Clinical trial recruitment of people who speak languages other than english: a children's oncology group report.

BACKGROUND: Persons who speak languages other than English (LOE) are underrepresented in clinical trials; this may be due in part to inadequate multilevel resources. We conducted a survey of institutions affiliated with the Children's Oncology Group (COG) to characterize current research recruitment practices and resources regarding translation and interpretation services. METHODS: In October 2022, a 20-item survey was distributed electronically to institutions affiliated with COG to assess consent practices and resources for recruiting participants who speak LOE to COG trials. Descriptive statistics were used to summarize responses; responses were compared by institution size, type, and respondent role. RESULTS: The survey was sent to a total of 230 institutions, and the response rate was 60% (n = 139). In total, 60% (n = 83) had access to short form consents. Full consent form translation was required at 50% of institutions, and 12% of Institutional Review Boards restricted use of centrally translated consent forms. Forty-six percent of institutions reported insufficient funding to support translation costs; 15% had access to no-cost translation services. Forty-four percent (n = 61) were required to use in-person interpreters for consent discussions; the most cited barrier to obtaining consent was lack of available in-person interpreters (56%). Forty-six percent (n = 69) reported that recruiting persons who speak LOE to clinical trials was somewhat or very difficult. CONCLUSIONS: Institutions affiliated with COG face resource-specific challenges that impede recruitment of participants who speak LOE in clinical trials. These findings indicate an urgent need to identify strategies aimed at reducing recruitment barriers to ensure equitable access to clinical trials.

Toward identification and intervention to address financial toxicity and unmet health-related social needs among adolescents and emerging adults with cancer and their caregivers: A cross-cultural perspective.

PURPOSE: We qualitatively explored the unique needs and preferences for financial toxicity screening and interventions to address financial toxicity among adolescents and emerging adults (younger AYAs: 15-25 years) with cancer and their caregivers. METHODS: We recruited English- or Spanish-speaking younger AYAs who were treated for cancer within the past 2 years and their caregivers. Semi-structured interviews were conducted to explore preferences for screening and interventional study development to address financial toxicity. The data were coded using conventional content analysis. Codes were reviewed with the study team, and interviews continued until saturation was reached; codes were consolidated into categories and themes during consensus discussions. RESULTS: We interviewed 17 participants; nine were younger AYAs. Seven of the 17 preferred to speak Spanish. We identified three cross-cutting themes: burden, support, and routine, consistent, and clear. The burden came in the form of unexpected costs such as transportation to appointments, as well as emotional burdens such as AYAs worrying about how much their family sacrificed for their care or caregivers worrying about the AYA's physical and financial future. Support, in the form of familial, community, healthcare institution, and insurance, was critical to mitigating the effects of financial toxicity in this population. Participants emphasized the importance of meeting individual financial needs by routinely and consistently asking about financial factors and providing clear guidance to navigate these needs. CONCLUSION: Younger AYAs and their caregivers experience significant financial challenges and unmet health-related social needs during cancer treatment and often rely on key supports to alleviate these unmet needs. When developing interventions to mitigate financial toxicity, clinicians and health systems should prioritize clear, consistent, and tailorable approaches to support younger AYA cancer survivors and their families.

Diagnostic accuracy of barium enema versus full-thickness rectal biopsy in children with clinically suspected Hirschsprung's disease: A comparative cross-sectional study.

