ELISA with TPHA was 90% and corresponding kappa value was substantial 0.795. Percent agreement for RPR was 66 % with kappa value of 0.375 which was a fair agreement.Chi-square result with p value 0.000 which is statistical significant indicate the association between categorical variables. Conclusion The study demonstrated that ELISA was very sensitive. There was good agreement between ELISA and TPHA. RPR was with high specific and weak sensitive results. There was poor agreement between RPR and TPHA
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    Antibiotic Resistance Patterns of Gram Negative Fermentative and non Bacilli isolated from patients Referred to Arsho Advanced Medical Laboratory Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-06) Tsige, Estifanos; Bitew, Adane (Associate Professor)
    Background: Gram negative bacilli are the most frequently isolated bacteria which recovered from various clinical samples. Conventionally, these microorganisms subdivided into two major groups’ fermentative and non-fermentative gram-negative bacteria. The aim of this study is to determine antibiotic resistance patterns of fermentative and non-fermentative gram negative bacilli from various clinical samples in study area. Method: A laboratory based cross-sectional study conducted at Arsho Advanced Medical laboratory, Addis Ababa, Ethiopia from January to April 2017; Study participants were required Urine , CSF, wound, Nasal fluid ,Ear ,Blood, Body fluid, Semen were collected and cultured on Blood agar, MacConkey agar and chocolate agar and incubated according to standard conditions. Then Species identification and antimicrobial susceptibility testing of gram negative bacteria were determined by automated Vitek 2 compact system using GN and AST GN72 card. Result: From the total of 824 various specimens, 284(34.5%) were culture positive , of which (90.8%, 258/284) of the isolates were fermentative and (9.2%), 26/284) were non fermentative Gram- negative bacteria from wide range of clinical specimens such as in urine 197(69.4%), in wound and abscess 34(11.9%), in Ear 20(7.0%), in CSF 11(3.87%), in Nasal 11(3.9%), in Blood 4 (1.4%), in Bodyfluid4 (1.4%) and in semen 3(1.1%) .The most common Gram- negative bacterial isolates being Escherichia coli 152(53.5%), followed by Klebsiella pneumonia 40(14.1%), Pseudomonas aeruginosa 13(4.6%), Proteus mirabilis 13(4.6%), Acinetobacter baumannii 8(2.8%) were the most dominant isolate respectively. Among gram negative bacteria, K.pneumoniae (82.5%), E.coli (82.9%), P.aeruginosa (100%), and A. baumanii (100%) were multi drug resistance. Concussion: High antimicrobial resistance and multi drug resistance was demonstrated over the study period, which may be due to associated with the improper antibiotic consumption or lack of a proper guideline for empirical therapy. Keywords: Antibiogram, Enterobacteriaceae, fermentative and non-fermenting gram-negative bacilli, antimicrobial susceptibility test and antimicrobial resistant
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    Antibiotic Susceptibility Pattern of Neisseria Meningitides Isolates From Asymptomatic Carriers in Gurage Zone, Southern Ethiopia
    (Addis Abeba university, 2017-06) Mulatu, Fikerte; Desta, Kassu(PhD)
    Background: Neisseria meningitides represents a pathogen of great public health importance in both developed and developing countries. Resistance to some antimicrobial agents used either for therapy of invasive infections or for prophylaxis of case contacts has long been recognized. However, there is a limited data in relation with the antimicrobial resistance pattern of Neisseria meningitides in Ethiopia. Therefore; the aim of this study was to assess drug susceptibility pattern of Neisseria meningitides isolates from asymptomatic carrierers of all age groups at Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State Ethiopia. Methods: Cross-sectional study was conducted on 187 Neisseria meningitides isolates obtained from MenAfricar project.A total of 4110 study participants from Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State, Ethiopia were screened for Neisseria meningitides by the project. Antimicrobial susceptibility test (AST) was done on stored Neisseria meningitides isolates.The activity of ten antimicrobial agents used for treatment and prophylaxis of meningococcal disease was investigated. The AST was performed for Neisseria meningitides isolates according to the criteria of the CLSI guide line by disk diffusion method. Data was analysed by using SPSS version 20.0 software. Results: From 187 Neisseria meningitides isolates 8(4.28%) were serogroup X, 24(12.83%) were serogroup Y, 1(0.53%) was serogroup W135 and 154(82.35%) were non determinant (ND). Resistance for Cotrimoxazol was high accounting 116(62%) followed by Ciprofloxacine 112(60%), Cefotaxime 26(14%), Ceftriaxone 24(13%) , Meropenenem 21(11%) , Minocycline 15(8%), Rifampine 14(7.5%), Azithromycine 10(5%), Chloramphenicol 7(4%),Levofloxacin 6(3%) . 102(54.5%) isolates were resistance for more than one drug. Conclusions: An antimicrobial resistance for Neisseria meningitides isolates from asymptomatic carriers for the present study is high. Continued surveillance of meningococci for antimicrobial resistance is necessary to monitor early detection of changes in susceptibility patterns that might affect recommendations for chemoprophylaxis and treatment. Key words: Neisseria meningitides, serogroups, sensitivity pattern, drug resistance
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    Antibiotic Susceptibility Pattern of Neisseria meningitides Isolates from Asymptomatic Carriers in Gurage zone, Southern Ethiopia
    (Addis Ababa University, 2017-06) Mulatu, Fikerte; Desta, Kassu (Assistant Professor)
    Background: Neisseria meningitides represents a pathogen of great public health importance in both developed and developing countries. Resistance to some antimicrobial agents used either for therapy of invasive infections or for prophylaxis of case contacts has long been recognized. However, there is a limited data in relation with the antimicrobial resistance pattern of Neisseria meningitides in Ethiopia. Therefore; the aim of this study was to assess drug susceptibility pattern of Neisseria meningitides isolates from asymptomatic carrierers of all age groups at Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State Ethiopia. Methods: Cross-sectional study was conducted on 187 Neisseria meningitides isolates obtained from MenAfricar project.A total of 4110 study participants from Meskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and Peoples Regional State, Ethiopia were screened for Neisseria meningitides by the project. Antimicrobial susceptibility test (AST) was done on stored Neisseria meningitides isolates.The activity of ten antimicrobial agents used for treatment and prophylaxis of meningococcal disease was investigated. The AST was performed for Neisseria meningitides isolates according to the criteria of the CLSI guide line by disk diffusion method. Data was analysed by using SPSS version 20.0 software. Results: From 187 Neisseria meningitides isolates 8(4.28%) were serogroup X, 24(12.83%) were serogroup Y, 1(0.53%) was serogroup W135 and 154(82.35%) were non determinant (ND). Resistance for Cotrimoxazol was high accounting 116(62%) followed by Ciprofloxacine 112(60%), Cefotaxime 26(14%), Ceftriaxone 24(13%) , Meropenenem 21(11%) , Minocycline 15(8%), Rifampine 14(7.5%), Azithromycine 10(5%), Chloramphenicol 7(4%),Levofloxacin 6(3%) . 102(54.5%) isolates were resistance for more than one drug. Conclusions: An antimicrobial resistance for Neisseria meningitides isolates from asymptomatic carriers for the present study is high. Continued surveillance of meningococci for antimicrobial resistance is necessary to monitor early detection of changes in susceptibility patterns that might affect recommendations for chemoprophylaxis and treatment. Key words: Neisseria meningitides, serogroups, sensitivity pattern, drug resistance
