Internal Medicine

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    Prevalence of Helminthic Infections and Associated Factor Among Pregnant Women Attending ANC in ALERT Hospital, Addis Ababa
    (Addis Ababa University, 2025-01-22) Hawi Nugusu; Hermela Feyisa
    Background: - Intestinal parasitic infections are a major concern, mostly in developing countries, particularly in sub-Saharan Africa. Ethiopia has one of the lowest quality drinking water supply and latrine coverage in the world. Pregnant women are also at high risk of parasitic infection due to their close relationship with children. Infections with helminth were associated with a modest decrease in hemoglobin levels and indicators of poor nutritional status. Hookworm is the leading cause of pathologic blood loss in endemic. Anemia in these highly endemic regions is common among pregnant women and often multi-factorial. Anemia has a devastating effect on pregnant women and has been associated with stillbirth, prematurity and low birth weight. Objective: - Assessment of the prevalence of helminthic infections among pregnant women attending ANC in ALERT hospital, Addis Ababa. Methods: - Facility based cross-sectional study was employed in ALERT hospital. The study subjects were selected using systematic sampling method and 185 women were participated making a response rate of 89.4%. The data were collected by interviewed method. The data entered, cleaned and analyzed by SPSS version 25 and Logistic regression analyses was employed to identify factors associated with helminthic infection. Using 95% CI variables with a p-value <0.05 was identified as statistically significant factors. Result: - The finding of was that the prevalence of helminthic infection among pregnant women was 28%. The determinant factor for helminthic infection were education level of illiterate (AOR=2.3, 95%CI=1.48, 10.87), rural in residency (AOR=3.1, 95%CI=1.88, 11.14), having water source of pipe water out of the compound (AOR=3.7, 95%CI=1.12, 12.23), didn’t use soap or antiseptic while washing hands (AOR=7.1, 95%CI=2.26, 22.58), having an availability of water bodies in the vicinity (AOR=5.4, 95%CI=1.87, 15.83) and having exposure of bathing in the river (AOR=5.4, 95%CI=1.11, 11.57). Recommendation: - To address the issue of helminthic infections in pregnancy a multi-faceted educational approach is essential. So, emphasize the importance of washing hands with soap and clean water, particularly after using the toilet, before handling food, and before eating.
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    Proportion and Predictors of Suboptimal Colonic Preparation among Patients who Undergone Elective Colonoscopy at a Tertiary Care Center, Addis Ababa, Ethiopia: a Prospective Cross-Sectional Study.
    (Addis Ababa University, 2023-09) Girma,Abel; Belachew Hiwot; Erkie Mengistu
    Background:colonoscopy is an important diagnostic and therapeutic tool for various conditions affecting the colon, rectum and terminal ileum. Bowel preparation is one of the key quality indicators among others. Suboptimal bowel preparation will significantly affect safety and diagnostic yield of the procedure. To date there is no adequate information regarding the quality and outcome of colposcopy preparation as well as predictors of sub optimal preparation in our set up.Aim: -The main objective of this study was determine the proportionand predictors of suboptimal bowel preparation among patients who undergone elective colonoscopy at TASH. Methods: -A prospective cross-sectional study was conducted on 282 elective colonoscopies done at TASH from March, 2023 to August 30, 2023 G.C.After informed consent,interviewer administered structured questioner was used to collect data by a trained interviewer. The edoscopist assessed the quality of preparation using Aronchick scale. The collected data was cleaned, checked for completeness, compiled, entered in to Epidata andexported to SPSS 26 for analysis. Bivariate and multivariable logistic regression analysis was conducted to identify determinants of suboptimal colonic preparation. Pvalue< 0.05 was taken as significant. Result:-Suboptimal colonic preparation was observed in 45% of the cases with 15.2% procedure cancelation rate attributable to inadequate colonic preparation. On multivariate analysis, age more than 60 years and non-adherence to the recommended dose of castor oil were predictors of suboptimal colonic preparation while short telephone call a day before the start of preparation and taking anti diabetic medication where negative predictors of suboptimal colonic preparation. Conclusion: -This study revealed unacceptably high proportion of suboptimal bowel preparation and procedure cancellation rate. Clinical variables independently associated with quality of preparation include; old age, adherence to preparation regimen, anti-diabetic medication intake and telephone counseling. Therefore intervention targeting these predictors should be designed to improve quality of pre –colonosopic bowel preparation.
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    Role of 18F-Fluorodeoxyglucose–Positron Emission Tomography Before, During and After Treatment in T cell and Nk-Cell Lymphomas: A Retrospective Study from Pascale Hospital, Napoli, Italy 2022 G.C.
