Comparison of Hematological and Biochemical Profile Changes in Pre- and Post-Chemotherapy Treatment of Cancer Patients Attended at Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia 2019: A Retrospective Cohort Study.

PURPOSE: This study aims to compare hematological and biochemical profile changes in pre- and post-chemotherapy among cancer patients admitted at the Oncology Unit of Ayder Comprehensive Specialized Hospital (ACSH), Mekelle, Northern Ethiopia. PATIENTS AND METHODS: A retrospective cohort study was conducted in 376 cancer patients admitted in the Oncology Unit at ACSH. Demographic data, hematological and biochemical profiles were collected from smart care and patient cards. The data were analyzed using SPSS version 20 statistical package. Descriptive statistics and paired sample students T-test statistical methods were used. RESULTS: From 376 study subjects, 228 (60.6%) were females. All the hematological profiles, except lymphocyte (LYM) (P > 0.05), showed significant decrement in post-chemotherapy compared to pre-chemotherapy; white blood cell (WBC) (P < 0.01), red blood cell (RBC) (P < 0.01), hemoglobin (Hb) (P<0.001), hematocrit (HCT) (P < 0.05), platelet (PLT) (P < 0.001) and neutrophil (NUT) (P < 0.05). The biochemical profiles showed that blood urea nitrogen and creatinine levels were non-significantly decreased, urea (P > 0.05) and creatinine (CR) (P > 0.05), in post-chemotherapy compared to pre-chemotherapy whereas alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were non significantly increased, ALT (P > 0.05) and AST (P> 0. 05), in post-chemotherapy compared to pre-chemotherapy. CONCLUSION: Hematological profiles, except lymphocytes, were found significantly decreased whereas biochemical profiles, urea, and creatinine were decreased non-significantly, while AST and ALT showed non-significant increments in post-chemotherapy compared to pre-chemotherapy.

Correction: Hematological responses to iron-folate supplementation and its determinants in pregnant women attending antenatal cares in Mekelle City, Ethiopia.

[This corrects the article DOI: 10.1371/journal.pone.0204791.].

Nutritional status among women whose pregnancy outcome was afflicted with neural tube defects in Tigray region of Ethiopia.

BACKGROUND: Nutritional deficiency in pregnant women is a confirmed cause of neural tube defects (NTDs). Alongside to this background, We sought to determine the nutritional status and level of awareness on the issue of the NTDs as well as folic acid (FA) utilization among women who born infants with NTDs in Tigray region of Ethiopia. METHOD: A standard interviewer and a food frequency questionnaire was used to obtain information from mothers of cases with neural tube defects (n = 205) and their controls (n = 412). Demographic information, weekly food frequency consumption, information on awareness on the issue of the NTDs as well as folic acid (FA) use was collected. RESULT: The mean age of the mothers of the cases and controls was 26.5 years (range 17-43 years) and 26.05 years (range 18-40 years), respectively. Approximately 92.2% (189/205) of the cases and 90.5% (373/412) control mothers do not know the term folic acid (FA). Notably, all participant mothers (100%) did not understand that NTDs are a serious health problem associated with inadequate intake of FA and none of them used FA prior to conception. Food frequency analysis revealed that except for cereals (p = 0.12) and milk products (p = 0.8), the proportion of the consumed food type within seven days recalls period showed a statistically significant difference (p < 0.05) as compared with controls. The dietary diversity score assessment showed those attained low and high dietary diversity score were a statistically significant difference (p = 0.0003) and (p = 0.0002) respectively) as compared with controls, but the medium dietary diversity score no significant variation was found (p = 0.35). CONCLUSION: This study has shown none of the study participants do understand that NTDs are a serious health problem associated with inadequate intake of FA. Dietary diversity score was significantly associated with incidence of NTDs. This Ethiopian study also highlighted the need of considering the basic food in future programs of food fortification with folic acid, preconceptional folic acid supplementation and adequate dietary intake counseling. Advance research is required to find out the gene-nutrient and gene environment interactions, as well as particular causative factors associated with NTDs in Ethiopia.

Hematological responses to iron-folate supplementation and its determinants in pregnant women attending antenatal cares in Mekelle City, Ethiopia.

