Determinants of externally visible birth defects among perinatal deaths at Adama Comprehensive Specialized Hospital: a case-control study.

BACKGROUND: Birth defects (BDs) are the major causes of infant morbidity and mortality in both developed and developing countries. Regardless of their clinical importance, few studies on predisposing factors have been conducted in Ethiopia. However, due to a lack of advanced diagnostic materials, we only considered the externally visible BDs. OBJECTIVE: To assess the determinants of externally visible birth defects among perinatal deaths at Adama Comprehensive Specialized Hospital. METHODS: A retrospective unmatched case-control study design was conducted from November 01 to 30, 2021. The sample size was determined by Epi Info version 7 software considering sample size calculation for an unmatched case-control study. A total of 315 participants (63 cases, and 252 controls) were selected by simple random sampling. Data were collected by an open data kit (ODK) and transported to a statical package for social sciences (SPSS) version 26 software for analysis. The bivariate followed by multivariable logistic regression analyses were done to determine the factors associated with the BD. RESULTS: This study showed that drinking alcohol during pregnancy (AOR = 6.575; 95% CI: 3.102,13.937), lack of antenatal care (ANC) follow-up during pregnancy (AOR = 2.794; 95% CI: 1.333, 5.859), having a history of stillbirth in a previous pregnancy (AOR = 3.967; 95% CI: 1.772, 8.881), exposure to pesticides during pregnancy (AOR = 4.840; 95% CI: 1.375, 17.034), having a history of BDs in a previous pregnancy (AOR = 4.853; 95% CI: 1.492, 15.788), and lack of folic acid supplementation during early pregnancy (AOR = 4.324; 95% CI: 2.062, 9.067) were significant determinants of externally visible BDs among perinatal deaths. CONCLUSION: In this study, alcohol use, exposure to pesticides, and lack of folic acid supplementation during pregnancy were identified as the major determinants of externally visible BDs among perinatal deaths. Thus, health education regarding the associated factors of BDs and their preventive strategies should be given to pregnant mothers.

Assessment of Electrocardiographic Changes and Associated Factors Among Thyroid Dysfunction Patients Attending Jimma Medical Center, Southwest Ethiopia: A Cross-Sectional Study.

Background: Thyroid dysfunction (TD) is a metabolic manifestation related to either excessive or inadequate production of thyroid hormones. It has been widely proven to have comorbidities like cardiovascular disease. An electrocardiograph is a simple investigative instrument used to assess cardiac status to prevent complications in the later stages of the disease. Objective: To assess electrocardiogram (ECG) changes and associated factors among TD patients. Methods: An institution-based cross-sectional study was conducted among 273 TD patients attending Jimma Medical Center from October 11 to December 11, 2021. An ECG tool with 12 leads was used to assess the cardiac status, and a semi-structured questionnaire was used to assess sociodemographic, behavioral, and comorbidity variables. Bodyweight, height, waist circumference (WC), hip circumference (HC), and blood pressure variables were recorded, and body mass index (BMI) and waist-to-hip ratio (WHR) were calculated. Results: Out of a total of 273 analyzed and interpreted ECG results by the cardiologists, 185 (67.8%) had ECG alterations. The most common types of ECG changes were arrhythmia 153 (56%), followed by myocardial infarction 74 (27.1%), ventricular hypertrophy [left 20 (7.3%) and right 15 (5.5%)], left atrial enlargement 3 (1%), axis deviation, and other abnormalities 24 (8.8%) and 18 (6.6%), respectively. The identified predictor variables for the ECG changes were the age group of 41 to 60 years old [AOR = 2.5, 95% CI: 1.25, 5.05], being female [AOR = 2.7, 95% CI: 1.28, 5.59], having diabetes mellitus [AOR = 4.25, 95% CI: 1.6, 11.2], and not starting the treatment [AOR = 8.6, 95% CI: 3.45, 21.6]. Conclusion: This study revealed that the prevalence of ECG changes was high among TD patients. The most common type of ECG change observed was arrhythmia followed by myocardial infarction. The age range of 41-60 years old, being female, having diabetes mellitus, and not starting the treatment were significantly associated with the ECG changes. Implementing an efficient noninvasive screening of cardiac status can detect unrecognized and asymptomatic cardiac impairment in TD patients.

