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
    Background: Serological diagnosis of syphilis is based on demonstration of specific treponemalantibody and non treponemal antibodies (reagin) in body fluids. Accurate and reliable testing is acritical 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 RapidPlasma Reagin and TreponemapallidumHaemagglutination Assay for screening and diagnosis ofsyphilis. Methods:Laboratory based Cross sectional study was carried out from January 2016 to June2016 at National Blood Bank Service Addis Ababa, Ethiopia. All positive (One hundred andninety) and 190 negative samples were used which stored in NBBS (National Blood BankService) laboratory from July 2015 to Dec 2015 (total 380 samples). Systematic randomsampling method was used to select negative samples .The data was analyzed by SPSS version20 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. Pvalue 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 falsenegative by RPR. From 190 ELISA negative sera all were negative by RPR and TPHA. Thesensitivity, 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 withTPHA was 90% and corresponding kappa value was substantial 0.795. Percent agreement forRPR was 66 % with kappa value of 0.375 which was a fair agreement.Chi-square result with pvalue 0.000 which is statistical significant indicate the association between categorical variables. Conclusion The study demonstrated that ELISA was very sensitive. There was good agreementbetween ELISA and TPHA. RPR was with high specific and weak sensitive results. There waspoor 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
    Background: Gram negative bacilli are the most frequently isolated bacteria which recoveredfrom various clinical samples. Conventionally, these microorganisms subdivided into two majorgroups’ fermentative and non-fermentative gram-negative bacteria. The aim of this study is todetermine antibiotic resistance patterns of fermentative and non-fermentative gram negativebacilli from various clinical samples in study area. Method: A laboratory based cross-sectional study conducted at Arsho Advanced Medicallaboratory,AddisAbaba,EthiopiafromJanuarytoApril2017;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 andincubated according to standard conditions. Then Species identification and antimicrobialsusceptibility testing of gram negative bacteria were determined by automated Vitek 2 compactsystem 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 andabscess 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 isolatesbeing Escherichia coli 152(53.5%), followed by Klebsiella pneumonia 40(14.1%), Pseudomonasaeruginosa 13(4.6%), Proteus mirabilis 13(4.6%), Acinetobacter baumannii 8(2.8%) were themost 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 thestudy period, which may be due to associated with the improper antibiotic consumption or lackof a proper guideline for empirical therapy. Keywords: Antibiogram, Enterobacteriaceae, fermentative and non-fermenting gram-negativebacilli, 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
    Background: Neisseria meningitides represents a pathogen of great public health importance inboth developed and developing countries. Resistance to some antimicrobial agents used eitherfor 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 Neisseriameningitides in Ethiopia. Therefore; the aim of this study was to assess drug susceptibilitypattern of Neisseria meningitides isolates from asymptomatic carrierers of all age groups atMeskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and PeoplesRegional State Ethiopia. Methods: Cross-sectional study was conducted on 187 Neisseria meningitides isolates obtainedfrom MenAfricar project.A total of 4110 study participants from Meskan and Mareko Districts,Gurage Zone, Southern Nations, Nationalities and Peoples Regional State, Ethiopia werescreened for Neisseria meningitides by the project. Antimicrobial susceptibility test (AST) wasdone on stored Neisseria meningitides isolates.The activity of ten antimicrobial agents used fortreatment and prophylaxis of meningococcal disease was investigated. The AST was performedfor Neisseria meningitides isolates according to the criteria of the CLSI guide line by diskdiffusion 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 Ciprofloxacine112(60%), Cefotaxime 26(14%), Ceftriaxone 24(13%) , Meropenenem 21(11%) , Minocycline15(8%), Rifampine 14(7.5%), Azithromycine 10(5%), Chloramphenicol 7(4%),Levofloxacin6(3%) . 102(54.5%) isolates were resistance for more than one drug. Conclusions: An antimicrobial resistance for Neisseria meningitides isolates from asymptomaticcarriers for the present study is high. Continued surveillance of meningococci for antimicrobialresistance is necessary to monitor early detection of changes in susceptibility patterns that mightaffect 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