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    Antimicrobial Susceptibility Pattern of Bacterial Isolates From Wound Infections at all Africa Leprosy, Tuberculosis and Rehabilitation Training Center, Addis Ababa Ethiopia
    (Addis Ababa University, 2017-06) Tessema, Asdesach; Bitew, Adane (Associate Professor)
    Background: Wound develops into an infected state when the balance between microorganism and the host shifts in favour of the micro-organism. Antimicrobial resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs. Objective: The main objective of this study was to isolate etiology of wound infections and determine their antimicrobial susceptibility pattern. Methods: A cross-sectional study was conducted at ALERT Center from February to May 2017. Swabs from different types of wounds was taken and processed to isolate etiologic agents by using standard microbiological techniques. Antimicrobial susceptibility tests were performed by disc diffusion technique as per the standard modified Kirby-Bauer method. Results: In this study 171 bacterial isolates were recovered from 188 specimens showing an isolation rate of 86.2%. The predominant bacteria isolated from the infected wounds were Staphylococcus aureus 96 (51.1%) followed by Klebsiella pneumoniae 26 (15.2%), Escherichia coli 23(13.4%). Out of 162 positive samples 9(5.5%) were mixed infections. Staphylococcus aureus exhibited highest sensitivity against Clindamycin (95.8%), Gentamycin (94.8%), Chloramphenicol (92.7%), Ciprofloxacillin (89.6%) and Cotrimoxazole (84%). Gram negative isolates, E.coli, P.vulgaris, P.mirabilis, P.aeroginosa and Citrobacter showed the highest sensitivity against Amikacin (100 %). E.coli showed high resistance for Ampicilin (95.7%) and Augumentin (91.3%) where as P.vulgaris showed 100% resistance for Ampicilin and 90.9 % for Tetracycline. Conclusion: There was high prevalence of bacterial isolates in this study. S. aureus was the predominant isolate 96 (56.1%). Most of the isolates showed high resistance to commonly used antimicrobials. The antimicrobial profile of drugs demonstrated that the commonly prescribed drugs against Gram positive bacteria (Penicillin, Tetracycline) and Gram-negative bacteria (Ampicillin and Tetracycline) as a single agent for empirical treatment of wound infections would not cover the majority of wounds infections. Antimicrobial treatment should be based on the result of culture and sensitivity. Keyword: wound infection, bacterial isolates, drug resistance pattern.
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    Antimicrobial Susceptibility Pattern of Common Bacteria Isolateted from Wound Infection In Paediatric Surgical Patients at Yekatit 12 Hospitals, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2017-06) Mahmud, Tofik; Desta, Kassu (Assistant Professor)
    Background: Wound infections contribute significantly to morbidity and mortality in surgical patients. Factors that increase the risk of wound infection include patient conditions such as; age, obesity, malnutrition, smoking, and the state of the wound which includes nonviable tissue in the wound, foreign bodies, long surgical procedures, and others. However microorganisms are the major causes with bacteria being the most prevalent. Severe and poorly managed infections can lead to gas gangrene and tetanus which may cause long-term disabilities. Bacterial wound infections are a common finding in open injuries.. Objective: The study aimed to identify bacteria that cause wound infections and to determine their antimicrobial patterns in the pediatric surgical wards at Yekatit 12 Hospital, Addis Ababa, Ethiopia. Method: A cross sectional study was conducted from December 2016 to April. A total 150 clinical specimens were collected from study participant. All wound samples were cultured on Blood agar and MacConkey agar. All culture positive samples were characterized by gram stain and biochemical tests using the standard procedure. Antimicrobial susceptibility test was performed using Kirby-Bauer method. All demographic, laboratory and risk factors data obtained were entered and analyzed using SPSS version 20. Result: The burden of wound infection among pediatric patients was 123 (82%). Of which 90 [65.7%] were gram positive and 47 [34.3%] were gram negative bacteria. Staphylococcus aureus 79[52.7%] was the most prevalent followed by Pseudomonas aeruginosa 26 [17.3%] and Proteus spp 14 [9.3%].Patients who had mixed infections were 8.67% of the total participants. Staphylococcus aureus was highly sensitive to ceftriaxone but resistant to ceftazidime [91.1%]. Methicillin Resistant Staphylococcus aureus formed 50.6% of the Staphylococcus aureus isolates. Beta hemolytic Streptococcus was highly sensitive to amoxicillin clavulanate and resistant to cefuroxime. Escherichia coli was sensitive to ciprofloxacin but resistant to amoxicillin clavulanate, cefuroxime, ceftriaxone, imipenem and ceftazidime. Klebsiellaspp was sensitive to all the antibiotics that were tested. Proteus mirabilis was sensitive to all the antibiotics except ceftazidime. The Non lactose fermenters were only sensitive to imipenem, ciprofloxacin and cefoxitim. Pseudomonas aeruginosa was highly sensitive to ciprofloxacin and imipenem but less sensitive to ceftazidime and resistant to ceftriaxone.Ceftriaxone, cefuroxime, flucloxacillin and amoxicillin clavulanate were widely used beside other antibiotics for either prophylaxis or treatment of the wound infections. Conclusion: The prevalence of wound infection remains high despite wide use of antibiotics in the paediatric surgical wards. Resistance to new antibiotics like imipenem was observed. Key terms: Bacterial isolates, antimicrobial susceptibility pattern, surgical site infection
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    Antimicrobial Susceptibility Pattern of Gram Negative Bacterial Isolates From Sewages Polluted Urban Rivers, Addis Ababa, Ethiopia, 2017
    (Addis Ababa University, 2017-06) Belachew, Teshome; Desta, Kassu (Assistant Professor)
