Internal Medicine

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    A Prospective Cross Sectional Study to Evaluate the Incidence of Acute Transfusion Reaction and its Associated Risk Factors in Ateritiary Care Center in Ethiopia.
    (Addis Ababa University, 2023-02) Assefa,Temesgen; Tadesse,Fissehatsion(Ass.Prof.)
    Background:Transfusion reactions are adverse events associated with the transfusion of whole blood or one of its components. There is no institutional or national data in Ethiopia regarding the incidence of ATR & their risk factors. Theaim of this study is to measure the incidence of ATRs, frequency& time of occurrence of each ATR & evaluate their association with risk factors there by contributing to the institutional & national hem vigilance system. Objective:The main objective of the study is to measure the incidence of ATR & determine their association with different clinical variables. Methods: Prospective cross sectional study design is used to study in patient & outpatient adult transfusion recipients at the department of internal medicine, data was collected with a structured check list, analyzed with IBM SPSS version 24 software. Result: A total of 210 study participants with the age of 13 & above were included in the study from September 1, 2022 – November 30 2022. 50.5 % of study participants are male & 49.5% are females ,the most common age group are between the age of 18 -40,the commonest blood group was O positive.Acute myelogenous leukemia is the commonest underlying diagnosis of the study participants; PRBC is transfused for the majority of patients given for 74.8% of cases. ATR incidence is found to be 10%,ATR was reported in 19.6%of platelet transfused patients as compared to 7% of PRBC, and none of FFP transfused patients develop ATR. FNHTR & urticaria are the commonest ATR observed. Significant association is seen between ATR & female gender, autoimmune disease & ABO incompatible platelettransfusion. Conclusion:The incidence of ATR is higher than reported from previous studies indicating the need to improve institutional transfusion services particularly in high risk patients.
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    A Retrospective Analysis of Newly Diagnosed ITP Patients to Analyze Response to First and Further Line Treatments.
    (Addis Ababa University, 2023-03) Maasho,Biniam; Gebrmedhin,Amha(Ass.Prof.)
    Background Primary immune thrombocytopenia (ITP) is a relatively uncommon hematologic disorder with an estimated incidence of 3 to 6 patients /100,000 per year in the West. Initial response rates to corticosteroids average at 70%. In our country data on patient characteristics and outcome of therapy are scarce. Objective The primary objective of this study is to determine the rate of initial response to corticosteroids in newly diagnosed ITP patients. Secondary objectives include duration of response, associations between independent/patient variables and response, duration of PDN therapy and outcomes with further line treatments. Method: This is a retrospective, single-center study conducted at Tikur Anbessa Specialized Hospital, a tertiary care hospital located in Addis Ababa. All newly diagnosed ITP patients for whom adequate information regarding their outcome after 1st line therapy was available were included in this study. Data obtained thru a standardized questioner was analyzed by IBM-IPSS version 20 statistical software. Result: A total of 48 study participants with the age of 18 & above were included in the study. Females constitute 85% of the participants. 63% of the patients are less than 35 years old. The mean and range of age are 34 Yrs and 17 Yrs – 52 Yrs. 62 % had an initial response to steroids (52% complete response). The rate of SR at 6 months was 68%, a statistically significant difference from previous reports (P-value < 0.0001< , with a 95% C.I. = 0.4544 - 0.7856). Rituximab and prednisolone were the most frequently used 2nd line drugs. 6 patients were splenectomized. Patients with a response to 1st line prednisolone had a marginally significant better outcome with 2nd /3rd line rituximab Conclusion: Initial response rate to steroids was in line with previous studies done elsewhere. The SR rate was 68% that is significantly more than that reported in previous studies of 1st line prednisolone therapy in newly diagnosed ITP patients.
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    A survey on the indications, diagnostic efficacy and safety of Fiberoptic bronchoscopy in Tikur Anbessa Specialized Hospital: Retrospective study from Dec, 2021 to Nov, 2023
    (Addis Ababa University, 2024-03) Ahmed,Seid; Yusuf,Hanan( MD, Ass.Prof.); Kebede, Dawit ( MD, Ass.Prof.); Worku,Aschalew( MD, Ass.Prof.)