    Background: Neisseria meningitides represents a pathogen of great public health importance inboth developed and developing countries. Resistance to some antimicrobial agents used eitherfor 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 Neisseriameningitides in Ethiopia. Therefore; the aim of this study was to assess drug susceptibilitypattern of Neisseria meningitides isolates from asymptomatic carrierers of all age groups atMeskan and Mareko Districts, Gurage Zone, Southern Nations, Nationalities and PeoplesRegional State Ethiopia. Methods: Cross-sectional study was conducted on 187 Neisseria meningitides isolates obtainedfrom MenAfricar project.A total of 4110 study participants from Meskan and Mareko Districts,Gurage Zone, Southern Nations, Nationalities and Peoples Regional State, Ethiopia werescreened for Neisseria meningitides by the project. Antimicrobial susceptibility test (AST) wasdone on stored Neisseria meningitides isolates.The activity of ten antimicrobial agents used fortreatment and prophylaxis of meningococcal disease was investigated. The AST was performedfor Neisseria meningitides isolates according to the criteria of the CLSI guide line by diskdiffusion 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 accounting116(62%)followed by Ciprofloxacine112(60%), Cefotaxime 26(14%), Ceftriaxone 24(13%) , Meropenenem21(11%) , Minocycline15(8%), Rifampine 14(7.5%), Azithromycine 10(5%), Chloramphenicol 7(4%),Levofloxacin6(3%) . 102(54.5%) isolates were resistance for more than one drug. Conclusions: An antimicrobial resistance for Neisseria meningitides isolates from asymptomaticcarriers for the present study is high. Continued surveillance of meningococci for antimicrobialresistance 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
    Background: Wound develops into an infected state when the balance between microorganismand the host shifts in favour of the micro-organism. Antimicrobial resistance occurs whenbacteria 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 anddetermine 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 byusing standard microbiological techniques. Antimicrobial susceptibility tests were performed bydisc diffusion technique as per the standard modified Kirby-Bauer method. Results: In this study 171 bacterial isolates were recovered from 188 specimens showing anisolation rate of 86.2%. The predominant bacteria isolated from the infected wounds wereStaphylococcus aureus 96 (51.1%) followed by Klebsiella pneumoniae 26 (15.2%), Escherichiacoli 23(13.4%). Out of 162 positive samples 9(5.5%) were mixed infections. Staphylococcusaureus 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 highestsensitivity against Amikacin (100 %). E.coli showed high resistance for Ampicilin (95.7%) andAugumentin (91.3%) where as P.vulgaris showed 100% resistance for Ampicilin and 90.9 % forTetracycline. Conclusion: There was high prevalence of bacterial isolates in this study. S. aureus was thepredominant isolate 96 (56.1%). Most of the isolates showed high resistance to commonly usedantimicrobials. The antimicrobial profile of drugs demonstrated that the commonly prescribeddrugs against Gram positive bacteria (Penicillin, Tetracycline) and Gram-negative bacteria(Ampicillin and Tetracycline) as a single agent for empirical treatment of wound infectionswould 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
    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, foreignbodies, long surgical procedures, and others. However microorganisms are the major causes with bacteriabeing the most prevalent. Severe and poorly managed infections can lead to gas gangrene and tetanuswhich 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 theirantimicrobial 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 clinicalspecimens were collected from study participant. All wound samples were cultured on Blood agar andMacConkey agar. All culture positive samples were characterized by gram stain and biochemical testsusing 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 version20. 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 themost prevalent followed by Pseudomonas aeruginosa 26 [17.3%] and Proteus spp 14 [9.3%].Patients whohad mixed infections were 8.67% of the total participants. Staphylococcus aureus was highly sensitive toceftriaxone 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 amoxicillinclavulanate and resistant to cefuroxime. Escherichia coli was sensitive to ciprofloxacin but resistant toamoxicillin clavulanate, cefuroxime, ceftriaxone, imipenem and ceftazidime. Klebsiellaspp was sensitive toall 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. Pseudomonasaeruginosa was highly sensitive to ciprofloxacin and imipenem but less sensitive to ceftazidime andresistant to ceftriaxone.Ceftriaxone, cefuroxime, flucloxacillin and amoxicillin clavulanate were widelyused 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 thepaediatric 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
    Background: rivers are an important source for drinking, irrigation, recreation and otherdomestic purposes. However, if it is polluted, it can act as the storehouse of harmfulinfectious agents that possess multiple drug resistant genes, which is a growing publichealth concern. Objective: To determine gram negative bacterial profile and antimicrobial susceptibilitypattern 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 wereinoculated on blood and MacConkey agar. Presumptively isolated organisms were identifiedby BioMerieux VITEK 2 COMPACT machine. Antimicrobialsusceptibility patternwasalsoperformedfor 19 antibiotics by the machine with minimum inhibitory concentrationtechnique. 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 wererecovered to the species level and 30 isolates were not identified by the machine. Theisolation 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 identifiedspecies was E.gergovia and C.braki1(1%). A. Hydrophila/Cavae showed high level ofresistance 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 likeampicillin 21 (91.3%), and 16(70%) resistance to Cefalotin, Cefuroxime, Ceftriaxone andCefepime. Both K.Pneumoniae and K.oxytoca showed high resistance to ampicillin 16(94%)and 17(95%) respectively. Among identified bacterial species, most of them showedmultidrug resistant pattern. Providential retigerri showed 100% MDR Followed byP.Alkalificiens (90%), E.coli (78%), Morganella species (75%), and C.frundi (60%). Conclusion and Recommendation:A.hydrophila/cavae and E.Coliwere the mostpredominant bacterial isolates. Most of identified bacterial species were highly resistant toampicillin and amoxicillin/clavulnic acid. Drug resistance and MDR were very high in thisstudy. 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
