Magnitude and associated factors of thrombocytopenia, among pregnant women at Mizan Tepi university teaching hospital south west Ethiopia.

BACKGROUND: Thrombocytopenia in pregnancy is a common multifactorial abnormality of the hematological system, next to anemia. It leads to more increased risk of bleeding during delivery, labour, or the postpartum period. Despite being a significant public health concern, there are limited studies done concerning thrombocytopenia during pregnancy. OBJECTIVE: To assess the magnitude and associated factors of thrombocytopenia among pregnant women at Mizan Tepi University Teaching Hospital from September 2023 to November 2023. METHODS: An institutional-based cross-sectional study was carried out on 230 systematic randomly selected pregnant women who attended antenatal visits from September 2023 to November 2023 G.C using data collection tools. The pretested structured questionnaires were employed to obtain clinical, nutritional, and sociodemographic information. Additionally, three millilitres of venous blood were collected from each participant and analyzed using a Sysmex hematology analyzer. The data was entered into Epidata version 4.6 and analyzed using STATA version 14. Descriptive statistics were computed, and logistic regression was used to identify predictors with a significance level of less than 0.05. RESULTS: Two hundred thirty pregnant women participated in the study. Among study participants, the magnitude of thrombocytopenia was 55(24.35%) with 32 (57.14%) mild, 19 (33.93%) moderate, and 5 (8.93%) severe thrombocytopenia. The determinant factors which shown significant association were Malaria parasite infection (AOR 9.27 at 95% CI 7.42, 10.87), one-year Inter-birth interval (AOR 1.7 at 95% CI 1.24, 2.14), History of abortion (AOR 3.94 95% CI 3.13, 4.86), History of hypertension (AOR 3.12 95% CI 1.56, 4.12), HIV infection (AOR 1.81 95% CI 1.32.2.52) and HBV infection (AOR 3.0 95% CI 2.82, 3.34). CONCLUSION: Thrombocytopenia is a public health problem and mild type of thrombocytopenia was the most predominant. The determinant factors that showed significant association with thrombocytopenia were Malaria Parasitic infection, one-year Inter-birth interval, History of abortion, History of hypertension, HIV infection, and HBV infection. Therefore, pregnant women should be continuously screened for thrombocytopenia to avoid excessive bleeding. Increasing Inter-birth interval, preventing abortion as well as timely diagnosis and treatment of underlying causes such as malaria infection, hypertension, HBV, and HIV is important to reduce the burden of thrombocytopenia.

Seroprevalence of hepatitis B and C viruses among waste handlers in Ethiopia: A systematic review and meta-analysis.

Objective: Hepatitis B virus and hepatitis C virus are the leading causes of global liver-related morbidity and mortality. Waste handlers are one of the high-risk groups for hepatitis B virus and hepatitis C virus acquisition. Thus, the aim of this study was to assess the pooled prevalence of hepatitis B virus and hepatitis C virus among waste handlers in Ethiopia. Methods: Articles were extensively searched in bibliographic databases and gray literature using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported to STATA version 14 software for statistical analysis. A random-effects model was used to compute the pooled magnitude of hepatitis B virus and hepatitis C virus. Heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was performed to assess the impact of a single study on pooled effect size. Result: Of the 116 studies identified, 8 studies were selected for meta-analysis. All studies reported hepatitis B virus, while 5 studies reported hepatitis C virus infection among waste handlers. The overall pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was 5.07% (2.0-8.15) and 1.46% (0.52-2.4), respectively. Moreover, the pooled prevalence of lifetime hepatitis B virus exposure among Ethiopian waste handlers was 33.98% (95% CI: 21.24-46.72). Hepatitis B virus and hepatitis C virus infection were not statistically associated with the type of waste handlers, that is, there was no difference between medical and nonmedical waste handlers. PROSPERO registration: CRD42023398686. Conclusion: The pooled prevalence of hepatitis B virus and hepatitis C virus infection among waste handlers in Ethiopia was intermediate and moderate, respectively. This showed that there is a strong need to scale up preventive efforts and strategic policy directions to limit the spread of these viruses. Moreover, we also conclude that handling healthcare and domestic waste is associated with a similar risk of hepatitis B virus and hepatitis C virus infection.

Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis.