Background and Aims: Hirschsprung's disease (HSD) remains a common cause of pediatric intestinal obstruction. Barium contrast enema (BE) is the primary imaging modality for the evaluation of clinically suspected cases. Here, we aimed to assess the diagnostic accuracy of BE in children with clinically suspected HSD when compared to a gold standard full-thickness rectal biopsy (FTRB). Methods: We recruited and consecutively enrolled children with clinically suspected HSD at two tertiary teaching hospitals. Participants underwent BE imaging and two radiologists interpreted the findings independently. Participants further underwent FTRB by pediatric surgeons as the confirmatory test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) with the area under the curve (AUC) were calculated on Stata version 14.2, taking FTRB as the standard. Results: We enrolled 55 cases, of which 49 completed the evaluation and were included in the final analysis. The median age was 9.4 months (interquartile range: 2-24], with a male-to-female ratio of 4.4:1. The sensitivity, specificity, PPV, and NPV of BE were 0.95 (95% confidence interval [CI] [0.81-0.99]), 0.73 (95% CI [0.39-0.94]), 0.92 (95% CI [0.82-0.97]), and 0.80 (95% CI [0.50-0.94]), respectively. On AUC, the diagnostic accuracy of BE compared to the confirmatory FTRB was 0.84 (95% CI [0.69-0.98]). The diagnostic accuracy was higher in neonates (ROC: 1.00) when compared to infants (ROC: 0.83) or those above 1 year of age (ROC: 0.798). HSD-suggestive BE findings were associated with absence of ganglion cells on FTRB (χ 2 = 23.301, p < 0.001). Inverted rectosigmoid ratio and transition zone were more sensitive in detecting HSD of 0.92 (95% CI [0.74-0.98]) and 0.81 (95% CI [0.63-0.92]), respectively. Conclusion: BE is sufficiently accurate in the diagnosis of children with HSD, suggesting BE would likely be used to inform surgical management in settings where confirmatory biopsy is lacking. However, clinical judgment is warranted in interpreting negative BE findings.

Effects of sedatives on radiologic enema reduction in children with ileocolic intussusception: A systematic review and meta-analysis.

BACKGROUND: In children with ileocolic intussusception, sedatives such as midazolam, ketamine and propofol may facilitate radiologic enema reduction, but studies on their separate and joint effects remain controversial. OBJECTIVES: We aimed to systematically analyze studies for the effects of sedatives on the radiologic reduction of ileocolic intussusception in children. METHODS: We searched PubMed, EMBASE, CINAHL, Scopus and Web of Science from database inception through March 2023 for articles that enrolled children with ileocolic intussusception who underwent non-operative pneumatic or hydrostatic enema reduction under ultrasound or fluoroscopic guidance with or without the use of sedatives. The primary and secondary outcomes were success rate in radiologic reduction of ileocolic intussusception and risk of perforation, respectively. Effect estimates from the individual studies were extracted and combined using the Hartung-Knapp-Sidik-Jonkman log-odds random-effects model. Heterogeneity between studies was checked using Cochran's Q test and the I2 statistic. RESULTS: A total of 17 studies with 2094 participants were included in the final review, of which 15 were included in the meta-analysis. Nine studies reported on the success rate of radiologic reduction performed under sedation in all participants, while six studies compared the success rate in two patient groups undergoing the procedure with or without sedation. The pooled success rate of non-operative reduction under sedation was 87 % (95 % CI: 80-95 %), P = 0.000 with considerable heterogeneity (I2 = 85 %). A higher success rate of 94 % (95 % CI: 88-99 %) and homogeneity (I2 = 12 %) were found in studies with pneumatic enema reduction. Among comparative studies, the odds of success of non-operative reduction were increased when the procedure was performed under sedation, with a pooled odds ratio of 2.41 (95 % CI: 1.27-4.57), P = 0.010 and moderate heterogeneity (I2 = 60 %). In a sensitivity analysis, homogeneity was found between analyzed studies when two outliers were excluded (I2 = 0.73 %). The risk of perforation was not significantly different (OR 1.52, 95 % CI: 0.09-23.34), P = 0.764 indicating small study effects. No publication, bias was detected on visual inspection of the funnel plots or the Begg's and Egger's bias tests. Most studies were categorized as having a low risk of bias using Joanna Briggs Institute checklists. CONCLUSIONS: In selected patient groups, sedation can increase the success rate of radiologic enema reduction in children with ileocolic intussusception without evidence of increased risk of perforation. Systematic review protocol registration: PROSPERO CRD42023404887.