    Background: Urinary tract infection (UTI) is considered as the most commonbacterial infectious disease seen among the pediatric patients. Objective:This study was carried out in order to determine the antimicrobialSusceptibility Profile of Bacterial Uropathogens Isolates from Pediatric Patients at Yekatit 12Hospital Medical College Materials and Methods Clean voided mid-stream urine specimens were obtained frompatients in sterile universal bottles. Urine collected from each patient was inoculated ontoCLED and blood agar plats using calibrated inoculating loop with a capacity of 0.001ml,Inoculated plates were incubated for 24- 48 hours at 37°C at inverted position aerobically.Bacterial isolates were characterized/ indented by gram stain and by using an array ofstandard routine biochemical test. Antimicrobial susceptibility test was carried out by usingthe Kirby Bauer disc diffusion. Result: The data was analyzed by using SPSS, version 17. Descriptive statistics wascomputed for most of the study variables and Frequency distribution tables were used todescribe the findings. In this study a total of 384 pediatric patients (199 males and 185females) aged between 0 years to 15 years from whom urine sample were collected wereenrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36(19.5%) have positive cultures while 25 (12.6%) of the 199 males had significant bacteriuriaand the largest number of study subjects were below age 3 years and the largest positiveculture was obtained from this age group, accounting 35 (57.4%.) out of 61 positive culture.Bacterial species belonging to six generawere isolated and identified from 61 positivecultures and the genera were Escherichiai, Klebsiella, Staphylococcus, Proteus, Acnitobacterand Entrococcus. and E. coli was isolated in 28 cases (28/61, 49.5 %), followed by Klebsillaspp. in 17 cases (17/61, 27.9%), Staphylococcus spp. in 5 patients (5/61, 8.2%.) ( S. aureus inone and coagulase negative staphylococci in 4 case), Entrococcus in 7 case (7/61, 11 5%),Proteus spp. in 3 cases (3/61, 4.9%) ) and Acenitobacte in one case (1/61,1.6%). Of bacterialisolates E. coli was found out to be the most common pathogen followed by Klebsiella spp..Furthermore E. coli and klebsiella spp. were the most common pathogen in female patientsaccounting 71. 4% and 64.7% respectively. percentage resistance of Klebsilla spp was muchhigher when compared to E.coli. Eighty eight percent of Klebsiell spp. were resistant tocefotaxim, ceftazidim, trimetroprimsulfamethoxazole and cefuroxime. Acentobacter spp. was100% resistances to gentamicin,trimetroprimsulfamethoxazole , agumentin, and nalidixicacid . But they were 100% susceptible to ciprofloxacin, cefuroxime , norfloxacine,cefotaxim,chloramphenicol and ceftazidim . On the other hand, proteus spp. were 100%sensitive to all drugs except nitrofurantion. Species of Entrocuccus were resistance of 71.4%to chloramphenicol and 85.7% to both trimetroprimsulfamethoxazole and ErythromycinS .aurueswas100%susceptibletociprofloxacin,cefuroxime,gentamicin, trimetroprimsulfamethoxazole, chloramphenicol, Clindamycine and Ceftriaxone while coagulase negative staphylococci were resistance to all of the above drugs except Clindamycine and gentamicin . Multidrug resistance to two or more drugs was observed in73.7% of bacterial isolates. Conclusion: This study determines the antimicrobial Susceptibility Profile of BacterialUropathogen Isolates from Pediatric Patients and highlighted the majorbacterial uro-pathogens involved in UTI up to my knowledge for the first time in the country. Furthermore,species bacterial pathogens and their frequency was consistent with the usually reportedpattern, with E. coli being the most common organism isolated followed by Klebsiella. Spp.In this study Majority of gram negative species were susceptible to ciprofloxacin,norfloxacine and nitrofurantion (exceptproteus spp) and gram positive species weresusceptible to ciprofloxacin Clindamycine and gentamicin so this drugs can be used to treatUTI in children however Most of bacterial isolates were multidrug resistant and it is thereforesuggested that appropriate antimicrobials should be administered to reduce the risk of multidrug resistant organisms developing and avert ineffectiveness of antibiotics
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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; Tegbaru Belete