    (Addis Ababa University, 2023-02) Chimdesa, Amanuel; Alemu Aschalew; Worku Bethelhem ; Carideo Luciano
    Background: Over the past years, 18F- FDG PET has emerged as an efficient tool to assessHodgkin’s lymphoma and diffuse large B-cell lymphoma’s response to treatment. 18F- FDG PETis both sensitive and specific for initial staging in T cell /Natural killer cell lymphomas. However,the predictive value of early or post-therapy 18F- FDG PET remains unknown. Objective: Therefore, the objective of this study was to assess the role of 18F- FDG PET before,during and after Treatment in T cell and Natural killer cell lymphomas. Method: A facility-based descriptive retrospective cohort study design was employed. A total of57 sample populations was selected using purposive sampling technique among patients visitingthe nuclear medicine department of the hospital. A quantitative method of data collection wasdeployed using a data abstraction tool. Data was entered and analyzed using statistical softwareSPSS for windows V 26.0. The verbal ethical clearance was obtained from National CancerInstitute of Napoli. Result: The result showed that 25 (61%) were males. About 17 (41.5%) of index cases were in theage group “61-75”, and the mean (+SD) age of respondents was 57.8 (±15.4). All 100% of theindex cases have been diagnosed with biopsy proven disease and PET/CT also showed positivity on all the index cases.Discussion: Findings of this study revealed that metabolic parameters like SUVmax and whole-body metabolic tumor volume at the time of the diagnostic, interim and post treatment 18F- FDG PET scans does not predict disease progression of T cell /Natural killer cell lymphomas in theindex cases. In addition, Sociodemographic variables such as sex and age on top of clinicalparameters such as Ann Arbor staging at the time of diagnosis, primary lesion location, ECOG andinternational prognostic index (IPI) does not seem to have statistical correlation with that of disease progression. Recommendation: It is recommended to conduct the study in other centers as well as amending the limitation of our study challe
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    The Use of third-line Combined Antiretroviral Treatment and Determinants of Treatment outcomes among HIV/AIDS Patients in Ethiopia
    (Addis Ababa University, 2023-11) Eshetu Anteneh; Amogne Wondwossen
    Background:The treatment of human immunodeficiency virus (HIV) infection involves the use of combination antiretroviral therapy (cART). The use of these multidrug regimens substantially reduces the progression to AIDS, opportunistic infections, hospitalizations, and death. The standard of care in HIV management is to maximally suppress plasma HIV RNA to preventHIV disease progression and the emergence of drug-resistant virus. Third-line regimensinclude drugs such as newer generation NNRTIs like etravirine (ETV), boosted PIs like ritonavir-boosted darunavir (DRV/r), as well as the integrase inhibitor like Dolutegravir (DTG) with or without previously used ARV drugs that potentially maintained residual antiviral activity, especially from the NRTI class.(1,2) Although there were few studies with newer agents, cohort data showed high mortality among people for whom second-line ARThad failed. Salvage regimens were recommended with new drugs such as DRV/r, ETV andRAL. Objectives:General objectives:To describe baseline, virologic and therapeutic characteristics of PWHIV on 3rd line cART Specific objectivesTo analyse the virologic suppression in PWHIV on 3rd line cARTTo describe the adherence status of PWHIV on 3rd line cARTTo assess the duration of protease inhibitors’ exposure in PWHIV on 3rd line cARTTo analyse medical comorbidities in PWHIV on 3rd line cART Methods:This is a retrospective study with longitudinal analysis among adults (≥ 18 years) attendingTikur Anbessa Specialized Hospital, Infectious Diseases unit, ART clinic. Then, alongitudinal analysis was conducted to determine virological suppression among patients who was initiated on third-line therapy and for whom a follow-up viral load was determined. Thestudy is aimed to describe the population of patients on third-line therapy. Results:A total of 51 patients are on third line cART( both guideline and expert recommendedregimens). Fifty one percent (n= 26) patients are female. Majority of the respondents claimedthat they acquired the virus through unprotected sexual intercourse (66%) and 28% percent ofpatents acquired the virus through vertical transmission from mother to child. Majority ofpatients had WHO stage-III or stage-IV defining conditions (37.3% & 35.3% respectively).Tenofovir Disoproxil Fumarate/Lamivudine/Efavirenz was the first line regimen in 37.3% ofpatients and Tenofovir Disoproxil Fumarate, Lamivudine and Ritonavir boosted Atazanavirwas a second line cART in 39.2% patients. Dolutegravir, Lamivudine, Ritonavir boostedDarunavir is the expert recommended thirdlineregimen (94.1%). 76.5% (n= 3haveundetectable viral load on third line cART. Patients transferred due to first line treatmentfailure had an 11 times greater chance of having undetectable HIV RNA levels compared tothose referred due to second line treatment failure. Conclusions:The use of expert recommended third line cART composed of DTG, 3TC, DRV and RTV iseffective in our setting especially in PWHIV who are referred to our center after 1st linecART treatment failure.