A Brief Screening Tool for Assessment of Financial Toxicity.

OBJECTIVES: To explore the utility of brief financial screening items to facilitate the implementation of routine financial toxicity screening. SAMPLE & SETTING: 50 women with breast cancer completed a one-time survey that included the Comprehensive Score for Financial Toxicity (COST): A FACIT Measure of Financial Toxicity, a visual analog scale, and a brief sociodemographic questionnaire. METHODS & VARIABLES: Survey responses were examined to assess the psychometric properties of individual COST items and the visual analog scale by calculating Cronbach's alpha and Pearson's correlation coefficients. RESULTS: The mean COST was 21.4, and 27 respondents met criteria for financial toxicity (a COST lower than 22). As expected, all items correlated strongly to the overall COST, but four items (items 3, 6, 8, and 10) performed strongest (r > 0.8). IMPLICATIONS FOR NURSING: This study provides evidence for individual COST items to be used as brief screening items. Future research should test the utility of these items in larger sample sizes with a more diverse representation of patients by age, race, ethnicity, and tumor type and stage.

A Five-Year (2016-2020) Trend Analysis of Malaria Surveillance Data in Oromia Regional State, Ethiopia.

Background: Continuous malaria surveillance data analysis plays a significant role in monitoring trends over time and evaluating the effectiveness of malaria prevention and control programs. Hence, this study was part of an effort to achieve this goal. This study's main aim was to analyse five years (2016-2020) of malaria surveillance data in the Oromia Region, Ethiopia. Methods: A descriptive cross-sectional study design was used to analyse the five-year (2016-2020) trend of malaria cases in the Oromia Regional State, Ethiopia. Results: A total of 5,843,373malaria suspected cases were reported during the five-year period. Among the total reported cases, 727,738 were a total of both clinical and parasitological confirmed cases. The average total malaria annual parasite incidence (API) was 4 per 1,000 persons. The highest malaria cases were observed during the spring and summer seasons. Conclusions and Recommendation. Trends of total clinical and confirmed malaria cases decreased from year to year except for the recent year with an exceptional variability in 2019. The highest or peak of malaria cases was observed during spring season (September-November). Malaria indicator-based performance plans and achievements should be regularly and strictly reviewed and evaluated at each level.

Mapping digital health ecosystems in Africa in the context of endemic infectious and non-communicable diseases.

Investments in digital health technologies such as artificial intelligence, wearable devices, and telemedicine may support Africa achieve United Nations (UN) Sustainable Development Goal for Health by 2030. We aimed to characterize and map digital health ecosystems of all 54 countries in Africa in the context of endemic infectious and non-communicable diseases (ID and NCD). We performed a cross-national ecological analysis of digital health ecosystems using 20-year data from the World Bank, UN Economic Commission for Africa, World Health Organization, and Joint UN Programme on HIV/AIDS. Spearman's rank correlation coefficients were used to characterize ecological correlations between exposure (technology characteristics) and outcome (IDs and NCDs incidence/mortality) variables. Weighted linear combination model was used as the decision rule, combining disease burden, technology access, and economy, to explain, rank, and map digital health ecosystems of a given country. The perspective of our analysis was to support government decision-making. The 20-year trend showed that technology characteristics have been steadily growing in Africa, including internet access, mobile cellular and fixed broadband subscriptions, high-technology manufacturing, GDP per capita, and adult literacy, while many countries have been overwhelmed by a double burden of IDs and NCDs. Inverse correlations exist between technology characteristics and ID burdens, such as fixed broadband subscription and incidence of tuberculosis and malaria, or GDP per capita and incidence of tuberculosis and malaria. Based on our models, countries that should prioritize digital health investments were South Africa, Nigeria, and Tanzania for HIV; Nigeria, South Africa, and Democratic Republic of the Congo (DROC) for tuberculosis; DROC, Nigeria, and Uganda for malaria; and Egypt, Nigeria, and Ethiopia for endemic NCDs including diabetes, cardiovascular disease, respiratory diseases, and malignancies. Countries such as Kenya, Ethiopia, Zambia, Zimbabwe, Angola, and Mozambique were also highly affected by endemic IDs. By mapping digital health ecosystems in Africa, this study provides strategic guidance about where governments should prioritize digital health technology investments that require preliminary analysis of country-specific contexts to bring about sustainable health and economic returns. Building digital infrastructure should be a key part of economic development programs in countries with high disease burdens to ensure more equitable health outcomes. Though infrastructure developments alongside digital health technologies are the responsibility of governments, global health initiatives can cultivate digital health interventions substantially by bridging knowledge and investment gaps, both through technology transfer for local production and negotiation of prices for large-scale deployment of the most impactful digital health technologies.