    Introduction: Development of HAART has brought significant suppression of viral replication,decreasing morbidity and mortality and dramatically transforming HIV into chronic disease.Unfortunately, the prospect of maintaining patients on HAART for long term may be restrictedby a heterogeneous collection of unexpected metabolic abnormalities, including dysregulation ofglucose metabolism, dyslipidemia and lipodystrophy. Objective: To assess antiretroviral treatment associated hyperglycemia and dyslipidemia amongHIV infected patients at Burayu Health Center, Addis Ababa, Ethiopia. Methodology: A cross-sectional study was conducted on adult HIV infected individuals atBurayu Health Center, Addis Ababa, Ethiopia from September, 2011 to May, 2012. Equalnumber of HAART naïve and HAART initiated patients (n=126 each) were included in thestudy. Demographic data were collected using a well-structured questionnaire. TC, TG, HDL-C,LDL-C and glucose were determined using COBAS INTERGA 400 chemistry analyzer. Thedata were analyzed using SPSS version 19 software. Chi-square, student-t-test and logisticregression were used to assess association between variables. P value < 0.05 was considered asstatistically significant. Result: Of 252 study participants, 72.2% were females, mean age was 35.3 years; mean BMIwas 21.4; mean time with the virus was 20.6 months; 62.7% were married; 48.4% were atprimary educational level; 52.4% were house wives; 15.5% were TB-HIV co-infected and 43.7%were categorized as WHO stage one. The prevalence of hyperglycemia, hypertriglyceridemia,hypercholesterolemia, decreased HDL-C and increased LDL-C was 7.9%, 22.8%, 42.1%, 50.8%and 23% in HAART initiated and 5.6%, 10.3%, 11.1%, 73% and 7.1% in non-HAART groups,respectively. ART regimens observed as a first line were only containing 2 nucleoside backbones(from AZT/D4T/3TC/TDF) with either NVP or EFV. Serum TG level ≥200 mg/dl was morecommon among patients who received D4T based than those with AZT based antiretrovirals(34% versus 16.4%, P = 0.029). Conclusion: First-line HAART is associated with potentially atherogenic lipid profile levels inpatients with HIV infection compared to untreated patients in our setting. This indicates glucose and lipid profile levels need to be monitored regularly in HIV infected patients taking antiretroviral treatment.
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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
    Background: Tuberculosis (TB) is a major public health problem in Ethiopia. Laboratory plays an important role inthe diagnosis of TB and its treatment monitoring. Quality assured molecular drug susceptibility assay is an essentialfor rapid detection of MDR-TB cases and early treatment initiation Proficiency testing is one of the EQA methods inevaluating the quality service delivery however, it was not widely applied for molecular assays in Ethiopia mainlydue 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 forProficiency Testing of the WHO endorsed Molecular Assays (GenoType® MTBDRplus and Xpert MTB/RIFassays) 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 hospitalTB culture and DST laboratories which have molecular GenoType® MTBDRplus assay of Ethiopia, and in eightselected health facilities with Xpert MTB/RIF testing sites in Addis Ababa during the period between July 2015 andJanuary 2016. PT DNA materials were validated at EPHI, NTRL and distributed to MTBDRplus and Xpert MTB/RIFtesting facilities. All data from participating laboratories were captured and analyzed using SPSS version 20. A totalof 194 (130 for MTBDRplus and 64 Xpert MTB/RIF) DNA panels were distributed to regional reference and hospitalTB laboratories. Test results agreement between the participant laboratories and reference were estimated usingKappa statistics. The sensitivity, specificity, predictive value susceptible, predictive value resistance, accuracy andreproducibility 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 testedin seven Regional Reference Laboratories which have MTBDRplus assay. Almost all, 129 (99.2 %) were correctlyreported to the Isoniazid and Rifampicin susceptibility. Sixty nine (53.1%) reported isolates were resistance to bothINH and RIF (MDR), 41 (31.5%) susceptible to both INH and RIF, and 19 (14.6%) INH susceptible but RIFresistance strains correctly reported with respect to the reference result. There was 100% agreement in detectingMDR and resistance to any of the two drugs (INH and RIF) (kappa = 1) but the agreement was 97.8% for thedetection of susceptible strains (Kappa = 0.9). Among 64 spiked sputum strains (32 M. tuberculosis DNA with noRIF resistance and 32 M. tuberculosis DNA with RIF resistance (probe E Mutant detected ) distributed to GeneXpertsites, all of them were correctly reported. Overall agreement on detection of M. tuberculosis and RIF susceptibilitywas 100 % (Kappa =1.0). Conclusion: There was an excellent agreement between the participant laboratories and the reference laboratory forthe detection M. tuberculosis and drug susceptibility using MTBDRplus and Xpert MTB/RIF assays. Therefore, wecan apply home validated PT DNA panels as one of the EQA methods for WHO endorsed molecular assaysMTBDRplus, 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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    Assessement of Platelet Parameters among Adult Ptb Patients at Two Hcs, in Nsc and Lsc, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2024-07-30) Alemu Desalegn; JEMAL ALEMU
    Background: Pulmonary Tuberculosis (PTB) is one of the most burdensome infectious diseases in the world. By the year 2022, 10.6 million people developed symptomatic tuberculosis disease and 1.3 million people died. Studies have shown that not only the lungs, but the disease also affects bone marrow and hematological abnormalities were reported. However, little is known about platelet profile of pulmonary tuberculosis patients in Ethiopia. Objective: To assess Platelet parameters among adult Pulmonary Tuberculosis patients at two health centers in NSC and LSC, Addis Ababa, Ethiopia. Methods: Institution based Comparative cross–sectional study was conducted among pulmonary tuberculosis patients. A convenience sampling technique, to recruit 156 PTB patients were newly starting treatment immediately after the diagnosis, among 156 PTB patients were 100 from woreda 02 and the rest was 56 from woreda 04. Also 