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    Prevalence of Periodontal Disease and Associated Factors of Periodontitis among Diabetic Patients Under Follow up at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: Institution Based Cross Sectional Study
    (Addis Ababa University, 2023-07) Leulseged Beza; KebedeTedla
    Introduction: Diabetes and periodontal disease are chronic diseases with a significant impact on public health. The relationship between these two diseases has been well established and is said to be bi-directional. Diabetes is a risk factor for periodontal disease, and periodontal disease may have impact on glycemic status and other diabetic complications. There is a paucity of datarelated to the prevalence and associated factors of periodontal disease among Ethiopian diabetic patients. Objective: The main objective of this study is to determine the prevalence of periodontal disease and associated factors of periodontitis in diabetic patients attending their treatment and follow up at Tikur Anbessa Specialized Hospital Methods: An institution based cross sectional study was conducted from June 1-July 31, 2023on sampled diabetic patients following in the endocrine clinic of Tikur Anbessa specialized hospital during the study period. The study enrolled 216 diabetic patients in total. To examine the prevalence of periodontal disease and associated factors for periodontists, data were collected using a pretested questionnaire to assess sociodemographic, physical features, clinical parameters, glycemic profile (FBS & HgA1C), and oral hygiene practices. Following that, an oral examination was performed to determine bleeding on probing, community periodontal index(CPI) and clinical attachment loss (CAL). The logistic regression analysis was used to examinefactors associated with periodontitis, and the ordinal regression analysis was used to estimate severity based on CAL. Data collected was analysed using STATA version 14 software and outcomes were presented by tables, figures and statements. Results: The overall prevalence of periodontal disease (either gingivitis or periodontitis) was100%, with gingivitis affecting 98.6% of subjects and periodontitis affecting 91.7%. Multivariate analysis revealed Increasing age (AOR=1.06, 95% CI:1.01-1.11), use of combinationantihyperglycemic medications (either combination oral or combination oral & insulin)(AOR=4.85, 95%:1.3-17.9), spironolactone use (AOR-0.21, 95% CI: 0.014-0.78) and presence of dentures (AOR-0.34; 95% CI: 0.04-0.65) to be significantly associated with periodontitis.In addition, bleeding on brushing was found to be significant indicator of periodontitis (AOR-6.6; 95% CI: 1.5-34.5). Male gender (AOR-2.4, 95% CI: 1.08-5.36), lack of flossing (AOR-4.1,95% CI: 0.04-1.04), and poor self perception of gum health (AOR-2.82, 95% CI: 1.25-6.38)were variables significantly associated with the risk of developing generalized periodontitis.Ordinal regression analysis showed that male gender (AOR-3.5, 95% CI: 1.4-8.7) and age ≥40years (AOR-5.3, 95% CI: 1.4-20) were significantly related to periodontitis severity. Conclusion: The finding of this study showed that the magnitude of periodontal disease among diabetic patients was high. Increasing age, use of combination anti hyperglycemic drugs,spironolactone use, presence of dentures, and bleeding on brushing wer independently associated with the occurrence of periodontitis. Furthermore, male gender and increasing agewere found to be significant predictors of the severity and development of generalizedperiodontitis.
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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
    Background:Primary immune thrombocytopenia (ITP) is a relativelyuncommon hematologic disorder with an estimatedincidence 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. ObjectiveThe primary objective of this study is to determine the rate of initial response to corticosteroids in newlydiagnosed IT patients.Secondary objectives include duration ofresponse ,association 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 hospitallocated in Addis Ababa.All newly diagnosed ITP patients for whom adequate information regarding their outcome after 1st line therapy was availablewere included in this study. Data obtained thru a standardized questioner was analyzed by IBM-IPSS version 20 statisticalsoftware. Result: A total of 48 study participants with the age of 18 & above were included in the study. Females constitute 85% of theparticipants. 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 statisticallysignificant 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 aresponse 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 issignificantly more than that reported in previous studies of 1st line prednisolone therapy in newly diagnosed ITP patients.
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    Major Causes and Factors Associated the outcome of Patients with Upper GI Bleeding in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: Institution Based Prospective Cohort study
    (Addis Ababa University, 2023-10) W/Giorgis Blen; Merdassa Guda; Berhe Rezene
    Background: Upper gastrointestinal bleeding refers to blood loss within the intraluminalgastrointestinal tract from any location between the upper esophagus to the duodenum at the levelof the ligament of Treitz. Bleeding from the upper gastrointestinal tract is approximately five timesmore common than from the lower gastrointestinal tract. The incidence of upper GI bleedingranges from 50 to 150/100,000 population annually, and as many as 70% of acute upper GIbleeding episodes occur in patients older than 60 years. This study aimed to assess the Rebleeding and Death at 30 days of the patient’s outcome with those upper GI bleeding in TASH, AddisAbaba, Ethiopia. Method: The study was an institution-based prospective cohort study. A total of 123 patients whohad upper GI bleeding were enrolled in this study, and associated factors studied. Data sampleswere collected from the study participants, together with associatesociodemographic, endoscopic findings, lab profiles, potential risk factors, and other importantquestionnaires, at the TASH GIClinic endoscopy unit from January 2023 to September 2023. Result: The mean age of participants with GIB was 41.28 ± 16.352 (range 13–84 years). About67 (54.5%) of patients were under 40 years of age. Out of 123 patients admitted with upper GIbleeding, 73 (58.5%) of them stayed in hospital for less than 3 days, rebleeding at 30 days occurredin 21 (17.1%) of patients, and death at 30 days occurred in 17 (13.8%). Conclusion: In this study, the mortality rate at 30 days was high about 13.8% and in 17.1% ofpatients, rebleeding occurred within 30 days. Variceal bleeding was found the most common causeof upper gastrointestinal bleeding accounting for 53.7% of patients.