    Background: rivers are an important source for drinking, irrigation, recreation and other domestic purposes. However, if it is polluted, it can act as the storehouse of harmful infectious agents that possess multiple drug resistant genes, which is a growing public health concern. Objective: To determine gram negative bacterial profile and antimicrobial susceptibility pattern from selected sewage polluted urban rivers of Addis Ababa. Methods: A cross sectional prospective study was conducted from February – April 2017. Water samples were collected from the rivers that pass through ten sub cities of Addis Ababa. Turbid samples were tenfold diluted (1:10) with sterile physiological saline. Samples were inoculated on blood and MacConkey agar. Presumptively isolated organisms were identified by BioMerieux VITEK 2 COMPACT machine. Antimicrobialsusceptibility patternwas alsoperformedfor 19 antibiotics by the machine with minimum inhibitory concentration technique. Epidata 3.1 was used as data entry and SPSS 20 was used for data analysis. Results:From a total of 94 river water samples, 150 gram negative bacterial isolates were recovered to the species level and 30 isolates were not identified by the machine. The isolation rate was 98% (92 samples were positive for one or more than one bacterial isolates). The predominant species were A. hydrophylia/cavae 26 (17%) followed by E.coli 23(15%), K.pneumonia 18(12%), Rautella species 18(12%), K. oxytoca 17 (11%).The least identified species was E.gergovia and C.braki1(1%). A. Hydrophila/Cavae showed high level of resistance to cefazolin 10 (38%), cefoxitin 9 (35%) and trimethoprim sulphomethoxazole 10 (38%). E.coli. showed also high level of resistance to many of tested antibiotics like ampicillin 21 (91.3%), and 16(70%) resistance to Cefalotin, Cefuroxime, Ceftriaxone and Cefepime. Both K.Pneumoniae and K.oxytoca showed high resistance to ampicillin 16(94%) and 17(95%) respectively. Among identified bacterial species, most of them showed multidrug resistant pattern. Providential retigerri showed 100% MDR Followed by P.Alkalificiens (90%), E.coli (78%), Morganella species (75%), and C.frundi (60%). Conclusion and Recommendation: A.hydrophila/cavae and E.Coliwere the most predominant bacterial isolates. Most of identified bacterial species were highly resistant to ampicillin and amoxicillin/clavulnic acid. Drug resistance and MDR were very high in this study. Key words: Gram negative bacteria, Multidrug Resistance, Antimicrobial susceptibility pattern, River, Addis Ababa
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    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 (Associate Professor)
    Background: Urinary tract infection (UTI) is considered as the most common bacterial infectious disease seen among the pediatric patients. Objective: This study was carried out in order to determine the antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolates from Pediatric Patients at Yekatit 12 Hospital Medical College Materials and Methods Clean voided mid-stream urine specimens were obtained from patients in sterile universal bottles. Urine collected from each patient was inoculated onto CLED 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 of standard routine biochemical test. Antimicrobial susceptibility test was carried out by using the Kirby Bauer disc diffusion. Result: The data was analyzed by using SPSS, version 17. Descriptive statistics was computed for most of the study variables and Frequency distribution tables were used to describe the findings. In this study a total of 384 pediatric patients (199 males and 185 females) aged between 0 years to 15 years from whom urine sample were collected were enrolled. 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 bacteriuria and the largest number of study subjects were below age 3 years and the largest positive culture was obtained from this age group, accounting 35 (57.4%.) out of 61 positive culture. Bacterial species belonging to six genera were isolated and identified from 61 positive cultures and the genera were Escherichiai, Klebsiella, Staphylococcus, Proteus, Acnitobacter and Entrococcus. and E. coli was isolated in 28 cases (28/61, 49.5 %), followed by Klebsilla spp. in 17 cases (17/61, 27.9%), Staphylococcus spp. in 5 patients (5/61, 8.2%.) ( S. aureus in one 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 bacterial isolates 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 patients accounting 71. 4% and 64.7% respectively. percentage resistance of Klebsilla spp was much higher when compared to E.coli. Eighty eight percent of Klebsiell spp. were resistant to cefotaxim, ceftazidim, trimetroprimsulfamethoxazole and cefuroxime. Acentobacter spp. was 100% resistances to gentamicin, trimetroprimsulfamethoxazole , agumentin, and nalidixic acid . 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 Erythromycin. S. aurues was 100% susceptible to ciprofloxacin, 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 in 73.7% of bacterial isolates. Conclusion: This study determines the antimicrobial Susceptibility Profile of Bacterial Uropathogen Isolates from Pediatric Patients and highlighted the major bacterial 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 reported pattern, 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 (except proteus spp) and gram positive species were susceptible to ciprofloxacin Clindamycine and gentamicin so this drugs can be used to treat UTI in children however Most of bacterial isolates were multidrug resistant and it is therefore suggested that appropriate antimicrobials should be administered to reduce the risk of multi drug resistant organisms developing and avert ineffectiveness of antibiotics
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    Antiretroviral Treatment Associated Hyperglycemia and Dyslipidemia among HIV Infected Patients at Burayu Health Center, Addis Ababa, Ethiopia, 2012
    (Addis Abeba University, 2012-06) Abebe, Molla; Kinde, Samuel; Dr.Tegbaru, 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 restricted by a heterogeneous collection of unexpected metabolic abnormalities, including dysregulation of glucose metabolism, dyslipidemia and lipodystrophy. Objective: To assess antiretroviral treatment associated hyperglycemia and dyslipidemia among HIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia. Methodology: A cross-sectional study was conducted on adult HIV infected individuals at Burayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equal number of HAART naïve and HAART initiated patients (n=126 each) were included in the study. Demographic data were collected using a well-structured questionnaire. TC, TG, HDL-C, LDL-C and glucose were determined using COBAS INTERGA 400 chemistry analyzer. The data were analyzed using SPSS version 19 software. Chi-square, student-t-test and logistic regression were used to assess association between variables. P value < 0.05 was considered as statistically significant. Result: Of 252 study participants, 72.2% were females, mean age was 35.3 years; mean BMI was 21.4; mean time with the virus was 20.6 months; 62.7% were married; 48.4% were at primary educational level; 52.4% were house wives; 15.5% were TB-HIV co-infected and 43.7% were categorized as WHO stage one. The prevalence of hyperglycemia, hypertriglyceridemia, hypercholesterolemia, decreased HDL-C and increased LDL-C was 7.9%, 22.8%, 42.1%, 50.8% and 23% in HAART initiated and 5.6%, 10.3%, 11.1%, 73% and 7.1% in non-HAART groups, respectively. ART regimens observed as a first line were only containing 2 nucleoside backbones (from AZT/D4T/3TC/TDF) with either NVP or EFV. Serum TG level ≥200 mg/dl was more common among patients who received D4T based than those with AZT based antiretrovirals (34% versus 16.4%, P = 0.029). Conclusion: First-line HAART is associated with potentially atherogenic lipid profile levels in patients with HIV infection compared to untreated patients in our setting. This indicates glucose and lipid profile levels need to be monitored regularly in HIV infected patients taking antiretroviral treatment.