    Back ground:In the field of respiratory medicine, Fiberoptic bronchoscopy (FOB) is a crucial diagnostic tool for both infectious respiratory diseases including Tuberculosis and non-infectious conditions, including lung cancer since it allows for direct visualization and sampling of the airways. Given the fact that both are one of the leading causes of morbidity and mortality in Ethiopia and worldwide, a comprehensive retrospective analysis of its usage, safety and diagnostic yield is beneficial to optimize its integration into the hospital's diagnostic protocols. Objective:This study aims to assess the indications, diagnostic efficacy and safety of FOB in the context of Tikur Anbessa Specialized Hospital (TASH) over a two-year period from December 2021 to November 2023. Methods:This study systematically analyses electronic medical records, bronchoscopy procedural reports and pathology and microbiology reports from TASH over a two-year period spanning from December 2021 to November 2023. Data extraction focuses on patient demographics, smoking history, platelet count and coagulation profile, indications for the procedure, bronchoscopic procedures and finally the safety and diagnostic outcomes of all patients who undergo bronchoscopy over the specified period of time. A waiver was taken from the IRB for the Ethical aspect of the study and patients’ information is anonymised. Collected data is evaluated for consistency and completeness by the investigator. Following collection, data is cleaned, coded, and analysed by SPSS version 26 software. Results:From a total of 227 bronchoscopies, records were available for 205 procedures, with a mean patient age of 43.63 years. The majority were male (52.2%), and 83.9% fell within the age range of 18-65 years. From the cases with HIV testing result, 11/108 (10.2%) were positive. Common indications for bronchoscopy include suspected mass or malignancy (45.85%), tuberculosis (28.29%), and airway inspection (13.66%). Comorbidities such as hypertension (14.15%) and bronchiectasis (11.71%) were identified. Samples collected during bronchoscopy include bronchoalveolar lavage (78.54%), transbronchial biopsy (25.85%), and endobronchial biopsy (10.24%). The overall diagnostic yield for FOB was 75.6%, with specific diagnostic yields for TB, sarcoidosis, and lung cancer at 41.38%, 45.45%, and 51.06%, respectively. Lung cancer was diagnosed in 23.41% of all cases, with adenocarcinoma (43.3%) being the most prevalent subtype. Tuberculosis and sarcoidosis were diagnosed in 14.63% and 5.36% of cases, respectively. Most cases (93.17%) were complication-free, with minor bleeding, hypertension, hypoxemia, and pneumothorax (on 2 patients) observed in a small percentage. Conclusion:Our study shows that the commonest indication for FOB is workup of suspected mass. FOB in TASH has a better yield compared to most other reports from Africa. The highest yield as expected was when there was a visible mass and coupled with endobronchial sampling. Cytology from fluid analysis has the lowest yield for malignancy. The practice of FOB in TASH is a safe procedure and even though rare, blind transbronchial biopsy has a risk of pneumothorax. The commonest histologic type of lung cancer identified is Adenocarcinoma but it was squamous cell carcinoma among smokers.
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    Accuracy of Revised Ibd-Refer Criteria for Evaluation of Patients with Suspected Inflammatory Bowel Disease in Low Resource Setting: A Diagnostic Prospective Cohort Study
    (Addis Ababa University, 2024-05) Rodas Temesgen; Yohannes Berhanu
    Diagnosis of inflammatory bowel disease (IBD) often faces significant delays. Early recognition tools offer the best chance for timely treatment and positive outcomes
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    Ambulatory Blood Pressure Control Pattern in Hypertensive Patients at Tikur Anbesa Specialized Hospital: A Cross Sectional Study
    (Addis Abeba University, 2021-05) Alemayehu, Mulualem; Dr.Abebe, Sintayehu; Dr.Yadeta, Dejuma; Dr.Alemayehu, Bekele
    Background: Hypertension is the most common cardiovascular problem globally with a particularly increasing burden in developing countries like Ethiopia. Ambulatory blood pressure (ABPM) is superior to office blood pressure (OBP) measurement for diagnosing, prognosticating and following treatment efficacy for hypertension. There is no available data on ABPM control pattern in Ethiopians. This study will determine the ABPM control patterns in Ethiopian hypertensive patients on treatment. Material and Methods: This was a cross sectional study in hypertensive patients at Tikur Anbessa Specialized Hospitals outpatient departments carried out during January to May 2021. ABPM values of 244 consecutively sampled patients were analyzed. All patients had their BP monitored over 24 h with a Tonoport V (GE CS V6 71), and the data was interpreted using GE CardiosoftTM ABPM software in accordance with European Society of hypertension guidelines. Ethical clearance was given by Addis Ababa University Institutional Review Board and the study was conducted in compliance to standard ethical guidelines. Results: The study involved 244 adult hypertensive patients; mean age of the patients was 59.4years and, 54% were females. 58.6% of patients had controlled OBP, while only 45.1% had controlled ABPM. The mean OBP was 137 (19)/81 (10) mmHg and mean 24-hr ABP was 137 (16)/81 (10) mmHg; mean daytime BP was 136/79 ± 17/11 mmHg; mean night-time BP, 138/84 ± 16/11 mmHg. Mean ABPM values were not significantly different between men and women. Comparison of ABPM values with OBP revealed high prevalence of the white coat effect (32%) and masked uncontrolled hypertension (46%). Presence of comorbidities particularly diabetes predicted poor ABPM control. Conclusion: More than half of patients had uncontrolled BP as per ABPM criteria and significant discrepancy exists between ABPM and OBP in assessing adequacy of BP control. Guiding management decisions using ABPM can improve BP control rates.