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    Burden of Tuberculosis in Stage 5 Chronic Kdney Disease Patients Undergoing Maintenance Haemodialysis Therapy in Governmental and Non-Governmental Dialysis Centers in Addis Ababa, Ethiopia: A Cross-Sectional Study
    (Addis Ababa University, 2023-11) Beyene Eyob; Amogne Wondossen; Melke Addisu; Jote Wubshet
    Background Patients with End stage renal disease appear to be at a higher risk of TB due toimmunosuppression along with socioeconomic, demographic, and comorbidities. Despite high burdenofTuberculosis in developing countries, there is a scarcity of data regarding burden ofTB in ESRD in Ethiopia. ObjectiveThe objective of this study is to assess the burden of TB in End stage renal patients receiving haemodialysis in Addis Ababa, Ethiopia. MethodA cross-sectional study was conducted on Burden of Tuberculosis in stage 5 chronic kidney disease patients undergoing maintenance hemodialysis therapy in governmental and non-governmental dialysis centers in Addis Ababa, Ethiopia from August 2022 to October 2022G.C. Patients with a baseline diagnosis of ESRD on HD and age 18 years and above wereincluded in the study. Patients were recruited during their dialysis visit using convenient sampling method and consent was obtained from all participants. A total of 263 participants were included in this study. The diagnosis of ESRD and TB was defined using KDGIO and WHO guidelines. Data were collected through patients interview and reviewing the patient’selectronic medical records. The Collected Data was analyzed using SPSS version 26.0. Results Our study found a diagnosis of tuberculosis in 71 (27%) of study participants. Among the study participants who was diagnosed with TB, 64 (24.3%) had a previous diagnosis of TB and 12 had active TB.Pulmonary tuberculosis was diagnosed in two-third of TB patients and about third had EPTB, TB lymphadenitis was the commonest followed by pleural TB.Imaging evidence was used to make a diagnosis of TB in one-third patients followed byFNAC (26.6%) and Pleural fluid analysis (26.6%). More than half (54.7%) of TB diagnosiswas made after initiation of haemodialysis. More than half (54.7%) of TB diagnosis was made after initiation of haemodialysis. Having a contact history with a known TB patient, presenceof HIV infection and duration on dialysis for more than 1 year were associated with increased prevalence of TB among CKD patients. Conclusions Because of its atypical presentation and since it is a mimicker of uremic symptoms, physicians should maintain a high degree of suspicion to consider TB among CKD patients. Early identification and treatment of TB among CKD patients is important in decreasing morbidity and mortality among these patients and in decreasing the transmission of TB among patients who undergo dialysis in the same center. TB preventive therapy should also be considered for this group of patients
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    Rate and Predictors of Endoscopic Mucosal Healing among IBD Patients on Medical Therapy at Tikur Anbessa Specialized Hospital: Institution Based Prospective Cross-Sectional Study
    (Addis Ababa University, 2023-10) Shibru Habtewold; Bane Abate; Adem Ahmed
    Introduction:Inflammatory bowel diseases (IBD) are characterized by chronic inflammation of the intestinal mucosa resulting from strong interaction between genetic, environmental, immunologic and intestinal microbial factors. Medical treatment for inflammatory bowel disease (IBD) has undergone a complete transformation over the last several decades due to the advent of different drugs. Clinical remission and endoscopic healing are integral components of the treat to target strategy in IBD therapy. Endoscopic healing is associated with significant reduction in complications of IBD and/or need for surgery. ObjectiveThe objectives of this study are to determine the rates of clinical remission and endoscopic mucosal healing among IBD patients on treatment and to sort out predictors of endoscopic healing. MethodologyA prospective cross-sectional study was conducted at Tikur Anbesa Specialized Hospital from January, 2023 to October 2023. The study included all consecutive IBD patients on treatment for six months or more who showed up for a regular follow up at TASH GI clinic in the study period and who were willing to consent and undergo follow up colonoscopy. Results Overall Clinical remission rate from this Cross-sectional study is 69 /106, including 62/87,(71.3%) of CD, 7/17 (41.2%) of UC and 0 /2 Unclassified. Thirty-five (33%) of IBD patients in the study achieved endoscopic healing. Twenty-six of the 87 (29%) patients with CD, 8 of the17(47%) UC, and one of the two with indeterminate colitis achieved endoscopic mucosal healing. Only 10 of the 32 CD patients with previous history of bowel resection achieved endoscopic healing. Higher ESR value (P = 0.040, AOR 0.946 with 95% CI 0.898-0.997) and younger age at diagnosis (P = 0.046, AOR 1.322 with 95% CI 1.005-1.739) predicted absence of endoscopic healing. Conclusion:Sixty-nine of the one hundred six IBD patients (65.1%, 70% for CD, 41.2% for UC) were inclinical remission. The overall endoscopic mucosal healing rate from this study is 33% (29.1%CD, 47.1% UC). Elevated ESR and younger age at the diagnosis predicted absence of endoscopic healing within the study period.
