Assessing the survival time of hospitalized patients in Eastern Ethiopia during 2019-2020 using the Bayesian approach: A retrospective cohort study.

Background and Aims: Severe acute malnutrition remains a significant health challenge, particularly in low- and middle-income countries. The aim of this study was to determine the survival time of under-five children with severe acute malnutrition. Methods: A retrospective cohort study was conducted at a hospital, focusing on under-five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analysed using Kaplan‒Meier plots and log-rank tests. The survival time of severe acute malnutrition was further analysed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods. Results: Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition. Conclusions: This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.

Dietary diversity practice and its associated factors among pregnant women in Eastern Ethiopia: A community-based cross-sectional study.

Micronutrient insufficiencies during pregnancy have a marked impact on the health of the woman and her offspring. Evidence about the dietary practice of pregnant women is limited in Ethiopia, particularly in drought-prone areas where food insecurity is widely seen. Therefore, this research aimed to assess the dietary diversity practice and associated factors among pregnant women in Chiro district, Eastern Ethiopia. We employed a community-based cross-sectional survey in Chiro district, Eastern Ethiopia. The data were collected from 417 randomly selected pregnant women using an interview-administered structured questionnaire. EpiData-3.1 and STATA-14 were used for data entry and analysis, respectively. The binary logistic regression analysis was deployed to assess the association between dietary diversity practice and predictor variables. Out of 420 calculated sample size, 417 pregnant women completed the survey giving a response rate of 99.3%. The overall prevalence of optimal dietary diversity was 38.4% (95% CI: 33.7%, 43.2%). Educational status (adjusted odds ratio [AOR]: 2.71, 95% CI: 1.08, 6.81), meal frequency (AOR: 1.91, 95% CI: 1.11, 3.28), home gardening (AOR: 4.21, 95% CI: 2.48, 7.16), and household food security (AOR: 0.23, 95% CI: 0.13, 0.40) were independent predictors of dietary diversity practice.This study found that a substantial proportion of pregnant women had suboptimal dietary diversity, indicating a fundamental micronutrient inadequacy. Educational status, meal frequency, home gardening practice, and household food security were independent determinants of dietary diversity practice. The findings suggest that promoting maternal education and home gardening practice, and controlling food insecurity might enhance optimal dietary diversity.

Modelling the longitudinal measurement of chronic obstructive pulmonary disease outpatient follow-up in the northwestern Ethiopia.

Chronic obstructive pulmonary disease is a condition which can be prevented and treated and is characterized by difficulty of breathing that is not entirely curable. The overall objective of this study was to model the variation of longitudinal measurement over time for outpatients with chronic obstructive pulmonary diseases at the University of Gondar referral hospital. From February 1, 2019, to February 1, 2022, a retrospective study of outpatients with chronic obstructive pulmonary disease was conducted in a hospital. The data was extracted from all patients' data records from the patient's chart. The information includes the fundamental demographic and clinical details of each outpatients with chronic obstructive pulmonary disease. Mixed linear model were used to investigate the determinant factor of chronic obstructive pulmonary disease. From a total of 266 outpatients, Averages of the ratio of forced expiratory volume to forced vital capacity among chronic obstructive pulmonary disease patients were 0.65, with a standard deviation of 0.043. Comorbidities (average = 2.18, 95% CI 0.43:3.9, P = 0.0133), HIV(average = 4.83, 95% CI 1.94:7.72, P = 0.0012), education (average = 2.98; 95% CI 0.75:4.8, P = 0.008), and weight (average = 0.178, 95% CI 0.045:0.311, P = 0.009) are risk factors for change in forced vital capacity. This study clearly shows that there is a high COPD prevalence in Ethiopia. The risk factors for chronic obstructive pulmonary diseases are the smoking status, comorbidities, HIV, education status of the patient, weight, and time of the visit.

Joint modeling of forced vital capacity measures with time to onset of polycythemia among chronic obstructive pulmonary outpatients follows-up: A case of University of Gondar Referral Hospital.

Background and Aims: Chronic obstructive pulmonary disease (COPD) causes airflow obstruction and respiratory problems. Thus, the main objective of this study was to determine the risk factors for the progression of COPD using longitudinally measured forced vital capacity with time to onset of polycythemia outpatients follow-up. Methods: A retrospective study design was used to gather the related data on longitudinal change of forced vital capacity and time to onset of polycythemia from the medical charts. The joint model consists of a longitudinal submodel for the change of forced vital capacity and a survival submodel for the time to onset of polycythemia of chronic obstructive pulmonary patients. Results: From the total of 266 patient's estimated value of forced vital capacity of chronic obstructive pulmonary patients was 74.45 years with a standard deviation of 8.59. The estimated value of the association parameter was -0.006, which indicates that the lower value for a forced vital capacity measure was associated with the higher risk of polycythemia and vice versa "Based on the joint model analysis found that the predictor smoking, comorbidities, marital status, weight, and HIV" jointly affected the two responses, which are change of forced vital capacity and time to onset of polycythemia among chronic obstructive pulmonary patients. Conclusion: The overall performance of separate and joint models, joint modeling of longitudinal measures with the time-to-event outcome was the best model due to smaller standard errors and statistical significance of both the association parameters.