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    Assessing Palliative Care Needs and Associated Factors Among Females with Gynecologic Malignancies Visiting TASH: Facility Based Prospective Study, 2023-2024
    (Addis Ababa University, 2024-10-19) Rediet Mekuria; Sisay Teklu
    Palliative care offers comprehensive support to patients and their families coping with life-limiting illnesses, addressing physical, psychosocial, and spiritual dimensions of suffering. In Ethiopia, palliative care is a relatively new concept and faces numerous challenges, including underutilization and an increasing burden due to a growing population affected by chronic and life-limiting illnesses such as cancer, HIV/AIDS, and cardiovascular diseases. Despite the high need, access to palliative care services remains limited due to insufficient healthcare infrastructure, a lack of trained professionals, and cultural barriers related to EOL care. Additionally, public awareness of palliative care is low, leading to a gap between need and utilization. These factors contribute to a heavy burden on families and the healthcare system, making it a critical area for improvement in public Health Care system of Ethiopia
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    Assessing the Risk Factors, Clinical and Coronary Angiographic Profile, and Hospital Mortality of Acute Coronary Syndrome in Young People : 5-Year Retrospective Cross-Sectional Study
    (Addis Ababa University, 2024-04) Zelalem Belay; Bekele Alemayehu
    The incidence of coronary disease is positively associated with age. However, in recent years there has been an increased incidence of Acute Coronary Syndromes (ACS) in young adults. The cardiovascular risk profile of these patients appears to be different
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    Assessment of Adherence to Iron – Folic Acid Supplementation Amongpregnant Women Atselected Health Centers of Gandhi Memorial Hospitalcatchments, Addis Ababa Ethiopia; Cross Sectional Study 2023/24
    (Addis Ababa University, 2024-10-11) Bethelhem Taddesse; Ahmed Abdu
    Assessment of Adherence to Iron – Folic Acid Supplementation Amongpregnant Women Atselected Health Centers of Gandhi Memorial Hospitalcatchments, Addis Ababa Ethiopia; Cross Sectional Study
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    Assessment of clinical practice of secondary prophylaxis for varceal bleeding and prevalence of recurrence, among adult patients in TikurAnbesa Specialized Hospital, in Addis Ababa, Ethiopia, 2020.
    (Addis Abeba University, 2020-12) Jemal, Kamil; Mersdessa, Guda(consultant internist,Gastro Interologist and Hepatologist)
    Background: - Variceal bleeding refers to bleeding due to rupture of varix which is usually found in the esophagus or stomach. Recurrent variceal bleeding is a bleeding episode that occurs after 5 th day of initial episode. The approaches to patients who have had first variceal bleeding is controlling the acute bleeding and prevent further re-bleeding. To prevent re-bleeding and mortality, secondary prophylaxis is indicated for all patients. This usually requires repeated variceal band ligation until varices are obliterated and/or nonselective Beta blocker. Failure to apply guideline based clinical practice of secondary prophylaxis will predispose to increased risk of recurrent variceal bleeding, hospitalization and mortality. There is no published data regarding clinical practice of secondary prophylaxis for variceal bleeding and prevalence of recurrence in Ethiopian context. Objective: - To assess the clinical practice of secondary prophylaxis for variceal bleeding and prevalence of recurrence among adult patients in Tikur Anbesa Specialized Hospital, in Addis Ababa, Ethiopia, 2015-2019. Methods: - A hospital based cross-sectional study was conducted on 140 adults who had endoscopically confirmed variceal bleeding during 2015-2019. Retrospective data from hospital records including socio-demographic characteristics, clinical and laboratory data and endoscopic results of the patients were collected. EpiData version 4.4.2.1 software was used for data entry and STATA15.1 for analysis. Descriptive data were presented as mean, percentage and standard deviations. Result: - Propranolol was the main medical treatment given as secondary prophylaxis. Propranolol (96.4%), EVL & propranolol (2.9%), and carvidelol (0.7%) were started before or at discharge. Of these patients 9.4%, 11.5%, 20.2% and 28.6% achieved the guide line recommended target heart rate at 2-6 week, 6 week-3 month, 3 month-6 month, and 6 month- 1 year respectively on follow up. More than 70% of the pat ients’ heart rate is not in the target rate in each follow up. 61.2%, 65.8%, 53.6%, 69% patients had their dose of propranolol adjusted at each consecutive follow up. Significant proportion of patients, 38.8%, 34.2%, 46.4%, & 31% were not provided with the appropriate dose adjustment. Of the patients who were on follow up 11.5% had experienced recurrence of variceal bleeding. Conclusion and recommendation:-There was a significant gap in clinical practice of guideline recommended secondary prophylaxis for the prevention of variceal rebleeding in patients on follow up in TASH during the study period. There was lack of continuous supply of EVL bands in the country and appropriate escalation of the dose of propranolol was not implemented as per guideline recommendations in significant proportion of patient. Physicians should follow the appropriate evidence based guidelines in the management of variceal bleeding and prevention of rebleeding. Furthermore the hospital should avail necessary supplies like EVL which are vital for endoscopic intervention to control acute bleeding and for prevention of rebleeding.