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    Clinical Characteristics,Treatment Pattern Andoutcome of Burkitt’slymphoma Patients Athaematology unit of Tikur Anbessa Specialized Hospital
    (Addis Ababa University, 2024-04-19) Megersa Yadeta; Burkitt Lymphoma.
    Background: Any sickness and injury characterized by the failure of important organs and a high risk of life-threatening conditions that necessitate prompt action beginning on the scene to preserve life and minimize morbidity is considered a critical illness. It is becoming more common, and the need for acute care is rising, facing a time-sensitive challenge to the healthcare system. In both prehospital and in-hospital settings, airway resuscitation is the cornerstone for the early care of critically ill patients. In addition to prehospital airway management, interfacility communication and continuity care during ambulance transferring are always demanding substantial tasks for all EMS workers from on the scene to treatment centers, anywhere in the globe. Still, Hypoxic agitation, hypoxic disability, peri intubation arrest, death on arrival, and dead body at arrival are poor clinical outcomes resulting from patients arriving with hypoxia at the ED too late as adversely affect. However, this prehospital insufficient care is being rushed to the ED. Real-time care and pre-arrival contact should be implemented to provide escalation of care according to evolving updated clinical practice for better patient outcomes. Objective: This study was intended to assess critically sick and injured patients' actual oxygenation state, prehospital communication, and mode of transportation upon arrival at the emergency department and to explain any gaps in prehospital treatment or in the ED. Methodology: TASH and ZMH ED hosted a prospective cross-sectional study design for two consecutive months, from August to October over 2 months. A total of 202 samples were recruited using a convenient sampling method. The data has been cleaned and analyzed using the SPSS version 27. Descriptive and chi-square tests were used. Result: Significant hypoxia (86.1%) and poor prehospital communication (16.8%) were seen in the results. Ambulance usage was also 46%. The chi-square test showed that the relation between mode of arrival and airway status was not statistically significant. Overall findings revealed that oxygen therapy was not based on respiratory support requirements during interfacility transferring; Ambulance transportation was not organized with resuscitation equipment and experts to optimize compromised airway; lack of clear communication on patients' clinical status between the prehospital system and the treating staff. Conclusion and recommendation: The study identified that there was suboptimal prehospital airway management in all modes of arrival. In addition to this, pre-arrival contact was loose between the treating team and the prehospital system to facilitate preparations for the receiving hospital. Based on the study findings, the recommendation would be to have a well-organized and equipped EMS to have optimal airway status at ED arrival by delivering sufficient prehospital care. EMS system should be the point of first medical contact to have better clinical outcomes for time-sensitive critical illness and injury. Ambulance mode of transferring should be given along with advanced resuscitation to address continuity of care during transportation and decrease time to intervention. A critically ill patient from any referring hospital or catchment health center should have been notified to the on-call treating team by the liaison officer beforehand.
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    Prevalence of Undernutrition and its Associated factors among Heart Failure Patients at the Cardiology Follow-up Clinic of Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia.
    (Addis Ababa University, 2024-02) Serkalem Getewey; Dejuma Yadeta
    Many studies have consistently highlighted a significant high incidence and prevalence of undernutrition among individuals diagnosed with heart failure. No study looked into undernutrition among heart failure patients in Ethiopia or Tikur Anbessa Specialized hospital
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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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    Comparison of Abdominal Ultrasound and Abdominal Computed Tomography Findings with Colonoscopy Features in the Diagnosis of Inflammatory Bowel Disease at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2024-03) Fekede Adil; Berhe Rezene
    Background: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of thegastrointestinal tract. It mainly includes ulcerative colitis and Crohn's disease. The mainstayfor the diagnosis of inflammatory bowel disorders is currently colonoscopy. Nevertheless,colonoscopy is a costly, time-consuming, and invasive procedure that patients might not alwaystolerate. As a result, there is increased interest in non-invasive diagnosing and monitoringtechniques such as ultrasonography and computed tomography. However, there is a lack ofstudies on the comparison between abdominal ultrasound and Computed tomography scan findings with colonoscopy in the diagnosis of inflammatory bowel disease in Ethiopia. Thestudy aims to investigate the correlation between abdominal Ultrasound and Computedtomography scan findings with colonoscopy in diagnosing inflammatory bowel disease among patients who presented with signs and symptoms suggestive of inflammatory bowel disease atTASH, Addis Ababa, Ethiopia. Objective: to assess the comparison of abdominal ultrasound and abdominal computed tomography findings with colonoscopy in diagnosing inflammatory bowel disease among patients who presented with symptoms suggestive of inflammatory bowel disease at TASH,Addis Ababa, Ethiopia. Method: A 6 year retrospective cross sectional study was employed from May 2023 to March 2024 among 120 patients who presented with symptoms suggestive of inflammatory bowel disease at TASH. The data was collected using a standardized questionnaire from the medicalrecords starting from January 01, 2018 to December 30 2023 of patients who underwent abdominal ultrasound, abdominal computed tomography and colonoscopy for suspected IBD.The collected data was entered after checked for completeness, then using SPSS 26,descriptive analysis was applied through frequency, percentage mean and standard deviation.Statistical analysis was employed to see the each test’s diagnostic accuracy through sensitivity,specificity, positive and negative predictive values and accuracy for both ultrasound andcomputed tomography in comparison to colonoscopy which was used as a gold standardreference for IBD diagnosis. Finally the result was presented using tables, charts and bars. Result: IBD was finally diagnosed in 79.2% of the total cases. Sensitivity, specificity, accuracy,PPV, and NPV were used to evaluate the diagnostic accuracy of each test. The results of ourfinal analysis indicated that Abdominal CT scan had the following values for sensitivity,specificity, accuracy, PPV and NPV: 73.4%, 44.0%, 67.5%, 83.3%, and 30.6%; whileAbdominal US had these values at 55.8%, 72.0%, 59.2%, 88.3%, and 30.0%, respectively. Thedegree of agreement was as follows: for abdominal US, kappa=0.183, there was a significantassociation and slight agreement; for Abdominal CT scan, kappa=0.152, there was nosignificant association and slight agreement.