Determinants of Asthma Attack Among Adult Asthmatic Patients Attending at Public Hospitals of West Shoa Zone, Oromia Regional State, Ethiopia, 2021: Case-Control Study.

Background: Asthma attacks are life-threatening episodes that place a costly burden on the individual and the community in both high- and low-income countries including Ethiopia. There is scant information on the determinant of it in the study area. Objective: To identify determinants of asthma attack among adult asthmatic patients attending at public hospitals of West Shoa Zone, Oromia Regional State, Ethiopia. Methods: An institutional-based unmatched case-control study design was conducted. In this study, 300 participants (100 cases and 200 controls) were included. A pre-tested structured questionnaire was used to collect data. After the data were entered into Epidata version 3.1, it was exported to SPSS version 25 for analysis. First, bivariable logistic regression was performed. Independent variables with a p-value < 0.25 in binary logistic regression were entered into a multivariable logistic regression model. In the multivariable logistic regression model, independent variables with a p-value < 0.05 were considered to be significant determinants of the outcome variable of the study. Results: This finding identified that upper respiratory tract infection (AOR = 5.89, 95% CI: 2.72, 12.79), obstructive sleep apnea (AOR = 3.48, 95% CI: 1.58, 7.66), passive smoker (AOR = 5.93, 95% CI: 2.07, 16.96), spring season (AOR = 2.49, 95% CI: 1.27, 4.89), pet ownership (AOR = 3.63, 95% CI: 1.82, 7.22), kitchen smoke (AOR = 2.31, 95% CI: 1.6, 4.6), rhinitis (AOR = 4.49, 95% CI: 2.25, 8.93) and being jobless (AOR = 5.68, 95% CI: 1.94, 16.68) were significant determinants of asthma attack. Conclusion: In this study, upper respiratory tract infection, obstructive sleep apnea, passive smoker, spring season, kitchen smoke, pet ownership, rhinitis, and being jobless were identified as significant determinants of an asthma attack. Because asthma attacks are life-threatening events, effective methods and interventions on determinants of asthma attack incidence should be implemented.

Chronic Kidney Disease And Associated Risk Factors Among Cardiovascular Patients.

BACKGROUND: Chronic kidney diseases (CKDs) are known in patients with cardiovascular diseases (CVDs) and cause extra morbidity and mortality. There were few related studies in Africa, and no such studies exist in Ethiopia. OBJECTIVE: To determine the magnitude of chronic kidney disease and associated risk factors among cardiovascular (CV) patients. METHODS: A cross-sectional study was conducted on randomly selected 163 CV patients attending Tikur-Anbessa Specialized Hospital (TASH), Ethiopia. Estimated glomerular filtration rate (GFR) was determined using the Simplified Modification of Diet in Renal Disease (MDRD) equation. Body weight, height, and blood pressure were recorded, and body mass index (BMI) was calculated. Serum urea and creatinine were analyzed using an automatic analyzer (MINDRAY, BE-2000), and blood urea nitrogen (BUN) was calculated. RESULTS: In this study, CKD, defined as estimated GFR (eGFR) < 60 mL/min/1.73m2 was found in 39 (23.9%) participants using the MDRD equation. Normal serum creatinine (SCr) was observed in 114 (69.9%) participants and proteinuria was found in 41 (25.2%) participants. CKD was significantly associated with systolic blood pressure (COR: -0.240, 95% CI: -0.439 to -0.041, p = 0.018), SCr (COR: -0.679; 95% CI: -0.778 to -0.580; p = 0.001) and BUN (COR: -0.422; 95% CI: -0.550 to -0.295; p = 0.001). In multivariate analysis, only high SCr (AOR = 47.57; 95% CI: 13.72-164.89; p = 0.001) was independently associated with CKD. CONCLUSION: These findings indicated that the CKD was significantly associated with SBP and increased BUN, while independently associated with increased SCr. Thus, early detection and recognition of CKD in-patient with CVD helps to avoid extra morbidity and mortality. We recommend using the MDRD formula in health facilities for diagnosing of CKD to reduce duplication of laboratory tests (SCr and BUN), as it is the easiest practice and saves patients and the public sector costs.