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    Application of Home Validated Panel Dna Materials for Proficiency Testing of Who Endorsed Molecular Assays: Mtbdrplus and Xpert Mtb/Rif Assay
    (Addis Ababa University, 2016-06) Dagne, Zekarias; Desta, Kassu (Assistant Professor)
    Background: Tuberculosis (TB) is a major public health problem in Ethiopia. Laboratory plays an important role in the diagnosis of TB and its treatment monitoring. Quality assured molecular drug susceptibility assay is an essential for rapid detection of MDR-TB cases and early treatment initiation Proficiency testing is one of the EQA methods in evaluating the quality service delivery however, it was not widely applied for molecular assays in Ethiopia mainly due to the inadequate capacity of preparing PT DNA panels’ in-country. Objective: The aim of this study was to assess Application of Homemade and validated panel DNA Materials for Proficiency Testing of the WHO endorsed Molecular Assays (GenoType® MTBDRplus and Xpert MTB/RIF assays) in TB Culture and DST laboratories, and in selected GeneXpert sites of Ethiopia. Methods: A cross sectional study was conducted in five regional reference laboratories and two specialized hospital TB culture and DST laboratories which have molecular GenoType® MTBDRplus assay of Ethiopia, and in eight selected health facilities with Xpert MTB/RIF testing sites in Addis Ababa during the period between July 2015 and January 2016. PT DNA materials were validated at EPHI, NTRL and distributed to MTBDRplus and Xpert MTB/RIF testing facilities. All data from participating laboratories were captured and analyzed using SPSS version 20. A total of 194 (130 for MTBDRplus and 64 Xpert MTB/RIF) DNA panels were distributed to regional reference and hospital TB laboratories. Test results agreement between the participant laboratories and reference were estimated using Kappa statistics. The sensitivity, specificity, predictive value susceptible, predictive value resistance, accuracy and reproducibility of participant laboratories were calculated against the reference lab. Results: 130 panel samples with a combination of 65 (50%) spiked sputum and 65 (50%) extracted DNA were tested in seven Regional Reference Laboratories which have MTBDRplus assay. Almost all, 129 (99.2 %) were correctly reported to the Isoniazid and Rifampicin susceptibility. Sixty nine (53.1%) reported isolates were resistance to both INH and RIF (MDR), 41 (31.5%) susceptible to both INH and RIF, and 19 (14.6%) INH susceptible but RIF resistance strains correctly reported with respect to the reference result. There was 100% agreement in detecting MDR and resistance to any of the two drugs (INH and RIF) (kappa = 1) but the agreement was 97.8% for the detection of susceptible strains (Kappa = 0.9). Among 64 spiked sputum strains (32 M. tuberculosis DNA with no RIF resistance and 32 M. tuberculosis DNA with RIF resistance (probe E Mutant detected ) distributed to GeneXpert sites, all of them were correctly reported. Overall agreement on detection of M. tuberculosis and RIF susceptibility was 100 % (Kappa =1.0). Conclusion: There was an excellent agreement between the participant laboratories and the reference laboratory for the detection M. tuberculosis and drug susceptibility using MTBDRplus and Xpert MTB/RIF assays. Therefore, we can apply home validated PT DNA panels as one of the EQA methods for WHO endorsed molecular assays MTBDRplus, whereas in the Xpert MTB/RIF assay a large scale validation is important to use as Panel test since, the sites we used for this study in Addis Ababa, are small compared to the general population in Ethiopian context.
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    Assessing the outcome of Strengthening Laboratory Management Towards Accreditation (SLMTA) on laboratory quality management system in City government of Addis Ababa.