104 apparently healthy individuals, 52 from woreda 02 and 52 were from 04 HCs. Socio-demographic data was obtained from structured, closed ended and pre tested questionnaires. Clinical data obtained from their medical records. Sysmex XP-300 and Weisman AC310 of woreda 02 and 04 HCs automated hematology analyzers that used for blood analysis. The data presented with words, tables, and figures and it analyzed by descriptive statistical tool, Epi-data V4.6.0.6 used for data entry, data transferred to SPSS version 20.0 for analysis, compared PTB versus control of platelet parameters with Pearson correlation and weight, independent t-test and Mann-Whitey U test compared the median value, P value 0.05). Regarding the magnitude of platelet abnormalities, 86(55%) had thrombocytosis and no thrombocytopenia was reported among PTB patients. The median of MPV and Platecrite values for PTB patients were slightly higher than the healthy control (10.00 ± 5.67 versus 9.3 ± 1.38 and 0.27 ± 0.07 versus 0.23 ± 0.07) respectively, then statistically significant difference (P < 0.05). In contrast, the median PDW of PTB patients were slightly less than the healthy control, however, it was not statistically significantly difference. Conclusion: This study demonstrated platelet indices such as platelet count, MPV and PCT values of PTB patients were higher but PDW was lower compared with healthy control. Thus, the clinicians could assess parameters for routine PTB treatment follow-up. Further studies are required to understand the role of platelet parameters for follow up and progress. Key words: Pulmonary Tuberculosis, Platelet parameter.
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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
    Background; Medical laboratory services are an essential component of health systems.Strengthening these services can combat the major infectious diseases. Laboratory accreditationsystem is found to be essential to have national and international acceptance of variouslaboratory test results. Poor quality laboratory services guide to massive causeof over-treatment, overuse of drugs which leads to the emergence of drug resistant and laboratory errorsguide the patients at risk of inappropriate care and potentially of adverse events .By recognizingthis gaps of the current state of laboratories and the requirements of ISO 15189 particularrequirements for quality and competence in Africa, Ethiopia, in 2009, WHO-AFRO establishedSLMTA in order to help laboratories with stepwise recognition of evolving fulfillment of theISO 15189 standard instead of a grading of pass-fail. Objectives: To assess the outcome of Strengthening Laboratory Management TowardsAccreditation (SLMTA) on laboratory quality management system in Addis Ababa. Methods: The study used an Institutional based cross sectional study design that employed aretrospective and prospective data collection approach on the participated institution of medicallaboratory in SLMTA in Addis Ababa city government. The study was conducted in AddisAbaba city government and the data was collected from February –April 2014 and data wasinterred 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 averagescores (141.4; range of 65-196, 95%CI =86.275-115.5, p = 0.000) at final with 3 laboratoriesbecome 3 star, 6 laboratories were at 2 star, 11 were at 1 star .76% of the respondents respondthat their facilities have no work plan and budget for laboratory specific purpose and lack ofresources 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 timesmore 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 theircustomer satisfaction survey were 2.261 times more likely to get less final result than laboratorywhich 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 outcomeof SLMTA were not conducting their customer satisfaction survey, shortage of resource, poorstaff motivation, and lack of regular equipment service maintenance. Mentorship, onsite andoffsite 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
    Back ground: Laboratory service is a key component of Focused Antenatal Care (FANC) to identify lifethreatening conditions of maternal and child health. Limited capacity of health facilities to provideadequate laboratory services remains a major problem for the quality of FANC service delivery. Objective: To assess the status of focused antenatal carelaboratory 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 participantsinterviewed on satisfaction towards FANC laboratory services by using structured questionnaire. Aqualitative data was collected by In-depth interview of providers. To assess availability and functionalityof the FANC laboratory, observation check list was used. Data were coded and analysed by using SPSSVersion 20 software. Logistic regression model was also used to examine the effect of selected variableson 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 basicFANC 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/RPRtest was found in 10 (76.9%) facilities. All laboratory facilities had at least one or more basic FANClaboratory 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 laboratoryservice showed, only 56.9 % (240/422) of pregnant mothers were satisfied with FANC laboratoryservices. Those clients who waited less than one hour to get laboratory results were six times more likelyto 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 slightlyhigher 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; Tsegaye Aster; Wolde Mistre; Taye Binyam