Background: Diabetes mellitus is a chronic metabolic disorder that causes hyperglycemia and various life-threatening health problems. Although hematological parameters play a significant role in the progression and pathogenesis of diabetes, many studies have explored contradictory findings. Therefore, this evidence-based study aimed to determine the pooled mean difference of white blood cell and red blood cell parameters in diabetic patients in order to investigate hematological dysfunctions in type 1 and type 2 diabetes mellitus. Methods: Articles were extensively searched in bibliographic databases (PubMed, Cochrane library, Scopus, Web of Science, PsycINFO, Embase, online archives and university repositories) using appropriate entry terms. For studies meeting the eligibility criteria, the first author's name, year of publication, study design and area, type of diabetes mellitus, sample size, and mean and standard deviation of hematological parameters were extracted using Microsoft Excel and exported to Stata 11 for meta-analysis. The pooled standardized mean difference (SMD) was determined using the random effects model, and heterogeneity was quantified using Higgins' I2 statistics. Egger's test and funnel plot were performed to measure bias. Furthermore, a sensitivity analysis was performed to determine the small study effect. Results: Initially 39, 222 articles were identified. After screening of the entire methodology, 22 articles with 14,041 study participants (6,146 T2DM, 416 T1DM patients and 7,479 healthy controls) were included in this study. The pooled SMD in TLC (109/L) was 0.66 and -0.21, in T2DM and T1DM, respectively. Differences in absolute differential WBC counts for neutrophils, eosinophils, basophils, lymphocytes and monocytes in T2DM were 0.84, -1.59, 3.20, 0.36 and 0.26, respectively. The differences in relative differential counts (%) in T2DM were as follows: neutrophils: 1.31, eosinophils: -0.99, basophils: 0.34, lymphocytes: -0.19 and monocyte: -0.64. The SMD of differential counts of WBC (109/L) parameters; neutrophils, lymphocytes, monocytes and basophils in T1DM were -0.10, -0.69, 0.19, and -0.32, respectively. The pooled SMD in RBC parameters in T2DM were as follows: RBC: -0.57 (106/µL), Hb: -0.73 g/dL and HCT: -1.22%, Where as in T1DM RBC, Hb and HCT were -1.23 (106/µL), -0.80 g/dL and -0.29%, respectively. Conclusion: Patients with T2DM had significantly increased TLC counts, absolute neutrophil, basophil, lymphocyte, monocyte counts and relative counts of neutrophils and basophils in comparison to controls. On the contrary, the absolute eosinophil count and relative lymphocyte, eosinophil and monocyte counts were decreased. In T1DM, WBC parameters were significantly decreased except monocytes. RBC parameters were found to be significantly decreased in T2DM patients. In T1DM, Hb and HCT were significantly decreased. However, there is no significant difference in RBC as compared with non-diabetic controls. The findings indicated a significant alteration of WBC and RBC parameters in both diabetic patients suggesting the considerable metabolic effect of diabetes on hematologic parameters. Systematic review registration: https://www.crd.york.ac.uk/prospero/export_details_pdf.php, identifier [CRD42023413486].

Dual view deep learning for enhanced breast cancer screening using mammography.

Breast cancer has the highest incidence rate among women in Ethiopia compared to other types of cancer. Unfortunately, many cases are detected at a stage where a cure is delayed or not possible. To address this issue, mammography-based screening is widely accepted as an effective technique for early detection. However, the interpretation of mammography images requires experienced radiologists in breast imaging, a resource that is limited in Ethiopia. In this research, we have developed a model to assist radiologists in mass screening for breast abnormalities and prioritizing patients. Our approach combines an ensemble of EfficientNet-based classifiers with YOLOv5, a suspicious mass detection method, to identify abnormalities. The inclusion of YOLOv5 detection is crucial in providing explanations for classifier predictions and improving sensitivity, particularly when the classifier fails to detect abnormalities. To further enhance the screening process, we have also incorporated an abnormality detection model. The classifier model achieves an F1-score of 0.87 and a sensitivity of 0.82. With the addition of suspicious mass detection, sensitivity increases to 0.89, albeit at the expense of a slightly lower F1-score of 0.79.

Preexposure prophylaxis availability among health facilities participating in the global International epidemiology Databases to Evaluate AIDS (IeDEA) consortium.