    (Addis Ababa University, 2014-06) Sisay, Abay; Mindaye, Tedila (PhD)
    Background; Medical laboratory services are an essential component of health systems. Strengthening these services can combat the major infectious diseases. Laboratory accreditation system is found to be essential to have national and international acceptance of various laboratory test results. Poor quality laboratory services guide to massive cause of over- treatment, overuse of drugs which leads to the emergence of drug resistant and laboratory errors guide the patients at risk of inappropriate care and potentially of adverse events .By recognizing this gaps of the current state of laboratories and the requirements of ISO 15189 particular requirements for quality and competence in Africa, Ethiopia, in 2009, WHO-AFRO established SLMTA in order to help laboratories with stepwise recognition of evolving fulfillment of the ISO 15189 standard instead of a grading of pass-fail. Objectives: To assess the outcome of Strengthening Laboratory Management Towards Accreditation (SLMTA) on laboratory quality management system in Addis Ababa. Methods: The study used an Institutional based cross sectional study design that employed a retrospective and prospective data collection approach on the participated institution of medical laboratory in SLMTA in Addis Ababa city government. The study was conducted in Addis Ababa city government and the data was collected from February –April 2014 and data was interred in to EPI-data version 3.1 and was analyzed by SPSS version 20. Results; The assessment finding indicate that there was a significant improvement in average scores (141.4; range of 65-196, 95%CI =86.275-115.5, p = 0.000) at final with 3 laboratories become 3 star, 6 laboratories were at 2 star, 11 were at 1 star .76% of the respondents respond that their facilities have no work plan and budget for laboratory specific purpose and lack of resources accounts 24% is the reason for this which is followed by absence of System. Laboratory facilities which get adequate and timely manner mentorship were found 2.5 times more likely to get good success in the final status of improvement project (AOR= 2.501, 95% CI= 1.109-4.602) than which did not get it and those laboratory which didn’t perform their customer satisfaction survey were 2.261 times more likely to get less final result than laboratory which are conducting their customer satisfaction survey (AOR= 2.261, 95% CI= 1.851-6.007). Conclusion: At the end of SLMTA 3 laboratories become 3 star, 6 laboratories were at 2 star, 11 were at 1 star .The most important contributing factor for not scoring star in the final outcome of SLMTA were not conducting their customer satisfaction survey, shortage of resource, poor staff motivation, and lack of regular equipment service maintenance. Mentorship, onsite and offsite coaching and training activities had shown that a great improvement on laboratory quality management system in most district laboratories. Keywords:-SLMTA, WHO-AFRO, Mentorship, Accreditation.
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    Assessment of Focused Antenatal Care Laboratory Services Statususing Availability, Functional Status and Clients Satisfaction at Public Health Facilities Addis Ababa, Ethiopia
    (Addis Ababa University, 2015-06) Melese, Daniel; Taye, Biniam ( Assistant Professor)
    Back ground: Laboratory service is a key component of Focused Antenatal Care (FANC) to identify life threatening conditions of maternal and child health. Limited capacity of health facilities to provide adequate laboratory services remains a major problem for the quality of FANC service delivery. Objective: To assess the status of focused antenatal care laboratory services using availability, functional status and client satisfaction at public health facilities in Addis Ababa, Ethiopia. Methods: Institution based, descriptive cross-sectional study was conducted from April to May 2015. Both quantitative and qualitative designs were used. Four hundred and twenty two study participants interviewed on satisfaction towards FANC laboratory services by using structured questionnaire. A qualitative data was collected by In-depth interview of providers. To assess availability and functionality of the FANC laboratory, observation check list was used. Data were coded and analysed by using SPSS Version 20 software. Logistic regression model was also used to examine the effect of selected variables on clients’ satisfaction with laboratory services. P-Value less than 0.05 were taken as statistically significant. Result: Only 5(38.5%) out of 13 visited health facilities reported the availability of all types of basic FANC laboratory investigations. Comparing the availability of individual tests in the study facilities, urine dipstick, urine miscopy and stool examination were available in all institutions. However, only 7 (53.8%) of the facilities reported the availability of Hepatitis B virus screening test. Rapid syphilis/RPR test was found in 10 (76.9%) facilities. All laboratory facilities had at least one or more basic FANC laboratory tests interruption more than a day within the last one year due to shortage of reagent and electric power disruption. Additional analysis of pregnant women's satisfaction toward FANC laboratory service showed, only 56.9 % (240/422) of pregnant mothers were satisfied with FANC laboratory services. Those clients who waited less than one hour to get laboratory results were six times more likely to be satisfied than those who waited more than one hours [AOR = 6.03; CI (2.86-12.67)]. Conclusion: Majority of the health facilities reported incomplete FANC laboratory investigations. Hepatitis B screening test was the lowest available test in the study facilities. Furthermore a slightly higher maternal dissatisfaction toward FANC laboratory service was observed compared with other institutional based study in similar settings
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    Assessment of anti-tissue transglutaminase-IgG with selected lipid panel tests among Helminths and H.pylori positive and non infected school aged children in Ziway Oromia region, South East Ethiopia
    (Addis Abeba University, 2020-07) Alem, Mekdes; Dr.Tsegaye, Aster(MSc, PhD, Associate Professor); Dr.Wolde, Mistre(MSc, PhD, Associate professor); Dr.Taye, Binyam(MSc, PhD, Assistant professor)
    Background: Celiac disease (CD) is an autoimmune disorder triggered by consuming a protein called gluten. It is determined by both environmental and genetic factors. Infection by Helminths and H.pylori are among the environmental factors involved that enhance anti-inflammatory response. Different auto antibodies and antibodies are used in the diagnosis of celiac disease, but Anti-tTG antibodies are highly sensitive and specific for the diagnosis of CD. IgG-based tests are useful for detecting celiac disease. Since Celiac disease is one of the areas that did not get much attention in its diagnosis; this study could give some insight on the necessity of doing more research in the area and gives a better understanding on the association between celiac diseases with that of lipid profiles, H.pylori and Helminths infection Objective: The objective of this study was to assess anti-tissue transglutaminase IgG antibody with selected lipid panels among H.pylori and Helminths positive and non infected Children. Methods: A cross sectional retrospective and prospective study was conducted in Ziway, South east of Addis Ababa, Ethiopia by using random sampling method. The retrospective part included taking serum samples that were collected and stored during another study and careful review of study groups sociodemographic and medical data. The samples that were kept refrigerated at -80ºC were used for analysis of anti tissue transglutaminase IgG and lipid profiles as for the prospective part of the study starting from May 2020 to June 2020. The transglutaminase IgG measurement used principle of Enzyme immunoassay for optical density measurement based on commercially available kit. While the lipid panels used kinetic assay that were measured on Cobas 6000 fully automated chemistry machine. The obtained data was entered and analyzed by using SPSS version 23 and descriptive analysis, Chisquare and logistic regression were used to see any associations and P-value <0.05 was considered as statistical significant. Result: A total of 97 samples of children with age group between 4-14 years old were involved in this crossectional study. 19% of study participants tested positive for anti-tissue transglutaminase IgG and Females had a higher magnituse of anti-tTG IgG than males (24.5 % vs 11.4%). A significant association was found between Helminths and anti-tTGIgG [OR 3.45 (95% CI: 1.057, 11.265), P=0.033] However this study failed to show association between anti-tTGIgG and H.pylori as well as with lipid profiles. Conclusion: Although the relation between H. pylori and Celiac diseases is controversial, our result doesn’t proof H.pylori can shield against celiac disease so measures to protect oneself against H.pylori should be continued. On the other hand, even though more trials are required, there is a strong association between Helminthes infection and anti-tTGIgG where children not infected with Helminths had a 3.45 times greater risk of developing a positive antitTGIgG. Although a significant difference was not found in this study between lipid profiles and anti tissue transglutaminase, it is advisable to assess lipid profiles of celiac patients as shown in other studies so as to minimize the long term effect associated with lipid profile alteration, Coronary artery disease for instance. We strongly recommend large scale case control study to understand the exact relationship between celiac diseases and other comorbidities.