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    Assessment of Dyslipidemia and its Associated Risk Factors among Adult Type-2 Diabetic Patients on Follow up at Tikur Anbessa Specialized Hospital: A Hospital based Cross Sectional Study
    (Addis Abeba University, 2021-12) Addis, Wondwosen; Aberra, Theodros(MD,Endocrinologist &assistant professor)
    Background: Dyslipidemia is one of the major modifiable risk factors for cardiovascular diseases (CVD) in a type-2 diabetic (T2DM) patient. Dyslipidemia in T2DM patients is attributed to increased free fatty acid flux secondary to insulin resistance. Globally burden of dyslipidemia in diabetic patients is continuously increasing. Intensive management of dyslipidemia and its associated factors is required to prevent cardiovascular disease. Objective: The study was designed to assess the prevalence and associated factors of dyslipidemia among adult patients with type 2 diabetes at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Method: An institution-based- cross-sectional study was conducted from July 10 to November 10, 2021. A convenience sampling technique was used to recruit 208 T2DM patients. Data on socio-demographic characteristics, behavioral, and clinical factors were collected using a structured questionnaire through face to face interview. Anthropometry and blood pressure were measured. Laboratory data were retrieved from patients chart. Data was entered and analyzed using SPSS version 25. To identify determinant factors of dyslipidemia, bivariate and multivariate binary logistic regression analyses were done. Statistical significance was considered at the level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association. Results: The overall prevalence of dyslipidemia among study participants was 78.4%. Hypertriglyceridemia was found in 42.8%, hypercholesterolemia in 25.1%, high low-density lipoprotein in 30.3%, and low high-density lipoprotein in 36.5% study participants. Longer duration of diabetes &physical inactivity were significantly associated with dyslipidemia. Patients who have more than 10 years duration of diabetes had five times (95% CI, 1.24-20.149) more risk of dyslipidemia as compared with less than 5 years duration. Type2 DM patients who don’t perform moderate physical activity had nearly three times (95% CI, 1.077-7.767) increased risk of dyslipidemia as compared with those who perform 5-7 days moderate physical activity in a week. Conclusion: A high prevalence of dyslipidemia was found among T2DM patients in the study area. Physical inactivity and longer duration of diabetes were significantly associated with dyslipidemia among T2DM patients. Clinicians need to screen, treat, and educate diabetic patients about dyslipidemia and its associated risk factors.