BACKGROUND: While recognized as a key HIV prevention strategy, preexposure prophylaxis (PrEP) availability and accessibility are not well documented globally. We aimed to describe PrEP drug registration status and the availability of PrEP services across HIV care sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium. METHODS: We used country-level PrEP drug registration status from the AIDS Vaccine Advocacy Coalition and data from IeDEA surveys conducted in 2014, 2017 and 2020 among participating HIV clinics in seven global regions. We used descriptive statistics to assess PrEP availability across IeDEA sites serving adult patients in 2020 and examined trends in PrEP availability among sites that responded to all three surveys. RESULTS: Of 199 sites that completed the 2020 survey, PrEP was available in 161 (81%). PrEP availability was highest at sites in North America (29/30; 97%) and East Africa (70/74; 95%) and lowest at sites in Central (10/20; 50%) and West Africa (1/6; 17%). PrEP availability was higher among sites in countries where PrEP was officially registered (146/161; 91%) than where it was not (14/32; 44%). Availability was higher at health centers (109/120; 90%) and district hospitals (14/16; 88%) compared to regional/teaching hospitals (36/63). Among the 94 sites that responded to all three surveys, PrEP availability increased from 47% in 2014 to 60% in 2017 and 76% in 2020. CONCLUSION: PrEP availability has substantially increased since 2014 and is now available at most IeDEA sites. However, PrEP service provision varies markedly across global regions.

Prevalence of biofilm producing Acinetobacter baumannii clinical isolates: A systematic review and meta-analysis.

BACKGROUND: Acinetobacter baumannii, the first human pathogen to be designated as a "red-alert" pathogen, is on the critical priority list of pathogens requiring new antibiotics. Biofilm-associated diseases are the most common infections caused by the antibiotic-resistant bacteria A. baumannii. Multidrug-resistant strains are more easily transmitted around the world due to A. baumannii's ability to produce biofilms, which allows it to develop antibiotic resistance mechanisms and thrive in healthcare environments. As a result, A. baumannii infections are becoming increasingly common in hospital settings allover the world. As a result, a comprehensive systematic review and meta-analysis were carried out to determine the global prevalence of biofilm-producing A. baumannii clinical isolates. METHODS: Articles were extensively searched in bibliographic databases and grey literatures using entry terms or phrases. Studies meeting eligibility criteria were extracted in MS Excel and exported into STATA version 12 software for statistical analysis. A random-effects model was used to compute the pooled prevalence of biofilm-producing A. baumannii clinical isolates. The heterogeneity was quantified by using the I2 value. Publication bias was assessed using a funnel plot and Egger's test. Sensitivity analysis was done to assess the impact of a single study on pooled effect size. RESULT: Of the 862 studies identified, 26 studies consisted of 2123 A.baumannii clinical isolates of which 1456 were biofilm-producing. The pooled prevalence of biofilm-producing A.baumannii clinical isolates was 65.63% (95% CI = 56.70%-74.56%). There was substantial heterogeneity with an I2 value of 98.1%. Moreover, 41.34%, 33.57%, and 27.63% of isolates of strong, mild, and weak producers of biofilm. Higher prevalence was found in studies published after 2014 (66.31%); Western Pacific region (76.17%); and Asia (66.22%) followed by the African continent (57.29%). CONCLUSION: The pooled prevalence of biofilm-producing A. baumannii clinical isolates has risen alarmingly, posing a public health risk. This indicates the burden of biofilm-producing A. baumannii infections urges routine screening and appropriate treatment for better management of hospitalized patients, as well as effective controlling of the emergence of drug resistance. Furthermore, this finding is an alert call for the stakeholders to develop strong infection prevention and antibiotics stewardship programs for the prevention and control of biofilm-producing bacterial infections.

Prevalence of asymptomatic malaria and associated factors among pregnant women in Ethiopia: systematic review and meta-analysis.