Digital health in the era of COVID-19: Reshaping the next generation of healthcare.

COVID-19 is one of the most deadly diseases to have stricken us in recent decades. In the fight against this disease, governments and stakeholders require all the assistance they can get from various systems, including digital health interventions. Digital health technologies are supporting the tracking of the COVID-19 outbreak, diagnosing patients, expediting the process of finding potential medicines and vaccines, and disinfecting the environment, The establishment of electronic medical and health records, computerized clinical decision support systems, telemedicine, and mobile health have shown the potential to strengthen the healthcare system. Recently, these technologies have aided the health sector in a variety of ways, including prevention, early diagnosis, treatment adherence, medication safety, care coordination, documentation, data management, outbreak tracking, and pandemic surveillance. On the other hand, implementation of such technologies has questions of cost, compatibility with existing systems, disruption in patient-provider interactions, and sustainability, calling for more evidence on clinical utility and economic evaluations to help shape the next generation of healthcare. This paper argues how digital health interventions assist in the fight against COVID-19 and their opportunities, implications, and limitations.

Prevalence of cryptococcal meningitis among people living with human immuno-deficiency virus and predictors of mortality in adults on induction therapy in Africa: A systematic review and meta-analysis.

Background: Cryptococcal meningitis (CM) is a leading cause of adult meningitis in countries with a high burden of HIV. It has remained a significant cause of morbidity and mortality in Africa despite the extensive rollout of HIV antiretroviral therapy (ART). This study aimed to systematically synthesize the evidence on the prevalence of CM among people living with HIV (PLWH) and its predictors of mortality among adults who are on induction antifungal therapy in Africa. Methods: PubMed/MEDLINE, Embase, and Google Scholar were searched for randomized clinical trials or observational studies published in Africa from 1995 to April 2021. Pooled prevalence of CM among PLWH was calculated using R-studio Version 1.4.1717 software and the data extracted from eligible studies were pooled as percentage with a 95% confidence interval (CI). Predictors of mortality among adults on induction antifungal therapy were synthesized narratively. Results: Out of 364 studies identified, 17 eligible articles were included in the analysis. The prevalence of CM among PLWH in Africa was 5.11% (95% CI 2.71-9.43%; participants = 10,813; studies = 9; I 2 = 97%). In the subgroup analysis, the prevalence was 12.9% (95% CI 4.883-30.0; participants = 533; studies = 3; I 2 = 63%) in the years 1995-2010 and 3.18% (95% CI 1.54-6.45; participants = 10,280; studies = 6; I 2 = 98%) in the years 2011-2021, with the prevalence significantly decreased by 51% (p = 0.02). Predictors of mortality were fluconazole monotherapy, focal neurological signs, low Glasgow coma scale, and delayed diagnosis of CM at varied timepoint. Conclusion: Prevalence of CM has significantly decreased from 1996-2010 to 2011-2021 among PLWH on induction therapy in Africa. Fluconazole monotherapy, focal neurological symptoms, diastolic blood pressure < 60 mmHg, and concurrent tuberculosis coinfection were significant predictors of mortality at 2- and 10-weeks timepoints. CM remains a major concern among PLWH despite increases in ART coverage. Improved access to effective antifungal therapies is needed in Africa for timely initiation of combination induction therapy and better treatment outcomes of PLWH. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=254113], identifier [CRD42021254113].