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    Assessment of Health-Related Quality of Life in Patients with Inflammatory Bowel Disease at Tikur Anbessa Specialized Hospital, Ethiopia
    (Addis Ababa University, 2024-02) Berihun,Asrat; Mohammed,Duelsome(MD)
    Introduction: Inflammatory bowel diseases are chronic progressive/relapsing conditions that affect the younger population and have been associated with reduced health-related quality of life. HRQOL is an important outcome measure in IBD and helps to understand impact of the disease on the patient and the effect of treatment on the disease. Aim: To assess health-related quality of life in IBD patients and associated socio-demographic and clinical factors. Methods: A hospital-based cross-sectional study using the "Short Inflammatory Bowel Disease Questionnaire" (SIBDQ) was conducted in Tikur Anbessa Special Hospital from September 1, 2023 to December 30, 2023. Data were entered and analyzed using SPSS version 27. Descriptive statistics were used to show frequencies and percentages. A binary logistic regression model was used to assess predictors of impaired HRQOL in patients with IBD. Strength of association is measured by AOR and 95% CI. Variables with a P-value < 0.05 have a statistically significant association. Results: Thirty-one percent of IBD patients in our study had impaired HRQOL (SIBDQ<50) with no statistically significant difference between IBD types, gender, marital status, residence, surgical treatment and duration of IBD. Unemployment (AOR= 4.36; CI 95%:1.34-14.18; p=0.014), not being in remission (AOR= 14.62; CI 95%: 2.31-92.53; p= 0.004), comorbidity (AOR= 9.18 ;CI 95%: 2.24-37.69, p=0.002), admission (AOR= 5.08; CI 95%: 1.45-17.76, p=0.011) and symptom duration > 6 months before diagnosis (AOR= 4.679; CI 95%: 1.31-16.74; P=0.018) were significantly associated with impaired HRQOL. Conclusion: In our study, about one in three of IBD patients had impaired HRQOL. HRQOL was better with controlled disease activity; no hospitalization, no EIMs, and no comorbidity; early diagnosis, employment, and higher educational level.
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    Assessment of indications and clinical significance of bone scintigraphy among patients referred to Nuclear Medicine Unit, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2023-02) Yemaneberha,Solome; Worku,Bethelehem(Ass.Prof.); Abeje,Desalegn
    Background: Bone scintigraphy is a very sensitive diagnostic nuclear medicine imaging technique that uses a radiotracer to assess the distribution of active bone growth in the skeleton in relation to malignant and benign disease as well as a physiologic process. The general indications for bone scintigraphy are to investigate for particular bone disease, unexplained symptoms and prior to therapy for metabolic evaluation. There is no baseline study to assess the indications and clinical significance in TASH. Objective: The aim of this study was to evaluate the clinical indication and significance of bone scintigraphy in patients who were referred to Tikur Anbessa Specialized Hospital. Methods: A hospital-based retrospective cross-sectional study was conducted using secondary data from a record of a bone scintigraphy from 2007 to 2012 at the Nuclear Medicine Unit at Tikur Anbessa Hospital. SPSS version 22 was used to examine and analyze the gathered data using descriptive and inferential statistics. Result: In this investigation, 110 Planar and SPECT scan record of patients was used. Out of which 76 (69.1%) were female and 34 (30.9%) were male. The most common indications was the evaluation of metastatic breast cancer at 59 (53.6%), followed by prostatic cancer 22 (20%), Using a binary logistic regression analysis there was a significant correlation between female patients and positive outcome of scans p=0.06 and OR=4. Those aged between 40-49 years had a significant correlation with outcome of the scan compared to their oldest counterpart ( >70yr) p=0.03, OR=11. Conclusion: In this study, 94.5% of indications were for oncologic work up. Breast cancer metastatic workup is the most common indication. Positive results were four times more likely to be seen in female patients than males. People between the ages of 40 and 49 had an eleven fold higher likelihood of obtaining positive scans than the oldest age group (>70 years).
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    Assessment of Knowledge and Practice of ICU Care Bundles in Infection Control among Physicians and Nurses Working in Three Governmental Hospitals (Tikur Anbesa Specialized Hospital (TASH),Yekatit 12 and st. Peter Specialized Hospital) Adult ICU,Ethiopia, 2021
    (Addis Abeba University, 2021-12) Teshome, Mulugeta; Dr.Haile, Tewodros(Consultant internist and PCCM)
    Background: Intensive care is a continuum of care from various source of admissions where patients‘ requiring a frequent evaluation and support to assure safe and effective outcomes. Mortality in intensive care unit (ICU) is a global burden which results in a huge loss of productivity and financial costs. In Africa, the ICU mortality rate is high compared to developed continents. ‗‗Evidence-Based Bundle‘‘ of care which involves 3–5 structured interventions help to reduce and prevent hospital acquired infections (HAI‘s). OBJECTIVE: To assess the knowledge and practice of ICU care bundles among physicians and nurses working in three government hospitals Adult ICU, Addis Ababa, Ethiopia 2021. METHODS: A cross-sectional descriptive study was conducted using a structured questionnaire and observational check list. Proportional sampling technique was used. Collected data was cleaned, coded and entered in to excel and SPSS version 26was used for analysis and descriptive methods such as frequencies, or proportions. A score of ≥ 60% is considered as knowledgeable or good practice. X 2 tests were used to look for association with P <0.05. RESULT: A total of 101 health professionals participated with the response rate of 96.2%. Of this 53 (52.5%) were nurses and 48 (47.3%) were physicians, majority 55 (54.5%) were from TASH, 64.4% of them were males and the mean age of respondents was 29.4 (SD ± 3.32) years. Regarding knowledge of ICU care bundles, 53 (52.5%), 69 (68.3%) and 79 (78.2%) were knowledgeable regarding VAP, sepsis and urinary catheter care bundle respectively. But 50 (49.5%), 64 (63.4%) and 68 (67.3%) were observed to have good practice of elements of VAP, sepsis and urinary catheter care bundles in their daily activity respectively. This study also showed that there is significant association between knowledge and practices (p < 0.001). DISCUSSION AND CONCLUSION: Even through nurses' and physicians‘ overall knowledge regarding ICU care bundles was good, the practice was inadequate and the health care workers do not implement the latest evidenced based bundle practices. So the overall knowledge and practice of ICU care bundles used for prevention of ICU infection was suboptimal.