The proactive identification of asymptomatic patients and the mitigation of associated problems are essential to the elimination of malaria. For asymptomatic malaria and related variables among pregnant women in Ethiopia, there are no national pooled estimates. As a result, the goal of this study is to compile thorough and compelling data from several Ethiopian investigations. Google Scholar, PubMed, Scopes, the Web of Science, the Cochrane Library, and African Journals Online were a few of the electronic resources that were accessed. The investigation included all observational studies. STATA version 15 was used to extract the data from the Microsoft Excel file and conduct the analysis. The estimated pooled prevalence of asymptomatic malaria among pregnant women was calculated using a random-effects model. An inverse variance index (I2) analysis was utilized to find heterogeneity. To assess the publication bias, funnel plots, and Egger's statistical tests were used. The study determined that the combined prevalence of asymptomatic malaria among pregnant women was 7.20 (95% confidence interval = 4.22, 10.18) and 4.69 (95% confidence interval = 2.77, 6.62) by microscopy and rapid diagnostic test, respectively. The presence of stagnant water near their home (odds ratio = 4.31; 95% confidence interval = 1.66, 11.20); not using insecticide-treated nets (odds ratio = 6.93; 95% confidence interval = 3.27, 14.71); the lack of indoor residual spray service (odds ratio = 2.68; 95% confidence interval = 1.63, 4.40); and the presence of pregnant women in their neighborhood (odds ratio = 3.14; 95% confidence interval = 1.4). This study showed that pregnant women have a high pooled prevalence of asymptomatic malaria. Women living in rural areas near stagnant water and those who never used insecticide-treated nets had a two-, four-, or six-fold higher prevalence of asymptomatic malaria, respectively. The use of advanced diagnostic techniques could produce a higher magnitude of the disease. For effective intervention toward elimination, active case detection at the community level is also advised. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023411385; identifier, CRD42023411385.

Clinical profiles, epidemiological characteristics and treatment outcomes of COVID-19 patients in North-eastern Ethiopia: A retrospective cohort study.

BACKGROUND: COVID-19 is a rapidly emerging global health threat and economic disaster. The epidemiology and outcomes of COVID-19 patients in Ethiopia are scarce. Thus, the present study aimed to assess clinical profiles, epidemiological characteristics, and treatment outcomes of patients with COVID-19 and to identify determinants of the disease outcome among COVID-19 patients in North-eastern Ethiopia. METHODS: A retrospective observational cohort study was conducted in North-eastern Ethiopia, from May 2020 to Jan 2022 on a total of 364 SARS-COV-2 infected patients. Demographic and clinical data were abstracted from the medical records of patients. Bivariable and multivariable analyses were conducted to determine the factors associated with the mortality of COVID-19 patients and variables with a P-value < 0.05 were considered statistically significant. RESULT: Among 364 COVID-19 patients included in this study, two-thirds (68.1%) were males with a median age of 34 years. The majority; 42.9% & 33.0% respectively cases were detected at the health facility and community level surveillance. Furthermore, 6.6% of patients had pre-existing comorbidities of which diabetes mellitus (23.1%) and hypertension (15.3%) had the highest frequency. The symptomatic rate of COVID-19 patients was 30.5%. The most common clinical presentations were cough (26.9%), fever (26.1%), and shortness of breath (15.2%). Moreover, the mortality rate of COVID-19 patients was 4.1% which was independently predicted by a history of underlining co-morbidity (AHR:6.09; 95%CI:1.299-28.56; P = 0.022) and a history of severe or critical conditions (AHR 11.8; 95%CI:4.89-28.83; P = 0.003). CONCLUSION: Severe or critical acute COVID-19 and underlining comorbidities are associated with higher mortality. Therefore, critical follow-up and management should be given to patients with underlying diseases is required.

Functional outcomes of the knee and associated factors after intramedullary nailing of tibial diaphysial fractures at Addis Ababa Emergency, burn, and Trauma Hospital (AaEBT) hospital, Ethiopia.