The association between HIV infection and precancerous cervical lesion. A systematic review and meta-analysis of case-control studies.

Background: The effect of human immunodeficiency virus (HIV) on precancerous cervical lesion is not consistent across studies. Besides to the variability in the presence of a significant association between HIV and precancerous cervical lesion, the reported strengths are inconsistent among studies that report a significant association. Therefore, we sought to determine the impact of HIV on women's risk of precancerous cervical lesion by conducting a systematic review and meta-analysis of case-control studies in Ethiopia. Methods: Relevant articles were systematically searched on African Journals Online, Cochrane Library, Science Direct, Google Scholar, and PubMed from January 1, 2023, to February 20, 2023. After critical appraisal, pertinent data were extracted into an Excel spreadsheet and then exported to STATA 14 for further statistical analysis. The pooled effect size was estimated using the random-effect model. The Egger's regression test and I 2 statistics were employed to assess publication bias and heterogeneity among included studies, respectively. Results: Ten case-control studies with a total of 3035 participants (992 cases and 2043 controls) were involved in this meta-analysis. According to our analysis, HIV-infected women were 2.86 times more likely to develop precancerous cervical lesion as compared with their counterparts (odds ratio: 2.86, 95% confidence interval: 1.79, 4.58). Conclusion: We found that HIV-infected women have a higher risk of precancerous cervical lesion. Thus, targeted screening programs should be considered to reduce the burden of cervical cancer among HIV-infected women in Ethiopia.

Assessing survival time of outpatients with cervical cancer: at the university of Gondar referral hospital using the Bayesian approach.

BACKGROUND: Cervical cancer is the 4th most common cancer in women worldwide. as well as the 4th most common cause of cancer-related death. The main objective of this study was to identify factors that affect the survival time of outpatients with cervical cancer. METHODS: A retrolective study including outpatients with cervical cancer was carried out in a hospital. To achieve the aim, 322 outpatients with cervical cancer were included in the study based on the data taken from the medical records of patients enrolled from May 15, 2018, to May 15, 2022, at the University of Gondar referral hospital, Gondar, Ethiopia. The Kaplan-Meier plots and log-rank test were used for the comparison of survival functions; the Cox-PH model and Bayesian parametric survival models were used to analyze the survival times of outpatients with cervical cancer. Integrated nested Laplace approximation methods have been applied. RESULTS: Out of a total of 322 patients, 118 (36.6%) died as outpatients. The estimated median survival time for patients was 42 months. Using model selection criteria, the Bayesian log-normal accelerated failure time model was found to be appropriate. According to the results of this model, oral contraceptive use, HIV, stage, grade, co-morbid disease, history of abortion, weight, histology type, FIGO stage, radiation, chemotherapy, LVSI, metastatic number, regional nodes examined, and tumor size all have a significant impact on the survival time of outpatients with cervical cancer. The Bayesian log-normal accelerated failure time model accurately predicted the survival time of cervical cancer outpatients. CONCLUSIONS: The findings of this study suggested that reductions in weight, treatment, the presence of comorbid disease, the presence of HIV, squamous cell histology type, having a history of abortion, oral contraceptive use, a large tumor size, an increase in the International Federation of Gynecologists and Obstetricians stage, an increase in metastasis number, an increase in grade, positive regional nodes, lymphatic vascular space invasion, and late stages of cancer all shortened the survival time of cervical cancer outpatients.

Magnitude and Functionality of the NS1-Specific Antibody Response Elicited by a Live-Attenuated Tetravalent Dengue Vaccine Candidate.

BACKGROUND: Dengue virus (DENV) can cause life-threatening disease characterized by endothelial dysfunction and vascular leakage. DENV nonstructural protein 1 (NS1) induces human endothelial hyperpermeability and vascular leak in mice, and NS1 vaccination confers antibody-mediated protective immunity. We evaluated the magnitude, cross-reactivity, and functionality of NS1-specific IgG antibody responses in sera from a phase 2 clinical trial of Takeda's live-attenuated tetravalent dengue vaccine candidate (TAK-003). METHODS: We developed an enzyme-linked immunosorbent assay to measure anti-DENV NS1 IgG in sera from DENV-naive or preimmune subjects pre- and postvaccination with TAK-003 and evaluated the functionality of this response using in vitro models of endothelial permeability. RESULTS: TAK-003 significantly increased DENV-2 NS1-specific IgG in naive individuals, which cross-reacted with DENV-1, -3, and -4 NS1 to varying extents. NS1-induced endothelial hyperpermeability was unaffected by prevaccination serum from naive subjects but was variably inhibited by serum from preimmune subjects. After TAK-003 vaccination, all samples from naive and preimmune vaccinees completely abrogated DENV-2 NS1-induced hyperpermeability and cross-inhibited hyperpermeability induced by DENV-1, -3, and -4 NS1. Inhibition of NS1-induced hyperpermeability correlated with NS1-specific IgG concentrations. Postvaccination sera also prevented NS1-induced degradation of endothelial glycocalyx components. CONCLUSION: We provide evidence for functional NS1-specific IgG responses elicited by a candidate dengue vaccine. CLINICAL TRIALS REGISTRATION: NCT01511250.