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    Assessment of Knowledge and Practice towards Household Transmission Prevention among People with Chronic Hepatitis B Attending Liver Clinic at Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia.
    (Addis Abeba University, 2021-12) Liban, Dida; Dr.Belachew, Hiwot(MD, Consultant Gastroenterologist and Hepatologist, Assistant Professor at Department of internal medicine)
    Background: Hepatitis B infection is a major global public health problem. Better disease related knowledge among Hepatitis B patients is important for prevention of transmission and facilitate screening of their sexual partners and household contacts. Objective: To assess the level of knowledge and practice of household transmission prevention among people with chronic hepatitis B attending liver clinic at Tikur Anbessa Specialized Hospital, Ethiopia. Methods: A cross-sectional study among 229 hepatitis B patients visiting liver clinic for follow up service was undertaken in 2021. Data were collected using a structured interviewer guided questionnaires and analyzed using descriptive and inferential statistical methods in SPSS 26. Results: Mean age of respondents was 40 years, 68% were male, Mean total knowledge score was 11.1(79 out of 100) with 65% of respondents scoring ≥75 (defined as a high knowledge). In adjusted linear regression, age <40 years, presence of additional infected household members and disease duration >3 years were associated with higher knowledge score (R 2 = 0.106, F=8.936, P<0.001).Mean total practice score was 4.7 with only 38.6% of paticipants scoring ≥6 (defined as good prevention practice). In Adjusted logistic regression, factors associated with poor practice were; low level of education (OR: 5.218; 95%CI: 1.34-20.23; p=0.017), being on anti HBV treatment (OR: 3.582; 95%CI: 1.04-12.33; p=0.043) and duration of follow up at TASH <2 years (OR: 2.93; 95%CI: 1.14-7.55; p=0.025). Conclusion: Poor implementation of recommended prevention practices and misunderstandings about transmission were identified among chronic hepatitis B patients.
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    Assessment of Knowledge on Hepatitis B infection, Hepatitis B Vaccine and Vaccination Status among Health Care Workers in TASH from March 10-Sept 10 ,2020 G.C
    (Addis Abeba University, 2020-12) Girum, Alebachew; Birhanu, Yohannes (MD, Internist, consultant Gastroenterologist and Hepatologist)
    Background: Hepatitis B infection is usually higher among health workers than the general population, particularly in the sub-Saharan region. WHO recommends vaccination for all health care workers (HCWs) against the highly infectious, blood borne virus: HBV. However, previous studies reported that knowledge of HCWs toward the hepatitis B infection, Hepatitis B vaccine and their vaccination coverage was low and vary among HCWs in different settings. Objective: This study was aimed to assess knowledge about HBV infection, HBV vaccine and status of HBV vaccination among healthcare workers in TASH, Addis Ababa, Ethiopia from March 10 to September 10, 2020. Methods and materials: Hospital based cross-sectional study was conducted on 358 HCWs who were selected randomly. Stratified random sampling method was used to collect the data using self-administered questionnaire. Then, the data was entered into Epi-data 4.2 version and was exported to Statistical Package for Social Science (SPSS) version 26 for analysis. All covariates that showed p value < 0.25 in binary logistic analysis were further analyzed by multiple logistic regressions to detect true predictors. Result: Among the health care workers, who participated in this study, 180 (51.4%) of them had adequate knowledge on the HBV infection. Medical doctors were the most knowledgeable among the HCWs, with interns [AOR=11.3(95% CI=4.5-28.6)], consultant physicians [AOR=7(95% CI=3.1-15.9)] & resident physicians [AOR=3.5(95% CI=1.9-6.9)] being significant predictors of good knowledge. Vaccination coverage was 60% which was predicted by a shorter work experience [AOR=4.7(95%=1.4-5.8)]. Conclusion: This study reveals that general knowledge level of HCWs about HBV is inadequate and vaccine coverage is suboptimal. Thus, concerned stakeholders should devote more efforts to improve the HCWs awareness about the virus and role of its vaccine and also more work to avail vaccine.