BACKGROUND: Tibial shaft fractures are the most common long bone fractures requiring treatment. High-energy trauma often causes tibia bone injuries, causing severe complications and long-term disability due to inadequate soft tissue coverage. Tibial shaft fractures can be treated using casts, external fixators, plating, or intramedullary nails. Intramural nailing leads to faster union and reduced complications like malunion and shortening. However, patients often report subjective and objective difficulties after Surgical Instrument generation network (SIGN) nail fixation, affecting knee range of motion, quality of life, and sport activities. Tibial nails and plates are associated with increased knee pain, which negatively affects functional outcomes. No study has been conducted in a poor resource setting like Ethiopia. This study aims to assess functional outcomes of the knee and associated factors after intramedullary nailing of Tibial Diaphysial Fractures at AaBET hospital in Ethiopia. METHODS: A retrospective health facility based cross-sectional study was conducted on functional outcomes of the knee and associated factors after intramedullary nailing of tibial diaphysial fractures done at AaBET hospital. A medical record review form and a structured questionnaire from patient chart and SIGN nail database collected data. The study was conducted on 151 patients registered on the SIGN nail database using a simple random sampling. Knee injury and Osteoarthritis Outcome Score (KOOS) was used to assess the knee functional outcome. Descriptive statistics such as frequency and percentage were used to summarize the results and binary logistic regression was used to describe the association between variables. P value < 0.05 was considered statistically significant association. RESULTS: The study constituted 151 patients with tibial shaft fractures; 113(74.8%) males and 38(25.2%) females with a mean age of 31.4 years, with a standard deviation of [10.5]. The prevalence of patients with good knee functional outcomes was 87(57.6%), while 64(42.4%) patients had poor knee functional outcomes. Associated factors identified include sex, age, soft tissue status, postoperative infection postoperative physiotherapy and comminuted fracture pattern. CONCLUSION AND RECOMMENDATION: This study determined the magnitude of knee functional outcomes revealed that more than half (57.6% ) of patients had good knee functional outcomes with identified factors increseaes odds of poor knee functional outcomes were sex, age, soft tissue injuries, post operative infection, postoperative physiotherapy and comminuted fracture patterns respectively. Therefore, Policymakers and health planners should closely monitor postoperative physiotherapy treatment courses among tibial shaft fractures treated with intramedullary nailing to increases good knee functional outcomes.

Prevalence of hyperuricemia among type 2 diabetes mellitus patients in Africa: a systematic review and meta-analysis.

BACKGROUND: Hyperuricemia increases morbidity and mortality in type 2 diabetic individuals. It is linked to the expansion of diabetes and cardiovascular diseases indicators, as well as being a significant predictor of coronary artery disease. It also leads to a poor prognosis and increment of diabetic complications including diabetic neuropathy, retinopathy, and nephropathy. Therefore, this systematic review and meta-analysis was aimed to determine the pooled prevalence of hyperuricemia among type 2 diabetes mellitus patients in Africa. METHODS: We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. To identify relevant articles, we searched electronic databases such as PubMed, Google Scholar, African Journal Online, Science Direct, Embase, ResearchGate, Scopus, and Web of Sciences. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Statistical analysis was performed using Stata 14.0 software. To evaluate heterogeneity, we utilized Cochran's Q test and I2 statistics. Publication bias was assessed through the examination of a funnel plot and Egger's test. The pooled prevalence was estimated using a random effect model. Furthermore, sub-group and sensitivity analyses were conducted. RESULTS: The overall pooled prevalence of hyperuricemia among type 2 diabetic patients in Africa was 27.28% (95% CI: 23.07, 31.49). The prevalence was highest in Central Africa 33.72% (95% CI: 23.49, 43.95), and lowest in North Africa 24.72% (95% CI: 14.38, 35.07). Regarding sex, the pooled prevalence of hyperuricemia among female and male type 2 diabetic patients was 28.02% (95% CI: 22.92, 33.48) and 28.20% (95% CI: 22.92, 33.48), respectively. CONCLUSION: This systematic review and meta-analysis showed a high prevalence of hyperuricemia among type 2 diabetic patients. So, regular screening and diagnosis of hyperuricemia required for preventing its pathological effects and contribution to chronic complications of diabetes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (2022: CRD42022331279).

Postpartum anemia and its determinant factors among postnatal women in two selected health institutes in Gondar, Northwest Ethiopia: A facility-based, cross-sectional study.