OBJECTIVE: To characterize anemia and evaluate hematological responses to universal iron-folic acid (IFA) supplementation in Ethiopian pregnant women. METHOD: A hospital- based prospective follow up study was done between December 2016 and June 2017. Hematological profiles were measured in pregnant women before and after a minimum of one-month IFA supplementation. Mean values and abnormal proportions of hematological profiles were compared before and after supplementation using paired t-test and McNemar test, respectively. Univariate and multivariate analysis were used to analyze the association between independent variables and poor treatment responses. RESULT: Lack of adequate hemoglobin response was found in 48.5%(95/196) of the participants. Prevalence of anemia and low hematocrit value were decreased significantly after IFA supplementation (p = 0.002, and p = 0.001, respectively). Normocytic hypochromic anemia was the commonest form of anemia found in this study followed by normocytic normochromic anemia. There was no statistically significant association between poor hemoglobin responses and all studied factors such as educational level, household size, parity, recent illness, stage of pregnancy, coffee consumption, and duration of iron treatment. CONCLUSION: Our study revealed poor hemoglobin responses in nearly half of the study participants and a high proportion of anemias morphologically atypical of iron deficiency anemia. There is a need to consider anemia attributable to etiologies other than an iron deficiency in anemia intervention programs.

Achievements of Diabetes Goals and Their Determinants in Type 2 Diabetic Patients Attending Outpatient Diabetic Clinic in Northern Ethiopia.

BACKGROUND: The aim of this study was to assess target diabetic goal achievements and to explore variables associated with them. METHODS: A cross-sectional study was conducted between December 2015 and April 2016 on 188 type 2 diabetic patients attending Ayder Referral Hospital's outpatient diabetic clinic. Glycemic control was assessed using fasting plasma glucose values and total cholesterol and triglyceride were used to evaluate lipid profiles. Bivariate and multivariate logistic regression analyses were done to identify factors associated with poor glycemic control, hypertension, and dyslipidemia. RESULT: Mean duration of diabetes was 6.5 years. Combined glycemic, lipid, and blood pressure targets were achieved only in 8.5% of the participants. More males achieved combined targets than females. Separately, while above two-thirds of the patients had poor glycemic control (67%), more than half of the participants have had poor lipid (58.5%) and blood pressure (52.1%) control. A significant portion of the patients (68.1%) had also comorbidities other than hyperglycemia. In bivariate and multivariate analyses, longer duration of diabetes disease (AOR: 3.4; P = 0.013) and marked month to month fasting plasma glucose (FPG) variability as measured by large standard deviation (AOR: 2.5; P = 0.023) were significantly associated with overall poor mean FPG results. Female sex was also significantly associated with dyslipidemia (AOR: 1.9; P = 0.049). CONCLUSION: The study showed that achievements of combined diabetic goals are generally poor.

Rare bacterial isolates causing bloodstream infections in Ethiopian patients with cancer.

BACKGROUND: In recent years, saprophytic bacteria have been emerging as potential human pathogens causing life-threatening infections in patients with malignancies. However, evidence is lacking concerning such bacteria, particularly in sub-Saharan countries. This study was designed to determine the spectrum and drug resistance profile of the rare bacterial pathogens causing bloodstream infections (BSIs) in febrile cancer patients at a referral hospital in Ethiopia. METHODS: Between December 2011 and June 2012, blood samples were collected from 107 patients with cancer in Tikur Anbessa hospital. Culturing was performed using the blood culture bottles and solid media and the microorganisms were identified using the gram staining and APINE identification kits (Biomerieux, France). The disk diffusion method was used for the antimicrobial susceptibility testing. RESULTS: Overall, 13 (12.2%) rare human pathogens were isolated from 107 adult febrile cancer patients investigated. Aeromonas hydrophilia species (a fermentative gram-negative rod) was the predominant isolate, 30.8% (4/13), followed by Chryseomonas luteola 15.4% (2/13), Sphignomonas poucimobilis 15.4% (2/13), and Pseudomonas fluorescens 15.4% (2/13). Of the nine isolates tested for a nine set of antibiotics, 89% were resistant to amoxicillin-clavulanic acid, ampicillin, and trimethoprim-sulphamethoxazole. CONCLUSIONS: This study revealed the emergence of saprophytic bacteria as potential drug-resistant nosocomial pathogens in Ethiopian patients with cancer. As these pathogens are ubiquitous in the environment, infection prevention actions should be strengthened in the hospital and early diagnosis and treatment with appropriate antibiotics are warranted for those already infected.