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    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 ART program, little is known about the quality of ART monitoring laboratory services in health facilities. Objective: - To assess the quality of ART monitoring laboratory services in public hospitals of Addis Ababa with emphasis on client satisfaction, providers’ views, functional & structural status of the ART monitoring laboratory service. Methods: - Hospital based, descriptive cross sectional study was conducted from October to November 2010. In this study both quantitative and qualitative design forms were used. A total of 422 clients were considered for exit interview about their satisfaction towards ART monitoring laboratory services using structured questionnaire. To assess the structural and functional aspects of ART monitoring laboratories, observation checklist was used. In-depth interview of providers were conducted to assess their views on quality of ART monitoring laboratory services. Data were coded and entered using EPI info 2002 (Centers for Disease Control and Prevention Atlanta, GA) and analyzed using SPSS version 15 software (SPSS INC, Chicago, IL, USA). Satisfaction score was calculated by giving a value of one for very satisfied. A value of two was assigned for response of satisfied; three for neutral response. Values of four and five were given for dissatisfied and very dissatisfied responses respectively. The mean, median and mode scores for the overall satisfaction were calculated. Median of the summary score of satisfaction was used to classify as satisfied and none satisfied since the distribution of summary scores was skewed. Bivariate and multivariate logistic regression models were also used to examine the effect of selected variables on patients’ satisfaction with ART monitoring laboratory services by using Odds Ratio (OR) with a 95% Confidence Interval (CI). P-Value less than 0.05 were taken as statistically significant. Variables that were found with a statistically significant association (p<0.05) at univariate logistic analysis were entered and analyzed by multiple logistic regression analysis. Results: - A total response rate of 406 (96.2%) from 422 sample size was obtained. Among those 255(62.8%) were females. The overall satisfaction rate was 47.5%. The major determinants for none satisfaction were lack of space in blood drawing room to put client personal thing (AOR= 3.377, 95% CI 1.511-7.550, P=0.00), lack of information regarding bruises following blood drawing (AOR= 2.029; CI 1.162-3.542, P=0.01 ),waiting time to get laboratory results (AOR= 4.096; CI 1.769-9.485, P=0.00), needle stick while attempting to draw blood (AOR=7.769, 95% CI 1.280-47.166, P=0.02), waiting time to get blood drawing service (AOR= 7.643, 95% CI 2.62722.236, P=0.00). None of the hospital laboratory had guideline for disposal of damaged or expired laboratory reagents. Equipment maintenance was one of the major problems found in almost all public hospital of the city providing ART services during in-depth interview of providers. Conclusion:-The overall satisfaction level of clients with ART monitoring laboratory services was 47.5%. Accessibility and availability of latrines, ability of phlebotomist to answer questions raised by clients and comfort of chairs in blood drawing room were considered the most significant factors for low satisfaction levels. Equipment maintenance was a major challenge in rendering ART monitoring laboratory services in public hospitals.
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    Assessment of Biosafety Practice and Associated Factors in Clinical Laboratory Workers Among Government Hospitals in Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-05) Seyoum, Alexsander; Worku, Walelegn (PhD)
    Background: Biosafety is an important practice in all laboratory settings especially in developing countries where standard operating procedures are lacking. There is only limited information about biosafety practices in government hospital laboratories in Addis Ababa. Objective: To assess the situation of biosafety practice and associated factors in clinical laboratory workers among government Hospitals in Addis Ababa, Ethiopia Method: Cross-sectional study design was conducted from March to May 2014; in all government Hospitals of Addis Ababa. A total of 290 laboratory professionals were participated about their biosafety practice and its associated factors using structured questionnaire to assess the structural and functional aspects of Biosafety Practice of laboratories. Data were coded and entered by Epi Info and Exported to SPSS V.20 for analysis. Bivariate and multivariate analysis were also used to identify factors that affect the outcome variable and to examine the effect of selected variables on laboratory personnel practice toward biosafety practice by using Odds Ratio (OR) with a 95% Confidence Interval. P- Value less than 0.05 were taken as statistically significant. Variables that were found with a statistically significant association (p<0.05) at bivariate logistic analysis were entered and analyzed by multiple logistic regression analysis. Results: - In this study a total of 290 laboratory professionals were involved. Out of those subjects the biosafety practice rates of protective barrier were 76.2%. The major factor for biosafety practice were practice of performing a written procedure for the clean-up of spills (AOR=2.31; CI 1.21-4.42), those who were practice of decontamination and wastes before disposal (AOR=2.69; CI 1.49-4.86) and those who got information in Participating a biosafety practice (AOR=5.07; CI 1.66-15.52) Conclusion: - This study revealed that there is an achievement of a minimum requirement of biosafety practice among studied laboratory personnel. Practice of performing clean-up of spills, practice of decontamination and wastes before disposal and information in participating a biosafety practice are a significant association with biosafety practice.