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    Assessment of Knowledge, Attitude and Practice of Diabetic Foot Care among Diabetic Patients in Tikur Anbessa Specialized Hospital, Ethiopia
    (Addis Abeba University, 2021-12) Fekadu, Elfign; Reja, Ahmed (MD, Endocrinologist)
    Background- The prevalence of diabetes continues to be a growing problem throughout the world and contributes significantly to the health care burden. One of the major complications that diabetes carries is foot ulcer. Diabetic foot ulcer (DFU) is one of the most feared complications and a common reason for the hospitalization of diabetic patients. The ultimate endpoint of diabetic foot disease could be amputation, which is associated with significant morbidity and mortality. It also has significant social, psychological, and financial consequences. Objective- This study is designed to address the status of knowledge, attitude and practice of diabetic foot care and barriers to foot care practice among diabetic patients on follow up at Endocrine clinic in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methodology- This is a descriptive cross-sectional study which was done on diabetic patients on follow up at Endocrine clinic in Tikur Anbessa specialized hospital. The study included 378 diabetic patients using a convenient sampling technique. All patients whose records met the inclusion criteria were reviewed. SPSS version 25 was used for data analyses. Knowledge, attitude, and practice of foot care were assessed using descriptive statistics and bivariable and multivariable logistic regression. Results- A total of 378 study diabetic patients were included in this study where the mean age of the participants was 54 years. There was comparable sex distribution. The mean knowledge score using questionnaires adapted from recommendations by American College of Foot and Ankle surgeons was 12.1 1.94 of which 47.6% and 52.4% had good and poor knowledge of diabetes foot care respectively. The mean attitude score using questionnaires adapted from a previous Saudi study was 3.85 0.90 of which 73.5% had good attitude and the remaining 26.5% had poor attitude towards foot care. The practice score using questionnaires that were adapted from the Nottingham Assessment of Functional Foot Care (NAFFC) was considered good if the participants scored above mean. Based on that, 54.5% of the participants had good practice while 45.5% of the participants were considered to have poor practice. With regards to barriers of foot care nearly one third didn’t know what to do, 27.5% didn’t think it was important, and 6.9% of the participants mentioned poor communication between patients and HCP. Conclusion and recommendation- Knowledge and practice of foot care among diabetes patients in our study participants weren’t satisfactory. The result of this study displays the gaps in their knowledge and practice and puts an emphasis on the need for patient education. Most patients are reported to have good attitude which can signify that patients are willing to learn and practice if they get access to proper diabetes education. In conclusion, it is important to focus on the role of health education to minimize diabetic foot complications.
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    Assessment of Quality of Care Given To Adult Acute Stroke Patients and Associated Factors in Tikur Anbessa Hospital, Zewditu Memorial Hospital, Yekatit 12 medical college Hospital ,Addis Ababa, cross sectional study, 2023
    (Addis Ababa University, 2024-02-23) Taye Birku; Fikru Tsehayneh
    Globally, stroke is the second-leading cause of death and the third-leading cause of death and disability combined worldwide. Even though the prevalence is decreasing in developed countries, it is increasing in developing countries. Quality of care given during acute phases of stroke has significant effect in improving mortality and morbidity. Studying the quality of care given for adult acute stroke patients helps to know the level of stroke care given and to improve the service
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    Assessment of Quality of Care Given To Adult Acute Stroke Patients and Associated Factors in Tikur Anbessa Hospital,Zewditu Memorial Hospital,Yekatit 12 medical college Hospital ,Addis Ababa, cross sectional study, 2023
    (Addis Ababa University, 2024-04-09) Birku Taye; Tsehayneh Fikru
    Globally, stroke is the second-leading cause of death and the third-leading cause of death and disability combined worldwide. Even though the prevalence is decreasing in developed countries, it is increasing in developing countries. Quality of care given during acute phases of stroke has significant effect in improving mortality and morbidity. Studying the quality of care given for adult acute stroke patients helps to know the level of stroke care given and to improve the service
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    Assessment Of Renal Scintigraphy, Indications And Results, Among Patients Referred For Renal Scintigraphy At Nuclear Medicine Unit, Instituto Nazionale Tumori IRCCS-Fondazione G-Pascale.