Meriandra dianthera Aqueous Extract and Its Fraction Prevents Blood Coagulation by Specifically Inhibiting the Intrinsic Coagulation Pathway: An in vitro Study.

Background: Currently, cardiovascular disorders are the primary cause of mortality in the world and constitute a serious medical problem. Blood coagulation is an essential process to prevent excessive blood loss through injured blood vessels; however, abnormal blood clotting in the blood vessels can result in fatal cardiovascular disorders. This study investigated the in vitro anticoagulant activity of Meriandra dianthera crude extract and its fractions and their erythrocyte membrane stabilizing activity. Methods: The plant leaves were extracted by a decoction method and were further fractionated by a liquid-liquid partition with a solvent of crescent polarity. The in vitro anticoagulant activity of the plant extract and its fractions was assessed by PT and APTT assays, while the membrane stabilizing activity was determined through hypotonic induced hemolysis. Results: The crude aqueous leaf extract of Meriandra dianthera significantly (P < 0.001) prolonged the intrinsic clotting pathway measured by APTT by specifically acting on the intrinsic coagulation pathway. By using liquid-liquid fractionation, the residual aqueous fraction was identified as the fraction responsible for the anticoagulant activity of the crude extract as it significantly (P<0.001) prolonged APTT while the other fractions failed. Both the crude extract and its aqueous residue fraction did not affect the extrinsic coagulation pathway measured by PT. In the membrane stabilizing assay, crude extract and aqueous residue fraction showed the highest membrane stabilizing activity. Conclusion: The crude extract and its aqueous residue fraction showed a potent in vitro anticoagulant and membrane stabilizing activity, which shows the potential of the plant's leaves as a new source of bioactive molecules for coagulation-related disorders.

Pertussis outbreak investigation in Northwest Ethiopia: A community based study.

BACKGROUND: Pertussis or whooping cough is a vaccine-preventable, highly contagious, respiratory illness caused by Bordetella pertussis or Bordetella parapertussis. Infants and young children have remained most susceptible to pertussis-related morbidity and mortality. The aim of this study was to investigate pertussis infection and analyze the associated factors involved in the occurrence of the cases. METHODS: Community-based case-control was conducted in Dahena district, Northwest Ethiopia, from March 27-April 30, 2019. All cases ages 1-18 years old were identified by using the clinical standard case definition of pertussis adopted from World Health Organization (WHO). Data was collected using a structured questionnaire via face-to-face interviews. The data collected was cleaned, coded and entered into Epi info version 7.2.1.0 and exported to SPSS version 23 for statistical analysis. Bivariable and multivariable logistic regression analysis were employed to identify predictors. Factors with a p-value of < 0.05 were considered as independent risk factors of pertussis infection in multivariable logistic regression analysis. RESULT: A total of 122 pertussis cases were enrolled from the Azila cluster of the Dahena district. Of these figures, 64 (52.5%) were females. The overall attack rate (AR) of pertussis cases in the cluster was 8.6/10000 population. The sex-specific AR of females was 8.9/10000 population. The multivariable logistic regression analysis showed that; being unvaccinated 4.17 (AOR, 4.17, 95% CI, 1.914-9.091), contact to cases 2.93 (AOR: 2.93, 95% CI 1.223-6.996), and living in a house with no window 2.6 (AOR: 2.6(95% CI 1.071 to 6.322) were the independent significantly risk factors for pertussis infection. CONCLUSION: The contributing factor for pertussis infection was associated with case-contact, living in the house without windows and being unvaccinated. Wag Hemra Zone and Dahena district health office should encourage the vaccination activities of the cluster health center and awareness for the community should be practiced to limit disease transmission.