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    Assessment of Biosafety practices in selected Public Hospital laboratories, East, South-West, and West Shoa Zones of Oromia Region, Ethiopia
    (Addis Ababa University, 2014-06) Tefera, Derese; Tsegaye, Aster (PhD)
    Background: Persons working in clinical diagnostic laboratories are exposed to many risks. The most hazardous agent in the laboratory is a microorganism that is frequently associated with laboratory infections and can be transmitted in variety of routes, especially by aerosols. Moreover, hospital and diagnostic laboratories are a challenging environment for the surrounding community. The more the laboratorians become aware of and adhere to recommended, science-based safety precautions, the lower the risk for laboratory acquired infections. The behavior patterns and attitude of individuals towards safety programs influence their involvement in laboratory accidents that put themselves and fellow workers at risk. Assessing laboratory biosafety practices will help the laboratories to identify factors that hindered laboratory personnel from practicing good laboratory biosafety measures and to determine the existing situation of the assessed laboratories so that laboratory managers can plan towards implementation of biosafety practices and hence safe working laboratory area will be created. Objective:The aim of this study was to assess biosafety practices among laboratory personnel working in selected public hospitals in the East, West and S/West Shoa zones of Oromia region. Methods: Institution based cross-sectional study was conducted between December 2013 and May 2014.The study was conducted among 45 studied laboratory personnel working in 5 selected public hospital laboratories located in East, West and S/West Shoa Adama, Bishoftu, Tulubolo, Ambo and St. Luke hospital laboratory). Datawas collected between April and May 2014 using structured questionnaire. The analysis was done by SPSS version16 statistical software using one-way ANOVA. P-values less than 0.05 wereconsidered as statistically significant. Result:Out 0f 45 participantsgreater than 37 (84%) of studied personnel were within the age range of 18-44 years. Of which the majority 23(64%) of the studied laboratory personnels’ age were aggregated within the age distribution category of 25-34. Male to female ratio of the studied participants were 3:1 with a count of male participant 34 (75.6%), and females accounted 11 (24.4%). Regarding the level of education, 23 (51.1%) of them had finished undergraduate study on medical laboratory sciences (Bachelor of sciences) and the rest 21(46.7%) were diploma holders in laboratory science. The duration of work experience in laboratory service of the studied laboratory showed that greater than 33(75%) of the group had a work experience of greater than 5years. This survey shown that the grand mean of the studied laboratory personnel for the overall biosafety practices was found to be 36.44±7.635 with a mean score range of 52%- 80%. Laboratory personnel B exceptionally scored the highest mean score of all 42.7(80%) and fall in upper moderate level which is close to high level. The mean score for laboratory D and E had shown similar results which are a mean value of38.6 (70%)and they are closed to be labeled as moderate. The rest two laboratories (A and C) found to be low level with laboratory A scored the least mean value of all 29.7 (50%), while laboratory C scored a mean value of 34.5. Conclusion: The overall biosafety practice of the studied hospital laboratories average score is 36.44±7.63 from a total score value of 55. The percent range forall studied labs is 52%-80%. Laboratory B exceptionally scored the highest mean of all with a score of 80% as a result it is in the upper moderate level category.
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    Assessment of Blood and Blood Component Utilization in Black Lion Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Abeba University, 2011-06) Tamene, Melaku; Tsegaye, Aster(MSc, PhD); Birhanu, Asaye( BSc, MSc ); Taye, Benyam(BSc, MPH)
    Background: Assessment of blood and blood components utilization is an important tool to reduce inappropriate transfusions and helps to show the frequency of blood and blood component utilization, recipient status by pre- and post- transfusion assessments in addition improved and not improved after transfusion. However in Ethiopia the regular audit and assessment of the transfusion practice is not well studied. Objective: To assess utilization of blood and blood components for transfusion at Black Lion Specialized Hospital, Addis Ababa Ethiopia. Methods: A one year (September 2009 to August 2010) hospital based retrospective study was conducted to analyze the pattern of blood component utilization in Black Lion Specialized Hospital blood transfusion service effected from October 2010 to January 2011.There were about 4,570 transfusion episodes and 10,836 units of blood were transfused. Using estimation of single population proportion formula and systematic random sampling we selected 373 subjects and collected information from the existing blood bank log book on ABO and RH blood group, amount of transfusion episodes, and type of blood administered. In addition, data on sex, age, profession, level of education and department of the health worker, type of blood component, and amount of unit administered, prevalence of unexpected reaction, pre- and post transfusion examinations including improvement status. Data was analyzed for descriptive statistics, univariate and multivariate analysis using SPSS version 15.0 software (SPSS INC Chicago IL, USA). Results: - Of 361 transfused study subjects 856 units of blood were transfused with the mean of 2.37 units. Of the transfused 188(52.1%) were Females. The most widely used blood and blood component type in this study was whole blood 307 (85%) and the combination of two blood products were given to 27(7.5%). Plasma was transfused only for single patient (0.3%). There were no transfusion reactions after transfusion. Out of the total none improved cases, 45(66.2%) were those transfused with whole blood transfusion. The proportion of improvement after transfusion according to service ranged from 69.0% to 100%. When 95% CI for the adjusted odds ratios were calculated among these variables, significant associations were found between the overall improvement statuses of the patient with their profession of the health worker ordered the transfusion and type of blood and blood product administered. Conclusion: - The overall utilization of blood and blood components were similar to other developing countries. However, transfusion of blood components was very low and there were high rate of whole blood transfusion. The prevalence rate of patient improvement status after transfusion was high.