Background: Anemia is highly prevalent globally and disproportionately affects postnatal women. It is a significant cause of maternal mortality and morbidity globally. Objective: The main aim of this study was to determine the extent of postpartum anemia and associated factors among postnatal women in two selected health facilities in Gondar, Northwest Ethiopia. Methods: A facility-based, cross-sectional study was conducted among 282 postnatal women from March to May 2021. A systematic sampling technique was used to recruit study participants from each institute. Sociodemographic, obstetric, and clinical data were collected through a semi-structured questionnaire. A venous blood sample was collected to determine the red blood cell parameters. A thin blood smear preparation was performed to examine blood morphology. In addition, direct wet mount and formalin-ether sedimentation techniques were used for stool examination to identify intestinal parasites. Data were entered into EpiData and exported to Stata 14 for statistical analysis. Descriptive statistics were presented in text, tables, and figures. A binary logistic regression model was used to identify factors associated with postpartum anemia. A p-value <0.05 was considered statistically significant. Results: The proportion of postpartum anemia was 47.16%; 95% CI; 41.30-53.03 with moderate, mild, and severe anemia accounting for 45.11, 42.86, and 12.03%, respectively. The majority of the anemia (94%) was of the normocytic normochromic type. It was associated with postpartum hemorrhage (AOR = 2.23; 95% CI: 1.24-4.01), cesarean section (AOR = 4.10; 95% CI: 2.11-7.78), lack of iron and folate supplementation during pregnancy (AOR = 2.12; 95% CI: 1.17-4.02), and low diet diversity level (AOR = 1.83; 95% CI: 1.05-3.18). Conclusion: The prevalence of anemia was found to be a major public health concern. Iron and folate supplementation during pregnancy, improved management of PPH, an effective cesarean section with post-operative care, and taking a diversified diet will reduce the burden. Therefore, identified factors should be considered to prevent and control postpartum anemia.

Outcome of tibial shaft fractures treated with the SIGN FIN nail at Addis Ababa Emergency, Burn, and Trauma Hospital (AaEBT) Addis Ababa, Ethiopia.

Objectives: To determine the outcome of tibial fractures treated with the SIGN FIN nail. Study Design: Retrospective case series study. Study Setting: Trauma center. Methods and Materials: We included 14 patients aged 18-51 years with 16 tibial fractures in this study. Patients were followed clinically and radiographically, and the minimum time followed was 6 months. Johner and Wruhs criteria with modification were used to assess the outcome. Result: There were 11 male (78.6%) and three female (21.4%) patients. The mean age was 32.44 ± 8.98 (range 18-51) years. The right-sided tibia was injured in six as compared with the left side in four, and four patients had bilateral injuries. Eight (50%) fractures were closed fractures, whereas the rest eight (50%) were open types of fractures. Among the latter, half (n = 4; 50%) fractures were Gustilo type II fractures, while three (37.5%) fractures were Gustilo type III fractures, and one (12.5%) patient had a Gustilo type I fracture. All patients had radiologic union. There were no infections or secondary surgery for any reason. Excellent, good, and fair results were achieved in 62.5%, 25%, and 12.5%, respectively. All patients were able to return to their preinjury activity except two patients. Conclusion: SIGN FIN nail is an option for treating tibial shaft fractures with good outcomes and few complications in selected fractures. Level of evidence: Level IV.

The magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults attending University of Gondar comprehensive specialized hospital north west Ethiopia 2021 GC, cross sectional study design.

BACKGROUND: Immune hemolytic anemia commonly affects human immune deficiency infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV which accompanies the greatest percent from acquired hemolytic anemia. OBJECTIVE: The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. METHODS: An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination and antihuman globulin test were performed to diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. RESULT: The overall prevalence of immune hemolytic anemia was 2.8% (10 of 358 participants). Of these 5 were males and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40% mild and 60% moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). CONCLUSION AND RECOMMENDATION: Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.

Lightweight Multireceptive Field CNN for 12-Lead ECG Signal Classification.

The electrical activity produced during the heartbeat is measured and recorded by an ECG. Cardiologists can interpret the ECG machine's signals and determine the heart's health condition and related causes of ECG signal abnormalities. However, cardiologist shortage is a challenge in both developing and developed countries. Moreover, the experience of a cardiologist matters in the accurate interpretation of the ECG signal, as the interpretation of ECG is quite tricky even for experienced doctors. Therefore, developing computer-aided ECG interpretation is required for its wide-reaching effect. 12-lead ECG generates a 1D signal with 12 channels among the well-known time-series data. Classical machine learning can develop automatic detection, but deep learning is more effective in the classification task. 1D-CNN is being widely used for CVDS detection from ECG datasets. However, adopting a deep learning model designed for computer vision can be problematic because of its massive parameters and the need for many samples to train. In many detection tasks ranging from semantic segmentation of medical images to time-series data classification, multireceptive field CNN has improved performance. Notably, the nature of the ECG dataset made performance improvement possible by using a multireceptive field CNN (MRF-CNN). Using MRF-CNN, it is possible to design a model that considers semantic context information within ECG signals with different sizes. As a result, this study has designed a multireceptive field CNN architecture for ECG classification. The proposed multireceptive field CNN architecture can improve the performance of ECG signal classification. We have achieved a 0.72 F 1 score and 0.93 AUC for 5 superclasses, a 0.46 F 1 score and 0.92 AUC for 20 subclasses, and a 0.31 F 1 score and 0.92 AUC for all the diagnostic classes of the PTB-XL dataset.