Factors associated with dyslipidemia and its prevalence among Awash wine factory employees, Addis Ababa, Ethiopia: a cross-sectional study.

BACKGROUND: Dyslipidemia is a highly prevalent and modifiable risk factor for atherosclerotic cardiovascular diseases. Though the problem is significant in Ethiopia, available data in this regard is very poor among alcoholic beverage industrial workers. This study aimed to assess factors associated with dyslipidemia and its prevalence among Awash wine factory employees in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted among 335 randomly selected employees of Awash wine factory, Addis Ababa, Ethiopia from January to February 2021. Data was collected by a face-to-face interview technique using the WHO STEPwise approach. Data were entered and analyzed using Epi Info 7 and SPSS version 26, respectively. Both bivariable and multivariable logistic regression analyses were performed to identify factors associated with dyslipidemia. All statistical tests were declared significant at p-value < 0.05. RESULTS: The overall prevalence of dyslipidemia was 67.8% (95% CI 62.5-72.7%). Elevated total cholesterol, elevated triglycerides, reduced high-density lipoprotein, and elevated low-density lipoprotein was found in 25.4%, 33.4%, 50.7%, and 21.5% of participants, respectively. Dyslipidemia was significantly associated with age group 30-39 years (AOR = 2.51; 95% CI 1.16-5.44, p = 0.019), ≥ 40 years (AOR = 6.45; 95% CI 2.01-20.71, p = 0.002), current alcohol consumption (AOR = 3.37; 95% CI 1.70-6.66, p < 0.001), eating vegetables < 2 days per week (AOR = 2.89; 95% CI 1.54-5.43, p = 0.001), sitting duration of > 4 h per day (AOR = 1.96; 95% CI 1.03-3.74, p = 0.041), and raised waist circumference (AOR = 4.56; 95% CI 2.07-10.08, p < 0.001). CONCLUSIONS: High prevalence of dyslipidemia was found among Awash wine factory employees in Addis Ababa. Periodic screening of high-risk groups along with effective health promotion and education which encourages a healthy lifestyle is essential.

Factors associated with recent HIV testing uptake and HIV-positive serostatus among female sex workers in Addis Ababa, Ethiopia.

The HIV burden is high among female sex workers (FSW) in Ethiopia, yet HIV testing coverage is suboptimal. We conducted a cross-sectional survey among 137 FSW in Addis Ababa. We examined factors related to recent HIV testing and self-reported HIV serostatus using logistic regression. HIV prevalence was 10%; and among HIV-negative participants, 63% reported recent HIV testing. Involvement in sex work for ≥5 years (aOR 3.25; 95% CI 1.22, 8.69; p-value 0.02) and hormonal contraceptive use (aOR 3.37; 95% CI 1.09, 10.41; p-value 0.03) were significantly associated with recent HIV testing. Involvement in sex work for ≥5 years (aOR 13.13, 95% CI 1.31 132.01, p-value 0.03), drug use (aOR 8.02; 95% CI 1.36, 47.31; p-value 0.02), and having a job other than sex work (aOR 122.05, 95% CI 2.97 > 999.99, p-value 0.01) were significantly associated with self-reported HIV-positive serostatus. These results identify areas to target future HIV risk-reduction interventions for FSW in Ethiopia.

Impact of the COVID-19 pandemic lockdown on weight status and factors associated with weight gain among adults in Massachusetts.