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    Assessment of Blood Transfusion Utilization , Patient Outcome andassociated factors at St. Paul Hospital Millennium Medical College Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-05) Abebe, Assefa; Tsegaye, Aster (MSc, PhD); Hagos, Afework (MD, Hematologist); Negash, Mikiyas(MSc, PhD candidate)
    Background: Assessment of blood utilization is an important way to minimize unnecessary use of blood and blood components for transfusions so as to effectively manage such scarce resources. However, in Ethiopia the regular assessment of transfusion practice is not performed consistently. Regular audits are necessary to ensure blood and blood products are appropriate and clinical. Objective: To assess blood transfusion utilization , patient outcome and assocaited factors from july 2020 to september 2020 at St, Paul’s Hospital Millennium Medical College. Methods: the utilization of blood, patient outcomes and associated factors were assessed in this Hospital based cross sectional study at St. Paul Hospital Millennium Medical College from July to September 2020. A standardized data extraction checklist was used to extract data from patient file and from blood bank log book. Transfusion indices werecalculated. Data was entered and analyzed using SPSS version 23. Dependent variable frequencies, percentage, mean and range were calculated. The association between patient improvement and independent variables was examined using bivariate and multivariable logistic regression analysis. P-value less than 0.05 were considered as statistically significant and Odds ratios with 95% confidence interval were used to determine strength of the association. Result: A total of 352 participants were included in the study. The majority of the patients were female 218 (61.9%). The median and interquartile range [IQR] age of study participant was 30 [20-43] years. For 352 study subjects, 1060 unit of blood components were transfused with the mean of 3.01units per patient. From 1242 cross matched units, 85.3% wereutilized, the rest 14.7% were returned to laboratory stock.Anemia was the commonest indication for transfusion and concentrated red cell was the major component transfused. The study revealed the number of units cross matched/transfused (C|T) ratio of 1.17, Transfusion probability (%T) of 61.3%, and Transfusion index (TI) of 1.84. Only 177(50.3%) of the patients showed improvement. Patients in the age group 1 to 10 years were more than 6 times more likely to improve than those aged under one year’sAOR and 95% CI =6.037[1.205-30.251], p=0.029. Conclusion: The study demonstrated an encouraging rate of transfusion utilization in which 85.3% of cross matched blood is utilized. Transfusion indices,C/T, %T and TI, values were within the acceptable standard. The high rate of non-improvement warrants further investigation.
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    Assessment of Chemotherapy induced Leukopenia and its determinants among solid cancer patients attending St. Paul Hospital Millennium Medical College Oncology Unit, Addis Ababa, Ethiopia
    (Addis Abeba University, 2020-05) Dessalegn, Mekonnen; Tsegaye, Aster(PhD, Associate Professor); Fantahun, Mengistu (MSc); Adem, Abdum (MD, Assistant professor of Clinical Oncology); Hussein, Mintewab(MSc)
    Background: Chemotherapy is among the standard treatments for cancer and leukopenia, neutropenia, febrile neutropenia and lymphopenia are the most common side effects. These side effects have been reported to be associated with substantial morbidity, mortality and healthcare costs. Objectives: To assess the prevalence of chemotherapy induced leukopenia (CIL) in solid cancer patients at St Paul‟s Hospital Millennium Medical College Oncology unit, Addis Ababa, Ethiopia. Methods: An institution based cross sectional study was performed at St Paul‟s Hospital Millennium Medical College Oncology unit from February 1st 2020 to May 2020. Using convenient sampling technique, 92 patients, who were diagnosed for any type of solid cancer, were recruited in this study. EDTA whole blood was collected before each cycle of treatments and analyzed for complete blood count (CBC) using Beckman coulter analyzer before and after the initiation of chemotherapy. The laboratory analysis was done for five times Data were entered; cleared and analyzed to match the objectives. Chi-square statistics were employed and p values less than 0.05 were taken as statistically significant. Results: Among the 92 patients who participated in this study, the following adverse effects were observed after the use of various chemotherapy regiments in the five cycles. The most common adverse effects of Chemotherapy Are Leukopenia 80.4%, Neutropenia 70.7 %, Febrile Neutropenia 50% and Lymphopenia 88%. occupation and ECOG have a significant association with the occurrence of hematological toxicities with (p=0.011) and (P=0.013) respectively. Also majority of hematological toxicities are caused by Adriamycin + cyclophosphamide. Conclusion: Even though chemotherapy is the standard treatment for cancer patients, it causes leukopenia, neutropenia, febrile neutropenia and lymphopenia which may cause delaying of treatment, morbidity and mortality.
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    Assessment of clinical and hematological alteration among visceral leishmaniasis patients attending Kahsay Abera and Mearg Hospitals, Western Tigrai, Northern Ethiopia, 2019
    (Addis Abeba University, 2019-06) Gebremichail, Gebremedhin; Dr. Tsegaye, Aster (MSc, PhD)
    Background: Hematological abnormalities are common in visceral leishmaniasis patients, which is one of the major public health problems worldwide. The most common hematological abnormalities are anemia, leucopenia and thrombocytopenia. Objective: To asses clinical and hematological alteration among visceral leishmaniasis patients attending Kahsay Abera and Mearg Hospitals,Western Tigrai, Northern Ethiopia , 2019 Method: Institutional based comparative cross sectional study was conducted from November 2018 to March 2019 at Kahsay Abera and Mearg hospitals, Western Tigrai, Northern Ethiopia. A total of 100 Visceral Leishmaniasis patients and 100 healthy control groups were included in this study. Blood was collected and analyzed by sysmex KX-21N hematology analyzer. Data was entered and analyzed using SPSS Version 23. Student independent t-test was used for data analysis. P value <0.05 was considered as statistically significant at 95% confidence level. Result: From the total 100 visceral leishmaniasis patients the following abnormalities were reported: 96(96%) anemia, 95(95%) leucopenia, 92(92%) neutropenia, 73(73%) Lymphopenia, 45(45%) eosinopenia and 97(97%) had thrombocytopenia. Splenomegally and fever was seen in all visceral leishimaniasis patients. Red blood cell, hemoglobin, hematocrit, red cell indices and platelet were significantly lower (p<0.05) in visceral leishmaniasis patients compared with the control groups. Similarly the total WBC, neutrophil, lymphocyte, eosinophil and basophil count were significantly lower (p<0.05) in visceral leishmaniasis patients compared with the control groups. Conclusion: The principal changes in peripheral blood of patient with visceral Leishmaniasis are reduced number of red blood cells, reduction in leukocytes and decreased platelet count. VL patients presented with splenomegaly, fever, bleeding, anemia, leucopenia and thrombocytopenia. This finding indicates that visceral leishmaniasis causes alterations of hematological parameters.