    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 involvedthat enhance anti-inflammatory response. Different auto antibodies and antibodies are used in the diagnosis of celiac disease, butAnti-tTG antibodies are highly sensitive and specific for the diagnosis of CD. IgG-based tests are useful for detecting celiacdisease. Since Celiac disease is one of the areas that did not get much attention in its diagnosis; this study could give some insighton the necessity of doing more research in the area and gives a better understanding on the association between celiac diseaseswith 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 lipidpanels 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 AddisAbaba, Ethiopia by using random sampling method. The retrospective part included taking serum samples that werecollected 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 lipidprofiles as for the prospective part of the study starting from May 2020 to June 2020. The transglutaminase IgGmeasurement used principle of Enzyme immunoassay for optical density measurement based on commerciallyavailable kit. While the lipid panels used kinetic assay that were measured on Cobas 6000 fully automated chemistrymachine. The obtained data was entered and analyzed by using SPSS version 23 and descriptive analysis, Chisquareand logistic regression were used to see any associations and P-value <0.05 was considered as statisticalsignificant. Result: A total of 97 samples of children with age group between 4-14 years old were involved in this crossectionalstudy. 19% of study participants tested positive for anti-tissue transglutaminase IgG and Females had a highermagnituse of anti-tTG IgG than males (24.5 % vs 11.4%). A significant association was found between Helminthsand anti-tTGIgG [OR 3.45 (95% CI: 1.057, 11.265), P=0.033] However this study failed to show associationbetween 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 proofH.pylori can shield against celiac disease so measures to protect oneself against H.pylori should be continued. Onthe other hand, even though more trials are required, there is a strong association between Helminthes infection andanti-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 tissuetransglutaminase, it is advisable to assess lipid profiles of celiac patients as shown in other studies so as to minimizethe 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 ARTprogram, little is known about the quality of ART monitoring laboratoryservices in health facilities. Objective: - To assess the quality of ART monitoring laboratory services inpublic hospitals of Addis Ababa with emphasis on client satisfaction,providers’ views, functional & structural status of the ART monitoringlaboratory service. Methods: - Hospital based, descriptive cross sectional study was conducted from October to November 2010. In this study both quantitative andqualitative design forms were used. A total of 422 clients were considered forexit interview about their satisfaction towards ART monitoring laboratoryservices using structured questionnaire. To assess the structural and functional aspects of ART monitoring laboratories, observation checklist wasused. In-depth interview of providers were conducted to assess their viewson quality of ART monitoring laboratory services. Data were coded andentered using EPI info 2002 (Centers for Disease Control and PreventionAtlanta, GA) and analyzed using SPSS version 15 software (SPSS INC,Chicago, IL, USA). Satisfaction score was calculated by giving a value of onefor very satisfied. A value of two was assigned for response of satisfied; threefor neutral response. Values of four and five were given for dissatisfied andvery dissatisfied responses respectively. The mean, median and mode scoresfor the overall satisfaction were calculated. Median of the summary score ofsatisfaction was used to classify as satisfied and none satisfied since thedistribution of summary scores was skewed. Bivariate and multivariatelogistic regression models were also used to examine the effect of selectedvariables on patients’ satisfaction with ART monitoring laboratory services byusing Odds Ratio (OR) with a 95% Confidence Interval (CI). P-Value less than0.05 were taken as statistically significant. Variables that were found with astatistically significant association (p<0.05) at univariate logistic analysiswere entered and analyzed by multiple logistic regression analysis. Results: - A total response rate of 406 (96.2%) from 422 sample size wasobtained. Among those 255(62.8%) were females. The overall satisfactionrate was 47.5%. The major determinants for none satisfaction were lack ofspace in blood drawing room to put client personal thing (AOR= 3.377, 95%CI 1.511-7.550, P=0.00), lack of information regarding bruises followingblood drawing (AOR= 2.029; CI 1.162-3.542, P=0.01 ),waiting time to get laboratory results (AOR= 4.096; CI 1.769-9.485, P=0.00), needle stick whileattempting to draw blood (AOR=7.769, 95% CI 1.280-47.166, P=0.02),waiting time to get blood drawing service (AOR= 7.643, 95% CI2.62722.236,P=0.00). None of the hospital laboratory had guideline for disposalof damagedor expired laboratory reagents. Equipmenm aintenance wasone ofthemajor problemsfound inalmost allpublichospital of thecity providingARTservicesduringin-depthinterviewofproviders. Conclusion:-Theoverall satisfactionlevelof clientswithART monitoringlaboratoryservices was 47.5%.Accessibilityand availability of latrines,abilityofphlebotomistto answerquestionsraisedby clientsandcomfort ofchairsinblooddrawingroomwereconsideredthemost significantfactors forlowsatisfactionlevels.Equipmentmaintenancewasa major challengeinrendering ART monitoring laboratory services in public hospitals.