    (Addis Ababa University, 2023-02) Abrahim, Ziyad; Jorge,Yohannes (Ass.Prof.); Damtew,Emeshaw(M.Sc, PhD fellow); Carideo,Luciano (MD)
    Background: Renal scintigraphy is an imaging method that uses radiopharmaceuticals to evaluate renal anatomy, physiology, and pathology. It is performed by using a variety of methods, each providing a slightly different approach to assess renal function or anatomy. These methods includes functional imaging (visual assessment of perfusion and function) and Renography (TAC representative of function). Objective: The aim of this study was to assess renal scintigraphy, indications and result, among patients referred for renal scan at nuclear medicine unit, Istituto Nazionale Tumori IRCCS-fondazione G-Pascale from November 1, 2017 to October 31, 2022. Methods: Hospital based retrospective cross-sectional study was conducted to assess renal scintigraphy. All patients with full records of Renal scintigraphy at nuclear medicine unit, Istituto Nazionale Tumori IRCCS-fondazione G-Pascale from November,1 2017 - October,31 2022 were used in this study. After completion of data collection and processing, data was checked for completeness, clarity and consistency. The collected data was edited, coded by microsoft Excel and entered processed and analyzed with computer using SPSS version 26 software. Result: Out of 265 renal scintigraphy studies most of the scan 110 (41.5%) were indicated for evaluation of hydronephrosis and 91 (34.3%) were indicated for evaluation of patient with renal cancer. Among 110 patient in whom renal scintigraphy are indicated for evaluation of hydronephrosis 83 (39%) renal unit were normal, 53 (24%) showed functional obstruction, and 38 (17%) renal unit showed anatomical obstruction. The most common risk factor for renal disorder is renal cancer constituting 63 (23.8%) followed by renal cancer plus obesity in 34 (12.8%) of patient Conclusion: The most common indication of renal scintigraphy in the study area was for evaluation of patients with various degrees of hydronephrosis followed by renal carcinoma, renal functional status evaluation and raised creatinine.
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    Assessment of self-reported insulin injection techniques among patients with Diabetes Mellitus on follow-up at adult Endocrine clinic at Tikur Anbessa Specialized Hospital: Hospital-based cross-sectional study September 1 - October 31, 2020 G.C.
    (Addis Abeba University, 2020-12) Efrem, Paulos; Dr.Tarekegn, Getahun(MD, Internist,Endocrinologist)
    Background Assessment of injection device use and injection technique, are key components of a comprehensive diabetes medical evaluation and treatment plan. Proper insulin injection technique may lead to more effective use of this therapy and, as such, holds the potential for improved clinica l outcomes. The lack of a clear number of patients with diabetes mellitus requiring insulin therapy, and few studies focused on either assessing injection techniques or associated complicat ions separately have indicated suboptimal knowledge and skill with higher than the worldwide average on the presence of complications. Objective Major insulin injection parameters were assessed among patients with diabetes mellitus on followup at the adult diabetes referral clinic in TASH, Addis Ababa from September 1 to October 31, 2020. Methods A cross-sectional survey was conducted from September 1 to October 31, 2020, at the diabetes clinic in Tikur Anbessa Specialized Hospital. Data were collected by using a structured, interviewer-administered questionnaire. Then, entered and analyzed using SPSS version 20. To identify factors associated with injection techniques, bivariable and multivariable binary logist ic regression analyses were done. Statistical significance was considered at a level of significance of 5%, and adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to present the estimates of the strength of the association Results A total of 293 participants were included in this study. The most common type of diabetes reported was Type 2 diabetes mellitus. From the recommended injection sites, 256 (87.4%) inject at more than 1 site with the thigh (249/85%) being the most often used site. The median total daily insulin dose was 54IU. Insulin syringe reuse was practiced by practically all (98%) of the participants. Injection site rotation is practiced by 272 (92.8%) of the participants. The presence of anyswellings or lumps over the injection sites was reported by 113 (38.6%) of the participants with the thigh being the most common site. Disposal of used syringes capped into the trash is the practice of 176 (60.1%) of the study participants. From the multivariate analysis, sex (AOR=2.33, 95% CI:1.13-4.83), total daily dose of insulin (AOR=0.99, 95% CI:0.98-0.99), last time injection instructions were reviewed (AOR=0.35, 95% CI:0.13-0.97) and hyperglycemia events (AOR=0.56, 95% CI:0.31-0.99) showed significant association with the presence of lipohypertrophy. Conclusion: This study revealed that there are alarmingly high rates of injection-related complications. The diabetes education given pertaining to injection parameters and evaluation of injection sites are neglected which will fuel the occurrence of complications. It highlights the need for the provision of patient-centered instruction and education about insulin injection techniques.