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    Prevalence of Cardiovascular Risk Factors in Systemic Lupus Erythematous Patients Having Rheumatology and Renal Clinc Follow Up
    (Addis Ababa University, 2024-03) Kindu Adugnaw; Abebe Sintayehu; Demelash Birhanu; Getachew Nebyu
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    Characterization of Connective Tissue Disease Related Interstitial Lung Disease At Selcted Centers in Addis Abeba, Ethiopia: A 4 years retrospective study
    (Addis Ababa University, 2024-02) Zewdu Ameha; Abdiss Becky
    Background: CTD-ILD in one of the most frequent systemic manifestation of CTD which isresponsible the majority of mortality and morbidity in these group of patient. Indeedcharacterization of connective tissue diseases related Interstitial lung diseases(CTD-ILD)includes clinical presentation, serological fiding ,Pulmonary function test(PFT) & high-resolution computed tomography (HRCT) findings will help in designing and implementingprevention and management interventions, thereby reducing the severity of illness and thenumber of deaths that could be associated with the disease. However published evidence are not much available in sub-saharan country including Ethiopia. Objective: To conduct a comprehensive characterization of CTD-related ILD including epidemiology, clinical presentation, radiological finding, PFT, and serological finding who attend the Rheumatology clinic at TASH, Lancet specialized hospital and Rheum specialty clinicfrom Jan 2020 – Feb 2024 Methods: A Multicenter cross-sectional analytical study was conducted by at the rheumatology clinic at TASH, Lancet and Rheum clinic in Addis Ababa, Ethiopia, during the period Jan 1st 2020 -Feb 2024. Data was collected using a structured checklist, and then entered and analyzed using SPSS version 26. Descriptive analysis was employed to identify the management gaps. Tables and figures were used to present the results. Result With a total patient 92 the majority of the patients are female(89.2) and male (10.8%) with afemale to male ratio of 1:8 and the mmedianage of onset is 47.33 years. The most common CTDidentified are RA (44.6%), SSC (40.9%) , PM/DM (6.5%), MCTD (4.3%), SLE (3.3%) &USCTD (1.1%). The most common clinical presentation is Cough (72.8%), Decreased exercise tolerance (40.5%) and Dyspnea (41.3% ) but 7.6% of the patient are asympromatic . The mostidentified Common Antibody Found In ILD are are ANA(47.8%), RF (47.8%) , Anti-scl-70(37.0%) ,ACPA (29.7%) and frequently encountered ANA pattern are speckled (16.3 %),Homogenous (15.2 %) and nuclear (10.9%). The most frequqnt CXR finding is reticilonodular and GGO but 11% of the patient are normal .The most frequent identified HRCT pattern are NSIP (69.6%) and UIP (28.3%). PFT test done for only 7 patients and 4 patients have restrictivepattern and 3 patients have obstructive pattern. ConlussionOur study identified that CTD-ILD are more common in female and patient with RA % SSc. MostRA patient are older and usually have long duration of illness before the diagnosis of ILD.Relatively SSc patient are younger and most of them have Anti-scl-70 and speckled ANA pattern. We do not identified MTX associated pneumonitis.
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    Prevalence of Lasparaginase Associated Thrombotic Events and Associated Factors in Adult Patients with Acute Lymphoblastic Leukemia in Tikur Anbessa Specialized Hospital.