Racial discrimination and adverse pregnancy outcomes: a systematic review and meta-analysis.

INTRODUCTION: Racial discrimination has been consistently linked to various health outcomes and health disparities, including studies associating racial discrimination with patterns of racial disparities in adverse pregnancy outcomes. To expand our knowledge, this systematic review and meta-analysis assesses all available evidence on the association between self-reported racial discrimination and adverse pregnancy outcomes. METHODS: Eight electronic databases were searched without language or time restrictions, through January 2022. Data were extracted using a pre-piloted extraction tool. Quality assessment was conducted using the Newcastle-Ottawa Scale (NOS), and across all included studies using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects meta-analyses were performed on preterm birth and small for gestational age. Heterogenicity was assessed using Cochran's χ2 test and I2 statistic. RESULTS: Of 13 597 retrieved records, 24 articles were included. Studies included cohort, case-control and cross-sectional designs and were predominantly conducted in the USA (n=20). Across all outcomes, significant positive associations (between experiencing racial discrimination and an adverse pregnancy event) and non-significant associations (trending towards positive) were reported, with no studies reporting significant negative associations. The overall pooled odds ratio (OR) for preterm birth was 1.40 (95% CI 1.17 to 1.68; 13 studies) and for small for gestational age it was 1.23 (95% CI 0.76 to 1.99; 3 studies). When excluding low-quality studies, the preterm birth OR attenuated to 1.31 (95% CI 1.08 to 1.59; 10 studies). Similar results were obtained across sensitivity and subgroup analyses, indicating a significant positive association. CONCLUSION: These results suggest that racial discrimination has adverse impacts on pregnancy outcomes. This is supported by the broader literature on racial discrimination as a risk factor for adverse health outcomes. To further explore this association and underlying mechanisms, including mediating and moderating factors, higher quality evidence from large ethnographically diverse cohorts is needed.

Wealth Inequality and Intimate Partner Violence: An Individual and Ecological Level Analysis Across 20 Countries.

Intimate Partner Violence (IPV) has been linked to poor health. Economic position may be an important risk factor for IPV. We examined the association between economic position and IPV at country and individual levels. We analyzed Demographic and Health Surveys data of 187,716 ever-partnered women between ages 10 and 59 from 20 low- and middle-income countries. We calculated direct age-standardized 12-month prevalence of physical IPV and performed ecological analysis using Gini coefficients and Concentration indexes to assess correlation with 12-month prevalence of physical IPV. We conducted multivariable logistic regression for each country to assess the association between wealth status and physical IPV and a meta-analysis of the regression model to present results across countries. Compared to the Poorest quintile, odds of IPV among wealthier quintiles varied by country. In the Middle quintile, India had significantly reduced IPV (OR 0.75, 95%CI: 0.68-0.83). In the Richer and Richest quintiles, 4 and 6 countries had significant reductions in IPV, respectively. Only Mozambique was found to have significant increased IPV in the wealthiest quintile (OR 2.51, 95%CI: 1.45-4.38). Gini coefficient and physical IPV had a correlation coefficient of 0.502 (p value 0.033), while Concentration index had -0.276 (p value .253). Standardized prevalence for physical IPV ranged from 1.58% to 18.91%. Findings suggest that the relationship between wealth and IPV vary considerably in the included low- and middle-income countries, and that risk of IPV may not necessarily be higher among women in lower wealth brackets. Mozambique was the only country with increased odds of IPV among the Richest group as compared to the Poorest group. This study provides evidence IPV may transcend economic boundaries, and that studies looking at the link between inequality and IPV are paramount for designing adequate preventative policies.

Enhanced Region Growing for Brain Tumor MR Image Segmentation.