The study aims to examine the impact of the coronavirus disease-2019 (COVID-19) pandemic lockdown on weight, overweight and obesity, and identify factors associated with weight gain. At a safety net health system in Massachusetts, 11 534 adults were retrospectively followed within 3 months of the COVID-19 lockdown. Chi-square and 95% confidence intervals (CI) were reported for categorical and continues variables, respectively. Multivariate analyses were performed to identify factors associated with weight gain (≥0.01 kg and 5%). During the lockdown period, greater proportion of women gained weight compared to men (46.1% vs 40.6%, P < .01). The obesity rate after the lockdown increased among women (40.7%-41.7, P < .01) but decreased among men (39.6%-38.6, P < .01) compared to before the lockdown. Post-lockdown obesity rates increased among Haitian (51.2%-55.0%, P < .01) and Hispanic women (50.7%-51.8%, P < .01). More than 5% weight gain was associated with 18 to 39 vs ≥60 years of age (OR = 1.45, 95% CI = 1.07, 1.97), food and housing insecurity (OR = 1.44, 95% CI = 1.05, 1.97) and tobacco use (OR = 1.38, 95% CI = 1.07, 1.78) among men; and 18 to 39 vs ≥60 years of age (OR = 1.55, 95% CI = 1.25, 1.91), Hispanics (OR = 1.25, 95% CI = 1.01, 1.54), Brazilians (OR = 1.22, 95% CI = 1.03, 1.45), and tobacco use (OR = 1.36, 95% CI = 1.10, 1.69) among women. During the COVID-19 lockdown, significant proportion of participants gained weight, but subgroup variations existed. Our study can inform healthcare professionals about the impact of the lockdown on unhealthy weight gain and identify vulnerable populations. Strategies are needed to combat unhealthy weight gain during and beyond the pandemic.

A five-year trend analysis of malaria surveillance data in selected zones of Amhara region, Northwest Ethiopia.

BACKGROUND: Trend analysis of malaria surveillance data is essential to inform stakeholders on progress towards malaria control. From the total 387,096 cases of malaria reported in Amhara region in 2017, 167,079 (43.2%) cases were in Central, North and West Gondar zones. From this total figure of zones, 15,445 (9.2%) were ≤ 5 years which contributes 4% of cases in the region. So, the purpose of this study was to analyze trends of malaria parasite in Selected Zones of Amhara Region, Northwest Ethiopia. METHODS: A Retrospective study was conducted on purposely selected Central, North and West Gondar zones from July 1-30/ 2018. Data were collected, entered, cleaned, analyzed and interpreted using Microsoft Excel-2010. Different tables, figures and maps were used to present results. RESULT: A total of 2,827,722 cases have been received a diagnostic test of; Microscopy 1,712,193(60.56%) and Rapid Diagnostic Test (RDT) 1,115,529(39.44%). Trends of total patients treated as confirmed and clinical malaria cases in July 2017-June 2018 were decreased to 139,297 (14%) as compared from July 2015-June 2016, 249,571(25%). From total cases received diagnostic tests only 1,003,391 (36%) were confirmed and clinical cases treated with antimalaria. Of these Plasmodium falciparum and vivax malaria cases were confirmed to be 1002,946 (99.96%) and clinical malaria cases were 445(0.04%), respectively. CONCLUSION: Risk of infection and diagnostic effort were high in West Gondar Zone. The Amhara public health institute including health Bureau, stakeholders and all responsible bodies should give special standing to highest malaria districts of West Gondar zone.

Disease burden and associated risk factors for metabolic syndrome among adults in Ethiopia.

BACKGROUND: Metabolic Syndrome (MetS) and Non-communicable diseases (NCDs) are alarmingly increasing in low-income countries. Yet, very limited is known about the prevalence and risk factors associated with MetS in Ethiopia. METHODS: A cross-sectional study was conducted among adult outpatients (N = 325) at St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. The study was conducted in accordance with STEPwise approach of the World Health Organization. MetS was defined using modified National Cholesterol Education Program's Adult Treatment Panel III criteria. Univariate and multivariate analyses were performed. RESULTS: The overall prevalence of MetS was 20.3%. Among the 325 participants, 76.9% had at least one MetS components. Reduced high-density lipoprotein cholesterol was the most common MetS component at 48.6%, followed by elevated blood pressure at 36.3%, and elevated fasting glucose at 32.6%. Older age (odds ratio [OR] = 4.15; 95% confidence interval [CI] = 1.43-12.04), Amhara ethnicity (OR = 2.36; 95%CI = 1.14-4.88), overweight status (OR = 2.21; 95%CI = 1.03-4.71), higher income (OR = 3.31; 95%CI = 1.11-9.84) and higher education levels (OR = 2.19; 95%CI = 1.05-4.59) were risk factors for MetS. CONCLUSION: The disease burden of MetS among Ethiopians is high, and is associated with age, weight, income, education and ethnicity. Comprehensive screening and assessment of MetS is needed along with effective preventive and treatment strategies in low-income countries, such as Ethiopia.