    (Addis Ababa University, 2024-02) Abrar Amira; Abdela Fozia
    Background –L-asparaginase is an important component of acutelymhoblastic leukemia treatment. However, it is associated with increased risk of thrombosis which in turn affects leukemia related outcomes and poses increased risk of mortality and morbidity. Objective- To assess the prevalence of thrombotic events associated with L-asparaginase treatment and its determinantfactorsinadult acute lymphoblastic leukemia patients treated inTikur Anbessa specialized hospital from November 2020- November 2023 Methodology: The study was conducted at Tikur Anbessa specializedhospital. A total of 152patients who have been treated or are on treatment for acute lymphoblastic leukemia with L-Asparginase containing regimens at Tikur Anbessa Specialized Hospital from November 2020 toNovember 2023 were included in the study. Data was collected from the patient’s medical records (both electronic and paper). Data was entered and analyzed with SPSS version 26, and achi-square test was used to assess the association of independent variables with the dependentvariable. Bi-variate and multivariate logistic regression were used to determine a significantcorrelation between independent and dependent variables. Results: A total of 152 patients were included in the study. The median age was 22.5 years (IQR18, 30.8), and 59.9% of them were male. The pediatric inspired ALL CL10403 regimen was usedfor treatment in 84.2% of cases, while CALGB 8811 protocol was used in the rest. Theprevalence of thrombotic events in acute lymphoblastic leukemia patients treated with an L-asparaginase containing regimen was 11%. All of the events were venous, and cerebral venousthrombosis was the commonest site of thrombosis, accounting for 41.2% of events, followed bylower extremity deep vein thrombosis. The majority of events were symptomatic, and 44.4%occurred during remission induction.Longer time to achieve complete remission (>4 weeks), adjusted odds ratio AOR 4.8 (95% CI =1.10, 20.72), and age ≥40 years AOR 10.4(95% CI = 1.47, 75.0) were significantly associatedwith an increased risk of thrombotic events. Mortality was higher in patients with thromboticevents (47%) when compared to patients who did not develop thrombosis (41.4%) but was notstatistically significant (P- value = 0.618). Mortality directly attributed to thrombotic events was23.5% among patients who developed thrombosis. Conclusion- This study showed that the risk of L-asparginase associated thrombosis in resourcelimited settings like ours is comparable with previous reports from other parts of the world.Longer time to achieve remission and age above 40 was associated with increased risk ofthrombosis.
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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
    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 theShortInflammatory 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), notbeing in remission (AOR= 14.62; CI 95%: 2.31-92.53; p= 0.004), comorbidity (AOR= 9.18 ;CI95%: 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 activityno hospitalization, no EIMs, and nocomorbidity;earlydiagnosis,employment,andhighereducational level.
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    Attributes and Factors Associated with Long COVID in Patients Hospitalized for Acute COVID-19: A Retrospective Cohort Study
    (Addis Ababa University, 2024-04) Minassie Bethlehem Berhanu; Kebede Dawit; AmogneWondwossen
    Background: It is now recognized that many patients have persistent symptoms after recovery from acuteCOVID-19 infection, an infection caused by the coronavirus SARS-CoV-2. This constellation of symptoms,commonly known in the literature as ‘Long COVID’ or ‘Post COVID-19 Condition’, may manifest with a wide range of physical and cognitive/psychological symptoms. Although the mechanisms are still poorlyunderstood, much effort has been made in the scientific community to characterize this condition better.However, there is a lack of data on the frequency, risk factors, and severity of Long COVID in Africa. Objective: To assess the prevalence, attributes, and factors associated with Long COVID in patients hospitalized for acute COVID 19 Method: This was a retrospective chart review (Electronic Medical Records [EMR]) of patients who were discharged after hospitalization for acute COVID-19 infection from Hallelujah General Hospital (one of thefirst private hospitals where patients were treated for COVID-19). The hospital’s database was searchedfor patients who were hospitalized for acute COVID-19 infection from March 2020 to December 2022.Two hundred and forty-seven participants who underwent follow-up beginning four weeks after symptomonset were assessed for Long COVID. A structured questionnaire was used to collect data about their sociodemographic, clinical, laboratory, and imaging information during their admission and follow-up. The data was entered into SPSS version 29 for analysis. The relationship between the independent and dependent variables was explored through binary logistic regression. Results: The mean age of the participants was 58.5 (±13.9) years, and 160 (64.8%) were males. One hundred seventy-eight (72.1%) participants had at least one persisting symptom 4 weeks post symptom onset, at a median follow up time of 35 (IQR 32-40) days. The most frequently reported symptoms were fatigue (41.7%), shortness of breath (31.2%), cough (27.1%), and sleep disturbances (15%). Duration of symptoms more than 7 days before admission [aOR = 1.97; CI95% = 1.04 to 3.75; P=0.038] and length of stay more than 10 days in the hospital [aOR = 2.62; CI95% =1.20 to 5.72; P=0.016] were found to be significantly associated with Long COVID on multivariate analysis. Conclusion: There is a high prevalence of Long COVID among patients hospitalized for acute COVID-19.Those who had longer duration of symptoms before admission and a longer stay in the hospital appear to have a higher risk.
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    The Proportion, Clinical characteristics, complications, Treatment Pattern & outcomes of Ph-negative Classic Myeloproliferative Neoplasms at TASH: A Hospital Based Retrospective Cross-Sectional Study.