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    Assessment of Basic Coagulation Profile and Platelet Parameters among type 2 Diabetes Mellitus Patients Attending at Durame General Hospital, Durame, Southeast Ethiopia: Comparative Cross-Sectional Study.
    (Addis Ababa University, 2024-07) Yazal Abay; Zemenu Tamir
    Back ground: Diabetes mellitus is related with disturbances of hemostasis that could subsidize the occurrence of thrombogenic complications. Diabetic patients are exposed to thrombosis abundantly, followed by cardiovascular events, the rest from cerebrovascular events along with peripheral vascular complications, and these is accounted for most of diabetes morbidity, and mortality. The current study was carried out to determine the coagulation profiles of type 2 diabetes mellitus patients in comparison with apparently healthy controls. Objective: To determine basic coagulation profiles and platelet parameters. Methods: A comparative cross-sectional study was carried out at Durame General Hospital from June 2023 to January 2024. Socio-demographic and clinical data were collected using questionnaires and checklist. Platelet parameters were determined from EDTA anticoagulated venous blood using ADVIA 560 hematological analyzer, whereas coagulation analysis was done by using ARES LiNEAR coagulation analyzer fom citrated plasma. The data was analyzed using SPSS version 26 statistical software. Kolmogorov-Smirnov test was used to check the data distribution. Independent t-test was used to compare mean between groups, whereas the Kruskal Wallis test was used for comparison of different category in groups. Statistical significance was set at P< 0.05. Result: There was significant shortening of prothrombin time (PT) (12.9±1.5, vs 13.5±1.3), (p=0.02), and International normalized ratio (INR) (1.08±0.16, vs 1.13±0.17), (p= 0.04) and significant increased of platelet count, MPV (12.1±1.9, vs 10.9±1.5, p
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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
    Background: Biosafety is an important practice in all laboratory settings especially in developingcountries where standard operating procedures are lacking. There is only limited information aboutbiosafety practices in government hospital laboratories in Addis Ababa. Objective: To assess the situation of biosafety practice and associated factors in clinical laboratoryworkers among government Hospitals in Addis Ababa, Ethiopia Method: Cross-sectional study design was conducted from March to May 2014; in all governmentHospitals of Addis Ababa. A total of 290 laboratory professionals were participated about theirbiosafety practice and its associated factorsusing structured questionnaire to assess the structural andfunctional aspects of Biosafety Practice of laboratories. Data were coded and entered by Epi Info andExported to SPSS V.20 for analysis. Bivariate and multivariate analysis were also used to identifyfactors that affect the outcome variable and to examine the effect of selected variables on laboratorypersonnel 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 statisticallysignificant association (p<0.05) at bivariate logistic analysis were entered and analyzed by multiple logisticregression analysis. Results: - In this study a total of 290 laboratory professionals were involved. Out of those subjects thebiosafety practice rates of protective barrier were 76.2%. The major factor for biosafety practice werepractice of performing a written procedure for the clean-up of spills (AOR=2.31; CI 1.21-4.42), thosewho were practice of decontamination and wastes before disposal (AOR=2.69; CI 1.49-4.86) and thosewho 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 biosafetypractice among studied laboratory personnel. Practice of performing clean-up of spills, practice ofdecontamination and wastes before disposal and information in participating a biosafety practice are asignificant 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
    Background: Persons working in clinical diagnostic laboratories are exposed to many risks. The mosthazardous agent in the laboratory is a microorganism that is frequently associated withlaboratory infections and can be transmitted in variety of routes, especially by aerosols.Moreover, hospital and diagnostic laboratories are a challenging environment for the surroundingcommunity. The more the laboratorians become aware of and adhere to recommended, science-basedsafety precautions, the lower the risk for laboratory acquired infections. The behavior patterns andattitude of individuals towards safety programs influence their involvement in laboratoryaccidents that put themselves and fellow workers at risk. Assessing laboratory biosafety practiceswill help the laboratories to identify factors that hindered laboratory personnel from practicinggood laboratory biosafety measures and to determine the existing situation of the assessedlaboratories so that laboratory managers can plan towards implementation of biosafety practicesand hence safe working laboratory area will be created. Objective:The aim of this study was to assess biosafety practices among laboratory personnelworking 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 andMay 2014.The study was conducted among 45 studied laboratory personnel working in 5selected 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 May2014 using structured questionnaire. The analysis was done by SPSS version16 statisticalsoftware using one-way ANOVA. P-values less than 0.05 wereconsidered as statisticallysignificant. Result:Out 0f 45 participantsgreater than 37 (84%) of studied personnel were within the agerange of 18-44 years. Of which the majority 23(64%) of the studied laboratory personnels’ agewere aggregated within the age distribution category of 25-34. Male to female ratio of thestudied participants were 3:1 with a count of male participant 34 (75.6%), and females accounted11 (24.4%). Regarding the level of education, 23 (51.1%) of them had finished undergraduatestudy on medical laboratory sciences (Bachelor of sciences) and the rest 21(46.7%) werediploma holders in laboratory science. The duration of work experience in laboratory service ofthe studied laboratory showed that greater than 33(75%) of the group had a work experience ofgreater than 5years. This survey shown that the grand mean of the studied laboratory personnelfor 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%) andfall in upper moderate level which is close to high level. The mean score for laboratory D and Ehad shown similar results which are a mean value of38.6 (70%)and they are closed to be labeledas moderate. The rest two laboratories (A and C) found to be low level with laboratory A scoredthe 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 is36.44±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 inthe 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; Birhanu Asaye; Taye Benyam
    Background: Assessment of blood and blood components utilization is an important tool to reduce inappropriate transfusions and helps to show the frequency of blood and bloodcomponent utilization, recipient status by pre- and post- transfusion assessments in additionimproved and not improved after transfusion. However in Ethiopia the regular audit andassessment of the transfusion practice is not well studied. Objective: To assess utilization of blood and blood components for transfusion at Black LionSpecialized Hospital, Addis Ababa Ethiopia. Methods: A one year (September 2009 to August 2010) hospital based retrospective studywas conducted to analyze the pattern of blood component utilization in Black LionSpecialized Hospital blood transfusion service effected from October 2010 to January2011.There were about 4,570 transfusion episodes and 10,836 units of blood were transfused.Using estimation of single population proportion formula and systematic random sampling weselected 373 subjects and collected information from the existing blood bank log book onABO and RH blood group, amount of transfusion episodes, and type of blood administered. Inaddition, data on sex, age, profession, level of education and department of the health worker,type of blood component, and amount of unit administered, prevalence of unexpectedreaction, pre- and post transfusion examinations including improvement status. Data wasanalyzed for descriptive statistics, univariate and multivariate analysis using SPSS version15.0 software (SPSS INC Chicago IL, USA). Results: - Of 361 transfused study subjects 856 units of blood were transfused with the meanof 2.37 units. Of the transfused 188(52.1%) were Females. The most widely used blood andblood component type in this study was whole blood 307 (85%) and the combination of twoblood products were given to 27(7.5%). Plasma was transfused only for single patient (0.3%).There were no transfusion reactions after transfusion. Out of the total none improved cases,45(66.2%) were those transfused with whole blood transfusion. The proportion ofimprovement after transfusion according to service ranged from 69.0% to 100%. When 95%CI for the adjusted odds ratios were calculated among these variables, significant associationswere found between the overall improvement statuses of the patient with their profession ofthe health worker ordered the transfusion and type of blood and blood product administered. Conclusion: - The overall utilization of blood and blood components were similar to otherdeveloping countries. However, transfusion of blood components was very low and therewere high rate of whole blood transfusion. The prevalence rate of patient improvement statusafter transfusion was high.
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    Assessment of Blood Transfusion Utilization , Patient Outcome and Ssociated Factors at St. Paul Hospital Millennium Medical College Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-05) Abebe Assefa; Tsegaye Aster ; Hagos Afework ; Negash Mikiyas
    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 scarceresources. However, in Ethiopia the regular assessment of transfusion practice is not performedconsistently. 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 fromjuly 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 thisHospital based cross sectional study at St. Paul Hospital Millennium Medical College from Julyto September 2020. A standardized data extraction checklist was used to extract data from patientfile and from blood bank log book. Transfusion indices werecalculated. Data was entered andanalyzed 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 0.05were 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 themean 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 andconcentrated red cell was the major component transfused. The study revealed the number ofunits cross matched/transfused (C|T) ratio of 1.17, Transfusion probability (%T) of 61.3%, andTransfusion index (TI) of 1.84. Only 177(50.3%) of the patients showed improvement. Patients inthe age group 1 to 10 years were more than 6 times more likely to improve than those aged underone 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 which85.3% 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.