Diagnosis and Risk Factors of Advantage Cancers in Ethiopia.

BACKGROUND: Cancer is one of the leading causes of morbidity and mortality worldwide. Yet, limited is known about patterns of cancer and risk factors for advanced stage cancers in Ethiopia. METHODS: A cross-sectional study was conducted on 919 patients with biopsy-confirmed cancers at Tikur Anbessa Hospital in Ethiopia, 2010 to 2014. Pearson chi-square test, t-test, analysis of variance and multivariate logistic regression analyses were performed. RESULTS: The majority of the patients were females (72.4%). The commonest malignancies among males were bone and soft tissue (16.5%), colorectal (12.2%), and esophageal (9.1%). Among females, the most common cancers were cervical (39.7%), breast (18.3%), and ovarian (7.1%); of these, 41.7%, 59.0%, and 42.6% were diagnosed at advanced stages, respectively. Females had more advanced stage cancers at diagnosis than males (37.6% vs. 24.8%, P < 0.01). Among males, 46.7% of prostate and 29.0% of colorectal cancers were in advanced stages at the time of diagnosis. Delay in presentation from onset of symptoms was associated with advanced cancer among females (OR = 3.21; 95% CI = 1.69-6.10). Prostate cancer among males (OR = 5.22; 95% CI = 1.26-21.60) and breast cancer among females (OR = 1.93; 95% CI = 1.23-3.03) were more likely to be diagnosed at advanced stages. CONCLUSIONS: Cancers with effective screening tests are common in Ethiopia and significant proportions of these were diagnosed at advanced stages, typically several months after onset of symptoms. Timely access to preventive care along with effective educational and screening strategies is needed in Ethiopia for early detection and treatment of common malignancies, such as cervical, breast and colorectal cancers.

Prevalence of initiation of complementary feeding at 6 months of age and associated factors among mothers of children aged 6 to 24 months in Addis Ababa, Ethiopia.

BACKGROUND: Inappropriate complementary feeding practices are a major contributor to poor nutritional status of children under 2 years old in Ethiopia. The Ethiopian Ministry of Health recommends that continued breast feeding beyond 6 months should be accompanied by consumption of nutritionally adequate, safe and appropriate complementary foods. The aim of this study was to determine the prevalence of initiation of complementary feeding at 6 months of age and its associated factors among mothers of children aged 6 to 24 months in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted during January and February of 2017 among 600 mothers with children aged 6 to 24 months in Addis Ababa City. The study participants were selected using systematic random sampling technique through a multistage sampling technique. Data were collected using a pre-tested and structured questionnaire by trained data collectors. Data were entered and analyzed using EpiInfo 7 and SPSS version 21, respectively. We used multivariable binary logistic regression to model the associations of selected independent variables with initiation of complementary feeding at 6 months of age. RESULTS: Approximately 83% of mothers initiated feeding of complementary foods to their child at 6 months of age. This practice was associated with maternal education (primary education v. no education) Adjusted Odds Ratio (AOR) (95%CI): 2.26(1.19, 4.43)), and home delivery of the child (AOR (95%CI): 0.32 (0.12, 0.82)). CONCLUSION: Most mothers in the study initiated feeding of complementary foods to their children at 6 months of age. To further improve complementary feeding practices, mothers should be educated on the benefits of introducing complementary feeding at 6 months of age and the consequences of early or late initiation of complementary feeding on child health.