A brain tumor is one of the foremost reasons for the rise in mortality among children and adults. A brain tumor is a mass of tissue that propagates out of control of the normal forces that regulate growth inside the brain. A brain tumor appears when one type of cell changes from its normal characteristics and grows and multiplies abnormally. The unusual growth of cells within the brain or inside the skull, which can be cancerous or non-cancerous has been the reason for the death of adults in developed countries and children in under developing countries like Ethiopia. The studies have shown that the region growing algorithm initializes the seed point either manually or semi-manually which as a result affects the segmentation result. However, in this paper, we proposed an enhanced region-growing algorithm for the automatic seed point initialization. The proposed approach's performance was compared with the state-of-the-art deep learning algorithms using the common dataset, BRATS2015. In the proposed approach, we applied a thresholding technique to strip the skull from each input brain image. After the skull is stripped the brain image is divided into 8 blocks. Then, for each block, we computed the mean intensities and from which the five blocks with maximum mean intensities were selected out of the eight blocks. Next, the five maximum mean intensities were used as a seed point for the region growing algorithm separately and obtained five different regions of interest (ROIs) for each skull stripped input brain image. The five ROIs generated using the proposed approach were evaluated using dice similarity score (DSS), intersection over union (IoU), and accuracy (Acc) against the ground truth (GT), and the best region of interest is selected as a final ROI. Finally, the final ROI was compared with different state-of-the-art deep learning algorithms and region-based segmentation algorithms in terms of DSS. Our proposed approach was validated in three different experimental setups. In the first experimental setup where 15 randomly selected brain images were used for testing and achieved a DSS value of 0.89. In the second and third experimental setups, the proposed approach scored a DSS value of 0.90 and 0.80 for 12 randomly selected and 800 brain images respectively. The average DSS value for the three experimental setups was 0.86.

Prevalence of Solar Keratopathy, Pterygium and Cataract in the Islands of Northern Red Sea Zone, Eritrea: Cross-Sectional Study, 2021.

BACKGROUND: Everybody is exposed to ultraviolet radiation and the natural source of ultraviolet radiation is sunlight. The objective of this study was to determine the prevalence of solar keratopathy, pterygium and cataract and further to evaluate other factors that cause blindness to the inhabitants of the Northern Red Sea Zone islands of Eritrea. METHODS: It was a community-based cross-sectional study of all people aged 40 years and above, with a census sampling method. Study participants were screened for presence of solar keratopathy and other ocular diseases, and data were collected by a checklist from March 20 to April 20, 2021. Data were entered on an Excel sheet and transported to SPSS version 21. Results were presented with frequencies and percentages and chi-squared bivariable analysis was carried. P-value less than 0.05 was considered significant. RESULTS: The prevalence of solar keratopathy and cataract was 19.6% and 15.8%, respectively. Pterygium (40%) and pinguecula (32.1%) were also commonly found in the community. Participants aged 70 years and above (P<0.001), fishermen (P<0.001), housewife (P<0.001) and females (P<0.001) had a higher rate of blindness. The prevalence of solar keratopathy was higher with increased age and work experience (P<0.001). Fishermen and housewives had higher rates of solar keratopathy (44.6%) and cataract (30.2%), respectively, (P<0.001). Respondents aged 40 to 49 years had the highest prevalence of pterygium (44.1%) and pinguecula (39.1%) (P<0.001). CONCLUSION: The prevalence of solar keratopathy, cataract, pterygium and pinguecula was high in the community. Fishermen with increased work experience were having the highest prevalence of blindness and solar keratopathy. Age, occupation, work experience, sex, vision problems and history of eye operations had showed significant association with visual acuity, solar keratopathy, cataract, pterygium, and pinguecula. Community awareness about the preventive aspects of these diseases is highly recommended.

Deep Learning in Selected Cancers' Image Analysis-A Survey.

Deep learning algorithms have become the first choice as an approach to medical image analysis, face recognition, and emotion recognition. In this survey, several deep-learning-based approaches applied to breast cancer, cervical cancer, brain tumor, colon and lung cancers are studied and reviewed. Deep learning has been applied in almost all of the imaging modalities used for cervical and breast cancers and MRIs for the brain tumor. The result of the review process indicated that deep learning methods have achieved state-of-the-art in tumor detection, segmentation, feature extraction and classification. As presented in this paper, the deep learning approaches were used in three different modes that include training from scratch, transfer learning through freezing some layers of the deep learning network and modifying the architecture to reduce the number of parameters existing in the network. Moreover, the application of deep learning to imaging devices for the detection of various cancer cases has been studied by researchers affiliated to academic and medical institutes in economically developed countries; while, the study has not had much attention in Africa despite the dramatic soar of cancer risks in the continent.