    (Addis Ababa University, 2024-03) Yirgu Dahlak Teshome; Abdela Fozia
    Background Haematological malignancies are among non-communicable diseases that are becoming increasingly more common both globally and in our country, Ethiopia. Out of these Philadelphia-negative classic myeloproliferative neoplasms, affecting the elderly population group of the society is seen in increased frequency in outpatient department. This is due to progressively rising global population age and life expectancy, so it is becoming an important public health problem worldwide.Investigations done with a small number of African countries indicated a gradually increasing frequency of philadelphia-negative MPNs in the continent. In growing country, there are few studiesthat truly define the clinical feature of these patients. Especially in Ethiopia there is no data regardingPh negative classic MPNs. This will aid to estimate the characteristics, treatment pattern & outcomesbased on a local data of patients with diagnosed Philadelphia-negative classic MPNs. Objective: The main objective of the study istomeasurthelinical characteristics, complications,treatment pattern & outcomes of Ph negative classic MPN patients. Methods: A single cantered hospital based retrospective cross sectional study was conducted athaematology follow up clinic from January 1, 2019 to December 312023data was collected and analyzed with IBM SPSS version27 Result: A total of 151 study participants with the age of 18 & above were included in this study. 57%( 86/151) of study participants are male & 43% are females, with a male to female ratio of 1.3:1.58.3% of PV patients were male, 56.7% of ET patients were females. Similarly 72.2% of PMF caseswere male. PV was the most common (68%) with a median age at diagnosis of 56 years, followed byET (20%, median age 55.5 years) and Primary Myelofibrosis (12%, median age 60 years). Femalepatients had mostly a history of ET; a higher number of male patients had a history of PV and PMF.Among PV cases, the main presenting symptoms were headache/vertigo (37%) followed by fatigue(31.4%), early satiety/ LUQ pain (31%) & splenomegaly was found in 28%. In ET, the mainpresenting symptoms were fatigue (36.8%), headache, joint pain, and splenomegaly being the othercommon presenting symptoms Among the PMF patients’, the main presenting symptoms weresymptoms of anaemia (40%), fatigue (38%), constitutional symptoms (35%), early satiety/ LUQ pain(35%) & Splenomegaly (72%). JAK2V617 mutation was positive in 92%, 54%, and 44.4% of PV, ETand PMF patients, respectively. The frequency of thrombotic events were high in PV patientscompared to other subtypes (PV=33%, ET=26% anPMF=5.6%) and venous thrombosis beinghigher than arterial. In contrast to other subtypes, bleeding was prevalent in PMF patients(PMF=11%). Thrombotic complication was high in high risk PV & ET patients, while Jak 2 mutationstatus didn’t affect thrombosis risk. Phlebotomy, ASA and hydroxyurea, Thalidomide/prednisoloneand transfusion support were the treatment options used. The five year survival rate of Ph –ve MPNswith median diagnosis of 27months were 81%, which was higher for ET (95%), PV=84% and low for PMF (median survival rate is 4 years). Conclusion: This study showed that, PV is a more prevalent ph negative MPN than ET and PMF.Thrombosis is an important complication in these patients, especially in PV patients occurring in~1/3rd of the cases. Based on our findings we emphasize that that Ph negative MPNs should beconsidered & proper evaluation should follow in patient with unexplained abnormalities in hematologic parameters.
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    The Magnitude of Premature Coronary Artery Disease and its Associated Factors among Patients who Underwent Coronary Angiography at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2024-02) Ayanaw Daniel; Gutet Senbeta
    Background: Coronary artery disease is a major cause of morbidity and mortality in developing countries with occurrence at a young age and association with diverse cardiovascular risk factors. Objective: The objective of this study was to assess the magnitude of premature coronary artery disease and its associated factors among patients who underwent coronary angiography at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. Method: A retrospective cross-sectional study was conducted at TASH, Addis Ababa, Ethiopia,on 218 patients who underwent coronary angiography between May 2017 and June 2023. Data on patients’ sociodemographic characteristics, cardiovascular disease risk factors, metabolic profile, cardiac imaging, and angiographic findings was collected using a structured dataabstraction checklist from patient medical records. Descriptive statistics and logistic regression were used to assess the association between dependent and independent variables using SPSS version 25. An adjusted odds ratio with a 95% confidence interval was used to show the strength of the association, while a p-value<0.05 was used to declare the significance of the association. Result: A total of 218 patients’ medical records were analyzed and revealed a median age of 55years with male predominance (82.1%). Forty (18.3%) of patients were diagnosed to have premature coronary artery disease (CAD) among a hundred fifty-eight (72.5 %) patients who had angiographically confirmed CAD. Male sex (AOR=3.5, 95%CI: 1.492,8.367), hypertension(AOR=2.8, 95% CI: 1.162,6.767), low HDL (AOR=2.3, 95% CI:1.025,5.191) and admission diagnosis of chronic coronary syndrome (AOR=2.2, 95% CI: 1.035,4.762) were significantly associated with premature CAD. Conclusion: The magnitude of premature coronary artery disease at TASH is high. It is significantly associated with male sex, hypertension, low HDL, and admission diagnosis of chronic coronary syndrome. Tremendous effort should be applied to preventing, early detection,and control of hypertension and Low HDL at the community and individual level.